Search results for: line search
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 4476

Search results for: line search

3636 Efficacy of Celecoxib Adjunct Treatment on Bipolar Disorder: Systematic Review and Meta-Analysis

Authors: Daniela V. Bavaresco, Tamy Colonetti, Antonio Jose Grande, Francesc Colom, Joao Quevedo, Samira S. Valvassori, Maria Ines da Rosa

Abstract:

Objective: Performed a systematic review and meta-analysis to evaluated the potential effect of the cyclo-oxygenases (Cox)-2 inhibitor Celecoxib adjunct treatment in Bipolar Disorder (BD), through of randomized controlled trials. Method: A search of the electronic databases was proceeded, on MEDLINE, EMBASE, Scopus, Cochrane Central Register of Controlled Trials (CENTRAL), Biomed Central, Web of Science, IBECS, LILACS, PsycINFO (American Psychological Association), Congress Abstracts, and Grey literature (Google Scholar and the British Library) for studies published from January 1990 to February 2018. A search strategy was developed using the terms: 'Bipolar disorder' or 'Bipolar mania' or 'Bipolar depression' or 'Bipolar mixed' or 'Bipolar euthymic' and 'Celecoxib' or 'Cyclooxygenase-2 inhibitors' or 'Cox-2 inhibitors' as text words and Medical Subject Headings (i.e., MeSH and EMTREE) and searched. The therapeutic effects of adjunctive treatment with Celecoxib were analyzed, it was possible to carry out a meta-analysis of three studies included in the systematic review. The meta-analysis was performed including the final results of the Young Mania Rating Scale (YMRS) at the end of randomized controlled trials (RCT). Results: Three primary studies were included in the systematic review, with a total of 121 patients. The meta-analysis had significant effect in the YMRS scores from patients with BD who used Celecoxib adjuvant treatment in comparison to placebo. The weighted mean difference was 5.54 (95%CI=3.26-7.82); p < 0.001; I2 =0%). Conclusion: The systematic review suggests that adjuvant treatment with Celecoxib improves the response of major treatments in patients with BD when compared with adjuvant placebo treatment.

Keywords: bipolar disorder, Cox-2 inhibitors, Celecoxib, systematic review, meta-analysis

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3635 Microencapsulation of Probiotic and Evaluation for Viability, Antimicrobial Property and Cytotoxic Activities of its Postbiotic Metabolites on MCF-7 Breast Cancer Cell Line

Authors: Nkechi V. Enwuru, Bullum Nkeki, Elizabeth A. Adekoya, Olumide A. Adebesin, Rebecca F. Peters, Victoria A. Aikhomu, Mendie E. U.

Abstract:

Background: Probiotics are live microbial feed supplement beneficial for host. Probiotics and their postbiotic products have been used to prevent or treat various health conditions. However, the products cell viability is often low due to harsh conditions subjected during processing, handling, storage, and gastrointestinal transit. These strongly influence probiotics’ benefits; thus, viability is essential for probiotics to produce health benefits for the host. Microencapsulation is a promising technique with considerable effects on probiotic survival. The study is aimed to formulate a microencapsulated probiotic and evaluate its viability, antimicrobial efficacy, and cytotoxic activity of its postbiotic on the MCF-7 breast cancer cell line. Method: Human and animal raw milk were sampled for lactic acid bacteria. The isolated bacteria were identified using conventional and VITEK 2 systems. The identified lactic acid bacterium was encapsulated using spray-dried and extrusion methods. The free, encapsulated, and chitosan-coated encapsulated probiotics were tested for viability in simulated-gastric intestinal (SGI) fluid and different storage conditions at refrigerated (4oC) and room (25oC) temperatures. The disintegration time and weight uniformity of the spray-dried hard gelatin capsules were tested. The antimicrobial property of free and encapsulated probiotics was tested against enteric pathogenic isolates from antiretroviral therapy (ART) treated HIV-positive patients. The postbiotic of the free cells was extracted, and its cytotoxic effect on the MCF-7 breast cancer cell line was tested through an MTT assay. Result: The Lactobacillus plantarum was isolated from animal raw milk. Zero-size hard gelatin L. plantarum capsules with granules within a size range of 0.71–1.00 mm diameter was formulated. The disintegration time ranges from 2.14±0.045 to 2.91±0.293 minutes, while the average weight is 502.1mg. Simulated gastric solution significantly affected viability of both free and microcapsules. However, the encapsulated cells were more protected and viable due to impermeability in the microcapsules. Furthermore, the viability of free cells stored at 4oC and 25oC were less than 4 log CFU/g and 6 log CFU/g respectively after 12 weeks. However, the microcapsules stored at 4oC achieved the highest viability among the free and microcapsules stored at 25oC and the free cells stored at 4oC. Encapsulated cells were released in the simulated gastric fluid, viable and effective against the enteric pathogens tested. However, chitosan-coated calcium alginate encapsulated probiotics significantly inhibited Shigella flexneri, Candida albicans, and Escherichia coli. The Postbiotic Metabolites (PM) of L. plantarum produced a cytotoxic effect on the MCF-7 breast cancer cell line. The postbiotic showed significant cytotoxic activity similar to 5FU, a standard antineoplastic agent. The inhibition concentration of 50% growth (IC50) of postbiotic metabolite K3 is low and consistent with the IC50 of the positive control (Cisplatin). Conclusions: Lactobacillus plantarum postbiotic exhibited a cytotoxic effect on the MCF-7 breast cancer cell line and could be used as combined adjuvant therapy in breast cancer management. The microencapsulation technique protects the probiotics, improving their viability and delivery to the gastrointestinal tract. Chitosan enhances antibacterial efficacy; thus, chitosan-coated microencapsulated L. plantarum probiotics could be more effective and used as a combined therapy in HIV management of opportunistic enteric infection.

Keywords: probiotics, encapsulation, gastrointestinal conditions, antimicrobial effect, postbiotic, cytotoxicity effect

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3634 From Scalpel to Leadership: The Landscape for Female Neurosurgeons in the UK

Authors: Anda-veronica Gherman, Dimitrios Varthalitis

Abstract:

Neurosurgery, like many surgical specialties, undoubtedly exhibits a significant gender gap, particularly in leadership positions. While increasing women representation in neurosurgery is important, it is crucial to increase their presence in leadership positions. Across the globe and Europe there are concerning trends of only 4% of all neurosurgical departments being chaired by women. This study aims to explore the situation regarding gender disparities in leadership in the United Kingdom and to identify possible contributing factors as well as discussing future strategies to bridge this gap. Methods: A literature review was conducted utilising PubMed as main database with search keywords including ‘female neurosurgeon’, ‘women neurosurgeon’, ‘gender disparity’, ‘leadership’ and ‘UK’. Additionally, a manual search of all neurosurgical departments in the UK was performed to identify the current female department leads and training director leads. Results: The literature search identified a paucity of literature addressing specifically leadership in female neurosurgeons within the UK, with very few published papers specifically on this topic. Despite more than half of medical students in the UK being female, only a small proportion pursue a surgical career, with neurosurgery being one of the least represented specialties. Only 27% of trainee neurosurgeons are female, and numbers are even lower at a consultant level, where women represent just 8%.Findings from published studies indicated that only 6.6% of leadership positions in neurosurgery are occupied by women in the UK. Furthermore, our manual searches across UK neurosurgical departments revealed that around 5% of department lead positions are currently held by women. While this figure is slightly higher than the European average of 4%, it remains lower compared to figures of 10% in other North-West European countries. The situation is slightly more positive looking at the training directors, with 15% being female. Discussion: The findings of this study highlight a significant gender disparity in leadership positions within neurosurgery in the UK, which may have important implications, perpetuating the lack of diversity on the decision-making process, limiting the career advancement opportunities of women and depriving the neurosurgical field from the voices, opinions and talents of women. With women representing half of the population, there is an undeniable need for more female leaders at the policy-making level. There are many barriers that can contribute to these numbers, including bias, stereotypes, lack of mentorship and work-like balance. A few solutions to overcome these barriers can be training programs addressing bias and impostor syndrome, leadership workshops tailored for female needs, better workplace policies, increased in formal mentorship and increasing the visibility of women in neurosurgery leadership positions through media, speaking opportunities, conferences, awards etc. And lastly, more research efforts should focus on the leadership and mentorship of women in neurosurgery, with an increased number of published papers discussing these issues.

Keywords: female neurosurgeons, female leadership, female mentorship, gender disparities

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3633 Induction of Cytotoxicity and Apoptosis in Ovarian Cancer Cell Line (CAOV-3) by an Isoquinoline Alkaloid Isolated from Enicosanthellum pulchrum (King) Heusden

Authors: Noraziah Nordin, Najihah Mohd Hashim, Nazia Abdul Majid, Mashitoh Abdul Rahman, Hamed Karimian, Hapipah Mohd Ali

Abstract:

Enicosanthellum pulchrum belongs to family Annonaceae is also known as family of 'mempisang' in Malaysia. Liriodenine was isolated by prep-HPLC method. This method was first technique used for the isolation of this compound. The structure of the liriodenine was elucidated by 1D and 2D spectroscopy techniques. Liriodenine was tested on ovarian cancer cells line (CAOV-3) for MTT, AO/PI and cytotoxicity 3 assays. The MTT assay was performed to determine the cytotoxicity effect of lirodenine on CAOV-3 cells. The morphological changes on CAOV-3 cells were observed by AO/PI assay for the early and late stage of apoptosis, as well as necrosis. Meanwhile, the measurement of cell loss, nuclear morphology, DNA content, cell membrane permeability, mitochondrial membrane potential changes and cytochrome c release from mitochondria were detected through cytotoxicity 3 assay. The IC50 results showed liriodenine inhibits the growth of CAOV-3 cells after 24 h of treatment at 10.25 ± 1.06 µg/mL. After 48 and 72 h of treatments, the IC50 values were decreased to 7.65 ± 0:07 and 6.35 ± 1.62 µg/mL, respectively. The morphology changes can be seen on CAOV-3 with a production of cell membrane blebbing, cromatin condensation and apoptotic bodies with increasing time of treatment from 24 to 72 h. Evaluation of cytotoxicity 3 on CAOV-3 cells after treated with liriodenine, resulting loss of mitochondrial membrane potential and release of cytochrome c from mitochondria. The results demonstrated the capability of liriodenine as a promising anticancer agent, particularly on human ovarian cancer.

Keywords: Enicosanthellum pulchrum, ovarian cancer, apoptosis, cytotoxicity

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3632 Make Populism Great Again: Identity Crisis in Western World with a Narrative Analysis of Donald Trump's Presidential Campaign Announcement Speech

Authors: Soumi Banerjee

Abstract:

In this research paper we will go deep into understanding Benedict Anderson’s definition of the nation as an imagined community and we will analyze why and how national identities were created through long and complex processes, and how there can exist strong emotional bonds between people within an imagined community, given the fact that these people have never known each other personally, but will still feel some form of imagined unity. Such identity construction on the part of an individual or within societies are always in some sense in a state of flux as imagined communities are ever changing, which provides us with the ontological foundation for reaching on this paper. This sort of identity crisis among individuals living in the Western world, who are in search for psychological comfort and security, illustrates a possible need for spatially dislocated, ontologically insecure and vulnerable individuals to have a secure identity. To create such an identity there has to be something to build upon, which could be achieved through what may be termed as ‘homesteading’. This could in short, and in my interpretation of Kinnvall and Nesbitt’s concept, be described as a search for security that involves a search for ‘home’, where home acts as a secure place, which one can build an identity around. The next half of the paper will then look into how populism and identity have played an increasingly important role in the political elections in the so-called western democracies of the world, using the U.S. as an example. Notions of ‘us and them’, the people and the elites will be looked into and analyzed through a social constructivist theoretical lens. Here we will analyze how such narratives about identity and the nation state affects people, their personality development and identity in different ways by studying the U.S. President Donald Trump’s speeches and analyze if and how he used different identity creating narratives for gaining political and popular support. The reason to choose narrative analysis as a method in this research paper is to use the narratives as a device to understand how the perceived notions of 'us and them' can initiate huge identity crisis with a community or a nation-state. This is a relevant subject as results and developments such as rising populist rightwing movements are being felt in a number of European states, with the so-called Brexit vote in the U.K. and the election of Donald Trump as president are two of the prime examples. This paper will then attempt to argue that these mechanisms are strengthened and gaining significance in situations when humans in an economic, social or ontologically vulnerable position, imagined or otherwise, in a general and broad meaning perceive themselves to be under pressure, and a sense of insecurity is rising. These insecurities and sense of being under threat have been on the rise in many of the Western states that are otherwise usually perceived to be some of the safest, democratically stable and prosperous states in the world, which makes it of interest to study what has changed, and help provide some part of the explanation as to how creating a ‘them’ in the discourse of national identity can cause massive security crisis.

Keywords: identity crisis, migration, ontological security(in), nation-states

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3631 Aerodynamic Design and Optimization of Vertical Take-Off and Landing Type Unmanned Aerial Vehicles

Authors: Enes Gunaltili, Burak Dam

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The airplane history started with the Wright brothers' aircraft and improved day by day. With the help of this advancements, big aircrafts replace with small and unmanned air vehicles, so in this study we design this type of air vehicles. First of all, aircrafts mainly divided into two main parts in our day as a rotary and fixed wing aircrafts. The fixed wing aircraft generally use for transport, cargo, military and etc. The rotary wing aircrafts use for same area but there are some superiorities from each other. The rotary wing aircraft can take off vertically from the ground, and it can use restricted area. On the other hand, rotary wing aircrafts generally can fly lower range than fixed wing aircraft. There are one kind of aircraft consist of this two types specifications. It is named as VTOL (vertical take-off and landing) type aircraft. VTOLs are able to takeoff and land vertically and fly horizontally. The VTOL aircrafts generally can fly higher range from the rotary wings but can fly lower range from the fixed wing aircraft but it gives beneficial range between them. There are many other advantages of VTOL aircraft from the rotary and fixed wing aircraft. Because of that, VTOLs began to use for generally military, cargo, search, rescue and mapping areas. Within this framework, this study answers the question that how can we design VTOL as a small unmanned aircraft systems for search and rescue application for benefiting the advantages of fixed wing and rotary wing aircrafts by eliminating the disadvantages of them. To answer that question and design VTOL aircraft, multidisciplinary design optimizations (MDO), some theoretical terminologies, formulations, simulations and modelling systems based on CFD (Computational Fluid Dynamics) is used in same time as design methodology to determine design parameters and steps. As a conclusion, based on tests and simulations depend on design steps, suggestions on how the VTOL aircraft designed and advantages, disadvantages, and observations for design parameters are listed, then VTOL is designed and presented with the design parameters, advantages, and usage areas.

Keywords: airplane, rotary, fixed, VTOL, CFD

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3630 Agile Software Effort Estimation Using Regression Techniques

Authors: Mikiyas Adugna

Abstract:

Effort estimation is among the activities carried out in software development processes. An accurate model of estimation leads to project success. The method of agile effort estimation is a complex task because of the dynamic nature of software development. Researchers are still conducting studies on agile effort estimation to enhance prediction accuracy. Due to these reasons, we investigated and proposed a model on LASSO and Elastic Net regression to enhance estimation accuracy. The proposed model has major components: preprocessing, train-test split, training with default parameters, and cross-validation. During the preprocessing phase, the entire dataset is normalized. After normalization, a train-test split is performed on the dataset, setting training at 80% and testing set to 20%. We chose two different phases for training the two algorithms (Elastic Net and LASSO) regression following the train-test-split. In the first phase, the two algorithms are trained using their default parameters and evaluated on the testing data. In the second phase, the grid search technique (the grid is used to search for tuning and select optimum parameters) and 5-fold cross-validation to get the final trained model. Finally, the final trained model is evaluated using the testing set. The experimental work is applied to the agile story point dataset of 21 software projects collected from six firms. The results show that both Elastic Net and LASSO regression outperformed the compared ones. Compared to the proposed algorithms, LASSO regression achieved better predictive performance and has acquired PRED (8%) and PRED (25%) results of 100.0, MMRE of 0.0491, MMER of 0.0551, MdMRE of 0.0593, MdMER of 0.063, and MSE of 0.0007. The result implies LASSO regression algorithm trained model is the most acceptable, and higher estimation performance exists in the literature.

Keywords: agile software development, effort estimation, elastic net regression, LASSO

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3629 Transforming Educational Leadership With Innovative Administrative Strategies

Authors: Kofi Nkonkonya Mpuangnan, Samantha Govender, Hlengiwe Romualda Mhlongo

Abstract:

Educational leaders are skilled architects crafting a vibrant environment where growth, creativity, and adaptability can flourish within schools. Their journey is one of transformation, urging them to explore administrative strategies that align seamlessly with evolving educational models and cater to the specific needs of students, educators, and stakeholders. Through this committed effort to innovate, they seek to enhance the effectiveness and influence of educational systems, paving the way for a more inclusive and forward-thinking educational environment. In this context, the authors explored the concept of transforming educational leadership with administrative strategies in alignment with the following research objectives. To find the strategies that can be adopted by transformation leaders to promote effective administrative practices in an educational setting and to explore the roles of educational leaders in promoting collaboration in education. To find answers to these questions, a systematic literature review underpinned by the transformational leadership model was adopted. Therefore, concepts integrated from a variety of outlets, including academic journals, conference proceedings, and reports found within SCOPUS, WoS, and IBSS databases. A search was aided using specific themes like innovative administrative practices, the roles of educational leaders, and interdisciplinary approaches to administrative practices. The process of conducting the search adhered to the five-step framework, which was subjected to inclusion and exclusion of studies. It was found that transformational leadership, agile methodologies, employee wellbeing, seminars and workshops could foster a culture of innovation and creativity among teachers and staff to transform administrative practices in education settings. It was recommended that professional development programs be organized periodically for educational leaders in educational institutions to help them revitalize their knowledge and skills in educational administration.

Keywords: educational leadership, innovative strategies, administrative practices, professional development, stakeholder engaement, student outcome

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3628 Compliance of Systematic Reviews in Plastic Surgery with the PRISMA Statement: A Systematic Review

Authors: Seon-Young Lee, Harkiran Sagoo, Katherine Whitehurst, Georgina Wellstead, Alexander Fowler, Riaz Agha, Dennis Orgill

Abstract:

Introduction: Systematic reviews attempt to answer research questions by synthesising the data within primary papers. They are an increasingly important tool within evidence-based medicine, guiding clinical practice, future research and healthcare policy. We sought to determine the reporting quality of recent systematic reviews in plastic surgery. Methods: This systematic review was conducted in line with the Cochrane handbook, reported in line with the PRISMA statement and registered at the ResearchRegistry (UIN: reviewregistry18). MEDLINE and EMBASE databases were searched in 2013 and 2014 for systematic reviews by five major plastic surgery journals. Screening, identification and data extraction was performed independently by two teams. Results: From an initial set of 163 articles, 79 met the inclusion criteria. The median PRISMA score was 16 out of 27 items (59.3%; range 6-26, 95% CI 14-17). Compliance between individual PRISMA items showed high variability. It was poorest for items related to the use of review protocol (item 5; 5%) and presentation of data on risk of bias of each study (item 19; 18%), while being the highest for description of rationale (item 3; 99%) and sources of funding and other support (item 27; 95%), and for structured summary in the abstract (item 2; 95%). Conclusion: The reporting quality of systematic reviews in plastic surgery requires improvement. ‘Hard-wiring’ of compliance through journal submission systems, as well as improved education, awareness and a cohesive strategy among all stakeholders is called for.

Keywords: PRISMA, reporting quality, plastic surgery, systematic review, meta-analysis

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3627 Hydrodynamics Study on Planing Hull with and without Step Using Numerical Solution

Authors: Koe Han Beng, Khoo Boo Cheong

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The rising interest of stepped hull design has been led by the demand of more efficient high-speed boat. At the same time, the need of accurate prediction method for stepped planing hull is getting more important. By understanding the flow at high Froude number is the key in designing a practical step hull, the study surrounding stepped hull has been done mainly in the towing tank which is time-consuming and costly for initial design phase. Here the feasibility of predicting hydrodynamics of high-speed planing hull both with and without step using computational fluid dynamics (CFD) with the volume of fluid (VOF) methodology is studied in this work. First the flow around the prismatic body is analyzed, the force generated and its center of pressure are compared with available experimental and empirical data from the literature. The wake behind the transom on the keel line as well as the quarter beam buttock line are then compared with the available data, this is important since the afterbody flow of stepped hull is subjected from the wake of the forebody. Finally the calm water performance prediction of a conventional planing hull and its stepped version is then analyzed. Overset mesh methodology is employed in solving the dynamic equilibrium of the hull. The resistance, trim, and heave are then compared with the experimental data. The resistance is found to be predicted well and the dynamic equilibrium solved by the numerical method is deemed to be acceptable. This means that computational fluid dynamics will be very useful in further study on the complex flow around stepped hull and its potential usage in the design phase.

Keywords: planing hulls, stepped hulls, wake shape, numerical simulation, hydrodynamics

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3626 Motif Search-Aided Screening of the Pseudomonas syringae pv. Maculicola Genome for Genes Encoding Tertiary Alcohol Ester Hydrolases

Authors: M. L. Mangena, N. Mokoena, K. Rashamuse, M. G. Tlou

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Tertiary alcohol ester (TAE) hydrolases are a group of esterases (EC 3.1.1.-) that catalyze the kinetic resolution of TAEs and as a result, they are sought-after for the production of optically pure tertiary alcohols (TAs) which are useful as building blocks for number biologically active compounds. What sets these enzymes apart is, the presence of a GGG(A)X-motif in the active site which appears to be the main reason behind their activity towards the sterically demanding TAEs. The genome of Pseudomonas syringae pv. maculicola (Psm) comprises a multitude of genes that encode esterases. We therefore, hypothesize that some of these genes encode TAE hydrolases. In this study, Psm was screened for TAE hydrolase activity using the linalyl acetate (LA) plate assay and a positive reaction was observed. As a result, the genome of Psm was screened for esterases with a GGG(A)X-motif using the motif search tool and two potential TAE hydrolase genes (PsmEST1 and 2, 1100 and 1000bp, respectively) were identified, PsmEST1 was amplified by PCR and the gene sequenced for confirmation. Analysis of the sequence data with the SingnalP 4.1 server revealed that the protein comprises a signal peptide (22 amino acid residues) on the N-terminus. Primers specific for the gene encoding the mature protein (without the signal peptide) were designed such that they contain NdeI and XhoI restriction sites for directional cloning of the PCR products into pET28a. The gene was expressed in E. coli JM109 (DE3) and the clones screened for TAE hydrolase activity using the LA plate assay. A positive clone was selected, overexpressed and the protein purified using nickel affinity chromatography. The activity of the esterase towards LA was confirmed using thin layer chromatography.

Keywords: hydrolases, tertiary alcohol esters, tertiary alcohols, screening, Pseudomonas syringae pv., maculicola genome, esterase activity, linalyl acetate

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3625 The Implementation of Level of Service for Development of Kuala Lumpur Transit Information System using GIS

Authors: Mokhtar Azizi

Abstract:

Due to heavy traffic and congested roads, it is crucial that the most popular main public transport services in Kuala Lumpur i.e. Putra LRT, Star LRT, KTM Commuter, KL Monorail and Rapid Bus must be continuously monitored and improved to fulfill the rider’s requirement and kept updated by the transit agencies. Evaluation on the current status of the services has been determined out by calculating the transit supportive area (TSA) and level of service (LOS) for each transit station. This research study has carried out the TSA and LOS mapping based on GIS techniques. The detailed census data of the region along the line of services has been collected from the Department of Statistics Malaysia for this purpose. The service coverage has been decided by 400 meters buffer zone for bus stations and 800 meters for rails station and railways in measurement the Quality of Service along the line of services. All the required information has been calculated by using the customized GIS software called Kuala Lumpur Transit Information System (KLTIS). The transit supportive area was calculated with the employment density at least 10 job/hectare or household density at 7.5 unit/hectare and total area covered by transit supportive area is 22516 hectare and the total area that is not supported by transit is 1718 hectare in Kuala Lumpur. The level of service is calculated with the percentage of transit supportive area served by transit for each station. In overall the percentage transit supportive areas served by transit for all the stations were less than 50% which falls in a very low level of service category. This research has proven its benefit by providing the current transit services operators with vital information for improvement of existing public transport services.

Keywords: service coverage, transit supportive area, level of service, transit system

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3624 Prevalence and Genetic Determinant of Drug Resistant Tuberculosis among Patients Completing Intensive Phase of Treatment in a Tertiary Referral Center in Nigeria

Authors: Aminu Bashir Mohammad, Agwu Ezera, Abdulrazaq G. Habib, Garba Iliyasu

Abstract:

Background: Drug resistance tuberculosis (DR-TB) continues to be a challenge in developing countries with poor resources. Routine screening for primary DR-TB before commencing treatment is not done in public hospitals in Nigeria, even with the large body of evidence that shows a high prevalence of primary DR-TB. Data on drug resistance and its genetic determinant among follow up TB patients is lacking in Nigeria. Hence the aim of this study was to determine the prevalence and genetic determinant of drug resistance among follow up TB patients in a tertiary hospital in Nigeria. Methods: This was a cross-sectional laboratory-based study conducted on 384 sputum samples collected from consented follow-up tuberculosis patients. Standard microbiology methods (Zeil-Nielsen staining and microscopy) and PCR (Line Probe Assay)] were used to analyze the samples collected. Person’s Chi-square was used to analyze the data generated. Results: Out of three hundred and eighty-four (384) sputum samples analyzed for mycobacterium tuberculosis (MTB) and DR-TB twenty-five 25 (6.5%) were found to be AFB positive. These samples were subjected to PCR (Line Probe Assay) out of which 18(72%) tested positive for DR-TB. Mutations conferring resistance to rifampicin (rpo B) and isoniazid (katG, and or inhA) were detected in 12/18(66.7%) and 6/18(33.3%), respectively. Transmission dynamic of DR-TB was not significantly (p>0.05) dependent on demographic characteristics. Conclusion: There is a need to strengthened the laboratory capacity for diagnosis of TB and drug resistance testing and make these services available, affordable, and accessible to the patients who need them.

Keywords: drug resistance tuberculosis, genetic determinant, intensive phase, Nigeria

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3623 Assessment of Climate Induced Hazards in Coastal Zone of Bangladesh: A Case Study of Koyra Upazilla under Khulna District and Shyamnagar Upazilla under Satkhira District

Authors: Kazi Ashief Mahmood

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Geographically Bangladesh is located in a natural hazard prone area. Compared to the rest of the areas, the coastal sub-districts are more vulnerable to climate variability and change. However, the hydro-geophysical reality of the sub-districts predominantly determines their contexts of vulnerability and its nature differs accordingly. Intriguingly enough, the poorest of the areas appear to be the most cornered among the different vulnerable sectors. Among of these deprived segments; however, the women, the persons with disability and the minorities are generally more vulnerable and they face a high risk of marginalized. The most threatening hydro-geophysical climate vulnerability have been created by prolonged dry season as observed at Koyra Upazilla in Khulna districts and Shyamnagar in Satkhira districts. The prolonged dry season creates severe surface salinity by which farmers cannot produce or use their to cultivate. The absence of land-based production and employment in the area has led to severe food insecurity. As a result, farmers tend to change their livelihood option and many of them are forced to migrate to the other areas of the country in search of livelihood. Besides salinity intrusion, water logging, drought and different climate change induced hazards are endangering safe drinking water sources and putting small-holders out of agriculture-based livelihoods in the Koyra and Shyamnagar Upazilla. A sizeable fraction of small-holders are still trying to hold on to their small scale shrimp production, despite being under pressure to sell off their cultivating lands to their influential shrimp merchants. While their desperate effort to take advantage of the increasing salinity is somewhat successful, their families still face a greater risk of health hazards owing to the lack of safe drinking water. Unless the issues of salinity in drinking water cannot be redressed, the state of the affected people will be in great jeopardy. Most of the inhabitants of oKyra and Shyamnagar Upazilla are living under the poverty line. Thus, poverty is a major factor that intensifies the vulnerability caused by hydro-geophysical climatic conditions. The government and different NGOs are trying to improve the present scenario by implementing different disaster risk reduction projects along with poverty reduction for community empowerment.

Keywords: assessment, climate change, climate induced hazards, coastal zone

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3622 Search for EEG Correlates of Mental States Using EEG Neurofeedback Paradigm

Authors: Cyril Kaplan

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26 participants played 4 EEG neurofeedback (NF) games encouraged to find their strategies to control the specific NF parameter. Mixed method analysis of performance in the games and post-session interviews led to the identification of states of consciousness that correlated with success in the game. We found that increase in left frontal beta activity was facilitated by evoking interest in observed surroundings, by wondering what is happening behind the window or what lies in a drawer in front.

Keywords: EEG neurofeedback, states of consciousness, frontal beta activity, mixed methods

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3621 Poverty Eradication Program in Malaysia

Authors: Ibrahim Mamat, Wan Mohd Zaifurin Wan Nawang

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Malaysia's poverty eradication program is a long-term plan that was initially implemented by the government after the riots of the races on May 13, 1969. The incident broke out due to the huge economic gap between the majority of Malaysians,Malays and non-Malays minorities. As a result of the event, the government drafted the New Economic Policy(NEP) in 1970 to reduce the differences in economic status among races in Malaysia. At the end of this policy period (NEP) in 1990, the incidence of poverty in Malaysia was around 6.5 per cent. The incidence of poverty in Malaysia continued to decline to 0.6 per cent (2014) through some other policy after the NEP. The decline in poverty has been the result of the government's efforts to implement the New Economic Policy (1970-1990), National Development Policy (1991-2000), NationalVision Policy (2001-2010), and National Transformation Policy (2011-2020).This article also explains the meaning, concepts and measurements of poverty in order to identify the Poverty Level and measure the Poverty Index using various dimensions. This explanation is very important for a country like Malaysia who has some people living below the poverty line. In such a context, an effective poverty eradication policy can benefit the poor.Consequently, this article examines the continuing involvement of the government and non-governmental organizations through the empowerment program of the hardcore poor to change their lifestyle and culture as well as the vicious circle of poverty is indispensable to ensure that poverty eradication programs are in line with current economic and social changes. In addition, the involvement of non-governmental organizations and the State Islamic Religious Council to provide assistance to the poor is appropriate as the institution has its own distinctive interpretation of poverty to determine the type of assistance, criteria and so on to enable the rights of the poor to be ensured and protected.

Keywords: economic policy, poor, poverty eradication, poverty program

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3620 The Development of a Nanofiber Membrane for Outdoor and Activity Related Purposes

Authors: Roman Knizek, Denisa Knizkova

Abstract:

This paper describes the development of a nanofiber membrane for sport and outdoor use at the Technical University of Liberec (TUL) and the following cooperation with a private Czech company which launched this product onto the market. For making this membrane, Polyurethan was electrospun on the Nanospider spinning machine, and a wire string electrode was used. The created nanofiber membrane with a nanofiber diameter of 150 nm was subsequently hydrophobisied using a low vacuum plasma and Fluorocarbon monomer C6 type. After this hydrophobic treatment, the nanofiber membrane contact angle was higher than 125o, and its oleophobicity was 6. The last step was a lamination of this nanofiber membrane with a woven or knitted fabric to create a 3-layer laminate. Gravure printing technology and polyurethane hot-melt adhesive were used. The gravure roller has a mesh of 17. The resulting 3-layer laminate has a water vapor permeability Ret of 1.6 [Pa.m2.W-1] (– measured in compliance with ISO 11092), it is 100% windproof (– measured in compliance with ISO 9237), and the water column is above 10 000 mm (– measured in compliance with ISO 20811). This nanofiber membrane which was developed in the laboratories of the Technical University of Liberec was then produced industrially by a private company. A low vacuum plasma line and a lamination line were needed for industrial production, and the process had to be fine-tuned to achieve the same parameters as those achieved in the TUL laboratories. The result of this work is a newly developed nanofiber membrane which offers much better properties, especially water vapor permeability, than other competitive membranes. It is an example of product development and the consequent fine-tuning for industrial production; it is also an example of the cooperation between a Czech state university and a private company.

Keywords: nanofiber membrane, start-up, state university, private company, product

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3619 Insect Cell-Based Models: Asutralian Sheep bBlowfly Lucilia Cuprina Embryo Primary Cell line Establishment and Transfection

Authors: Yunjia Yang, Peng Li, Gordon Xu, Timothy Mahony, Bing Zhang, Neena Mitter, Karishma Mody

Abstract:

Sheep flystrike is one of the most economically important diseases affecting the Australian sheep and wool industry (>356M/annually). Currently, control of Lucillia cuprina relies almost exclusively on chemicals controls, and the parasite has developed resistance to nearly all control chemicals used in the past. It is, therefore, critical to develop an alternative solution for the sustainable control and management of flystrike. RNA interference (RNAi) technologies have been successfully explored in multiple animal industries for developing parasites controls. This research project aims to develop a RNAi based biological control for sheep blowfly. Double-stranded RNA (dsRNA) has already proven successful against viruses, fungi, and insects. However, the environmental instability of dsRNA is a major bottleneck for successful RNAi. Bentonite polymer (BenPol) technology can overcome this problem, as it can be tuned for the controlled release of dsRNA in the gut challenging pH environment of the blowfly larvae, prolonging its exposure time to and uptake by target cells. To investigate the potential of BenPol technology for dsRNA delivery, four different BenPol carriers were tested for their dsRNA loading capabilities, and three of them were found to be capable of affording dsRNA stability under multiple temperatures (4°C, 22°C, 40°C, 55°C) in sheep serum. Based on stability results, dsRNA from potential targeted genes was loaded onto BenPol carriers and tested in larvae feeding assays, three genes resulting in knockdowns. Meanwhile, a primary blowfly embryo cell line (BFEC) derived from L. cuprina embryos was successfully established, aim for an effective insect cell model for testing RNAi efficacy for preliminary assessments and screening. The results of this study establish that the dsRNA is stable when loaded on BenPol particles, unlike naked dsRNA rapidly degraded in sheep serum. The stable nanoparticle delivery system offered by BenPol technology can protect and increase the inherent stability of dsRNA molecules at higher temperatures in a complex biological fluid like serum, providing promise for its future use in enhancing animal protection.

Keywords: lucilia cuprina, primary cell line establishment, RNA interference, insect cell transfection

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3618 Clinical Efficacy of Nivolumab and Ipilimumab Combination Therapy for the Treatment of Advanced Melanoma: A Systematic Review and Meta-Analysis of Clinical Trials

Authors: Zhipeng Yan, Janice Wing-Tung Kwong, Ching-Lung Lai

Abstract:

Background: Advanced melanoma accounts for the majority of skin cancer death due to its poor prognosis. Nivolumab and ipilimumab are monoclonal antibodies targeting programmed cell death protein 1 (PD-1) and cytotoxic T-lymphocytes antigen 4 (CTLA-4). Nivolumab and ipilimumab combination therapy has been proven to be effective for advanced melanoma. This systematic review and meta-analysis are to evaluate its clinical efficacy and adverse events. Method: A systematic search was done on databases (Pubmed, Embase, Medline, Cochrane) on 21 June 2020. Search keywords were nivolumab, ipilimumab, melanoma, and randomised controlled trials. Clinical trials fulfilling the inclusion criteria were selected to evaluate the efficacy of combination therapy in terms of prolongation of progression-free survival (PFS), overall survival (OS), and objective response rate (ORR). The odd ratios and distributions of grade 3 or above adverse events were documented. Subgroup analysis was performed based on PD-L1 expression-status and BRAF-mutation status. Results: Compared with nivolumab monotherapy, the hazard ratios of PFS, OS and odd ratio of ORR in combination therapy were 0.64 (95% CI, 0.48-0.85; p=0.002), 0.84 (95% CI, 0.74-0.95; p=0.007) and 1.76 (95% CI, 1.51-2.06; p < 0.001), respectively. Compared with ipilimumab monotherapy, the hazard ratios of PFS, OS and odd ratio of ORR were 0.46 (95% CI, 0.37-0.57; p < 0.001), 0.54 (95% CI, 0.48-0.61; p < 0.001) and 6.18 (95% CI, 5.19-7.36; p < 0.001), respectively. In combination therapy, the odds ratios of grade 3 or above adverse events were 4.71 (95% CI, 3.57-6.22; p < 0.001) compared with nivolumab monotherapy, and 3.44 (95% CI, 2.49-4.74; p < 0.001) compared with ipilimumab monotherapy, respectively. High PD-L1 expression level and BRAF mutation were associated with better clinical outcomes in patients receiving combination therapy. Conclusion: Combination therapy is effective for the treatment of advanced melanoma. Adverse events were common but manageable. Better clinical outcomes were observed in patients with high PD-L1 expression levels and positive BRAF-mutation.

Keywords: nivolumab, ipilimumab, advanced melanoma, systematic review, meta-analysis

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3617 Fibrin Glue Reinforcement of Choledochotomy Closure Suture Line for Prevention of Bile Leak in Patients Undergoing Laparoscopic Common Bile Duct Exploration with Primary Closure: A Pilot Study

Authors: Rahul Jain, Jagdish Chander, Anish Gupta

Abstract:

Introduction: Laparoscopic common bile duct exploration (LCBDE) allows cholecystectomy and the removal of common bile duct (CBD) stones to be performed during the same sitting, thereby decreasing hospital stay. CBD exploration through choledochotomy can be closed primarily with an absorbable suture material, but can lead to biliary leakage postoperatively. In this study we tried to find a solution to further lower the incidence of bile leakage by using fibrin glue to reinforce the sutures put on choledochotomy suture line. It has haemostatic and sealing action, through strengthening the last step of the physiological coagulation and biostimulation, which favours the formation of new tissue matrix. Methodology: This study was conducted at a tertiary care teaching hospital in New Delhi, India, from 2011 to 2013. 20 patients with CBD stones documented on MRCP with CBD diameter of 9 mm or more were included in this study. Patients were randomized into two groups namely Group A in which choledochotomy was closed with polyglactin 4-0 suture and suture line reinforced with fibrin glue, and Group ‘B’ in which choledochotomy was closed with polyglactin 4-0 suture alone. Both the groups were evaluated and compared on clinical parameters such as operative time, drain content, drain output, no. of days drain was required, blood loss & transfusion requirements, length of postoperative hospital stay and conversion to open surgery. Results: The operative time for Group A ranged from 60 to 210 min (mean 131.50 min) and Group B 65 to 300 min (mean 140 minutes). The blood loss in group A ranged from 10 to 120 ml (mean 51.50 ml), in group B it ranged from 10 to 200 ml (mean 53.50 ml). In Group A, there was no case of bile leak but there was bile leak in 2 cases in Group B, minimum 0 and maximum 900 ml with a mean of 97 ml and p value of 0.147 with no statistically significant difference in bile leak in test and control groups. The minimum and maximum serous drainage in Group A was nil & 80 ml (mean 11 ml) and in Group B was nil & 270 ml (mean 72.50 ml). The p value came as 0.028 which is statistically significant. Thus serous leakage in Group A was significantly less than in Group B. The drains in Group A were removed from 2 to 4 days (mean: 3 days) while in Group B from 2 to 9 days (mean: 3.9 days). The patients in Group A stayed in hospital post operatively from 3 to 8 days (mean: 5.30) while in Group B it ranged from 3 to 10 days with a mean of 5 days. Conclusion: Fibrin glue application on CBD decreases bile leakage but in statistically insignificant manner. Fibrin glue application on CBD can significantly decrease post operative serous drainage after LCBDE. Fibrin glue application on CBD is safe and easy technique without any significant adverse effects and can help less experienced surgeons performing LCBDE.

Keywords: bile leak, fibrin glue, LCBDE, serous leak

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3616 Topical Nonsteroidal Anti-Inflammatory Eye Drops and Oral Acetazolamide for Macular Edema after Uncomplicated Phacoemulsification: Outcome and Predictors of Non-Response

Authors: Wissam Aljundi, Loay Daas, Yaser Abu Dail, Barbara Käsmann-Kellner, Berthold Seitz, Alaa Din Abdin

Abstract:

Purpose: To investigate the effectiveness of nonsteroidal anti-inflammatory eye drops (NSAIDs) combined with oral acetazolamide for postoperative macular edema (PME) after uncomplicated phacoemulsification (PE) and to identify predictors of non-response. Methods: We analyzed data of uncomplicated PE and identified eyes with PME. First-line therapy included topical NSAIDs combined with oral acetazolamide. In case of non-response, triamcinolone was administered subtenonally. Outcome measures included best-corrected visual acuity (BCVA) and central macular thickness (CMT). Results: 94 eyes out of 9750 uncomplicated PE developed PME, of which 60 eyes were included. Follow-ups occurred 6.4±1.8, 12.5±3.7, and 18.6±6.0 weeks after diagnosis. BCVA and CMT improved significantly in all follow-ups. 40 eyes showed response to first-line therapy at first follow-up (G1). The remaining 20 eyes showed no response and required subtenon triamcinolone (G2), of which 11 eyes showed complete regression at the second follow-up and 4 eyes at the third follow-up. 5 eyes showed no response and required intravitreal injection. Multivariate linear regression model showed that diabetes mellitus (DM) and increased cumulative dissipated energy (CDE) are predictors of non-response. Conclusion: Topical NSAIDs with acetazolamide resulted in complete regression of PME in 67% of all cases. DM and increased CDE might be considered as predictors of nonresponse to this treatment.

Keywords: postoperative macular edema, intravitreal injection, cumulative energy, irvine gass syndrome, pseudophakie

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3615 Knowledge and Utilization of Partograph among Obstetric Care Givers in Public Health Institutions of Addis Ababa, Ethiopia

Authors: Engida Yisma, Berhanu Dessalegn, Ayalew Astatkie, Nebreed Fesseha

Abstract:

Background: The use of the partograph is a well-known best practice for quality monitoring of labour and subsequent prevention of obstructed and prolonged labour. However, a number of cases of obstructed labour do happen in health facilities due to poor quality of intrapartum care. Methods: A cross-sectional quantitative study assessed knowledge and utilization of partograph among obstetric care givers in public health institutions of Addis Ababa, Ethiopia using a structured interviewer administered questionnaire. The collected data was analyzed using SPSS version 16.0. Logistic regression analysis was used to identify factors associated with knowledge and use of partograph among obstetric care givers. Results: Knowledge about the partograph was fair: 189 (96.6%) of all the respondents correctly mentioned at least one component of the partograph, 104 (53.3%) correctly explained the function of alert line and 161 (82.6%) correctly explained the function of action line. The study showed that 112 (57.3%) of the obstetric care givers at public health institutions reportedly utilized partograph to monitor mothers in labour. The utilization of the partograph was significantly higher among obstetric care givers working in health centres (67.9%) compared to those working in hospitals (34.4%) [Adjusted OR = 3.63(95%CI: 1.81, 7.28)]. Conclusions: A significant percentage of obstetric care givers had fair knowledge of the partograph and why it is necessary to use it in the management of labour and over half of obstetric care givers reported use of the partograph to monitor mothers in labour. Pre-service and on-job training of obstetric care givers on the use of the partograph should be given emphasis. Mandatory health facility policy is also recommended to ensure safety of women in labour in public health facilities in Addis Ababa, Ethiopia.

Keywords: partograph, knowledge, utilization, obstetric care givers, public health institutions

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3614 A Comparative Study of the Proposed Models for the Components of the National Health Information System

Authors: M. Ahmadi, Sh. Damanabi, F. Sadoughi

Abstract:

National Health Information System plays an important role in ensuring timely and reliable access to Health information which is essential for strategic and operational decisions that improve health, quality and effectiveness of health care. In other words, by using the National Health information system you can improve the quality of health data, information and knowledge used to support decision making at all levels and areas of the health sector. Since full identification of the components of this system for better planning and management influential factors of performance seems necessary, therefore, in this study, different attitudes towards components of this system are explored comparatively. Methods: This is a descriptive and comparative kind of study. The society includes printed and electronic documents containing components of the national health information system in three parts: input, process, and output. In this context, search for information using library resources and internet search were conducted and data analysis was expressed using comparative tables and qualitative data. Results: The findings showed that there are three different perspectives presenting the components of national health information system, Lippeveld, Sauerborn, and Bodart Model in 2000, Health Metrics Network (HMN) model from World Health Organization in 2008 and Gattini’s 2009 model. All three models outlined above in the input (resources and structure) require components of management and leadership, planning and design programs, supply of staff, software and hardware facilities, and equipment. In addition, in the ‘process’ section from three models, we pointed up the actions ensuring the quality of health information system and in output section, except Lippeveld Model, two other models consider information products, usage and distribution of information as components of the national health information system. Conclusion: The results showed that all the three models have had a brief discussion about the components of health information in input section. However, Lippeveld model has overlooked the components of national health information in process and output sections. Therefore, it seems that the health measurement model of network has a comprehensive presentation for the components of health system in all three sections-input, process, and output.

Keywords: National Health Information System, components of the NHIS, Lippeveld Model

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3613 Data Protection and Regulation Compliance on Handling Physical Child Abuse Scenarios- A Scoping Review

Authors: Ana Mafalda Silva, Rebeca Fontes, Ana Paula Vaz, Carla Carreira, Ana Corte-Real

Abstract:

Decades of research on the topic of interpersonal violence against minors highlight five main conclusions: 1) it causes harmful effects on children's development and health; 2) it is prevalent; 3) it violates children's rights; 4) it can be prevented and 5) parents are the main aggressors. The child abuse scenario is identified through clinical observation, administrative data and self-reports. The most used instruments are self-reports; however, there are no valid and reliable self-report instruments for minors, which consist of a retrospective interpretation of the situation by the victim already in her adult phase and/or by her parents. Clinical observation and collection of information, namely from the orofacial region, are essential in the early identification of these situations. The management of medical data, such as personal data, must comply with the General Data Protection Regulation (GDPR), in Europe, and with the General Law of Data Protection (LGPD), in Brazil. This review aims to answer the question: In a situation of medical assistance to minors, in the suspicion of interpersonal violence, due to mistreatment, is it necessary for the guardians to provide consent in the registration and sharing of personal data, namely medical ones. A scoping review was carried out based on a search by the Web of Science and Pubmed search engines. Four papers and two documents from the grey literature were selected. As found, the process of identifying and signaling child abuse by the health professional, and the necessary early intervention in defense of the minor as a victim of abuse, comply with the guidelines expressed in the GDPR and LGPD. This way, the notification in maltreatment scenarios by health professionals should be a priority and there shouldn’t be the fear or anxiety of legal repercussions that stands in the way of collecting and treating the data necessary for the signaling procedure that safeguards and promotes the welfare of children living with abuse.

Keywords: child abuse, disease notifications, ethics, healthcare assistance

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3612 Factors Associated with Overweight and Obesity among Recipients of Antiretroviral Therapy at HIV Clinics in Botswana

Authors: Jose G. Tshikuka, Goabaone Rankgoane-Pono, Mgaywa G. M. D. Magafu, Julius C. Mwita, Tiny Masupe, Fortunat M. Kandanda, Shimeles G. Hamda, Roy Tapera, Mooketsi Molefi, John T. Tlhakanelo

Abstract:

Background: Factors associated with overweight and obesity among antiretroviral therapy (ART) recipients have not been sufficiently studied in Botswana. We aimed to study (i) the prevalence and trends in overweight/obesity by duration of exposure to ART among recipients, (ii) changes in body mass index (BMI) categories among recipients before ART initiation (BMI-1) and after ART initiation (BMI-2), (iii) associations between ART and overweight/obesity and (iv) factors associated with BMI changes among ART recipients. Methods: A 12 years retrospective record-based review was conducted. Factors potentially associated with BMI change among patients after at least three years of ART exposure were examined using multiple regression model. Adjusted odds ratios (AOR) and their 95% confidence intervals (CIs) were computed. ART regimens, duration of exposure to ART, and recipients’ demographic and biomedical characteristics including the presence or absence of diabetes mellitus related comorbidities (DRC) were investigated as potential factors associated with overweight/obesity. Results: Twenty-nine percent of recipients were overweight, 16.6% had obesity of whom 2.4% were morbidly-obese at the last clinic visit. Overweight/obesity recipients were more likely to be female, to have DRC and less likely to have nadir CD4 count or CD4 count between 201 – 249 cells/mm³. Neither the first-line nor the second-, third-line ART regimens predicted overweight/obesity more than the other and neither did the duration of exposure to ART. No significant linear trends were observed in the prevalence of overweight/obesity by the duration of exposure to ART. Conclusions: These results indicate that overweight/obesity seen among ART recipients is not directly induced by ART. ART used CD4 and/or DRC pathway to induce overweight/obesity seen among recipients; suggesting that, weight gain documented herein is likely a reflection of improved health status that mirrors trends in the general population or a DRC related effect. Weight management programs may be important components of HIV care.

Keywords: overweight/obesity, recipients of antiretroviral therapy, HIV/AIDS, Botswana

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3611 Lipid-Chitosan Hybrid Nanoparticles for Controlled Delivery of Cisplatin

Authors: Muhammad Muzamil Khan, Asadullah Madni, Nina Filipczek, Jiayi Pan, Nayab Tahir, Hassan Shah, Vladimir Torchilin

Abstract:

Lipid-polymer hybrid nanoparticles (LPHNP) are delivery systems for controlled drug delivery at tumor sites. The superior biocompatible properties of lipid and structural advantages of polymer can be obtained via this system for controlled drug delivery. In the present study, cisplatin-loaded lipid-chitosan hybrid nanoparticles were formulated by the single step ionic gelation method based on ionic interaction of positively charged chitosan and negatively charged lipid. Formulations with various chitosan to lipid ratio were investigated to obtain the optimal particle size, encapsulation efficiency, and controlled release pattern. Transmission electron microscope and dynamic light scattering analysis demonstrated a size range of 181-245 nm and a zeta potential range of 20-30 mV. Compatibility among the components and the stability of formulation were demonstrated with FTIR analysis and thermal studies, respectively. The therapeutic efficacy and cellular interaction of cisplatin-loaded LPHNP were investigated using in vitro cell-based assays in A2780/ADR ovarian carcinoma cell line. Additionally, the cisplatin loaded LPHNP exhibited a low toxicity profile in rats. The in-vivo pharmacokinetics study also proved a controlled delivery of cisplatin with enhanced mean residual time and half-life. Our studies suggested that the cisplatin-loaded LPHNP being a promising platform for controlled delivery of cisplatin in cancer therapy.

Keywords: cisplatin, lipid-polymer hybrid nanoparticle, chitosan, in vitro cell line study

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3610 Examining Statistical Monitoring Approach against Traditional Monitoring Techniques in Detecting Data Anomalies during Conduct of Clinical Trials

Authors: Sheikh Omar Sillah

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Introduction: Monitoring is an important means of ensuring the smooth implementation and quality of clinical trials. For many years, traditional site monitoring approaches have been critical in detecting data errors but not optimal in identifying fabricated and implanted data as well as non-random data distributions that may significantly invalidate study results. The objective of this paper was to provide recommendations based on best statistical monitoring practices for detecting data-integrity issues suggestive of fabrication and implantation early in the study conduct to allow implementation of meaningful corrective and preventive actions. Methodology: Electronic bibliographic databases (Medline, Embase, PubMed, Scopus, and Web of Science) were used for the literature search, and both qualitative and quantitative studies were sought. Search results were uploaded into Eppi-Reviewer Software, and only publications written in the English language from 2012 were included in the review. Gray literature not considered to present reproducible methods was excluded. Results: A total of 18 peer-reviewed publications were included in the review. The publications demonstrated that traditional site monitoring techniques are not efficient in detecting data anomalies. By specifying project-specific parameters such as laboratory reference range values, visit schedules, etc., with appropriate interactive data monitoring, statistical monitoring can offer early signals of data anomalies to study teams. The review further revealed that statistical monitoring is useful to identify unusual data patterns that might be revealing issues that could impact data integrity or may potentially impact study participants' safety. However, subjective measures may not be good candidates for statistical monitoring. Conclusion: The statistical monitoring approach requires a combination of education, training, and experience sufficient to implement its principles in detecting data anomalies for the statistical aspects of a clinical trial.

Keywords: statistical monitoring, data anomalies, clinical trials, traditional monitoring

Procedia PDF Downloads 81
3609 A Proposal for an Excessivist Social Welfare Ordering

Authors: V. De Sandi

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In this paper, we characterize a class of rank-weighted social welfare orderings that we call ”Excessivist.” The Excessivist Social Welfare Ordering (eSWO) judges incomes above a fixed threshold θ as detrimental to society. To accomplish this, the identification of a richness or affluence line is necessary. We employ a fixed, exogenous line of excess. We define an eSWF in the form of a weighted sum of individual’s income. This requires introducing n+1 vectors of weights, one for all possible numbers of individuals below the threshold. To do this, the paper introduces a slight modification of the class of rank weighted class of social welfare function. Indeed, in our excessivist social welfare ordering, we allow the weights to be both positive (for individuals below the line) and negative (for individuals above). Then, we introduce ethical concerns through an axiomatic approach. The following axioms are required: continuity above and below the threshold (Ca, Cb), anonymity (A), absolute aversion to excessive richness (AER), pigou dalton positive weights preserving transfer (PDwpT), sign rank preserving full comparability (SwpFC) and strong pareto below the threshold (SPb). Ca, Cb requires that small changes in two income distributions above and below θ do not lead to changes in their ordering. AER suggests that if two distributions are identical in any respect but for one individual above the threshold, who is richer in the first, then the second should be preferred by society. This means that we do not care about the waste of resources above the threshold; the priority is the reduction of excessive income. According to PDwpT, a transfer from a better-off individual to a worse-off individual despite their relative position to the threshold, without reversing their ranks, leads to an improved distribution if the number of individuals below the threshold is the same after the transfer or the number of individuals below the threshold has increased. SPb holds only for individuals below the threshold. The weakening of strong pareto and our ethics need to be justified; we support them through the notion of comparative egalitarianism and income as a source of power. SwpFC is necessary to ensure that, following a positive affine transformation, an individual does not become excessively rich in only one distribution, thereby reversing the ordering of the distributions. Given the axioms above, we can characterize the class of the eSWO, getting the following result through a proof by contradiction and exhaustion: Theorem 1. A social welfare ordering satisfies the axioms of continuity above and below the threshold, anonymity, sign rank preserving full comparability, aversion to excessive richness, Pigou Dalton positive weight preserving transfer, and strong pareto below the threshold, if and only if it is an Excessivist-social welfare ordering. A discussion about the implementation of different threshold lines reviewing the primary contributions in this field follows. What the commonly implemented social welfare functions have been overlooking is the concern for extreme richness at the top. The characterization of Excessivist Social Welfare Ordering, given the axioms above, aims to fill this gap.

Keywords: comparative egalitarianism, excess income, inequality aversion, social welfare ordering

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3608 Systematic Review of Current Best Practice in the Diagnosis and Treatment of Obsessive Compulsive Disorder

Authors: Zahra R. Almansoor

Abstract:

Background: Selective serotonin reuptake inhibitors (SSRI’s) and cognitive behavioural therapy (CBT) are the main treatment methods used for patients with obsessive compulsive disorder (OCD) under the National Institute of Health and Care Excellence (NICE) guidelines. Yet many patients are left with residual symptoms or remit, so several other therapeutic approaches have been explored. Objective: The objective was to systematically review the available literature regarding the treatment efficacy of current and potential approaches and diagnostic strategies. Method: First, studies were examined concerning diagnosis, prognosis, and influencing factors. Then, one reviewer conducted a systematic search of six databases using stringent search terms. Results of studies exploring the efficacy of treatment interventions were analysed and compared separately for adults and children. This review was limited to randomised controlled trials (RCT’s) conducted from 2016 onwards, and an improved Y-BOCS (Yale- Brown obsessive compulsive scale) score was the primary outcome measure. Results: Technology-based interventions including internet-based cognitive behavioural therapy (iCBT) were deemed as potentially effective. Discrepancy remains about the benefits of SSRI use past one year, but potential medication adjuncts include amantadine. Treatments such as association splitting and family and mindfulness strategies also have future potential. Conclusion: A range of potential therapies exist, either as treatment adjuncts to current interventions or as sole therapies. To further improve efficacy, it may be necessary to remodel the current NICE stepped-care model, especially regarding the potential use of lower intensity, cheaper treatments, including iCBT. Although many interventions show promise, further research is warranted to confirm this.

Keywords: family and group treatment, mindfulness strategies, novel treatment approaches, standard treatment, technology-based interventions

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3607 Toxicological Interactions of Silver Nanoparticles and Non-Essential Metals in Human Hepatocarcinoma Cell Line

Authors: Renata Rank Miranda, Arandi Ginane Bezerra, Ciro Alberto Oliveira Ribeiro, Marco AntôNio Ferreira Randi, Carmen Lúcia Voigt, Lilian Skytte, Kaare Lund Rasmussen, Francisco Filipak Neto, Frank Kjeldsen

Abstract:

Synergetic and antagonistic effects of drugs are well-known concerns in pharmacological assessments of dose and toxicity. Similar approach should be used in assessing cellular uptake and cytotoxicity of nanoparticles. Since nanoparticles are released into the aquatic environment they may interact with existing xenobiotics. Here we used biochemical assays and quantitative proteomics to assess the cytotoxicity of silver nanoparticles (AgNP) when human hepatoma HepG2 cells were co-exposed to 2 nm AgNP together with either Cd2+ or Hg2+ ions. Time-course experiments (2h, 4h, and 24h) were conducted to assess the first response to the exposure studies. The general trend was that a synergetic toxicological response was observed in cells exposed to both AgNP and Cd2+ or Hg2+, with AgNP and Cd2+ being more toxic. This was observed by a significant increase in the ROS and superoxide level of >35% in the case of AgNP+Cd2+ compared to the sum of responses of AgNP and Cd2+, individually. Metabolic activity and viability also dropped more for AgNP+Cd2+ (>10%) than for AgNP and Cd2+ combined. We used inductively coupled plasma mass spectrometry to investigate if AgNP facilitates larger influx of toxic metal ions into HepG2 cells. Only Hg2+ ions was found to be more efficiently engulfed as the concentration of Hg2+ was found 2.8 times larger compared to exposure experiments with only Hg2+. This effect was not observed for Cd2+. We now continue with deep proteomics studies to obtain wider details on the mechanism of the toxicity related to AgNP, Cd2+, and AgNP+Cd2+, respectively.

Keywords: nanotoxicology, silver nanoparticles, proteomics, human cell line

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