Search results for: 24-hour uptake
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 653

Search results for: 24-hour uptake

593 Contraceptive Uptake among Women in Low Socio-Economic Areas in Kenya: Quantitative Analysis of Secondary Data

Authors: J. Waita, S. Wamuhu, J. Makoyo, M. Rachel, T. Ngangari, W. Christine, M. Zipporah

Abstract:

Contraceptive use is one of the key global strategies to alleviate maternal mortality. Global efforts through advocating for contraceptive uptake and service provision has led improved contraceptive prevalence. In Kenya maternal mortality rate has remained a challenged despites efforts by government and non-governmental organizations. Objective: To describe the uptake of contraceptives among women in Tunza Clinics, Kenya. Design and Methods: Ps Kenya through health care marketing fund is implementing a family planning program among its 350 Tunza fractional franchise facilities. Through private partnership, private owned facilities in low socio-economic areas are recruited and trained on contraceptive technology update. The providers are supported through facilitative supervision through a mobile based application Health Network Quality Improvement System (HNQIS) and interpersonal communication through 150 community based volunteers. The data analyzed in this paper was collected between January to July 2017 to show the uptake of modern Contraceptives among women in the Tunza franchise, method mix, age and distribution among the age bracket. Further analysis compares two different service delivery strategies; outreach and walk ins. Supportive supervision HNQIS scores was analyzed. Results: During the time period, a total of 132121 family planning clients were attended in 350 facilities. The average age of clients was 29.6 years. The average number of clients attended in the facilities per month was 18874. 73.7 %( n=132121) of the clients attended in the Tunza facilities were aged above 25 years while 22.1% 20-24 years and 4.2% 15-19 years. On contraceptive method mix, intra uterine device insertions clients contributed to 7.5%, implant insertions 15.3%, pills 11.2%, injections 62.7% while condoms and emergency pills had 2.7% and 0.6% respectively. Analysis of service delivery strategy indicated more than 79% of the clients were walk ins while 21% were attended to during outreaches. Uptake of long term contraceptive methods during outreaches was 73% of the clients while short term modern methods were 27%. Health Network Quality Improvement system assessment scores indicated 51% of the facilities scored over 90%, 25% scoring 80-89% while 21% scored below 80%. Conclusion: Preference for short term methods by women is possibly associated to cost as they are cheaper and easy to administer. When the cost of intra uterine device Implants is meant affordable during outreaches, the uptake is observed to increase. Making intra uterine device and implants affordable to women is a key strategy in increasing contraceptive prevalence hence averting maternal mortality.

Keywords: contraceptives, contraceptive uptake, low socio economic, supportive supervision

Procedia PDF Downloads 168
592 Effect of Compost Application on Uptake and Allocation of Heavy Metals and Plant Nutrients and Quality of Oriental Tobacco Krumovgrad 90

Authors: Violina R. Angelova, Venelina T. Popova, Radka V. Ivanova, Givko T. Ivanov, Krasimir I. Ivanov

Abstract:

A comparative research on the impact of compost on uptake and allocation of nutrients and heavy metals and quality of Oriental tobacco Krumovgrad 90 has been carried out. The experiment was performed on an agricultural field contaminated by the lead zinc smelter near the town of Kardzali, Bulgaria, after closing the lead production. The compost treatments had significant effects on the uptake and allocation of plant nutrients and heavy metals. The incorporation of compost leads to decrease in the amount of heavy metals present in the tobacco leaves, with Cd, Pb and Zn having values of 36%, 12% and 6%, respectively. Application of the compost leads to increased content of potassium, calcium and magnesium in the leaves of tobacco, and therefore, may favorably affect the burning properties of tobacco. The incorporation of compost in the soil has a negative impact on the quality and typicality of the oriental tobacco variety of Krumovgrad 90. The incorporation of compost leads to an increase in the size of the tobacco plant leaves, the leaves become darker in colour, less fleshy and undergo a change in form, becoming (much) broader in the second, third and fourth stalk position. This is accompanied by a decrease in the quality of the tobacco. The incorporation of compost also results in an increase in the mineral substances (pure ash), total nicotine and nitrogen, and a reduction in the amount of reducing sugars, which causes the quality of the tobacco leaves to deteriorate (particularly in the third and fourth harvests).

Keywords: chemical composition, compost, heavy metals, oriental tobacco, quality

Procedia PDF Downloads 273
591 Factors Affecting the Uptake of Modern Contraception Services in Oyo State, Nigeria

Authors: Folajinmi Oluwasina, Magbagbeola Dairo, Ikeoluwapo Ajayi

Abstract:

Contraception has proven to be an effective way of controlling fertility and spacing births. Studies have shown that contraception can avert the high-risk pregnancies and consequently reduce maternal deaths up to 32%. Uptake of modern contraception is promoted as a mechanism to address the reproductive health needs of men and women, as well as the crucial challenge of rapid population increase. A cross- sectional descriptive study using a two- stage systematic sampling technique was used to select 530 women of reproductive age out of 20,000 households. Respondents were interviewed using a semi-structured questionnaire. Knowledge was assessed on a 5 point score in which a score of ≤ 2 rated poor while perception was scored on 36 points score in which a score of ≤ 18 was rated low. Data were analyzed using descriptive statistics, Chi-square test and logistic regression at p< 0.05. There were 530 respondents. Age of respondents was 30.3 ±7.8 years, and 73.0% were married. About 90% had good knowledge of contraception while 60.8% had used contraceptives. The commonest source of information about contraception was mass media (72.8%). Minority (26.1%) obtained husbands approval before using contraceptive while 20.0% had used modern contraceptives before the first birth. Many (54.5%) of the respondents agreed that contraception helps in improving standard of living and 64.7% had good perception about contraception. Factors that hindered effective uptake of contraception services included poor service provider’s attitude (33.3%) and congestion at the service centers (4.5%). Respondents with nonuse of contraceptive before first birth are less likely to subsequently use contraceptives (OR= 0.324, 95% CI= 0.1-0.5). Husband approval of contraceptives use was the major determinant of women’s contraceptive use (OR = 3.4, 95% CI = 1.3-8.7). Respondents who had family planning centers not more than 5 kilometers walking distance to their residence did not significantly use contraception services (41.5%) more than 21.1% of those who had to take means of transportation to the service venues. This study showed that majority of the respondents were knowledgeable and aware of contraception services, but husband’s agreement on the use of modern contraceptives remains poor. Programmes that enhances husbands approval of modern contraception is thus recommended.

Keywords: contraception services, service provider’s attitude, uptake, husbands approval

Procedia PDF Downloads 364
590 Chelator-assisted Phytoextraction of Nickel from Nickeliferous Lateritic Soil by Phyllanthus sp. nov.

Authors: Grecco M. Ante, Princess Rochelle O. Gan

Abstract:

Plants that can absorb greater than 10,000 µg Ni/g dry mass in their stems and leaves are termed as ‘hypernickelophores’. Chelators are chemicals that make the metals in the soil more soluble, making them a potential enhancer for phytoextraction. This study aims to observe the effect of different concentrations of the chelating agent ethylene diamine tetraacetate (EDTA) on the metal uptake (or rate of phytoextraction) of Nickel by Phyllanthus sp. nov. The plant is found to be a hyperickelophore in normal conditions. The addition of EDTA increased the metal uptake of the plant. The increasing amount of the chelating agent causes a decrease in the phytoextraction of the plant but moves the onset of its peak of maximum nickel content in its tissue to an earlier time. The chelator-assisted phytoextraction of nickel by Phyllanthus sp. nov. is proven to be an efficient auxiliary mining operation for nickel laterite mines.

Keywords: phytomining, Phyllanthus sp. nov., EDTA, nickel, laterite

Procedia PDF Downloads 465
589 Development of Partial Sulphonated Poly(Vinylidene Fluoride - Hexafluoro Propylene)–Montmorillonite Nano-Composites as Proton Exchange Membranes

Authors: K. Selvakumar, J. Kalaiselvimary, B. Jansirani, M. Ramesh Prabhu

Abstract:

Proton conducting sulphonated poly (vinylidene fluoride- hexafluoro propylene) PVdF-HFP membranes were modified with nano – sized montmorillonite (MMT) through homogeneous dispersive mixing and solution casting technique for fuel cell applications. The prepared composite membranes were characterized using Fourier Transform Infrared Spectroscopy and 1HNMR technique. The suitability of the composite membranes for fuel cell application was evaluated in terms of water uptake, swelling behavior, and proton conductivity. These composites showed good conductivities and durability and expected to be used in the development of proton exchange membrane for fuel cells.

Keywords: composite, proton conduction, sulphonation, water uptake

Procedia PDF Downloads 249
588 Phytoremediation Potential of Enhanced Tobacco BAC F3 in Soil Contaminated with Heavy Metals

Authors: Violina Angelova

Abstract:

A comparative study has been carried out into the impact of organic meliorants on the uptake of heavy metals, micro and macroelements and the phytoremediation potential of enhanced tobacco BAC F3. The soil used as part of this experiment was sampled from the vicinity of the Non-Ferrous-Metal Works near Plovdiv, Bulgaria. The pot experiment carried out consisted of a randomized, complete block design containing nine treatments and three replications (27 pots). The treatments consisted of a control (with no organic meliorants) and compost and vermicompost meliorants (added at 5%, 10%, 15%, and 30%, and recalculated based on their dry soil weight). Upon reaching commercial ripeness, the tobacco plants were gathered. Heavy metals, micro and macroelement contents in roots, stems, and leaves of tobacco were analyzed by the method of the microwave mineralization. To determine the elements in the samples, inductively coupled emission spectrometry (Jobin Yvon Emission - JY 38 S, France) was used. The distribution of the heavy metals, micro, and macroelements in the organs of the enhanced tobacco has a selective character and depended above all on the parts of the plants and the element that was examined. Pb, Zn, Cu, Fe, Mn, P and Mg distribution in tobacco decreases in the following order: roots > leaves > stems, and for Cd, K, and Ca - leaves > roots > stems. The high concentration of Cd in the leaves and the high translocation factor indicate the possibility of enhanced tobacco to be used in phytoextraction. Tested organic amendments significantly influenced the uptake of heavy metals, micro and macroelements by the roots, stems, and leaves of tobacco. A correlation was found between the quantity of the mobile forms and the uptake of Pb, Zn, and Cd by the enhanced tobacco. The compost and vermicompost treatments significantly reduced heavy metals concentration in leaves and increased uptake of K, Ca and Mg. The 30% compost and 30% vermicompost treatments led to the maximal reduction of heavy metals in enhanced tobacco BAC F3. The addition of compost and vermicompost further reduces the ability to digest the heavy metals in the leaves, and phytoremediation potential of enhanced tobacco BAC F3. Acknowledgment: The financial support by the Bulgarian National Science Fund Project DFNI Н04/9 is greatly appreciated.

Keywords: heavy metals, micro and macroelements, enhanced tobacco BAC F3, phytoremediation, organic meliorants

Procedia PDF Downloads 156
587 Development of Zero-Cement Binder Activated by Carbonation

Authors: Young Cheol Choi, Eun-Jin Moon, Sung-Won Yoo, Sang-Hwa Jung, In-Hwan Yang

Abstract:

Stainless steel slag (STS) is a by-product generated from the stainless steel refining process. The recycling of STS produced in Korea for construction applications is limited due to its poor hydraulic properties. On the other hand, STS has high carbonation reactivity to CO2 as it contains gamma-C2S content. This material is ideal for mineral carbonation which is one of the techniques proposed for carbon emission reduction. The objective of this study is to investigate the feasibility of developing a zero-cement STS binder activated by carbonation as alternative cementitious material. The quantitative analyses for CO2 uptake of STS powder and STS blended cement were investigated using thermogravimetric analysis (TGA), X-ray diffraction (XRD). In addition, the compressive strength and microstructure of STS pastes after CO2 curing were evaluated. Test results showed that STS can be activated by carbonation to gain a sufficient strength as alternative cementitious material.

Keywords: gamma-C2S, CO2 uptake, carbonation, stainless steel slag

Procedia PDF Downloads 464
586 Accelerating the Uptake of Smart City Applications through Cloud Computing

Authors: Panagiotis Tsarchopoulos, Nicos Komninos, Christina Kakderi

Abstract:

Smart cities are high on the political agenda around the globe. However, planning smart cities and deploying applications dealing with the complex problems of the urban environment is a very challenging task that is difficult to be undertaken solely by the cities. We argue that the uptake of smart city strategies is facilitated, first, through the development of smart city application repositories allowing re-use of already developed and tested software, and, second, through cloud computing which disengages city authorities from any resource constraints, technical or financial, and has a higher impact and greater effect at the city level The combination of these two solutions allows city governments and municipalities to select and deploy a large number of applications dedicated to different city functions, which collectively could create a multiplier effect with a greater impact on the urban environment.

Keywords: smart cities, applications, cloud computing, migration to the cloud, application repositories

Procedia PDF Downloads 356
585 The Improvement of Disease-Modifying Osteoarthritis Drugs Model Uptake and Retention within Two Cartilage Models

Authors: Polina Prokopovich

Abstract:

Disease-modifying osteoarthritis drugs (DMOADs) are a new therapeutic class for OA, preventing or inhibiting OA development. Unfortunately, none of the DMOADs have been clinically approved due to their poor therapeutic effects in clinical trials. The joint environment has played a role in the poor clinical performance of these drugs by limiting the amount of drug effectively delivered as well as the time that the drug spends within the joint space. The current study aims to enhance the cartilage uptake and retention time of the DMOADs-model (licofelone), which showed a significant therapeutic effect against OA progression and is currently in phase III. Licofelone will be covalently conjugated to the hydrolysable, cytocompatible, and cationic poly beta-amino ester polymers (PBAE). The cationic polymers (A16 and A87) can be electrostatically attached to the negatively charged cartilage component (glycosaminoglycan), which will increase the drug penetration through the cartilage and extend the drug time within the cartilage. In the cartilage uptake and retention time studies, an increase of 18 to 37 times of the total conjugated licofelone to A87 and A16 was observed when compared to the free licofelone. Furthermore, the conjugated licofelone to A87 was detectable within the cartilage at 120 minutes, while the free licofelone was not detectable after 60 minutes. Additionally, the A87-licofelone conjugate showed no effect on the chondrocyte viability. In conclusion, the cationic A87 and A16 polymers increased the percentage of licofelone within the cartilage, which could potentially enhance the therapeutic effect and pharmacokinetic performance of licofelone or other DMOADs clinically.

Keywords: PBAE, cartilage., osteoarthritis, injectable biomaterials, drug delivery

Procedia PDF Downloads 74
584 Effect of Zinc-Lysine on Growth, Photosynthesis, Oxidative Stress and Antioxidant System and Chromium Uptake in Rice under Cr Stress

Authors: Shafaqat Ali, Afzal Hussain, Muhammad Rizwan, Longhua Wu

Abstract:

Chromium (Cr) is one of the widespread and toxic trace elements present in the agricultural land. Chromium can enter into the food chain mainly through agricultural crops grown on Cr-contaminated soils such as rice (Oryza sativa L.). The current study was done to evaluate the effects of increasing concentrations foliar applied zinc (Zn) chelated with lysine (Zn-lys) (0, 10, 20, and 30 mg L⁻¹) on rice biomass, photosynthesis, oxidative stress, key antioxidant enzyme activities and Cr uptake under increasing levels of Cr in the soil (0, 100, 500 mg kg⁻¹). Cr-induced toxicity reduced the height of plants, biomass, chlorophyll contents, gas exchange parameters, and antioxidant enzyme activities while increased the Cr concentrations and oxidative stress (malondialdehyde, electrolyte leakage, and H₂O₂) in shoots and roots than control plants. Foliar application of Zn-lys increased the plant growth, photosynthesis, Zn concentrations, and enzyme activities in rice seedlings. In addition, Zn-lys reduced the Cr concentrations and oxidative stress compared to the respective Cr treatments alone. The present results indicate that foliar Zn-lys stimulates the antioxidant defense system in rice, increase the rice growth while reduced the Cr concentrations in plants by promoting the Zn uptake and photosynthesis. Taken together, foliar spray of Zn-lys chelate can efficiently be employed for improving plant growth and Zn contents while reducing Cr concentration in rice grown in Cr-contaminated and Zn-deficient soils.

Keywords: antioxidants, chromium, zinc-lysine, oxidative stress, photosynthesis, tolerance

Procedia PDF Downloads 194
583 Comparing Double-Stranded RNA Uptake Mechanisms in Dipteran and Lepidopteran Cell Lines

Authors: Nazanin Amanat, Alison Tayler, Steve Whyard

Abstract:

While chemical insecticides effectively control many insect pests, they also harm many non-target species. Double-stranded RNA (dsRNA) pesticides, in contrast, can be designed to target unique gene sequences and thus act in a species-specific manner. DsRNA insecticides do not, however, work equally well for all insects, and for some species that are considered refractory to dsRNA, a primary factor affecting efficacy is the relative ease by which dsRNA can enter a target cell’s cytoplasm. In this study, we are examining how different structured dsRNAs (linear, hairpin, and paperclip) can enter mosquito and lepidopteran cells, as they represent dsRNA-sensitive and refractory species, respectively. To determine how the dsRNAs enter the cells, we are using chemical inhibitors and RNA interference (RNAi)-mediated knockdown of key proteins associated with different endocytosis processes. Understanding how different dsRNAs enter cells will ultimately help in the design of molecules that overcome refractoriness to RNAi or develop resistance to dsRNA-based insecticides. To date, we have conducted chemical inhibitor experiments on both cell lines and have evidence that linear dsRNAs enter the cells using clathrin-mediated endocytosis, while the paperclip dsRNAs (pcRNAs) can enter both species’ cells in a clathrin-independent manner to induce RNAi. An alternative uptake mechanism for the pcRNAs has been tentatively identified, and the outcomes of our RNAi-mediated knockdown experiments, which should provide corroborative evidence of our initial findings, will be discussed.

Keywords: dsRNA, RNAi, uptake, insecticides, dipteran, lepidopteran

Procedia PDF Downloads 73
582 The Next Frontier for Mobile Based Augmented Reality: An Evaluation of AR Uptake in India

Authors: K. Krishna Milan Rao, Nelvin Joseph, Praveen Dwarakanath

Abstract:

Augmented and Virtual Realties is quickly becoming a hotbed of activity with millions of dollars being spent on R & D and companies such as Google and Microsoft rushing to stake their claim. Augmented reality (AR) is however marching ahead due to the spread of the ideal AR device – the smartphone. Despite its potential, there remains a deep digital divide between the Developed and Developing Countries. The Technological Acceptance Model (TAM) and Hofstede cultural dimensions also predict the behaviour intention to uptake AR in India will be large. This paper takes a quantified approach by collecting 340 survey responses to AR scenarios and analyzing them through statistics. The Survey responses show that the Intention to Use, Perceived Usefulness and Perceived Enjoyment dimensions are high among the urban population in India. This along with the exponential smartphone indicates that India is on the cusp of a boom in the AR sector.

Keywords: mobile augmented reality, technology acceptance model, Hofstede, cultural dimensions, India

Procedia PDF Downloads 250
581 Exploring Alignability Effects and the Role of Information Structure in Promoting Uptake of Energy Efficient Technologies

Authors: Rebecca Hafner, David Elmes, Daniel Read

Abstract:

The current research applies decision-making theory to the problem of increasing uptake of energy efficient technologies in the market place, where uptake is currently slower than one might predict following rational choice models. We apply the alignable/non-alignable features effect and explore the impact of varying information structure on the consumers’ preference for standard versus energy efficient technologies. In two studies we present participants with a choice between similar (boiler vs. boiler) vs. dissimilar (boiler vs. heat pump) technologies, described by a list of alignable and non-alignable attributes. In study One there is a preference for alignability when options are similar; an effect mediated by an increased tendency to infer missing information is the same. No effects of alignability on preference are found when options differ. One explanation for this split-shift in attentional focus is a change in construal levels potentially induced by the added consideration of environmental concern. Study two was designed to explore the interplay between alignability and construal level in greater detail. We manipulated construal level via a thought prime task prior to taking part in the same heating systems choice task, and find that there is a general preference for non-alignability, regardless of option type. We draw theoretical and applied implications for the type of information structure best suited for the promotion of energy efficient technologies.

Keywords: alignability effects, decision making, energy-efficient technologies, sustainable behaviour change

Procedia PDF Downloads 313
580 Influence of Pseudomonas japonica on Growth and Metal Tolerance of Celosia cristata L.

Authors: Muhammad Umair Mushtaq, Ameena Iqbal, Muhammad Aqib Hassan Ali Khan, Ismat Nawaz, Sohail Yousaf, Mazhar Iqbal

Abstract:

Heavy metals are one of the priority pollutants as they pose serious health and environmental threats. They can be removed by various physiochemical methods but are costly and responsible for additional environmental problems. Bioremediation that exploits plants and their associated microbes have been referred as cost effective and environmental friendly technique. In this study, a pot experiment was conducted in a greenhouse to evaluate the potential of Celosia cristata and effects of bacteria, Pseudomonas japonica, and organic amendment moss/compost on tolerating/accumulating heavy metals. Two weeks old seedlings were transferred to soil in pots, and after four weeks they were inoculated with bacterial strain, while after growth of six weeks they were watered with a metal containing synthetic wastewater and were harvested after a growth period of nine weeks. After harvesting, morphological and physiological parameters and metal content of plants were measured. The results showed highest plant growth and biomass production in case of organic amendments while highest metal uptake has been found in non-amended pots. Positive controls have shown highest Pb uptake of 2900 mg/kg DW, while P. japonica amended pots have shown highest Cd, Cr, Ni and Cu uptake of 963.53, 1481.17, 1022.01 and 602.17 mg/kg DW, respectively. In conclusion organic amendments have strong impacts on growth enhancement while P. japonica enhances metal translocation and accumulation to aerial parts with little significant involvement in plant growth.

Keywords: ornamental plants, plant microbe interaction, amendments, bacteria

Procedia PDF Downloads 294
579 A Qualitative Study Exploring Factors Influencing the Uptake of and Engagement with Health and Wellbeing Smartphone Apps

Authors: D. Szinay, O. Perski, A. Jones, T. Chadborn, J. Brown, F. Naughton

Abstract:

Background: The uptake of health and wellbeing smartphone apps is largely influenced by popularity indicators (e.g., rankings), rather than evidence-based content. Rapid disengagement is common. This study aims to explore how and why potential users 1) select and 2) engage with such apps, and 3) how increased engagement could be promoted. Methods: Semi-structured interviews and a think-aloud approach were used to allow participants to verbalise their thoughts whilst searching for a health or wellbeing app online, followed by a guided search in the UK National Health Service (NHS) 'Apps Library' and Public Health England’s (PHE) 'One You' website. Recruitment took place between June and August 2019. Adults interested in using an app for behaviour change were recruited through social media. Data were analysed using the framework approach. The analysis is both inductive and deductive, with the coding framework being informed by the Theoretical Domains Framework. The results are further mapped onto the COM-B (Capability, Opportunity, Motivation - Behaviour) model. The study protocol is registered on the Open Science Framework (https://osf.io/jrkd3/). Results: The following targets were identified as playing a key role in increasing the uptake of and engagement with health and wellbeing apps: 1) psychological capability (e.g., reduced cognitive load); 2) physical opportunity (e.g., low financial cost); 3) social opportunity (e.g., embedded social media); 4) automatic motivation (e.g., positive feedback). Participants believed that the promotion of evidence-based apps on NHS-related websites could be enhanced through active promotion on social media, adverts on the internet, and in general practitioner practices. Future Implications: These results can inform the development of interventions aiming to promote the uptake of and engagement with evidence-based health and wellbeing apps, a priority within the UK NHS Long Term Plan ('digital first'). The targets identified across the COM-B domains could help organisations that provide platforms for such apps to increase impact through better selection of apps.

Keywords: behaviour change, COM-B model, digital health, mhealth

Procedia PDF Downloads 165
578 Glucose Uptake Rate of Insulin-Resistant Human Liver Carcinoma Cells (IR/HepG2) by Flavonoids from Enicostema littorale via IR/IRS1/AKT Pathway

Authors: Priyanka Mokashi, Aparna Khanna, Nancy Pandita

Abstract:

Diabetes mellitus is a chronic metabolic disorder which will be the 7th leading cause of death by 2030. The current line of treatment for the diabetes mellitus is oral antidiabetic drugs (biguanides, sulfonylureas, meglitinides, thiazolidinediones and alpha-glycosidase inhibitors) and insulin therapy depending upon the type 1 or type 2 diabetes mellitus. But, these treatments have their disadvantages, ranging from the developing of resistance to the drugs and adverse effects caused by them. Alternative to these synthetic agents, natural products provides a new insight for the development of more efficient and safe drugs due to their therapeutic values. Enicostema littorale blume (A. Raynal) is a traditional Indian plant belongs to the Gentianaceae family. It is widely distributed in Asia, Africa, and South America. There are few reports on Swrtiamarin, major component of this plant for its antidiabetic activity. However, the antidiabetic activity of flavonoids from E. littorale and their mechanism of action have not yet been elucidated. Flavonoids have a positive relationship with disease prevention and can act on various molecular targets and regulate different signaling pathways in pancreatic β-cells, adipocytes, hepatocytes and skeletal myofibers. They may exert beneficial effects in diabetes by (i) improving hyperglycemia through regulation of glucose metabolism in hepatocytes; (ii) enhancing insulin secretion and reducing apoptosis and promoting proliferation of pancreatic β-cells; (iii) increasing glucose uptake in hepatocytes, skeletal muscle and white adipose tissue (iv) reducing insulin resistance, inflammation and oxidative stress. Therefore, we have isolated four flavonoid rich fractions, Fraction A (FA), Fraction B (FB), Fraction C (FC), Fraction D (FD) from crude alcoholic hot (AH) extract from E. littorale, identified by LC/MS. Total eight flavonoids were identified on the basis of fragmentation pattern. Flavonoid FA showed the presence of swertisin, isovitexin, and saponarin; FB showed genkwanin, quercetin, isovitexin, FC showed apigenin, swertisin, quercetin, 5-O-glucosylswertisin and 5-O-glucosylisoswertisin whereas FD showed the presence of swertisin. Further, these fractions were assessed for their antidiabetic activity on stimulating glucose uptake in insulin-resistant HepG2 cell line model (IR/HepG2). The results showed that FD containing C-glycoside Swertisin has significantly increased the glucose uptake rate of IR/HepG2 cells at the concentration of 10 µg/ml as compared to positive control Metformin (0.5mM) which was determined by glucose oxidase- peroxidase method. It has been reported that enhancement of glucose uptake of cells occurs due the translocation of Glut4 vesicles to cell membrane through IR/IRS1/AKT pathway. Therefore, we have studied expressions of three genes IRS1, AKT and Glut4 by real-time PCR to evaluate whether they follow the same pathway or not. It was seen that the glucose uptake rate has increased in FD treated IR/HepG2 cells due to the activation of insulin receptor substrate-1 (IRS1) followed by protein kinase B (AKT) through phosphoinositide 3-kinase (PI3K) leading to translocation of Glut 4 vesicles to cell membrane, thereby enhancing glucose uptake and insulin sensitivity of insulin resistant HepG2 cells. Hence, the up-regulation indicated the mechanism of action through which FD (Swertisin) acts as antidiabetic candidate in the treatment of type 2 diabetes mellitus.

Keywords: E. littorale, glucose transporter, glucose uptake rate, insulin resistance

Procedia PDF Downloads 307
577 Citrullinated Myelin Basic Protein Mediated Inflammation in Astrocytes

Authors: Lali Shanshiashvili, Marika Chikviladze, Nino Mamulashvili, Maia Sepashvili, Nana Narmania, David Mikeladze

Abstract:

Purpose: During demyelinating inflammatory diseases and after the damage of the myelin sheet, myelin-derived proteins, including myelin basic protein (MBP), are secreted into the extracellular space. MBP shows extensive post-translational modifications, including the deimination of arginine residues. Deiminated MBP is structurally less ordered, susceptible to proteolytic attack, and more immunogenic than the unmodified one. It is hypothesized that MBP could change the inflammatory response in astrocytes. Methods: MBP was isolated and purified from bovine brain white matter. Primary astrocyte cultures were prepared from whole brains of 2-day-old Wistar rats. For evaluation of glutamate uptake/release in astrocytes following treatment of cells with MBP charge isomers, Glutamate Assay Kit was used. The expression of EAAT-2 (excitatory amino acid transporters), peroxisome proliferator-activated receptor gamma (PPAR- γ), inhibitor of nuclear factor kappa B (IkB), and high mobility group protein B1 (HMGB1) in astrocytes were assayed by Western Blot analysis. Results: This study investigated the action of deiminated isomer (C8) on the cultured primary astrocytes and compared its effects with the effects of unmodified C1 isomers. The study found that C8 and C1 MBP differently act on the uptake and release of glutamate in astrocytes: nonmodified C1 MBP increases the uptake of glutamate and does not change the release, whereas C8 decreases the release of glutamate but does not alter the uptake. Nevertheless, both isomers increased the expression of PPAR-γ and EAAT2 in the same intensity. However, immunostaining and Western Blots of cell lysates showed a decrease of IkB and increased expression of HMGB1 after the treatment of astrocytes by C8. Moreover, in the presence of C8, astrocytes release more nitric oxide than unmodified C1 isomers. Conclusion: These data suggest that the deiminated isomer of MBP evokes an inflammatory response and enhances the ability of astrocytes to release proinflammatory mediators through activation of NF-kB after the breakdown of myelin sheets. Acknowledgment: This research was supported by the SRNSF Georgia RF17_534 grant.

Keywords: myelin basic protein, glutamate, deimination, astrocytes, inflammation

Procedia PDF Downloads 205
576 Public Preferences for Lung Cancer Screening in China: A Discrete Choice Experiment

Authors: Zixuan Zhao, Lingbin Du, Le Wang, Youqing Wang, Yi Yang, Jingjun Chen, Hengjin Dong

Abstract:

Objectives: Few results from public attitudes for lung cancer screening are available both in China and abroad. This study aimed to identify preferred lung cancer screening modalities in a Chinese population and predict uptake rates of different modalities. Materials and Methods: A discrete choice experiment questionnaire was administered to 392 Chinese individuals aged 50–74 years who were at high risk for lung cancer. Each choice set had two lung screening options and an option to opt-out, and respondents were asked to choose the most preferred one. Both mixed logit analysis and stepwise logistic analysis were conducted to explore whether preferences were related to respondent characteristics and identify which kinds of respondents were more likely to opt out of any screening. Results: On mixed logit analysis, attributes that were predictive of choice at 1% level of statistical significance included the screening interval, screening venue, and out-of-pocket costs. The preferred screening modality seemed to be screening by low-dose computed tomography (LDCT) + blood test once a year in a general hospital at a cost of RMB 50; this could increase the uptake rate by 0.40 compared to the baseline setting. On stepwise logistic regression, those with no endowment insurance were more likely to opt out; those who were older and housewives/househusbands, and those with a health check habit and with commercial endowment insurance were less likely to opt out from a screening programme. Conclusions: There was considerable variance between real risk and self-perceived risk of lung cancer among respondents, and further research is required in this area. Lung cancer screening uptake can be increased by offering various screening modalities, so as to help policymakers further design the screening modality.

Keywords: lung cancer, screening, China., discrete choice experiment

Procedia PDF Downloads 260
575 Preparation and Characterization of PVA Pure and PVA/MMT Matrix: Effect of Thermal Treatment

Authors: Albana Hasimi, Edlira Tako, Elvin Çomo, Partizan Malkaj, Blerina Papajani, Ledjan Malaj, Mirela Ndrita

Abstract:

Many endeavors have been exerted during the last years for developing new artificial polymeric membranes which fulfill the demanded conditions for biomedical uses. One of the most tested polymers is Poly(vinyl alcohol) [PVA]. Ours groups, is based on the possibility of using PVA for personal protective equipment against covid. In them, we explore the possibility of modifying the properties of the polymer by adding Montmorillonite [MMT]. Heat-treatment above the glass transition temperature are used to improve mechanical properties mainly by increasing the crystallinity of the polymer, which acts as a physical network. Temperature-Modulated Differential Scanning Calorimetry (TMDSC) measurements indicated that the presence of 0.5% MMT in PVA causes a higher Tg value and shaped peak of crystallinity. Decomposition is observed at two of the melting points of the crystals during heating 25-240oC and overlap of the recrystallization ridges during cooling 240-25oC. This is indicative of the presence of two types (quality or structure ) of polymer crystals. On the other hand, some indication of improvement of the quality of the crystals by heat-treatment is given by the distinct non-reversing contribution to melting. Data on sorption and transport of water in polyvinyl alcohol films: PVA pure and PVA/MMT matrix, modified by thermal treatment, are presented. The thermal treatment has aftereffect the films become more rigid, and because of this, the water uptake is significantly lower in membranes. That is indicates by analysis of the resulting water uptake kinetics. The presence 0.5% w/w of MMT has no significant impact on the properties of PVA membranes. Water uptake kinetics deviates from Fick’s law due to slow relaxation of glassy polymer matrix for all membranes category.

Keywords: crystallinity, montmorillonite, nanocomposite, poly (vinyl alcohol)

Procedia PDF Downloads 126
574 Promotive Role of 5-Aminolevulinic Acid on Chromium-Induced Morphological, Photosynthetic and Oxidative Changes in Cauliflower (Brassica oleracea Botrytis L.)

Authors: Shafaqat Ali, Rehan Ahmad, Muhammad Rizwan

Abstract:

Chromium (Cr) is one of the most toxic pollutants among heavy metals that adversely affect living organisms and physiological processes in plants. The present study investigated the effect of without and with 15 mg L-1 5-Aminolevulinic acid (ALA) on morpho-physiological attributes of cauliflower (Brassica oleracea botrytis L.) under different Cr concentrations (0, 10, 100 and 200 μM) in the growth medium. Results showed that Cr stress decreased the plant growth, biomass, photosynthetic pigments, and gas exchange characteristics. Chromium stress enhanced the activities of enzymatic antioxidants, catalase (CAT), superoxide dismutase (SOD), and guaiacol peroxidase (POD), and caused oxidative stress, as observed by increased level of malondialdehyde (MDA), hydrogen peroxide (H2O2), electrolyte leakage (EL), in both leaves and roots of cauliflower. Chromium concentrations and total Cr uptake increased in roots, stem and leaves of plants with increasing Cr levels in the growth medium. Foliar application of ALA increased plant growth, biomass, photosynthetic pigments and gas exchange characteristics under Cr stress as compared to without ALA application. As compared to Cr stress alone, ALA application decreased the levels of MDA, H2O2 and EL while further enhanced the activities of antioxidant enzymes in both leaves and roots. Chromium concentrations and total Cr uptake decreased by the ALA application as compared to without ALA. These results showed that foliar application of ALA might be effective in reducing Cr uptake and toxicity in cauliflower.

Keywords: antioxidant enzymes, cauliflower, photosynthesis, chromium, ALA, hydrogen peroxide, electrolyte leakage

Procedia PDF Downloads 301
573 Influenza Vaccine Uptake Among Tunisian Physicians in the 2018-2019 Influenza Season

Authors: Ines Cherif, Ghassen Kharroubi, Leila Bouabid, Adel Gharbi, Aicha Boukthir, Margaret Mccarron, Nissaf Ben Alaya, Afif Ben Salah, Jihene Bettaieb

Abstract:

Healthcare workers' flu vaccination prevents influenza disease among both patients and caregivers. We aimed in this study to assess influenza vaccine (IV) coverage in 2018-2019 among Tunisian physicians and to determine factors associated with IV receipt. A cross sectional study was carried out in Tunisian primary and secondary health care facilities in the 2018-2019 influenza season. Physicians with direct patient contact were recruited according to a self-weighted multistage sampling. Data were collected through a face to face questionnaire containing questions on knowledge, attitudes, and practices regarding IV. Bivariate analysis was used in order to determine factors associated with IV receipt. A total of 167 physicians were included in the study with a mean age of 48.2 ± 7.7 years and a sex-ratio (M: F) of 0.37. Among participants, 15.1% (95% CI: [9.7%-20.3%]) were vaccinated against influenza in the 2018-2019 influenza season. Bivariate analysis revealed that previous flu immunization in the four years preceding the 2018-2019 influenza season (OR=32.3; p < 10-3), belief that vaccinating healthcare workers may reduce work absenteeism (OR=4.7, p=0.028), belief that flu vaccine should be mandatory to healthcare workers (OR=3.3, p=0.01) and high confidence towards IV efficacy in preventing influenza among caregivers (OR= 4.5, p=0.01) were associated with a higher IV receipt in 2018-2019 among physicians. Less than one fifth of Tunisian physicians were vaccinated against influenza in 2018-2019. Higher vaccine uptake was related to a higher belief in vaccine efficacy in preventing influenza disease among both patients and caregivers. This underscores the need for periodic educational campaigns to raise physicians' awareness about IV efficacy. The switch to an IV mandatory policy should also be considered.

Keywords: influenza vaccine, physicians, Tunisia, vaccination uptake

Procedia PDF Downloads 136
572 Uptake of Copper by Dead Biomass of Burkholderia cenocepacia Isolated from a Metal Mine in Pará, Brazil

Authors: Ingrid R. Avanzi, Marcela dos P. G. Baltazar, Louise H. Gracioso, Luciana J. Gimenes, Bruno Karolski, Elen A. Perpetuo, Claudio Auguto Oller do Nascimento

Abstract:

In this study was developed a natural process using a biological system for the uptake of Copper and possible removal of copper from wastewater by dead biomass of the strain Burkholderia cenocepacia. Dead and live biomass of Burkholderia cenocepacia was used to analyze the equilibrium and kinetics of copper biosorption by this strain in function of the pH. Living biomass exhibited the highest biosorption capacity of copper, 50 mg g−1, which was achieved within 5 hours of contact, at pH 7.0, temperature of 30°C, and agitation speed of 150 rpm. The dead biomass of Burkholderia cenocepacia may be considered an efficiently bioprocess, being fast and low-cost to production of copper and also a probably nano-adsorbent of this metal ion in wastewater in bioremediation process. In this study was developed a natural process using a biological system for the uptake of Copper and possible removal of copper from wastewater by dead biomass of the strain Burkholderia cenocepacia. Dead and live biomass of Burkholderia cenocepacia was used to analyze the equilibrium and kinetics of copper biosorption by this strain in function of the pH. Living biomass exhibited the highest biosorption capacity of copper, 50 mg g−1, which was achieved within 5 hours of contact, at pH 7.0, temperature of 30°C, and agitation speed of 150 rpm. The dead biomass of Burkholderia cenocepacia may be considered an efficiently bioprocess, being fast and low-cost to production of copper and also a probably nano-adsorbent of this metal ion in wastewater in bioremediation process.

Keywords: biosorption, dead biomass, biotechnology, copper recovery

Procedia PDF Downloads 337
571 Structural and Ion Exchange Studies of Terpolymer Resin Derived from 4, 4'-Biphenol-4,4'-Oxydianiline-Formaldehyde

Authors: Pawan P. Kalbende, Anil B. Zade

Abstract:

A novel terpolymer resin has been synthesized by condensation polymerization reaction of 4,4’-biphenol and 4,4’-oxydianiline with formaldehyde in presence of 2M hydrochloric acid as catalyst. Composition of resin was determined on the basis of their elemental analysis and further characterized by UV-Visible, infra-red and nuclear magnetic resonance spectroscopy to confine the most probable structure of synthesized terpolymer. Newly synthesized terpolymer was proved to be a selective chelating ion-exchanger for certain metal ions and were studied for Fe3+, Cu2+, Ni2+, Co2+, Zn2+, Cd2+, Hg2+ and Pb2+ ions using their metal nitrate solutions. A batch equilibrium method was employed to study the selectivity of metal ions uptake involving the measurements of the distribution of a given metal ion between the terpolymer sample and a solution containing the metal ion. The study was carried out over a wide pH range, shaking time and in media of different electrolytes at different ionic strengths. Distribution ratios of metal ions were found to be increased by rising pH of the solutions. Hence, it can be used to recover certain metal ions from waste water for the purpose of purification of water and removal of iron from boiler water.

Keywords: terpolymers, ion-exchangers, distribution ratio, metal ion uptake

Procedia PDF Downloads 296
570 Biosorption of Cu (II) and Zn (II) from Real Wastewater onto Cajanus cajan Husk

Authors: Mallappa A. Devani, John U. Kennedy Oubagaranadin, Basudeb Munshi

Abstract:

In this preliminary work, locally available husk of Cajanus cajan (commonly known in India as Tur or Arhar), a bio-waste, has been used in its physically treated and chemically activated form for the removal of binary Cu (II) and Zn(II) ions from the real waste water obtained from an electroplating industry in Bangalore, Karnataka, India and from laboratory prepared binary solutions having almost similar composition of the metal ions, for comparison. The real wastewater after filtration and dilution for five times was used for biosorption studies at the normal pH of the solutions at room temperature. Langmuir's binary model was used to calculate the metal uptake capacities of the biosorbents. It was observed that Cu(II) is more competitive than Zn(II) in biosorption. In individual metal biosorption, Cu(II) uptake was found to be more than that of the Zn(II) and a similar trend was observed in the binary metal biosorption from real wastewater and laboratory prepared solutions. FTIR analysis was carried out to identify the functional groups in the industrial wastewater and EDAX for the elemental analysis of the biosorbents after experiments.

Keywords: biosorption, Cajanus cajan, multi metal remediation, wastewater

Procedia PDF Downloads 386
569 Antidiabetic Potential of Pseuduvaria monticola Bark Extract on the Pancreatic Cells, NIT-1 and Type 2 Diabetic Rat Model

Authors: Hairin Taha, Aditya Arya, M. A. Hapipah, A. M. Mustafa

Abstract:

Plants have been an important source of medicine since ancient times. Pseuduvaria monticola is a rare montane forest species from the Annonaceae family. Traditionally, the plant was used to cure symptoms of fever, inflammation, stomach-ache and also to reduce the elevated levels of blood glucose. Scientifically, we have evaluated the antidiabetic potential of the Pseuduvaria monticola bark methanolic extract on certain in vitro cell based assays, followed by in vivo study. Results from in vitro models displayed PMm upregulated glucose uptake and insulin secretion in mouse pancreatic β-cells. In vivo study demonstrated the PMm down-regulated hyperglycaemia, oxidative stress and elevated levels of pro-inflammatory cytokines in type 2 diabetic rat models. Altogether, the study revealed that Pseuduvaria monticola might be used as a potential candidate for the management of type 2 diabetes and its related complications.

Keywords: type 2 diabetes, Pseuduvaria monticola, insulin secretion, glucose uptake

Procedia PDF Downloads 439
568 Potential of Two Pelargonium Species for EDTA-Assisted Phytoextraction of Cadmium

Authors: Iram Gul, Maria Manzoor, Muhammad Arshad

Abstract:

The enhanced phytoextraction techniques have been proposed for the remediation of heavy metals contaminated soil. Chelating agents enhance the availability of Cd, which is the main factor in the phytoremediation. This study was conducted to assessed the potential of two Pelargonium species (Pelargonium zonale, Pelargonium hortorum) in EDTA enhanced phytoextraction of Cd using pot experiment. Different doses of EDTA (0, 1, 2, 3, 4, 5 mmol kg-1) was used, and results showed that there was significant increase (approximately 2.1 folds) in the mobility of Cd at EDTA 5 mg kg-1 as compared to control. Both plants have TF and BCF more than 1 and have potential for the phytoextraction of Cd. However, the Pelargonium hortorum showed higher biomass and Cd uptake as compared to Pleragonium zonale. The maximum Cd accumulation in shoot and root of Pelargonium zonale was 484.4 and 264.41 mg kg-1 respectively at 2 mmol kg-1. However, the Pelargonium hortorum accumulate 996.9 and 350 mg kg-1 of Cd in shoot and root respectively at 4 mmol kg-1. Pelargonium hortorum uptake approximately 10.7 folds higher Cd concentration as compared to the Pelargonium zonale. Results revealed that P. hortorum performed better than P. zonal even at higher Cd and EDTA doses however toxicity and leaching potential of increased Cd and EDTA concentrations needs to be explored before field application.

Keywords: Cadmium, EDTA, Pelargonium, phytoextraction

Procedia PDF Downloads 300
567 COVID-19 Vaccine Hesitancy: The Role of Existential Concerns in Individual’s Decisions Regarding the Vaccine Uptake

Authors: Vittoria Franchina, Laura Salerno, Rubinia Celeste Bonfanti, Gianluca Lo Coco

Abstract:

This study examines the relationships between existential concerns (ECs), basic psychological needs (BPNs), vaccine hesitancy (VH), and the mediating role of negative attitudes toward COVID-19 vaccines. A cross-sectional survey was carried out on a sample of two-hundred eighty-seven adults (Mage = 36.04 (12.07); 59.9% females). Participants were recruited online through clickworker and filled in measures on existential concerns, basic psychological needs, attitudes toward COVID-19 vaccines, and vaccine hesitancy for Pfizer-BioNTech and Astrazeneca vaccines separately. Structural equation modelling showed that existential concerns were related to Pfizer-BioNTech and Astrazeneca vaccine hesitancy both directly and indirectly through negative attitudes toward possible side effects of COVID-19 vaccines. The present study has identified several predictive factors relating to the intention to uptake vaccination to protect against COVID-19 in Italy. Specifically, these findings suggest a causal link between existential concerns, attitudes, and vaccine hesitancy.

Keywords: COVID-19, existential concerns, Pfizer-BioNTech and Astrazeneca vaccines, vaccine hesitancy

Procedia PDF Downloads 100
566 Exploring Individual Decision Making Processes and the Role of Information Structure in Promoting Uptake of Energy Efficient Technologies

Authors: Rebecca J. Hafner, Daniel Read, David Elmes

Abstract:

The current research applies decision making theory in order to address the problem of increasing uptake of energy-efficient technologies in the market place, where uptake is currently slower than one might predict following rational choice models. Specifically, in two studies we apply the alignable/non-alignable features effect and explore the impact of varying information structure on the consumers’ preference for standard versus energy efficient technologies. As researchers in the Interdisciplinary centre for Storage, Transformation and Upgrading of Thermal Energy (i-STUTE) are currently developing energy efficient heating systems for homes and businesses, we focus on the context of home heating choice, and compare preference for a standard condensing boiler versus an energy efficient heat pump, according to experimental manipulations in the structure of prior information. In Study 1, we find that people prefer stronger alignable features when options are similar; an effect which is mediated by an increased tendency to infer missing information is the same. Yet, in contrast to previous research, we find no effects of alignability on option preference when options differ. The advanced methodological approach used here, which is the first study of its kind to randomly allocate features as either alignable or non-alignable, highlights potential design effects in previous work. Study 2 is designed to explore the interaction between alignability and construal level as an explanation for the shift in attentional focus when options differ. Theoretical and applied implications for promoting energy efficient technologies are discussed.

Keywords: energy-efficient technologies, decision-making, alignability effects, construal level theory, CO2 reduction

Procedia PDF Downloads 329
565 Strengthening Service Delivery to Improving Cervical Cancer Screening in Southwestern Nigeria: A Pilot Project

Authors: Afolabi K. Esther, Kuye Tolulope, Babafemi, L. Olayemi, Omikunle Yemisi

Abstract:

Background: Cervical cancer is a potentially preventable disease of public significance. All sexually active women are at risk of cervical cancer; however, the uptake and coverage are low in low-middle resource countries. Hence, the programme explored the feasibility of demonstrating an innovative and low-cost system approach to cervical cancer screening service delivery among reproductive-aged women in low–resource settings in Southwestern Nigeria. This was to promote the uptake and quality improvement of cervical cancer screening services. Methods: This study was an intervention project in three senatorial districts in Osun State that have primary, secondary and tertiary health facilities. The project was in three phases; Pre-intervention, Intervention, and Post-intervention. The study utilised the existing infrastructure, facilities and staff in project settings. The study population was nurse-midwives, community health workers and reproductive-aged women (30-49 years). The intervention phase entailed using innovative, culturally appropriate strategies to create awareness of cervical cancer and preventive health-seeking behaviour among women in the reproductive-aged group (30-49) years. Also, the service providers (community health workers, Nurses, and Midwives) were trained on screening methods and treatment of pre-cancerous lesions, and there was the provision of essential equipment and supplies for cervical cancer screening services at health facilities. Besides, advocacy and engagement were made with relevant stakeholders to integrate the cervical cancer screening services into related reproductive health services and greater allocation of resources. The expected results compared the pre and post-intervention using the baseline and process indicators and the effect of the intervention phase on screening coverage using a plausibility assessment design. The project lasted 12 months; visual Inspection with Acetic acid (VIA) screening for the women for six months and follow-up in 6 months for women receiving treatment. Results: The pre-intervention phase assessed baseline service delivery statistics in the previous 12 months drawn from the retrospective data collected as part of the routine monitoring and reporting systems. The uptake of cervical cancer screening services was low as the number of women screened in the previous 12 months was 156. Service personnel's competency level was fair (54%), and limited availability of essential equipment and supplies for cervical cancer screening services. At the post-intervention phase, the level of uptake had increased as the number of women screened was 1586 within six months in the study settings. This showed about a 100-%increase in the uptake of cervical cancer screening services compared with the baseline assessment. Also, the post-intervention level of competency of service delivery personnel had increased to 86.3%, which indicates quality improvement of the cervical cancer screening service delivery. Conclusion: the findings from the study have shown an effective approach to strengthening and improving cervical cancer screening service delivery in Southwestern Nigeria. Hence, the intervention promoted a positive attitude and health-seeking behaviour among the target population, significantly influencing the uptake of cervical cancer screening services.

Keywords: cervical cancer, screening, nigeria, health system strengthening

Procedia PDF Downloads 103
564 Different Types of Amyloidosis Revealed with Positive Cardiac Scintigraphy with Tc-99M DPD-SPECT

Authors: Ioannis Panagiotopoulos, Efstathios Kastritis, Anastasia Katinioti, Georgios Efthymiadis, Argyrios Doumas, Maria Koutelou

Abstract:

Introduction: Transthyretin amyloidosis (ATTR) is a rare but serious infiltrative disease. Myocardial scintigraphy with DPD has emerged as the most effective, non-invasive, highly sensitive, and highly specific diagnostic method for cardiac ATTR amyloidosis. However, there are cases in which additional laboratory investigations reveal AL amyloidosis or other diseases despite a positive DPD scintigraphy. We describe the experience from the Onassis Cardiac Surgery Center and the monitoring center for infiltrative myocardial diseases of the cardiology clinic at AHEPA. Materials and Methods: All patients with clinical suspicion of cardiac or extracardiac amyloidosis undergo a myocardial scintigraphy scan with Tc-99m DPD. In this way, over 500 patients have been examined. Further diagnostic approach based on clinical and imaging findings includes laboratory investigation and invasive techniques (e.g., biopsy). Results: Out of 76 patients in total with positive myocardial scintigraphy Grade 2 or 3 according to the Perugini scale, 8 were proven to suffer from AL Amyloidosis during the investigation of paraproteinemia. Among these patients, 3 showed Grade 3 uptake, while the rest were graded as Grade 2, or 2 to 3. Additionally, one patient presented diffuse and unusual radiopharmaceutical uptake in soft tissues throughout the body without cardiac involvement. These findings raised suspicions, leading to the analysis of κ and λ light chains in the serum, as well as immunostaining of proteins in the serum and urine of these specific patients. The final diagnosis was AL amyloidosis. Conclusion: The value of DPD scintigraphy in the diagnosis of cardiac amyloidosis from transthyretin is undisputed. However, positive myocardial scintigraphy with DPD should not automatically lead to the diagnosis of ATTR amyloidosis. Laboratory differentiation between ATTR and AL amyloidosis is crucial, as both prognosis and therapeutic strategy are dramatically altered. Laboratory exclusion of paraproteinemia is a necessary and essential step in the diagnostic algorithm of ATTR amyloidosis for all positive myocardial scintigraphy with diphosphonate tracers since >20% of patients with Grade 3 and 2 uptake may conceal AL amyloidosis.

Keywords: AL amyloidosis, amyloidosis, ATTR, myocardial scintigraphy, Tc-99m DPD

Procedia PDF Downloads 81