Search results for: clinical guidelines

Authors: Sonal Tuljaram Kame

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Growth and development is based on proper diet. A balanced diet contains all the nutrients in required quantum. Although physical growth is completed by young adulthood, the body tissues remain in a dynamic state with catabolism slightly exceeding anabolism, resulting in a net decrease in the number of cells. After the years of adolescence which cause upheavals in the life of the person, the individual struggle to emerge as an adult who know who he is and what his goals are. During this period nutrients are needed for maintaining the health and energy is required for physical functions and physical activities. The nutritional requirement in young adulthood differs from other periods of life. Iron is needed for haemoglobin synthesis and necessitates by the considerable examination of blood volume. Young adult girls need to ensure adequate intake of iron as they loose 0.5 mg/day by way of menstruation. This is complete awareness about nutritional and health on the other side there is widespread ignorance about nutrition and health among young adult girls. The young adult girls who are aware about nutrition and health seem to be very conscious about nutritional intake and health. Figure consciousness and fear of obesity leads to self imposed intake of nutrients. It may result in various health problems. The study was planned to investigate nutrient intake, find relation between nutritional intake, clinical examination score and health status of young adult girls. The present study is based on the data collected from 120 young adult girls studying in four different competitive exams coaching academies in Akola city of Maharashtra. It was found that nutritional intake of these young adult girls was below the recommended level, nutritional knowledge level and nutritional intake are associated attributes, calories, calcium and protein intake is positively correlated with clinical examination and health status. It was concluded that well planned nutritional counseling for the young adult girls can help prevent nutritional deficiency diseases and disorders which may lead to anaemic condition in young adult girls. Girls need to be educated on intake of iron and vitamin B12.

Keywords: nutritional intake, health status, young adult girls, correlation studies

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Authors: Mohammad Hossain Validad

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Background and Aim: Epidemic keratoconjunctivitis is a type of conjunctivitis caused by adenoviruses that can spread rapidly through direct and indirect contact. The aim of this study was to evaluate the therapeutic effects of Povidone-Iodine 0.4% and 0.2% in improving the symptoms and signs of patients with epidemic keratoconjunctivitis. Materials and Methods: In this clinical trial study, 60 patients with a mean age of 27.8±8.4 years who were eligible for inclusion criteria were randomly divided into three groups. The first group received eye drops of Povidone-Iodine 0.4% and betamethasone 0.1%, the second group received PovidoneIodine 0.2% and betamethasone 0.1% and the third group received betamethasone 0.1%. Follow-ups were on the first, fourth, seventh and tenth days after starting treatment. Parameters examined at each examination were hyperaemia, mucopurulent discharge, eyelid edema, hemorrhage, and subepithelial infiltration. Results: The results showed that mucopurulent discharge on the fourth day of the examination (P = 0.005) and the seventh day of the examination (P = 0.001) were significantly different in the three treatment groups. Sub-epithelial infiltration on the tenth day after treatment did not show a significant difference in the 3 groups (P = 0.287). Conclusion: Based on the results of this study, Povidone-Iodine is more effective in relieving some of signs of EKC, such as reduced mucopurulent discharge than steroids alone.

Keywords: EKC, topical bethadine, adenovirus, sub epithelial opacity

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Authors: Peter Collett, Mike Pynn, Haseeb Ur Rahman

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For the last few years across the UK there has been a push towards implementing treatment escalation plans (TEP) for every patient admitted to hospital. This is a paper form which is completed by a junior doctor then countersigned by the consultant responsible for the patient's care. It is designed to address what level of care is appropriate for the patient in question at point of entry to hospital. It helps decide whether the patient would benefit for ward based, high dependency or intensive care. They are completed to ensure the patient's best interests are maintained and aim to facilitate difficult decisions which may be required at a later date. For example, a frail patient with significant co-morbidities, unlikely to survive a pathology requiring an intensive care admission is admitted to hospital the decision can be made early to state the patient would not benefit from an ICU admission. This decision can be reversed depending on the clinical course of the patient's admission. It promotes discussions with the patient regarding their wishes to receive certain levels of healthcare. This poster describes the steps taken in the Aneurin Bevan University Health Board (ABUHB) when implementing the TEP form. The team implementing the TEP form campaigned for it's use to the board of directors. The directors were eager to hear of experiences of other health boards who had implemented the TEP form. The team presented the data produced in a number of health boards and demonstrated the proposed form. Concern was raised regarding the legalities of the form and that it could upset patients and relatives if the form was not explained properly. This delayed the effectuation of the TEP form and further research and discussion would be required. When COVID 19 reached the UK the National Institute for Health and Clinical Excellence issued guidance stating every patient admitted to hospital should be issued a TEP form. The TEP form was accelerated through the vetting process and was approved with immediate effect. The TEP form in ABUHB has now been in circulation for a month. An audit investigating it's uptake and a survey gathering opinions have been conducted.

Keywords: acute medicine, clinical governance, intensive care, patient centered decision making

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Authors: Syeda Sahra, Abdullah Jahangir, Rachelle Hamadi, Ahmad Jahangir, Allison Glaser

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Background: Antimicrobial resistance is on the rise. The use of redundant and inappropriate antibiotics is contributing to recurrent infections and resistance. Newer antibiotics with more robust coverage for gram-negative bacteria are in great demand for complicated urinary tract infections (cUTIs), complicated intra-abdominal infections (cIAIs), hospital-acquired bacterial pneumonia (H.A.B.P.), and ventilator-associated bacterial pneumonia (V.A.B.P.). Objective: We performed this meta-analysis to evaluate the efficacy and safety profile of a new antibiotic, Imipenem/cilastatin/relebactam, compared to other broad-spectrum antibiotics for complicated infections. Search Strategy: We conducted a systemic review search on PubMed, Embase, and Central Cochrane Registry. Selection Criteria: We included randomized clinical trials (R.C.T.s) with the standard of care as comparator arm with Imipenem/cilastatin/relebactam as intervention arm. Analysis: For continuous variables, the mean difference was used. For discrete variables, we used the odds ratio. For effect sizes, we used a confidence interval of 95%. A p-value of less than 0.05 was used for statistical significance. Analysis was done using a random-effects model irrespective of heterogeneity. Heterogeneity was evaluated using the I2 statistic. Results: The authors observed similar efficacy at clinical and microbiologic response levels on early follow-up and late follow-up compared to the established standard of care. The incidence of drug-related adverse events, serious adverse events, and drug discontinuation due to adverse events were comparable across both groups. Conclusion: Imipenem/cilastatin/relebactam has a non-inferior safety and efficacy profile compared to peer antibiotics to treat severe bacterial infections (cUTIs, cIAIs, H.A.B.P., V.A.B.P.).

Keywords: bacterial pneumonia, complicated intra-abdominal infections, complicated urinary tract infection, Imipenem, cilastatin, relebactam

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Authors: Gizachew Assefa Tessema, Mohammad Afzal Mahmood, Judith Streak Gomersall, Caroline O. Laurence

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Introduction: Improving access to quality family planning services is the key to improving health of women and children. However, there is currently little evidence on the quality and scope of family planning services provided by private facilities, and this compares to the services provided in public facilities in Ethiopia. This is important, particularly in determining whether the government should further expand the roles of the private sector in the delivery of family planning facility. Methods: This study used the 2014 Ethiopian Services Provision Assessment Plus (ESPA+) survey dataset for comparing the structural aspects of quality of care in family planning services. The present analysis used a weighted sample of 1093 primary health care facilities (955 public and 138 private). This study employed logistic regression analysis to compare key structural variables between public and private facilities. While taking the structural variables as an outcome for comparison, the facility type (public vs private) were used as the key exposure of interest. Results: When comparing availability of basic amenities (infrastructure), public facilities were less likely to have functional cell phones (AOR=0.12; 95% CI: 0.07-0.21), and water supply (AOR=0.29; 95% CI: 0.15-0.58) than private facilities. However, public facilities were more likely to have staff available 24 hours in the facility (AOR=0.12; 95% CI: 0.07-0.21), providers having family planning related training in the past 24 months (AOR=4.4; 95% CI: 2.51, 7.64) and possessing guidelines/protocols (AOR= 3.1 95% CI: 1.87, 5.24) than private facilities. Moreover, comparing the availability of equipment, public facilities had higher odds of having pelvic model for IUD demonstration (AOR=2.60; 95% CI: 1.35, 5.01) and penile model for condom demonstration (AOR=2.51; 95% CI: 1.32, 4.78) than private facilities. Conclusion: The present study suggests that Ethiopian government needs to provide emphasis towards the private sector in terms of providing family planning guidelines and training on family planning services for their staff. It is also worthwhile for the public health facilities to allocate funding for improving the availability of basic amenities. Implications for policy and/ or practice: This study calls policy makers to design appropriate strategies in providing opportunities for training a health care providers working in private health facility.

Keywords: quality of care, family planning, public-private, Ethiopia

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Authors: Fatma Ahmed, Heba Mostafa, Bassem Ramdan, Azza El-Soussi

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Background: World Health Organization stated that by 2020 cardiac disease will be the number one cause of death worldwide and estimates that 25 million people per year will suffer from heart disease. Cardiac surgery is considered an effective treatment for severe forms of cardiovascular diseases that cannot be treated by medical treatment or cardiac interventions. In spite of the benefits of cardiac surgery, it is considered a major stressful experience for patients who are candidate for surgery. Prehabilitation can decrease incidences of postoperative complications as it prepares patients for surgical stress through enhancing their defenses to meet the demands of surgery. When patients anticipate the postoperative sequence of events, they will prepare themselves to act certain behaviors, identify their roles and actively participate in their own recovery, therefore, anxiety levels are decreased and functional capacity is enhanced. Prehabilitation programs can comprise interventions that include physical exercise, psychological prehabilitation, nutritional optimization and risk factor modification. Physical exercises are associated with improvements in the functioning of the various physiological systems, reflected in increased functional capacity, improved cardiac and respiratory functions and make patients fit for surgical intervention. Prehabilitation programs should also prepare patients psychologically in order to cope with stress, anxiety and depression associated with postoperative pain, fatigue, limited ability to perform the usual activities of daily living through acting in a healthy manner. Notwithstanding the benefits of psychological preparations, there are limited studies which investigated the effect of psychological prehabilitation to confirm its effect on psychological, quality of life and physiological outcomes of patients who had undergone cardiac surgery. Aim of the study: The study aims to determine the effect of prehabilitation interventions on outcomes of patients undergoing cardiac surgeries. Methods: Quasi experimental study design was used to conduct this study. Sixty eligible and consenting patients were recruited and divided into two groups: control and intervention group (30 participants in each). One tool namely emotional, physiological, clinical, cognitive and functional capacity outcomes of prehabilitation intervention assessment tool was utilized to collect the data of this study. Results: Data analysis showed significant improvement in patients' emotional state, physiological and clinical outcomes (P < 0.000) with the use of prehabilitation interventions. Conclusions: Cardiac prehabilitation in the form of providing information about surgery, circulation exercise, deep breathing exercise, incentive spirometer training and nutritional education implemented daily by patients scheduled for elective open heart surgery one week before surgery have been shown to improve patients' emotional state, physiological and clinical outcomes.

Keywords: emotional recovery, clinical recovery, coronary artery bypass grafting patients, prehabilitation

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Authors: Augustar Omoze Ehighalua, Itotenaan Henry Ogiri

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As a mono-product economy, Nigeria relies largely on oil revenues for its foreign exchange earnings and the exploration activities of firms operating in the Niger Delta region have left in its wake tales of environmental degradation, poverty and misery. This, no doubt, have created corporate social responsibility issues in the region. The focus of this research is the critical evaluation of the ethical response to Corporate Social Responsibility (CSR) practice by firms operating in Nigeria Delta Swamplands. While CSR is becoming more popular in developed society with effective practice guidelines and reporting benchmark, there is a relatively low level of awareness and selective applicability of existing international guidelines to effectively support CSR practice in Nigeria. This study, haven identified the lack of CSR institutional framework attempts to develop an ethically-driven CSR transparency benchmark laced within a regulatory framework based on international best practices. The research adopts a qualitative methodology and makes use of primary data collected through semi-structured interviews conducted across the six core states of the Niger Delta Region. More importantly, the study adopts an inductive, interpretivist philosophical paradigm that reveal deep phenomenological insights into what local communities, civil society and government officials consider as good ethical benchmark for responsible CSR practice by organizations. The institutional theory provides for the main theoretical foundation, complemented by the stakeholder and legitimacy theories. The Nvivo software was used to analyze the data collected. This study shows that ethical responsibility is lacking in CSR practice by firms in the Niger Delta Region of Nigeria. Furthermore, findings of the study indicate key issues of environmental, health and safety, human rights, and labour as fundamental in developing an effective CSR practice guideline for Nigeria. The study has implications for public policy formulation as well as managerial perspective.

Keywords: corporate social responsibility, CSR, ethics, firms, Niger-Delta Swampland, Nigeria

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Authors: Patricia Abigail B. Miranda, Imelda A. Luna

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Introduction: COVID-19 infection is a novel viral illness that began as a local epidemic in December 2019 in Wuhan, China which quickly emerged into a pandemic by February 2020. The virus causes a spectrum of signs and symptoms, ranging from mild upper respiratory symptoms to acute respiratory distress syndrome, which may lead to death. Among children and neonates, those afflicted with the disease may present asymptomatically or with mild symptoms. To date, there has been limited local data that describes the outcomes of the growing number of COVID-19 cases, specifically in neonates. Methods: A cross-sectional study was conducted to determine the outcomes of neonates born to COVID-19 Positive Mothers from March 2020 until June 2022. The prevalence of COVID-19 among these neonates was also determined. Results: COVID-positive prevalence after 24 hours of life is at 8%, while prevalence after 48 hours among those who still underwent testing was at 13.51%. Moreover, among those COVID-19-negative neonates who had symptoms, they mostly presented with tachypnea (5.7%). The prevalence of complications among COVID-19-negative neonates delivered to COVID-19-positive mothers is 22.7%. Conclusion: Neonates born to COVID-19-positive mothers who yielded positive COVID-19 results are generally asymptomatic. Moreover, there are no associated mortalities among those who yielded positive results.

Keywords: COVID-19, neonates, outcomes, clinical profile

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Authors: Adel Alblihy, Reem Ali, Mashael Algethami, Ahmed Shoqafi, Michael S. Toss, Juliette Brownlie, Natalie J. Tatum, Ian Hickson, Paloma Ordonez Moran, Anna Grabowska, Jennie N. Jeyapalan, Nigel P. Mongan, Emad A. Rakha, Srinivasan Madhusudan

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Platinum resistance is a clinical challenge in ovarian cancer. Platinating agents induce DNA damage which activate Mre11 nuclease directed DNA damage signalling and response (DDR). Upregulation of DDR may promote chemotherapy resistance. Here we have comprehensively evaluated Mre11 in epithelial ovarian cancers. In clinical cohort that received platinum- based chemotherapy (n=331), Mre11 protein overexpression was associated with aggressive phenotype and poor progression free survival (PFS) (p=0.002). In the ovarian cancer genome atlas (TCGA) cohort (n=498), Mre11 gene amplification was observed in a subset of serous tumours (5%) which correlated highly with Mre11 mRNA levels (p<0.0001). Altered Mre11 levels was linked with genome wide alterations that can influence platinum sensitivity. At the transcriptomic level (n=1259), Mre11 overexpression was associated with poor PFS (p=0.003). ROC analysis showed an area under the curve (AUC) of 0.642 for response to platinum-based chemotherapy. Pre-clinically, Mre11 depletion by gene knock down or blockade by small molecule inhibitor (Mirin) reversed platinum resistance in ovarian cancer cells and in 3D spheroid models. Importantly, Mre11 inhibition was synthetically lethal in platinum sensitive XRCC1 deficient ovarian cancer cells and 3D-spheroids. Selective cytotoxicity was associated with DNA double strand break (DSB) accumulation, S-phase cell cycle arrest and increased apoptosis. We conclude that pharmaceutical development of Mre11 inhibitors is a viable clinical strategy for platinum sensitization and synthetic lethality in ovarian cancer.

Keywords: MRE11; XRCC1, ovarian cancer, platinum sensitization, synthetic lethality

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Authors: Sherine Shafik Aly, Farida Ahmed El Mallah

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Technology is a quoted keyword nowadays in all fields; it has been recently thought of and integrated into urban development. This research explains the role of technology in establishing intelligent urbanism to create a convivial and sustainable environment for people to live in. Cities are downgrading socially, economically and environmentally. A framework is to be developed where these three pillars are involved in the planning, design, and spreading of technology to create convivial environments. The aim of this research is achieved by highlighting the importance and approaches of intelligent urbanism, it’s characteristics and principles, then analyzing some relevant examples to achieve a set of guidelines.

Keywords: convivial, intelligent, technology, urban development

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Authors: Soledad Carinelli, Iñigo Fernández, José Luis González-Mora, Pedro A. Salazar-Carballo

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Mastitis is the most relevant inflammatory disease in cattle, affecting the animal health and causing important economic losses on dairy farms. This disease takes place in the mammary gland or udder when some opportunistic microorganisms, such as Staphylococcus aureus, Streptococcus agalactiae, Corynebacterium bovis, etc., invade the teat canal. According to the severity of the inflammation, mastitis can be classified as sub-clinical, clinical and chronic. Standard methods for mastitis detection include counts of somatic cells, cell culture, electrical conductivity of the milk, and California test (evaluation of “gel-like” matrix consistency after cell lysed with detergents). However, these assays present some limitations for accurate detection of subclinical mastitis. Currently, haptoglobin, an acute phase protein, has been proposed as novel and effective biomarker for mastitis detection. In this work, an electrochemical biosensor based on polydopamine-modified magnetic nanoparticles (MNPs@pDA) for haptoglobin detection is reported. Thus, MNPs@pDA has been synthesized by our group and functionalized with hemoglobin due to its high affinity to haptoglobin protein. The protein was labeled with specific antibodies modified with alkaline phosphatase enzyme for its electrochemical detection using an electroactive substrate (1-naphthyl phosphate) by differential pulse voltammetry. After the optimization of assay parameters, the haptoglobin determination was evaluated in milk. The strategy presented in this work shows a wide range of detection, achieving a limit of detection of 43 ng/mL. The accuracy of the strategy was determined by recovery assays, being of 84 and 94.5% for two Hp levels around the cut off value. Milk real samples were tested and the prediction capacity of the electrochemical biosensor was compared with a Haptoglobin commercial ELISA kit. The performance of the assay has demonstrated this strategy is an excellent and real alternative as screen method for sub-clinical bovine mastitis detection.

Keywords: bovine mastitis, haptoglobin, electrochemistry, magnetic nanoparticles, polydopamine

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Authors: Pouya Karimi, Ramin Gasemi Shayan, Parsa Sheykhzade

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Ease shotgun DNA sequencing is changing the microbial sciences. Sequencing instruments are compelling to the point that example planning is currently the key constraining element. Here, we present a microfluidic test readiness stage that incorporates the key strides in cells to grouping library test groundwork for up to 96 examples and decreases DNA input prerequisites 100-overlay while keeping up or improving information quality. The universally useful microarchitecture we show bolsters work processes with subjective quantities of response and tidy up or catch steps. By decreasing the example amount necessities, we empowered low-input (∼10,000 cells) entire genome shotgun (WGS) sequencing of Mycobacterium tuberculosis and soil miniaturized scale settlements with prevalent outcomes. We additionally utilized the upgraded throughput to succession ∼400 clinical Pseudomonas aeruginosa libraries and exhibit magnificent single-nucleotide polymorphism discovery execution that clarified phenotypically watched anti-toxin opposition. Completely coordinated lab-on-chip test arrangement beats specialized boundaries to empower more extensive organization of genomics across numerous fundamental research and translational applications.

Keywords: clinical microbiology, DNA, microbiology, microbial genomics

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Authors: Mohd Asharf Ganie, Aafia Rashid, Mohd Afzal Zargar, Showkat Ali Zargar, Syed Mudasar, Tabasum Parvaiz, Zafar Amin Shah

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Accumulating evidence suggests that Vitamin D deficiency (VDD) might at least contribute to the metabolic co-morbidities in PCOS. Hence, we aimed to study the effect of vitamin D supplementation in co-prescription with insulin sensitizers like metformin and pioglitazone on clinical, hormonal and metabolic parameters in women with PCOS. In this open label randomized, controlled trial a total of 120 women with PCOS diagnosis (AE-PCOS 2009 Criteria) were assigned to four treatment groups (n= 30 in each): group I (metformin 1 gm/day in combination with cholecalciferol 4000 IU/day), group II (pioglitazone 30 mg/day in combination with cholecalciferol 4000 IU/day), group III (metformin 1 gm /day) and group IV (pioglitazone 30 mg/day). Vitamin D supplementation was given as 60,000 units every two weeks for 24 weeks. All the subjects were routinely evaluated for clinical, biochemical, hormonal and insulin sensitivity parameters in addition to various safety parameters especially serum calcium levels at baseline and after 24 weeks of the treatment. Our results indicate that 95.5% of PCOS women were vitamin D deficient at baseline. Serum 25 (OH) D levels increased significantly (p < 0.001) in groups I and II without any adverse effects after 24 weeks of oral administration of 4000 IU cholecalciferol daily. However, serum 25 (OH) D levels remained unchanged in group III and IV. By six months, number of menstrual cycles per year increased whereas Ferriman-Gallwey score, serum total testosterone and HOMA-IR decreased significantly (P < 0.001) in the treatment groups supplemented with cholecalciferol as compared to those treated either drug alone. No significant beneficial changes were observed on weight, BMI, blood pressure, glucose tolerance and serum lipids in any of the groups supplemented with cholecalciferol. We conclude that daily dose of 4000 IU cholecalciferol might be a useful adjunct in complex treatment of PCOS with fewer adverse events. Furthermore, pioglitazone and cholecalciferol combination seems to be marginally better although there was no statistical significance.

Keywords: PCOS, vitamin D supplementation, insulin resistance, spironolactone, metformin, pioglitazone

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Authors: Tuula Heinonen, Wilhelm Gaus

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At present safety, assessment starts with animal tests although their predictivity is often poor. Even after extended human use experimental data are often judged as the core information for risk assessment. However, the best opportunity to generate true evidence is to match all available information. Cross matching methodology combines the different fields of knowledge and types of data (e.g. in-vitro and in-vivo experiments, clinical observations, clinical and epidemiological studies, and daily life observations) and gives adequate weight to individual findings. To achieve a consolidated outcome, the information from all available sources is analysed and compared with each other. If single pieces of information fit together a clear picture becomes visible. If pieces of information are inconsistent or contradictory careful consideration is necessary. 'Cross' can be understood as 'orthographic' in geometry or as 'independent' in mathematics. Results coming from different sources bring independent and; therefore, they result in new information. Independent information gives a larger contribution to evidence than results coming repeatedly from the same source. A successful example of cross matching is the assessment of Ginkgo biloba where we were able to come to the conclusive result: Ginkgo biloba leave extract is well tolerated and safe for humans.

Keywords: cross-matching, human use, safety assessment, Ginkgo biloba leave extract

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Authors: Sophie N. Selby-Pham, Yudie Wang, Louise Bennett

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Consumption of grapes promotes health and reduces the risk of chronic diseases due to the action of grape phytochemicals in regulation of Oxidative Stress and Inflammation (OSI). The bioefficacy of phytochemicals depends on their absorption in the human body. The time required for phytochemicals to achieve maximal plasma concentration (Tₘₐₓ) after oral intake reflects the time window of maximal bioefficacy of phytochemicals, with Tₘₐₓ dependent on physicochemical properties of phytochemicals. This research collated physicochemical properties of grape phytochemicals from white and red grapes to predict their Tₘₐₓ using pharmacokinetic modelling. The predicted values of Tₘₐₓ were then compared to the measured Tₘₐₓ collected from clinical studies to determine the accuracy of prediction. In both liquid and solid intake forms, white grapes exhibit a shorter Tₘₐₓ range (0.5-2.5 h) versus red grapes (1.5-5h). The prediction accuracy of Tₘₐₓ for grape phytochemicals was 33.3% total error of prediction compared to the mean, indicating high prediction accuracy. Pharmacokinetic modelling allows prediction of Tₘₐₓ without costly clinical trials, informing dosing frequency for sustained presence of phytochemicals in the body to optimize the health benefits of phytochemicals.

Keywords: absorption kinetics, phytochemical, phytochemical absorption prediction model, Vitis vinifera

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Authors: Gayathri Pramod, Sheeja K. P.

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Urban flooding has been seen rising in cities for the past few years. This rise in urban flooding is the result of increasing urbanization and increasing climate change. A resilient city design focuses on 'living with water'. This means that the city is capable of accommodating the floodwaters without having to risk any loss of lives or properties. The resilient city design incorporates green infrastructure, river edge treatment, open space design, etc. to form a city that functions as a whole for resilience. Sponge urbanism is a recent method for building resilient cities and is founded by China in 2014. Sponge urbanism is the apt method for resilience building for a tropical town like Aluva of Kerala. Aluva is a tropical town that experiences rainfall of about 783 mm per month during the rainy season. Aluva is an urbanized town which faces the risk of urban flooding and riverine every year due to the presence of Periyar River in the town. Impervious surfaces and hard construction and developments contribute towards flood risk by posing as interference for a natural flow and natural filtration of water into the ground. This type of development is seen in Aluva also. Aluva is designed in this research as a town that have resilient strategies of sponge city and which focusses on natural methods of construction. The flood susceptibility of Aluva is taken into account to design the spaces for sponge urbanism and in turn, reduce the flood susceptibility for the town. Aluva is analyzed, and high-risk zones for development are identified through studies. These zones are designed to withstand the risk of flooding. Various catchment areas are identified according to the natural flow of water, and then these catchment areas are designed to act as a public open space and as detention ponds in case of heavy rainfall. Various development guidelines, according to land use, is also prescribed, which help in increasing the green cover of the town. Aluva is then designed to be a completely flood-adapted city or sponge city according to the guidelines and interventions.

Keywords: climate change, flooding, resilient city, sponge city, sponge urbanism, urbanization

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Authors: Haralabos C. karantonis, Afroditi Michalaki

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High intakes of carbohydrates and fats have been associated with an increased risk of chronic diseases due to the role of postprandial oxidative stress. This pilot nutritional intervention aimed to examine the acute effect of consuming two different types of breadsticks prepared from durum wheat flour mixtures differing in total phenolic content on postprandial inflammatory and oxidant responses in healthy volunteers. A cross-over, controlled, and single-blind clinical trial was designed, and two isocaloric high-fat and high-carbohydrate meals were tested. Serum total, High Density Lipoprotein (HDL)- and Low Density Lipoprotein (LDL)-cholesterol, triglycerides, glucose, C-reactive protein (CRP), uric acid, plasma total antioxidant capacity, and antiplatelet activity were determined in fasting and 30, 60, and 120 min after consumption. The results showed a better postprandial HDL-cholesterol and total antioxidant activity response in the intervention group. The choice of durum wheat flours with higher phenolic content and antioxidant activity is presented as promising for human health, and clinical studies will expand to draw safer conclusions.

Keywords: antioxidant, antiplatelet, durum wheat, nutritional value

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Authors: André Luis Messias Dos Santos Duque, Daniela Polessa Paula, Rosane Harter Griep

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The intensity of physical activity (PA) over time is essential for health promotion. However, there are few studies that have analyzed the practice of different intensities of PA longitudinally. The objective was to identify PA intensity trajectories in men and women from a Brazilian multicentric cohort and their associated factors. Data from 10,367 participants (5,777 women and 4,590 men) aged 35 to 74 years from the baseline and two follow-up visits (2012-2014 and 2017-2019) of the Longitudinal Study of Adult Health (ELSA-Brasil) were analyzed. PA intensity (low, moderate, or high) was assessed using the leisure-time PA module of the International Physical Activity Questionnaire (IPAQ), and sociodemographic, behavioral, and clinical variables were included. Chi-square and T-student tests were used, considering a significant level of 5%. Four intensity trajectories were identified: low, moderate, high, and no pattern. Most participants (82.5% of women and 75.7% of men) had low PA intensity trajectories, and only 2% of women and 4.8% of men had high PA intensity trajectories. For both sexes, a significant difference (p<0.05) was found for age group, education level, income, smoking, type 2 diabetes, obesity, hypertriglyceridemia, and hypertension. Actions that promote the practice of high-intensity PA over time and consider sociodemographic, clinical, and behavioral factors are necessary.

Keywords: lifestyle, longterm effects, physical activity, socioeconomic factors

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Authors: Eman Nagi Gowid Selim

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Nowadays, the relevance of places to people has been questioned from different perspectives. This is attributed to the fact that many international concrete blocks were used to create multi-use public spaces in neighborhoods based on the techniques of mass-productions concepts that became one of the most effective ways in building construction, replacing the local and traditional built environment. During the last decades, the world has become increasingly globalized and citizen more mobilized, and thus, ignoring the social and environmental dimensions of the local identity. The main enquiries of the research are “How did building technologies affect urban settlement’s identity?” and “What are the impacts of technologies and globalization on local identities in urban spaces? “From this perspective, the research presents firstly, a historical review that shows how old civilizations enhance their local identities using the newly discovered building materials in each era in different urban settlement and fabrics without losing the identity. The second part of the research highlights the different approaches of building technologies and urban design to present a clear understanding of ways of applying and merging between different methodologies to achieve the most efficient urban space design. The third part aims at analyzing some international and national case studies where the form and structure of particular spaces are vital to identifying the morphological elements of urban settlements and the links existing between them. In addition, it determines how the building materials are used to enrich the vocabulary of the local identity. This part ends with the deduction of the guidelines for the integration of the environmental and social dimensions within the building technologies` approaches to enhance the sustainability of local identities and thus, ending up with redefining "Urban Identity" to guide future research in such cultural areas. Finally, the research uses the comparative methodology for applying the deduced guidelines on a national case study namely “Othman`s Towers” in corniche El Maadi, and then ends up by some results in the form of strategies for future researcher, that identifies how to ensure local identity in urban settlements using new building materials and technologies to achieve social and environmental comfort within the cultural areas.

Keywords: building technologies, cultural context, environmental approach, participatory design, social dimension, urban spaces

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Authors: H.C. Chen, S. W. C. Chan, K. Cheng, A. Vathsala, H. K. Sran, H. He

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Background: End-stage renal disease (ESRD) is the last stage of chronic kidney disease. The numbers of patients with ESRD have increased worldwide due to the growing number of aging, diabetes and hypertension populations. Patients with ESRD suffer from physical illness and psychological distress due to complex treatment regimens, which often affect the patients’ social and psychological functioning. As a result, the patients may fail to perform daily self-care and self-management, and consequently experience worsening conditions. Aims: The study aims to examine the effectiveness of a self-efficacy psychoeducational programme on primary outcome (self-efficacy) and secondary outcomes (psychological wellbeing, treatment adherence, and quality of life) in patients with ESRD and haemodialysis in Singapore. Methodology: A randomised controlled, two-group pretest and repeated posttests design will be carried out. A total of 154 participants (n=154) will be recruited. The participants in the control group will receive a routine treatment. The participants in the intervention group will receive a self-efficacy psychoeducational programme in addition to the routine treatment. The programme is a two-session of educational intervention in a week. A booklet, two consecutive sessions of face-to-face individual education, and an abdominal breathing exercise are adopted in the programme. Outcome measurements include Dialysis Specific Self-efficacy Scale, Kidney Disease Quality of Life- 36 Hospital Anxiety and Depression Scale, Renal Adherence Attitudes Questionnaire and Renal Adherence Behaviour Questionnaire. The questionnaires will be used to measure at baseline, 1- and 3- and 6-month follow-up periods. Process evaluation will be conducted with a semi-structured face to face interview. Quantitative data will be analysed using SPSS21.0 software. Qualitative data will be analysed by content analysis. Significance of the study: This study will identify a clinically useful and potentially effective approach to help patients with end-stage renal disease and haemodialysis by enhancing their self-efficacy in self-care behaviour, and therefore improving their psychological wellbeing, treatment adherence and quality of life. This study will provide information to develop clinical guidelines to improve patients’ disease self-management and to enhance health-related outcomes. Hopefully it will help reducing disease burden.

Keywords: end-stage renal disease (ESRD), haemodialysis, psychoeducation, self-efficacy

Procedia PDF Downloads 303

Authors: Fumihiro Ima, Shinichi Watanabe, Shingo Maeda, Haruna Imai, Hiroki Niimi

Abstract:

It is important to know growth rate of brain tumors before surgery because it influences treatment planning including not only surgical resection strategy but also adjuvant therapy after surgery. Amide proton transfer (APT) imaging is an emerging molecular magnetic resonance imaging (MRI) technique based on chemical exchange saturation transfer without administration of contrast medium. The underlying assumption in APT imaging of tumors is that there is a close relationship between the proliferative activity of the tumor and mobile protein synthesis. We aimed to evaluate the diagnostic performance of APT imaging of pre-and post-treatment brain tumors. Ten patients with brain tumor underwent conventional and APT-weighted sequences on a 3.0 Tesla MRI before clinical intervention. The maximum and the minimum APT-weighted signals (APTWmax and APTWmin) in each solid tumor region were obtained and compared before and after clinical intervention. All surgical specimens were examined for histopathological diagnosis. Eight of ten patients underwent adjuvant therapy after surgery. Histopathological diagnosis was glioma in 7 patients (WHO grade 2 in 2 patients, WHO grade 3 in 3 patients and WHO grade 4 in 2 patients), meningioma WHO grade1 in 2 patients and primary lymphoma of the brain in 1 patient. High-grade gliomas showed significantly higher APTW-signals than that in low-grade gliomas. APTWmax in one huge parasagittal meningioma infiltrating into the skull bone was higher than that in glioma WHO grade 4. On the other hand, APTWmax in another convexity meningioma was the same as that in glioma WHO grade 3. Diagnosis of primary lymphoma of the brain was possible with APT imaging before pathological confirmation. APTW-signals in residual tumors decreased dramatically within one year after adjuvant therapy in all patients. APT imaging demonstrated excellent diagnostic performance for the planning of surgery and adjuvant therapy of brain tumors.

Keywords: amides, magnetic resonance imaging, brain tumors, cell proliferation

Procedia PDF Downloads 139

Authors: Aleksandra Rajewska-Rager, Maria Skibinska, Monika Dmitrzak-Weglarz, Natalia Lepczynska, Pawel Kapelski, Joanna Pawlak, Joanna Hauser

Abstract:

Introduction: Inflammation and cytokines have emerged as a promising target in mood disorders research; however there are still very limited numbers of study regarding inflammatory alterations among adolescents and young adults with mood disorders. The Macrophage Migration Inhibitory Factor (MIF) and Stem Cell Factor (SCF) are the pleiotropic cytokines which may play an important role in mood disorders pathophysiology. The aim of this study was to investigate levels of these factors in serum of adolescent and young adults with mood disorders compared to healthy controls. Subjects: We involved 79 patients aged 12-24 years in 2-year follow-up study with a primary diagnosis of mood disorders: bipolar disorder (BP) and unipolar disorder with BP spectrum. Study group includes 23 males (mean age 19.08, SD 3.3) and 56 females (18.39, SD 3.28). Control group consisted 35 persons: 7 males (20.43, SD 4.23) and 28 females (21.25, SD 2.11). Clinical diagnoses according to DSM-IV-TR criteria were assessed using Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version (K-SADS-PL) and Structured Clinical Interview for the Diagnostic and Statistical Manual (SCID) in young adults respectively. Clinical assessment includes evaluation of clinical factors and symptoms severity (rated using the Hamilton Depression Rating Scale and Young Mania Rating Scale). Clinical and biological evaluations were made at control visits respectively at baseline (week 0), euthymia (at month 3 or 6) and after 12 and 24 months. Methods: Serum protein concentration was determined by Enzyme-Linked Immunosorbent Assays (ELISA) method. Human MIF and SCF DuoSet ELISA kits were used. In the analyses non-parametric tests were used: Mann-Whitney U test, Kruskal-Wallis ANOVA, Friedman’s ANOVA, Wilcoxon signed rank test, Spearman correlation. We defined statistical significance as p < 0.05. Results: Comparing MIF and SCF levels between acute episode of depression/hypo/mania at baseline and euthymia (at month 3 or 6) we did not find any statistical differences. At baseline patients with age above 18 years old had decreased MIF level compared to patients younger than 18 years. MIF level at baseline positively correlated with age (p=0.004). Positive correlations of SCF level at month 3 and 6 with depression or mania occurrence at month 24 (p=0.03 and p=0.04, respectively) was detected. Strong correlations between MIF and SCF levels at baseline (p=0.0005) and month 3 (p=0.03) were observed. Discussion: Our results did not show any differences in MIF and SCF levels between acute episode of depression/hypo/mania and euthymia in young patients. Further studies on larger groups are recommended. Grant was founded by National Science Center in Poland no 2011/03/D/NZ5/06146.

Keywords: cytokines, MIF, mood disorders, SCF

Procedia PDF Downloads 201

Authors: Ana Rita Conde, Pilar Mota, Tânia Botelho, Carlos Rodrigues, Osvaldo Silva, Áurea Sousa, Suzana Caldeira, Isabel Rego, Jéssica Pacheco

Abstract:

Families with children with ASD are interested in traveling but end up not traveling due to the obstacles they face and not finding inclusive traveling offers. This study will identify the needs of families with children with ASD, to develop the products targeted to their tourist needs. 137 families from different countries answered a questionnaire about their travel experiences, needs and preferences. Based on the results, guidelines are presented for the development of products specially aimed for this market niche.

Keywords: inclusive tourism, sustainability, autism spectrum disorder, children, families

Procedia PDF Downloads 137

Authors: Jenny Jin

Abstract:

Background: The therapeutic use of cannabis for cancer symptom control in Australia is gaining momentum, reflecting a broader global acceptance of its medicinal potential. Objective: This overview examines the historical context, current regulations, and clinical applications of cannabis in oncology within Australia. Methods: A historical analysis outlines the ancient and 19th-century medicinal uses of cannabis, followed by its prohibition in the early 20th century and subsequent resurgence in the late 20th century. The current legal framework under the therapeutic gods administration (TGA) is discussed. Results: Research indicates that cannabinoids, particularly THC and CBD, effectively alleviate pain, reduce chemotherapy-induced nausea and vomiting, stimulate appetite, and enhance overall quality of life for cancer patients. Despite these benefits, challenges such as dosing standardization, stigma, and access barriers persist. Conclusion: Continued clinical research, policy development, and educational initiatives are essential to optimize the use of cannabis in cancer care. A patient-centred approach, emphasizing interdisciplinary collaboration and informed decision-making, is crucial for improving therapeutic outcomes in this evolving field.

Keywords: historical context of cannabis, symptom control in oncology patients, therapeutic benefits, outcome and future

Procedia PDF Downloads 13

Authors: Jayeon Kim, Eunjung Yu, Taeki Yoon

Abstract:

Most spontaneous miscarriage is believed to be a consequence of embryo aneuploidies. Transferring eukaryotic embryos selected by PGS is expected to decrease the miscarriage rate. Current PGS indications include advanced maternal age, recurrent pregnancy loss, repeated implantation failure. Recently, use of PGS for healthy women without above indications for the purpose of improving in vitro fertilization (IVF) outcomes is on the rise. However, it is still controversy about the beneficial effect of PGS in this population, especially, in women with a history of no more than 2 miscarriages or miscarriage of eukaryotic abortus. This study aimed to investigate if karyotyping result of abortus is a good indicator of preimplantation genetic screening (PGS) in subsequent IVF cycle in women with a history of spontaneous abortion. A single-center retrospective cohort study was performed. Women who had spontaneous abortion(s) (less than 3) and dilatation and evacuation, and subsequent IVF from January 2016 to November 2016 were included. Their medical information was extracted from the charts. Clinical pregnancy was defined as presence of a gestational sac with fetal heart beat detected on ultrasound in week 7. Statistical analysis was performed using SPSS software. Total 234 women were included. 121 out of 234 (51.7%) underwent karyotyping of the abortus, and 113 did not have the abortus karyotyped. Embryo biopsy was performed on 3 or 5 days after oocyte retrieval, followed by embryo transfer (ET) on a fresh or frozen cycle. The biopsied materials were subjected to microarray comparative genomic hybridization. Clinical pregnancy rate per ET was compared between PGS and non-PGS group in each study group. Patients were grouped by two criteria: karyotype of the abortus from previous miscarriage (unknown fetal karyotype (n=89, Group 1), eukaryotic abortus (n=36, Group 2) or aneuploidy abortus (n=67, Group 3)), and pursuing PGS in subsequent IVF cycle (pursuing PGS (PGS group, n=105) or not pursuing PGS (non-PGS group, n=87)). The PGS group was significantly older and had higher number of retrieved oocytes and prior miscarriages compared to non-PGS group. There were no differences in BMI and AMH level between those two groups. In PGS group, the mean number of transferable embryos (eukaryotic embryo) was 1.3 ± 0.7, 1.5 ± 0.5 and 1.4 ± 0.5, respectively (p = 0.049). In 42 cases, ET was cancelled because all embryos biopsied turned out to be abnormal. In all three groups (group 1, 2, and 3), clinical pregnancy rates were not statistically different between PGS and non-PGS group (Group 1: 48.8% vs. 52.2% (p=0.858), Group 2: 70% vs. 73.1% (p=0.730), Group 3: 42.3% vs. 46.7% (p=0.640), in PGS and non-PGS group, respectively). In both groups who had miscarriage with eukaryotic and aneuploidy abortus, the clinical pregnancy rate between IVF cycles with and without PGS was not different. When we compare miscarriage and ongoing pregnancy rate, there were no significant differences between PGS and non-PGS group in all three groups. Our results show that the routine application of PGS in women who had less than 3 miscarriages would not be beneficial, even in cases that previous miscarriage had been caused by fetal aneuploidy.

Keywords: preimplantation genetic diagnosis, miscarriage, kpryotyping, in vitro fertilization

Procedia PDF Downloads 181

Authors: Tomi Lois Olatunji, Frances Siebert, Ademola Emmanuel Adetunji, Brian Harvey, Johane Gericke, Josias Hamman, Frank Van Der Kooy

Abstract:

Ethnopharmacological relevance: Sceletium tortuosum (L.) N.E.Br, the most sought after and widely researched species in the genus Sceletium is a succulent forb endemic to South Africa. Traditionally, this medicinal plant is mainly masticated or smoked and used for the relief of toothache, abdominal pain, and as a mood-elevator, analgesic, hypnotic, anxiolytic, thirst and hunger suppressant, and for its intoxicating/euphoric effects. Sceletium tortuosum is currently of widespread scientific interest due to its clinical potential in treating anxiety and depression, relieving stress in healthy individuals, and enhancing cognitive functions. These pharmacological actions are attributed to its phytochemical constituents referred to as mesembrine-type alkaloids. Aim of the review: The aim of this review was to comprehensively summarize and critically evaluate recent research advances on the phytochemistry, pharmacokinetics, biological and clinical activities of the medicinal plant S. tortuosum. Additionally, current ongoing research and future perspectives are also discussed. Methods: All relevant scientific articles, books, MSc and Ph.D. dissertations on botany, behavioral pharmacology, traditional uses, and phytochemistry of S. tortuosum were retrieved from different databases (including Science Direct, PubMed, Google Scholar, Scopus and Web of Science). For pharmacokinetics and pharmacological effects of S. tortuosum, the focus fell on relevant publications published between 2009 and 2021. Results: Twenty-five alkaloids belonging to four structural classes viz: mesembrine, Sceletium A4, joubertiamine, and tortuosamine, have been identified from S. tortuosum, of which the mesembrine class is predominant. The crude extracts and commercially available standardized extracts of S. tortuosum have displayed a wide spectrum of biological activities (e.g. antimalarial, anti-oxidant, immunomodulatory, anti-HIV, neuroprotection, enhancement of cognitive function) in in vitro or in vivo studies. This plant has not yet been studied in a clinical population, but has potential for enhancing cognitive function, and managing anxiety and depression. Conclusion: As an important South African medicinal plant, S. tortuosum has garnered many research advances on its phytochemistry and biological activities over the last decade. These scientific studies have shown that S. tortuosum has various bioactivities. The findings have further established the link between the phytochemistry and pharmacological application, and support the traditional use of S. tortuosum in the indigenous medicine of South Africa.

Keywords: Aizoaceae, Mesembrine, Serotonin, Sceletium tortuosum, Zembrin®, psychoactive, antidepressant

Procedia PDF Downloads 215

Authors: Kiran Fatima, Kashif Ali

Abstract:

Staphylococcus aureus is an opportunistic human as well as animal pathogen that causes a variety of diseases. A total of 70 staphylococci isolates were obtained from soil, water, yogurt, and clinical samples. The likely staphylococci clinical isolates were identified phenotypically by different biochemical tests. Molecular identification was done by PCR using species-specific 16S rRNA primer pairs, and finally, 50 isolates were found to be positive as Staphylococcus aureus, sciuri, xylous and cohnii. Screened isolates were further analyzed by several microbiological diagnostics tests, including gram staining, coagulase, capsule, hemolysis, fermentation of glucose, lactose, maltose, and sucrose tests enzymatic reactions. It was found that 78%, 81%, and 51% of isolates were positive for gelatin hydrolysis, protease, and lipase activities, respectively. Antibiogram analysis of isolated Staphylococcus aureus strains with respect to different antimicrobial agents revealed resistance patterns ranging from 57 to 96%. Our study also shows 70% of strains to be MRSA, 54.3% as VRSA, and 54.3% as both MRSA and VRSA. All the identified isolates were subjected to detection of mecA, nuc, and hlb genes, and 70%, 84%, and 40% were found to harbour mecA, nuc, and hlb genes, respectively. The current investigation is highly important and informative for the high-level multidrug-resistant Staphylococcus aureus infections inclusive also of methicillin and vancomycin.

Keywords: MRSA, VRSA, mecA, MSSA

Procedia PDF Downloads 130

Authors: Natesan Balasubramanian, Palpandi Pounpandi, Venkatraman Thamil Priya, Vellasamy Shanmugaiah, Karubbiah Balakrishnan, Mandayam Anandam Thirunarayan

Abstract:

Streptococcus agalactiae is commonly known as Group B Streptococcus (GBS) and it is the most common cause of life-threatening bacterial infection. GBS first considered as a veterinary pathogen causing mastitis in cattle later becomes a human pathogen for severe neonatal infections. In this present study, a total of 20 new clinical isolates of S. agalactiae were collected from male (6) and female patient (14) with different age group. The isolates were from Urinary tract infection (UTI), blood, pus and eye ulcer. All the 20 S. agalactiae isolates has clear hemolysis properties on blood agar medium and were identified by serogrouping and MALTI-TOF-MS analysis. Antibiotic susceptibility/resistance test was performed for 20 S. agalactiae isolates, further phenotypic resistance pattern was observed for tetracycline, vancomycin, ampicillin and penicillin. Genotypically we found two antibiotic resistance genes such as Betalactem antibiotic resistance gene (Tem) (70%) and tetracycline resistance gene Tet(O) 15% in our isolates. Six virulence factors encoding genes were performed by PCR in twenty GBS isolates, cfb gene (100%), followed by, cylE(90.47%), lmp(85.7%), bca(71.42%), rib (38%) and low frequency in bac gene (4.76%) were determined. Most of the S. agalactiae isolates produced strong biofilm in the polystyrene surface (hydrophobic), and low-level biofilm formation was found in glass tube (hydrophilic) surface. lytR is secreted protein and localized in bacterial cell wall, extra cellular membrane, and cytoplasm. In silico docking studies were performed for lytR protein with four antibiofilm compounds, including a peptide (PR39) with the docking study showed peptide has strong interaction followed by ellagic acid and interaction length is 2.95, 2.97 and 2.95 A°. In ligand EGCGO10 and O11 two atoms intract with lytR (Leu271), with binding bond affinity length is 3.24 and 3.14. The aminoacid Leu 271 is act as an impartant aminoacid, since ellagic acid and EGCG interact with same aminoacid.

Keywords: antibiotics, biofilms, clinical isolates, S. agalactiae, virulence

Procedia PDF Downloads 108

Authors: Fumihiro Imai, Shinichi Watanabe, Shingo Maeda, Haruna Imai, Hiroki Niimi

Abstract:

It is important to know the growth rate of brain tumors before surgery because it influences treatment planning, including not only surgical resection strategy but also adjuvant therapy after surgery. Amide proton transfer (APT) imaging is an emerging molecular magnetic resonance imaging (MRI) technique based on chemical exchange saturation transfer without the administration of a contrast medium. The underlying assumption in APT imaging of tumors is that there is a close relationship between the proliferative activity of the tumor and mobile protein synthesis. We aimed to evaluate the diagnostic performance of APT imaging of pre-and post-treatment brain tumors. Ten patients with brain tumor underwent conventional and APT-weighted sequences on a 3.0 Tesla MRI before clinical intervention. The maximum and the minimum APT-weighted signals (APTWmax and APTWmin) in each solid tumor region were obtained and compared before and after a clinical intervention. All surgical specimens were examined for histopathological diagnosis. Eight of ten patients underwent adjuvant therapy after surgery. Histopathological diagnosis was glioma in 7 patients (WHO grade 2 in 2 patients, WHO grade 3 in 3 patients, and WHO grade 4 in 2 patients), meningioma WHO grade 1 in 2 patients, and primary lymphoma of the brain in 1 patient. High-grade gliomas showed significantly higher APTW signals than that low-grade gliomas. APTWmax in one huge parasagittal meningioma infiltrating into the skull bone was higher than that in glioma WHO grade 4. On the other hand, APTWmax in another convexity meningioma was the same as that in glioma WHO grade 3. Diagnosis of primary lymphoma of the brain was possible with APT imaging before pathological confirmation. APTW signals in residual tumors decreased dramatically within one year after adjuvant therapy in all patients. APT imaging demonstrated excellent diagnostic performance for the planning of surgery and adjuvant therapy of brain tumors.

Keywords: amides, magnetic resonance imaging, brain tumors, cell proliferation

Procedia PDF Downloads 86

Authors: Donald Zullick, Cihan Varol

Abstract:

This research paper begins with a look at current work in business continuity as it relates to the cloud and small to medium business (SMB). While cloud services are an emerging paradigm that is quickly making an impact on business, there has been no substantive research applied to SMB. Seeing this lapse, we have taken a fusion of continuity and cloud research with application to the SMB market. It is an initial reflection with base framework guidelines as a starting point for implementation. In this approach, our research ties together existing work and fill the gap with an SMB outlook.

Keywords: business continuity, cloud services, medium size business, risk assessment, small business

Procedia PDF Downloads 404