Search results for: injury predictor
Commenced in January 2007
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Edition: International
Paper Count: 1292

Search results for: injury predictor

302 Evaluation of the Gamma-H2AX Expression as a Biomarker of DNA Damage after X-Ray Radiation in Angiography Patients

Authors: Reza Fardid, Aliyeh Alipour

Abstract:

Introduction: Coronary heart disease (CHD) is the most common and deadliest diseases. A coronary angiography is an important tool for the diagnosis and treatment of this disease. Because angiography is performed by exposure to ionizing radiation, it can lead to harmful effects. Ionizing radiation induces double-stranded breaks in DNA, which is a potentially life-threatening injury. The purpose of the present study is an investigation of the phosphorylation of histone H2AX in the location of the double-stranded break in Peripheral blood lymphocytes as an indication of Biological effects of radiation on angiography patients. Materials and Methods: This method is based on measurement of the phosphorylation of histone (gamma-H2AX, gH2AX) level on serine 139 after formation of DNA double-strand break. 5 cc of blood from 24 patients with angiography were sampled before and after irradiation. Blood lymphocytes were removed, fixed and were stained with specific ϒH2AX antibodies. Finally, ϒH2AX signal as an indicator of the double-strand break was measured with Flow Cytometry Technique. Results and discussion: In all patients, an increase was observed in the number of breaks in double-stranded DNA after irradiation (20.15 ± 14.18) compared to before exposure (1.52 ± 0.34). Also, the mean of DNA double-strand break was showed a linear correlation with DAP. However, although induction of DNA double-strand breaks associated with radiation dose in patients, the effect of individual factors such as radiosensitivity and regenerative capacity should not be ignored. If in future we can measure DNA damage response in every patient angiography and it will be used as a biomarker patient dose, will look very impressive on the public health level. Conclusion: Using flow cytometry readings which are done automatically, it is possible to detect ϒH2AX in the number of blood cells. Therefore, the use of this technique could play a significant role in monitoring patients.

Keywords: coronary angiography, DSB of DNA, ϒH2AX, ionizing radiation

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301 The Impact of Co-Administration of Phosphodiesterase-5 Inhibitor and Sodium Selenite on Ischemia/Reperfusion Injury in a Rat Ovary Model: Biochemical and Histopathologic Evaluation

Authors: Waleed Aly Sayed Ahmed, Eman Kishk, Tahani Shams

Abstract:

Aim: To study the effects of co-administration of phosphodiesterase-5 inhibitor (PDE-5) and sodium selenite against the damage induced by ovarian ischemia-reperfusion in rats. Materials and Methods: A total of forty-two sexually mature, virgin, female rats were divided randomly into six groups of seven each: sham group (C), ischemia group (I), ischemia/reperfusion group (I/R), ischemia/reperfusion plus 1.4mg/kg sildenafil (I/R+S) group, ischemia/reperfusion plus 0.2mg/kg selenium (I/R+Se) group and ischemia/reperfusion plus combination of sildenafil and selenium (I/R+S+Se) group. In ischemia group (I), rats were exposed to ischemia for 3 hours (h). In ischemia/reperfusion group (I/R), rats were exposed to ischemia for 3 h followed by 6 h of reperfusion. Treated groups received 1.4mg/kg sildenafil or 0.2 mg/kg selenium or both 30 min before reperfusion. Both ovaries were surgically removed carefully. One ovary was examined for histopathological changes and the other was subject to biochemical analysis including malondialdehyde (MDA), catalase (CAT) and glutathione peroxidase (GPx). Results: Assessment of ovarian tissue damage using a scoring system showed marked vascular congestion, interstitial edema, leukocyte infiltration, hemorrhage, and follicular degeneration in ischemia and ischemia/reperfusion groups. Tissue damage score for I, IR and all treated groups were significantly higher than those of the sham group (p<0.001), while tissue damage score decreased significantly in I/R+S and I/R+Se groups compared to I/R group (p<0.05), and notably, the difference was highly significant in I/R+S+Se group (p<0.001). There was significant increase in MDA levels and reduction in activities of CAT and GPx in I/R group compared to the sham group (p < 0.05). In I/R+S and I/R+Se groups, MDA was significantly decreased compared to the I/R group (p<0.05) and the difference was highly significant with co-administration of sildenafil and selenium (p<0.001). CAT and GPx were higher in all treated groups compared to I/R group (p<0.05). Conclusion: The co-administration of sildenafil citrate and selenium are highly protective against damage induced by ovarian ischemia/reperfusion in rats.

Keywords: phosphodiesterase-5 inhibitor, sildenafil, antioxidant, selenium, ovarian ischemia

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300 Psychological Distress and Associated Factors among Patients Attending Orthopedic Unit of at Dilla University Referral Hospital in Ethiopia, 2022

Authors: Chalachew Kassaw, Henok Ababu, Bethelhem Sileshy, Lulu Abebe, Birhanie Mekuriaw

Abstract:

Background: Psychological discomfort is a state of emotional distress caused by everyday stressors and obligations that are difficult to manage. Orthopedic trauma has a wide range of effects on survivors' physical health, as well as a variety of mental health concerns that impede recovery. Psychiatric and behavioral conditions are 3-5 times more common in people who have undergone physical trauma, and they are a predictor of poor outcomes. Despite the above facts, there is a shortage of research done on the subject. Therefore, this study aimed to determine the magnitude of psychological distress and associated factor among patients attending orthopedic treatment at Gedeo zone, South Ethiopia 2022. Methods: A cross-sectional study was undertaken at Dilla University Referral Hospital from October –November 2022. The data was collected via a face-to-face interview, and the Kessler psychological distress scale (K-10) was used to assess psychological distress. A total of 386 patients receiving outpatient and inpatient services at the orthopedic unit were chosen using a simple random selection technique. A Statistical Package for the Social Science version 21 (SPSS-21) was used to enter and evaluate the data. To find related factors, bivariate, and multivariate logistic regressions were used. Variables having a p-value of less than 0.05 were deemed statistically significant. Result: A total of 386 participants with a response rate of 94.8% were included in the study. Out of all respondents, 114 (31.4%) of the individuals have experienced psychological distress. Independent variables such as Females [Adjusted odds ratio (AOR)=5.8, 95%CI=(4.6-15.6)], Average monthly income of <3500 birrs [Adjusted odds ratio (AOR) =4.8, 95% CI=(2.4-9.8) ], Current history of substance use [Adjusted odds ratio (AOR) =2.6, 95% CI=(1.66-4.7)], Strong social support [Adjusted odds ratio (AOR)=0.4, 95% CI= 0.4(0.2-0.8)], and Poor sleep quality (PSQI score>5) [Adjusted odds ratio (AOR)=2.0, 95%CI= 2.0(1.2-2.8)] were significantly associated with psychological distress. Conclusion: The prevalence of psychological distress was high. Being female, having poor social support, and having a high PSQI score were significantly associated factors with psychological distress. It is good if clinicians emphasize orthopedic patients, especially females and those having poor social support and low sleep quality symptoms.

Keywords: psychological distress, orthopedic unit, Dilla University hospital, Dilla Town, Southern Ethiopia

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299 Nanoparticle Induced Neurotoxicity Mediated by Mitochondria

Authors: Nandini Nalika, Suhel Parvez

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Nanotechnology has emerged to play a vital role in developing all through the industrial world with an immense production of nanomaterials including nanoparticles (NPs). Many toxicological studies have confirmed that due to unique small size and physico-chemical properties of NPs (1-100nm), they can be potentially hazardous. Metallic NPs of small size have been shown to induce higher levels of cellular oxidative stress and can easily pass through the Blood Brain Barrier (BBB) and significantly accumulate in brain. With the wide applications of titanium dioxide nanoparticles (TNPs) in day-to-day life in form of cosmetics, paints, sterilisation and so on, there is growing concern regarding the deleterious effects of TNPs on central nervous system and mitochondria appear to be important cellular organelles targeted to the pro-oxidative effects of NPs and an important source that contribute significantly for the production of reactive oxygen species after some toxicity or an injury. The aim of our study was to elucidate the effect of TNPs in anatase form with different concentrations (5-50 µg/ml) following with various oxidative stress markers in isolated brain mitochondria as an in vitro model. Oxidative stress was determined by measuring the different oxidative stress markers like lipid peroxidation as well as the protein carbonyl content which was found to be significantly increased. Reduced glutathione content and major glutathione metabolizing enzymes were also modulated signifying the role of glutathione redox cycle in the pathophysiology of TNPs. The study also includes the mitochondrial enzymes (Complex 1, Complex II, complex IV, Complex V ) and the enzymes showed toxicity in a relatively short time due to the effect of TNPs. The study provide a range of concentration that were toxic to the neuronal cells and data pointing to a general toxicity in brain mitochondria by TNPs, therefore, it is in need to consider the proper utilization of NPs in the environment.

Keywords: mitochondria, nanoparticles, brain, in vitro

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298 Effects of Hydroxysafflor Yellow a (HSYA) on UVA-Induced Damage in HaCaT Keratinocytes

Authors: Szu-Chieh Yu, Pei-Chin Chiand, Chih-Yi Lin, Yi-Wen Chien

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UV radiation from sunlight cause numbers of acute and chronic skin damage which can result in inflammation, immune changes, physical changes and DNA damage that facilitates skin aging and the development of skin carcinogenesis. Reactive oxygen species (ROS) are generated by excessive solar UV radiation, resulting in oxidative damage to cellar components, proteins, lipids, and nucleic acids. Thus, antioxidation plays an important role that protects skin against ROS-induced injury. Safflower (Carthamus tinctorius L.) is an important Chinese medicine contained abundance flavones and hydroxysafflor yellow A (HSYA) which is main active ingredient. HSYA is part of quinochalcone and has unique structures of hydroxy groups that provided the antioxidant effect. In this study, the aim was to investigate the protective role of HYSA in human keratinocytes (HaCaT) against UVA-induced oxidative damage and the possible mechanism. The HaCaT cells were UVA-irradiated and the effects of HYSA on cell viability, reactive oxygen species generation, DNA fragmentation and lipid peroxidation were measured. The mRNA expression of matrix metalloproteinase Ι (MMP Ι), cyclooxygenase-2 (COX-2) were determined by RT-PCR. In this study, UVA exposure lead to decrease in cell viability and increase in reactive oxygen species generation in HaCaT cells. HYSA could effectively increase the viability of HaCaT cells after UVA exposure and protect them from UVA-induced oxidative stress. Moreover, HYSA can reduce inflammation through inhibition the mRNA expression of MMP Ι and COX-2. Our results suggest that HSYA can act as a free radical scavenger while keratinocytes were photodamaged. HYSA could be a useful natural medicine for the protection of epidermal cells from UVA-induced damage and will be developed into products for skin care.

Keywords: HaCaT keratinocytes, hydroxysafflor yellow A (HSYA), MMP Ι, oxidative stress

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297 Immunolabeling of TGF-β during Muscle Regeneration

Authors: K. Nikovics, D. Riccobono, M. Oger, H. Morin, L. Barbier, T. Poyot, X. Holy, A. Bendahmane, M. Drouet, A. L. Favier

Abstract:

Muscle regeneration after injury (as irradiation) is of great importance. However, the molecular and cellular mechanisms are still unclear. Cytokines are believed to play fundamental role in the different stages of muscle regeneration. They are secreted by many cell populations, but the predominant producers are macrophages and helper T cells. On the other hand, it has been shown that adipose tissue derived stromal/stem cell (ASC) injection could improve muscle regeneration. Stem cells probably induce the coordinated modulations of gene expression in different macrophage cells. Therefore, we investigated the patterns and timing of changes in gene expression of different cytokines occurring upon stem cells loading. Muscle regeneration was studied in an irradiated muscle of minipig animal model in presence or absence of ASC treatment (irradiated and treated with ASCs, IRR+ASC; irradiated not-treated with ASCs, IRR; and non-irradiated no-IRR). We characterized macrophage populations by immunolabeling in the different conditions. In our study, we found mostly M2 and a few M1 macrophages in the IRR+ASC samples. However, only few M2b macrophages were noticed in the IRR muscles. In addition, we found intensive fibrosis in the IRR samples. With in situ hybridization and immunolabeling, we analyzed the cytokine expression of the different macrophages and we showed that M2d macrophage are the most abundant in the IRR+ASC samples. By in situ hybridization, strong expression of the transforming growth factor β (TGF-β) was observed in the IRR+ASC but very week in the IRR samples. But when we analyzed TGF-β level with immunolabeling the expression was very different: many M2 macrophages showed week expression in IRR+ASC and few cells expressing stronger level in IRR muscles. Therefore, we investigated the MMP expressions in the different muscles. Our data showed that the M2 macrophages of the IRR+ASC muscle expressed MMP2 proteins. Our working hypothesis is that MMP2 expression of the M2 macrophages can decrease fibrosis in the IRR+ASC muscle by capturing TGF-β.

Keywords: adipose tissue derived stromal/stem cell, cytokine, macrophage, muscle regeneration

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296 Consolidated Predictive Model of the Natural History of Breast Cancer Considering Primary Tumor and Secondary Distant Metastases Growth

Authors: Ella Tyuryumina, Alexey Neznanov

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This study is an attempt to obtain reliable data on the natural history of breast cancer growth. We analyze the opportunities for using classical mathematical models (exponential and logistic tumor growth models, Gompertz and von Bertalanffy tumor growth models) to try to describe growth of the primary tumor and the secondary distant metastases of human breast cancer. The research aim is to improve predicting accuracy of breast cancer progression using an original mathematical model referred to CoMPaS and corresponding software. We are interested in: 1) modelling the whole natural history of the primary tumor and the secondary distant metastases; 2) developing adequate and precise CoMPaS which reflects relations between the primary tumor and the secondary distant metastases; 3) analyzing the CoMPaS scope of application; 4) implementing the model as a software tool. The foundation of the CoMPaS is the exponential tumor growth model, which is described by determinate nonlinear and linear equations. The CoMPaS corresponds to TNM classification. It allows to calculate different growth periods of the primary tumor and the secondary distant metastases: 1) ‘non-visible period’ for the primary tumor; 2) ‘non-visible period’ for the secondary distant metastases; 3) ‘visible period’ for the secondary distant metastases. The CoMPaS is validated on clinical data of 10-years and 15-years survival depending on the tumor stage and diameter of the primary tumor. The new predictive tool: 1) is a solid foundation to develop future studies of breast cancer growth models; 2) does not require any expensive diagnostic tests; 3) is the first predictor which makes forecast using only current patient data, the others are based on the additional statistical data. The CoMPaS model and predictive software: a) fit to clinical trials data; b) detect different growth periods of the primary tumor and the secondary distant metastases; c) make forecast of the period of the secondary distant metastases appearance; d) have higher average prediction accuracy than the other tools; e) can improve forecasts on survival of breast cancer and facilitate optimization of diagnostic tests. The following are calculated by CoMPaS: the number of doublings for ‘non-visible’ and ‘visible’ growth period of the secondary distant metastases; tumor volume doubling time (days) for ‘non-visible’ and ‘visible’ growth period of the secondary distant metastases. The CoMPaS enables, for the first time, to predict ‘whole natural history’ of the primary tumor and the secondary distant metastases growth on each stage (pT1, pT2, pT3, pT4) relying only on the primary tumor sizes. Summarizing: a) CoMPaS describes correctly the primary tumor growth of IA, IIA, IIB, IIIB (T1-4N0M0) stages without metastases in lymph nodes (N0); b) facilitates the understanding of the appearance period and inception of the secondary distant metastases.

Keywords: breast cancer, exponential growth model, mathematical model, metastases in lymph nodes, primary tumor, survival

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295 Magnetic Navigation in Underwater Networks

Authors: Kumar Divyendra

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Underwater Sensor Networks (UWSNs) have wide applications in areas such as water quality monitoring, marine wildlife management etc. A typical UWSN system consists of a set of sensors deployed randomly underwater which communicate with each other using acoustic links. RF communication doesn't work underwater, and GPS too isn't available underwater. Additionally Automated Underwater Vehicles (AUVs) are deployed to collect data from some special nodes called Cluster Heads (CHs). These CHs aggregate data from their neighboring nodes and forward them to the AUVs using optical links when an AUV is in range. This helps reduce the number of hops covered by data packets and helps conserve energy. We consider the three-dimensional model of the UWSN. Nodes are initially deployed randomly underwater. They attach themselves to the surface using a rod and can only move upwards or downwards using a pump and bladder mechanism. We use graph theory concepts to maximize the coverage volume while every node maintaining connectivity with at least one surface node. We treat the surface nodes as landmarks and each node finds out its hop distance from every surface node. We treat these hop-distances as coordinates and use them for AUV navigation. An AUV intending to move closer to a node with given coordinates moves hop by hop through nodes that are closest to it in terms of these coordinates. In absence of GPS, multiple different approaches like Inertial Navigation System (INS), Doppler Velocity Log (DVL), computer vision-based navigation, etc., have been proposed. These systems have their own drawbacks. INS accumulates error with time, vision techniques require prior information about the environment. We propose a method that makes use of the earth's magnetic field values for navigation and combines it with other methods that simultaneously increase the coverage volume under the UWSN. The AUVs are fitted with magnetometers that measure the magnetic intensity (I), horizontal inclination (H), and Declination (D). The International Geomagnetic Reference Field (IGRF) is a mathematical model of the earth's magnetic field, which provides the field values for the geographical coordinateson earth. Researchers have developed an inverse deep learning model that takes the magnetic field values and predicts the location coordinates. We make use of this model within our work. We combine this with with the hop-by-hop movement described earlier so that the AUVs move in such a sequence that the deep learning predictor gets trained as quickly and precisely as possible We run simulations in MATLAB to prove the effectiveness of our model with respect to other methods described in the literature.

Keywords: clustering, deep learning, network backbone, parallel computing

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294 Maternal Health Care Mirage: A Study of Maternal Health Care Utilization for Young Married Muslim Women in India

Authors: Saradiya Mukherjee

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Background: Indian Muslims, compared to their counterparts in other religions, generally do not fare well on many yardsticks related to socio-economic progress and the same is true with maternal health care utilization. Due to low age at marriage a major percentage of child birth is ascribed to young (15-24 years) Muslim mothers in, which pose serious concerns on the maternal health care of Young Married Muslim women (YMMW). A thorough search of past literature on Muslim women’s health and health care reveals that studies in India have mainly focused on religious differences in fertility levels and contraceptive use while the research on the determinants of maternal health care utilization among Muslim women are lacking in India. Data and Methods: Retrieving data from the National Family Health Survey -3 (2005-06) this study attempts to assess the level of utilization and factors effecting three key maternal health indicators (full ANC, safe delivery and PNC) among YMMW (15-24 years) in India. The key socio-economic and demographic variables taken as independent or predictor variables in the study was guided by existing literature particularly for India. Bi-variate analysis and chi square test was applied and variables which were found to be significant were further included in binary logistic regression. Results: The findings of the study reveal abysmally low levels of utilization for all three indicators i.e. full ANC, safe delivery and PNC of maternal health care included in the study. Mother’s education, mass media exposure, women’s autonomy, birth order, economic status wanted status of child and region of residence were found to be significant variables effecting maternal health care utilization among YMMW. Multivariate analysis reveals that no mass media exposure, lower autonomy, education, poor economic background, higher birth order and unintended pregnancy are some of the reasons behind low maternal health care utilization. Conclusion: Considering the low level of safe maternal health care utilization and its proximate determinants among YMMW the study suggests educating Muslim girls, promoting family planning use, involving media and collaboration between religious leader and health care system could be some important policy level interventions to address the unmet need of maternity services among YMMW.

Keywords: young Muslim women, religion, socio-economic condition, antenatal care, delivery, post natal care

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293 Association between Physical Composition, Swimming Performance and Somatotype of Male Competitive Swimmers of Age Group 10-13 Years

Authors: Ranjit Singh

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Body fat % lean body mass and body type play vital role in sports performance. A sports person who is having optional body composition can show its performance flawlessly whereas other who is not physical fit may be more prone to injury. Competitive swimming is an association of plethora of aspects like morphological, physiological, biochemical, biomechanical and psychological. The primary key of the present research is to examine the correlation among selected morphological dimensions such as height, weight, body fat%, lean body mass, somatotype and swimming performance. The present study also focused to investigate by potential deficiencies if any and to find out remedial measures to curb the training stresses. Thirty (age group 10-14 years) swimmers undergoing training under skilled and professional coaches were selected in the present study. The morphological variables and performance criterion like 50 meter swimming time and speed were calculated by using standard training methodology. Correlation coefficient among body composition, somatotype and performance variables were assessed by using standard statistical package SPSS. Mean height, weight, fat% and lean body mass of the present group is 150.97±8.68 cm, 44.0±9.34 kg., 15.97±4.42 % and 37.10±8.77 kg respectively. Somatotype of the young swimmers of this research is revealed ectomorphic mesomorph. The analysis of the results Illustrated that swimming performance is significantly correlated (p<0.05) with height, body weight, mesomorphoic component and lean body mass. Body fat is significantly and negatively correlated (p<0.05) with mesomorphic component, lean body mass and swimming speed. From this present study, it can be concluded that along with techniques and tactics other the physical attributes also play significant role in swimming performance which can help the swimmers to excel in higher level of competition and swimmers having improved morphological qualities can ultimately perform well.

Keywords: body fat, mass, mesomorphic component, somatotype

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292 Efficacy of Light-Emitting Diode-Mediated Photobiomodulation in Tendon Healing in a Murine Model

Authors: Sukwoong Kang

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Background: The application of light-emitting diode (LED)-dependent photobiomodulation (PBM) in promoting post-tendon injury healing has been recently reported. Despite the establishment of a theoretical basis for ligament restoration through PBM, the lack of any empirical evidence deems this therapeutic strategy contentious. Therefore, the aim of this study was to investigate the potency of LED-based PBM in facilitating tendon healing in a murine model. Methods: Migration kinetics were analyzed at two specific wavelengths: 630 and 880 nm. The Achilles tendon in the hind limbs of Balb/c mice was severed via Achilles tendon transection. Subsequently, the mice were randomized into LED non-irradiation and LED irradiation groups. Mice with intact tendons were employed as healthy controls. The wounds were LED-irradiated for 20 min daily for two days. Histological properties, tendon healing mediators, and inflammatory mediators were screened on day 14. Results: The roundness of the nuclei and fiber structure, indicating the degree of infiltrated inflammatory cells and severity of fiber fragmentation, respectively, were considerably lower in the LED irradiation group than in the LED non-irradiation group. Immunohistochemical analysis depicted an increase in tenocytes (SCX+ cells) and a recovery of wounds with reduced fibrosis (lower collagen 3 and TGF-β1) in the LED irradiation group during healing; conversely, the LED non-irradiation group exhibited tissue fibrosis. The ratio of M2 macrophages to total macrophages was higher in the LED irradiation group than in the injured group. Conclusion: LED-based PBM in the Achilles tendon rupture murine model effectuated a rapid restoration of histological and immunochemical outcomes. The aforementioned findings suggest that LED-based PBM presents remarkable potential as an adjunct therapeutic for tendon healing and warrants further research to standardize various parameters to advance and establish it as a reliable treatment regime.

Keywords: photobiomodulation, light-emitting diode, tendon, regeneration

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291 Two-Way Reminder Systems to Support Activities of Daily Living for Adults with Cognitive Impairments: A Scoping Review

Authors: Julia Brudzinski, Ashley Croswell, Jade Mardin, Hannah Shilling, Jennifer Berg-Carnegie

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Adults with brain injuries and mental illnesses commonly experience cognitive impairments that interfere with their participation in activities of daily living (ADLs). Prior research states that electronic reminder systems can support adults with cognitive impairments; however, previous studies focus primarily on one-way reminder systems. Research on adults with chronic diseases reported that two-way reminder systems yield better health outcomes and disease self-management compared to one-way reminder systems. Literature was identified through systematically searching 7 databases and hand-searching relevant reference lists. Retrieved studies were independently screened and reviewed by at least two members of the research team. Data was extracted on study design, participant characteristics, intervention details, study objectives, outcome measures, and important results. 574 articles were screened and reviewed. Nine articles met all inclusion criteria and were included. The literature focused on three main areas: system feasibility (n=8), stakeholder satisfaction (n=6), and efficacy of the two-way reminder systems (n=6). Participants in eight of the studies had brain injuries, with participants in only one study having a mental illness (i.e., schizophrenia). Two-way reminder systems were used to support participation in a wide range of ADLs. The current literature on two-way reminder systems to support ADLs for adults with cognitive impairments focuses on feasibility, stakeholder satisfaction, and system efficacy. Future research should focus on addressing the barriers to accessing and implementing two-way reminder systems and identifying specific client characteristics that would benefit most from using these systems.

Keywords: brain injury, digital health, occupational therapy, activities of daily living, two-way reminder systems

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290 Biomimetic Strategies to Design Non-Toxic Antimicrobial Textiles

Authors: Isabel Gouveia

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Antimicrobial textile materials may significantly reduce the risk of infections and because they are able to absorb substances from the skin and release therapeutic compounds to the skin, they can also find applications as complementary therapy of skin-diseases as part of standard management. Although functional textiles may be a promising area in skin disease/injury management, as part of standard management, few offer complementary treatment even though they are well known to reduce scratching and aiding emollient absorption, reducing infection, and alleviating pruritus. The reason for this may rely on the low quality of supporting evidence and negative effect that antimicrobial agents may exert on skin microbiome, as for example additional irritation of the vulnerable skin, and by causing resistant bacteria. Several antimicrobial agents have been tested in textiles: quaternary ammonium compounds, silver, polyhexamethylene-biguanides and triclosan have been used, with success. They have powerful bactericidal activity but the majority have a reduce spectrum of microbial inhibition and may cause skin irritation, ecotoxicity and bacteria resistance. Furthermore, the rising flow of strains resistant to last-resort antibiotics rekindles interest in alternative strategies. In this regard, new functional textiles incorporating highly specific antimicrobial agents towards pathogenic bacteria, are required. Recent research has been conducted on naturally occurring antimicrobials as novel alternatives to antibiotics. Conscious of this need our team firstly reported new approaches using L-cysteine and antimicrobial peptides (AMP). Briefly, we were able to develop different immobilization processes towards 6 Log Reduction against bacteria such as S. aureus and K. pneumoniae. Therefore, here we present several innovative antimicrobial textiles incorporating AMP and L-Cysteine which may open new avenues for the medical textiles market and biomaterials in general. Team references will be discussed as an overview and for comparison purposes in terms of potential therapeutic applications.

Keywords: Antimicrobials, Antimicrobial Textiles, Biomedical Textiles, Biomimetic surface functionalization

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289 Microalbuminuria in Patients with Hypertension Visiting Tertiary Care Centre, Western Nepal

Authors: Binaya Tamang, Buddhi R. Pokharel, Narayan Gautam, Puspa R. Dhakal, Yuresh Twayana

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Background and Objective: Microalbuminuria is often regarded as a sign of end-organ damage due to hypertension, with an increased risk for renal diseases. The present study was designed to find the prevalence of microalbuminuria in hypertensive patients by determining albumin creatinine ratio (ACR) and the association of ACR and microalbuminuria status with different stages and duration of hypertension (HTN). Also, to establish the correlation of systolic and diastolic blood pressure (SBP and DBP) with various parameters viz; ACR, urinary microalbumin (UMA), estimated glomerular filtration rate (eGFR), urinary creatinine (Ucreat), serum creatinine (Screat), and find out their significance among HTN and ACR status. Materials and Methods: A hospital-based cross-sectional study was conducted in the Department of Biochemistry in collaboration with the Department of Internal Medicine, UCMS, Bhairahawa, Nepal from April 2019 to September 2019 after obtaining ethical approval from institutional review committee (IRC), UCMS. A total of 120 hypertensive patients were enrolled whose blood, and spot urine samples were taken. eGFR was calculated by using Cockcroft-Gault formula after determining Screat while ACR was calculated after measuring Ucreat and UMA from the spot urine sample. Creatinine was estimated from modified jaffes’ reaction, whereas urinary micro albumin was done by Mispa i3 analyzer. Data were analyzed by using SPSS. 20 using p-value ≤ 0.05 as statistically significant. Results: In our study, the highest enrolled were grade II HTN (36.7%) followed by normal (33.3%), grade I (20.8%) and grade III (9.2%). Evaluating the ACR status, 19.2% were microalbuminuria, and the rest were normal. Though the ACR status (normal and microalbuminuria) was not statistically significant with HTN status (P=0.860) and the duration of HTN status (P=0.165), 5 (45.5%) out of 11 grade III HTN were microalbuminuria and the prevalence was also higher for longer duration .i.e., more than 10 years. In microalbuminuria, both the SBP (p=0.023, r=0.471) and DBP (P=0.034, r= 0.444) were strongly and positively correlated with Screat, in contrast to eGFR, which was negatively but weakly correlated. With the significant difference between the HTN group, the mean ACR (P=0.047) and UMA (P=0.02) were found to be highest among grade III patients, i.e., 84.3 ± 113.3 mg/gm. and 88.4 ± 83.9 mg/l respectively. The mean eGFR (64.2 ± 24.8 vs 77.2 ± 18.1 ml/min) was considerably lower in microalbuminuria ( p=0.026) than the normal in contrast to the SBP (160 ± 33.7 vs. 146.6 ± 19.5 mm of Hg) which was significantly higher (P=0.008). Among the different BMI category, the mean ACR was found to be significantly different (P= 0.01) with the highest value in underweight (115.2 ± 51.5 mg/gm.) and lowest in overweight (31.8 ± 4.3 mg/gm.). Conclusion: The study recommends that the microalbuminuria can be a very useful and imperative predictor of deranged kidney functions in hypertensive patients. The high value of ACR and UMA in hypertensive patients along with significant increased Screat, SBP whereas decreased eGFR in microalbuminuria patients explicitly supports the above statement.

Keywords: albumin creatinine ratio, hypertension, microalbuminuria, renal disease

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288 Perceived Criticism, Anxiety Disorders, Substance Use Disorders in Women with Borderline Personality Disorders

Authors: Ipek Sensu

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Comorbid Axis I disorders are highly common for suicidal borderline personality disorder (BPD) patients, especially substance use disorder and anxiety disorders. Since interpersonal dysfunction is one of the core symptoms in BPD, the purpose of the current study is to examine perceived criticism and anxiety disorders and also substance abuse disorders (SUD) for women with borderline personality disorder (BPD) who attempt suicide at least once in their lifetime. In the current study, it was suggested that the perceived criticism from others and being upset by criticism differ between suicidal women with BPD with comorbidity of anxiety disorders and SUD (separately) and suicidal women with BPD without anxiety disorders and without SUD (separately). The participants in this study included ninety-nine women who have already been diagnosed with borderline personality disorder and also have had at least two episodes of deliberate self-harm, in other words, suicide attempts and/or non-suicidal self-injury (NSSI) in the last five years and at least one episode in the 8-week period before joining the research study and at least one suicide attempt in the previous year. Structured Clinical Interview for DSM-IV Axis I Disorders (SCID) and Social History Interview (SHI) were conducted to determine the comorbid axis I disorders and level of perceived criticism. As a result of the independent sample t-tests, the first hypothesis was rejected, in other words, women with BPD and a comorbid anxiety disorder did not show significantly higher levels of ‘criticized by others’, compared to women with BPD alone. However, the levels of ‘upset at criticism’ were significantly different between suicidal women with BPD with or without any anxiety disorders, which is the second hypothesis. In addition, the third hypothesis was also accepted; this means, women with BPD who had any substance use dependence would show significantly higher levels of 'criticized by others' compared to women with BPD alone. Finally, the fourth hypothesis was partly accepted: that is, women with BPD with alcohol dependence had significantly higher levels of ‘how upset when they expose to criticism’, compared to those without alcohol dependence. Limitations, implications, and directions for future research are discussed.

Keywords: anxiety disorders, borderline personality disorders, perceived criticism, substance use disorders

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287 Predicting Resistance of Commonly Used Antimicrobials in Urinary Tract Infections: A Decision Tree Analysis

Authors: Meera Tandan, Mohan Timilsina, Martin Cormican, Akke Vellinga

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Background: In general practice, many infections are treated empirically without microbiological confirmation. Understanding susceptibility of antimicrobials during empirical prescribing can be helpful to reduce inappropriate prescribing. This study aims to apply a prediction model using a decision tree approach to predict the antimicrobial resistance (AMR) of urinary tract infections (UTI) based on non-clinical features of patients over 65 years. Decision tree models are a novel idea to predict the outcome of AMR at an initial stage. Method: Data was extracted from the database of the microbiological laboratory of the University Hospitals Galway on all antimicrobial susceptibility testing (AST) of urine specimens from patients over the age of 65 from January 2011 to December 2014. The primary endpoint was resistance to common antimicrobials (Nitrofurantoin, trimethoprim, ciprofloxacin, co-amoxiclav and amoxicillin) used to treat UTI. A classification and regression tree (CART) model was generated with the outcome ‘resistant infection’. The importance of each predictor (the number of previous samples, age, gender, location (nursing home, hospital, community) and causative agent) on antimicrobial resistance was estimated. Sensitivity, specificity, negative predictive (NPV) and positive predictive (PPV) values were used to evaluate the performance of the model. Seventy-five percent (75%) of the data were used as a training set and validation of the model was performed with the remaining 25% of the dataset. Results: A total of 9805 UTI patients over 65 years had their urine sample submitted for AST at least once over the four years. E.coli, Klebsiella, Proteus species were the most commonly identified pathogens among the UTI patients without catheter whereas Sertia, Staphylococcus aureus; Enterobacter was common with the catheter. The validated CART model shows slight differences in the sensitivity, specificity, PPV and NPV in between the models with and without the causative organisms. The sensitivity, specificity, PPV and NPV for the model with non-clinical predictors was between 74% and 88% depending on the antimicrobial. Conclusion: The CART models developed using non-clinical predictors have good performance when predicting antimicrobial resistance. These models predict which antimicrobial may be the most appropriate based on non-clinical factors. Other CART models, prospective data collection and validation and an increasing number of non-clinical factors will improve model performance. The presented model provides an alternative approach to decision making on antimicrobial prescribing for UTIs in older patients.

Keywords: antimicrobial resistance, urinary tract infection, prediction, decision tree

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286 Correlation between Flexible Flatfoot and Lumbosacral Angle

Authors: Moustafa Elwan, Sohier Shehata, Fatma Sedek, Manar Hussine

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One of the most risky factors that lead to a foot injury during physical activities are both high and low arched feet. Normally the medial longitudinal arch of the foot develops in the first 10 years of life, so flexible flat foot has an inversely relationship with age in the first decade, all over the world, the prevalence of flat foot is increasing. In approximately 15% of foot deformities cases, the deformity does not disappear and remains throughout adulthood, 90% of the clinical cases are complaining from foot problems are due to flatfoot. Flatfoot creates subtalar over pronation, which creates tibial and femoral medial rotation, and that is accompanied with increases of pelvic tilting anteriorly, which may influence the lumbar vertebrae alignment by increasing muscle tension and rotation. Objective: To study the impact of the flexible flatfoot on lumbosacral angle (angle of Ferguson). Methods: This experiment included 40 volunteers (14 females &26 males) gathered from the Faculty of Physical Therapy, Modern University of Technology and Information, Cairo, Egypt, for each participant, four angles were measured in the foot( talar first metatarsal angle, lateral talocalcaneal angle, , Calcaneal first metatarsal angle, calcaneal inclination angle) and one angle in the lumbar region (lumbosacral angle). Measurement of these angles was conducted by using Surgimap Spine software (version 2.2.9.6). Results: The results demonstrated that there was no significant correlation betweenFerguson angle and lateral talocalcaneal (r=0.164, p=0.313). Also, there was no significant correlation between Ferguson angle and talo first metatarsal “Meary’s angle" (r=0.007, p=0.968). Moreover, there was no significant correlation between Ferguson angle and calcaneal-first metatarsal angle (r=0.083, p=0.612). Also, there was no significant correlation between Ferguson angle and calcaneal inclination angle (r= 0.032, p= 0.846). Conclusion: It can be concluded that there is no significant correlation between the flexible flat foot and lumbosacral angle So, more study should be conducted in large sample and different ages and conditions of foot problems.

Keywords: calcaneal first metatarsal, calcaneal inclination, flatfoot, ferguson’s angle, lateral talocalcaneal angle, lumbosacral angle, and talar first metatarsal angle

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285 Contribution of mTOR to Oxidative/Nitrosative Stress via NADPH Oxidase System Activation in Zymosan-Induced Systemic Inflammation in Rats

Authors: Seyhan Sahan-Firat, Meryem Temiz-Resitoglu, Demet Sinem Guden, Sefika Pinar Kucukkavruk, Bahar Tunctan, Ayse Nihal Sari, Zumrut Kocak

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We hypothesized that mTOR inhibition may prevent the multiple organ failures following severe multiple tissue injury associated with increased NADPH oxidase system activity occur in zymosan-induced systemic inflammation. Therefore, we investigated the role of mTOR in oxidative/nitrosative stress associated with increase in NADPH oxidase activity in zymosan-induced systemic inflammation model in rats. Male Wistar rats received saline (4 ml/kg, i.p.) and zymosan (500 mg/kg, i.p.) at time 0. Saline, or zymosan-treated rats were given rapamycin (1 mg/kg, i.p.) 1 h after saline or zymosan injections. Rats were sacrified 4 h after zymosan challenge and kidney, heart, thoracic aorta, and superior mesenteric artery were collected. NADPH oxidase activity, p22phox, gp91phox, and p47phox protein expression and nitrotyrosine levels were measured in tissue samples. Zymosan administration caused an increase in NADPH oxidase activity, p22phox, gp91phox, and p47phox protein expression and nitrotyrosine levels in kidney, heart, thoracic aorta, and superior mesenteric artery. These changes caused by zymosan reversed by rapamycin, a selective mTOR inhibitor. Rapamycin alone had no effect on the parameters measured. Our results demonstrated that zymosan-induced oxidative/nitrosative stress presumably due to enhanced activity of NADPH oxidase, expression of p22phox, gp91phox, and p47phox and production of peroxynitrite were mediated by mTOR. [This work was financially supported by Research Foundation of Mersin University (2016-2-AP3-1900)].

Keywords: oxidative stress, mTOR, nitrosative stress, zymosan

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284 Utility of Executive Function Training in Typically Developing Adolescents and Special Populations: A Systematic Review of the Literature

Authors: Emily C. Shepard, Caroline Sweeney, Jessica Grimm, Sophie Jacobs, Lauren Thompson, Lisa L. Weyandt

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Adolescence is a critical phase of development in which individuals are prone to more risky behavior while also facing potentially life-changing decisions. The balance of increased behavioral risk and responsibility indicates the importance of executive functioning ability. In recent years, executive function training has emerged as a technique to enhance this cognitive ability. The aim of the present systematic review was to discuss the reported efficacy of executive functioning training techniques among adolescents. After reviewing 3110 articles, a total of 24 articles were identified which examined the role of executive functioning training techniques among adolescents (age 10-19). Articles retrieved demonstrated points of comparison across psychiatric and medical diagnosis, location of training, and stage of adolescence. Typically developing samples, as well as those with attention-deficit hyperactivity disorder (ADHD), autism spectrum disorder (ASD), conduct disorder, and physical health concerns were found, allowing for the comparison of the efficacy of techniques considering physical and psychological heterogeneity. Among typically developing adolescents, executive functioning training yielded nonsignificant or low effect size improvements in executive functioning, and in some cases executive functioning ability was decreased following the training. In special populations, including those with ADHD, (ASD), conduct disorder, and physical health concerns significant differences and larger effect sizes in executive functioning were seen following treatment, particularly among individuals with ADHD. Future research is needed to identify the long-term efficacy of these treatments, as well as their generalizability to real-world conditions.

Keywords: adolescence, attention-deficit hyperactivity disorder, executive function, executive function training, traumatic brain injury

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283 Assessing the Impact of Construction Projects on Disabled Accessibility and Inclusion

Authors: Yasser Aboel-Magd

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This research addresses the critical issue of accessibility for individuals with special needs and the broader implications of disability on one's ability to lead an independent and integrated life within society. It highlights the consequences of injury, illness, or disability not only on the physical level but also on psychological, social, educational, economic, and functional aspects of life. The study emphasizes the importance of inclusive design in urban spaces, reflecting on how a society's treatment of individuals with disabilities serves as a measure of its progress. The research delves into the challenges faced by people with special needs in the Kingdom, where, despite advancements in various sectors, there is a noticeable lack of accommodating public opportunities for this significant demographic. It argues for the necessity of a Saudi building code that considers the needs of a diverse population during the design phase. The paper discusses the role of urban space as a fundamental element in urban formation and its impact on the societal integration of individuals with special needs. The study explores a variety of inclusive design principles, ranging from physical features like ramps and tactile paving to digital and cognitive accessibility measures such as screen readers, closed captions, plain language, and visual aids. It also considers the impact of wayfinding and appropriate lighting design on the orientation and assistance of individuals within urban spaces at the lowest cost. The researchers connect inclusive design with sustainable practices, advocating for environments that are not only environmentally friendly but also adaptable and lasting. The paper concludes with the assertion that the integration of accessibility, universal design, and sustainability signifies a society's commitment to inclusivity and the empowerment of all individuals, paving the way for a future where everyone can participate fully and independently in society.

Keywords: accessibility, inclusive design, Saudi building code, disability inclusion, socioeconomic progress

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282 Structural and Morphological Characterization of Inorganic Deposits in Spinal Ligaments

Authors: Sylwia Orzechowska, Andrzej Wróbel, Eugeniusz Rokita

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The mineralization is a curious problem of connective tissues. Factors which may play a decisive role in the regulation of the yellow ligaments (YL) mineralization are still open questions. The aim of the studies was a detailed description of the chemical composition and morphology of mineral deposits in the human yellow ligaments. Investigations of the structural features of deposits were used to explain the impact of various factors on mineralization process. The studies were carried out on 24 YL samples, surgically removed from patients suffer from spinal canal stenosis and the patients who sustained a trauma. The micro-computed tomography was used to describe the morphology of mineral deposits. The X-ray fluorescence method and Fourier transform infrared spectroscopy were applied to determine the chemical composition of the samples. In order to eliminate the effect of blur in microtomographic images, the correction method of partial volume effect was used. The mineral deposits appear in 60% of YL samples, both in patients with a stenosis and following injury. The mineral deposits have a heterogeneous structure and they are a mixture of the tissue and mineral grains. The volume of mineral grains amounts to (1.9 ± 3.4)*10-3 mm3 while the density distribution of grains occurs in two distinct ranges (1.75 - 2.15 and 2.15-2.5) g/cm3. Application of the partial volume effect correction allows accurate calculations by eliminating the averaging effect of gray levels in tomographic images. The B-type carbonate-containing hydroxyapatite constitutes the mineral phase of majority YLs. The main phase of two samples was calcium pyrophosphate dihydrate (CPPD). The elemental composition of minerals in all samples is almost identical. This pathology may be independent on the spine diseases and it does not evoke canal stenosis. The two ranges of grains density indicate two stages of grains growth and the degree of maturity. The presence of CPPD crystals may coexist with other pathologies.

Keywords: FTIR, micro-tomography, mineralization, spinal ligaments

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281 A Collaborative Approach to Improving Mental and Physical Health-Related Outcomes for a Heart Transplant Patient Through Music and Art Therapy Treatment

Authors: Elizabeth Laguaite, Alexandria Purdy

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Heart transplant recipients face psycho-physiological stressors, including pain, lengthy hospitalizations, delirium, and existential crises. They pose an increased risk for Post Traumatic Stress Disorder (PTSD) and can be a predictor of poorer mental and physical Health-Related Quality of Life (HRQOL) outcomes and increased mortality. There is limited research on the prevention of Post Traumatic Stress Symptoms (PTSS) in transplant patients. This case report focuses on a collaborative Music and Art Therapy intervention used to improve outcomes for HMH transplant recipient John (Alias). John, a 58-year-old man with congestive heart failure, was admitted to HMH in February of 2021 with cardiogenic shock, cannulated with an Intra-aortic Balloon Pump, Impella 5.5, and Venoarterial Extracorporeal Membrane Oxygenation (VA-ECMO) as a bridge to heart and kidney transplant. He was listed as status 1 for transplant. Music Therapy and Art Therapy (MT and AT) were ordered by the physician for mood regulation, trauma processing and anxiety management. During MT/AT sessions, John reported a history of anxiety and depression exacerbated by medical acuity, shortness of breath, and lengthy hospitalizations. He expressed difficulty sleeping, pain, and existential questions. Initially seen individually by MT/AT, it was determined he could benefit from a collaborative approach due to similar thematic content within sessions. A Life Review intervention was developed by MT/AT. The purpose was for him to creatively express, reflect and process his medical narrative, including the identification of positive and negative events leading up to admission at HMH, the journey to transplant, and his hope for the future. Through this intervention, he created artworks that symbolized each event and paired them with songs, two of which were composed with the MT during treatment. As of September 2023, John has not been readmitted to the hospital and expressed that this treatment is what “got him through transplant”. MT and AT can provide opportunities for a patient to reminisce through creative expression, leading to a shift in the personal meaning of these experiences, promoting resolution, and ameliorating associated trauma. The closer to trauma it is processed, the less likely to develop PTSD. This collaborative MT/AT approach could improve long-term outcomes by reducing mortality and readmission rates for transplant patients.

Keywords: art therapy, music therapy, critical care, PTSD, trauma, transplant

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280 When Conducting an Analysis of Workplace Incidents, It Is Imperative to Meticulously Calculate Both the Frequency and Severity of Injuries Sustain

Authors: Arash Yousefi

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Experts suggest that relying exclusively on parameters to convey a situation or establish a condition may not be adequate. Assessing and appraising incidents in a system based on accident parameters, such as accident frequency, lost workdays, or fatalities, may not always be precise and occasionally erroneous. The frequency rate of accidents is a metric that assesses the correlation between the number of accidents causing work-time loss due to injuries and the total working hours of personnel over a year. Traditionally, this has been calculated based on one million working hours, but the American Occupational Safety and Health Organization has updated its standards. The new coefficient of 200/000 working hours is now used to compute the frequency rate of accidents. It's crucial to ensure that the total working hours of employees are equally represented when calculating individual event and incident numbers. The accident severity rate is a metric used to determine the amount of time lost or wasted during a given period, often a year, in relation to the total number of working hours. It measures the percentage of work hours lost or wasted compared to the total number of useful working hours, which provides valuable insight into the number of days lost or wasted due to work-related incidents for each working hour. Calculating the severity of an incident can be difficult if a worker suffers permanent disability or death. To determine lost days, coefficients specified in the "tables of days equivalent to OSHA or ANSI standards" for disabling injuries are used. The accident frequency coefficient denotes the rate at which accidents occur, while the accident severity coefficient specifies the extent of damage and injury caused by these accidents. These coefficients are crucial in accurately assessing the magnitude and impact of accidents.

Keywords: incidents, safety, analysis, frequency, severity, injuries, determine

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279 Ocular Immunology: In Face of Immune Privilege the Eye Remains Vulnerable to Autoimmune and Inflammatory-Mediated Diseases

Authors: Husham Bayazed

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Purpose of Presentation: The eye is one of a few sites in the body with immune privilege (IP). However, this IP is relatively easily bypassed in the face of sufficient strong local or systemic immunological responses. As immune responses are crucial elements of the repair response, the eye has developed distinct mechanisms to deliver immune responses to injury in the avascular regions of the eye. This presentation may cover and provide an overview of the mechanisms that dictate immune cell trafficking to the local ocular microenvironment in response to different autoimmune and inflammatory-mediated diseases. Recent Findings: Literature reviews declare that immune responses and inflammation play a key role in a diverse range of eye diseases. In recent years, our understanding of ocular immune responses has widely spread in ocular surface inflammation, uveitis, age-related macular degeneration (AMD), glaucoma, transplantation rejection, and other ocular diseases. It is becoming increasingly clear that multiple seemingly unrelated diseases involve immune responses with common themes in their ocular pathogenesis. Recent studies are focusing on elucidating the pathogenesis of ocular inflammatory disease to identify new targets for immunotherapy that will not only improve efficacy but also minimize adverse effects from traditional therapy. Summary: While IP was believed to protect the eye from day-to-day inflammatory insults, however, it is relatively easily breached in the face of different strong local or systemic immunological and inflammatory responses. Therefore, the ocular immune response encapsulates the full range of classical and non-classical immune responses and demonstrates many features which are reflected in other tissues, but eye tissues, by modifying these responses, may reveal unexpected and novel findings which are relevant to immune responses generally. This may have therapeutic potential for new targeting immunotherapy, restoring immune tolerance in ocular autoimmune and inflammatory diseases, and preventing rejection such as stem cells, currently being considered for treatment of worldwide blinding diseases such as AMD.

Keywords: ocular diseases, immunology, immune privilege, immunotherapy

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278 The Research of Hand-Grip Strength for Adults with Intellectual Disability

Authors: Haiu-Lan Chin, Yu-Fen Hsiao, Hua-Ying Chuang, Wei Lee

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An adult with intellectual disability generally has insufficient physical activity which is an important factor leading to premature weakness. Studies in recent years on frailty syndrome have accumulated substantial data about indicators of human aging, including unintentional weight loss, self-reported exhaustion, weakness, slow walking speed, and low physical activity. Of these indicators, hand-grip strength can be seen as a predictor of mortality, disability, complications, and increased length of hospital stay. Hand-grip strength in fact provides a comprehensive overview of one’s vitality. The research is about the investigation on hand-grip strength of adults with intellectual disabilities in facilities, institutions and workshops. The participants are 197 male adults (M=39.09±12.85 years old), and 114 female ones (M=35.80±8.2 years old) so far. The aim of the study is to figure out the performance of their hand-grip strength, and initiate the setting of training on hand-grip strength in their daily life which will decrease the weakening on their physical condition. Test items include weight, bone density, basal metabolic rate (BMR), static body balance except hand-grip strength. Hand-grip strength was measured by a hand dynamometer and classified as normal group ( ≧ 30 kg for male and ≧ 20 kg for female) and weak group ( < 30 kg for male, < 20 kg for female)The analysis includes descriptive statistics, and the indicators of grip strength fo the adults with intellectual disability. Though the research is still ongoing and the participants are increasing, the data indicates: (1) The correlation between hand-grip strength and degree of the intellectual disability (p ≦. 001), basal metabolic rate (p ≦ .001), and static body balance (p ≦ .01) as well. Nevertheless, there is no significant correlation between grip strength and basal metabolic rate which had been having significant correlation with hand-grip strength. (2) The difference between male and female subjects in hand-grip strength is significant, the hand-grip strength of male subjects (25.70±12.81 Kg) is much higher than female ones (16.30±8.89 Kg). Compared to the female counterparts, male participants indicate greater individual differences. And the proportion of weakness between male and female subjects is also different. (3) The regression indicates the main factors related to grip strength performance include degree of the intellectual disability, height, static body balance, training and weight sequentially. (4) There is significant difference on both hand-grip and static body balance between participants in facilities and workshops. The study supports the truth about the sex and gender differences in health. Nevertheless, the average hand-grip strength of left hand is higher than right hand in both male and female subjects. Moreover, 71.3% of male subjects and 64.2% of female subjects have better performance in their left hand-grip which is distinctive features especially in low degree of the intellectual disability.

Keywords: adult with intellectual disability, frailty syndrome, grip strength, physical condition

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277 Detection of Bcl2 Polymorphism in Patient with Hepatocellular carcinoma

Authors: Mohamed Abdel-Hamid, Olfat Gamil Shaker, Doha El-Sayed Ellakwa, Eman Fathy Abdel-Maksoud

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Introduction: Despite advances in the knowledge of the molecular virology of hepatitis C virus (HCV), the mechanisms of hepatocellular injury in HCV infection are not completely understood. Hepatitis C viral infection (HCV) influences the susceptibility to apoptosis. This could lead to insufficient antiviral immune response and persistent viral infection. Aim of this study: was to examine whether BCL-2 gene polymorphism at codon 43 (+127G/A or Ala43Thr) has an impact on development of hepatocellular carcinoma caused by chronic hepatitis C Egyptian patients. Subjects and Methods: The study included three groups; group 1: composing of 30 patients with hepatocellular carcinoma (HCC), group 2 composing of 30 patients with HCV, group 3 composing of 30 healthy subjects matching the same age and socioeconomic status were taken as a control group. Gene polymorphism of BCL2 (Ala43Thr) were evaluated by PCR-RFLP technique and measured for all patients and controls. Results: The summed 43Thr genotype was more frequent and statistically significant in HCC patients as compared to control group. This genotype of BCL2 gene may inhibit the programmed cell death which leads to disturbance in tissue and cells homeostasis and reduction in immune regulation. This result leads to viral replication and HCV persistence. Moreover, virus produces variety of mechanisms to block genes participated in apoptosis. This mechanism proves that HCV patients who have 43Thr genotype are more susceptible to HCC. Conclusion: The data suggest for the first time that the BCL2 polymorphism is associated with the susceptibility to HCC in Egyptian populations and might be used as molecular markers for evaluating HCC risk. This study clearly demonstrated that Chronic HCV exhibit a deregulation of apoptosis with the disease progression. This provides an insight into the pathogenesis of chronic HCV infection, and may contribute to the therapy.

Keywords: BCL2 gene, Hepatitis C Virus, Hepatocellular carcinoma, sensitivity, specificity, apoptosis

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276 TopClosure® of Large Abdominal Wall Defect Instead of Staged Hernia Repair as Part of Damage Control Laparotomy

Authors: Andriy Fedorenko

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Background Early closure of the open abdomen is a priority after damage control laparotomy to prevent retraction of fascial layers and prevent hernia formation that requires definitive repair at a later stage. This substantially reduces the complications associated with ventral hernia formation for up to a year after initial surgery. TopClosure® is an innovative method that employs stress-relaxation and mechanical creep for skin stretching. Its use enables the primary closure of large abdominal wall defects and mitigates large ventral hernia formation. Materials and Methods A 7-year-old girl presented with severe blast injury. She underwent initial laparotomy in a facility within the conflict zone and was transferred in a state of septic shock to our facility for further care. Her abdominal injuries included liver lacerations, multiple perforations of the transverse colon and ileum, and a 8x16cm oblique abdominal wall defect. Further damage control laparotomy was performed with primary suture of the colon and ileum and temporary closure of the abdomen using a Bagota bag. Twelve hours later, negative pressure wound therapy (NPWT) was applied to the abdominal wound after relook laparotomy. Five days later, TopClosure® was applied to the lower part of the wound incorporating NPWT to the upper wound. Results The patient suffered leak from the colonic suture line and required relaparotomy. TopClosure® abdominal closure was achieved after every laparotomy. Conclusion TopClosure® utilizes the viscoelastic properties of the skin achieving full closure of the abdominal wall (including the fascia and skin),eliminating the need for prolonged NPWT, skin graft, and delayed ventral hernia repair surgery.

Keywords: topclosure, abdominal wall defect, hernia, damage control

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275 Variation of Carbon Isotope Ratio (δ13C) and Leaf-Productivity Traits in Aquilaria Species (Thymelaeceae)

Authors: Arlene López-Sampson, Tony Page, Betsy Jackes

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Aquilaria genus produces a highly valuable fragrant oleoresin known as agarwood. Agarwood forms in a few trees in the wild as a response to injure or pathogen attack. The resin is used in perfume and incense industry and medicine. Cultivation of Aquilaria species as a sustainable source of the resin is now a common strategy. Physiological traits are frequently used as a proxy of crop and tree productivity. Aquilaria species growing in Queensland, Australia were studied to investigate relationship between leaf-productivity traits with tree growth. Specifically, 28 trees, representing 12 plus trees and 16 trees from yield plots, were selected to conduct carbon isotope analysis (δ13C) and monitor six leaf attributes. Trees were grouped on four diametric classes (diameter at 150 mm above ground level) ensuring the variability in growth of the whole population was sampled. Model averaging technique based on the Akaike’s information criterion (AIC) was computed to identify whether leaf traits could assist in diameter prediction. Carbon isotope values were correlated with height classes and leaf traits to determine any relationship. In average four leaves per shoot were recorded. Approximately one new leaf per week is produced by a shoot. Rate of leaf expansion was estimated in 1.45 mm day-1. There were no statistical differences between diametric classes and leaf expansion rate and number of new leaves per week (p > 0.05). Range of δ13C values in leaves of Aquilaria species was from -25.5 ‰ to -31 ‰ with an average of -28.4 ‰ (± 1.5 ‰). Only 39% of the variability in height can be explained by δ13C in leaf. Leaf δ13C and nitrogen content values were positively correlated. This relationship implies that leaves with higher photosynthetic capacities also had lower intercellular carbon dioxide concentrations (ci/ca) and less depleted values of 13C. Most of the predictor variables have a weak correlation with diameter (D). However, analysis of the 95% confidence of best-ranked regression models indicated that the predictors that could likely explain growth in Aquilaria species are petiole length (PeLen), values of δ13C (true13C) and δ15N (true15N), leaf area (LA), specific leaf area (SLA) and number of new leaf produced per week (NL.week). The model constructed with PeLen, true13C, true15N, LA, SLA and NL.week could explain 45% (R2 0.4573) of the variability in D. The leaf traits studied gave a better understanding of the leaf attributes that could assist in the selection of high-productivity trees in Aquilaria.

Keywords: 13C, petiole length, specific leaf area, tree growth

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274 Histological and Microbiological Study about the Pneumonic Lungs of Calves Slaughtered in the Slaughterhouse of Batna

Authors: Hamza Hadj Abdallah, Brahim Belabdi

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Respiratory disease is a dominant pathology in cattle. It causes mortality and especially morbidity and irreversible damage. Although the dairy herd is affected, it is essentially the lactating herd and especially young cattle either nursing or fattening that undergo the greatest economic impact. The objective of this study is to establish a microbiological diagnosis of bovine respiratory inffections from lung presented with gross lesions at the slaughter of Batna. A total of 124 samples (pharyngeal and nasal swabs and lung fragments) from 31 seven months old calves, with lung lesions was collected to determine possible correlations between etiologic agents and lesion types. The hépatisation injury (or consolidation) was the major lesion (45.17%) preferentially localized in the right apical lobe. A diverse microbial flora (15 genera and 291 strains was isolated. The bacteria most frequently isolated are the Enterobacteriaceae (49.45%), Staphylococci (25.1%) followed by non Enterobacteriaceae bacilli represented by Pseudomonas (5.83%) and finally, Streptococcus (13.38 %). The pneumotropic bacteria (Pasteurellaaerogenes and Pasteurellapneumotropica) were isolated at a rate of 0.68%. The study of the sensitivity of some germs to antibiotics showed a sensitivity of 100% for ceftazidime. A very high sensitivity was also observed for kanamycin, Ciprofloxacin, Imepinem, Cefepime, Tobramycin and Gentamycin (between 90% and 97%). Strains of E. coli showed a sensitivity of 100% for Imepinem, while only 55.9% of the strains were sensitive to Ampicillin. The isolated Pasteurella exhibited excellent sensitivity (100%) for the antimicrobials used with the exception of Colistin and Ticarcillin-Clavulanic acid association which showed a sensitivity of 50%.This survey has demonstrated the strong spread of atypical pneumonia in cattle population (bulls) at the slaughterhouse of Batna justifying stunting and losses in cattle farms in the region.Thus, it was considered urgent to establish a profile of sensitivity of different germs to antibiotics isolated to limit this increasingly dreadful infection.

Keywords: Pasteurella, enterobacteria, bacteriology, pneumonia

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273 Characteristics and Challenges of Post-Burn Contractures in Adults and Children: A Descriptive Study

Authors: Hardisiswo Soedjana, Inne Caroline

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Deep dermal or full thickness burns are inevitably lead to post-burn contractures. These contractures remain to be one of the most concerning late complications of burn injuries. Surgical management includes releasing the contracture followed by resurfacing the defect accompanied by post-operative rehabilitation. Optimal treatment of post-burn contractures depends on the characteristics of the contractures. This study is aimed to describe clinical characteristics, problems, and management of post-burn contractures in adults and children. A retrospective analysis was conducted from medical records of patients suffered from contractures after burn injuries admitted to Hasan Sadikin general hospital between January 2016 and January 2018. A total of 50 patients with post burn contractures were included in the study. There were 17 adults and 33 children. Most patients were male, whose age range within 15-59 years old and 5-9 years old. Educational background was mostly senior high school among adults, while there was only one third of children who have entered school. Etiology of burns was predominantly flame in adults (82.3%); whereas flame and scald were the leading cause of burn injury in children (11%). Based on anatomical regions, hands were the most common affected both in adults (35.2%) and children (48.5%). Contractures were identified in 6-12 months since the initial burns. Most post-burn hand contractures were resurfaced with full-thickness skin graft (FTSG) both in adults and children. There were 11 patients who presented with recurrent contracture after previous history of contracture release. Post-operative rehabilitation was conducted for all patients; however, it is important to highlight that it is still challenging to control splinting and exercise when patients are discharged and especially the compliance in children. In order to improve quality of life in patients with history of deep burn injuries, prevention of contractures should begin right after acute care has been established. Education for the importance of splinting and exercise should be administered as comprehensible as possible for adult patients and parents of pediatric patients.

Keywords: burn, contracture, education, exercise, splinting

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