Search results for: diagnostic examination
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2733

Search results for: diagnostic examination

1563 How to Capitalize on BioCNG at a Wastewater Plant

Authors: William G. "Gus" Simmons

Abstract:

Municipal and industrial wastewater plants across our country utilize anaerobic digestion as either primary treatment or as a means of waste sludge treatment and reduction. The emphasis on renewable energy and clean energy over the past several years, coupled with increasing electricity costs and increasing consumer demands for efficient utility operations has led to closer examination of the potential for harvesting the energy value of the biogas produced by anaerobic digestion. Although some facilities may have already come to the belief that harvesting this energy value is not practical or a top priority as compared to other capital needs and initiatives at the wastewater plant, we see that many are seeing biogas, and an opportunity for additional revenues, go up in flames as they continue to flare. Conversely, few wastewater plants under progressive and visionary leadership have demonstrated that harvesting the energy value from anaerobic digestion is more than “smoke and hot air”. From providing thermal energy to adjacent or on-campus operations to generating electricity and/or transportation fuels, these facilities are proving that energy harvesting can not only be profitable, but sustainable. This paper explores ways in which wastewater treatment plants can increase their value and import to the communities they serve through the generation of clean, renewable energy; also presented the processes in which these facilities moved from energy and cost sinks to sparks of innovation and pride in the communities in which they operate.

Keywords: anaerobic digestion, harvesting energy, biogas, renewable energy, sustainability

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1562 Teachers’ Attitudes and Techniques in EFL Writing in Secondary Schools in Egypt

Authors: Hosam Mohamed Darwish

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In 2008, the Egyptian Ministry of Education introduced a new national coursebook ‘Hello for Secondary Schools, which recommends a shift in EFL teachers’ instructional practices. Since then, very little attention has been paid to teachers’ techniques in EFL writing classes. Hence, this study aimed at investigating teaching writing practices in secondary schools and exploring the teachers’ attitudes towards EFL writing skill in addition to exploring the difficulties that teachers encountered in EFL writing lessons. The study depended on data triangulation through administering two questionnaires: one to 44 teachers and the other to 24 students, and conducting semi-structured interviews with 11 teachers. Both teachers and students were asked to describe teaching practices in EFL writing classes while the open-ended questions and interviews collected data about the teachers’ difficulties in writing lessons. The questionnaires indicate that teachers have negative attitudes towards teaching writing, and most of their practices are still traditional. Five factors have influenced teachers’ practices: backwash of the test, teachers’ professional development, students’ culture of reading and large classes. The study recommends there has to be a necessary change in the students’ examination system, and ongoing teachers’ professional development should be considered. Finally, a teaching model and implications are suggested.

Keywords: EFL writing, Egyptian secondary schools, teachers’ attitudes, teachers’ techniques

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1561 Effect of Chromium Yeast on Hematological Parameters in Camel Calves (Camelus dromedaries) Reared under Hot Summer Conditions

Authors: Khalid Ahmed Abdoun, Mohamed Abdulwahid Alsoufi, Ibrahim Abdullah Alhidary

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The intention of this study was to evaluate the effect of dietary Cr supplementation on haematological parameters in camel calves reared under hot summer conditions. Fifteen male camel calves (5 – 6 months old) were randomly allotted to three dietary treatments (n = 5) for a period of 84 days. Camel calves were fed ad libitum on basal diet without Cr supplementation (control), basal diet supplemented with 0.5 mg Cr/kg DM (Cr 0.5) or basal diet supplemented with 1.0 mg Cr/kg DM (Cr 1.0). During this, blood samples were collected every four weeks for hematological examination. The obtained results revealed that dietary Cr supplementation to camel calves reared under hot summer did not show significant effects (P> 0.05) on hematological variables. However, the neutrophil to lymphocytes ratio (N: L ratio) was significantly (P < 0.05) reduced in camel calves fed on diets supplemented with chromium. In conclusion, Chromium supplementation to the diet of camel calves did not show any significant effects on hematological variables. Whereas, the neutrophil to lymphocytes ratio (N: L ratio) was reduced in camel calves fed diets supplemented with chromium.

Keywords: camel calves, chromium, haematological, immune response

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1560 Using Simulation Modeling Approach to Predict USMLE Steps 1 and 2 Performances

Authors: Chau-Kuang Chen, John Hughes, Jr., A. Dexter Samuels

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The prediction models for the United States Medical Licensure Examination (USMLE) Steps 1 and 2 performances were constructed by the Monte Carlo simulation modeling approach via linear regression. The purpose of this study was to build robust simulation models to accurately identify the most important predictors and yield the valid range estimations of the Steps 1 and 2 scores. The application of simulation modeling approach was deemed an effective way in predicting student performances on licensure examinations. Also, sensitivity analysis (a/k/a what-if analysis) in the simulation models was used to predict the magnitudes of Steps 1 and 2 affected by changes in the National Board of Medical Examiners (NBME) Basic Science Subject Board scores. In addition, the study results indicated that the Medical College Admission Test (MCAT) Verbal Reasoning score and Step 1 score were significant predictors of the Step 2 performance. Hence, institutions could screen qualified student applicants for interviews and document the effectiveness of basic science education program based on the simulation results.

Keywords: prediction model, sensitivity analysis, simulation method, USMLE

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1559 Development of a Diagnostic Device to Predict Clinically Significant Inflammation Associated with Cardiac Surgery

Authors: Mohamed Majrashi, Patricia Connolly, Terry Gourlay

Abstract:

Cardiopulmonary bypass is known to cause inflammatory response during open heart surgery. It includes the initiation of different cascades such as coagulation, complement system and cytokines. Although the immune system is body’s key defense mechanism against external assault, when overexpressed, it can be injurious to the patient, particularly in a cohort of patients in which there is a heightened and uncontrolled response. The inflammatory response develops in these patients to an exaggerated level resulting in an autoimmune injury and may lead to poor postoperative outcomes (systemic inflammatory response syndrome and multi-organs failure). Previous studies by this group have suggested a correlation between the level of IL6 measured in patient’s blood before surgery and after polymeric activation and the observed inflammatory response during surgery. Based upon these findings, the present work is aimed at using this response to develop a test which can be used prior to the open heart surgery to identify the high-risk patients before their operation. The work will be accomplished via three main clinical phases including some pilot in-vitro studies, device development and clinical investigation. Current findings from studies using animal blood, employing DEHP and DEHP plasticized PVC materials as the activator, support the earlier results in patient samples. Having established this relationship, ongoing work will focus on developing an activated lateral flow strip technology as a screening device for heightened inflammatory propensity.

Keywords: cardiopulmonary bypass, cytokines, inflammatory response, overexpression

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1558 Septic Pulmonary Emboli as a Complication of Peripheral Venous Cannula Insertion

Authors: Ankita Baidya, Vanishri Ganakumar, Ranveer S. Jadon, Piyush Ranjan, Rita Sood

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Septic embolism can have varied presentations and clinical considerations. Infected central venous catheters are commonly associated with septic emboli but peripheral vascular catheters are rarely implicated. We describe a rare case of septic pulmonary emboli related to infected peripheral venous cannulation caused by an unusual etiological agent. A young male presented with complaints of fever, productive cough, sudden onset shortness of breath and cellulitis in both the upper limbs. He was recently hospitalised for dengue fever and administered intravenous fluids through peripheral venous line. The patient was febrile, tachypneic and in respiratory distress, there were multiple pus filled bullae in left hand alongwith swelling and erythema involving right forearm that started at the site of cannulation. Chest examination showed active accessory muscles of respiration, stony dull percussion at the base of right lung and decreased breath sounds at right infrascapular, infraaxillary and mammary area. Other system examination was within normal limits. Chest X-ray revealed bilateral multiple patchy heterogenous peripheral opacities and infiltrates with right-sided pleural effusion. Contrast-enhanced computed tomography (CECT) chest showed feeding vessel sign confirming the diagnosis as septic emboli. Venous Doppler and 2D-echocardiogarm were normal. Laboratory findings showed marked leucocytosis (22000/mm3). Pus aspirate, blood sample, and sputum sample were sent for microbiological testing. The patient was started empirically on ceftriaxone, vancomycin, and clindamycin. The Pus culture and sputum culture showed Klebsiella pneumoniae sensitive to cefoperazone-sulbactum, piperacillin-tazobactum, meropenem and amikacin. The antibiotics were modified accordingly to antimicrobial sensitivity profile to Cefoperazone-sulbactum. Bronchoalveolar lavage (BAL) was done and sent for microbiological investigations. BAL culture showed Klebsiella pneumoniae with same antimicrobial resistance profile. On day 6 of starting cefoperazone-sulbactum, he became afebrile. The skin lesions improved significantly. He was administered 2 weeks of cefoperazone–sulbactum and discharged on oral faropenem for 4 weeks. At the time of discharge, TLC was 11200/mm3 with marked radiological resolution of infection and healed skin lesions. He was kept in regular follow up. Chest X-ray and skin lesions showed complete resolution after 8 weeks. Till date, only couple of case reports of septic emboli through peripheral intravenous line have been reported in English literature. This case highlights that a simple procedure of peripheral intravenous cannulation can lead to catastrophic complication of septic pulmonary emboli and widespread cellulitis if not done with proper care and precautions. Also, the usual pathogens in such clinical settings are gram positive bacteria, but with the history of recent hospitalization, empirical therapy should also cover drug resistant gram negative microorganisms. It also emphasise the importance of appropriate healthcare practices to be taken care during all procedures.

Keywords: antibiotics, cannula, Klebsiella pneumoniae, septic emboli

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1557 The Effects of Three Pre-Reading Activities (Text Summary, Vocabulary Definition, and Pre-Passage Questions) on the Reading Comprehension of Iranian EFL Learners

Authors: Leila Anjomshoa, Firooz Sadighi

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This study investigated the effects of three types of pre-reading activities (vocabulary definitions, text summary and pre-passage questions) on EFL learners’ English reading comprehension. On the basis of the results of a placement test administered to two hundred and thirty English students at Kerman Azad University, 200 subjects (one hundred intermediate and one hundred advanced) were selected.Four texts, two of them at intermediate level and two of them at advanced level were chosen. The data gathered was subjected to the statistical procedures of ANOVA. A close examination of the results through Tukey’s HSD showed the fact that the experimental groups performed better than the control group, highlighting the effect of the treatment on them. Also, the experimental group C (text summary), performed remarkably better than the other three groups (both experimental & control). Group B subjects, vocabulary definitions, performed better than groups A and D. The pre-passage questions group’s (D) performance showed higher scores than the control condition.

Keywords: pre-reading activities, text summary, vocabulary definition, and pre-passage questions, reading comprehension

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1556 Examination of the Influence of the Near-Surface Geology on the Initial Infrastructural Development Using High-Resolution Seismic Method

Authors: Collins Chiemeke, Stephen Ibe, Godwin Onyedim

Abstract:

This research work on high-resolution seismic tomography method was carried out with the aim of investigating how near-surface geology influences the initial distribution of infrastructural development in an area like Otuoke and its environs. To achieve this objective, seismic tomography method was employed. The result revealed that the overburden (highly-weathered layer) thickness ranges from 27 m to 50 m within the survey area, with an average value of 37 m. The 3D surface analysis for the overburden thickness distribution within the survey area showed that the thickness of the overburden is more in regions with less infrastructural development, and least in built-up areas. The range of velocity distribution from the surface to within a depth of 5 m is about 660 m/s to 1160 m/s, with an average value of 946 m/s. The 3D surface analysis of the velocity distribution also revealed that the areas with large infrastructural development are characterized with large velocity values compared with the undeveloped regions that has average low-velocity values. Hence, one can conclusively say that the initial settlement of Otuoke and its environs and the subsequent infrastructural development was influenced by the underlying near surface geology (rigid earth), among other factors.

Keywords: geology, seismic, infrastructural, near-surface

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1555 A Lesson in the Social Welfare System in Mexico: Limited Resources for Unlimited Needs

Authors: Vanessa L. Haro

Abstract:

Beginning with a historical foundation of Mexico, this marks the start of a close examination of this major Latin American country by providing the context needed to understand the reasons for Mexico’s strengths and struggles today, specific to their response to the issue of gender violence. Responding to the challenge of combating gender violence and inequality, Mexico has created social programs and initiatives in hopes of addressing these issues and modernizing their gender norms, which currently disempower and dehumanize women, while simultaneously denying women the necessary tools needed to fight back or bring balance to the gender scales. Nevertheless, women in Mexico have made their voices heard with the most salient image of that of the mothers protesting while holding the photos of their young daughters who lost their lives. This case study on gender issues in Mexico works to acknowledge the diverse forces that contribute to the issue of gender violence, and to make a statement that this is a crisis that requires a more dynamic response within Mexico’s social welfare policies, and should not be allowed to continue to progress as a normative phenomenon. As the advocacy groups and protesters cry out, “Ni una menos! (Not one less), meaning we will not lose one more woman and making the statement that all women’s lives matter.

Keywords: gender issues, Mexico, poverty, social welfare

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1554 Isolation of Different Brachyspira spp. from Laying Hens in North-East of Iran

Authors: Ahdieh Alijani, Mina Zarrabi, Abdollah Jamshidi, Jamshid Razmyar

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Avian intestinal spirochetosis (AIS) is caused by spiral-shaped Gram-negative Brachyspira spp. in poultry and is known as a cause of diarrhea, low egg production and increased the occurrence of dirty eggs in layer hens. In this study the presence of some Brachyspira spp. was investigated in laying hens. A total of 100 cloacal swab samples were individually collected from 20 laying hen flocks showing fecal egg staining in northeastern Iran. By culture and morphologic examination, 41 samples (41%) from 20 flocks were positive but by using genus–specific PCR only 37 (37%) samples were confirmed as Brachyspira spp. Using species-specific primers, single colonization was identified in 18 samples associated with B. pilosicoli (48.6%) while single colonization with B. intermedia was found in only two samples (5.4%). Simultaneous colonization by B. intermedia and B. murdochii was detected in 3 samples (8.1%). B. pilosicoli was the most prevalent species in concurrent colonization in 11 cases (29.7%). Finally, co-colonization by B. intermedia and B. innocens was identified in 3 samples (8.1%). The results of this study show the colonization of different species of Brachyspira with the dominance of B. pilosicoli in layer hens. In simultaneous colonization with pathogenic and non-pathogenic species the symptoms of intestinal spirochetosis were reduced, suggesting a competitive role in preventing and reducing the colonization of pathogenic species.

Keywords: intestinal spirochetosis, Brachyspira, laying hen, PCR

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1553 Effects of Harmful Alcohol Consumption and Gender on Academic and Personal-Emotional Adjustment in First Year University Students in Spain

Authors: M. F. Páramo, F. Cadaveira, M. S. Rodríguez

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The first year at university is a critical period for personal-emotional and academic adjustment in emerging adults. Moreover, some studies show that alcohol consumption increases in young adults on transition to university. The main purpose of this study was to analyze the impact of hazardous alcohol consumption and gender on adjustment to university, understood as a multidimensional construct involving an array of demands. A sample of 300 first year students in Spain completed the Student Adaptation to College Questionnaire (SACQ) and the Alcohol Use Disorders Identification Test (AUDIT). Examination of the data by analysis of variance revealed that adjustment to university was lower in the students undertaking hazardous alcohol consumption than in the other students. Surprisingly, the personal-emotional adjustment of students with hazardous alcohol consumption was not lower than in the other students. Analysis of the gender effect revealed that levels of personal-emotional adjustment were higher in males than in females. This is our first study examining the influence of alcohol consumption on university adjustment. Future research should examine this relationship more closely, with the aim of designing public health strategies focused on limiting abusive consumption of alcohol in university students.

Keywords: alcohol consumption, first year university students, gender, SACQ

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1552 Clinical Features of Acute Aortic Dissection Patients Initially Diagnosed with ST-Segment Elevation Myocardial Infarction

Authors: Min Jee Lee, Young Sun Park, Shin Ahn, Chang Hwan Sohn, Dong Woo Seo, Jae Ho Lee, Yoon Seon Lee, Kyung Soo Lim, Won Young Kim

Abstract:

Background: Acute myocardial infarction (AMI) concomitant with acute aortic syndrome (AAS) is rare but prompt recognition of concomitant AAS is crucial, especially in patients with ST-segment elevation myocardial infarction (STEMI) because misdiagnosis with early thrombolytic or anticoagulant treatment may result in catastrophic consequences. Objectives: This study investigated the clinical features of patients of STEMI concomitant with AAS that may lead to the diagnostic clue. Method: Between 1 January 2010 and 31 December 2014, 22 patients who were the initial diagnosis of acute coronary syndrome (AMI and unstable angina) and AAS (aortic dissection, intramural hematoma and ruptured thoracic aneurysm) in our emergency department were reviewed. Among these, we excluded 10 patients who were transferred from other hospital and 4 patients with non-STEMI, leaving a total of 8 patients of STEMI concomitant with AAS for analysis. Result: The mean age of study patients was 57.5±16.31 years and five patients were Standford type A and three patients were type B aortic dissection. Six patients had ST-segment elevation in anterior leads and two patients had in inferior leads. Most of the patients had acute onset, severe chest pain but no patients had dissecting nature chest pain. Serum troponin I was elevated in three patients but all patients had D-dimer elevation. Aortic regurgitation or regional wall motion abnormality was founded in four patients. However, widened mediastinum was seen in all study patients. Conclusion: When patients with STEMI have elevated D-dimer and widened mediastinum, concomitant AAS may have to be suspected.

Keywords: aortic dissection, myocardial infarction, ST-segment, d-dimer

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1551 Lumbar Tuberculous Spondylitis in a Child Treated by Posterior Osteosynthesis: Apropos of a Case

Authors: Ghoul Rachid Brahim

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Introduction: Tuberculous spondylodiscitis is an infection of the spine by Mycobacterium tuberculosis. Tuberculous spondylodiscitis still remains a topical disease in developing countries and continues to pose a public health problem in endemic countries. Materials and methods: Clinical case: This is a 12-year-old child followed in pediatrics for weight loss and progressively worsening low back pain. The neurological examination found an irritative pyramidal syndrome in both lower limbs with a severe lumbar spinal syndrome. The radiological assessment: (Rx of the spine supplemented by CT and MRI) shows L1L2 spondylodiscitis. Treatment: The child is put on anti-tuberculosis treatment, and the spine is restrained with a corset. Control MRI shows a worsening of the dorsal kyphosis with a backward movement of the posterior wall and spinal cord compression. The child is operated on via the posterior approach (the operative procedure consists of an L1 laminectomy and D11 L3 osteosynthesis). Results: Spinal cord décompression and stabilization of the spine. Conclusion: Tuberculous spondylodiscitis in children remains a rare, aggressive, and progressive condition. The prognosis depends on the diagnosis's precocity and the therapeutic management quality.

Keywords: tuberculous spondylodiscitis, mycobacterium tuberculosis, laminectomy, MRI

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1550 Metastatic Invasive Lobular Cancer Presenting as a Cervical Polyp

Authors: Sally Shepherd, Craig Murphy

Abstract:

Introduction: The uterus or cervix are unusual locations as metastatic sites for cancers. It is further unusual for it to be a site of metastasis, whilst the primary malignancy remains occult. Case Report: A 63-year-old female with three months of altered bowel habits underwent a CT scan of the abdomen and pelvis, revealing a bulky uterus and left ovary, nonspecific colonic thickening, and diffuse peritoneal changes. She underwent colposcopy, which revealed a large endocervical polyp that was excised, revealing strongly hormone-positive metastatic invasive lobular breast cancer. She subsequently underwent a PET scan, which showed moderately diffuse activity in the cervix and left adnexa. Breast examination was unremarkable, and screening mammography, ultrasound, and MRI of the breast did not identify any lesions. Her blood tests revealed a Ca 15-3 of 934, CA-125 of 220, and CEA of 27. She was commenced on letrozole and ribociclib with an improvement in her symptoms. Conclusion: It is rare for occult breast cancer to be established and diagnosed by pelvic imaging and biopsy. Suspicion of uterine or cervical metastasis should be heightened in patients with an active or past history of breast cancer.

Keywords: occult breast cancer, cervical metastasis, invasive lobular carcinoma, metastasis

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1549 Quantification of Extent of Pollution from Total Lead in the Shooting Ranges Found in Southern and Central Botswana: A Pioneering Study

Authors: Nicholas Sehube, Rosemary Kelebemang, Pogisego Dinake

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The extent of Pb contamination of shooting range soils has never been ascertained in Botswana, this was the first attempt in evaluating the deposition of Pb into the soils emanating from munitions. A total of 8 military shooting ranges were used for this study. Soil samples were collected at each of the 8 shooting ranges at the berm (stop butt), target line, 50 and 100 m from the berm. In all of the shooting ranges investigated the highest concentrations were found in the berm soils. The highest Pb concentrations of 38 406.87 mg/Kg were found in the berm soils of Thebephatshwa shooting range which is enclosed within a military camp with staff residential dwelling only a kilometre away. Most of the shooting ranges soils contained elevated levels of Pb in the ranges above 2000 mg/kg far exceeding the United States Environmental Protection Agency (USEPA) critical value of 400 mg/Kg. Mobilization of lead at high pH is attributed to low organic matter and such was the case with Thebephatshwa shooting range with a percept organic matter of 0.35±0.08. The predominant weathering products in these shooting ranges were cerussite (PbCO3), hydrocerussite (Pb(CO3)2(OH)2 and massicot (PbO). The detailed examination and characterization of the extent of pollution will help in the development and implementation of scientifically sound remediation and restoration of shooting ranges soils.

Keywords: ammunition, Botswana, Pb, pollution, soil

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1548 Study of Circulatory MiR-122 and MiR-130a Expression among Chronic Hepatitis C Egyptian Patients

Authors: Hend K. Moosa, Eman A. Rashwan, Ezzat M. Hassan, Amany A. Ghazy, Amel G. Sheredy

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The stability of microRNA (miR) in the circulation can show a great progress toward the discovery of non-invasive diagnostic and prognostic biomarkers in many diseases. In the present study, circulatory miR-122 and miR-130a were analysed in chronic hepatitis C Egyptian patients in predicting the clinical outcome of interferon treatment. In addition, their expression levels were correlated to viral RNA levels, necro-inflammatory markers (AST, ALT) and to each other. This study was conducted on 51 subjects where 36 were chronic HCV patients in which they were divided into naive and interferon treated HCV patients (responders and non-responders) and 15 matched healthy controls. Serum quantification of miR-122 and miR-130a were performed by quantitative Real-time Polymerase Chain Reaction (qRT-PCR). The results showed a significant upregulation of miR-122 in non-responder patients (P=0.049). By receiver operating characteristic analysis curve, miR-122 revealed 65% sensitivity and 92.3% specificity in predicting non-responsiveness of patients to IFN treatment, while miR-130a showed a sensitivity of 100% and specificity of 53.85%. Remarkably, there was a significant positive correlation between miR-122 and miR-130a in naive HCV patients (r=0.714, p=0.003). However, there was no significant correlation between serum miR-122, miR-130a expression levels and necro-inflammatory markers (AST, ALT). To conclude, miR-122 and miR-130a have a significant association with viral RNA levels and accordingly, they may have a synergistic power in promoting viral replication. Interestingly, miR-122 and miR-130a have a predictive power in predicting clinical outcome of IFN treatment which can be further studied in currently used drugs in order to reduce the socio-economic burden of potentially non-responders.

Keywords: hepatitis C, microRNA, miR-122, miR-130a

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1547 Soul-Body Relationship in Medieval Islamic Thought – Analysis of Avicenna’s Psychology and Medicine with Implication to Mental Health

Authors: Yula Milshteyn

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The present study focuses on the science of the “Soul” in Islamic Medieval Psychology.The main objective of the current essay is to analyze the concept of the “soul” in relation to “mental” disorders, in the philosophical psychology and medicinal treatise of Ibn Sina, a Muslim Persian physician-philosopher (known as Avicenna in the Western world) (981-1037 CE). The examination will concentrate on the nature of the soul, and the relationship of the soul to the body, as well as the manifestation of health and sickness in soul and body, The analysis draws on Avicenna’s Psychology (Kitab al-Najat or The Book of Salvation), Remarks and Admonitions (Al-isharat wa al-tanbihat), and the medical treatise – The Canon of Medicine (al-Qānūn fī al-Ṭibb). Avicenna’s psychology of the soul is primarily based on Aristotelian and Neo-platonic paradigms. For Avicenna, soul is a metaphysical, independent substance, which in modern terms implies independence of human consciousness from the material body. The soul however, is linked to the body and controls all its’ faculties or functions. It is suggested that in the specific case study of schizophrenia, it is a disorder pertained to both, soul and body and can be characterized as a multi-faceted neurobiological, physiological, psychological and metaphysical spiritual phenomenon.

Keywords: Avicenna, canon of the medicine, mental disorders, psychology, schizophrenia, soul-body

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1546 Orthodontic Treatment Using CAD/CAM System

Authors: Cristiane C. B. Alves, Livia Eisler, Gustavo Mota, Kurt Faltin Jr., Cristina L. F. Ortolani

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The correct positioning of the brackets is essential for the success of orthodontic treatment. Indirect bracket placing technique has the main objective of eliminating the positioning errors, which commonly occur in the technique of direct system of brackets. The objective of this study is to demonstrate that the exact positioning of the brackets is of extreme relevance for the success of the treatment. The present work shows a case report of an adult female patient who attended the clinic with the complaint of being in orthodontic treatment for more than 5 years without noticing any progress. As a result of the intra-oral clinical examination and documentation analysis, a class III malocclusion, an anterior open bite, and absence of all third molars and first upper and lower bilateral premolars were observed. For the treatment, the indirect bonding technique with self-ligating ceramic braces was applied. The preparation of the trays was done after the intraoral digital scanning and printing of models with a 3D printer. Brackets were positioned virtually, using a specialized software. After twelve months of treatment, correction of the malocclusion was observed, as well as the closing of the anterior open bite. It is concluded that the adequate and precise positioning of brackets is necessary for a successful treatment.

Keywords: anterior open-bite, CAD/CAM, orthodontics, malocclusion, angle class III

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1545 Alexandrium pacificum Cysts Distribution in One North African Lagoon Ecosystem

Authors: M. Fertouna Bellakhal, M. Bellakhal, A. Dhib, A. Fathalli, S. Turki, L. Aleya

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Study of dinoflagellate cysts is a precious tool to get information about environment and water quality in many aquatic ecosystems. The distribution of Alexandrium pacificum cysts, in Bizerta lagoon located in North of Tunisia, was made based on sediment samples analysis from 123 equidistant stations delimiting 125 km² surfaces. Sediment characteristics such as percentage of water, organic matter, and particle size were analyzed to determine the factors that influence the distribution of this dinoflagellate. In addition, morphological examination and ribotyping of vegetative forms from microalgal cultures made from cyst germination confirmed the identity of the species attributed to A. pacificum. A correlation between the abundance of A. pacificum cysts and the percentage of water and sediment organic matter was recorded. In addition, the sedimentary fraction < 63μm was found to be potentially favorable for the installation and initiation of the Alexandrium pacificum efflorescence at the Bizerte lagoon. The mapping of cysts in this aquatic ecosystem has also allowed us to define distinct areas with specific abundance with closed relationship with shellfish aquaculture stations located within the lagoon.

Keywords: Alexandrium pacificum, cysts, Dinoflagellate, microalgal culture

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1544 Rapid Identification and Diagnosis of the Pathogenic Leptospiras through Comparison among Culture, PCR and Real Time PCR Techniques from Samples of Human and Mouse Feces

Authors: S. Rostampour Yasouri, M. Ghane, M. Doudi

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Leptospirosis is one of the most significant infectious and zoonotic diseases along with global spreading. This disease is causative agent of economoic losses and human fatalities in various countries, including Northern provinces of Iran. The aim of this research is to identify and compare the rapid diagnostic techniques of pathogenic leptospiras, considering the multifacetedness of the disease from a clinical manifestation and premature death of patients. In the spring and summer of 2020-2022, 25 fecal samples were collected from suspected leptospirosis patients and 25 Fecal samples from mice residing in the rice fields and factories in Tonekabon city. Samples were prepared by centrifugation and passing through membrane filters. Culture technique was used in liquid and solid EMJH media during one month of incubation at 30°C. Then, the media were examined microscopically. DNA extraction was conducted by extraction Kit. Diagnosis of leptospiras was enforced by PCR and Real time PCR (SYBR Green) techniques using lipL32 specific primer. Out of the patients, 11 samples (44%) and 8 samples (32%) were determined to be pathogenic Leptospira by Real time PCR and PCR technique, respectively. Out of the mice, 9 Samples (36%) and 3 samples (12%) were determined to be pathogenic Leptospira by the mentioned techniques, respectively. Although the culture technique is considered to be the gold standard technique, but due to the slow growth of pathogenic Leptospira and lack of colony formation of some species, it is not a fast technique. Real time PCR allowed rapid diagnosis with much higher accuracy compared to PCR because PCR could not completely identify samples with lower microbial load.

Keywords: culture, pathogenic leptospiras, PCR, real time PCR

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1543 Narrative Psychology and Its Role in Illuminating the Experience of Suffering

Authors: Maureen Gibney

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The examination of narrative in psychology has a long tradition, starting with psychoanalytic theory and embracing over time cognitive, social, and personality psychology, among others. Narrative use has been richly detailed as well in medicine, nursing, and social service. One aspect of narrative that has ready utility in higher education and in clinical work is the exploration of suffering and its meaning. Because it is such a densely examined topic, suffering provides a window into identity, sense of purpose, and views of humanity and of the divine. Storytelling analysis permits an exploration of a host of specific manifestations of suffering such as pain and illness, moral injury, and the impact of prolonged suffering on love and relationships. This presentation will review the origins and current understandings of narrative theory in general, and will draw from psychology, medicine, ethics, nursing, and social service in exploring the topic of suffering in particular. It is suggested that the use of narrative themes such as meaning making, agency and communion, generativity, and loss and redemption allows for a finely grained analysis of common and more atypical sources of suffering, their resolution, and the acceptance of their continuation when resolution is not possible. Such analysis, used in professional work and in higher education, can enrich one’s empathy and one’s sense of both the fragility and strength of everyday life.

Keywords: meaning making, narrative theory, suffering, teaching

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1542 Research on the Strategy of Old City Reconstruction under Market Orientation: Taking Mutoulong Community in Shenzhen as an Example

Authors: Ziwei Huang

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In order to promote Inventory development in Shenzhen, the market-oriented real estate development mode has occupied a dominant position in the urban renewal activities of Shenzhen. This research is based on the theory of role relationship and urban regime, taking the Mutoulong community as the research object. Carries on the case depth analysis found that: Under the situation of absence and dislocation of the government's role, land property rights disputes and lack of communication platforms is the main reason for the problems of nail households and market failures, and the long-term delay in the progress of old city reconstruction. Through the analysis of the cause of the transformation problem and the upper planning and interest coordination mechanism, the optimization strategy of the old city transformation is finally proposed as follows: the establishment of interest coordination platform, the risk assessment of the government's intervention in the preliminary construction of the land, the adaptive construction of laws and regulations, and the re-examination of the interest relationship between the government and the market.

Keywords: Shenzhen city, Mutoulong community, urban regeneration, urban regime theory, role relationship theory

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1541 Estimation Cytokines IL-2, IL-4, IL-8 in Serum and Nasal Secretions of Patients with Various Forms of Chronic Polypoid Rhinosinusitis

Authors: U. N. Vokhidov, U. S. Khasanov, A. A. Ismailova

Abstract:

Background: Currently, the researches on the development of chronic polypoid rhinosinusitis cytokines play a major role. The aim of this study was the comparison of indicators IL-2, IL-4, IL-8 in the peripheral blood and nasal secretions of patients with various forms of chronic polypoid rhinosinusitis. Material and methods: We studied 50 patients with chronic polypoid rhinosinusitis receiving hospital treatment in the ENT department of the 3-rd clinic of Tashkent Medical Academy. It was carried out a comprehensive study including morphological examination, immunological study of blood and nasal secretions on the IL-2, IL-4 and IL-8. Results: The results of immunological studies of peripheral blood showed that patients with ‘eosinophilic’ polyps were increased IL-2 and IL-4 in patients with ‘neutrophils’ polyps were increased IL-2 and IL-8. Immunological investigation nasal secretions taken from patients with nasal polyposis rhinosinusitis showed that patients with ‘eosinophilic’ polyps also increased IL- 2 and IL- 4 in patients with ‘neutrophils’ polyps - increased IL-2 and IL-8. Conclusion: In patients with ‘eosinophilic’ polyps revealed the presence of immunity to the allergy of the body, patients with ‘neutrophilic’ polyps identified immunity to the presence of inflammation, it is necessary to take into account the doctor-otolaryngologist when choosing a treatment strategy for the prevention of recurrence of the disease.

Keywords: chronic polypoid rhinosinusitis, immunology, cytikines, nasal secretion

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1540 Liquid Biopsy and Screening Biomarkers in Glioma Grading

Authors: Abdullah Abdu Qaseem Shamsan

Abstract:

Background: Gliomas represent the most frequent, heterogeneous group of tumors arising from glial cells, characterized by difficult monitoring, poor prognosis, and fatality. Tissue biopsy is an established procedure for tumor cell sampling that aids diagnosis, tumor grading, and prediction of prognosis. We studied and compared the levels of liquid biopsy markers in patients with different grades of glioma. Also, it tried to establish the potential association between glioma and specific blood groups antigen. Result: 78 patients were identified, among whom maximum percentage with glioblastoma possessed blood group O+ (53.8%). The second highest frequency had blood group A+ (20.4%), followed by B+ (9.0%) and A- (5.1%), and least with O-. Liquid biopsy biomarkers comprised of ALT, LDH, lymphocytes, Urea, Alkaline phosphatase, AST Neutrophils, and CRP. The levels of all the components increased significantly with the severity of glioma, with maximum levels seen in glioblastoma (grade IV), followed by grade III and grade II respectively. Conclusion: Gliomas possess significant clinical challenges due to their progression with heterogeneous nature and aggressive behavior. Liquid biopsy is a non-invasive approach which aids to establish the status of the patient and determine the tumor grade, therefore may show diagnostic and prognostic utility. Additionally, our study provides evidence to demonstrate the role of ABO blood group antigens in the development of glioma. However, future clinical research on liquid biopsy will improve the sensitivity and specificity of these tests and validate their clinical usefulness to guide treatment approaches.

Keywords: GBM: glioblastoma multiforme, CT: computed tomography, MRI: magnetic resonance imaging, ctRNA: circulating tumor RNA

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1539 Equipment Donation: A Perspective from a Teaching Tertiary Care Hospital in North India

Authors: Jitender Sodhi, Shweta Talati, A. K. Gupta, Pankaj Arora

Abstract:

Background:Equipment donation to hospitals in resource-limited settings can significantly benefit services in these settings albeit requires important ethical, practical and financial issues to be considered before accepting donations. Objective: To understand the decision making process leading to acceptance/ rejection/ deferment of equipment donation from the perspective of a public sector teaching tertiary care hospital. Design: Retrospective, record based study. Setting: 2000-bedded public sector teaching tertiary care hospital in North India. Methods: A total of 30 cases of equipment donation from March 2010-October 2013, were analysed for their decision process leading to acceptance/rejection/deferment.Each case was studied retrospectively and data pertaining to the agenda and decision taken was collected. Results: A total of 30 cases of equipment donation received from March 2010- October 2013 were screened, out of which 17 (56.6%) were for diagnostic purpose and 13 (43.3%) for therapeutic purpose. Out of 30 cases, 16 (53.3%) were accepted and 8 (26.6%) were rejected. The remaining 6 cases included 3 (10%) which required further clarification and other 3 (10%) which were out of the domain of committee. Conclusion: This study highlights the importance of equipment donation in resource limited settings and considerations involved while making decisions for acceptance/rejections/defermentof such donations.

Keywords: equipment donation, teaching hospital, decision-making, North India

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1538 An Audit of Local Guidance Compliance For Stereotactic Core Biopsy For DCIS In The Breast Screening Programme

Authors: Aisling Eves, Andrew Pieri, Ross McLean, Nerys Forester

Abstract:

Background: The breast unit local guideline recommends that 12 cores should be used in a stereotactic-guided biopsy to diagnose DCIS. Twelve cores are regarded to provide good diagnostic value without removing more breast tissue than necessary. This study aimed to determine compliance with guidelines and investigated how the number of cores impacted upon the re-excision rate and size discrepancies. Methods: This single-centre retrospective cohort study of 72 consecutive breast screened patients with <15mm DCIS on radiological report underwent stereotactic-guided core biopsy and subsequent surgical excision. Clinical, radiological, and histological data were collected over 5 years, and ASCO guidelines for margin involvement of <2mm was used to guide the need for re-excision. Results: Forty-six (63.9%) patients had <12 cores taken, and 26 (36.1%) patients had ≥12 cores taken. Only six (8.3%) patients had 12 cores taken in their stereotactic biopsy. Incomplete surgical excision was seen in 17 patients overall (23.6%), and of these patients, twelve (70.6%) had fewer than 12 cores taken (p=0.55 for the difference between groups). Mammogram and biopsy underestimated the size of the DCIS in this subgroup by a median of 15mm (range: 6-135mm). Re-excision was required in 9 patients (12.5%), and five patients (6.9%) were found to have invasive ductal carcinoma on excision (80% had <12 cores, p=0.43). Discussion: There is poor compliance with the breast unit local guidelines and higher rates of re-excision in patients who did not have ≥12 cores taken. Taking ≥12 cores resulted in fewer missed invasive cancers lower incomplete excision and re-excision rates.

Keywords: stereotactic core biopsy, DCIS, breast screening, Re-excision rates, core biopsy

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1537 Classifier for Liver Ultrasound Images

Authors: Soumya Sajjan

Abstract:

Liver cancer is the most common cancer disease worldwide in men and women, and is one of the few cancers still on the rise. Liver disease is the 4th leading cause of death. According to new NHS (National Health Service) figures, deaths from liver diseases have reached record levels, rising by 25% in less than a decade; heavy drinking, obesity, and hepatitis are believed to be behind the rise. In this study, we focus on Development of Diagnostic Classifier for Ultrasound liver lesion. Ultrasound (US) Sonography is an easy-to-use and widely popular imaging modality because of its ability to visualize many human soft tissues/organs without any harmful effect. This paper will provide an overview of underlying concepts, along with algorithms for processing of liver ultrasound images Naturaly, Ultrasound liver lesion images are having more spackle noise. Developing classifier for ultrasound liver lesion image is a challenging task. We approach fully automatic machine learning system for developing this classifier. First, we segment the liver image by calculating the textural features from co-occurrence matrix and run length method. For classification, Support Vector Machine is used based on the risk bounds of statistical learning theory. The textural features for different features methods are given as input to the SVM individually. Performance analysis train and test datasets carried out separately using SVM Model. Whenever an ultrasonic liver lesion image is given to the SVM classifier system, the features are calculated, classified, as normal and diseased liver lesion. We hope the result will be helpful to the physician to identify the liver cancer in non-invasive method.

Keywords: segmentation, Support Vector Machine, ultrasound liver lesion, co-occurance Matrix

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1536 Wireless Sensor Network Energy Efficient and QoS-Aware MAC Protocols: A Survey

Authors: Bashir Abdu Muzakkari, Mohamad Afendee Mohamad, Mohd Fadzil Abdul Kadir

Abstract:

Wireless Sensor Networks (WSNs) is an aggregation of several tiny, low-cost sensor nodes, spatially distributed to monitor physical or environmental status. WSN is constantly changing because of the rapid technological advancements in sensor elements such as radio, battery and operating systems. The Medium Access Control (MAC) protocols remain very vital in the WSN because of its role in coordinating communication amongst the sensors. Other than battery consumption, packet collision, network lifetime and latency are factors that largely depend on WSN MAC protocol and these factors have been widely treated in recent days. In this paper, we survey some latest proposed WSN Contention-based, Scheduling-based and Hybrid MAC protocols while presenting an examination, correlation of advantages and limitations of each protocol. Concentration is directed towards investigating the treatment of Quality of Service (QoS) performance metrics within these particular protocols. The result shows that majority of the protocols leaned towards energy conservation. We, therefore, believe that other performance metrics of guaranteed QoS such as latency, throughput, packet loss, network and bandwidth availability may play a critical role in the design of future MAC protocols for WSNs.

Keywords: WSN, QoS, energy consumption, MAC protocol

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1535 Subacute Toxicity Study of Total Alkaloids of Seeds of Peganum harmala in Female Rat

Authors: Mahdeb Nadia, Ghadjati Nadhra, Bettihi Sara, Daamouche Z. El Youm, Bouzidi Abdelouahab

Abstract:

The effects of subacute administration of total alkaloids of seeds Peganum harmala were studied in female Albino-Wistar rats. After intraperitoneal administration of dose 50 mg/kg for 10 days and 40 mg/kg for 7 days of total alkaloids to the seeds of Peganum harmala (animal treatment lasted 17 days), there were remarkable changes in general appearance and deaths occurred in experimental group. After 17 days a significant reduction was observed in the surviving animals treated with total alkaloid seeds.The Red Blood Cells (RBC), Hematocrit (HCT), Hemoglobin (HGB) and White blood cells (WBCs), show significant reduction in the treated groups. There were no statistical differences in Glutamic-Oxaloacetic Transaminase (GOT), Glutamic-pyruvic Transaminase (GPT) and Alkaline Phosphatase (ALP), total protein, glucose and creatinine observed between groups. However the urea was significantly higher in the treated female rats than the control group. Histological examination of liver showed no histopathological changes. Alkaloids of Peganum harmala showed significant toxicity in female rats.

Keywords: Peganum harmala, rat, liver, kidney, alkaloids, toxicity

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1534 Developing HRCT Criterion to Predict the Risk of Pulmonary Tuberculosis

Authors: Vandna Raghuvanshi, Vikrant Thakur, Anupam Jhobta

Abstract:

Objective: To design HRCT criterion to forecast the threat of pulmonary tuberculosis. Material and methods: This was a prospective study of 69 patients with clinical suspicion of pulmonary tuberculosis. We studied their medical characteristics, numerous separate HRCT-results, and a combination of HRCT findings to foresee the danger for PTB by utilizing univariate and multivariate investigation. Temporary HRCT diagnostic criteria were planned in view of these outcomes to find out the risk of PTB and tested these criteria on our patients. Results: The results of HRCT chest were analyzed, and Rank was given from 1 to 4 according to the HRCT chest findings. Sensitivity, specificity, positive predictive value, and negative predictive value were calculated. Rank 1: Highly suspected PTB. Rank 2: Probable PTB Rank 3: Nonspecific or difficult to differentiate from other diseases Rank 4: Other suspected diseases • Rank 1 (Highly suspected TB) was present in 22 (31.9%) patients, all of them finally diagnosed to have pulmonary tuberculosis. The sensitivity, specificity, and negative likelihood ratio for RANK 1 on HRCT chest was 53.6%, 100%, and 0.43, respectively. • Rank 2 (Probable TB) was present in 13 patients, out of which 12 were tubercular, and 1 was non-tubercular. • The sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio of the combination of Rank 1 and Rank 2 was 82.9%, 96.4%, 23.22, and 0.18, respectively. • Rank 3 (Non-specific TB) was present in 25 patients, and out of these, 7 were tubercular, and 18 were non-tubercular. • When all these 3 ranks were considered together, the sensitivity approached 100% however, the specificity reduced to 35.7%. The positive likelihood ratio and negative likelihood ratio were 1.56 and 0, respectively. • Rank 4 (Other specific findings) was given to 9 patients, and all of these were non-tubercular. Conclusion: HRCT is useful in selecting individuals with greater chances of pulmonary tuberculosis.

Keywords: pulmonary, tuberculosis, multivariate, HRCT

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