Search results for: retention period of orthodontic treatment
Commenced in January 2007
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Edition: International
Paper Count: 13696

Search results for: retention period of orthodontic treatment

1546 The Potential of Edaphic Algae for Bioremediation of the Diesel-Contaminated Soil

Authors: C. J. Tien, C. S. Chen, S. F. Huang, Z. X. Wang

Abstract:

Algae in soil ecosystems can produce organic matters and oxygen by photosynthesis. Heterocyst-forming cyanobacteria can fix nitrogen to increase soil nitrogen contents. Secretion of mucilage by some algae increases the soil water content and soil aggregation. These actions will improve soil quality and fertility, and further increase abundance and diversity of soil microorganisms. In addition, some mixotrophic and heterotrophic algae are able to degrade petroleum hydrocarbons. Therefore, the objectives of this study were to analyze the effects of algal addition on the degradation of total petroleum hydrocarbons (TPH), diversity and activity of bacteria and algae in the diesel-contaminated soil under different nutrient contents and frequency of plowing and irrigation in order to assess the potential bioremediation technique using edaphic algae. The known amount of diesel was added into the farmland soil. This diesel-contaminated soil was subject to five settings, experiment-1 with algal addition by plowing and irrigation every two weeks, experiment-2 with algal addition by plowing and irrigation every four weeks, experiment-3 with algal and nutrient addition by plowing and irrigation every two weeks, experiment-4 with algal and nutrient addition by plowing and irrigation every four weeks, and the control without algal addition. Soil samples were taken every two weeks to analyze TPH concentrations, diversity of bacteria and algae, and catabolic genes encoding functional degrading enzymes. The results show that the TPH removal rates of five settings after the two-month experimental period were in the order: experiment-2 > expermient-4 > experiment-3 > experiment-1 > control. It indicated that algal addition enhanced the degradation of TPH in the diesel-contaminated soil, but not for nutrient addition. Plowing and irrigation every four weeks resulted in more TPH removal than that every two weeks. The banding patterns of denaturing gradient gel electrophoresis (DGGE) revealed an increase in diversity of bacteria and algae after algal addition. Three petroleum hydrocarbon-degrading algae (Anabaena sp., Oscillatoria sp. and Nostoc sp.) and two added algal strains (Leptolyngbya sp. and Synechococcus sp.) were sequenced from DGGE prominent bands. The four hydrocarbon-degrading bacteria Gordonia sp., Mycobacterium sp., Rodococcus sp. and Alcanivorax sp. were abundant in the treated soils. These results suggested that growth of indigenous bacteria and algae were improved after adding edaphic algae. Real-time polymerase chain reaction results showed that relative amounts of four catabolic genes encoding catechol 2, 3-dioxygenase, toluene monooxygenase, xylene monooxygenase and phenol monooxygenase were appeared and expressed in the treated soil. The addition of algae increased the expression of these genes at the end of experiments to biodegrade petroleum hydrocarbons. This study demonstrated that edaphic algae were suitable biomaterials for bioremediating diesel-contaminated soils with plowing and irrigation every four weeks.

Keywords: catabolic gene, diesel, diversity, edaphic algae

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1545 Drug Delivery Nanoparticles of Amino Acid Based Biodegradable Polymers

Authors: Sophio Kobauri, Tengiz Kantaria, Temur Kantaria, David Tugushi, Nina Kulikova, Ramaz Katsarava

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Nanosized environmentally responsive materials are of special interest for various applications, including targeted drug to a considerable potential for treatment of many human diseases. The important technological advantages of nanoparticles (NPs) usage as drug carriers (nanocontainers) are their high stability, high carrier capacity, feasibility of encapsulation of both hydrophilic or hydrophobic substances, as well as a high variety of possible administration routes, including oral application and inhalation. NPs can also be designed to allow controlled (sustained) drug release from the matrix. These properties of NPs enable improvement of drug bioavailability and might allow drug dosage decrease. The targeted and controlled administration of drugs using NPs might also help to overcome drug resistance, which is one of the major obstacles in the control of epidemics. Various degradable and non-degradable polymers of both natural and synthetic origin have been used for NPs construction. One of the most promising for the design of NPs are amino acid-based biodegradable polymers (AABBPs) which can clear from the body after the fulfillment of their function. The AABBPs are composed of naturally occurring and non-toxic building blocks such as α-amino acids, fatty diols and dicarboxylic acids. The particles designed from these polymers are expected to have an improved bioavailability along with a high biocompatibility. The present work deals with a systematic study of the preparation of NPs by cost-effective polymer deposition/solvent displacement method using AABBPs. The influence of the nature and concentration of surfactants, concentration of organic phase (polymer solution), and the ratio organic phase/inorganic (water) phase, as well as of some other factors on the size of the fabricated NPs have been studied. It was established that depending on the used conditions the NPs size could be tuned within 40-330 nm. As the next step of this research an evaluation of biocompatibility and bioavailability of the synthesized NPs has been performed, using two stable human cell culture lines – HeLa and A549. This part of study is still in progress now.

Keywords: amino acids, biodegradable polymers, nanoparticles (NPs), non-toxic building blocks

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1544 Development and Validation of a Coronary Heart Disease Risk Score in Indian Type 2 Diabetes Mellitus Patients

Authors: Faiz N. K. Yusufi, Aquil Ahmed, Jamal Ahmad

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Diabetes in India is growing at an alarming rate and the complications caused by it need to be controlled. Coronary heart disease (CHD) is one of the complications that will be discussed for prediction in this study. India has the second most number of diabetes patients in the world. To the best of our knowledge, there is no CHD risk score for Indian type 2 diabetes patients. Any form of CHD has been taken as the event of interest. A sample of 750 was determined and randomly collected from the Rajiv Gandhi Centre for Diabetes and Endocrinology, J.N.M.C., A.M.U., Aligarh, India. Collected variables include patients data such as sex, age, height, weight, body mass index (BMI), blood sugar fasting (BSF), post prandial sugar (PP), glycosylated haemoglobin (HbA1c), diastolic blood pressure (DBP), systolic blood pressure (SBP), smoking, alcohol habits, total cholesterol (TC), triglycerides (TG), high density lipoprotein (HDL), low density lipoprotein (LDL), very low density lipoprotein (VLDL), physical activity, duration of diabetes, diet control, history of antihypertensive drug treatment, family history of diabetes, waist circumference, hip circumference, medications, central obesity and history of CHD. Predictive risk scores of CHD events are designed by cox proportional hazard regression. Model calibration and discrimination is assessed from Hosmer Lemeshow and area under receiver operating characteristic (ROC) curve. Overfitting and underfitting of the model is checked by applying regularization techniques and best method is selected between ridge, lasso and elastic net regression. Youden’s index is used to choose the optimal cut off point from the scores. Five year probability of CHD is predicted by both survival function and Markov chain two state model and the better technique is concluded. The risk scores for CHD developed can be calculated by doctors and patients for self-control of diabetes. Furthermore, the five-year probabilities can be implemented as well to forecast and maintain the condition of patients.

Keywords: coronary heart disease, cox proportional hazard regression, ROC curve, type 2 diabetes Mellitus

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1543 The Role of Flexible Cystoscopy in Managing Recurrent Urinary Tract Infections in Patients with Mesh Implants

Authors: George Shaker, Maike Eylert

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Recurrent urinary tract infections (UTIs) in patients with mesh implants, particularly following pelvic or abdominal surgeries, pose significant clinical challenges. This paper investigates whether flexible cystoscopy is an essential diagnostic and therapeutic tool in managing such patients. With the increasing prevalence of mesh-related complications, it is crucial to explore how diagnostic procedures like cystoscopy can aid in identifying mesh-associated issues that contribute to recurrent UTIs. While flexible cystoscopy is commonly used to evaluate lower urinary tract conditions, its necessity in cases involving patients with mesh implants remains under debate. This study aims to determine the value of flexible cystoscopy in identifying complications such as mesh erosion, fistula formation, and chronic inflammation, which may contribute to recurrent infections. The research compares patients who underwent flexible cystoscopy to those managed without this procedure, examining the diagnostic yield of cystoscopy in detecting mesh-related complications. Furthermore, the study investigates the relationship between recurrent UTIs and the mechanical effects of mesh on the urinary tract, as well as the potential for cystoscopy to guide treatment decisions, such as mesh removal or revision. The results indicate that while flexible cystoscopy can identify mesh-related complications in some cases, its routine use may not be necessary for all patients with recurrent UTIs and mesh. The study emphasizes the importance of patient selection, clinical history, and symptom severity in deciding whether to employ cystoscopy. In cases where there are clear signs of mesh erosion or unexplained recurrent infections despite standard treatments, cystoscopy proves valuable. However, the study also highlights potential risks and discomfort associated with the procedure, suggesting that cystoscopy should be reserved for select cases where non-invasive methods fail to provide clarity. The research concludes that while flexible cystoscopy remains a valuable tool in certain cases, its routine use for all patients with recurrent UTIs and mesh is not justified. The paper provides recommendations for clinical guidelines, emphasizing a more personalized approach to diagnostics that considers the patient’s overall condition, infection history, and mesh type.

Keywords: flexible cystoscopy, recurrent urinary tract infections, mesh implants, mesh erosion, diagnostic procedures, urology

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1542 Microbial and SARS-CoV-2 Efficiency Analysis of Froumann HEPA Filter Air Cleaner Brand

Authors: Serap Gedikli, Hakan Çakmak, M. Buğra Güldiken, Duygu Yalnızoğlu

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Air, which is necessary for living things to survive; while it carries some useful substances in it, it can also carry foreign particles of different sizes that may be harmful to the health. All airborne organic substances of biological origin, including bacteria, fungi, fungal spores, viruses, pollen, and their components, are called "bioaerosols". Nowadays, everyone spends most of their time in closed areas such as home, workplace, school, etc. Although it is known that outdoor air pollution affects health, it is not known that indoor air pollution has harmful effects in terms of health. In this study, indoor air microbial load and SARS-CoV-2 virus cleaning efficiency of Froumann brand air cleaners were studied. This work in 300 m³, 600 m³, and 1000 m³ completely closed areas without any air circulation with Froumann N80, N90, and N100 air-cleaning devices. Analyzes were performed for both areas at 60 minutes before and after the device was operated using a particle measuring device (Particles Plus 7302) and an air sampler (Mas-100 ECO). The measurements were taken by placing the test equipment 1.5-2 m away from the air cleaner. At the same time, the efficiency of the HEPA filter was evaluated by taking samples from the air outlet point of the HEPA filter using the air sampling device (Mas-100 ECO) after the device was started. Nutrient agar and malt agar are used as total mesophilic bacteria and total fungi. The number of colony-forming units per m³ (cfu/m³) was calculated by counting colonies in Petri dishes after incubation for 48 hours at 37°C for bacteria and 72 hours at 30°C for fungi. The change in the number of colonies and the decrease in the microbial load was calculated as a percentage value. SARS-CoV-2 activity analysis studies were carried out by İnönü University Microbiology Department in accordance with the World Health Organization regulations. Finally, the HEPA filter in the devices used was taken and kept under a certain temperature and humidity, and the change in the microbial load on it was monitored over a 6-month period. At the end of the studies, a 91%-94% reduction was determined in the total mesophilic bacteria count of Frouman brand N80, N90, and N100 model air cleaners. A decrease of 94%-96% was detected in the total number of yeast/molds. HEPA filter efficiency was evaluated, and at the end of the analysis, 98% of the bacterial load and approximately 100% of yeast/mold load at the HEPA filter air outlet point were decreased. According to the SARS- CoV-2 analysis results, when the device is operating at the medium airflow level 3, it can filter virus-carrying aerosols by 99%. As a result, it was determined that the Froumann model air cleaner was effective in controlling and reducing the microbial load in the indoor air.

Keywords: HEPA filter, indoor air quality, microbial load, SARS-CoV-2

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1541 Sunflower Oil as a Nutritional Strategy to Reduce the Impacts of Heat Stress on Meat Quality and Dirtiness Pigs Score

Authors: Angela Cristina Da F. De Oliveira, Salma E. Asmar, Norbert P. Battlori, Yaz Vera, Uriel R. Valencia, Tâmara D. Borges, Antoni D. Bueno, Leandro B. Costa

Abstract:

The present study aimed to evaluate the replacement of 5% of starch per 5% of sunflower oil (SO) on meat quality and animal welfare of growing and finishing pigs (Iberic x Duroc), exposed to a heat stress environment. The experiment lasted 90 days, and it was carried out in a randomized block design, in a 2 x 2 factorial, composed of two diets (starch or sunflower oil (with or without) and two feed intake management (ad libitum and restriction). Seventy-two crossbred males (51± 6,29 kg body weight - BW) were housed in climate-controlled rooms, in collective pens and exposed to heat stress environment (32°C; 35% to 50% humidity). The treatments studies were: 1) control diet (5% starch x 0% SO) with ad libitum intake (n = 18); 2) SO diet (replacement of 5% of starch per 5% of SO) with ad libitum intake (n = 18); 3) control diet with restriction feed intake (n = 18); or 4) SO diet with restriction feed intake (n = 18). Feed were provided in two phases, 50-100 Kg BW for growing and 100-140 Kg BW for finishing, respectively. Within welfare evaluations, dirtiness score was evaluated all morning during ninety days of the experiment. The presence of manure was individually measured based on one side of the pig´s body and scored according to: 0 (less than 20% of the body surface); 1 (more than 20% but less than 50% of the body surface); 2 (over 50% of the body surface). After the experimental period, when animals reach 130-140 kg BW, they were slaughtered using carbon dioxide (CO2) stunning. Carcass weight, leanness and fat content, measured at the last rib, were recorded within 20 min post-mortem (PM). At 24h PM, pH, electrical conductivity and color measures (L, a*, b*) were recorded in the Longissimus thoracis and Semimembranosus muscles. Data shown no interaction between diet (control x SO) and management feed intake (ad libitum x restriction) on the meat quality parameters. Animals in ad libitum management presented an increase (p < 0.05) on BW, carcass weight (CW), back fat thickness (BT), and intramuscular fat content (IM) when compared with animals in restriction management. In contrast, animals in restriction management showing a higher (p < 0.05) carcass yield, percentage of lean and loin thickness. To welfare evaluations, the interaction between diet and management feed intake did not influence the degree of dirtiness. Although, the animals that received SO diet, independently of the management, were cleaner than animals in control group (p < 0,05), which, for pigs, demonstrate an important strategy to reduce body temperature. Based in our results, the diet and management feed intake had a significant influence on meat quality and animal welfare being considered efficient nutritional strategies to reduce heat stress and improved meat quality.

Keywords: dirtiness, environment, meat, pig

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1540 Investigation and Comprehensive Benefit Analysis of 11 Typical Polar-Based Agroforestry Models Based on Analytic Hierarchy Process in Anhui Province, Eastern China

Authors: Zhihua Cao, Hongfei Zhao, Zhongneng Wu

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The development of polar-based agroforestry was necessary due to the influence of the timber market environment in China, which can promote the coordinated development of forestry and agriculture, and gain remarkable ecological, economic and social benefits. The main agroforestry models of the main poplar planting area in Huaibei plain and along the Yangtze River plain were carried out. 11 typical management models of poplar were selected to sum up: pure poplar forest, poplar-rape-soybean, poplar-wheat-soybean, poplar-rape-cotton, poplar-wheat, poplar-chicken, poplar-duck, poplar-sheep, poplar-Agaricus blazei, poplar-oil peony, poplar-fish, represented by M0-M10, respectively. 12 indexes related with economic, ecological and social benefits (annual average cost, net income, ratio of output to investment, payback period of investment, land utilization ratio, utilization ratio of light energy, improvement and system stability of ecological and production environment, product richness, labor capacity, cultural quality of labor force, sustainability) were screened out to carry on the comprehensive evaluation and analysis to 11 kinds of typical agroforestry models based on analytic hierarchy process (AHP). The results showed that the economic benefit of each agroforestry model was in the order of: M8 > M6 > M9 > M7 > M5 > M10 > M4 > M1 > M2 > M3 > M0. The economic benefit of poplar-A. blazei model was the highest (332, 800 RMB / hm²), followed by poplar-duck and poplar-oil peony model (109, 820RMB /hm², 5, 7226 RMB /hm²). The order of comprehensive benefit was: M8 > M4 > M9 > M6 > M1 > M2 > M3 > M7 > M5 > M10 > M0. The economic benefit and comprehensive benefit of each agroforestry model were higher than that of pure poplar forest. The comprehensive benefit of poplar-A. blazei model was the highest, and that of poplar-wheat model ranked second, while its economic benefit was not high. Next were poplar-oil peony and poplar-duck models. It was suggested that the model of poplar-wheat should be adopted in the plain along the Yangtze River, and the whole cycle mode of poplar-grain, popalr-A. blazei, or poplar-oil peony should be adopted in Huaibei plain, northern Anhui. Furthermore, wheat, rape, and soybean are the main crops before the stand was closed; the agroforestry model of edible fungus or Chinese herbal medicine can be carried out when the stand was closed in order to maximize the comprehensive benefit. The purpose of this paper is to provide a reference for forest farmers in the selection of poplar agroforestry model in the future and to provide the basic data for the sustainable and efficient study of poplar agroforestry in Anhui province, eastern China.

Keywords: agroforestry, analytic hierarchy process (AHP), comprehensive benefit, model, poplar

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1539 Incidence and Risk Factors of Traumatic Lumbar Puncture in Newborns in a Tertiary Care Hospital

Authors: Heena Dabas, Anju Paul, Suman Chaurasia, Ramesh Agarwal, M. Jeeva Sankar, Anurag Bajpai, Manju Saksena

Abstract:

Background: Traumatic lumbar puncture (LP) is a common occurrence and causes substantial diagnostic ambiguity. There is paucity of data regarding its epidemiology. Objective: To assess the incidence and risk factors of traumatic LP in newborns. Design/Methods: In a prospective cohort study, all inborn neonates admitted in NICU and planned to undergo LP for a clinical indication of sepsis were included. Neonates with diagnosed intraventricular hemorrhage (IVH) of grade III and IV were excluded. The LP was done by operator - often a fellow or resident assisted by bedside nurse. The unit has policy of not routinely using any sedation/analgesia during the procedure. LP is done by 26 G and 0.5-inch-long hypodermic needle inserted in third or fourth lumbar space while the infant is in lateral position. The infants were monitored clinically and by continuous measurement of vital parameters using multipara monitor during the procedure. The occurrence of traumatic tap along with CSF parameters and other operator and assistant characteristics were recorded at the time of procedure. Traumatic tap was defined as presence of visible blood or more than 500 red blood cells on microscopic examination. Microscopic trauma was defined when CSF is not having visible blood but numerous RBCs. The institutional ethics committee approved the study protocol. A written informed consent from the parents and the health care providers involved was obtained. Neonates were followed up till discharge/death and final diagnosis was assigned along with treating team. Results: A total of 362 (21%) neonates out of 1726 born at the hospital were admitted during the study period (July 2016 to January, 2017). Among these neonates, 97 (26.7%) were suspected of sepsis. A total of 54 neonates were enrolled who met the eligibility criteria and parents consented to participate in the study. The mean (SD) birthweight was 1536 (732) grams and gestational age 32.0 (4.0) weeks. All LPs were indicated for late onset sepsis at the median (IQR) age of 12 (5-39) days. The traumatic LP occurred in 19 neonates (35.1%; 95% C.I 22.6% to 49.3%). Frank blood was observed in 7 (36.8%) and in the remaining, 12(63.1%) CSF was detected to have microscopic trauma. The preliminary risk factor analysis including birth weight, gestational age and operator/assistant and other characteristics did not demonstrate clinically relevant predictors. Conclusion: A significant number of neonates requiring lumbar puncture in our study had high incidence of traumatic tap. We were not able to identify modifiable risk factors. There is a need to understand the reasons and further reduce this issue for improving management in NICUs.

Keywords: incidence, newborn, traumatic, lumbar puncture

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1538 Effect of Phytohormones on the Development and Nutraceutical Characteristics of the Fruit Capsicum annuum

Authors: Rossy G. Olan Villegas, Gerardo Acosta Garcia, Aurea Bernardino Nicanor, Leopoldo Gonzalez Cruz, Humberto Ramirez Medina

Abstract:

Capsicum annuum is a crop of agricultural and economic importance in Mexico and other countries. The fruit (pepper) contains bioactive components such as carotenoids, phenolic compounds and capsaicinoids that improve health. However, pepper cultivation is affected by biotic and abiotic factors that decrease yield. Some phytohormones like gibberellins and auxins induce the formation and development of fruit in several plants. In this study, we evaluated the effect of the exogenous application of phytohormones like gibberellic acid and indolbutyric acid on fruit development of jalapeno pepper plants, the protein profile of plant tissues, the accumulation of bioactive compounds and antioxidant activity in the pericarp and seeds. For that, plants were sprinkled with these phytohormones. The fruit collection for the control, indolbutyric acid and gibberellic acid treatments was 7 peppers per plant; however, for the treatment that combines indolbutyric acid and gibberellic acid, a fruit with the shortest length (1.52 ± 1.00 cm) and weight (0.41 ± 1.0 g) was collected compared to fruits of plants grown under other treatments. The length (4,179 ± 0,130 cm) and weight of the fruit (8,949 ± 0.583 g) increased in plants treated with indolbutyric acid, but these characteristics decreased with the application of GA3 (length of 3,349 ± 0.127 cm and a weight 4,429 ± 0.144 g). The content of carotenes and phenolic compounds increased in plants treated with GA3 (1,733 ± 0.092 and 1,449 ± 0.009 mg / g, respectively) or indolbutyric acid (1,164 ± 0.042 and 0.970 ± 0.003 mg / g). However, this effect was not observed in plants treated with both phytohormones (0.238 ± 0.021 and 0.218 ± 0.004 mg / g). Capsaicin content was higher in all treatments; but it was more noticeable in plants treated with both phytohormones, the value being 0.913 ± 0.001 mg / g (three times greater in amount). The antioxidant activity was measured by 3 different assays, 2,2-diphenyl-1-picrylhydrazyl (DPPH), antioxidant power of ferric reduction (FRAP) and 2,2'-Azinobis-3-ethyl-benzothiazoline-6-sulfonic acid ( ABTS) to find the minimum inhibitory concentration of the reducing radical (IC50 and EC50). Significant differences were observed from the application of the phytohormone, being the fruits treated with gibberellins, which had a greater accumulation of bioactive compounds. Our results suggest that the application of phytohormones modifies the development of fruit and its content of bioactive compounds.

Keywords: auxins, capsaicinoids, carotenoids, gibberellins

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1537 Ocean Planner: A Web-Based Decision Aid to Design Measures to Best Mitigate Underwater Noise

Authors: Thomas Folegot, Arnaud Levaufre, Léna Bourven, Nicolas Kermagoret, Alexis Caillard, Roger Gallou

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Concern for negative impacts of anthropogenic noise on the ocean’s ecosystems has increased over the recent decades. This concern leads to a similar increased willingness to regulate noise-generating activities, of which shipping is one of the most significant. Dealing with ship noise requires not only knowledge about the noise from individual ships, but also how the ship noise is distributed in time and space within the habitats of concern. Marine mammals, but also fish, sea turtles, larvae and invertebrates are mostly dependent on the sounds they use to hunt, feed, avoid predators, during reproduction to socialize and communicate, or to defend a territory. In the marine environment, sight is only useful up to a few tens of meters, whereas sound can propagate over hundreds or even thousands of kilometers. Directive 2008/56/EC of the European Parliament and of the Council of June 17, 2008 called the Marine Strategy Framework Directive (MSFD) require the Member States of the European Union to take the necessary measures to reduce the impacts of maritime activities to achieve and maintain a good environmental status of the marine environment. The Ocean-Planner is a web-based platform that provides to regulators, managers of protected or sensitive areas, etc. with a decision support tool that enable to anticipate and quantify the effectiveness of management measures in terms of reduction or modification the distribution of underwater noise, in response to Descriptor 11 of the MSFD and to the Marine Spatial Planning Directive. Based on the operational sound modelling tool Quonops Online Service, Ocean-Planner allows the user via an intuitive geographical interface to define management measures at local (Marine Protected Area, Natura 2000 sites, Harbors, etc.) or global (Particularly Sensitive Sea Area) scales, seasonal (regulation over a period of time) or permanent, partial (focused to some maritime activities) or complete (all maritime activities), etc. Speed limit, exclusion area, traffic separation scheme (TSS), and vessel sound level limitation are among the measures supported be the tool. Ocean Planner help to decide on the most effective measure to apply to maintain or restore the biodiversity and the functioning of the ecosystems of the coastal seabed, maintain a good state of conservation of sensitive areas and maintain or restore the populations of marine species.

Keywords: underwater noise, marine biodiversity, marine spatial planning, mitigation measures, prediction

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1536 A Prospective Audit to Look into Antimicrobial Prescribing in the Clinical Setting: In a Teaching Hospital in the UK

Authors: Richa Sinha, Mohammad Irfan Javed, Sanjay Singh

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Introduction: Good antimicrobial prescribing reduces length of stay in hospital, risk of adverse events, antimicrobial resistance, and unnecessary hospital expenditure. The aim of this prospective audit was to identify any problems with antimicrobial prescribing including documentation of the relevant aspects as well as appropriateness of antibiotics use. The audit was conducted on the surgical wards in a teaching hospital in the UK. Methods: Standards included the indication, duration, choice, and prescription of antibiotic should be in line with current Regional Guidelines and should be clearly documented on the prescription chart. There should be an entry in each patients’ medical record of the diagnosis and indication for each acute antibiotic prescription issued. All prescriptions should clearly document the route, frequency and dose of antibiotic. Data collection was done for 2 weeks in the month of March 2014. A proforma including all the questions above was completed for all the patients. The results were analysed using Excel. Results: 35 patients in total were selected for the audit. 85.7% of patients had indication of antibiotic documented on the prescription chart and 68.5% of patients had indication documented in the notes. The antibiotic used was in line with hospital guidelines in 45.7% of patients, however, in a further 28.5% of patients the reason for the antibiotic prescription was microbiology approved. Therefore, in total 74.2% of patients had been prescribed appropriate antibiotics. The duration of antibiotic was documented in 68.6% of patients and the antibiotic was reviewed in 37.1% of patients. The dose, frequency and route was documented clearly in 100% of patients. Conclusion: Overall, prescribing can be improved on the surgical wards in this hospital. Only 37.1% of patients had clear documentation of a review of antibiotics. It may be that antibiotics have been reviewed but this should be clearly highlighted on the prescription chart or the notes. Failure to review antibiotics can lead to poor patient care and antimicrobial resistance and therefore it is important to address this. It is also important to address the appropriateness of antibiotics as inappropriate antibiotic prescription can lead to failure of treatment as well as antimicrobial resistance. The good points from the audit was that all patients had clear documentation of dose, route and frequency which is extremely important in the administration of antibiotics. Recommendations from this audit included to emphasize good antimicrobial prescribing at induction (twice yearly), an antimicrobial handbook for junior doctors, and re-audit in 6 months time.

Keywords: prescribing, antimicrobial, indication, duration

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1535 Impact of Two Xenobiotics in Mosquitofish: Gambusia affinis: Several Approaches

Authors: Chouahda Salima, Soltani Noureddine

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The present study is a part of biological control against mosquitoes. It aims to assess the impact of two xenobiotics (a selective insect growth regulator: halofenozide and heavy metals: cadmium, more toxic and widespread in the region) in mosquitofish: Gambusia affinis. Several approaches were examined: Acute toxicity of cadmium and halofenozide: The acute toxicity of cadmium and halofenozide was examined in juvenile and adult males and females of G. affinis at different concentrations, cadmium causes mortality of the species studied with a relation dose-response. In laboratory conditions, the impact of cadmium was determined on two biomarkers of environmental stress: glutathione and acetylcholinesterase. The results show that the juvenile followed by adult males are more susceptible than adult females, while the halofenozide does not have any effect on the mortality of juvenile and adult males and females of G.affinis. Chronic toxicity of cadmium and halofenozide: both xenobiotics were added to the water fish raising at different doses tested in juveniles and adults males and females during two months of experience. Growth and metric indices; results show that halofenozide added to the water juveniles of G. affinis has no effect on their growth (length and weight). On the other side, the cadmium at the dose 5 µg/L shows a higher toxicity against juvenile, where he appears to reduce significantly their linear growth and weight. In females, the both xenobiotics have significant effects on metric indices, but these effects are more important on the hepatosomatic index that the gonadosomatic index and the coefficient of condition. Biomarkers; acetylcholinesterase (AChE), glutathione S-transferase (GST) and glutathione (GSH) used in assessing of environmental stress were measured in juveniles and adults males and females. The response of these biomarkers reveals an inhibition of AChE specific activity, an induction of GST activity, and decrease of GSH rates in juveniles in the end of experiment and during chronic treatment adult males and females. The effect of these biomarkers is more pronounced in females compared to males and juveniles. These different biomarkers have a similar profile for the duration of exposure.

Keywords: gambusia affinis, insecticide, heavy metal, morphology, biomarkers, chronic toxicity, acute toxicity, pollution

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1534 Nanotechnology in Conservation of Artworks: TiO2-Based Nanocoatings for the Protection and Preservation of Stone Monuments

Authors: Sayed M. Ahmed, Sawsan S. Darwish, Nagib A. Elmarzugi, Mohammad A. Al-Dosari, Mahmoud A. Adam, Nadia A. Al-Mouallimi

Abstract:

The preservation of cultural heritage is a worldwide problem. Stone monuments represent an important part of this heritage, but due to their prevalently outdoor location, they are generally subject to a complex series of weathering and decay processes, in addition to physical and chemical factors, also biological agents usually play an important role in deterioration phenomena. The aim of this paper is to experimentally verify applicability and feasibility of titanium dioxide (TiO2) nanoparticles for the preservation of historical (architectural, monumental, archaeological) stone surfaces which enables to reduce the deterioration behaviors mentioned above. TiO2 nanoparticles dispersed in an aqueous colloidal suspension were applied directly on travertine (Marble and limestone often used in historical and monumental buildings) by spray-coating in order to obtain a nanometric film on stone samples. SEM, coupled with EDX microanalysis. (SEM-EDX), in order to obtain information oncoating homogeneity, surface morphology before and after aging and penetration depth of the TiO2 within the samples. Activity of the coated surface was evaluated with UV accelerated aging test. Capillary water absorption, thermal aging and colorimetric measurements have been performed on on coated and uncoated samples to evaluate their properties and estimate change of appearance with colour variation. Results show Tio2 nanoparticles good candidate for coating applications on calcareous stone, good water-repellence was observed on the samples after treatment; analyses were carried out on both untreated and freshly treated samples as well as after artificial aging. Colour change showed negligible variations on the coated or uncoated stone as well as after aging. Results showed that treated stone surfaces seem to be not affected after 1000 hours of exposure to UV radiation, no alteration of the original features.

Keywords: architectural and archaeological heritage, calcareous stone, photocatalysis TiO2, self-cleaning, thermal aging

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1533 Insulin-Producing Cells from Adult Human Bone Marrow Mesenchymal Stem Cells Control Chemically-Induced Diabetes in Dogs

Authors: Maha Azzam, Mahmoud Gabr, Mahmoud Zakaria, Ayman Refaie, Amani Ismail, Sherry Khater, Sylvia Ashamallah, Mohamed Ghoniem

Abstract:

Evidence was provided that human bone marrow-derived mesenhymal stem cells (HBM-MSCs) could be differentiated to form insulin-producing cells (IPCs). Transplantation of these cells was able to cure chemically-induced diabetes in nude mice. The efficacy of these cells to control diabetes in large animals was carried out to evaluate the sufficient number of cells needed/Kg body weight and to determine the functional longevity in vivo. Materials/Methods: Ten male mongrel dogs weighing 15-20 Kg were used in this study. Diabetes was chemically-induced in 7 dogs by a mixture of alloxan and streptozotocin. Three non-diabetic served as normal controls. Differentiated HBM-MSCs (5 million/Kg) were encapsulated in theracyte capsules and transplanted beneath the rectus sheath. Each dog received 2 capsules. One dog died 4 days postoperative from inhalation pneumonia. The remaining 6 dogs were followed up for 6-18 months. Results: Four dogs became normoglycemic within 6-8 weeks with normal glucose tolerance curves providing evidence that the transplanted cells were glucose-sensitive and insulin-responsive. In the remaining 2 dogs, fasting blood glucose was reduced but did not reach euglycemic levels. The sera of all transplanted dogs contained human insulin and c-peptide but negligible levels of canine insulin. When the HBM-MSCs loaded capsules were removed, rapid return of diabetic state was noted. The harvested capsules were examined by immunofluorescence. IPCs were seen and co-expression of with c-peptide was confirmed. Furthermore, all the pancreatic endocrine genes were expressed by the transplanted cells. Conclusions: This study provided evidence that theracyte capsules could protect the xenogenic HBM-MSCs from the host immune response. This is an important issue when clinical stem cell therapy is considered for definitive treatment for T1DM.

Keywords: diabetes, mesenchymal stem cells, dogs, Insulin-producing cells

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1532 The Accuracy of an In-House Developed Computer-Assisted Surgery Protocol for Mandibular Micro-Vascular Reconstruction

Authors: Christophe Spaas, Lies Pottel, Joke De Ceulaer, Johan Abeloos, Philippe Lamoral, Tom De Backer, Calix De Clercq

Abstract:

We aimed to evaluate the accuracy of an in-house developed low-cost computer-assisted surgery (CAS) protocol for osseous free flap mandibular reconstruction. All patients who underwent primary or secondary mandibular reconstruction with a free (solely or composite) osseous flap, either a fibula free flap or iliac crest free flap, between January 2014 and December 2017 were evaluated. The low-cost protocol consisted out of a virtual surgical planning, a prebend custom reconstruction plate and an individualized free flap positioning guide. The accuracy of the protocol was evaluated through comparison of the postoperative outcome with the 3D virtual planning, based on measurement of the following parameters: intercondylar distance, mandibular angle (axial and sagittal), inner angular distance, anterior-posterior distance, length of the fibular/iliac crest segments and osteotomy angles. A statistical analysis of the obtained values was done. Virtual 3D surgical planning and cutting guide design were performed with Proplan CMF® software (Materialise, Leuven, Belgium) and IPS Gate (KLS Martin, Tuttlingen, Germany). Segmentation of the DICOM data as well as outcome analysis were done with BrainLab iPlan® Software (Brainlab AG, Feldkirchen, Germany). A cost analysis of the protocol was done. Twenty-two patients (11 fibula /11 iliac crest) were included and analyzed. Based on voxel-based registration on the cranial base, 3D virtual planning landmark parameters did not significantly differ from those measured on the actual treatment outcome (p-values >0.05). A cost evaluation of the in-house developed CAS protocol revealed a 1750 euro cost reduction in comparison with a standard CAS protocol with a patient-specific reconstruction plate. Our results indicate that an accurate transfer of the planning with our in-house developed low-cost CAS protocol is feasible at a significant lower cost.

Keywords: CAD/CAM, computer-assisted surgery, low-cost, mandibular reconstruction

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1531 The Effect of Foot Progression Angle on Human Lower Extremity

Authors: Sungpil Ha, Ju Yong Kang, Sangbaek Park, Seung-Ju Lee, Soo-Won Chae

Abstract:

The growing number of obese patients in aging societies has led to an increase in the number of patients with knee medial osteoarthritis (OA). Artificial joint insertion is the most common treatment for knee medial OA. Surgery is effective for patients with serious arthritic symptoms, but it is costly and dangerous. It is also inappropriate way to prevent a disease as an early stage. Therefore Non-operative treatments such as toe-in gait are proposed recently. Toe-in gait is one of non-surgical interventions, which restrain the progression of arthritis and relieves pain by reducing knee adduction moment (KAM) to facilitate lateral distribution of load on to knee medial cartilage. Numerous studies have measured KAM in various foot progression angle (FPA), and KAM data could be obtained by motion analysis. However, variations in stress at knee cartilage could not be directly observed or evaluated by these experiments of measuring KAM. Therefore, this study applied motion analysis to major gait points (1st peak, mid –stance, 2nd peak) with regard to FPA, and to evaluate the effects of FPA on the human lower extremity, the finite element (FE) method was employed. Three types of gait analysis (toe-in, toe-out, baseline gait) were performed with markers placed at the lower extremity. Ground reaction forces (GRF) were obtained by the force plates. The forces associated with the major muscles were computed using GRF and marker trajectory data. MRI data provided by the Visible Human Project were used to develop a human lower extremity FE model. FE analyses for three types of gait simulations were performed based on the calculated muscle force and GRF. We observed the maximum stress point during toe-in gait was lower than the other types, by comparing the results of FE analyses at the 1st peak across gait types. This is the same as the trend exhibited by KAM, measured through motion analysis in other papers. This indicates that the progression of knee medial OA could be suppressed by adopting toe-in gait. This study integrated motion analysis with FE analysis. One advantage of this method is that re-modeling is not required even with changes in posture. Therefore another type of gait simulation or various motions of lower extremity can be easily analyzed using this method.

Keywords: finite element analysis, gait analysis, human model, motion capture

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1530 Disagreement among the United Nations Human Rights Bodies over the Legality of Deprivation of Liberty on the Grounds of Mental Disability

Authors: Ravan Samadov

Abstract:

Mentally disabled people are the most discriminated against among other disabled people and face much stronger negative attitudes across many cultures. The most complex and severe form of exclusion of these people is deprivation of liberty on the grounds of their disability. This problem was for many years overlooked to a great extent by the core human rights instruments. However, the United Nations (UN) Convention on the Rights of Persons with Disabilities (CRPD), adopted in 2006, is considered a potential tool to successfully fill the gap. It is especially vital for the developing countries with the vast majority of disabled people of the world and the CRPD is presumed to be able to trigger drastic positive changes. Article 14 of the mentioned human rights treaty has brought into the international forum a new notion, as prohibits deprivation of liberty on the grounds of disability. It is to be understood as an absolute prohibition of deprivation of liberty on the grounds of disability, including mental disability, which manifests in the form of non-consensual psychiatric hospitalisation. The interpretation by the CRPD Committee indicates that this prohibition well embraces all types of non-consensual psychiatric hospitalisation – whether it is based on illness, impairment or disability. This prohibition also extends to such justifications as ‘dangerousness’, ‘need for treatment’ and ‘diminished capacity’. Moreover, providing due substantive and/or procedural safeguards does not render any legitimacy to application of deprivation of liberty on the grounds of mental disability. Logically, this new prohibition form was to be duly considered by different UN human rights bodies, and was subsequently to bring changes to their practices. However, the analyses of post-CRPD work of those bodies allows for asserting the contrary, as they have continued displaying the position which recognises deprivation of liberty on the grounds of disability to be legitimate. While such a position could be justified in the pre-CRPD time as stemming from the silence of human rights documents about it, the continuation of this course after the CRPD entered into force may call the integrity and coherence of the UN human rights treaty system into question. The non-coherent approaches of different UN bodies to this novelty give grounds for misinterpretation thereof, and hinder its due implementation by the States Parties. The paper will discuss the nature of the mentioned new prohibition and the controversial approaches to that notion by different UN human rights bodies.

Keywords: CRPD, deprivation of liberty, mental disability, non-consensual psychiatric hospitalisation, UN bodies

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1529 The Politics of Foreign Direct Investment for Socio-Economic Development in Nigeria: An Assessment of the Fourth Republic Strategies (1999 - 2014)

Authors: Muritala Babatunde Hassan

Abstract:

In the contemporary global political economy, foreign direct investment (FDI) is gaining currency on daily basis. Notably, the end of the Cold War has brought about the dominance of neoliberal ideology with its mantra of private-sector-led economy. As such, nation-states now see FDI attraction as an important element in their approach to national development. Governments and policy makers are preoccupying themselves with unraveling the best strategies to not only attract more FDI but also to attain the desired socio-economic development status. In Nigeria, the perceived development potentials of FDI have brought about aggressive hunt for foreign investors, most especially since transition to civilian rule in May 1999. Series of liberal and market oriented strategies are being adopted not only to attract foreign investors but largely to stimulate private sector participation in the economy. It is on this premise that this study interrogates the politics of FDI attraction for domestic development in Nigeria between 1999 and 2014, with the ultimate aim of examining the nexus between regime type and the ability of a state to attract and benefit from FDI. Building its analysis within the framework of institutional utilitarianism, the study posits that the essential FDI strategies for achieving the greatest happiness for the greatest number of Nigerians are political not economic. Both content analysis and descriptive survey methodology were employed in carrying out the study. Content analysis involves desk review of literatures that culminated in the development of the study’s conceptual and theoretical framework of analysis. The study finds no significant relationship between transition to democracy and FDI inflows in Nigeria, as most of the attracted investments during the period of the study were market and resource seeking as was the case during the military regime, thereby contributing minimally to the socio-economic development of the country. It is also found that the country placed much emphasis on liberalization and incentives for FDI attraction at the neglect of improving the domestic investment environment. Consequently, poor state of infrastructure, weak institutional capability and insecurity were identified as the major factors seriously hindering the success of Nigeria in exploiting FDI for domestic development. Given the reality of the currency of FDI as a vector of economic globalization and that Nigeria is trailing the line of private-sector-led approach to development, it is recommended that emphasis should be placed on those measures aimed at improving the infrastructural facilities, building solid institutional framework, enhancing skill and technological transfer and coordinating FDI promotion activities by different agencies and at different levels of government.

Keywords: foreign capital, politics, socio-economic development, FDI attraction strategies

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1528 Comparative Evaluation of Ultrasound Guided Internal Jugular Vein Cannulation Using Measured Guided Needle and Conventional Size Needle for Success and Complication of Cannulation

Authors: Devendra Gupta, Vikash Arya, Prabhat K. Singh

Abstract:

Background: Ultrasound guidance could be beneficial in placing central venous catheters by improving the success rate, reducing the number of needle passes, and decreasing complications. Central venous cannulation set has a single puncture needle of a fixed length of 6.4 cm. However, the average distance of midpoint of IJV to the skin is around 1 cm to 2 cm. The long length needle has tendency to go in depth more than required and this is very common during learning period of any individual. Therefore, we devised a long needle with a guard which can be adjusted according to the required length. Methods: After approval from the institute ethics committee and patient’s written informed consent, a prospective, randomized, single-blinded controlled study was conducted. Adult patient aged of both sexes with ASA grade 1-2 undergoing surgery requiring internal jugular venous (IJV) access was included. After intubation, the head was rotated to the contralateral side at 30 degree head rotation on the position of the right IJV. The transducer probe a 6.5 to 13-MHz linear transducer (Sonosite, USA) had been placed at the apex of triangle with minimal pressure to avoid IJV compression. The distance from skin to midpoint of the right IJV and skin to anterior wall of Common Carotid Artery (CCA) had been done using B-mode duplex sonography with a 6.5 to 13-MHz linear transducer. Depending upon the results of randomization 420 patients had been divided into two groups of equal numbers (n=210). Group 1. USG guided right sided IJV cannulation was done with conventional (6.4 cm) needle; and Group 2. USG guided right sided IJV cannulation was done with conventional (6.4 cm) needle with guard fixed to a required length (length between skin and midpoint of IJV) by an experienced anesthesiologist. Independent observer has noted the number of attempts and occurrence of complications (CCA puncture, pneumothorax or adjacent tissue damage). Results: Demographic data were similar in both the group. The groups were comparable when considered for relationship of IJV to CCA. There was no significant difference between groups as regard to distance of midpoint of IJV to the skin (p<0.05). IJV cannulation was successfully done in single attempts in 180 (85.7%), in two attempts in 27 (12.9%) and three attempts in 3 (1.4%) in group I, whereas in single attempt in 207 (98.6%) and second attempts in 3 (1.4%) in group II (p <0.000). Incidence of carotid artery puncture was significantly more in group I (7.1%) compared to group II (0%) (p<0.000). Incidence of adjacent tissue puncture was significantly more in group I (8.6%) compared to group II (0%) (p<0.000). Conclusion: Therefore IJV catheterization using guard over the needle at predefined length with the help of real-time ultrasound results in better success rates and lower immediate complications.

Keywords: ultrasound guided, internal jugular vein cannulation, measured guided needle, common carotid artery puncture

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1527 A Review of Lexical Retrieval Intervention in Primary Progressive Aphasia and Alzheimer's Disease: Mechanisms of Change, Cognition, and Generalisation

Authors: Ashleigh Beales, Anne Whitworth, Jade Cartwright

Abstract:

Background: While significant benefits of lexical retrieval intervention are evident within the Primary Progressive Aphasia (PPA) and Alzheimer’s disease (AD) literature, an understanding of the mechanisms that underlie change or improvement is limited. Change mechanisms have been explored in the non-progressive post-stroke literature that may offer insight into how interventions affect change with progressive language disorders. The potential influences of cognitive factors may also play a role here, interacting with the aims of intervention. Exploring how such processes have been applied is likely to grow our understanding of how interventions have, or have not, been effective, and how and why generalisation is likely, or not, to occur. Aims: This review of the literature aimed to (1) investigate the proposed mechanisms of change which underpin lexical interventions, mapping the PPA and AD lexical retrieval literature to theoretical accounts of mechanisms that underlie change within the broader intervention literature, (2) identify whether and which nonlinguistic cognitive functions have been engaged in intervention with these populations and any proposed influence, and (3) explore evidence of linguistic generalisation, with particular reference to change mechanisms employed in interventions. Main contribution: A search of Medline, PsycINFO, and CINAHL identified 36 articles that reported data for individuals with PPA or AD following lexical retrieval intervention. A review of the mechanisms of change identified 10 studies that used stimulation, 21 studies utilised relearning, three studies drew on reorganisation, and two studies used cognitive-relay. Significant treatment gains, predominantly based on linguistic performance measures, were reported for all client groups for each of the proposed mechanisms. Reorganisation and cognitive-relay change mechanisms were only targeted in PPA. Eighteen studies incorporated nonlinguistic cognitive functions in intervention; these were limited to autobiographical memory (16 studies), episodic memory (three studies), or both (one study). Linguistic generalisation outcomes were inconsistently reported in PPA and AD studies. Conclusion: This review highlights that individuals with PPA and AD may benefit from lexical retrieval intervention, irrespective of the mechanism of change. Thorough application of a theory of intervention is required to gain a greater understanding of the change mechanisms, as well as the interplay of nonlinguistic cognitive functions.

Keywords: Alzheimer's disease, lexical retrieval, mechanisms of change, primary progressive aphasia

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1526 Reproductive Behavior of the Red Sea Immigrant Lagocephalus sceleratus (Gmelin, 1789) from the Mediterranean Coast, Egypt

Authors: Mahmoud M. S. Farrag, Alaa A. K. Elhaweet, El-Sayed Kh. A. Akel, Mohsen A. Moustafa

Abstract:

The present work aimed to study the reproductive strategy of the common lessepsian puffer fish Lagocephalus sceleratus (Gmelin, 1879) from the Egyptian Mediterranean Waters. It is a famous migratory species plays an important role in the field of fisheries and ecology of aquatic ecosystem. The specimens were collected monthly from the landing centers along the Egyptian Mediterranean coast during 2012. Six maturity stages were recorded: (I) Thread like stage, (II) Immature stage (Virgin stage), (III) Maturing stage (Developing Virgin and recovering spent), (IV) Nearly ripe stage, (V) Fully ripe, (VI) Spawning stage, (VII) Spent stage. According to sex ratio, males exhibited higher number than females representing 52.44 % of the total fishes with sex ratio 1: 0.91. Fish length corresponding to 50% maturation was 38.5 cm for males and 41 cm for females. The corresponding ages (age at first maturity) are equal to 2.14 and 2.27 years for male and female respectively. The ova diameter ranged from 0.02mm to 0.85mm, the mature ova ranged from 0.16mm to 0.85mm and showed progressive increase from April towards September. Also, the presences of ova diameter in one peak of mature and ripe eggs in the ovaries were observed during spawning period. The relationship between gutted weight and absolute fecundity indicated that that fecundity increased as the fish grew in weight. The absolute fecundity ranged from 260288 to 2372931 for fish weight ranged from 698 to 3285 cm with an average of 1449522±720975. The relative fecundity ranged from 373 to 722 for fish weight ranged from 698 to 3285 cm with an average of 776±231. The spawning season of L. sceleratus was investigated from the data of gonado-somatic index and monthly distribution of maturity stages along the year as well as sequence of ova diameter for mature stages and exhibited a relatively prolong spawning season extending from April for both sexes and ends in August for male while ends in September for female. Fish releases its ripe ova in one batch during the spawning season. Histologically, the ovarian cycle of L. sceleratus was classified into six stages and the testicular cycle into five stages. Histological characters of gonads of L. sceleratus during the year of study had confirmed the previous results of distribution of maturity stages, gonado-somatic index and ova diameter, indicating this fish species has prolonged spawning season from April to September. This species is considered totally or uni spawner with synchronous group as it contained one to two developmental stages at the same gonad.

Keywords: Lagocephalus sceleratus, reproductive biology, oogenesis, histology

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1525 Dermatophytoses: Spectrum Evolution of Dermatophytes in Sfax, Tunisia, Between 1999 and 2019

Authors: Khemakhem Nahed, Hammami Fatma, Trabelsi Houaida, Neji Sourour, Sellami Hayet, Makni Fattouma, Turki Hamida, Ayadi Ali

Abstract:

Dermatophytoses are considered a public health problem and represent 10% of dermatological consultations in our region. Their epidemiology is influenced by various factors, such as lifestyle, human migration patterns, changes in the environment and the host relationship. The understanding of epidemiology has a major impact on their prevention and treatment. The aim of the study is to determine the prevalence pattern of aetiological agents and to describe the clinical characteristics of dermatophytoses between 1999 and 2019. Out of 65 059 subjects suspected to have superficial mycoses, 36 220 (55.67%) were affected with dermatophytoses. The mean age was 40.1 years (range: 10 days to 99 years). The sex ratio was 0.8. Our patients were from urban regions in 80.9% of cases. The most common type of infection was onychomycosis (42.64%), followed by tinea pedis (20.8%), intertrigo (18.3%), tinea corporis (8.48%) and tinea capitis (7.87%). The most isolated dermatophyte was Trichophyton rubrum (76.5%), followed by T. mentagrophytes complex (6.3%), Microsporum canis (5.8%), T. violaceum (5.3%), T. verrucosum (0.83%) and Epidermophyton floccosum (0.3%). Zoophilic agents have become more prevalent and their frequency has been increased from 6.46% in 1999 to 13% in 2019. It is interesting to note that M. canis has been on the rise since 2010 and it was the first etiological agent of tinea capitis (48%), while infections caused by T. violaceum continued to decrease from 1999 (16.2%) to 2019 (4.7%). Other dermatophytes have been rarely isolated: T. tonsurans (9 cases), T. schoenleinii (3 cases), T. soudanense (2 cases), M. fulvum (1 case), M. audouinii (1 case) and M. ferrugineum (2 cases).T. mentagrophytes var. quinckeanum was isolated from an inflammatory tinea capitis lesion in an a-3-year-old girl. T. mentagrophytes var. erinacei was isolated from the first case of tinea manuum, in-a-10-year-old girl. The same fungus was isolated from the hair and scales of the hedgehog. Our study showed significant changes in the dermatophytes spectrum in our region. The prevalence of zoophilic species increased in recent years due to people's behavioral changes with the adoption of pets and animal husbandry in urban settings. Molecular methods are often crucial that help us to refine the identification strains of dermatophytes and to identify their origin of the contamination.

Keywords: dermatophytoses, PCR-sequencing, spectrum, Sfax, Tunisia

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1524 Causal Estimation for the Left-Truncation Adjusted Time-Varying Covariates under the Semiparametric Transformation Models of a Survival Time

Authors: Yemane Hailu Fissuh, Zhongzhan Zhang

Abstract:

In biomedical researches and randomized clinical trials, the most commonly interested outcomes are time-to-event so-called survival data. The importance of robust models in this context is to compare the effect of randomly controlled experimental groups that have a sense of causality. Causal estimation is the scientific concept of comparing the pragmatic effect of treatments conditional to the given covariates rather than assessing the simple association of response and predictors. Hence, the causal effect based semiparametric transformation model was proposed to estimate the effect of treatment with the presence of possibly time-varying covariates. Due to its high flexibility and robustness, the semiparametric transformation model which shall be applied in this paper has been given much more attention for estimation of a causal effect in modeling left-truncated and right censored survival data. Despite its wide applications and popularity in estimating unknown parameters, the maximum likelihood estimation technique is quite complex and burdensome in estimating unknown parameters and unspecified transformation function in the presence of possibly time-varying covariates. Thus, to ease the complexity we proposed the modified estimating equations. After intuitive estimation procedures, the consistency and asymptotic properties of the estimators were derived and the characteristics of the estimators in the finite sample performance of the proposed model were illustrated via simulation studies and Stanford heart transplant real data example. To sum up the study, the bias of covariates was adjusted via estimating the density function for truncation variable which was also incorporated in the model as a covariate in order to relax the independence assumption of failure time and truncation time. Moreover, the expectation-maximization (EM) algorithm was described for the estimation of iterative unknown parameters and unspecified transformation function. In addition, the causal effect was derived by the ratio of the cumulative hazard function of active and passive experiments after adjusting for bias raised in the model due to the truncation variable.

Keywords: causal estimation, EM algorithm, semiparametric transformation models, time-to-event outcomes, time-varying covariate

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1523 The Importance of Urban Pattern and Planting Design in Urban Transformation Projects

Authors: Mustafa Var, Yasin Kültiğin Yaman, Elif Berna Var, Müberra Pulatkan

Abstract:

This study deals with real application of an urban transformation project in Trabzon, Turkey. It aims to highlight the significance of using native species in terms of planting design of transformation projects which will also promote sustainability of urban identity. Urban identity is a phenomenon shaped not only by physical, but also by natural, spatial, social, historical and cultural factors. Urban areas face with continuous change which can be whether positive or negative way. If it occurs in a negative way that may have some destructive effects on urban identity. To solve this problematic issue, urban renewal movements initally started after 1840s around the world especially in the cities with ports. This process later followed by the places where people suffered a lot from fires and has expanded to all over the world. In Turkey, those processes have been experienced mostly after 1980s as country experienced the worst effects of unplanned urbanization especially in 1950-1990 period. Also old squares, streets, meeting points, green areas, Ottoman bazaars have changed slowly. This change was resulted in alienation of inhabitants to their environments. As a solution, several actions were taken like Mass Housing Laws which was enacted in 1981 and 1984 or urban transformation projects. Although projects between 1990-2000 were tried to satisfy the expectations of local inhabitants by the help of several design solutions to promote cultural identity; unfortunately those modern projects has also been resulted in alienation of urban environments to the inhabitants. Those projects were initially done by TOKI (Housing Development Administration of Turkey) and later followed by the Ministry of Environment and Urbanization after 2011. Although they had significant potentials to create healthy urban environments, they could not use this opportunity in an effective way. The reason for their failure is that their architectural styles and planting designs are unrespectful to local identity and environments. Generally, it can be said that the most of the urban transformation projects implementing in Turkey nearly have no concerns about the locality. However, those projects can be used as a positive tool for enhanching the urban identity of cities by means of local planting material. For instance, Kyoto can be identified by Japanese Maple trees or Seattle can be specified by Dahlia. In the same way, in Turkey, Istanbul city can be identified by Judas and Stone Pine trees or Giresun city can be identified by Cherry trees. Thus, in this paper, the importance of conserving urban identity is discussed specificly with the help of using local planting elements. After revealing the mistakes that are made during urban transformation projects, the techniques and design criterias for preserving and promoting urban identity are examined. In the end, it is emphasized that every city should have their own original, local character and specific planting design which can be used for highlighting its identity as well as architectural elements.

Keywords: urban identity, urban transformation, planting design, landscape architecture

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1522 Phytochemicals Quatification, Trace Metal Accumulation Pattern and Contamination Risk Assessment of Different Variety of Tomatoes Cultivated on Municipal Waste Sludge Treated Soil

Authors: Mathodzi Nditsheni, Olawole Emmanuel Aina, Joshua Oluwole Olowoyo

Abstract:

The ever-increasing world population is putting extreme pressure on the already limited agricultural resources for food production. Different soil enhancers were introduced by famers to meet the need of the ever-increasing population demand for food. One of the soil enhancers is the municipal waste sludge. This research investigated the differences in the concentrations of trace metals and levels of phytochemicals in four different tomato varieties cultivated on soil treated with municipal waste sludge in Pretoria, South Africa. Fruits were harvested at maturity and analyzed for trace metals and phytochemicals contents using Inductively Coupled Plasma Optical Emission Spectrometry (ICP-OES) and a High-Performance Liquid Chromatography (HPLC) respectively. A one-way analysis of variance (ANOVA) was used to determine the differences in the concentrations of trace metals and phytochemical from different tomato varieties were significant. From the study, Rodade tomato bioaccumulated the highest concentrations of Mn, Cr, Cu and Ni, Roma bioaccumulated the highest concentrations of, Cd, Fe and Pb while Heinz bioaccumulated the highest concentrations of As and Zn. Cherry tomato on the other hand, recorded the lowest concentrations for most metals, Cd, Cr, Cu, Mn, Ni, Pb and Zn. The results of the study further showed that phenolic and flavonoids content were higher in the Solanum lycopersicum fruit grown in soils treated with municipal waste sludge. The study also showed that there was an inverse relationship between the levels of trace metals and phytochemicals. The calculated contamination factor values of trace metals like Cr, Cu, Pb and Zn were above the safe value of 1 which indicated that the tomato fruits may be unsafe for human consumption. However, the contamination factor values for the remaining trace metals were well below the safe value of 1. From the results obtained either for the control group or the treatment, the tomato varieties used in the study, bioaccumulated the toxic trace metals in their fruits and some of the values obtained were higher than the acceptable limit, which may then imply that the varieties of tomato used in this study bio accumulated the toxic trace metals from the soil, hence care should be taken when these tomato varieties are either cultivated or harvested from polluted areas

Keywords: trace metals, flavonoids, phenolics, waste sludge, tomato, contamination factors

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1521 12 Real Forensic Caseworks Solved by the DNA STR-Typing of Skeletal Remains Exposed to Extremely Environment Conditions without the Conventional Bone Pulverization Step

Authors: Chiara Della Rocca, Gavino Piras, Andrea Berti, Alessandro Mameli

Abstract:

DNA identification of human skeletal remains plays a valuable role in the forensic field, especially in missing persons and mass disaster investigations. Hard tissues, such as bones and teeth, represent a very common kind of samples analyzed in forensic laboratories because they are often the only biological materials remaining. However, the major limitation of using these compact samples relies on the extremely time–consuming and labor–intensive treatment of grinding them into powder before proceeding with the conventional DNA purification and extraction step. In this context, a DNA extraction assay called the TBone Ex kit (DNA Chip Research Inc.) was developed to digest bone chips without powdering. Here, we simultaneously analyzed bone and tooth samples that arrived at our police laboratory and belonged to 15 different forensic casework that occurred in Sardinia (Italy). A total of 27 samples were recovered from different scenarios and were exposed to extreme environmental factors, including sunlight, seawater, soil, fauna, vegetation, and high temperature and humidity. The TBone Ex kit was used prior to the EZ2 DNA extraction kit on the EZ2 Connect Fx instrument (Qiagen), and high-quality autosomal and Y-chromosome STRs profiles were obtained for the 80% of the caseworks in an extremely short time frame. This study provides additional support for the use of the TBone Ex kit for digesting bone fragments/whole teeth as an effective alternative to pulverization protocols. We empirically demonstrated the effectiveness of the kit in processing multiple bone samples simultaneously, largely simplifying the DNA extraction procedure and the good yield of recovered DNA for downstream genetic typing in highly compromised forensic real specimens. In conclusion, this study turns out to be extremely useful for forensic laboratories, to which the various actors of the criminal justice system – such as potential jury members, judges, defense attorneys, and prosecutors – required immediate feedback.

Keywords: DNA, skeletal remains, bones, tbone ex kit, extreme conditions

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1520 Ischemic Stroke Detection in Computed Tomography Examinations

Authors: Allan F. F. Alves, Fernando A. Bacchim Neto, Guilherme Giacomini, Marcela de Oliveira, Ana L. M. Pavan, Maria E. D. Rosa, Diana R. Pina

Abstract:

Stroke is a worldwide concern, only in Brazil it accounts for 10% of all registered deaths. There are 2 stroke types, ischemic (87%) and hemorrhagic (13%). Early diagnosis is essential to avoid irreversible cerebral damage. Non-enhanced computed tomography (NECT) is one of the main diagnostic techniques used due to its wide availability and rapid diagnosis. Detection depends on the size and severity of lesions and the time spent between the first symptoms and examination. The Alberta Stroke Program Early CT Score (ASPECTS) is a subjective method that increases the detection rate. The aim of this work was to implement an image segmentation system to enhance ischemic stroke and to quantify the area of ischemic and hemorrhagic stroke lesions in CT scans. We evaluated 10 patients with NECT examinations diagnosed with ischemic stroke. Analyzes were performed in two axial slices, one at the level of the thalamus and basal ganglion and one adjacent to the top edge of the ganglionic structures with window width between 80 and 100 Hounsfield Units. We used different image processing techniques such as morphological filters, discrete wavelet transform and Fuzzy C-means clustering. Subjective analyzes were performed by a neuroradiologist according to the ASPECTS scale to quantify ischemic areas in the middle cerebral artery region. These subjective analysis results were compared with objective analyzes performed by the computational algorithm. Preliminary results indicate that the morphological filters actually improve the ischemic areas for subjective evaluations. The comparison in area of the ischemic region contoured by the neuroradiologist and the defined area by computational algorithm showed no deviations greater than 12% in any of the 10 examination tests. Although there is a tendency that the areas contoured by the neuroradiologist are smaller than those obtained by the algorithm. These results show the importance of a computer aided diagnosis software to assist neuroradiology decisions, especially in critical situations as the choice of treatment for ischemic stroke.

Keywords: ischemic stroke, image processing, CT scans, Fuzzy C-means

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1519 Treating Complex Pain and Addictions with Bioelectrode Therapy: An Acupuncture Point Stimulus Method for Relieving Human Suffering

Authors: Les Moncrieff

Abstract:

In a world awash with potent opioids flaming an international crisis, the need to explore safe alternatives has never been more urgent. Bio-electrode Therapy is a novel adjunctive treatment method for relieving acute opioid withdrawal symptoms and many types of complex acute and chronic pain (often the underlying cause of opioid dependence). By combining the science of developmental bioelectricity with Traditional Chinese Medicine’s theory of meridians, rapid relief from pain is routinely being achieved in the clinical setting. Human body functions are dependent on electrical factors, and acupuncture points on the body are known to have higher electrical conductivity than surrounding skin tissue. When tiny gold- and silver-plated electrodes are secured to the skin at specific acupuncture points using established Chinese Medicine principles and protocols, an enhanced microcurrent and electrical field are created between the electrodes, influencing the entire meridian and connecting meridians. No external power source or electrical devices are required. Endogenous DC electric fields are an essential fundamental component for development, regeneration, and wound healing. Disruptions in the normal ion-charge in the meridians and circulation of blood will manifest as pain and development of disease. With the application of these simple electrodes (gold acting as cathode and silver as anode) according to protocols, the resulting microcurrent is directed along the selected meridians to target injured or diseased organs and tissues. When injured or diseased cells have been stimulated by the microcurrent and electrical fields, the permeability of the cell membrane is affected, resulting in an immediate relief of pain, a rapid balancing of positive and negative ions (sodium, potassium, etc.) in the cells, the restoration of intracellular fluid levels, replenishment of electrolyte levels, pH balance, removal of toxins, and a re-establishment of homeostasis.

Keywords: bioelectricity, electrodes, electrical fields, acupuncture meridians, complex pain, opioid withdrawal management

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1518 A Case Study of Remote Location Viewing, and Its Significance in Mobile Learning

Authors: James Gallagher, Phillip Benachour

Abstract:

As location aware mobile technologies become ever more omnipresent, the prospect of exploiting their context awareness to enforce learning approaches thrives. Utilizing the growing acceptance of ubiquitous computing, and the steady progress both in accuracy and battery usage of pervasive devices, we present a case study of remote location viewing, how the application can be utilized to support mobile learning in situ using an existing scenario. Through the case study we introduce a new innovative application: Mobipeek based around a request/response protocol for the viewing of a remote location and explore how this can apply both as part of a teacher lead activity and informal learning situations. The system developed allows a user to select a point on a map, and send a request. Users can attach messages alongside time and distance constraints. Users within the bounds of the request can respond with an image, and accompanying message, providing context to the response. This application can be used alongside a structured learning activity such as the use of mobile phone cameras outdoors as part of an interactive lesson. An example of a learning activity would be to collect photos in the wild about plants, vegetation, and foliage as part of a geography or environmental science lesson. Another example could be to take photos of architectural buildings and monuments as part of an architecture course. These images can be uploaded then displayed back in the classroom for students to share their experiences and compare their findings with their peers. This can help to fosters students’ active participation while helping students to understand lessons in a more interesting and effective way. Mobipeek could augment the student learning experience by providing further interaction with other peers in a remote location. The activity can be part of a wider study between schools in different areas of the country enabling the sharing and interaction between more participants. Remote location viewing can be used to access images in a specific location. The choice of location will depend on the activity and lesson. For example architectural buildings of a specific period can be shared between two or more cities. The augmentation of the learning experience can be manifested in the different contextual and cultural influences as well as the sharing of images from different locations. In addition to the implementation of Mobipeek, we strive to analyse this application, and a subset of other possible and further solutions targeted towards making learning more engaging. Consideration is given to the benefits of such a system, privacy concerns, and feasibility of widespread usage. We also propose elements of “gamification”, in an attempt to further the engagement derived from such a tool and encourage usage. We conclude by identifying limitations, both from a technical, and a mobile learning perspective.

Keywords: context aware, location aware, mobile learning, remote viewing

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1517 Improving Depression, Anxiety and Distress Symptoms in Type 2 Diabetes Patients

Authors: Seyed Reza Alvani, Norzarina Mohd Zaharim

Abstract:

Diabetes mellitus is one of the chronic, progressive illnesses that has reached a widespread level all over the world and considered an extreme life-threatening condition in South East Asian countries region include Malaysia. Co-morbid psychological factors like diabetes-related distress and low level of psychological well-being are related to high levels of blood sugar and hypo/hyperglycemia complications. As a result, the implementation of any effective psychological interventions among diabetes patients is necessary. One such intervention is cognitive behavioural therapy (CBT) that is approved and suggested by many professionals as an empirically-supported technique of treatment for people how are suffering from diabetes around the world where there is no clear evidence of using this technique in Malaysia. The target of this study was to see whether or not participation in group CBT would end in an improvement of psychological well-being (by decreasing the levels of depression and anxiety) and diabetes-related distress followed by lower level of blood sugar level. The sample of the present study was 60 type 2 diabetes adults (ages 20-65) with HbA1c ≥ 7 from Universiti Sains Malaysia (USM) clinic. All participants were selected by the convenience sampling technique. Participants completed Well-Being Questionaire (W-BQ) and Distress Scale (DDS-17) after signing written consent form. Those participants who were interested to join CBT groups were placed to the experimental groups, and people who were not interested were assigned to the control group. The experimental groups (n = 30) received group CBT, whereas participants in the control group (n = 30) did not receive any kind of psychological intervention. For testing the effect of intervention, mixed between-within ANOVA used. The entire intervention program took three months, and a significant improvement in the level of psychological well-being and decline in the level of diabetes distress observed among participants from experimental group, but not for those in the control group. Additionally, the result of the study suggested that group CBT could help participants in experimental group achieve more acceptable HbA1c levels in comparison with those in the control group. Malaysian Ministry of Health, researcher and governors should give due interest and commitment to psychological care as a pathway to diabetes mitigation among Malaysian adults.

Keywords: cognitive behavioral therapy, diabetes related distress, diabetes type 2, Malaysia, well-being

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