Search results for: insulin infusion protocol

Authors: Rodziana M. Razali, Tamara J. Duraisingham

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Malaysia is not a signatory to the 1951 Refugee Convention and its 1967 Protocol despite receiving the largest share of refugee inflows in Southeast Asia aside from Thailand. In Peninsular Malaysia, the majority of refugees and asylum seekers are from Myanmar, with Rohingya refugees recording the highest number compared to all other ethnicities. In the eastern state of Sabah, the presence of refugees who have long established themselves in the state is connected to those who escaped military persecution in southern Philippines in the 1970’s and 1980’s. A combination of legal and non-legal factors has created and sustained an adverse atmosphere of deprivation of legal identity for children of migrants including refugees born in Malaysia. This paper aims to qualitatively analyse the barriers to birth registration as the cornerstone of every person’s legal identity for children of refugees born in this country, together with the associated human rights implications. Data obtained through semi-structured interviews with refugees in Kota Kinabalu, Sabah and Rohingya refugees in Peninsular Malaysia shall be studied alongside secondary sources. Results show that births out of medical facilities, suspension of birth records, illiteracy, lack of awareness on the importance and procedures of birth registration, inability to meet documentary requirements, as well as fear of immigration enforcement, are the key factors hindering birth registration. These challenges exist against the backdrop of restrictive integration policy to avoid destabilising demographic and racial balance, political sentiment stirring xenophobic prejudices, as well as other economic and national security considerations. With no proof of their legal identity, the affected children grow up in a legal limbo, facing multiple human rights violations across generations. This research concludes that the country’s framework and practice concerning birth registration is in need of serious reform and improvement to reflect equality and universality of access to its birth registration system. Such would contribute significantly towards meeting its commitments to the post-2015 sustainable development agenda that pledges to 'Leave no one behind', as well as its recently announced National Human Rights Action Plan.

Keywords: birth registration, children, Malaysia, refugees

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Authors: A. Schander, T. Tessmann, H. Stemmann, S. Strokov, A. Kreiter, W. Lang

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For the chronic application of neural prostheses and other brain-computer interfaces, long-term stable microelectrodes for electrical stimulation are essential. In recent years many developments were done to investigate different appropriate materials for these electrodes. One of these materials is the electrical conductive polymer poly(3,4-ethylenedioxythiophene) (PEDOT), which has lower impedance and higher charge injection capacity compared to noble metals like gold and platinum. However the long-term stability of this polymer is still unclear. Thus this paper reports on the in-vitro evaluation of the long-term stability of PEDOT coated gold microelectrodes. For this purpose a highly flexible electrocorticography (ECoG) electrode array, based on the polymer polyimide, is used. This array consists of circular gold electrodes with a diameter of 560 µm (0.25 mm2). In total 25 electrodes of this array were coated simultaneously with the polymer PEDOT:PSS in a cleanroom environment using a galvanostatic electropolymerization process. After the coating the array is additionally sterilized using a steam sterilization process (121°C, 1 bar, 20.5 min) to simulate autoclaving prior to the implantation of such an electrode array. The long-term measurements were performed in phosphate-buffered saline solution (PBS, pH 7.4) at the constant body temperature of 37°C. For the in-vitro electrical stimulation a one channel bipolar current stimulator is used. The stimulation protocol consists of a bipolar current amplitude of 5 mA (cathodal phase first), a pulse duration of 100 µs per phase, a pulse pause of 50 µs and a frequency of 1 kHz. A PEDOT:PSS coated gold electrode with an area of 1 cm2 serves as the counter electrode. The electrical stimulation is performed continuously with a total amount of 86.4 million bipolar current pulses per day. The condition of the PEDOT coated electrodes is monitored in between with electrical impedance spectroscopy measurements. The results of this study demonstrate that the PEDOT coated electrodes are stable for more than 3.6 billion bipolar current pulses. Also the unstimulated electrodes show currently no degradation after the time period of 5 months. These results indicate an appropriate long-term stability of this electrode coating for chronic recording and electrical stimulation. The long-term measurements are still continuing to investigate the life limit of this electrode coating.

Keywords: chronic recording, electrical stimulation, long-term stability, microelectrodes, PEDOT

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Authors: Ugur Fidan, Naim Karasekreter

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Healthy and clean water should not contain disease-causing micro-organisms and toxic chemicals and must contain the necessary minerals in a balanced manner. Today, water resources have a limited and strategic importance, necessitating the management of water reserves. Water tanks meet the water needs of people and should be regularly chlorinated to prevent waterborne diseases. For this purpose, automatic chlorination systems placed in water tanks for killing bacteria. However, the regular operation of automatic chlorination systems depends on refilling the chlorine tank when it is empty. For this reason, there is a need for a stock control system, in which chlorine levels are regularly monitored and supplied. It has become imperative to take urgent measures against epidemics caused by the fact that most of our country is not aware of the end of chlorine. The aim of this work is to rehabilitate existing water tanks and to provide a method for a modern water storage system in which chlorination is digitally monitored by turning the newly established water tanks into a closed system. A sensor network structure using GSM/GPRS communication infrastructure has been developed in the study. The system consists of two basic units: hardware and software. The hardware includes a chlorine level sensor, an RFID interlock system for authorized personnel entry into water tank, a motion sensor for animals and other elements, and a camera system to ensure process safety. It transmits the data from the hardware sensors to the host server software via the TCP/IP protocol. The main server software processes the incoming data through the security algorithm and informs the relevant unit responsible (Security forces, Chlorine supply unit, Public health, Local Administrator) by e-mail and SMS. Since the software is developed base on the web, authorized personnel are also able to monitor drinking water tank and report data on the internet. When the findings and user feedback obtained as a result of the study are evaluated, it is shown that closed drinking water tanks are built with GRP type material, and continuous monitoring in digital environment is vital for sustainable health water supply for people.

Keywords: wireless sensor networks (WSN), monitoring, chlorine, water tank, security

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Authors: Nuttapimon Bhirommuang, Kulapong Jayanama

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Background: Prevalence of malnutrition in hospitalized patient is higher than general population. As a result of the unawareness of consequence and the more concerning in the other aspects of care, many patients with high risk of malnutrition are unrecognized. Even if malnutrition has been identified as affecting in many patient outcomes, the impact may differ in each population and group of patients. Objectives: The aims of this study were to examine the association between the nutritional status and the length of stay and hospital costs in hospitalized patients, to investigate the factors related these outcomes and to determine the frequency of malnutrition in hospitals. Method: This retrospective cohort study enrolled all patients aged 15 years old or older and admitted in SDMC, Ramathibodi Hospital between 1st January 2016 and 30th September 2016. The nutritional status assessment by Nutrition Alert Form (NAF) was performed by well-trained nurses in all patients at admission. Baseline characteristics were recorded. Length of stay and hospital costs were collected during their hospitalization. Univariate analysis, nonparametric rank test, Kruskal-Wallis test were used to compare means in the case of nonnormally and noncontinuously distributed data. Chi-square used to analyze categorical variables, the nutritional status and the length of stay and hospital costs and identify possible confounding factors (data were analyzed using SPSS version 18.0). Result: Of the 2,906 patients, 3.9% were severe malnutrition (NAF-C score > 10) and 11.4% were moderate malnutrition (NAF-B score 6 - 10). Both length of stay and hospital costs were found significantly higher in more severe malnutrition group (p < 0.001), NAF = A: 3.21 days, 95% CI 3.06-3.35 and 111,544.25 THB, 95% CI 106,994.41 – 116,094.1; NAF = B: 7.54 days, 95% CI 6.32 – 8.76 and 162,302.4 THB, 95% CI 129,557.88 – 195,046.92; NAF =C: 14.77 days, 95% CI 11.34 – 18.2 and 323,572.11 THB, 95% CI 226,958.1 – 420,096.13 (1 THB = 0.03019 USD). Age of each nutritional status group had also significant increase from NAF A to NAF C (p < 0.001): 55.07, 67.03 and 73.88 years old, respectively. Conclusion: The prevalence of malnutrition in Ramathibodi hospital is voluminous. Severe malnutrition screening by NAF is significantly correlated with worse clinical outcome, especially higher length of stay and hospital costs. Elderly is also a significant factor which correlates with malnutrition. The results of this study could change the awareness of health personnel and the practice protocol. Moreover, the further study concerning nutritional support in high-risk group of malnutrition is ongoing to confirm this hypothesis.

Keywords: malnutrition, NAF, length of stay, hospital costs

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Authors: Emanuela Chiarella, Clelia Nisticò, Nicola Lombardo, Giovanna Lucia Piazzetta, Nadia Lobello, Maria Mesuraca

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Killian’s Antrochoanal Polyp is a benign lesion of the maxillary sinus characterized by unilateral nasal obstruction, pus discharge, and headache. It affects, more commonly children and young adults. Although its etiology still remains unclear, chronic inflammation, autoreactivity, allergies, and viral infections are strongly associated with its formation and development, resulting in nasal tissue remodeling. We aimed to investigate the stem cells components which reside in this pathological tissue. In particular, we adopted a protocol for the isolation and culturing of mesenchymal stem cells from surgical biopsies of three Killian nasal polyp patients (KNP-MSCs) as well as from their healthy nasal tissue (HNT-MSCs) that were used as controls. The immunophenotype profile of HNT-MSCs and KNP-MSCs was more similar, with a marked positivity for CD73, CD90, and CD105 expression, while being negative for CD34 and CD14 haematopoietic genes. Cell proliferation assay showed that KNP-MSCs had a replicative disadvantage compared to HNT-MSCs, as evidenced by the significantly lower number of cells in the S-phase of the cell cycle. KNP-MSCs also took longer to close a wound than HNT-MSCs, indicating a partial epithelial phenotype in which low levels of ICAM-1 mRNA and a significant increase in E-CAD transcript were detectable. Subsequently, the differentiation potential of both MSCs populations was analyzed by inducing osteoblastic or adipocyte differentiation for up to 20 days. KNP-MSCs showed the ability to differentiate into osteoblasts, although ALP activity as well as the number and size of calcium deposits were lower than osteogenic induced-HNT-MSCs. Also, mRNA levels of osteoblastic marker genes (OCN, OPN, OSX, RUNX2) resulted lower compared to control cell population. Instead, the analysis of the adipogenic differentiation potential showed a similar behavior between KNP-MSCs and HNT-MSCs considering that the amount of lipid droplets, the expression of adipocyte-specific genes (FABP4, AdipoQ, PPARγ2, LPL) and the content of triacylglycerols were almost overlapping. Taken together, these results first demonstrated that Killian's nasal polyp is a source of mesenchymal stem cells with self-renewal and multi-differentiative capabilities.

Keywords: Mesenchymal stem cells, adipogenic differentiation, osteogenic differentiation, EMT

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Authors: Bharti Jain, Rajeev Jain, Abuzar Kabir, Torki Zughaibi, Shweta Sharma

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Drug-facilitated crimes (DFCs) entail the use of a single drug or a mixture of drugs to render a victim unable. Traditionally, biological samples have been gathered from victims and conducted analysis to establish evidence of drug administration. Nevertheless, the rapid metabolism of various drugs and delays in analysis can impede the identification of such substances. For this, the present article describes a rapid, sustainable, highly efficient and miniaturized protocol for the identification and quantification of three sedative-hypnotic drugs, namely diazepam, chlordiazepoxide and ketamine in alcoholic beverages and complex food samples (cream of biscuit, flavored milk, juice, cake, tea, sweets and chocolate). The methodology involves utilizing fabric phase sorptive extraction (FPSE) to extract diazepam (DZ), chlordiazepoxide (CDP), and ketamine (KET). Subsequently, the extracted samples are subjected to analysis using gas chromatography-mass spectrometry (GC-MS). Several parameters, including the type of membrane, pH, agitation time and speed, ionic strength, sample volume, elution volume and time, and type of elution solvent, were screened and thoroughly optimized. Sol-gel Carbowax 20M (CW-20M) has demonstrated the most effective extraction efficiency for the target analytes among all evaluated membranes. Under optimal conditions, the method displayed linearity within the range of 0.3–10 µg mL–¹ (or µg g–¹), exhibiting a coefficient of determination (R2) ranging from 0.996–0.999. The limits of detection (LODs) and limits of quantification (LOQs) for liquid samples range between 0.020-0.069 µg mL-¹ and 0.066-0.22 µg mL-¹, respectively. Correspondingly, the LODs for solid samples ranged from 0.056-0.090 µg g-¹, while the LOQs ranged from 0.18-0.29 µg g-¹. Notably, the method showcased better precision, with repeatability and reproducibility both below 5% and 10%, respectively. Furthermore, the FPSE-GC-MS method proved effective in determining diazepam (DZ) in forensic food samples connected to drug-facilitated crimes (DFCs). Additionally, the proposed method underwent evaluation for its whiteness using the RGB12 algorithm.

Keywords: drug facilitated crime, fabric phase sorptive extraction, food forensics, white analytical chemistry

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Authors: Ajit Brindhaban

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Background and Purpose: Computed Tomography (CT) scans have become the largest source of radiation in radiological imaging. The purpose of this study was to compare the quality of pediatric Computed Tomography (CT) images reconstructed using Filtered Back Projection (FBP) with images reconstructed using different strengths of Iterative Reconstruction (IR) technique, and to perform a feasibility study to assess the use of IR techniques as a dose reduction tool. Materials and Methods: An anthropomorphic phantom representing a 5-year old child was scanned, in two stages, using a Siemens Somatom CT unit. In stage one, scans of the head, chest and abdomen were performed using standard protocols recommended by the scanner manufacturer. Images were reconstructed using FBP and 5 different strengths of IR. Contrast-to-Noise Ratios (CNR) were calculated from average CT number and its standard deviation measured in regions of interest created in the lungs, bone, and soft tissues regions of the phantom. Paired t-test and the one-way ANOVA were used to compare the CNR from FBP images with IR images, at p = 0.05 level. The lowest strength value of IR that produced the highest CNR was identified. In the second stage, scans of the head was performed with decreased mA(s) values relative to the increase in CNR compared to the standard FBP protocol. CNR values were compared in this stage using Paired t-test at p = 0.05 level. Results: Images reconstructed using IR technique had higher CNR values (p < 0.01.) in all regions compared to the FBP images, at all strengths of IR. The CNR increased with increasing IR strength of up to 3, in the head and chest images. Increases beyond this strength were insignificant. In abdomen images, CNR continued to increase up to strength 5. The results also indicated that, IR techniques improve CNR by a up to factor of 1.5. Based on the CNR values at strength 3 of IR images and CNR values of FBP images, a reduction in mA(s) of about 20% was identified. The images of the head acquired at 20% reduced mA(s) and reconstructed using IR at strength 3, had similar CNR as FBP images at standard mA(s). In the head scans of the phantom used in this study, it was demonstrated that similar CNR can be achieved even when the mA(s) is reduced by about 20% if IR technique with strength of 3 is used for reconstruction. Conclusions: The IR technique produced better image quality at all strengths of IR in comparison to FBP. IR technique can provide approximately 20% dose reduction in pediatric head CT while maintaining the same image quality as FBP technique.

Keywords: filtered back projection, image quality, iterative reconstruction, pediatric computed tomography imaging

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Authors: Constanza Levicán, Andrés Aparicio, Rodrigo F. Cádiz

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The artistic usage of Brain-computer interfaces (BCI), initially intended for medical purposes, has increased in the past few years as they become more affordable and available for the general population. One interesting question that arises from this practice is whether it is possible to compose or perform music by using only the brain as a musical instrument. In order to approach this question, we propose a BCI for musical composition, based on the representation of some mental states as the musician thinks about sounds. We developed software, called Insight2OSC, that allows the usage of the Emotiv Insight device as a musical instrument, by sending the EEG data to audio processing software such as MaxMSP through the OSC protocol. We provide two compositional applications bundled with the software, which we call Mapping your Mental State and Thinking On. The signals produced by the brain have different frequencies (or rhythms) depending on the level of activity, and they are classified as one of the following waves: delta (0.5-4 Hz), theta (4-8 Hz), alpha (8-13 Hz), beta (13-30 Hz), gamma (30-50 Hz). These rhythms have been found to be related to some recognizable mental states. For example, the delta rhythm is predominant in a deep sleep, while beta and gamma rhythms have higher amplitudes when the person is awake and very concentrated. Our first application (Mapping your Mental State) produces different sounds representing the mental state of the person: focused, active, relaxed or in a state similar to a deep sleep by the selection of the dominants rhythms provided by the EEG device. The second application relies on the physiology of the brain, which is divided into several lobes: frontal, temporal, parietal and occipital. The frontal lobe is related to abstract thinking and high-level functions, the parietal lobe conveys the stimulus of the body senses, the occipital lobe contains the primary visual cortex and processes visual stimulus, the temporal lobe processes auditory information and it is important for memory tasks. In consequence, our second application (Thinking On) processes the audio output depending on the users’ brain activity as it activates a specific area of the brain that can be measured using the Insight device.

Keywords: BCI, music composition, emotiv insight, OSC

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Authors: Hebah M. Musalem, Jeylan El-Mansoury, Lin M. Tuleimat, Selwa Alhazza, Abdul-Aziz A. Al Zoba

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Background: Amblyopia is a condition that affects the visual system triggering a decrease in visual acuity without a known underlying pathology. It is due to abnormal vision development in childhood or infancy. Most importantly, vision loss is preventable or reversible with the right kind of intervention in most of the cases. Strabismus, sensory defects, and anisometropia are all well-known causes of amblyopia. However, ocular misalignment in Strabismus is considered the most common form of amblyopia worldwide. The risk of developing amblyopia increases in premature children, developmentally delayed or children who had brain lesions affecting the visual pathway. The prevalence of amblyopia varies between 2 to 5 % in the world according to the literature. Objective: To determine the different causes of Amblyopia in pediatric patients seen in ophthalmology clinic of a tertiary care center, i.e. King Faisal Specialist Hospital and Research Center (KFSH&RC). Methods: This is a hospital based, random retrospective, based on reviewing patient’s files in the Ophthalmology Department of KFSH&RC in Riyadh city, Kingdom of Saudi Arabia. Inclusion criteria: amblyopic pediatric patients who attended the clinic from 2015 to 2016, who are between 6 months and 18 years old. Exclusion Criteria: patients above 18 years of age and any patient who is uncooperative to obtain an accurate vision or a proper refraction. Detailed ocular and medical history are recorded. The examination protocol includes a full ocular exam, full cycloplegic refraction, visual acuity measurement, ocular motility and strabismus evaluation. All data were organized in tables and graphs and analyzed by statistician. Results: Our preliminary results will be discussed on spot by our corresponding author. Conclusions: We focused on this study on utilizing various examination techniques which enhanced our results and highlighted a distinguished correlation between amblyopia and its’ causes. This paper recommendation emphasizes on critical testing protocols to be followed among amblyopic patient, especially in tertiary care centers.

Keywords: amblyopia, amblyopia causes, amblyopia diagnostic criterion, amblyopia prevalence, Saudi Arabia

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Authors: Khosro Barkhordari, Fateme Sadr, Mina Pashang

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Back ground: Blood transfusion is one of the major issues in cardiac surgery patients. Transfusing patients based on fixed cut-off points of hemoglobin is the current protocol in most institutions. The hemoglobin level of 7- 10 has been suggested for blood transfusion in cardiac surgery patients. We aimed to evaluate if blood transfusion based on change in percentage of hematocrit has different outcomes. Methods: In this retrospective cohort study, we investigated the early postoperative outcome of cardiac surgery patients who received blood transfusions at Tehran Heart Center Hospital, IRAN. We reviewed and analyzed the basic characteristics and clinical data of 700 patients who met our exclusion and inclusion criteria. The two groups of blood transfused patients were compared, those who have 30-50 percent decrease in basal hematocrit versus those with 10 -29 percent decrease. Results: This is ongoing study, and the results would be completed in two weeks after analysis of the date. Conclusion: Early analysis has shown no difference in early post-operative outcomes between the two groups, but final analysis will be completed in two weeks. 1-Department of Anesthesiology and Critical Care, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, IRAN 2- Department of Research, Tehran Heart Center, Tehran, IRAN Quantitative variables were compared using the Student t-test or the Mann‐Whitney U test, as appropriate, while categorical variables were compared using the χ2 or the Fisher exact test, as required. Our intention was to compare the early postoperative outcomes between the two groups, which include 30 days mortality, Length of ICU stay, Length of hospital stay, Intubation time, Infection rate, acute kidney injury, and respiratory complications. The main goal was to find if transfusing blood based on changes in hematocrit from a basal level was better than to fixed cut-off point regarding early post-operative outcomes. This has not been studied enough and may need randomized control trials.

Keywords: post-operative, cardiac surgery, outcomes, blood transfusion

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Authors: Shirazu Issahaku, Isaac Kwesi Acquah, Simon Mensah Amoh, George Nunoo

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Introduction: Diagnostic Reference Levels are important indicators for monitoring and optimizing protocol and procedure in medical imaging between facilities and equipment. This helps to evaluate whether, in routine clinical conditions, the median value obtained for a representative group of patients within an agreed range from a specified procedure is unusually high or low for that procedure. This study aimed to propose Diagnostic Reference Levels for Computed Tomography examination of the most common routine examination of the head, chest and abdominal pelvis regions at the University of Ghana Medical Centre. Methods: The Diagnostic Reference Levels were determined based on the investigation of the most common routine examinations, including head Computed Tomography examination with and without contrast, abdominopelvic Computed Tomography examination with and without contrast, and chest Computed Tomography examination without contrast. The study was based on two dose indicators: the volumetric Computed Tomography Dose Index and Dose-Length Product. Results: The estimated median distribution for head Computed Tomography with contrast for volumetric-Computed Tomography dose index and Dose-Length Product were 38.33 mGy and 829.35 mGy.cm, while without contrast, were 38.90 mGy and 860.90 mGy.cm respectively. For an abdominopelvic Computed Tomography examination with contrast, the estimated volumetric-Computed Tomography dose index and Dose-Length Product values were 40.19 mGy and 2096.60 mGy.cm. In the absence of contrast, the calculated values were 14.65 mGy and 800.40 mGy.cm, respectively. Additionally, for chest Computed Tomography examination, the estimated values were 12.75 mGy and 423.95 mGy.cm for volumetric-Computed Tomography dose index and Dose-Length Product, respectively. These median values represent the proposed diagnostic reference values of the head, chest, and abdominal pelvis regions. Conclusions: The proposed Diagnostic Reference Level is comparable to the recommended International Atomic Energy Agency and International Commission Radiation Protection Publication 135 and other regional published data by the European Commission and Regional National Diagnostic Reference Level in Africa. These reference levels will serve as benchmarks to guide clinicians in optimizing radiation dose levels while ensuring accurate diagnostic image quality at the facility.

Keywords: diagnostic reference levels, computed tomography dose index, computed tomography, radiation exposure, dose-length product, radiation protection

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Authors: L. Meers, L. Contalbrigo, V. Stevens, O. Ulitina, S. Laufer, W. E. Samuels, S. Normando

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Since the COVID-19 pandemic started, there has been concern that domestic animals may help spread SARS-Cov-2. This concern also greatly affected human-animal interaction projects such as animal-assisted interventions (AAI). As a result, institutions and AAI practitioners developed new safety protocols and procedures to control the spread of the SARS-Cov-2 virus during AAI sessions and to guarantee safety for their clients and animals. However, little is known yet about the impact on animals' needs and the possible welfare issues due to these lifestyle adaptions. Fifteen therapists in Flanders, Belgium, who were currently conducting canine-assisted interventions, conducted unstructured observations on how their dogs' (11 mixed breeds, 3 Labradors, 1 terrier aged 2 – 12 years) behaviors changed due to institutional COVID-19 safety protocols. Most (80%) of the respondents reported that their dogs showed sniffing or sneezing after smelling disinfected areas. Two (13%) dogs responded with vomiting and gagging, and three (20%) dogs urinated over disinfected areas. All protocols advise social distancing between participants and animals. When held back, eight (53%) dogs showed self-calming behaviors. Respondents reported that most (73%) dogs responded with flight reactions when seeing humans wearing facial masks. When practitioners threw their used masks in open dustbins, five (33%) dogs tried to take them out with their mouths and play with them; two (13%) Labradors tried to eat them. Taking the dogs' temperatures was the most frequently (53%) used method to supervise their health. However, all dogs showed behaviors as ducking the tail, trying to escape, or biting the animal handler during this procedure. We interpret these results to suggest that dogs tended to react with stress and confusion to the changes in AAI practices they're part of. The health and safety protocols that institutions used were largely borne from recommendations made to protect humans. The participating practitioners appeared to use their knowledge of dog behavior and safety to modify them as best they could—but with more significant concern directed towards the other humans. Given their inter-relatedness and mutual importance for welfare, we advocate for integrated human and animal health and welfare assessments and protocols to provide a framework for "One health" approaches in animal-assisted interventions.

Keywords: animal-assisted therapy, COVID-19 protocol, one health, welfare

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Authors: Igbakura I. Luga, Alex A. Adikwu

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A comparison of resistance to quinolones was carried out on isolates of Shiga toxin-producing Escherichia coliO157:H7 from cattle and mecA and nuc genes harbouring Staphylococcus aureus from pigs. The isolates were separately tested in the first and current decades of the 21^st century. The objective was to demonstrate the dissemination of resistance to this frontline class of antibiotic by bacteria from food animals and bring to the limelight the spread of antibiotic resistance in Nigeria. A total of 10 isolates of the E. coli O157:H7 and 9 of mecA and nuc genes harbouring S. aureus were obtained following isolation, biochemical testing, and serological identification using the Remel Wellcolex E. coli O157:H7 test. Shiga toxin-production screening in the E. coli O157:H7 using the verotoxin E. coli reverse passive latex agglutination (VTEC-RPLA) test; and molecular identification of the mecA and nuc genes in S. aureus. Detection of the mecA and nuc genes were carried out using the protocol by the Danish Technical University (DTU) using the following primers mecA-1:5'-GGGATCATAGCGTCATTATTC-3', mecA-2: 5'-AACGATTGTGACACGATAGCC-3', nuc-1: 5'-TCAGCAAATGCATCACAAACAG-3', nuc-2: 5'-CGTAAATGCACTTGCTTCAGG-3' for the mecA and nuc genes, respectively. The nuc genes confirm the S. aureus isolates and the mecA genes as being methicillin-resistant and so pathogenic to man. The fluoroquinolones used in the antibiotic resistance testing were norfloxacin (10 µg) and ciprofloxacin (5 µg) in the E. coli O157:H7 isolates and ciprofloxacin (5 µg) in the S. aureus isolates. Susceptibility was tested using the disk diffusion method on Muller-Hinton agar. Fluoroquinolone resistance was not detected from isolates of E. coli O157:H7 from cattle. However, 44% (4/9) of the S. aureus were resistant to ciprofloxacin. Resistance of up to 44% in isolates of mecA and nuc genes harbouring S. aureus is a compelling evidence for the rapid spread of antibiotic resistance from bacteria in food animals from Nigeria. Ciprofloxacin is the drug of choice for the treatment of Typhoid fever, therefore widespread resistance to it in pathogenic bacteria is of great public health significance. The study concludes that antibiotic resistance in bacteria from food animals is on the increase in Nigeria. The National Food and Drug Administration and Control (NAFDAC) agency in Nigeria should implement the World Health Organization (WHO) global action plan on antimicrobial resistance. A good starting point can be coordinating the WHO, Office of International Epizootics (OIE), Food and Agricultural Organization (FAO) tripartite draft antimicrobial resistance monitoring and evaluation (M&E) framework in Nigeria.

Keywords: Fluoroquinolone, Nigeria, resistance, Staphylococcus aureus

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Authors: O. Ekrami, P. Claes, S. Van Dongen

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Fluctuating asymmetry (FA) has been studied for many years as an indicator of developmental stability or ‘genetic quality’ based on the assumption that perfect symmetry is ideally the expected outcome for a bilateral organism. Further studies have also investigated the possible link between FA and attractiveness or levels of masculinity or femininity. These hypotheses have been mostly examined using 2D images, and the structure of interest is usually presented using a limited number of landmarks. Such methods have the downside of simplifying and reducing the dimensionality of the structure, which will in return increase the error of the analysis. In an attempt to reach more conclusive and accurate results, in this study we have used high-resolution 3D scans of human faces and have developed an algorithm to measure and localize FA, taking a spatially-dense approach. A symmetric spatially dense anthropometric mask with paired vertices is non-rigidly mapped on target faces using an Iterative Closest Point (ICP) registration algorithm. A set of 19 manually indicated landmarks were used to examine the precision of our mapping step. The protocol’s accuracy in measurement and localizing FA is assessed using simulated faces with known amounts of asymmetry added to them. The results of validation of our approach show that the algorithm is perfectly capable of locating and measuring FA in 3D simulated faces. With the use of such algorithm, the additional captured information on asymmetry can be used to improve the studies of FA as an indicator of fitness or attractiveness. This algorithm can especially be of great benefit in studies of high number of subjects due to its automated and time-efficient nature. Additionally, taking a spatially dense approach provides us with information about the locality of FA, which is impossible to obtain using conventional methods. It also enables us to analyze the asymmetry of a morphological structures in a multivariate manner; This can be achieved by using methods such as Principal Components Analysis (PCA) or Factor Analysis, which can be a step towards understanding the underlying processes of asymmetry. This method can also be used in combination with genome wide association studies to help unravel the genetic bases of FA. To conclude, we introduced an algorithm to study and analyze asymmetry in human faces, with the possibility of extending the application to other morphological structures, in an automated, accurate and multi-variate framework.

Keywords: developmental stability, fluctuating asymmetry, morphometrics, 3D image processing

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Authors: Tan Xin Zhong Timothy, Chang Chen Jie Victor, Yew Kwan Tong, Lim Geok Peng Sandy

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Background: Leaders in crisis response teams such as Trauma Teams in hospitals are essential to the effective coordination and direction of the team. The response to emergency trauma situations must be accurate, rapid, and well executed. To this end, the team leader’s social, technical and leadership skills are essential factors that implicate the success of an emergency trauma intervention. While each emergency trauma case varies in severity and complexity, and the experience and expertise of team leaders may vary, it would be productive to identify certain coordinative and directive functions that improve the capacity for leading a team. Methods: This qualitative study of Trauma Team physicians in Singapore General Hospital (SGH) involved 50 in-depth interviews with doctors and nurses involved in Trauma Team activations, observations of Trauma Teams managing emergency patients, and reviews of audio/video recordings of 65 trauma activations. The interviews were conducted with doctors of various ranks across the relevant departments, 12 from the Emergency Department (ED), 11 from General Surgery (GS) and 8 from Orthopaedics, while the 6 nurses were from ED. In accordance with the grounded theory approach, the content of the interviews was coded and analysed in order to derive broad leadership themes that corresponded with certain behavioural traits exhibited by trauma team leaders, supplemented with the observational and audio/video data. Results: The leadership behaviours of the team leaders could be typified into three broad categories: team orientation, engagement and activeness. Team orientation corresponds with the source and form of cognitive responsibility, decision-making and informational contributions, divisible into individualistic and consultative sub-categories. Engagement refers to the type of activity that leaders prefer to engage in, and which implicates their attentional focus, divisible into participatory and supervisory sub-categories. Activeness is a function of the leader’s attitudes towards the behavioural regulation of the team, which manifests in inactivity or activity to augment or merely align with protocol. These factors are not exhaustive and are contextually sensitive, but collectively implicate a significant portion of the leadership activity observed in trauma teams.

Keywords: trauma team activations, critical event management, leadership, teamwork

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Authors: Magdalena Smoktunowicz, Renata Wawrzyniak, Malgorzata Waleron, Krzysztof Waleron

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Pectobacterium spp. were previously classified into the Erwinia genus founded in 1917 to unite at that time all Gram-negative, fermentative, nonsporulating and peritrichous flagellated plant pathogenic bacteria. After work of Waldee (1945), on Approved Lists of Bacterial Names and bacteriology manuals in 1980, they were described either under the species named Erwinia or Pectobacterium. The Pectobacterium genus was formally described in 1998 of 265 Pectobacterium strains. Currently, there are 21 species of Pectobacterium bacteria, including Pectobacterium betavasculorum since 2003, which caused soft rot on sugar beet tubers. Based on the biochemical experiments carried out for this, it is known that these bacteria are gram-negative, catalase-positive, oxidase-negative, facultatively anaerobic, using gelatin and causing symptoms of soft rot on potato and sugar beet tubers. The mere fact of growing on sugar beet may indicate a metabolism characteristic only for this species. Metabolomics, broadly defined as the biology of the metabolic systems, which allows to make comprehensive measurements of metabolites. Metabolomics, in combination with genomics, are complementary tools for the identification of metabolites and their reactions, and thus for the reconstruction of metabolic networks. The aim of this study was to apply the GC-MS-based untargeted metabolomics to study the metabolism of P. betavasculorum in different growing conditions. The metabolomic profiles of biomass and biomass media were determined. For sample preparation the following protocol was used: extraction with 900 µl of methanol: chloroform: water mixture (10: 3: 1, v: v) were added to 900 µl of biomass from the bottom of the tube and up to 900 µl of nutrient medium from the bacterial biomass. After centrifugation (13,000 x g, 15 min, 4oC), 300µL of the obtained supernatants were concentrated by rotary vacuum and evaporated to dryness. Afterwards, two-step derivatization procedure was performed before GC-MS analyses. The obtained results were subjected to statistical calculations with the use of both uni- and multivariate tests. The obtained results were evaluated using KEGG database, to asses which metabolic pathways are activated and which genes are responsible for it, during the metabolism of given substrates contained in the growing environment. The observed metabolic changes, combined with biochemical and physiological tests, may enable pathway discovery, regulatory inference and understanding of the homeostatic abilities of P. betavasculorum.

Keywords: GC-MS chromatograpfy, metabolomics, metabolism, pectobacterium strains, pectobacterium betavasculorum

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Authors: Anna Tokajuk, Agnieszka Zakrzeska, Ewa Chabielska, Halina Car

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Whey is a by-product generated mainly in the production of cheese and casein. Powder forms of whey are used widely in the food industry as well as a high-protein food for infants, for convalescents, by athletes and especially by bodybuilders to increase muscle mass during exercise. Whey protein concentrate-80 (WPC-80) is a source of bioactive peptides with beneficial effects on the cardiovascular system. It is known that whey proteins health beneficial properties include antidiabetic, blood pressure lowering, improving cardiovascular system function, antibacterial, antiviral and other effects. To study its influence on the development of thrombosis, venous thrombosis model was performed according to the protocol featured by Reyers with modification by Chabielska and Gromotowicz. Male Wistar-Crl: WI (Han) rats from researched groups were supplemented with two doses of WPC-80 (0.3 or 0.5 g/kg) for 7, 14 or 21 days and after these periods, one-hour venous thrombosis model was performed. Control group received 0.9 % NaCl solution and was sham operated. The statistical significance of results was computed by Mann – Whitney’s test. We observed that thrombus weight was decreased in animals obtaining WPC-8080 and that was statistically significant in 14 and 21-day supplemented groups. Blood count parameters did not differ significantly in rats with and without thrombosis induction whether they were fed with WPC-80 or not. Moreover, the number of platelets (PLT) was within the normal range in each group. The examined coagulation parameters in rats of the control groups were within normal limits. After WPC-80 supplementation there was the tendency to prolonged activated partial thromboplastin time (aPTT), but in comparison, the results did not turn out significant. In animals that received WPC-80 0.3 g·kg-1 for 21 days with and without induced thrombosis, prothrombin time (PT) and an international normalized ratio (INR) was somewhat decreased, remaining within the normal range, but the nature and significance of this observation are beyond the framework of the current study. Additionally, fibrinogen and thrombin time (TT) did not differ significantly between groups. Therefore the exact effect of WPC-80 on coagulation system is still elusive and requires further thorough research including mechanisms of action. Determining the potential clinical application of WPC-80 requires the selection of the optimal dose and duration of supplementation.

Keywords: antithrombotic, rats, venous thrombosis, WPC-80

Procedia PDF Downloads 119

Authors: Allyson Augusta Shrikhande, Alexa Rains, Tayyaba Ahmed, Marjorie Mamsaang, Rakhi Vyas, Janaki Natarajan, Erika Moody, Christian Reutter, Kimberlee Leishear, Yogita Tailor, Sandra Sandhu-Restaino, Lora Liu, Neha James, Rosemarie Filart

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Characterized by consistent difficulty getting and keeping an erection firm enough for intercourse, Erectile Dysfunction may affect up to 15% of adult men. Although awareness and access to treatment have improved in recent years, many patients do not actively seek diagnosis or treatment due to the stigma surrounding this condition. Patients who do seek treatment are often dissatisfied by the efficacy of the medication. The condition inhibits patients’ quality of life by worsening mental health and relationships. The purpose of this study was to test the effectiveness of an outpatient neuromuscular treatment protocol in treating the symptoms of Chronic Pelvic Pain and Erectile Dysfunction, improving pain and function. 56 patients ages 20-79 presented to an outpatient clinic for treatment of pelvic pain and Erectile Dysfunction symptoms. These symptoms had persisted for an average of 4 years. All patients underwent external ultrasound-guided hydro-dissection technique targeted at pelvic peripheral nerves in combination with pelvic floor musculature trigger-point injections. To measure the effects of this treatment, a five question Erectile Dysfunction questionnaire was completed by each patient at their first visit to a clinic and three months after treatment began. Answers were summed for a total score of 5-25, with a higher score indicating optimal function. The average score before treatment was 14.125 (SD 5.411) (a=0.05; CI 12.708-15.542), which increased by 18% to an average of 16.625 (SD 6.423) (a=0.05; CI 14.943-18.307) after treatment (P=0.0004). Secondary outcome variables included a Visual Analogue Scale (VAS) to measure pelvic pain intensity and the Functional Pelvic Pain Scale (FPPS) to measure function across multiple areas. VAS scores reduced by 51% after three months. Before treatment, the mean VAS score was 5.87, and the posttreatment mean VAS score was 2.89. Pelvic pain functionality improved by 34% after three months. Pretreatment FPPS scores averaged at 7.48, decreasing to 4.91 after treatment. These results indicate that this unique treatment was very effective at relieving pain and increasing function for patients with Erectile Dysfunction.

Keywords: chronic pelvic pain, erectile dysfunction, nonsurgical, outpatient, trigger point injections

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Authors: Mark Gavriel, Ariel J. Jaffa, Dan Grisaru, David Elad

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The human endometrium-myometrium interface (EMI) is the uterine inner barrier without a separatig layer. It is composed of endometrial epithelial cells (EEC) and endometrial stromal cells (ESC) in the endometrium and myometrial smooth muscle cells (MSMC) in the myometrium. The EMI undergoes structural remodeling during the menstruation cycle which are essential for human reproduction. Recently, we co-cultured a layer-by-layer in vitro model of EEC, ESC and MSMC on a synthetic membrane for mechanobiology experiments. We also treated the model with progesterone and β-estradiol in order to mimic the in vivo receptive uterus In the present study we analyzed the cytokines profile in a single layer of EEC the hormonal treated in vitro model of the EMI. The methodologies of this research include simple tissue-engineering . First, we cultured commercial EEC (RL95-2, ATCC® CRL-1671™) in 24-wellplate. Then, we applied an hormonal stimuli protocol with 17-β-estradiol and progesterone in time dependent concentration according to the human physiology that mimics the menstrual cycle. We collected cell supernatant samples of control, pre-ovulation, ovulation and post-ovulaton periods for analysis of the secreted proteins and cytokines. The cytokine profiling was performed using the Proteome Profiler Human XL Cytokine Array Kit (R&D Systems, Inc., USA) that can detect105 human soluble cytokines. The relative quantification of all the cytokines will be analyzed using xMAP – LUMINEX. We conducted a fishing expedition with the 4 membranes Proteome Profiler. We processed the images, quantified the spots intensity and normalized these values by the negative control and reference spots at the membrane. Analyses of the relative quantities that reflected change higher than 5% of the control points of the kit revealed the The results clearly showed that there are significant changes in the cytokine level for inflammation and angiogenesis pathways. Analysis of tissue-engineered models of the uterine wall will enable deeper investigation of molecular and biomechanical aspects of early reproductive stages (e.g. the window of implantation) or developments of pathologies.

Keywords: tissue-engineering, hormonal stimuli, reproduction, multi-layer uterine model, progesterone, β-estradiol, receptive uterine model, fertility

Procedia PDF Downloads 132

Authors: Albert Amagyei, Julia Carroll, Amanda R. Amorim Adegboye, Laura Strumidlo, Rosie Kneafsey

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Introduction: Classroom-based learning has persisted as the mainstream model of pre-registration nurse education. This model is often rigid, teacher-centered, and unable to support active learning and the practical learning needs of nursing students. Health Education England (HEE), a public body of the Department of Health and Social Care, hypothesises that blended learning (BL) programmes may address health system and nursing profession challenges, such as nursing shortages and lack of digital expertise, by exploring opportunities for providing predominantly online, remote-access study which may increase nursing student recruitment, offering alternate pathways to nursing other than the traditional classroom route. This study will provide evidence for blended learning strategies adopted in nursing education as well as examine nursing student learning experiences concerning the challenges and opportunities related to using blended learning within nursing education. Objective: This review will explore the challenges and opportunities of BL within pre-registration nurse education from the student's perspective. Methods: The search was completed within five databases. Eligible studies were appraised independently by four reviewers. The JBI-convergent segregated approach for mixed methods review was used to assess and synthesize the data. The study’s protocol has been registered with the International Register of Systematic Reviews with registration number// PROSPERO (CRD42023423532). Results: Twenty-seven (27) studies (21 quantitative and 6 qualitative) were included in the review. The study confirmed that BL positively impacts nursing students' learning outcomes, as demonstrated by the findings of the meta-analysis and meta-synthesis. Conclusion: The review compared BL to traditional learning, simulation, laboratory, and online learning on nursing students’ learning and programme outcomes as well as learning behaviour and experience. The results show that BL could effectively improve nursing students’ knowledge, academic achievement, critical skills, and clinical performance as well as enhance learner satisfaction and programme retention. The review findings outline that students’ background characteristics, BL design, and format significantly impact the success of the BL nursing programme.

Keywords: nursing student, blended learning, pre-registration nurse education, online learning

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Authors: Mustafa M. Donma, Ayşen Haksayar, Bahadır Batar, Buse Tepe, Birol Topçu, Orkide Donma

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Childhood obesity is an ever-increasing health problem. The Association of obesity with severe chronic diseases such as diabetes and cardiovascular diseases makes the problem life-threatening. Aside from psychological, societal and metabolic factors, genetic polymorphisms have gained importance concerning etiology in recent years. The aim of this study was to evaluate the relationship between rs10455872 gene polymorphism in the Lipoprotein (a) locus and the development of childhood obesity. This was a prospective study carried out according to the Helsinki Declarations. The study protocol was approved by the Institutional Ethics Committee. This study was supported by Tekirdag Namik Kemal University Rectorate, Scientific Research Projects Coordination Unit. Project No: NKUBAP.02.TU.20.278. A total of 180 children (103 obese (OB) and 77 healthy), aged 6-18 years, without any acute or chronic disease, participated in the study. Two different groups were created: OB and healthy control. Each group was divided into two further groups depending on the nature of the polymorphism. Anthropometric measurements were taken during the detailed physical examination. Laboratory tests and TANITA measurements were performed. For the statistical evaluations, SPSS version 28.0 was used. A P-value smaller than 0.05 was the statistical significance degree. The distribution of lipoprotein (a) rs10455872 gene polymorphism did not differ between OB and healthy children. Children with AG genotype in both OB and control groups had lower body mass index (BMI), diagnostic obesity notation model assessment index (DONMA II), body fat ratio (BFR), C-reactive protein (CRP), and metabolic syndrome index (MetS index) values compared to children with normal AA genotype. In the OB group, serum iron, vitamin B12, hemoglobin, MCV, and MCH values were found to be higher in the AG genotype group than those of children with the normal AA genotype. A significant correlation was found between the MetS index and BFR among OB children with normal homozygous genotype. MetS index increased as BFR increased in this group. However, such a correlation was not observed in the OB group with heterozygous AG genotype. To the best of our knowledge, the association of lipoprotein (a) rs10455872 gene polymorphism with the etiology of childhood obesity has not been studied yet. Therefore, this study was the first report suggesting polymorphism with AG genotype as a good risk factor for obesity.

Keywords: child, gene polymorphism, lipoprotein (a), obesity, rs10455872

Procedia PDF Downloads 81

Authors: Alana E. Jansen

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With such a large proportion of organisations relying on the use of team-based structures, it is surprising that so few teams would be classified as high-performance teams. While the impact of team composition on performance has been researched frequently, there have been conflicting findings as to the effects, particularly when examined alongside other team factors. To broaden the theoretical perspectives on this topic and potentially explain some of the inconsistencies in research findings left open by other various models of team effectiveness and high-performing teams, the present study aims to use the Job-Demands-Resources model, typically applied to burnout and engagement, as a framework to examine how team composition factors (particularly diversity in team member characteristics) can facilitate or hamper team effectiveness. This study used a virtual interview design where participants were asked to both rate and describe their experiences, in one high-performing and one low-performing team, over several factors relating to demands, resources, team composition, and team effectiveness. A semi-structured interview protocol was developed, which combined the use of the Likert style and exploratory questions. A semi-targeted sampling approach was used to invite participants ranging in age, gender, and ethnic appearance (common surface-level diversity characteristics) and those from different specialties, roles, educational and industry backgrounds (deep-level diversity characteristics). While the final stages of data analyses are still underway, thematic analysis using a grounded theory approach was conducted concurrently with data collection to identify the point of thematic saturation, resulting in 35 interviews being completed. Analyses examine differences in perceptions of demands and resources as they relate to perceived team diversity. Preliminary results suggest that high-performing and low-performing teams differ in perceptions of the type and range of both demands and resources. The current research is likely to offer contributions to both theory and practice. The preliminary findings suggest there is a range of demands and resources which vary between high and low-performing teams, factors which may play an important role in team effectiveness research going forward. Findings may assist in explaining some of the more complex interactions between factors experienced in the team environment, making further progress towards understanding the intricacies of why only some teams achieve high-performance status.

Keywords: diversity, high-performing teams, job demands and resources, team effectiveness

Procedia PDF Downloads 188

Authors: S. Ben Fredj, H. Ghali, M. Ben Rejeb, S. Layouni, S. Khefacha, L. Dhidah, H. Said

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Background: The Intensive Care Unit (ICU) provides continuous care and uses a high level of treatment technologies. Although developed country hospitals allocate only 5–10% of beds in critical care areas, approximately 20% of nosocomial infections (NI) occur among patients treated in ICUs. Whereas in the developing countries the situation is still less accurate. The aim of our study is to assess mortality rates in ICUs and to determine its predictive factors. Methods: We carried out a nested case-control study in a 630-beds public tertiary care hospital in Eastern Tunisia. We included in the study all patients hospitalized for more than two days in the surgical or medical ICU during the entire period of the surveillance. Cases were patients who died before ICU discharge, whereas controls were patients who survived to discharge. NIs were diagnosed according to the definitions of ‘Comité Technique des Infections Nosocomiales et les Infections Liées aux Soins’ (CTINLIS, France). Data collection was based on the protocol of Rea-RAISIN 2009 of the National Institute for Health Watch (InVS, France). Results: Overall, 301 patients were enrolled from medical and surgical ICUs. The mean age was 44.8 ± 21.3 years. The crude ICU mortality rate was 20.6% (62/301). It was 35.8% for patients who acquired at least one NI during their stay in ICU and 16.2% for those without any NI, yielding an overall crude excess mortality rate of 19.6% (OR= 2.9, 95% CI, 1.6 to 5.3). The population-attributable fraction due to ICU-NI in patients who died before ICU discharge was 23.46% (95% CI, 13.43%–29.04%). Overall, 62 case-patients were compared to 239 control patients for the final analysis. Case patients and control patients differed by age (p=0,003), simplified acute physiology score II (p < 10-3), NI (p < 10-3), nosocomial pneumonia (p=0.008), infection upon admission (p=0.002), immunosuppression (p=0.006), days of intubation (p < 10-3), tracheostomy (p=0.004), days with urinary catheterization (p < 10-3), days with CVC ( p=0.03), and length of stay in ICU (p=0.003). Multivariate analysis demonstrated 3 factors: age older than 65 years (OR, 5.78 [95% CI, 2.03-16.05] p=0.001), duration of intubation 1-10 days (OR, 6.82 [95% CI, [1.90-24.45] p=0.003), duration of intubation > 10 days (OR, 11.11 [95% CI, [2.85-43.28] p=0.001), duration of CVC 1-7 days (OR, 6.85[95% CI, [1.71-27.45] p=0.007) and duration of CVC > 7 days (OR, 5.55[95% CI, [1.70-18.04] p=0.004). Conclusion: While surveillance provides important baseline data, successful trials with more active intervention protocols, adopting multimodal approach for the prevention of nosocomial infection incited us to think about the feasibility of similar trial in our context. Therefore, the implementation of an efficient infection control strategy is a crucial step to improve the quality of care.

Keywords: intensive care unit, mortality, nosocomial infection, risk factors

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Authors: Kudrat-E-Khuda Babu

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Rohingya refugees are the most marginalized and persecuted section of people in the world. The heinous brutality of Myanmar has forced the Muslim minority community to flee themselves to their neighboring country, Bangladesh for quite a few times now. The recent atrocity of the Buddhist country has added insult to injury on the existing crisis. In lieu of protection, the rights of the Rohingya community in Myanmar are being violated through exclusion from citizenship and steamroller of persecution. The mass influx of Rohingya refugees to Bangladesh basically took place in 1978, 1992, 2012, and 2017. At present, there are around one million Rohingyas staying at Teknaf, Ukhiya of Cox’s Bazar, the southern part of Bangladesh. The country, despite being a poverty-stricken one, has shown unprecedented generosity in sheltering the Rohingya people. For sheltering half of the total refugees in 2017, the Prime Minister of Bangladesh, Sheikh Hasina is now being regarded as the lighthouse of humanity or the mother of humanity. Though Bangladesh is not a ratifying state of the UN Refugee Convention, 1951 and its Additional Protocol, 1967, the country cannot escape its obligation under international human rights jurisprudence. Bangladesh is a party to eight human rights instruments out of nine core instruments, and thus, the country has an indirect obligation to protect and promote the rights of the refugees. Pressure from international bodies has also made Bangladesh bound to provide refuge to Rohingya people. Even though the demographic vulnerability and socio-economic condition of the country do not suggest taking over extra responsibility, the principle of non-refoulment as a part of customary international law reminds us to stay beside those persecuted or believed to have well-founded fear of persecution. In the case of HM Ershad v. Bangladesh and Others, 7 BLC (AD) 67, it was held that any international treaty or document after signing or ratification is not directly enforceable unless and until the parliament enacts a similar statute howsoever sweet the document is. As per Article 33(2) of the 1951 Refugee Convention, there are even exceptions for a state party in case of serious consequences like threat to national security, apprehension of serious crime and danger to safeguard state population. Bangladesh is now at a cross-road of human rights and national interest. The world community should come forward to resolve the crisis of the persecuted Rohingya people through repatriation, resettlement, and reintegration.

Keywords: Rohingya refugees, human rights, Bangladesh, Myanmar

Procedia PDF Downloads 190

Authors: Jillian M. Hagel, Joseph E. Tucker, Peter J. Facchini

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With the aim of establishing a holistic approach for the treatment of central nervous system (CNS) disorders, we are pursuing a drug development program rapidly progressing through discovery and characterization phases. The drug candidates identified in this program are referred to as neuroplastogens owing to their ability to mediate neuroplasticity, which can be beneficial to patients suffering from anxiety, depression, or posttraumatic stress disorder. These and other related neuropsychiatric conditions are associated with the onset of neuronal atrophy, which is defined as a reduction in the number and/or productivity of neurons. The stimulation of neuroplasticity results in an increase in the connectivity between neurons and promotes the restoration of healthy brain function. We have synthesized a substantial catalogue of proprietary indolethylamine derivatives based on the general structures of serotonin (5-hydroxytryptamine) and psychedelic molecules such as N,N-dimethyltryptamine (DMT) and psilocin (4-hydroxy-DMT) that function as neuroplastogens. A primary objective in our screening protocol is the identification of derivatives associated with a significant reduction in hallucination, which will allow administration of the drug at a dose that induces neuroplasticity and triggers other efficacious outcomes in the treatment of targeted CNS disorders but which does not cause a psychedelic response in the patient. Both neuroplasticity and hallucination are associated with engagement of the 5HT2A receptor, requiring drug candidates differentially coupled to these two outcomes at a molecular level. We use novel and proprietary artificial intelligence algorithms to predict the mode of binding to the 5HT2A receptor, which has been shown to correlate with the hallucinogenic response. Hallucination is tested using the mouse head-twitch response model, whereas mouse marble-burying and sucrose preference assays are used to evaluate anxiolytic and anti-depressive potential. Neuroplasticity is assays using dendritic outgrowth assays and cell-based ELISA analysis. Pharmacokinetics and additional receptor-binding analyses also contribute the selection of lead candidates. A summary of the program is presented.

Keywords: neuroplastogen, non-hallucinogenic, drug development, anxiety, depression, PTSD, indolethylamine derivatives, psychedelic-inspired, 5-HT2A receptor, computational chemistry, head-twitch response behavioural model, neurite outgrowth assay

Procedia PDF Downloads 139

Authors: Xiquan Weng, Chaoge Wang, Guoqin Xu, Wentao Lin

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Objective: Cold exposure and exercise serve as two powerful physiological stimuli to launch the conversion of fat-accumulating white adipose tissue (WAT) into energy-dissipating brown adipose tissue (BAT). So far, it remains to be elucidated whether exercise plus cold exposure can produce an addictive effect on promoting WAT browning. Methods: 64 SD rats were subjected to high-fat and high-sugar diets for 9-week and successfully established an obesity model. They were randomly divided into 8 groups: normal control group (NC), normal exercise group (NE), continuous cold control group (CC), continuous cold exercise group (CE), intermittent cold control group (IC) and intermittent cold exercise group (IE). For continuous cold exposure, the rats stayed in a cold environment all day; For intermittent cold exposure, the rats were exposed to cold for only 4h per day. The protocol for treadmill exercises were as follows: 25m/min (speed), 0°C (slope), 30mins each time, an interval for 10 mins between two exercises, twice/two days, lasting for 5 weeks. Sampling were conducted on the 5th weekend. The body length and weight of the rats were measured, and the Lee's index was calculated. The visceral fat rate (VFR), subcutaneous fat rate (SFR), brown fat rate (BrFR) and body fat rate (BoFR) were measured by Micro-CT LCT200, and the expression of UCP1 protein in inguinal fat was examined by Western-blot. SPSS 22.0 was used for statistical analysis of the experimental results, and the ANOVA analysis was performed between groups (P < 0.05 was significant). Results: (1) Compared with the NC group, the weight of obese rats was significantly declined in the NE, CE and IE groups (P < 0.05), the Lee's index of obese rats significantly declined in the CE group (P < 0.05). Compared with the NE group, the weight of obese rats was significantly declined in the CE and IE groups (P < 0.05). (2)Compared with the NC group, the VFR and BoFR of the rats significantly declined in the NE, CE and IE groups (P < 0.05), the SFR of the rats significantly declined in the CE and IE groups (P < 0.05), and the BFR of the rats was significantly higher in the CC and IC groups (P < 0.05), respectively. Compared with the NE group, the VFR and BoFR of the rats significantly declined in the CE group (P < 0.05), the SFR of the rats was significantly higher in the CC and IS groups (P < 0.05), and the BrFR of the rats was significantly higher in the IC group (P < 0.05). (3)Compared with the NC group, the up-regulation of UCP1 protein expression in the inguinal fat of the rats was significant in the NE, CC, CE, IC and IE groups (P < 0.05). Compared with the NE group, the up-regulation of UCP1 protein expression in the inguinal fat of the rats was significant in the CC, CE and IE groups (P < 0.05). Conclusions: Exercise in the continuous and intermittent cold, especially in the former, can effectively decline the weight and body fat rate of obese rats. This is related to the effect of cold and exercise on the browning of white fat in rats.

Keywords: cold, browning of white fat, exercise, obesity

Procedia PDF Downloads 133

Authors: Melanie Ostermann, Eivind Birkeland, Ying Xue, Alexander Sauter, Mihaela R. Cimpan

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Background: New reliable and robust techniques to assess biological effects of nanomaterials (NMs) in vitro are needed to speed up safety analysis and to identify key physicochemical parameters of NMs, which are responsible for their acute cytotoxicity. The central aim of this study was to validate and evaluate the applicability and reliability of an impedance-based flow cytometry (IFC) technique for the high-throughput screening of NMs. Methods: Eight inorganic NMs from the European Commission Joint Research Centre Repository were used: NM-302 and NM-300k (Ag: 200 nm rods and 16.7 nm spheres, respectively), NM-200 and NM- 203 (SiO₂: 18.3 nm and 24.7 nm amorphous, respectively), NM-100 and NM-101 (TiO₂: 100 nm and 6 nm anatase, respectively), and NM-110 and NM-111 (ZnO: 147 nm and 141 nm, respectively). The aim was to assess the biological effects of these materials on human monoblastoid (U937) cells. Dispersions of NMs were prepared as described in the NANOGENOTOX dispersion protocol and cells were exposed to NMs at relevant concentrations (2, 10, 20, 50, and 100 µg/mL) for 24 hrs. The change in electrical impedance was measured at 0.5, 2, 6, and 12 MHz using the IFC AmphaZ30 (Amphasys AG, Switzerland). A traditional toxicity assay, Trypan Blue Dye Exclusion assay, and dark-field microscopy were used to validate the IFC method. Results: Spherical Ag particles (NM-300K) showed the highest toxic effect on U937 cells followed by ZnO (NM-111 ≥ NM-110) particles. Silica particles were moderate to non-toxic at all used concentrations under these conditions. A higher toxic effect was seen with smaller sized TiO2 particles (NM-101) compared to their larger analogues (NM-100). No interferences between the IFC and the used NMs were seen. Uptake and internalization of NMs were observed after 24 hours exposure, confirming actual NM-cell interactions. Conclusion: Results collected with the IFC demonstrate the applicability of this method for rapid nanotoxicity assessment, which proved to be less prone to nano-related interference issues compared to some traditional toxicity assays. Furthermore, this label-free and novel technique shows good potential for up-scaling in directions of an automated high-throughput screening and for future NM toxicity assessment. This work was supported by the EC FP7 NANoREG (Grant Agreement NMP4-LA-2013-310584), the Research Council of Norway, project NorNANoREG (239199/O70), the EuroNanoMed II 'GEMN' project (246672), and the UH-Nett Vest project.

Keywords: cytotoxicity, high-throughput, impedance, nanomaterials

Procedia PDF Downloads 362

Authors: Chandra Shekhar Majumder, Md. Shamsul Haque, Khondaker Anower Hossain, Md. Rafiqul Islam

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Introduction: Ocular helminths are parasites that infect the eye or its adnexa. They can be either motile worms or sessile worms that form cysts. These parasites require two hosts for their life cycle, a definite host (usually a human) and an intermediate host (usually an insect). While there have been reports of ocular helminths infecting various structures of the eye, including the anterior chamber and subconjunctival space, there is no previous record of such a case involving the lens. Research Aim: The aim of this case report is to present a rare case of ocular helminth infection in the lens and to contribute to the understanding of this unusual site of infection. Methodology: This study is a case report, presenting the details and findings of an 80-year-old retired policeman who presented with severe pain, redness, and vision loss in the left eye. The patient had a history of diabetes mellitus and hypertension. The examination revealed the presence of a thread-like helminth in the lens. The patient underwent treatment and follow-up, and the helminth specimen was sent for identification to the department of Parasitology. Case report: An 80-year-old retired policeman attended the OPD, Faridpur Medical College Hospital with the complaints of severe pain, redness and gross dimness of vision of the left eye for 5 days. He had a history of diabetes mellitus and hypertension for 3 years. On examination, L/E visual acuity was PL only, moderate ciliary congestion, KP 2+, cells 2+ and posterior synechia from 5 to 7 O’clock position was found. Lens was opaque. A thread like helminth was found under the anterior of the lens. The worm was moving and changing its position during examination. On examination of R/E, visual acuity was 6/36 unaided, 6/18 with pinhole. There was lental opacity. Slit-lamp and fundus examination were within normal limit. Patient was admitted in Faridpur Medical College Hospital. Diabetes mellitus was controlled with insulin. ICCE with PI was done on the same day of admission under depomedrol coverage. The helminth was recovered from the lens. It was thread like, about 5 to 6 mm in length, 1 mm in width and pinkish in colour. The patient followed up after 7 days, VA was HM, mild ciliary congestion, few KPs and cells were present. Media was hazy due to vitreous opacity. The worm was sent to the department of Parasitology, NIPSOM, Dhaka for identification. Findings: The findings of this case report highlight the presence of a helminth in the lens, which has not been previously reported. The helminth was successfully removed from the lens, but the patient experienced complications such as anterior uveitis and vitreous opacity. The exact mechanism by which the helminth enters the lens remains unclear. Theoretical Importance: This case report contributes to the existing literature on ocular helminth infections by reporting a unique case involving the lens. It highlights the need for further research to understand the pathogenesis and mechanism of entry of helminths in the lens. Data Collection and Analysis Procedures: The data for this case report were collected through clinical examination and medical records of the patient. The findings were described and presented in a descriptive manner. No statistical analysis was conducted. Question Addressed: This case report addresses the question of whether ocular helminth infections can occur in the lens, which has not been previously reported. Conclusion: To the best of our knowledge, this is the first reported case of ocular helminth infection in the lens. The presence of the helminth in the lens raises interesting questions regarding its pathogenesis and entry mechanism. Further study and research are needed to explore these aspects. Ophthalmologists and parasitologists should be aware of the possibility of ocular helminth infections in unusual sites like the lens.

Keywords: ocular, helminth, unsual site, lens

Procedia PDF Downloads 66

Authors: Prince Vivek, Vijay K. Bharti, Manishi Mukesh, Ankita Sharma, Om Prakash Chaurasia, Bhuvnesh Kumar

Abstract:

High performance of endurance in equid requires adaptive changes involving physio-biochemical, and molecular responses in an attempt to regain homeostasis. We hypothesized that the identification of the suitable reference genes might be considered for assessing of endurance related traits in pony at high altitude and may ensure for individuals struggling to potent endurance trait in ponies at high altitude. A total of 12 mares of ponies, Zanskar breed, were divided into three groups, group-A (without load), group-B, (60 Kg) and group-C (80 Kg) on backpack loads were subjected to a load carry protocol, on a steep climb of 4 km uphill, and of gravel, uneven rocky surface track at an altitude of 3292 m to 3500 m (endpoint). Blood was collected before and immediately after the load carry on sodium heparin anticoagulant, and the peripheral blood mononuclear cell was separated for total RNA isolation and thereafter cDNA synthesis. Real time-PCR reactions were carried out to evaluate the mRNAs expression profile of a panel of putative internal control genes (ICGs), related to different functional classes, namely glyceraldehyde 3-phosphate dehydrogenase (GAPDH), β₂ microglobulin (β₂M), β-actin (ACTB), ribosomal protein 18 (RS18), hypoxanthine-guanine phosophoribosyltransferase (HPRT), ubiquitin B (UBB), ribosomal protein L32 (RPL32), transferrin receptor protein (TFRC), succinate dehydrogenase complex subunit A (SDHA) for normalizing the real-time quantitative polymerase chain reaction (qPCR) data of native pony’s. Three different algorithms, geNorm, NormFinder, and BestKeeper software, were used to evaluate the stability of reference genes. The result showed that GAPDH was best stable gene and stability value for the best combination of two genes was observed TFRC and β₂M. In conclusion, the geometric mean of GAPDH, TFRC and β₂M might be used for accurate normalization of transcriptional data for assessing endurance related traits in Zanskar ponies during load carrying.

Keywords: endurance exercise, ubiquitin B (UBB), β₂ microglobulin (β₂M), high altitude, Zanskar ponies, reference gene

Procedia PDF Downloads 132

Authors: Nick Woodier, Paul Sampson, Iain Moppett

Abstract:

Background: For years, healthcare across the world has recognised that patients are coming to harm from the very processes meant to help them. In response, healthcare tells itself that it needs to ‘be more like aviation.’ Aviation safety is highly regarded by those in healthcare and is seen as an exemplar. Specifically, healthcare is keen to learn from how aviation uses near misses to make their industry safer. Healthcare is rife with near misses; however, there has been little progress addressing them, with most research having focused on reporting. Addressing the factors that contribute to near misses will potentially help reduce the number of significant, harm patientsafety incidents. While the healthcare literature states the need to learn from aviation’s use of near misses, there is nothing that describes how best to do this. The authors, as part of a larger study of near-miss management in healthcare, sought to learn from aviation to develop principles for how healthcare can identify, report, and learn from near misses to improve patient safety. Methods: A Grounded Theory (GT) methodology, augmented by a scoping review, was used. Data collection included interviews, field notes, and the literature. The review protocol is accessible online. The GT aimed to develop theories about how aviation, amongst other safety-critical industries, manages near misses. Results: Twelve aviation interviews contributed to the GT across passenger airlines, air traffic control, and bodies involved in policy, regulation, and investigation. The scoping review identified 83 articles across a range of safety-critical industries, but only seven focused on aviation. The GT identified that aviation interprets the term ‘near miss’ in different ways, commonly using it to specifically refer to near-miss air collisions, also known as Airproxes. Other types of near misses exist, such as health and safety, but the reporting of these and the safety climate associated with them is not as mature. Safety culture in aviation was regularly discussed, with evidence that culture varies depending on which part of the industry is being considered (e.g., civil vs. business aviation). Near misses are seen as just one part of an extensive safety management system, but processes to support their reporting and their analysis are not consistent. Their value alone is also questionable, with the challenge to long-held beliefs originating from the ‘common cause hypothesis.’ Conclusions: There is learning that healthcare can take from how parts of aviation manage and learn from near misses. For example, healthcare would benefit from a formal safety management system that currently does not exist. However, it may not be as simple as ‘healthcare should learn from aviation’ due to variation in safety maturity across the industry. Healthcare needs to clarify how to incorporate near misses into learning and whether allocating resources to them is of value; it was heard that catastrophes have led to greater improvements in safety in aviation.

Keywords: aviation safety, patient safety, near miss, safety management systems

Procedia PDF Downloads 152