Search results for: medical studies
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 13915

Search results for: medical studies

145 Impact of Simulated Brain Interstitial Fluid Flow on the Chemokine CXC-Chemokine-Ligand-12 Release From an Alginate-Based Hydrogel

Authors: Wiam El Kheir, Anais Dumais, Maude Beaudoin, Bernard Marcos, Nick Virgilio, Benoit Paquette, Nathalie Faucheux, Marc-Antoine Lauzon

Abstract:

The high infiltrative pattern of glioblastoma multiforme cells (GBM) is the main cause responsible for the actual standard treatments failure. The tumor high heterogeneity, the interstitial fluid flow (IFF) and chemokines guides GBM cells migration in the brain parenchyma resulting in tumor recurrence. Drug delivery systems emerged as an alternative approach to develop effective treatments for the disease. Some recent studies have proposed to harness the effect CXC-lchemokine-ligand-12 to direct and control the cancer cell migration through delivery system. However, the dynamics of the brain environment on the delivery system remains poorly understood. Nanoparticles (NPs) and hydrogels are known as good carriers for the encapsulation of different agents and control their release. We studied the release of CXCL12 (free or loaded into NPs) from an alginate-based hydrogel under static and indirect perfusion (IP) conditions. Under static conditions, the main phenomena driving CXCL12 release from the hydrogel was diffusion with the presence of strong interactions between the positively charged CXCL12 and the negatively charge alginate. CXCL12 release profiles were independent from the initial mass loadings. Afterwards, we demonstrated that the release could tuned by loading CXCL12 into Alginate/Chitosan-Nanoparticles (Alg/Chit-NPs) and embedded them into alginate-hydrogel. The initial burst release was substantially attenuated and the overall cumulative release percentages of 21%, 16% and 7% were observed for initial mass loadings of 0.07, 0.13 and 0.26 µg, respectively, suggesting stronger electrostatic interactions. Results were mathematically modeled based on Fick’s second law of diffusion framework developed previously to estimate the effective diffusion coefficient (Deff) and the mass transfer coefficient. Embedding the CXCL12 into NPs decreased the Deff an order of magnitude, which was coherent with experimental data. Thereafter, we developed an in-vitro 3D model that takes into consideration the convective contribution of the brain IFF to study CXCL12 release in an in-vitro microenvironment that mimics as faithfully as possible the human brain. From is unique design, the model also allowed us to understand the effect of IP on CXCL12 release in respect to time and space. Four flow rates (0.5, 3, 6.5 and 10 µL/min) which may increase CXCL12 release in-vivo depending on the tumor location were assessed. Under IP, cumulative percentages varying between 4.5-7.3%, 23-58.5%, 77.8-92.5% and 89.2-95.9% were released for the three initial mass loadings of 0.08, 0.16 and 0.33 µg, respectively. As the flow rate increase, IP culture conditions resulted in a higher release of CXCL12 compared to static conditions as the convection contribution became the main driving mass transport phenomena. Further, depending on the flow rate, IP had a direct impact on CXCL12 distribution within the simulated brain tissue, which illustrates the importance of developing such 3D in-vitro models to assess the efficiency of a delivery system targeting the brain. In future work, using this very model, we aim to understand the impact of the different phenomenon occurring on GBM cell behaviors in response to the resulting chemokine gradient subjected to various flow while allowing them to express their invasive characteristics in an in-vitro microenvironment that mimics the in-vivo brain parenchyma.

Keywords: 3D culture system, chemokines gradient, glioblastoma multiforme, kinetic release, mathematical modeling

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144 Optimal Pressure Control and Burst Detection for Sustainable Water Management

Authors: G. K. Viswanadh, B. Rajasekhar, G. Venkata Ramana

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Water distribution networks play a vital role in ensuring a reliable supply of clean water to urban areas. However, they face several challenges, including pressure control, pump speed optimization, and burst event detection. This paper combines insights from two studies to address these critical issues in Water distribution networks, focusing on the specific context of Kapra Municipality, India. The first part of this research concentrates on optimizing pressure control and pump speed in complex Water distribution networks. It utilizes the EPANET- MATLAB Toolkit to integrate EPANET functionalities into the MATLAB environment, offering a comprehensive approach to network analysis. By optimizing Pressure Reduce Valves (PRVs) and variable speed pumps (VSPs), this study achieves remarkable results. In the Benchmark Water Distribution System (WDS), the proposed PRV optimization algorithm reduces average leakage by 20.64%, surpassing the previous achievement of 16.07%. When applied to the South-Central and East zone WDS of Kapra Municipality, it identifies PRV locations that were previously missed by existing algorithms, resulting in average leakage reductions of 22.04% and 10.47%. These reductions translate to significant daily Water savings, enhancing Water supply reliability and reducing energy consumption. The second part of this research addresses the pressing issue of burst event detection and localization within the Water Distribution System. Burst events are a major contributor to Water losses and repair expenses. The study employs wireless sensor technology to monitor pressure and flow rate in real time, enabling the detection of pipeline abnormalities, particularly burst events. The methodology relies on transient analysis of pressure signals, utilizing Cumulative Sum and Wavelet analysis techniques to robustly identify burst occurrences. To enhance precision, burst event localization is achieved through meticulous analysis of time differentials in the arrival of negative pressure waveforms across distinct pressure sensing points, aided by nodal matrix analysis. To evaluate the effectiveness of this methodology, a PVC Water pipeline test bed is employed, demonstrating the algorithm's success in detecting pipeline burst events at flow rates of 2-3 l/s. Remarkably, the algorithm achieves a localization error of merely 3 meters, outperforming previously established algorithms. This research presents a significant advancement in efficient burst event detection and localization within Water pipelines, holding the potential to markedly curtail Water losses and the concomitant financial implications. In conclusion, this combined research addresses critical challenges in Water distribution networks, offering solutions for optimizing pressure control, pump speed, burst event detection, and localization. These findings contribute to the enhancement of Water Distribution System, resulting in improved Water supply reliability, reduced Water losses, and substantial cost savings. The integrated approach presented in this paper holds promise for municipalities and utilities seeking to improve the efficiency and sustainability of their Water distribution networks.

Keywords: pressure reduce valve, complex networks, variable speed pump, wavelet transform, burst detection, CUSUM (Cumulative Sum), water pipeline monitoring

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143 Improving Preconception Health and Lifestyle Behaviours through Digital Health Intervention: The OptimalMe Program

Authors: Bonnie R. Brammall, Rhonda M. Garad, Helena J. Teede, Cheryce L. Harrison

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Introduction: Reproductive aged women are at high-risk for accelerated weight gain and obesity development, with pregnancy recognised as a critical contributory life phase. Healthy lifestyle interventions during the preconception and antenatal period improve maternal and infant health outcomes. Yet, interventions from preconception through to postpartum and translation and implementation into real-world healthcare settings remain limited. OptimalMe is a randomised, hybrid implementation effectiveness study of evidence-based healthy lifestyle intervention. Here, we report engagement, acceptability of the intervention during preconception, and self-reported behaviour change outcomes as a result of the preconception phase of the intervention. Methods: Reproductive aged women who upgraded their private health insurance to include pregnancy and birth cover, signalling a pregnancy intention, were invited to participate. Women received access to an online portal with preconception health and lifestyle modules, goal-setting and behaviour change tools, monthly SMS messages, and two coaching sessions (randomised to video or phone) prior to pregnancy. Results: Overall n=527 expressed interest in participating. Of these, n=33 did not meet inclusion criteria, n=8 were not contactable for eligibility screening, and n=177 failed to engage after the screening, leaving n=309 who were enrolled in OptimalMe and randomised to intervention delivery method. Engagement with coaching sessions dropped by 25% for session two, with no difference between intervention groups. Women had a mean (SD) age of 31.7 (4.3) years and, at baseline, a self-reported mean BMI of 25.7 (6.1) kg/m², with 55.8% (n=172) of a healthy BMI. Behaviour was sub-optimal with infrequent self-weighing (38.1%), alcohol consumption prevalent (57.1%), sub-optimal pre-pregnancy supplementation (61.5%), and incomplete medical screening. Post-intervention 73.2% of women reported engagement with a GP for preconception care and improved lifestyle behaviour (85.5%), since starting OptimalMe. Direct pre-and-post comparison of individual participant data showed that of 322 points of potential change (up-to-date cervical screening, elimination of high-risk behaviours [alcohol, drugs, smoking], uptake of preconception supplements and improved weighing habits) 158 (49.1%) points of change were achieved. Health coaching sessions were found to improve accountability and confidence, yet further personalisation and support were desired. Engagement with video and phone sessions was comparable, having similar impacts on behaviour change, and both methods were well accepted and increased women's accountability. Conclusion: A low-intensity digital health and lifestyle program with embedded health coaching can improve the uptake of preconception care and lead to self-reported behaviour change. This is the first program of its kind to reach an otherwise healthy population of women planning a pregnancy. Women who were otherwise healthy showed divergence from preconception health and lifestyle objectives and benefited from the intervention. OptimalMe shows promising results for population-based behaviour change interventions that can improve preconception lifestyle habits and increase engagement with clinical health care for pregnancy preparation.

Keywords: preconception, pregnancy, preventative health, weight gain prevention, self-management, behaviour change, digital health, telehealth, intervention, women's health

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142 Female Frontline Health Workers in High-Risk Workplaces: Legal Protection in Bangladesh amid the Covid-19 Pandemic

Authors: Nabila Farhin, Israt Jahan

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Despite the feminisation of the global health force, women mostly engage in nursing, midwifery and community health workers (HWs), and the posts like surgeons, doctors, and specialists are generally male-dominated. It is also prominent in Bangladesh, where female HWs witness systematic workplace inequalities, discrimination, and underpayment. The Covid-19 pandemic put unsurmountable pressure on HWs as they had to serve in high-risk workplaces as frontliners. The already disadvantaged female HWs shouldered the same burden, were overworked without adequate occupational health and safety measures (OSH) and risked their lives. Acknowledging their vulnerable workplace conditions, the World Health Organization (WHO) and International Labour Organization (ILO) circulated a few specialised guidelines amid the peril. Bangladesh tried to adhere to international guidelines while formulating pandemic management strategies. In reality, the already weak and understaffed health sector collapsed with the patient influx and many HWs got infected and died in the line of duty, exposing the high-risk nature of the work. Unfortunately, the gender-segregated data of infected HWs are absent. This qualitative research investigates whether the existing laws of Bangladesh are adequate in protecting female HWs as frontliners in high-risk workplaces during the Covid-19 pandemic. The paper first examines international labour laws safeguarding female frontline HWs. It also analyses the specialised Covid-19 pandemic guidelines protecting their interests. Finally, the research investigates the compliance of Bangladesh as per international legal guidance during the pandemic. In doing so, it explores the domestic laws, professional guidelines for HWs and pandemic response strategies. The paper critically examines the primary sources like international and national statutes, rules, regulations and guidelines. Secondary sources like authoritative journal articles, books and newspaper reports are contextually analysed in line with the objective of the paper. The definition of HW is ambiguous in the labour laws of Bangladesh. It leads to confusion regarding the extent of legal protection rendered to female HWs at private hospitals in high-risk situations. The labour laws are not applicable in Public hospitals, as the employees follow the public service rules. Unfortunately, the country has no specialised law to protect HWs in high-risk workplaces, and the professional guidelines for HWs also remain inadequate in this regard. Even though the pandemic management strategies highlight some protective measures in high-risk situations, they only deal with HWs who are pregnant or have underlying health issues. No specialised protective guidelines can be found for female HWs as frontliners. Therefore, the laws are insufficient and failed to render adequate legal protection to female frontline HWs during the pandemic. The country also lacks comprehensive health legislation and uniform institutional and professional guidelines, preventing them from accessing grievance mechanisms. Hence, the female HWs felt victimised while duty-bound to serve in high-risk workplaces without adequate safeguards. Bangladesh should clarify the definition of HWs and standardise the service rules for providing medical care in high-risk workplaces. The research also recommends adequate health legislation and specialised legal protection to safeguard female HWs in future emergencies.

Keywords: female health workers (HWs), high-risk workplaces, Covid-19 pandemic, Bangladesh

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141 The Prevalence of Soil Transmitted Helminths among Newly Arrived Expatriate Labors in Jeddah, Saudi Arabia

Authors: Mohammad Al-Refai, Majed Wakid

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Introduction: Soil-transmitted diseases (STD) are caused by intestinal worms that are transmitted via various routes into the human body resulting in various clinical manifestations. The intestinal worms causing these infections are known as soil transmitted helminths (STH), including Hook worms, Ascaris lumbricoides (A. lumbricoides), Trichuris trichiura (T. trichiura), and Strongyloides sterocoralis (S. sterocoralis). Objectives: The aim of this study was to investigate the prevalence of STH among newly arrived expatriate labors in Jeddah city, Saudi Arabia, using three different techniques (direct smears, sedimentation concentration, and real-time PCR). Methods: A total of 188 stool specimens were collected and investigated at the parasitology laboratory in the Special Infectious Agents Unit at King Fahd Medical Research Center, King Abdulaziz University in Jeddah, Saudi Arabia. Microscopic examination of wet mount preparations using normal saline and Lugols Iodine was carried out, followed by the formal ether sedimentation method. In addition, real-time PCR was used as a molecular tool to detect several STH and hookworm speciation. Results: Out of 188 stool specimens analyzed, in addition to STH parasite, several other types were detected. 9 samples (4.79%) were positive for Entamoeba coli, 7 samples (3.72%) for T. trichiura, 6 samples (3.19%) for Necator americanus, 4 samples (2.13%) for S. sterocoralis, 4 samples (2.13%) for A. lumbricoides, 4 samples (2.13%) for E. histolytica, 3 samples (1.60%) for Blastocystis hominis, 2 samples (1.06%) for Ancylostoma duodenale, 2 samples (1.06%) for Giardia lamblia, 1 sample (0.53%) for Iodamoeba buetschlii, 1 sample (0.53%) for Hymenolepis nana, 1 sample (0.53%) for Endolimax nana, and 1 sample (0.53%) for Heterophyes heterophyes. Out of the 35 infected cases, 26 revealed single infection, 8 with double infections, and only one triple infection of different STH species and other intestinal parasites. Higher rates of STH infections were detected among housemaids (11 cases) followed by drivers (7 cases) when compared to other occupations. According to educational level, illiterate participants represent the majority of infected workers (12 cases). The majority of workers' positive cases were from the Philippines. In comparison between laboratory techniques, out of the 188 samples screened for STH, real-time PCR was able to detect the DNA in (19/188) samples followed by Ritchie sedimentation technique (18/188), and direct wet smear (7/188). Conclusion: STH infections are a major public health issue to healthcare systems around the world. Communities must be educated on hygiene practices and the severity of such parasites to human health. As far as drivers and housemaids come to close contact with families, including children and elderlies. This may put family members at risk of developing serious side effects related to STH, especially as the majority of workers were illiterate, lacking the basic hygiene knowledge and practices. We recommend the official authority in Jeddah and around the kingdom of Saudi Arabia to revise the standard screening tests for newly arrived workers and enforce regular follow-up inspections to minimize the chances of the spread of STH from expatriate workers to the public.

Keywords: expatriate labors, Jeddah, prevalence, soil transmitted helminths

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140 Multiple Primary Pulmonary Meningiomas: A Case Report

Authors: Wellemans Isabelle, Remmelink Myriam, Foucart Annick, Rusu Stefan, Compère Christophe

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Primary pulmonary meningioma (PPM) is a very rare tumor, and its occurrence has been reported only sporadically. Multiple PPMs are even more exceptional, and herein, we report, to the best of our knowledge, the fourth case, focusing on the clinicopathological features of the tumor. Moreover, the possible relationship between the use of progesterone–only contraceptives and the development of these neoplasms will be discussed. Case Report: We report a case of a 51-year-old female presenting three solid pulmonary nodules, with the following localizations: right upper lobe, middle lobe, and left lower lobe, described as incidental findings on computed tomography (CT) during a pre-bariatric surgery check-up. The patient revealed no drinking or smoking history. The physical exam was unremarkable except for the obesity. The lesions ranged in size between 6 and 24 mm and presented as solid nodules with lobulated contours. The largest lesion situated in the middle lobe had mild fluorodeoxyglucose (FDG) uptake on F-18 FDG positron emission tomography (PET)/CT, highly suggestive of primary lung neoplasm. For pathological assessment, video-assisted thoracoscopic middle lobectomy and wedge resection of the right upper nodule was performed. Histological examination revealed relatively well-circumscribed solid proliferation of bland meningothelial cells growing in whorls and lobular nests, presenting intranuclear pseudo-inclusions and psammoma bodies. No signs of anaplasia were observed. The meningothelial cells expressed diffusely Vimentin, focally Progesterone receptors and were negative for epithelial (cytokeratin (CK) AE1/AE3, CK7, CK20, Epithelial Membrane Antigen (EMA)), neuroendocrine markers (Synaptophysin, Chromogranin, CD56) and Estrogenic receptors. The proliferation labelling index Ki-67 was low (<5%). Metastatic meningioma was ruled out by brain and spine magnetic resonance imaging (MRI) scans. The third lesion localized in the left lower lobe was followed-up and resected three years later because of its slow but significant growth (14 mm to 16 mm), alongside two new infra centimetric lesions. Those three lesions showed a morphological and immunohistochemical profile similar to previously resected lesions. The patient was disease-free one year post-last surgery. Discussion: Although PPMs are mostly benign and slow-growing tumors with an excellent prognosis, they do not present specific radiological characteristics, and it is difficult to differentiate it from other lung tumors, histopathologic examination being essential. Aggressive behavior is associated with atypical or anaplastic features (WHO grades II–III) The etiology is still uncertain and different mechanisms have been proposed. A causal connection between sexual hormones and meningothelial proliferation has long been suspected and few studies examining progesterone only contraception and meningioma risk have all suggested an association. In line with this, our patient was treated with Levonorgestrel, a progesterone agonist, intra-uterine device (IUD). Conclusions: PPM, defined by the typical histological and immunohistochemical features of meningioma in the lungs and the absence of central nervous system lesions, is an extremely rare neoplasm, mainly solitary and associating, and indolent growth. Because of the unspecific radiologic findings, it should always be considered in the differential diagnosis of lung neoplasms. Regarding multiple PPM, only three cases are reported in the literature, and this is the first described in a woman treated by a progesterone-only IUD to the best of our knowledge.

Keywords: pulmonary meningioma, multiple meningioma, meningioma, pulmonary nodules

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139 Stress and Distress among Physician Trainees: A Wellbeing Workshop

Authors: Carmen Axisa, Louise Nash, Patrick Kelly, Simon Willcock

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Introduction: Doctors experience high levels of burnout, stress and psychiatric morbidity. This can affect the health of the doctor and impact patient care. Study Aims: To evaluate the effectiveness of a workshop intervention to promote wellbeing for Australian Physician Trainees. Methods: A workshop was developed in consultation with specialist clinicians to promote health and wellbeing for physician trainees. The workshop objectives were to improve participant understanding about factors affecting their health and wellbeing, to outline strategies on how to improve health and wellbeing and to encourage participants to apply these strategies in their own lives. There was a focus on building resilience and developing long term healthy behaviours as part of the physician trainee daily lifestyle. Trainees had the opportunity to learn practical strategies for stress management, gain insight into their behaviour and take steps to improve their health and wellbeing. The workshop also identified resources and support systems available to trainees. The workshop duration was four and a half hours including a thirty- minute meal break where a catered meal was provided for the trainees. Workshop evaluations were conducted at the end of the workshop. Sixty-seven physician trainees from Adult Medicine and Paediatric training programs in Sydney Australia were randomised into intervention and control groups. The intervention group attended a workshop facilitated by specialist clinicians and the control group did not. Baseline and post intervention measurements were taken for both groups to evaluate the impact and effectiveness of the workshop. Forty-six participants completed all three measurements (69%). Demographic, personal and self-reported data regarding work/life patterns was collected. Outcome measures include Depression Anxiety Stress Scale (DASS), Professional Quality of Life Scale (ProQOL) and Alcohol Use Disorders Identification Test (AUDIT). Results: The workshop was well received by the physician trainees and workshop evaluations showed that the majority of trainees strongly agree or agree that the training was relevant to their needs (96%) and met their expectations (92%). All trainees strongly agree or agree that they would recommend the workshop to their medical colleagues. In comparison to the control group we observed a reduction in alcohol use, depression and burnout but an increase in stress, anxiety and secondary traumatic stress in the intervention group, at the primary endpoint measured at 6 months. However, none of these differences reached statistical significance (p > 0.05). Discussion: Although the study did not reach statistical significance, the workshop may be beneficial to physician trainees. Trainees had the opportunity to share ideas, gain insight into their own behaviour, learn practical strategies for stress management and discuss approach to work, life and self-care. The workshop discussions enabled trainees to share their experiences in a supported environment where they learned that other trainees experienced stress and burnout and they were not alone in needing to acquire successful coping mechanisms and stress management strategies. Conclusion: These findings suggest that physician trainees are a vulnerable group who may benefit from initiatives that promote wellbeing and from a more supportive work environment.

Keywords: doctors' health, physician burnout, physician resilience, wellbeing workshop

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138 Farm-Women in Technology Transfer to Foster the Capacity Building of Agriculture: A Forecast from a Draught-Prone Rural Setting in India

Authors: Pradipta Chandra, Titas Bhattacharjee, Bhaskar Bhowmick

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The foundation of economy in India is primarily based on agriculture while this is the most neglected in the rural setting. More significantly, household women take part in agriculture with higher involvement. However, because of lower education of women they have limited access towards financial decisions, land ownership and technology but they have vital role towards the individual family level. There are limited studies on the institution-wise training barriers with the focus of gender disparity. The main purpose of this paper is to find out the factors of institution-wise training (non-formal education) barriers in technology transfer with the focus of participation of rural women in agriculture. For this study primary and secondary data were collected in the line of qualitative and quantitative approach. Qualitative data were collected by several field visits in the adjacent areas of Seva-Bharati, Seva Bharati Krishi Vigyan Kendra through semi-structured questionnaires. In the next level detailed field surveys were conducted with close-ended questionnaires scored on the seven-point Likert scale. Sample size was considered as 162. During the data collection the focus was to include women although some biasness from the end of respondents and interviewer might exist due to dissimilarity in observation, views etc. In addition to that the heterogeneity of sample is not very high although female participation is more than fifty percent. Data were analyzed using Exploratory Factor Analysis (EFA) technique with the outcome of three significant factors of training barriers in technology adoption by farmers: (a) Failure of technology transfer training (TTT) comprehension interprets that the technology takers, i.e., farmers can’t understand the technology either language barrier or way of demonstration exhibited by the experts/ trainers. (b) Failure of TTT customization, articulates that the training for individual farmer, gender crop or season-wise is not tailored. (c) Failure of TTT generalization conveys that absence of common training methods for individual trainers for specific crops is more prominent at the community level. The central finding is that the technology transfer training method can’t fulfill the need of the farmers under an economically challenged area. The impact of such study is very high in the area of dry lateritic and resource crunch area of Jangalmahal under Paschim Medinipur district, West Bengal and areas with similar socio-economy. Towards the policy level decision this research may help in framing digital agriculture for implementation of the appropriate information technology for the farming community, effective and timely investment by the government with the selection of beneficiary, formation of farmers club/ farm science club etc. The most important research implication of this study lies upon the contribution towards the knowledge diffusion mechanism of the agricultural sector in India. Farmers may overcome the barriers to achieve higher productivity through adoption of modern farm practices. Corporates will be interested in agro-sector through investment under corporate social responsibility (CSR). The research will help in framing public or industry policy and land use pattern. Consequently, a huge mass of rural farm-women will be empowered and farmer community will be benefitted.

Keywords: dry lateritic zone, institutional barriers, technology transfer in India, farm-women participation

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137 Amniotic Fluid Mesenchymal Stem Cells Selected for Neural Specificity Ameliorates Chemotherapy Induced Hearing Loss and Pain Perception

Authors: Jan F. Talts, Amit Saxena, Kåre Engkilde

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Chemotherapy-induced peripheral neuropathy (CIPN) is one of the most frequent side effects caused by anti-neoplastic agents, with a prevalence from 19 % to 85 %. Clinically, CIPN is a mostly sensory neuropathy leading to pain and to motor and autonomic changes. Due to its high prevalence among cancer patients, CIPN constitutes a major problem for both cancer patients and survivors, especially because currently, there is no single effective method of preventing CIPN. Hearing loss is the most common form of sensory impairment in humans and can be caused by ototoxic chemical compounds such as chemotherapy (platinum-based antineoplastic agents).In rodents, single or repeated cisplatin injections induce peripheral neuropathy and hearing impairment mimicking human disorder, allowing studying the efficacy of new pharmacological candidates in chemotherapy-induced hearing loss and peripheral neuropathy. RNA sequencing data from full term amniotic fluid (TAF) mesenchymal stemcell (MSC) clones was used to identify neural-specific markers present on TAF-MSC. Several prospective neural markers were tested by flow cytometry on cultured TAF-MSC. One of these markers was used for cell-sorting using Tyto MACSQuant cell sorter, and the neural marker positive cell population was expanded for several passages to the final therapeutic product stage. Peripheral neuropathy and hearing loss was induced in mice by administration of cisplatin in three week-long cycles. The efficacy of neural-specific TAF-MSC in treating hearing loss and pain perception was evaluated by administration of three injections of 3 million cells/kg by intravenous route or three injections of 3 million cells/kg by intra-arterial route after each cisplatin cycle treatment. Auditory brainstem responses (ABR) are electric potentials recorded from scalp electrodes, and the first ABR wave represents the summed activity of the auditory nerve fibers contacting the inner hair cells. For ABR studies, mice were anesthetized, then earphones were placed in the left ear of each mouse, an active electrode was placed in the vertex of the skull, a reference electrode under the skin of the mastoid bone, and a ground electrode in the neck skin. The stimuli consisted of tone pips of five frequencies (2, 4, 6, 12, 16, and 24 kHz) at various sound levels (from 0 to 90 dB) ranging to cover the mouse auditory frequency range. The von Frey test was used to assess the onset and maintenance of mechanical allodynia over time. Mice were placed in clear plexiglass cages on an elevated mesh floor and tested after 30 min of habituation. Mechanical paw withdrawal threshold was examined using an electronic von Frey anesthesiometer. Cisplatin groups treated with three injections of 3 million cells/kg by intravenous route and three injections of 3 million cells/kg by intra-arterial route after each cisplatin cycle treatment presented, a significant increase of hearing acuity characterized by a decrease of ABR threshold and a decrease of neuropathic pain characterized by an increase of von Frey paw withdrawal threshold compared to controls only receiving cisplatin. This study shows that treatment with MSCselected for neural specificity presents significant positive efficacy on the chemotherapy-induced neuropathic pain and the chemotherapy-induced hearing loss.

Keywords: mesenchymal stem cell, peripheral neuropathy, amniotic fluid, regenerative medicine

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136 Speciation of Bacteria Isolated from Clinical Canine and Feline Urine Samples by Using ChromID CPS Elite Agar: A Preliminary Study

Authors: Delsy Salinas, Andreia Garcês, Augusto Silva, Paula Brilhante Simões

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Urinary tract infection (UTI) is a common disease affecting dogs and cats in both community and hospital environment. Bacteria is the most frequent agent isolated, fewer than 1% of infections are due to parasitic, fungal, or viral agents. Common symptoms and laboratory abnormalities includeabdominal pain, pyrexia, renomegaly, and neutrophilia with left shift. A rapid and precise identification of the bacterial agent is still a challenge in veterinarian laboratories. Therefore, this cross-sectional study aims to describe bacterial colony patterns of urine samples by using chromID™ CPS® EliteAgar (BioMérieux, France) from canine and feline specimens submitted to a veterinary laboratory in Portugal (INNO Veterinary Laboratory, Braga)from January to March2022. All urine samples were cultivated in CPS Elite Agar with calibrated 1 µL inoculating loop and incubated at 37ºC for 18-24h. Color,size, and shape (regular or irregular outline)were recorded for all samples. All colonies were classified as Gram-negative or Gram-positive bacteriausing Gram stain (PREVI® Color BioMérieux, France) and determined if they were pure colonies. Identification of bacteria species was performed using GP and GN cards inVitek 2® Compact(BioMérieux, France). A total of 256/1003 submitted urine samples presented bacterial growth, from which 172 isolates were included in this study. The sample’s population included 111 dogs (n=45 males and n=66 females) and 61 cats (n=35 males and n=26 females). The most frequent isolated bacteria wasEscherichia coli (44,7%), followed by Proteus mirabilis (13,4%). All Escherichia coli isolates presented red to burgundy colonies, a colony diameter between 2 to 6 mm, and regular or irregular outlines. Similarly, 100% of Proteus mirabilis isolates were dark yellow colonies with a diffuse pigment and the same size and shape as Escherichia coli. White and pink pale colonies where Staphylococcus species exclusively and S. pseudintermedius was the most frequent (8,2 %). Cian to blue colonies were mostly Enterococcusspp. (8,2%) and Streptococcus spp. (4,6%). Beige to brown colonies were Pseudomonas aeruginosa (2,9%) and Citrobacter spp. (1,2%).Klebsiella spp.,Serratia spp. and Enterobacter spp were green colonies. All Gram-positive isolates were 1 to 2 mm diameter long and had a regular outline, meanwhile, Gram-negative rods presented variable patterns. This results showed that theprevalence of E coli and P. mirabilis as uropathogenic agents follows the same trends in Europe as previously described in other studies. Both agents presented a particular color pattern in CPS Elite Agar to identify them without needing complementary tests. No other bacteria genus could be correlated strongly to a specific color pattern, and similar results have been observed instudies using human’s samples. Chromogenic media shows a great advantage for common urine bacteria isolation than traditional COS, McConkey, and CLEDAgar mediums in a routine context, especially when mixed fermentative Gram-negative agents grow simultaneously. In addition, CPS Elite Agar is versatile for Artificial Intelligent Reading Plates Systems. Routine veterinarian laboratories could use CPS Elite Agar for a rapid screening for bacteria identification,mainlyE coli and P.mirabilis, saving 6h to 10h of automatized identification.

Keywords: cats, CPS elite agar, dogs, urine pathogens

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135 Promotion of Healthy Food Choices in School Children through Nutrition Education

Authors: Vinti Davar

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Introduction: Childhood overweight increases the risk for certain medical and psychological conditions. Millions of school-age children worldwide are affected by serious yet easily treatable and preventable illnesses that inhibit their ability to learn. Healthier children stay in school longer, attend more regularly, learn more and become healthier and more productive adults. Schools are an important setting for nutrition education because one can reach most children, teachers and parents. These years offer a key window for shaping their lifetime habits, which have an impact on their health throughout life. Against this background, an attempt was made to impart nutrition education to school children in Haryana state of India to promote healthy food choices and assess the effectiveness of this program. Methodology: This study was completed in two phases. During the first phase, pre-intervention anthropometric and dietary survey was conducted; the teaching materials for nutrition intervention program were developed and tested; and the questionnaire was validated. In the second phase, an intervention was implemented in two schools of Kurukshetra, Haryana for six months by personal visits once a week. A total of 350 children in the age group of 6-12 years were selected. Out of these, 279 children, 153 boys and 126 girls completed the study. The subjects were divided into four groups namely: underweight, normal, overweight and obese based on body mass index-for-age categories. A power point colorful presentation to improve the quality of tiffin, snacks and meals emphasizing inclusion of all food groups especially vegetables every day and fruits at least 3-4 days per week was used. An extra 20 minutes of aerobic exercise daily was likewise organized and a healthy school environment created. Provision of clean drinking water by school authorities was ensured. Selling of soft drinks and energy-dense snacks in the school canteen as well as advertisements about soft drink and snacks on the school walls were banned. Post intervention, anthropometric indices and food selections were reassessed. Results: The results of this study reiterate the critical role of nutrition education and promotion in improving the healthier food choices by school children. It was observed that normal, overweight and obese children participating in nutrition education intervention program significantly (p≤0.05) increased their daily seasonal fruit and vegetable consumption. Fat and oil consumption was significantly reduced by overweight and obese subjects. Fast food intake was controlled by obese children. The nutrition knowledge of school children significantly improved (p≤0.05) from pre to post intervention. A highly significant increase (p≤0.00) was noted in the nutrition attitude score after intervention in all four groups. Conclusion: This study has shown that a well-planned nutrition education program could improve nutrition knowledge and promote positive changes in healthy food choices. A nutrition program inculcates wholesome eating and active life style habits in children and adolescents that could not only prevent them from chronic diseases and early death but also reduce healthcare cost and enhance the quality of life of citizens and thereby nations.

Keywords: children, eating habits healthy food, obesity, school going, fast foods

Procedia PDF Downloads 197
134 Development of Portable Hybrid Renewable Energy System for Sustainable Electricity Supply to Rural Communities in Nigeria

Authors: Abdulkarim Nasir, Alhassan T. Yahaya, Hauwa T. Abdulkarim, Abdussalam El-Suleiman, Yakubu K. Abubakar

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The need for sustainable and reliable electricity supply in rural communities of Nigeria remains a pressing issue, given the country's vast energy deficit and the significant number of inhabitants lacking access to electricity. This research focuses on the development of a portable hybrid renewable energy system designed to provide a sustainable and efficient electricity supply to these underserved regions. The proposed system integrates multiple renewable energy sources, specifically solar and wind, to harness the abundant natural resources available in Nigeria. The design and development process involves the selection and optimization of components such as photovoltaic panels, wind turbines, energy storage units (batteries), and power management systems. These components are chosen based on their suitability for rural environments, cost-effectiveness, and ease of maintenance. The hybrid system is designed to be portable, allowing for easy transportation and deployment in remote locations with limited infrastructure. Key to the system's effectiveness is its hybrid nature, which ensures continuous power supply by compensating for the intermittent nature of individual renewable sources. Solar energy is harnessed during the day, while wind energy is captured whenever wind conditions are favourable, thus ensuring a more stable and reliable energy output. Energy storage units are critical in this setup, storing excess energy generated during peak production times and supplying power during periods of low renewable generation. These studies include assessing the solar irradiance, wind speed patterns, and energy consumption needs of rural communities. The simulation results inform the optimization of the system's design to maximize energy efficiency and reliability. This paper presents the development and evaluation of a 4 kW standalone hybrid system combining wind and solar power. The portable device measures approximately 8 feet 5 inches in width, 8 inches 4 inches in depth, and around 38 feet in height. It includes four solar panels with a capacity of 120 watts each, a 1.5 kW wind turbine, a solar charge controller, remote power storage, batteries, and battery control mechanisms. Designed to operate independently of the grid, this hybrid device offers versatility for use in highways and various other applications. It also presents a summary and characterization of the device, along with photovoltaic data collected in Nigeria during the month of April. The construction plan for the hybrid energy tower is outlined, which involves combining a vertical-axis wind turbine with solar panels to harness both wind and solar energy. Positioned between the roadway divider and automobiles, the tower takes advantage of the air velocity generated by passing vehicles. The solar panels are strategically mounted to deflect air toward the turbine while generating energy. Generators and gear systems attached to the turbine shaft enable power generation, offering a portable solution to energy challenges in Nigerian communities. The study also addresses the economic feasibility of the system, considering the initial investment costs, maintenance, and potential savings from reduced fossil fuel use. A comparative analysis with traditional energy supply methods highlights the long-term benefits and sustainability of the hybrid system.

Keywords: renewable energy, solar panel, wind turbine, hybrid system, generator

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133 Application of the Carboxylate Platform in the Consolidated Bioconversion of Agricultural Wastes to Biofuel Precursors

Authors: Sesethu G. Njokweni, Marelize Botes, Emile W. H. Van Zyl

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An alternative strategy to the production of bioethanol is by examining the degradability of biomass in a natural system such as the rumen of mammals. This anaerobic microbial community has higher cellulolytic activities than microbial communities from other habitats and degrades cellulose to produce volatile fatty acids (VFA), methane and CO₂. VFAs have the potential to serve as intermediate products for electrochemical conversion to hydrocarbon fuels. In vitro mimicking of this process would be more cost-effective than bioethanol production as it does not require chemical pre-treatment of biomass, a sterile environment or added enzymes. The strategies of the carboxylate platform and the co-cultures of a bovine ruminal microbiota from cannulated cows were combined in order to investigate and optimize the bioconversion of agricultural biomass (apple and grape pomace, citrus pulp, sugarcane bagasse and triticale straw) to high value VFAs as intermediates for biofuel production in a consolidated bioprocess. Optimisation of reactor conditions was investigated using five different ruminal inoculum concentrations; 5,10,15,20 and 25% with fixed pH at 6.8 and temperature at 39 ˚C. The ANKOM 200/220 fiber analyser was used to analyse in vitro neutral detergent fiber (NDF) disappearance of the feedstuffs. Fresh and cryo-frozen (5% DMSO and 50% glycerol for 3 months) rumen cultures were tested for the retainment of fermentation capacity and durability in 72 h fermentations in 125 ml serum vials using a FURO medical solutions 6-valve gas manifold to induce anaerobic conditions. Fermentation of apple pomace, triticale straw, and grape pomace showed no significant difference (P > 0.05) in the effect of 15 and 20 % inoculum concentrations for the total VFA yield. However, high performance liquid chromatographic separation within the two inoculum concentrations showed a significant difference (P < 0.05) in acetic acid yield, with 20% inoculum concentration being the optimum at 4.67 g/l. NDF disappearance of 85% in 96 h and total VFA yield of 11.5 g/l in 72 h (A/P ratio = 2.04) for apple pomace entailed that it was the optimal feedstuff for this process. The NDF disappearance and VFA yield of DMSO (82% NDF disappearance and 10.6 g/l VFA) and glycerol (90% NDF disappearance and 11.6 g/l VFA) stored rumen also showed significantly similar degradability of apple pomace with lack of treatment effect differences compared to a fresh rumen control (P > 0.05). The lack of treatment effects was a positive sign in indicating that there was no difference between the stored samples and the fresh rumen control. Retaining of the fermentation capacity within the preserved cultures suggests that its metabolic characteristics were preserved due to resilience and redundancy of the rumen culture. The amount of degradability and VFA yield within a short span was similar to other carboxylate platforms that have longer run times. This study shows that by virtue of faster rates and high extent of degradability, small scale alternatives to bioethanol such as rumen microbiomes and other natural fermenting microbiomes can be employed to enhance the feasibility of biofuels large-scale implementation.

Keywords: agricultural wastes, carboxylate platform, rumen microbiome, volatile fatty acids

Procedia PDF Downloads 116
132 DH-Students Promoting Underage Asylum Seekers' Oral Health in Finland

Authors: Eeva Wallenius-Nareneva, Tuula Toivanen-Labiad

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Background: Oral health promotion event was organised for forty Afghanistan, Iraqi and Bangladeshi underage asylum seekers in Finland. The invitation to arrange this coaching occasion was accepted in the Degree Programme in Oral Hygiene in Metropolia. The personnel in the reception center found the need to improve oral health among the youngsters. The purpose was to strengthen the health literacy of the boys in their oral self-care and to reduce dental fears. The Finnish studies, especially the terminology of oral health was integrated to coaching with the help of interpreters. Cooperative learning was applied. Methods: Oral health was interactively discussed in four study group sessions: 1. The importance of healthy eating habits; - Good and bad diets, - Regular meals, - Acid attack o Xylitol. 2. Oral diseases − connection to general health; - Aetiology of gingivitis, periodontitis and caries, - Harmfulness of smoking 3. Tools and techniques for oral self-care; - Brushing and inter dental cleaning. 4. Sharing earlier dental care experiences; - Cultural differences, - Dental fear, - Regular check-ups. Results: During coaching deficiencies appeared in brushing and inter dental cleaning techniques. Some boys were used to wash their mouth with salt justifying it by salt’s antiseptic properties. Many brushed their teeth by vertical movements. The boys took feedback positively when a demonstration with model jaws revealed the inefficiency of the technique. The advantages of fluoride tooth paste were advised. Dental care procedures were new and frightening for many boys. Finnish dental care system was clarified. The safety and indolence of the treatments and informed consent were highlighted. Video presentations and the dialog lowered substantially the threshold to visit dental clinic. The occasion gave the students means for meeting patients from different cultural and language backgrounds. The information hidden behind the oral health problems of the asylum seekers was valuable. Conclusions: Learning dental care practices used in different cultures is essential for dental professionals. The project was a good start towards multicultural oral health care. More experiences are needed before graduation. Health education themes should be held simple regardless of the target group. The heterogeneity of the group does not pose a problem. Open discussion with questions leading to the theme works well in clarifying the target group’s knowledge level. Sharing own experiences strengthens the sense of equality among the participants and encourages them to express own opinions. Motivational interview method turned out to be successful. In the future coaching occasions must confirm active participation of everyone. This could be realized by dividing the participants to even smaller groups. The different languages impose challenges but they can be solved by using more interpreters. Their presence ensures that everyone understands the issues properly although the use of plain and sign languages are helpful. In further development, it would be crucial to arrange a rehearsal occasion to the same participants in two/three months’ time. This would strengthen the adaption of self-care practices and give the youngsters opportunity to pose more open questions. The students would gain valuable feedback regarding the effectiveness of their work.

Keywords: cooperative learning, interactive methods, motivational interviewing, oral health promotion, underage asylum seekers

Procedia PDF Downloads 278
131 Review of Health Disparities in Migrants Attending the Emergency Department with Acute Mental Health Presentations

Authors: Jacqueline Eleonora Ek, Michael Spiteri, Chris Giordimaina, Pierre Agius

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Background: Malta is known for being a key player as a frontline country with regard to irregular immigration from Africa to Europe. Every year the island experiences an influx of migrants as boat movement across the Mediterranean continues to be a humanitarian challenge. Irregular immigration and applying for asylum is both a lengthy and mentally demanding process. Those doing so are often faced with multiple challenges, which can adversely affect their mental health. Between January and August 2020, Malta disembarked 2 162 people rescued at sea, 463 of them between July & August. Given the small size of the Maltese islands, this regulation places a disproportionately large burden on the country, creating a backlog in the processing of asylum applications resulting in increased time periods of detention. These delays reverberate throughout multiple management pathways resulting in prolonged periods of detention and challenging access to health services. Objectives: To better understand the spatial dimensions of this humanitarian crisis, this study aims to assess disparities in the acute medical management of migrants presenting to the emergency department (ED) with acute mental health presentations as compared to that of local and non-local residents. Method: In this retrospective study, 17795 consecutive ED attendances were reviewed to look for acute mental health presentations. These were further evaluated to assess discrepancies in transportation routes to hospital, nature of presenting complaint, effects of language barriers, use of CT brain, treatment given at ED, availability of psychiatric reviews, and final admission/discharge plans. Results: Of the ED attendances, 92.3% were local residents, and 7.7% were non-locals. Of the non-locals, 13.8% were migrants, and 86.2% were other-non-locals. Acute mental health presentations were seen in 1% of local residents; this increased to 20.6% in migrants. 56.4% of migrants attended with deliberate self-harm; this was lower in local residents, 28.9%. Contrastingly, in local residents, the most common presenting complaint was suicidal thought/ low mood 37.3%, the incidence was similar in migrants at 33.3%. The main differences included 12.8% of migrants presenting with refused oral intake while only 0.6% of local residents presented with the same complaints. 7.7% of migrants presented with a reduced level of consciousness, no local residents presented with this same issue. Physicians documented a language barrier in 74.4% of migrants. 25.6% were noted to be completely uncommunicative. Further investigations included the use of a CT scan in 12% of local residents and in 35.9% of migrants. The most common treatment administered to migrants was supportive fluids 15.4%, the most common in local residents was benzodiazepines 15.1%. Voluntary psychiatric admissions were seen in 33.3% of migrants and 24.7% of locals. Involuntary admissions were seen in 23% of migrants and 13.3% of locals. Conclusion: Results showed multiple disparities in health management. A meeting was held between entities responsible for migrant health in Malta, including the emergency department, primary health care, migrant detention services, and Malta Red Cross. Currently, national quality-improvement initiatives are underway to form new pathways to improve patient-centered care. These include an interpreter unit, centralized handover sheets, and a dedicated migrant health service.

Keywords: emergency department, communication, health, migration

Procedia PDF Downloads 97
130 Sinhala Sign Language to Grammatically Correct Sentences using NLP

Authors: Anjalika Fernando, Banuka Athuraliya

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This paper presents a comprehensive approach for converting Sinhala Sign Language (SSL) into grammatically correct sentences using Natural Language Processing (NLP) techniques in real-time. While previous studies have explored various aspects of SSL translation, the research gap lies in the absence of grammar checking for SSL. This work aims to bridge this gap by proposing a two-stage methodology that leverages deep learning models to detect signs and translate them into coherent sentences, ensuring grammatical accuracy. The first stage of the approach involves the utilization of a Long Short-Term Memory (LSTM) deep learning model to recognize and interpret SSL signs. By training the LSTM model on a dataset of SSL gestures, it learns to accurately classify and translate these signs into textual representations. The LSTM model achieves a commendable accuracy rate of 94%, demonstrating its effectiveness in accurately recognizing and translating SSL gestures. Building upon the successful recognition and translation of SSL signs, the second stage of the methodology focuses on improving the grammatical correctness of the translated sentences. The project employs a Neural Machine Translation (NMT) architecture, consisting of an encoder and decoder with LSTM components, to enhance the syntactical structure of the generated sentences. By training the NMT model on a parallel corpus of Sinhala wrong sentences and their corresponding grammatically correct translations, it learns to generate coherent and grammatically accurate sentences. The NMT model achieves an impressive accuracy rate of 98%, affirming its capability to produce linguistically sound translations. The proposed approach offers significant contributions to the field of SSL translation and grammar correction. Addressing the critical issue of grammar checking, it enhances the usability and reliability of SSL translation systems, facilitating effective communication between hearing-impaired and non-sign language users. Furthermore, the integration of deep learning techniques, such as LSTM and NMT, ensures the accuracy and robustness of the translation process. This research holds great potential for practical applications, including educational platforms, accessibility tools, and communication aids for the hearing-impaired. Furthermore, it lays the foundation for future advancements in SSL translation systems, fostering inclusive and equal opportunities for the deaf community. Future work includes expanding the existing datasets to further improve the accuracy and generalization of the SSL translation system. Additionally, the development of a dedicated mobile application would enhance the accessibility and convenience of SSL translation on handheld devices. Furthermore, efforts will be made to enhance the current application for educational purposes, enabling individuals to learn and practice SSL more effectively. Another area of future exploration involves enabling two-way communication, allowing seamless interaction between sign-language users and non-sign-language users.In conclusion, this paper presents a novel approach for converting Sinhala Sign Language gestures into grammatically correct sentences using NLP techniques in real time. The two-stage methodology, comprising an LSTM model for sign detection and translation and an NMT model for grammar correction, achieves high accuracy rates of 94% and 98%, respectively. By addressing the lack of grammar checking in existing SSL translation research, this work contributes significantly to the development of more accurate and reliable SSL translation systems, thereby fostering effective communication and inclusivity for the hearing-impaired community

Keywords: Sinhala sign language, sign Language, NLP, LSTM, NMT

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129 The Path to Ruthium: Insights into the Creation of a New Element

Authors: Goodluck Akaoma Ordu

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Ruthium (Rth) represents a theoretical superheavy element with an atomic number of 119, proposed within the context of advanced materials science and nuclear physics. The conceptualization of Rth involves theoretical frameworks that anticipate its atomic structure, including a hypothesized stable isotope, Rth-320, characterized by 119 protons and 201 neutrons. The synthesis of Ruthium (Rth) hinges on intricate nuclear fusion processes conducted in state-of-the-art particle accelerators, notably utilizing Calcium-48 (Ca-48) as a projectile nucleus and Einsteinium-253 (Es-253) as a target nucleus. These experiments aim to induce fusion reactions that yield Ruthium isotopes, such as Rth-301, accompanied by neutron emission. Theoretical predictions outline various physical and chemical properties attributed to Ruthium (Rth). It is envisaged to possess a high density, estimated at around 25 g/cm³, with melting and boiling points anticipated to be exceptionally high, approximately 4000 K and 6000 K, respectively. Chemical studies suggest potential oxidation states of +2, +3, and +4, indicating a versatile reactivity, particularly with halogens and chalcogens. The atomic structure of Ruthium (Rth) is postulated to feature an electron configuration of [Rn] 5f^14 6d^10 7s^2 7p^2, reflecting its position in the periodic table as a superheavy element. However, the creation and study of superheavy elements like Ruthium (Rth) pose significant challenges. These elements typically exhibit very short half-lives, posing difficulties in their stabilization and detection. Research efforts are focused on identifying the most stable isotopes of Ruthium (Rth) and developing advanced detection methodologies to confirm their existence and properties. Specialized detectors are essential in observing decay patterns unique to Ruthium (Rth), such as alpha decay or fission signatures, which serve as key indicators of its presence and characteristics. The potential applications of Ruthium (Rth) span across diverse technological domains, promising innovations in energy production, material strength enhancement, and sensor technology. Incorporating Ruthium (Rth) into advanced energy systems, such as the Arc Reactor concept, could potentially amplify energy output efficiencies. Similarly, integrating Ruthium (Rth) into structural materials, exemplified by projects like the NanoArc gauntlet, could bolster mechanical properties and resilience. Furthermore, Ruthium (Rth)--based sensors hold promise for achieving heightened sensitivity and performance in various sensing applications. Looking ahead, the study of Ruthium (Rth) represents a frontier in both fundamental science and applied research. It underscores the quest to expand the periodic table and explore the limits of atomic stability and reactivity. Future research directions aim to delve deeper into Ruthium (Rth)'s atomic properties under varying conditions, paving the way for innovations in nanotechnology, quantum materials, and beyond. The synthesis and characterization of Ruthium (Rth) stand as a testament to human ingenuity and technological advancement, pushing the boundaries of scientific understanding and engineering capabilities. In conclusion, Ruthium (Rth) embodies the intersection of theoretical speculation and experimental pursuit in the realm of superheavy elements. It symbolizes the relentless pursuit of scientific excellence and the potential for transformative technological breakthroughs. As research continues to unravel the mysteries of Ruthium (Rth), it holds the promise of reshaping materials science and opening new frontiers in technological innovation.

Keywords: superheavy element, nuclear fusion, bombardment, particle accelerator, nuclear physics, particle physics

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128 Mineralized Nanoparticles as a Contrast Agent for Ultrasound and Magnetic Resonance Imaging

Authors: Jae Won Lee, Kyung Hyun Min, Hong Jae Lee, Sang Cheon Lee

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To date, imaging techniques have attracted much attention in medicine because the detection of diseases at an early stage provides greater opportunities for successful treatment. Consequently, over the past few decades, diverse imaging modalities including magnetic resonance (MR), positron emission tomography, computed tomography, and ultrasound (US) have been developed and applied widely in the field of clinical diagnosis. However, each of the above-mentioned imaging modalities possesses unique strengths and intrinsic weaknesses, which limit their abilities to provide accurate information. Therefore, multimodal imaging systems may be a solution that can provide improved diagnostic performance. Among the current medical imaging modalities, US is a widely available real-time imaging modality. It has many advantages including safety, low cost and easy access for patients. However, its low spatial resolution precludes accurate discrimination of diseased region such as cancer sites. In contrast, MR has no tissue-penetrating limit and can provide images possessing exquisite soft tissue contrast and high spatial resolution. However, it cannot offer real-time images and needs a comparatively long imaging time. The characteristics of these imaging modalities may be considered complementary, and the modalities have been frequently combined for the clinical diagnostic process. Biominerals such as calcium carbonate (CaCO3) and calcium phosphate (CaP) exhibit pH-dependent dissolution behavior. They demonstrate pH-controlled drug release due to the dissolution of minerals in acidic pH conditions. In particular, the application of this mineralization technique to a US contrast agent has been reported recently. The CaCO3 mineral reacts with acids and decomposes to generate calcium dioxide (CO2) gas in an acidic environment. These gas-generating mineralized nanoparticles generated CO2 bubbles in the acidic environment of the tumor, thereby allowing for strong echogenic US imaging of tumor tissues. On the basis of this previous work, it was hypothesized that the loading of MR contrast agents into the CaCO3 mineralized nanoparticles may be a novel strategy in designing a contrast agent for dual imaging. Herein, CaCO3 mineralized nanoparticles that were capable of generating CO2 bubbles to trigger the release of entrapped MR contrast agents in response to tumoral acidic pH were developed for the purposes of US and MR dual-modality imaging of tumors. Gd2O3 nanoparticles were selected as an MR contrast agent. A key strategy employed in this study was to prepare Gd2O3 nanoparticle-loaded mineralized nanoparticles (Gd2O3-MNPs) using block copolymer-templated CaCO3 mineralization in the presence of calcium cations (Ca2+), carbonate anions (CO32-) and positively charged Gd2O3 nanoparticles. The CaCO3 core was considered suitable because it may effectively shield Gd2O3 nanoparticles from water molecules in the blood (pH 7.4) before decomposing to generate CO2 gas, triggering the release of Gd2O3 nanoparticles in tumor tissues (pH 6.4~7.4). The kinetics of CaCO3 dissolution and CO2 generation from the Gd2O3-MNPs were examined as a function of pH and pH-dependent in vitro magnetic relaxation; additionally, the echogenic properties were estimated to demonstrate the potential of the particles for the tumor-specific US and MR imaging.

Keywords: calcium carbonate, mineralization, ultrasound imaging, magnetic resonance imaging

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127 Biomedical Application of Green Biosynthesis Magnetic Iron Oxide (Fe3O4) Nanoparticles Using Seaweed (Sargassum muticum) Aqueous Extract

Authors: Farideh Namvar, Rosfarizan Mohamed

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In the field of nanotechnology, the use of various biological units instead of toxic chemicals for the reduction and stabilization of nanoparticles, has received extensive attention. This use of biological entities to create nanoparticles has designated as “Green” synthesis and it is considered to be far more beneficial due to being economical, eco-friendly and applicable for large-scale synthesis as it operates on low pressure, less input of energy and low temperatures. The lack of toxic byproducts and consequent decrease in degradation of the product renders this technique more preferable over physical and classical chemical methods. The variety of biomass having reduction properties to produce nanoparticles makes them an ideal candidate for fabrication. Metal oxide nanoparticles have been said to represent a "fundamental cornerstone of nanoscience and nanotechnology" due to their variety of properties and potential applications. However, this also provides evidence of the fact that metal oxides include many diverse types of nanoparticles with large differences in chemical composition and behaviour. In this study, iron oxide nanoparticles (Fe3O4-NPs) were synthesized using a rapid, single step and completely green biosynthetic method by reduction of ferric chloride solution with brown seaweed (Sargassum muticum) water extract containing polysaccharides as a main factor which acts as reducing agent and efficient stabilizer. Antimicrobial activity against six microorganisms was tested using well diffusion method. The resulting S-IONPs are crystalline in nature, with a cubic shape. The average particle diameter, as determined by TEM, was found to be 18.01 nm. The S-IONPs were efficiently inhibited the growth of Listeria monocytogenes, Escherichia coli and Candida species. Our favorable results suggest that S-IONPs could be a promising candidate for development of future antimicrobial therapies. The nature of biosynthesis and the therapeutic potential by S-IONPs could pave the way for further research on design of green synthesis therapeutic agents, particularly nanomedicine, to deal with treatment of infections. Further studies are needed to fully characterize the toxicity and the mechanisms involved with the antimicrobial activity of these particles. Antioxidant activity of S-IONPs synthesized by green method was measured by ABTS (2, 2'-azino-bis (3-ethylbenzothiazoline-6-sulphonic acid) (IC50= 1000µg) radical scavenging activity. Also, with the increasing concentration of S-IONPs, catalase gene expression compared to control gene GAPDH increased. For anti-angiogenesis study the Ross fertilized eggs were divided into four groups; the control and three experimental groups. The gelatin sponges containing albumin were placed on the chorioalantoic membrane and soaked with different concentrations of S-IONPs. All the cases were photographed using a photo stereomicroscope. The number and the lengths of the vessels were measured using Image J software. The crown rump (CR) and weight of the embryo were also recorded. According to the data analysis, the number and length of the blood vessels, as well as the CR and weight of the embryos reduced significantly compared to the control (p < 0.05), dose dependently. The total hemoglobin was quantified as an indicator of the blood vessel formation, and in the treated samples decreased, which showed its inhibitory effect on angiogenesis.

Keywords: anti-angiogenesis, antimicrobial, antioxidant, biosynthesis, iron oxide (fe3o4) nanoparticles, sargassum muticum, seaweed

Procedia PDF Downloads 305
126 Improving Data Completeness and Timely Reporting: A Joint Collaborative Effort between Partners in Health and Ministry of Health in Remote Areas, Neno District, Malawi

Authors: Wiseman Emmanuel Nkhomah, Chiyembekezo Kachimanga, Moses Banda Aron, Julia Higgins, Manuel Mulwafu, Kondwani Mpinga, Mwayi Chunga, Grace Momba, Enock Ndarama, Dickson Sumphi, Atupere Phiri, Fabien Munyaneza

Abstract:

Background: Data is key to supporting health service delivery as stakeholders, including NGOs rely on it for effective service delivery, decision-making, and system strengthening. Several studies generated debate on data quality from national health management information systems (HMIS) in sub-Saharan Africa. This limits the utilization of data in resource-limited settings, which already struggle to meet standards set by the World Health Organization (WHO). We aimed to evaluate data quality improvement of Neno district HMIS over a 4-year period (2018 – 2021) following quarterly data reviews introduced in January 2020 by the district health management team and Partners In Health. Methods: Exploratory Mixed Research was used to examine report rates, followed by in-depth interviews using Key Informant Interviews (KIIs) and Focus Group Discussions (FGDs). We used the WHO module desk review to assess the quality of HMIS data in the Neno district captured from 2018 to 2021. The metrics assessed included the completeness and timeliness of 34 reports. Completeness was measured as a percentage of non-missing reports. Timeliness was measured as the span between data inputs and expected outputs meeting needs. We computed T-Test and recorded P-values, summaries, and percentage changes using R and Excel 2016. We analyzed demographics for key informant interviews in Power BI. We developed themes from 7 FGDs and 11 KIIs using Dedoose software, from which we picked perceptions of healthcare workers, interventions implemented, and improvement suggestions. The study was reviewed and approved by Malawi National Health Science Research Committee (IRB: 22/02/2866). Results: Overall, the average reporting completeness rate was 83.4% (before) and 98.1% (after), while timeliness was 68.1% and 76.4 respectively. Completeness of reports increased over time: 2018, 78.8%; 2019, 88%; 2020, 96.3% and 2021, 99.9% (p< 0.004). The trend for timeliness has been declining except in 2021, where it improved: 2018, 68.4%; 2019, 68.3%; 2020, 67.1% and 2021, 81% (p< 0.279). Comparing 2021 reporting rates to the mean of three preceding years, both completeness increased from 88% to 99% (in 2021), while timeliness increased from 68% to 81%. Sixty-five percent of reports have maintained meeting a national standard of 90%+ in completeness while only 24% in timeliness. Thirty-two percent of reports met the national standard. Only 9% improved on both completeness and timeliness, and these are; cervical cancer, nutrition care support and treatment, and youth-friendly health services reports. 50% of reports did not improve to standard in timeliness, and only one did not in completeness. On the other hand, factors associated with improvement included improved communications and reminders using internal communication, data quality assessments, checks, and reviews. Decentralizing data entry at the facility level was suggested to improve timeliness. Conclusion: Findings suggest that data quality in HMIS for the district has improved following collaborative efforts. We recommend maintaining such initiatives to identify remaining quality gaps and that results be shared publicly to support increased use of data. These results can inform Ministry of Health and its partners on some interventions and advise initiatives for improving its quality.

Keywords: data quality, data utilization, HMIS, collaboration, completeness, timeliness, decision-making

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125 Application of Large Eddy Simulation-Immersed Boundary Volume Penalization Method for Heat and Mass Transfer in Granular Layers

Authors: Artur Tyliszczak, Ewa Szymanek, Maciej Marek

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Flow through granular materials is important to a vast array of industries, for instance in construction industry where granular layers are used for bulkheads and isolators, in chemical engineering and catalytic reactors where large surfaces of packed granular beds intensify chemical reactions, or in energy production systems, where granulates are promising materials for heat storage and heat transfer media. Despite the common usage of granulates and extensive research performed in this field, phenomena occurring between granular solid elements or between solids and fluid are still not fully understood. In the present work we analyze the heat exchange process between the flowing medium (gas, liquid) and solid material inside the granular layers. We consider them as a composite of isolated solid elements and inter-granular spaces in which a gas or liquid can flow. The structure of the layer is controlled by shapes of particular granular elements (e.g., spheres, cylinders, cubes, Raschig rings), its spatial distribution or effective characteristic dimension (total volume or surface area). We will analyze to what extent alteration of these parameters influences on flow characteristics (turbulent intensity, mixing efficiency, heat transfer) inside the layer and behind it. Analysis of flow inside granular layers is very complicated because the use of classical experimental techniques (LDA, PIV, fibber probes) inside the layers is practically impossible, whereas the use of probes (e.g. thermocouples, Pitot tubes) requires drilling of holes inside the solid material. Hence, measurements of the flow inside granular layers are usually performed using for instance advanced X-ray tomography. In this respect, theoretical or numerical analyses of flow inside granulates seem crucial. Application of discrete element methods in combination with the classical finite volume/finite difference approaches is problematic as a mesh generation process for complex granular material can be very arduous. A good alternative for simulation of flow in complex domains is an immersed boundary-volume penalization (IB-VP) in which the computational meshes have simple Cartesian structure and impact of solid objects on the fluid is mimicked by source terms added to the Navier-Stokes and energy equations. The present paper focuses on application of the IB-VP method combined with large eddy simulation (LES). The flow solver used in this work is a high-order code (SAILOR), which was used previously in various studies, including laminar/turbulent transition in free flows and also for flows in wavy channels, wavy pipes and over various shape obstacles. In these cases a formal order of approximation turned out to be in between 1 and 2, depending on the test case. The current research concentrates on analyses of the flows in dense granular layers with elements distributed in a deterministic regular manner and validation of the results obtained using LES-IB method and body-fitted approach. The comparisons are very promising and show very good agreement. It is found that the size, number of elements and their distribution have huge impact on the obtained results. Ordering of the granular elements (or lack of it) affects both the pressure drop and efficiency of the heat transfer as it significantly changes mixing process.

Keywords: granular layers, heat transfer, immersed boundary method, numerical simulations

Procedia PDF Downloads 120
124 Modern Cardiac Surgical Outcomes in Nonagenarians: A Multicentre Retrospective Observational Study

Authors: Laurence Weinberg, Dominic Walpole, Dong-Kyu Lee, Michael D’Silva, Jian W. Chan, Lachlan F. Miles, Bradley Carp, Adam Wells, Tuck S. Ngun, Siven Seevanayagam, George Matalanis, Ziauddin Ansari, Rinaldo Bellomo, Michael Yii

Abstract:

Background: There have been multiple recent advancements in the selection, optimization and management of cardiac surgical patients. However, there is limited data regarding the outcomes of nonagenarians undergoing cardiac surgery, despite this vulnerable cohort increasingly receiving these interventions. This study describes the patient characteristics, management and outcomes of a group of nonagenarians undergoing cardiac surgery in the context of contemporary peri-operative care. Methods: A retrospective observational study was conducted of patients 90 to 99 years of age (i.e., nonagenarians) who had undergone cardiac surgery requiring a classic median sternotomy (i.e., open-heart surgery). All operative indications were included. Patients who underwent minimally invasive surgery, transcatheter aortic valve implantation and thoracic aorta surgery were excluded. Data were collected from four hospitals in Victoria, Australia, over an 8-year period (January 2012 – December 2019). The primary objective was to assess six-month mortality in nonagenarians undergoing open-heart surgery and to evaluate the incidence and severity of postoperative complications using the Clavien-Dindo classification system. The secondary objective was to provide a detailed description of the characteristics and peri-operative management of this group. Results: A total of 12,358 adult patients underwent cardiac surgery at the study centers during the observation period, of whom 18 nonagenarians (0.15%) fulfilled the inclusion criteria. The median (IQR) [min-max] age was 91 years (90.0:91.8) [90-94] and 14 patients (78%) were men. Cardiovascular comorbidities, polypharmacy and frailty, were common. The median (IQR) predicted in-hospital mortality by EuroSCORE II was 6.1% (4.1-14.5). All patients were optimized preoperatively by a multidisciplinary team of surgeons, cardiologists, geriatricians and anesthetists. All index surgeries were performed on cardiopulmonary bypass. Isolated coronary artery bypass grafting (CABG) and CABG with aortic valve replacement were the most common surgeries being performed in four and five patients, respectively. Half the study group underwent surgery involving two or more major procedures (e.g. CABG and valve replacement). Surgery was undertaken emergently in 44% of patients. All patients except one experienced at least one postoperative complication. The most common complications were acute kidney injury (72%), new atrial fibrillation (44%) and delirium (39%). The highest Clavien-Dindo complication grade was IIIb occurring once each in three patients. Clavien-Dindo grade IIIa complications occurred in only one patient. The median (IQR) postoperative length of stay was 11.6 days (9.8:17.6). One patient was discharged home and all others to an inpatient rehabilitation facility. Three patients had an unplanned readmission within 30 days of discharge. All patients had follow-up to at least six months after surgery and mortality over this period was zero. The median (IQR) duration of follow-up was 11.3 months (6.0:26.4) and there were no cases of mortality observed within the available follow-up records. Conclusion: In this group of nonagenarians undergoing cardiac surgery, postoperative six-month mortality was zero. Complications were common but generally of low severity. These findings support carefully selected nonagenarian patients being offered cardiac surgery in the context of contemporary, multidisciplinary perioperative care. Further, studies are needed to assess longer-term mortality and functional and quality of life outcomes in this vulnerable surgical cohort.

Keywords: cardiac surgery, mortality, nonagenarians, postoperative complications

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123 Enhancing Plant Throughput in Mineral Processing Through Multimodal Artificial Intelligence

Authors: Muhammad Bilal Shaikh

Abstract:

Mineral processing plants play a pivotal role in extracting valuable minerals from raw ores, contributing significantly to various industries. However, the optimization of plant throughput remains a complex challenge, necessitating innovative approaches for increased efficiency and productivity. This research paper investigates the application of Multimodal Artificial Intelligence (MAI) techniques to address this challenge, aiming to improve overall plant throughput in mineral processing operations. The integration of multimodal AI leverages a combination of diverse data sources, including sensor data, images, and textual information, to provide a holistic understanding of the complex processes involved in mineral extraction. The paper explores the synergies between various AI modalities, such as machine learning, computer vision, and natural language processing, to create a comprehensive and adaptive system for optimizing mineral processing plants. The primary focus of the research is on developing advanced predictive models that can accurately forecast various parameters affecting plant throughput. Utilizing historical process data, machine learning algorithms are trained to identify patterns, correlations, and dependencies within the intricate network of mineral processing operations. This enables real-time decision-making and process optimization, ultimately leading to enhanced plant throughput. Incorporating computer vision into the multimodal AI framework allows for the analysis of visual data from sensors and cameras positioned throughout the plant. This visual input aids in monitoring equipment conditions, identifying anomalies, and optimizing the flow of raw materials. The combination of machine learning and computer vision enables the creation of predictive maintenance strategies, reducing downtime and improving the overall reliability of mineral processing plants. Furthermore, the integration of natural language processing facilitates the extraction of valuable insights from unstructured textual data, such as maintenance logs, research papers, and operator reports. By understanding and analyzing this textual information, the multimodal AI system can identify trends, potential bottlenecks, and areas for improvement in plant operations. This comprehensive approach enables a more nuanced understanding of the factors influencing throughput and allows for targeted interventions. The research also explores the challenges associated with implementing multimodal AI in mineral processing plants, including data integration, model interpretability, and scalability. Addressing these challenges is crucial for the successful deployment of AI solutions in real-world industrial settings. To validate the effectiveness of the proposed multimodal AI framework, the research conducts case studies in collaboration with mineral processing plants. The results demonstrate tangible improvements in plant throughput, efficiency, and cost-effectiveness. The paper concludes with insights into the broader implications of implementing multimodal AI in mineral processing and its potential to revolutionize the industry by providing a robust, adaptive, and data-driven approach to optimizing plant operations. In summary, this research contributes to the evolving field of mineral processing by showcasing the transformative potential of multimodal artificial intelligence in enhancing plant throughput. The proposed framework offers a holistic solution that integrates machine learning, computer vision, and natural language processing to address the intricacies of mineral extraction processes, paving the way for a more efficient and sustainable future in the mineral processing industry.

Keywords: multimodal AI, computer vision, NLP, mineral processing, mining

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122 Capsaicin Derivatives Enhanced Activity of α1β2γ2S-Aminobutyric Acid Type a Receptor Expressed in Xenopus laevis Oocytes

Authors: Jia H. Wong, Jingli Zhang, Habsah Mohamad, Iswatun H. Abdullah Ripain, Muhammad Bilal, Amelia J. Lloyd, Abdul A. Mohamed Yusoff, Jafri M. Abdullah

Abstract:

Epilepsy is one of the most common neurological diseases affecting more than 50 million of people worldwide. Epilepsy is a state of recurrent, spontaneous seizures with multiple syndromes and symptoms of different causes of brain dysfunction, prognosis, and treatments; characterized by transient, occasional and stereotyped interruptions of behavior whereby the excitatory-inhibitory activities within the central nervous system (CNS) are thrown out of balance due to various kinds of interferences. The goal of antiepileptic treatment is to enable patients to be free from seizures or to achieve control of seizures through surgical treatment and/or pharmacotherapy. Pharmacotherapy through AED plays an important role especially in countries with epilepsy treatment gap due to costs and availability of health facilities, skills and resources, yet there are about one-third of the people with epilepsy have drug-resistant seizures. Hence, this poses considerable challenges to the healthcare system and the effort in providing cost-effective treatment as well as the search for alternatives to treatment and management of epilepsy. Enhancement of γ-aminobutyric acid (GABA)-mediated inhibitory neurotransmission is one of the key mechanisms of actions of antiepileptic drugs. GABA type > a receptors (GABAAR) are ligand-gated ion channels that mediate rapid inhibitory neurotransmission upon the binding of GABA with a heteropentameric structure forming a central pore that is permeable to the influx of chloride ions in its activated state. The major isoform of GABAA receptors consists of two α1, two β2, and one γ2 subunit. It is the most abundantly expressed combinations in the brain and the most commonly researched through Xenopus laevis oocytes. With the advancing studies on ethnomedicine and traditional treatments using medicinal plants, increasing evidence reveal that spice and herb plants with medicinal properties play an important role in the treatment of ailments within communities across different cultures. Capsaicin is the primary natural capsaicinoid in hot peppers of plant genus Capsicum, consist of an aromatic ring, an amide linkage and a hydrophobic side chain. The study showed that capsaicins conferred neuroprotection in status epilepticus mouse models through anti-ictogenic, hypothermic, antioxidative, anti-inflammatory, and anti-apoptotic actions in a dose-dependent manner. In this study, five capsaicin derivatives were tested for their ability to increase the GABA-induced chloride current on α1β2γ2S of GABAAR expressed on Xenopus laevis oocytes using the method of two-microelectrode voltage clamp. Two of the capsaicin derivatives, IS5 (N-(4-hydroxy-3-methoxybenzyl)-3-methylbutyramide) and IS10 (N-(4-hydroxy-3-methoxybenzyl)-decanamide) at a concentration of 30µM were able to significantly increase the GABA-induced chloride current with p=0.002 and p=0.026 respectively. This study were able to show the enhancement effect of two capsaicin derivatives with moderate length of hydrocarbon chain on this receptor subtype, revealing the promising inhibitory activity of capsaicin derivatives through enhancement of GABA-induced chloride current and further investigations should be carried out to verify its antiepileptic effects in animal models.

Keywords: α1β2γ2 GABAA receptors, α1β2γ2S, antiepileptic, capsaicin derivatives, two-microelectrode voltage clamp, Xenopus laevis oocytes

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121 A Prospective Neurosurgical Registry Evaluating the Clinical Care of Traumatic Brain Injury Patients Presenting to Mulago National Referral Hospital in Uganda

Authors: Benjamin J. Kuo, Silvia D. Vaca, Joao Ricardo Nickenig Vissoci, Catherine A. Staton, Linda Xu, Michael Muhumuza, Hussein Ssenyonjo, John Mukasa, Joel Kiryabwire, Lydia Nanjula, Christine Muhumuza, Henry E. Rice, Gerald A. Grant, Michael M. Haglund

Abstract:

Background: Traumatic Brain Injury (TBI) is disproportionally concentrated in low- and middle-income countries (LMICs), with the odds of dying from TBI in Uganda more than 4 times higher than in high income countries (HICs). The disparities in the injury incidence and outcome between LMICs and resource-rich settings have led to increased health outcomes research for TBIs and their associated risk factors in LMICs. While there have been increasing TBI studies in LMICs over the last decade, there is still a need for more robust prospective registries. In Uganda, a trauma registry implemented in 2004 at the Mulago National Referral Hospital (MNRH) showed that RTI is the major contributor (60%) of overall mortality in the casualty department. While the prior registry provides information on injury incidence and burden, it’s limited in scope and doesn’t follow patients longitudinally throughout their hospital stay nor does it focus specifically on TBIs. And although these retrospective analyses are helpful for benchmarking TBI outcomes, they make it hard to identify specific quality improvement initiatives. The relationship among epidemiology, patient risk factors, clinical care, and TBI outcomes are still relatively unknown at MNRH. Objective: The objectives of this study are to describe the processes of care and determine risk factors predictive of poor outcomes for TBI patients presenting to a single tertiary hospital in Uganda. Methods: Prospective data were collected for 563 TBI patients presenting to a tertiary hospital in Kampala from 1 June – 30 November 2016. Research Electronic Data Capture (REDCap) was used to systematically collect variables spanning 8 categories. Univariate and multivariate analysis were conducted to determine significant predictors of mortality. Results: 563 TBI patients were enrolled from 1 June – 30 November 2016. 102 patients (18%) received surgery, 29 patients (5.1%) intended for surgery failed to receive it, and 251 patients (45%) received non-operative management. Overall mortality was 9.6%, which ranged from 4.7% for mild and moderate TBI to 55% for severe TBI patients with GCS 3-5. Within each TBI severity category, mortality differed by management pathway. Variables predictive of mortality were TBI severity, more than one intracranial bleed, failure to receive surgery, high dependency unit admission, ventilator support outside of surgery, and hospital arrival delayed by more than 4 hours. Conclusions: The overall mortality rate of 9.6% in Uganda for TBI is high, and likely underestimates the true TBI mortality. Furthermore, the wide-ranging mortality (3-82%), high ICU fatality, and negative impact of care delays suggest shortcomings with the current triaging practices. Lack of surgical intervention when needed was highly predictive of mortality in TBI patients. Further research into the determinants of surgical interventions, quality of step-up care, and prolonged care delays are needed to better understand the complex interplay of variables that affect patient outcome. These insights guide the development of future interventions and resource allocation to improve patient outcomes.

Keywords: care continuum, global neurosurgery, Kampala Uganda, LMIC, Mulago, prospective registry, traumatic brain injury

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120 Diffusion MRI: Clinical Application in Radiotherapy Planning of Intracranial Pathology

Authors: Pomozova Kseniia, Gorlachev Gennadiy, Chernyaev Aleksandr, Golanov Andrey

Abstract:

In clinical practice, and especially in stereotactic radiosurgery planning, the significance of diffusion-weighted imaging (DWI) is growing. This makes the existence of software capable of quickly processing and reliably visualizing diffusion data, as well as equipped with tools for their analysis in terms of different tasks. We are developing the «MRDiffusionImaging» software on the standard C++ language. The subject part has been moved to separate class libraries and can be used on various platforms. The user interface is Windows WPF (Windows Presentation Foundation), which is a technology for managing Windows applications with access to all components of the .NET 5 or .NET Framework platform ecosystem. One of the important features is the use of a declarative markup language, XAML (eXtensible Application Markup Language), with which you can conveniently create, initialize and set properties of objects with hierarchical relationships. Graphics are generated using the DirectX environment. The MRDiffusionImaging software package has been implemented for processing diffusion magnetic resonance imaging (dMRI), which allows loading and viewing images sorted by series. An algorithm for "masking" dMRI series based on T2-weighted images was developed using a deformable surface model to exclude tissues that are not related to the area of interest from the analysis. An algorithm of distortion correction using deformable image registration based on autocorrelation of local structure has been developed. Maximum voxel dimension was 1,03 ± 0,12 mm. In an elementary brain's volume, the diffusion tensor is geometrically interpreted using an ellipsoid, which is an isosurface of the probability density of a molecule's diffusion. For the first time, non-parametric intensity distributions, neighborhood correlations, and inhomogeneities are combined in one segmentation of white matter (WM), grey matter (GM), and cerebrospinal fluid (CSF) algorithm. A tool for calculating the coefficient of average diffusion and fractional anisotropy has been created, on the basis of which it is possible to build quantitative maps for solving various clinical problems. Functionality has been created that allows clustering and segmenting images to individualize the clinical volume of radiation treatment and further assess the response (Median Dice Score = 0.963 ± 0,137). White matter tracts of the brain were visualized using two algorithms: deterministic (fiber assignment by continuous tracking) and probabilistic using the Hough transform. The proposed algorithms test candidate curves in the voxel, assigning to each one a score computed from the diffusion data, and then selects the curves with the highest scores as the potential anatomical connections. White matter fibers were visualized using a Hough transform tractography algorithm. In the context of functional radiosurgery, it is possible to reduce the irradiation volume of the internal capsule receiving 12 Gy from 0,402 cc to 0,254 cc. The «MRDiffusionImaging» will improve the efficiency and accuracy of diagnostics and stereotactic radiotherapy of intracranial pathology. We develop software with integrated, intuitive support for processing, analysis, and inclusion in the process of radiotherapy planning and evaluating its results.

Keywords: diffusion-weighted imaging, medical imaging, stereotactic radiosurgery, tractography

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119 The Lytic Bacteriophage VbɸAB-1 Against Drug-Resistant Acinetobacter Baumannii Isolated from Hospitalized Pressure Ulcers Patients

Authors: M. Doudi, M. H. Pazandeh, L. Rahimzadeh Torabi

Abstract:

Bedsores are pressure ulcers that occur on the skin or tissue due to being immobile and lying in bed for extended periods. Bedsores have the potential to progress into open ulcers, increasing the possibility of a variety of bacterial infections. Acinetobacter baumannii, a pathogen of considerable clinical importance, exhibited a significant correlation with Bedsores (pressure ulcers) infections, thereby manifesting a wide spectrum of antibiotic resistance. The emergence of drug resistance has led researchers to focus on alternative methods, particularly phage therapy, for tackling bacterial infections. Phage therapy has emerged as a novel therapeutic approach to regulate the activity of these agents. The management of bacterial infections greatly benefits from the clinical utilization of bacteriophages as a valuable antimicrobial intervention. The primary objective of this investigation consisted of isolating and discerning potent bacteriophage capable of targeting multi-drug-resistant (MDR) and extensively drug-resistant (XDR) bacteria obtained from pressure ulcers. The present study analyzed and isolated A. baumannii strains obtained from a cohort of patients suffering from pressure ulcers at Taleghani Hospital in Ahvaz, Iran. An approach that included biochemical and molecular identification techniques was used to determine the taxonomic classification of bacterial isolates at the genus and species levels. The molecular identification process was facilitated by using the 16S rRNA gene in combination with universal primers 27 F and 1492 R. Bacteriophage was obtained through the isolation process conducted on treatment plant sewage located in Isfahan, Iran. The main goal of this study was to evaluate different characteristics of phage, such as their appearance, the range of hosts they can infect, how quickly they can enter a host, their stability at varying temperatures and pH levels, their effectiveness in killing bacteria, the growth pattern of a single phage stage, mapping of enzymatic digestion, and identification of proteomics patterns. The findings demonstrated that an examination was conducted on a sample of 50 specimens, wherein 15 instances of A. baumannii were identified. These microorganisms are the predominant Gram-negative agents known to cause wound infections in individuals suffering from bedsores. The study's findings indicated a high prevalence of antibiotic resistance in the strains isolated from pressure ulcers, excluding the clinical strains that exhibited responsiveness to colistin. According to the findings obtained from assessments of host range and morphological characteristics of bacteriophage VbɸAB-1, it can be concluded that this phage possesses specificity towards A. Baumannii BAH_Glau1001 was classified as a member of the Podoviridae family. The bacteriophage mentioned earlier showed the strongest antibacterial effect at a temperature of 18 °C and a pH of 6.5. Through the utilization of sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) analysis on protein fragments, it was established that the bacteriophage VbɸAB-1 exhibited a size range between 50 and 75 kilodaltons (KDa). The numerous research findings on the effectiveness of phages and the safety studies conducted suggest that the phages studied in this research can be considered as a practical solution and recommended approach for controlling and treating stubborn pathogens in burn wounds among hospitalized patients. The findings of our research indicated that isolated phages could be an effective antimicrobial and an appreciate candidate for prophylaxis against pressure ulcers.

Keywords: acinetobacter baumannii, extremely drug-resistant, phage therapy, surgery wound

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118 Hidden Wild Edible Agaric Wealth in North West India: Diversity and Domestication Studies

Authors: Munruchi Kaur

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Agarics are the fruiting bodies of the fungi falling under Phylum Basidiomycota of class Agaricomycetes. North Western parts of India which comprises of mighty Himalayas decorated with snow cap mountains, forested areas, grassland and the Gangetic plains with the altitude varying between 196m to 3600m have a huge potential of naturally growing wild agarics. These mushrooms lavishly grow in wet humid weather conditions that prevail in these parts of India during the monsoon which hits in the early June and continue up to mid-October. In this area, a diverse form of mixed vegetation is available which is represented by coniferous and angiospermic trees, shrubs, herbs, epiphytes, parasites, climbers etc. The vegetation, topography and climate of this area is quite favorable for the growth of agarics. Cedrus deodara, Pinus longifolia, P. roxburghii, P. wallichiana, Abies pindrow, A. spectabilis, Picea smithiana, Taxus sp., Rhododendron sp. and Quercus sp. occur in pure formations or as scattered patches or as mixed forests, whereas the Gangetic plains are dominated by the angiospermic trees and shrubs, they commonly occur along roadsides or in conserved areas or are the avenues plantations, common amongst these are Shorea robusta, Dalbergia sissoo, Melia azadirachta, Acacia sp., Ficus benghalensis, Eucalyptus sp. and Butea monosperma. These agarics can be categorized on the basis of the habitat in which they grow they are usually foliocolous, lignicolous, humicolous, coprophilous or termitophilous. A number of fungal forays were undertaken to different parts of North West India from time to time during the monsoon season with an aim to decipher the agarics diversity of this part of India. Along with collecting the various agarics from diverse habitat, the ethnomycological data was also collected along with by interacting with the local inhabitants of those areas. Based upon the ethnomycological data collected over the years, cataloging of the edible and inedible agarics has been done and cultures of such potential edible agarics were raised with an aim to domesticate these selected taxa. With an aim to reduce the local pressure on these natural resources, a low-cost technology was developed to make it available to the public for cultivation. As a result, 104 taxa were found edible such as Amanita hemibapha var. ochracea, A. chepangiana, A. banningiana, A. vaginata, Agrocybe parasitica, Author: Professor & Dean Faculty of Life Sciences Punjabi University, Patiala. Punjab, India [email protected] Agaricus bisporus, A. andrewii, A. campestris var. campestris, A. silvicola, A. subrutilescens, A. bernardii, A. abruptibulbus, A. fuscovelatus, A. brunnescens, A. augustus, A. silvaticus, A. arvensis, Volvariella bakeri, V. terastia, V. bombycina, V. diplasia, Psathyrella candolleana, Volvopluteus gloiocephalus, Russula cyanoxantha, R. atropurpurea, R. aurea, Clitocybe gibba,Lentinus transitus, L. kashmirinus, L. crinitus, L. ligrinus, Lactarius rubrilacteus, Pleurotus sapidus, Pluteus subcervinus, Macrocybe gigantea, etc. Cultures of various taxa viz. Pleurotus sajor-caju, Macrocybe gigantea, Pluteus petasatus and Lentinus tigrinus were raised and a proper protocol for the domestication of Pleurotus sajor-caju, Macrocybe gigantea, and Lentinus tigrinus has been developed using the locally available agro-wastes.

Keywords: Agaric, culture, domestication, edible

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117 A Rapid and Greener Analysis Approach Based on Carbonfiber Column System and MS Detection for Urine Metabolomic Study After Oral Administration of Food Supplements 

Authors: Zakia Fatima, Liu Lu, Donghao Li

Abstract:

The analysis of biological fluid metabolites holds significant importance in various areas, such as medical research, food science, and public health. Investigating the levels and distribution of nutrients and their metabolites in biological samples allows researchers and healthcare professionals to determine nutritional status, find hypovitaminosis or hypervitaminosis, and monitor the effectiveness of interventions such as dietary supplementation. Moreover, analysis of nutrient metabolites provides insight into their metabolism, bioavailability, and physiological processes, aiding in the clarification of their health roles. Hence, the exploration of a distinct, efficient, eco-friendly, and simpler methodology is of great importance to evaluate the metabolic content of complex biological samples. In this work, a green and rapid analytical method based on an automated online two-dimensional microscale carbon fiber/activated carbon fiber fractionation system and time-of-flight mass spectrometry (2DμCFs-TOF-MS) was used to evaluate metabolites of urine samples after oral administration of food supplements. The automated 2DμCFs instrument consisted of a microcolumn system with bare carbon fibers and modified carbon fiber coatings. Carbon fibers and modified carbon fibers exhibit different surface characteristics and retain different compounds accordingly. Three kinds of mobile-phase solvents were used to elute the compounds of varied chemical heterogeneities. The 2DμCFs separation system has the ability to effectively separate different compounds based on their polarity and solubility characteristics. No complicated sample preparation method was used prior to analysis, which makes the strategy more eco-friendly, practical, and faster than traditional analysis methods. For optimum analysis results, mobile phase composition, flow rate, and sample diluent were optimized. Water-soluble vitamins, fat-soluble vitamins, and amino acids, as well as 22 vitamin metabolites and 11 vitamin metabolic pathway-related metabolites, were found in urine samples. All water-soluble vitamins except vitamin B12 and vitamin B9 were detected in urine samples. However, no fat-soluble vitamin was detected, and only one metabolite of Vitamin A was found. The comparison with a blank urine sample showed a considerable difference in metabolite content. For example, vitamin metabolites and three related metabolites were not detected in blank urine. The complete single-run screening was carried out in 5.5 minutes with the minimum consumption of toxic organic solvent (0.5 ml). The analytical method was evaluated in terms of greenness, with an analytical greenness (AGREE) score of 0.72. The method’s practicality has been investigated using the Blue Applicability Grade Index (BAGI) tool, obtaining a score of 77. The findings in this work illustrated that the 2DµCFs-TOF-MS approach could emerge as a fast, sustainable, practical, high-throughput, and promising analytical tool for screening and accurate detection of various metabolites, pharmaceuticals, and ingredients in dietary supplements as well as biological fluids.

Keywords: metabolite analysis, sustainability, carbon fibers, urine.

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116 Predicting Open Chromatin Regions in Cell-Free DNA Whole Genome Sequencing Data by Correlation Clustering  

Authors: Fahimeh Palizban, Farshad Noravesh, Amir Hossein Saeidian, Mahya Mehrmohamadi

Abstract:

In the recent decade, the emergence of liquid biopsy has significantly improved cancer monitoring and detection. Dying cells, including those originating from tumors, shed their DNA into the blood and contribute to a pool of circulating fragments called cell-free DNA. Accordingly, identifying the tissue origin of these DNA fragments from the plasma can result in more accurate and fast disease diagnosis and precise treatment protocols. Open chromatin regions are important epigenetic features of DNA that reflect cell types of origin. Profiling these features by DNase-seq, ATAC-seq, and histone ChIP-seq provides insights into tissue-specific and disease-specific regulatory mechanisms. There have been several studies in the area of cancer liquid biopsy that integrate distinct genomic and epigenomic features for early cancer detection along with tissue of origin detection. However, multimodal analysis requires several types of experiments to cover the genomic and epigenomic aspects of a single sample, which will lead to a huge amount of cost and time. To overcome these limitations, the idea of predicting OCRs from WGS is of particular importance. In this regard, we proposed a computational approach to target the prediction of open chromatin regions as an important epigenetic feature from cell-free DNA whole genome sequence data. To fulfill this objective, local sequencing depth will be fed to our proposed algorithm and the prediction of the most probable open chromatin regions from whole genome sequencing data can be carried out. Our method integrates the signal processing method with sequencing depth data and includes count normalization, Discrete Fourie Transform conversion, graph construction, graph cut optimization by linear programming, and clustering. To validate the proposed method, we compared the output of the clustering (open chromatin region+, open chromatin region-) with previously validated open chromatin regions related to human blood samples of the ATAC-DB database. The percentage of overlap between predicted open chromatin regions and the experimentally validated regions obtained by ATAC-seq in ATAC-DB is greater than 67%, which indicates meaningful prediction. As it is evident, OCRs are mostly located in the transcription start sites (TSS) of the genes. In this regard, we compared the concordance between the predicted OCRs and the human genes TSS regions obtained from refTSS and it showed proper accordance around 52.04% and ~78% with all and the housekeeping genes, respectively. Accurately detecting open chromatin regions from plasma cell-free DNA-seq data is a very challenging computational problem due to the existence of several confounding factors, such as technical and biological variations. Although this approach is in its infancy, there has already been an attempt to apply it, which leads to a tool named OCRDetector with some restrictions like the need for highly depth cfDNA WGS data, prior information about OCRs distribution, and considering multiple features. However, we implemented a graph signal clustering based on a single depth feature in an unsupervised learning manner that resulted in faster performance and decent accuracy. Overall, we tried to investigate the epigenomic pattern of a cell-free DNA sample from a new computational perspective that can be used along with other tools to investigate genetic and epigenetic aspects of a single whole genome sequencing data for efficient liquid biopsy-related analysis.

Keywords: open chromatin regions, cancer, cell-free DNA, epigenomics, graph signal processing, correlation clustering

Procedia PDF Downloads 133