Search results for: nursing protocol

Authors: Mustafa Metin Donma, Orkide Donma

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Obesity is a disease with an ever-increasing prevalence throughout the world. The metabolic network associated with obesity is very complicated. In metabolic syndrome (MetS), it becomes even more difficult to understand. Within this context, hormones, cytokines, and many others participate in this complex matrix. The collaboration among all of these parameters is a matter of great wonder. Cortisol, as a stress hormone, is closely associated with obesity. Thyroid hormones are involved in the regulation of energy as well as glucose metabolism with all of its associates. Fetuin A is known for years; however, the involvement of this parameter in obesity discussions is rather new. Recently, it has been defined as one of the new generation markers of obesity. In this study, the aim was to introduce complex interactions among all to be able to make clear comparisons, at least for a part of this complicated matter. Morbid obese (MO) children participated in the study. Two groups with 46 MO children and 43 with MetS were constituted. All children included in the study were above 99th age- and sex-adjusted body mass index (BMI) percentiles according to World Health Organization criteria. Forty-three morbid obese children in the second group had also MetS components. Informed consent forms were filled by the parents of the participants. The institutional ethics committee has given approval for the study protocol. Data as well as the findings of the study were evaluated from a statistical point of view. Two groups were matched for their age and gender compositions. Significantly higher body mass index (BMI), waist circumference, thyrotropin, and insulin values were observed in the MetS group. Triiodothyronine concentrations did not differ between the groups. Elevated levels for thyroxin, cortisol, and fetuin-A were detected in the MetS group compared to the first group (p > 0.05). In MO MetS- group, cortisol was correlated with thyroxin and fetuin-A (p < 0.05). In the MO MetS+ group, none of these correlations were present. Instead, a correlation between cortisol and thyrotropin was found (p < 0.05). In conclusion, findings have shown that cortisol was the key player in severely obese children. The association of this hormone with the participants of thyroid hormone metabolism was quite important. The lack of association with fetuin A in the morbid obese MetS+ group has suggested the possible interference of MetS components in the behavior of this new generation obesity marker. The most remarkable finding of the study was the unique correlation between cortisol and thyrotropin in the morbid obese MetS+ group, suggesting that thyrotropin may serve as a target along with cortisol in the morbid obese MetS+ group. This association may deserve specific attention during the development of remedies against MetS in the pediatric population.

Keywords: children, cortisol, fetuin A, morbid obesity, thyrotropin

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Authors: Syed Asif Hassan, Tabrej Khan

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Multiple sclerosis (MS) is a chronic demyelinating autoimmune disorder, of the central nervous system (CNS). In the present scenario, the current therapies either do not halt the progression of the disease or have side effects which limit the usage of current Disease Modifying Therapies (DMTs) for a longer period of time. Therefore, keeping the current treatment failure schema, we are focusing on screening novel analogues of the available DMTs that specifically bind and inhibit the Sphingosine1-phosphate receptor1 (S1PR1) thereby hindering the lymphocyte propagation toward CNS. The novel drug-like analogs molecule will decrease the frequency of relapses (recurrence of the symptoms associated with MS) with higher efficacy and lower toxicity to human system. In this study, an integrated approach involving ligand-based virtual screening protocol (Ultrafast Shape Recognition with CREDO Atom Types (USRCAT)) to identify the non-toxic drug like analogs of the approved DMTs were employed. The potency of the drug-like analog molecules to cross the Blood Brain Barrier (BBB) was estimated. Besides, molecular docking and simulation using Auto Dock Vina 1.1.2 and GOLD 3.01 were performed using the X-ray crystal structure of Mtb LprG protein to calculate the affinity and specificity of the analogs with the given LprG protein. The docking results were further confirmed by DSX (DrugScore eXtented), a robust program to evaluate the binding energy of ligands bound to the ligand binding domain of the Mtb LprG lipoprotein. The ligand, which has a higher hypothetical affinity, also has greater negative value. Further, the non-specific ligands were screened out using the structural filter proposed by Baell and Holloway. Based on the USRCAT, Lipinski’s values, toxicity and BBB analysis, the drug-like analogs of fingolimod and BG-12 showed that RTL and CHEMBL1771640, respectively are non-toxic and permeable to BBB. The successful docking and DSX analysis showed that RTL and CHEMBL1771640 could bind to the binding pocket of S1PR1 receptor protein of human with greater affinity than as compared to their parent compound (Fingolimod). In this study, we also found that all the drug-like analogs of the standard MS drugs passed the Bell and Holloway filter.

Keywords: antagonist, binding affinity, chemotherapeutics, drug-like, multiple sclerosis, S1PR1 receptor protein

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Authors: Patrick Nurse, Professor Neil Sebire, Polly Livermore

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The use of digital systems in healthcare is now highly prevalent. With further advancement of technology, these systems will become increasingly utilised within the healthcare sector. Therefore understanding how clinicians (for example, doctors, nurses) interact with technology and digital systems is critical to making care safer. Seven members from the Parent/Carers’ Research Advisory Group and the Young-Persons’ Research Group at a healthcare Trust in London and three staff members contributed to an engagement workshop to assess the impact of digital systems on the practice of nurses. The group also advised on the viability of a research study to investigate this further. A wide range of issues within digital system implementation in healthcare were raised, such as ‘workarounds’, system’s training, and upkeep and regulation of usage, which all emerged as early themes during the discussion. Further discussion focused on the subject of escalation of issues, ‘workarounds’, and problem solving. While challenging to implement, digital systems are hugely beneficial to healthcare providers. The workshop indicated that there is scope for investigation of the prevalence, nature, and escalation of ‘workarounds’, this was of key interest to the advisory group. An interesting concern of the group was their worry from a patient and parental perspective regarding how nurses might feel when needing to complete a ‘workaround’ during a busy shift. This is especially relevant if the reasons to complete the ‘workaround’ were outside the nurse’s control, driven by clinical need and urgency of care. This showed the level of insight that those using healthcare services have into the reality of workflows of those providing care. Additionally, it reflects the desire for patients and families to understand more about the administration and methodology of their care. Future study should be dedicated to understanding why nurses deploy ‘workarounds’, as well as their perspective and experience of them and subsequent escalation through leadership hierarchies

Keywords: patient engagement/involvement, workarounds, medication-administration, digital systems

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Authors: Bing Xu, Kerry Lee, Jason M. Stephen

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Collaborative learning (CL) has been regarded as a way to facilitate students to gain knowledge and improve social skills. In China, lecturers in higher education institutions have commonly adopted CL in their daily practice. However, such a strategy could not be effective when it is designed and applied in an inappropriate way. Previous research hardly focused on how CL was applied in Chinese universities. This present study aims to gain a deep understanding of how Chinese lecturers design and implement CL tasks. The researchers interviewed ten lecturers from different faculties in various universities in China and usedGroup Learning Activity Instructional Design (GLAID) framework to analyse the data. We found that not all lecturers pay enough attention to eight essential components (proposed by GLAID) when they designed CL tasks, especially the components of Structure and Guidance. Meanwhile, only a small part of lecturers made formative assessment to help students improve learning. We also discuss the strengths and limitations and CL design and further provide suggestions to the lecturers who intend to use CL in class. Research Objectives: The aims of the present research are threefold. We intend to 1) gain a deep understanding of how Chinese lecturers design and implement collaborative learning (CL) tasks, 2) find strengths and limitations of CL design in higher education, and 3) give suggestions about how to improve the design and implement. Research Methods: This research adopted qualitative methods. We applied the semi-structured interview method to interview ten Chinese lecturers about how they designed and implemented CL tasks in their courses. There were 9 questions in the interview protocol focusing on eight components of GLAID. Then, underpinning the GLAID framework, we utilized the coding reliability thematic analysis method to analyse the research data. The coding work was done by two PhD students whose research fields are CL, and the Cohen’s Kappa was 0.772 showing the inter-coder reliability was good. Contribution: Though CL has been commonly adopted in China, few studies have paid attention to the details about how lecturers designed and implemented CL tasks in practice. This research addressed such a gap and found not lecturers were aware of how to design CL and felt it difficult to structure the task and guide the students on collaboration, and further ensure student engagement in CL. In summary, this research advocates for teacher training; otherwise, students may not gain the expected learning outcomes.

Keywords: collaborative learning, higher education, task design, GLAID framework

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Authors: Aneta Nitsch-Osuch, Sylwia Dyk, Izabela Gołebiak

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Background. Since 2014 the pertussis vaccine is recommended to Polish health care workers who have close contacts with infants. Although this recommendation is implemented into the National Immunization Programme, its realization has remained unknown. The Purpose: The aim of the study, conducted at the department of Social Medicine and Public Health (Medical University of Warsaw, Poland), was to describe a perception, knowledge and coverage rates regarding pertussis vaccination among nursing staff. According to the authors' knowledge, it was the first study related to this topic in our country. Material and Methods: A total number of 543 nurses who work at pediatric or neonatal wards was included into the study (501 women and 42 men), average age was 47 years. All nurses were asked to fulfill the anonymous survey, previously validated. Results: 1. Coverage rates: The analysis of results revealed that only 4% of responders reported they were vaccinated with Tdpa within past 10 years, while 8% declared they would plan the vaccine in the future. 35% of responders would consider the Tdpa vaccine whether there is some kind of the reimbursement. 2. Perception and knowledge of the disease and vaccination: The majority (82%) of nurses did not recognize pertussis as a re-emerging infectious disease. 54% of them believed that obligatory vaccinations in the childhood protect against the disease and the protection is a life-long one. Only 15% of nurses considered pertussis as a possible nosocomial infection. The current epidemiology of the disease was known to 6% of responders, while 24% of them were familiar with pertussis vaccination schedules for infants, children and adolescents, but only 9% of responders knew that adults older than 19 years are recommended to be vaccinated with Tdpa every 10 years. Many nurses (82%) would expect more educational activities related to pertussis and methods of its prophylaxis. Conclusions: The pertussis vaccine coverage rate among Polish nurses is extremely low. This is a result of not enough knowledge about the disease and its prevention. Educational activities addressed to health care workers and reimbursement of the pertussis vaccine are required to improve awareness and increase of vaccine coverage rates in the future.

Keywords: coverage, nurse, pertussis, vaccine

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Authors: Samane Eftekhari Ranjbar

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Diabetes mellitus, a metabolic disorder characterized by elevated blood glucose levels, ranks among the leading causes of adult mortality. This study investigates the impact of an eight-week high-intensity interval training (HIIT) program combined with sodium nitrite supplementation on TNF- α, MURF1, and PI3K in a type 2 diabetes rodent model. Elevated TNF-α levels have been associated with insulin resistance, while MURF1 and PI3K play roles in muscle atrophy and insulin signaling pathways, respectively. In this experimental study, 15 eight-week-old rats from the Sara Laboratory Center in Tabriz were assigned to one of five groups: healthy control, diabetic control, diabetic with sodium nitrite supplementation, diabetic with eight weeks of intermittent exercise, and diabetic with eight weeks of interval training plus sodium nitrite supplementation. The HIIT protocol was designed to span eight weeks, with five weekly sessions at specified intensities and durations. Sodium nitrite, known for its vasodilatory and cytoprotective properties, was administered via injection. The findings revealed that the HIIT program and sodium nitrite supplementation influenced the examined biomarkers. ANOVA test outcomes indicated statistically significant differences in TNF- α (P=0.001), MURF1 (P=0.001), and PI3K (P=0.001) concentrations among the various groups. The healthy control group exhibited substantially decreased TNF- α, and MURF1 levels, as well as elevated PI3K levels compared to the diabetic control group. The exercise group, in conjunction with sodium nitrite supplementation, demonstrated a significant rise in PI3K levels (P=0.001) and a decline in TNF- α levels (P=0.018) relative to the diabetic control group. These results suggest that the combined intervention may help improve insulin sensitivity and reduce inflammation. However, MURF1 levels, which are related to muscle atrophy, showed no significant difference (P=0.24). In conclusion, in type 2 diabetic rats, an eight-week high-intensity interval training program with sodium nitrite supplementation does not affect MURF1 levels but does influence PI3K and TNF- α levels. This combination may hold potential for improving insulin sensitivity and reducing inflammation in type 2 diabetes patients, warranting further investigation and potential translation to human clinical trials.

Keywords: high-intensity interval training, sodium nitrate supplementation, type 2 diabetes, tumor necrosis factor-alpha, phosphatidylinositol-3-kinase, muscle RING-finger protein-1

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Authors: Agnieszka Krzemińska, Katarzyna Świderek, Vicente Molinier, Piotr Paneth

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In order to understand in details the interactions between ligands and the enzyme isotope effects were studied between clinically used drugs that bind in the active site of Human Immunodeficiency Virus Reverse Transcriptase, HIV-1 RT, as well as triazole-based inhibitor that binds in the allosteric pocket of this enzyme. The magnitudes and origins of the resulting binding isotope effects were analyzed. Subsequently, binding isotope effect of the same triazole-based inhibitor bound in the active site were analyzed and compared. Together, these results show differences in binding origins in two sites of the enzyme and allow to analyze binding mode and place of newly synthesized inhibitors. Typical protocol is described below on the example of triazole ligand in the allosteric pocket. Triazole was docked into allosteric cavity of HIV-1 RT with Glide using extra-precision mode as implemented in Schroedinger software. The structure of HIV-1 RT was obtained from Protein Data Bank as structure of PDB ID 2RKI. The pKa for titratable amino acids was calculated using PROPKA software, and in order to neutralize the system 15 Cl- were added using tLEaP package implemented in AMBERTools ver.1.5. Also N-terminals and C-terminals were build using tLEaP. The system was placed in 144x160x144Å3 orthorhombic box of water molecules using NAMD program. Missing parameters for triazole were obtained at the AM1 level using Antechamber software implemented in AMBERTools. The energy minimizations were carried out by means of a conjugate gradient algorithm using NAMD. Then system was heated from 0 to 300 K with temperature increment 0.001 K. Subsequently 2 ns Langevin−Verlet (NVT) MM MD simulation with AMBER force field implemented in NAMD was carried out. Periodic Boundary Conditions and cut-offs for the nonbonding interactions, range radius from 14.5 to 16 Å, are used. After 2 ns relaxation 200 ps of QM/MM MD at 300 K were simulated. The triazole was treated quantum mechanically at the AM1 level, protein was described using AMBER and water molecules were described using TIP3P, as implemented in fDynamo library. Molecules 20 Å apart from the triazole were kept frozen, with cut-offs established on range radius from 14.5 to 16 Å. In order to describe interactions between triazole and RT free energy of binding using Free Energy Perturbation method was done. The change in frequencies from ligand in solution to ligand bounded in enzyme was used to calculate binding isotope effects.

Keywords: binding isotope effects, molecular dynamics, HIV, reverse transcriptase

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Authors: Mohsin Shahab, Shagufta Rehmat, Faisal F. Khan

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Background: The global COVID-19 pandemic has generated health problems worldwide. Health care workers are the front-line warriors against the pandemic. The aim of this study was to find out the prevalence of COVID-19 (7th May 2021 to 3rd August 2021) amongst Health Care Workers (HCWs) and to assess the complications associated with it and its effects on their quality of life. Material and Method: The study was conducted in healthcare facilities which serve as pandemic hospitals in district Swat. A total of 140 healthcare workers, who were employed in the COVID-19 health care facilities, including the department of Pulmonology, Intensive Care Unit (ICU), and COVID-19 wards. Participants were tested for COVIID-19 using RT PCR test. A Case Report Form (CRF) for conditions during and post COVID-19 was filled to assess the complications and quality of life of health care workers. Results: A total of 140 Health Care Workers were studied, out of which 40% were doctors, 22% nursing staff, 17% paramedic staff, 9% cleaning staff, lab technologist 6%, 2% operation theater staff, administration staff, and pharmacist. The respondents were also investigated for pre-existing illness prior to SARS-CoV-2 infection, hypertension was the most prevalent, followed by chronic heart diseases and neurological disorders. Fever was the most common symptom, recorded 76.42% in the participants, while 55.71% of participants had dry cough, 55% had a sore throat, following by chest pain 43.56%. Reinfection rate was 10%, with chest pain being recorded in 85.71%. Post disease complication analysis showed that 47.14% of the participants were diagnosed with a new diagnosis after the COVID-19 recovery. Pulmonological diseases were recorded the most as a new diagnosis in, followed by gastrointestinal and psychological problems. Conclusions: The results of the study illustrates how COVID-19 has affected the overall health and quality of life of HCWs in District Swat of Khyber Pakhtunkhwa, Pakistan.

Keywords: SARS-CoV-2, COVID-19, HCW's, symptoms, questionnaire, post COVID-19

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Authors: Sharat Chandra, Zilong Wang, Ru-Rong Ji, Andrey Bortsov

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Chronic pain (CP) therapeutic approaches have limited efficacy. As a result, doctors are prescribing opioids for chronic pain, leading to opioid overuse, abuse, and addiction epidemic. Therefore, the development of effective and safe CP drugs remains an unmet medical need. Voltage-gated sodium (Nav) channels act as cardiovascular and neurological disorder’s molecular targets. Nav channels selective inhibitors are hard to design because there are nine closely-related isoforms (Nav1.1-1.9) that share the protein sequence segments. We are targeting the Nav1.7 found in the peripheral nervous system and engaged in the perception of pain. The objective of this project was to screen a 1.5 million compound library for identification of inhibitors for Nav1.7 with analgesic effect. In this study, we designed a protocol for identification of isoform-selective inhibitors of Nav1.7, by utilizing the prior information on isoform-selective antagonists. First, a similarity search was performed; then the identified hits were docked into a binding site on the fourth voltage-sensor domain (VSD4) of Nav1.7. We used the FTrees tool for similarity searching and library generation; the generated library was docked in the VSD4 domain binding site using FlexX and compounds were shortlisted using a FlexX score and SeeSAR hyde scoring. Finally, the top 25 compounds were tested with molecular dynamics simulation (MDS). We reduced our list to 9 compounds based on the MDS root mean square deviation plot and obtained them from a vendor for in vitro and in vivo validation. Whole-cell patch-clamp recordings in HEK-293 cells and dorsal root ganglion neurons were conducted. We used patch pipettes to record transient Na⁺ currents. One of the compounds reduced the peak sodium currents in Nav1.7-HEK-293 stable cell line in a dose-dependent manner, with IC50 values at 0.74 µM. In summary, our computer-aided analgesic discovery approach allowed us to develop pre-clinical analgesic candidate with significant reduction of time and cost.

Keywords: chronic pain, voltage-gated sodium channel, isoform-selective antagonist, similarity search, virtual screening, analgesics development

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Authors: Elissar Mansour, Emily Chen, Tracee Fernandez, Mariam Basheti, Christopher Gordon, Bandana Saini

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Sleep is an essential process for the maintenance of several neurobiological processes such as memory consolidation, mood, and metabolic processes. It is known that sleep patterns vary with age and is affected by multiple factors. While non-pharmacological strategies are generally considered first-line, sedatives are excessively used in the older population. This study aimed to explore the management of sleep in residential aged care facilities (RACFs) by nurse professionals and to identify the key factors that impact provision of optimal sleep health care. An inductive thematic qualitative research method was employed to analyse the data collected from semi-structured interviews with registered nurses working in RACF. Seventeen interviews were conducted, and the data yielded three themes: 1) the nurses’ observations and knowledge of sleep health, 2) the strategies employed in RACF for the management of sleep disturbances, 3) the organizational barriers to evidence-based sleep health management. Nurse participants reported the use of both non-pharmacological and pharmacological interventions. Sedatives were commonly prescribed due to their fast action and accessibility despite the guidelines indicating their use in later stages. Although benzodiazepines are known for their many side effects, such as drowsiness and oversedation, temazepam was the most commonly administered drug. Sleep in RACF was affected by several factors such as aging and comorbidities (e.g., dementia, pain, anxiety). However, the were also many modifiable factors that negatively impacted sleep management in RACF. These include staffing ratios, nursing duties, medication side effects, and lack of training and involvement of allied health professionals. This study highlighted the importance of involving a multidisciplinary team and the urge to develop guidelines and training programs for healthcare professionals to improve sleep health management in RACF.

Keywords: registered nurses, residential aged care facilities, sedative use, sleep

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Authors: Asfa Hussain, Chee Tang, Mien Nguyen

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Introduction: The safe usage of medications is dependent on clear, well-documented prescribing. Medical drug charts should be regularly checked to ensure that they are fit for purpose. Aims: The purpose of this study was to evaluate whether the Isabel Hospice drug charts were effective or prone to medical errors. The aim was to create a comprehensive palliative care drug chart in line with medico-legal guidelines and to minimise drug administration and prescription errors. Methodology: 50 medical drug charts were audited from March to April 2020, to assess whether they complied with medico-legal guidelines, in a hospice within East of England. Meetings were held with the larger multi-disciplinary team (MDT), including the pharmacists, nursing staff and doctors, to raise awareness of the issue. A preliminary drug chart was created, using the input from the wider MDT. The chart was revised and trialled over 15 times, and each time feedback from the MDT was incorporated into the subsequent template. In the midst of the COVID-19 pandemic in September 2020, the finalised drug chart was trialled. 50 new palliative drug charts were re-audited, to evaluate the changes made. Results: Prescribing and administration errors were high prior to the implementation of the new chart. This improved significantly after introducing the new drug charts, therefore improving patient safety and care. The percentage of inadequately documented allergies went down from 66% to 20% and incorrect oxygen prescription from 40% to 16%. The prescription drug-drug interactions decreased by 30%. Conclusion: It is vital to have clear standardised drug charts, in line with medico-legal standards, to allow ease of prescription and administration of medications and ensure optimum patient-centred care. This closed loop audit demonstrated significant improvement in documentation and prevention of possible fatal drug errors and interactions.

Keywords: palliative care, drug chart, medication errors, drug-drug interactions, COVID-19, patient safety

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Authors: Ortega Ivan, De La Plaza Edurne

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Background: Spain and other European countries have implemented Uncontrolled Donation after Cardiac Death (uDCD) programs. After 15 years of experience in Spain, many things have changed. Recent evidence and technical breakthroughs achieved in resuscitation are relevant for uDCD programs and raise some ethical concerns related to these protocols. Aim: To rethink current uDCD programs in the light of recent evidence on available therapeutic procedures applicable to victims of out-of-hospital cardiac arrest (OHCA). To address the following question: What is the current standard of treatment owed to victims of OHCA before including them in an uDCD protocol? Materials and Methods: Review of the scientific and ethical literature related to both uDCD programs and innovative resuscitation techniques. Results: 1) The standard of treatment received and the chances of survival of victims of OHCA depend on whether they are classified as Non-Heart Beating Patients (NHBP) or Non-Heart-Beating-Donors (NHBD). 2) Recent studies suggest that NHBPs are likely to survive, with good quality of life, if one or more of the following interventions are performed while ongoing CPR -guided by suspected or known cause of OHCA- is maintained: a) direct access to a Cath Lab-H24 or/and to extra-corporeal life support (ECLS); b) transfer in induced hypothermia from the Emergency Medical Service (EMS) to the ICU; c) thrombolysis treatment; d) mobile extra-corporeal membrane oxygenation (mini ECMO) instituted as a bridge to ICU ECLS devices. 3) Victims of OHCA who cannot benefit from any of these therapies should be considered as NHBDs. Conclusion: Current uDCD protocols do not take into account recent improvements in resuscitation and need to be adapted. Operational criteria to distinguish NHBDs from NHBP should seek a balance between the technical imperative (to do whatever is possible), considerations about expected survival with quality of life, and distributive justice (costs/benefits). Uncontrolled DCD protocols can be performed in a way that does not hamper the legitimate interests of patients, potential organ donors, their families, the organ recipients, and the health professionals involved in these processes. Families of NHBDs’ should receive information which conforms to the ethical principles of respect of autonomy and transparency.

Keywords: uncontrolled donation after cardiac death resuscitation, refractory cardiac arrest, out of hospital cardiac, arrest ethics

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Authors: Saifalarab A. Mohmmed, Morgana E. Vianna, Jonathan C. Knowles

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The issue of apical periodontitis has received considerable critical attention. Bacteria is integrated into communities, attached to surfaces and consequently form biofilm. The biofilm structure provides bacteria with a series protection skills against, antimicrobial agents and enhances pathogenicity (e.g. apical periodontitis). Sodium hypochlorite (NaOCl) has become the irrigant of choice for elimination of bacteria from the root canal system based on its antimicrobial findings. The aim of the study was to investigate the effect of different agitation techniques on the efficacy of 2.5% NaOCl to eliminate the biofilm from the surface of the lateral canal using the residual biofilm, and removal rate of biofilm as outcome measures. The effect of canal complexity (lateral canal) on the efficacy of the irrigation procedure was also assessed. Forty root canal models (n = 10 per group) were manufactured using 3D printing and resin materials. Each model consisted of two halves of an 18 mm length root canal with apical size 30 and taper 0.06, and a lateral canal of 3 mm length, 0.3 mm diameter located at 3 mm from the apical terminus. E. faecalis biofilms were grown on the apical 3 mm and lateral canal of the models for 10 days in Brain Heart Infusion broth. Biofilms were stained using crystal violet for visualisation. The model halves were reassembled, attached to an apparatus and tested under a fluorescence microscope. Syringe and needle irrigation protocol was performed using 9 mL of 2.5% NaOCl irrigant for 60 seconds. The irrigant was either left stagnant in the canal or activated for 30 seconds using manual (gutta-percha), sonic and ultrasonic methods. Images were then captured every second using an external camera. The percentages of residual biofilm were measured using image analysis software. The data were analysed using generalised linear mixed models. The greatest removal was associated with the ultrasonic group (66.76%) followed by sonic (45.49%), manual (43.97%), and passive irrigation group (control) (38.67%) respectively. No marked reduction in the efficiency of NaOCl to remove biofilm was found between the simple and complex anatomy models (p = 0.098). The removal efficacy of NaOCl on the biofilm was limited to the 1 mm level of the lateral canal. The agitation of NaOCl results in better penetration of the irrigant into the lateral canals. Ultrasonic agitation of NaOCl improved the removal of bacterial biofilm.

Keywords: 3D printing, biofilm, root canal irrigation, sodium hypochlorite

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Authors: S. Rodosik, J. P. Poirot-Crouvezier, Y. Bultel

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With the expansion of the hydrogen economy, Proton Exchange Membrane Fuel Cell (PEMFC) systems are often presented as promising energy converters suitable for transport applications. However, reaching a durability of 5000 h recommended by the U.S. Department of Energy and decreasing system cost are still major hurdles to their development. In order to increase the system efficiency and simplify the system without affecting the fuel cell lifetime, an architecture called alternative fuel feeding has been developed. It consists in a fuel cell stack divided into two parts, alternatively fed, implemented on a 5-kW system for real scale testing. The operation strategy can be considered close to Dead End Anode (DEA) with specific modifications to avoid water and nitrogen accumulation in the cells. The two half-stacks are connected in series to enable each stack to be alternatively fed. Water and nitrogen accumulated can be shifted from one half-stack to the other one according to the alternative feeding frequency. Thanks to the homogenization of water vapor along the stack, water management was improved. The operating conditions obtained at system scale are close to recirculation without the need of a pump or an ejector. In a first part, a performance comparison with the DEA strategy has been performed. At high temperature and low pressure (80°C, 1.2 bar), performance of alternative fuel feeding was higher, and the system efficiency increased. In a second part, in order to highlight the benefits of the architecture on the fuel cell lifetime, two durability tests, lasting up to 1000h, have been conducted. A test on the 5-kW system has been compared to a reference test performed on a test bench with a shorter stack, conducted with well-controlled operating parameters and flow-through hydrogen strategy. The durability test is based upon the Fuel Cell Dynamic Load Cycle (FC-DLC) protocol but adapted to the system limitations: without OCV steps and a maximum current density of 0.4 A/cm². In situ local measurements with a segmented S++® plate performed all along the tests, showed a more homogeneous distribution of the current density with alternative fuel feeding than in flow-through strategy. Tests performed in this work enabled the understanding of this architecture advantages and drawbacks. Alternative fuel feeding architecture appeared to be a promising solution to ensure the humidification function at the anode side with a simplified fuel cell system.

Keywords: automotive conditions, durability, fuel cell system, proton exchange membrane fuel cell, stack architecture

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Authors: Elif Tugce Aksun Tumerkan, Chris Lowe, Hannah Krupa

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Fluorescent proteins are self-sufficient in forming chromophores with a visible wavelength from 3 amino acids sequence within their own polypeptide structure. This chromophore – a molecule that absorbs a photon of light and exhibits an energy transition equal to the energy of the absorbed photon. Fluorescent proteins (FPs) consisted of a chain of 238 amino acid residues and composed of 11 beta strands shaped in a cylinder surrounding an alpha helix structure. A better understanding of the system of the chromospheres and the increasing advance in protein engineering in recent years, the properties of FPs offers the potential for new applications. They have used sensors and probes in molecular biology and cell-based research that giving a chance to observe these FPs tagged cell localization, structural variation and movement. For clarifying functional uses of fluorescent proteins, electrophoretic properties of these proteins are one of the most important parameters. Sodium dodecyl sulphate polyacrylamide gel electrophoresis (SDS-PAGE) analysis is used for determining electrophoretic properties commonly. While there are many techniques are used for determining the functionality of protein-based research, SDS-PAGE analysis can only provide a molecular level assessment of the proteolytic fragments. Before SDS-PAGE analysis, fluorescent proteins need to successfully purified. Due to directly purification of the target, FPs is difficult from the animal, gene expression is commonly used which must be done by transformation with the plasmid. Furthermore, used gel within electrophoresis and staining agents properties have a key role. In this review, the different factors that have the impact on the electrophoretic properties of fluorescent proteins explored. Fluorescent protein separation and purification are the essential steps before electrophoresis that should be done very carefully. For protein purification, gene expression process and following steps have a significant function. For successful gene expression, the properties of selected bacteria for expression, used plasmid are essential. Each bacteria has own characteristics which are very sensitive to gene expression, also used procedure is the important factor for fluorescent protein expression. Another important factors are gel formula and used staining agents. Gel formula has an effect on the specific proteins mobilization and staining with correct agents is a key step for visualization of electrophoretic bands of protein. Visuality of proteins can be changed depending on staining reagents. Apparently, this review has emphasized that gene expression and purification have a stronger effect than electrophoresis protocol and staining agents.

Keywords: cell biology, gene expression, staining agents, SDS-page

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Authors: P. Efstathiou, E. Kouskouni, Z. Manolidou, K. Karageorgou, M. Tseroni, A. Efstathiou, V. Karyoti, I. Agrafa

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Aim: The aim of this prospective comparative study is to evaluate the reduction of microbial flora on the surface of an axillary digital thermometer, made of antimicrobial copper, in relation with a common digital thermometer. Material – Methods: A brand new digital electronic thermometer implemented with antimicrobial copper (Cu 70% - Nic 30%, low lead) on the two edges of the device (top and bottom: World Patent Number WO2013064847 and Register Number by the Hellenic Copper Development Institute No 11/2012) was manufactured and a comparative study with common digital electronic thermometer was conducted on 18 ICU (Intensive Care Unit) patients of three different hospitals. The thermometry was performed in accordance with the projected International Nursing Protocols for body temperature measurement. A total of 216 microbiological samples were taken from the axillary area of the patients, using both of the investigated body temperature devises. Simultaneously the “Halo” phenomenon (phenomenon “Stefanis”) was studied at the non-antimicrobial copper-implemented parts of the antimicrobial digital electronic thermometer. Results: In all samples collected from the surface of the antimicrobial electronic digital thermometer, the reduction of microbial flora (Klebsiella spp, Staphylococcus aureus, Staphylococcus epidermitis, Candida spp, Pneudomonas spp) was progressively reduced to 99% in two hours after the thermometry. The above flora was found in the axillary cavity remained the same in common thermometer. The statistical analysis (SPSS 21) showed a statistically significant reduction of the microbial load (N = 216, < 0.05). Conclusions: The hospital-acquired infections are linked to the transfer of pathogens due to the multi-usage of medical devices from both health professionals and patients, such as axillary thermometers. The use of antimicrobial digital electronic thermometer minimizes microbes' transportation between patients and health professionals while having all the conditions of reliability, proper functioning, security, ease of use and reduced cost.

Keywords: antimicrobial copper, cross infections, digital thermometers, ICU

Procedia PDF Downloads 377

Authors: Bunindro Nameirakpam, Sonia Sougrapakam, Shannon B. Olsson, Rajashekar Yallappa

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Natural sources for new pesticidal compounds hold promise in view of their eco-friendly nature, selectivity and mammalian safety. Despite a large number of plants that show insecticidal activity and diversity of natural chemistry with inherent eco-friendly nature, newer classes of insecticides have eluded discovery. Artemisia vulgaris, known as Mugwort, is a universal herb used for folk medicine and religious purposes throughout the ancient world. In India, the essential oils of Artemisia vulgaris are used for its insecticidal, anti parasiticidal and antimicrobial properties. Traditionally, the dried leaves of Artemisia vulgaris are used to repel insects as well as rats in and around the granaries in the North-East India. Artemisia vulgaris collected during November from different ecological sites were studied for the bio-pesticidal utility against the stored grain pests. The insecticidal activities were found in the crude extracts of n-hexane and methanol from the samples collected in Sikkim and Manipur respectively. Using silica gel column chromatography protocol, we have isolated one novel bioactive molecule from the aerial parts of Artemisia vulgaris L based on various physical-chemical and spectroscopic techniques (IR, 1H NMR, 13C NMR and mass). The novel bioactive molecule is highly toxic and very low concentration (4.35 µg/l) is needed to control the stored product insects. In additional experiment results clearly showed the involvement of sodium pumps inhibition in the insecticidal action of purified compound in the Sitophilus oryzae. The knockdown activity of the purified compound is concomitant with the in vivo inhibition of Na+/ K+- ATPase. Further, our study showed insignificant differences in the seed germination of control and the treated grains. The lack of adverse effect of the novel bioactive molecule on the seed germination is highly desirable for seed/grain protectant and showing the potential to be developed as possible natural fumigants for the control of stored grain pests. The novel bioactive molecule is selective insecticide with a high margin of safety to mammals and showed promise as novel biopesticide candidate for grain protection. It is believed that Bio-pesticides can serve as the most important pest management tools as far as global safety is concerned.

Keywords: Indian traditional plant, Artemisia vulgaris, bio-pesticides, Na+/ K+- ATPase, seed germination

Procedia PDF Downloads 168

Authors: Mustafa Metin Donma

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Circumference measurements are important because they are easily obtained values for the identification of the weight gain without determining body fat. They may give meaningful information about the varying stages of obesity. Besides, some formulas may be derived from a number of body circumference measurements to estimate body fat. Waist (WC), hip (HC) and neck (NC) circumferences are currently the most frequently used measurements. The aim of this study was to develop a formula derived from these three anthropometric measurements, each giving a valuable information independently, to question whether their combined power within a formula was capable of being helpful for the differential diagnosis of morbid obesity without metabolic syndrome (MetS) from MetS. One hundred and eighty seven children were recruited from the pediatrics outpatient clinic of Tekirdag Namik Kemal University Faculty of Medicine. The parents of the participants were informed about asked to fill and sign the consent forms. The study was carried out according to the Helsinki Declaration. The study protocol was approved by the institutional non-interventional ethics committee. The study population was divided into four groups as normal-body mass index (N-BMI), obese (OB), morbid obese (MO) and MetS, which were composed of 35, 44, 75 and 33 children, respectively. Age- and gender-adjusted BMI percentile values were used for the classification of groups. The children in MetS group were selected based upon the nature of the MetS components described as MetS criteria. Anthropometric measurements, laboratory analysis and statistical evaluation confined to study population were performed. Body mass index values were calculated. A circumference index, advanced Donma circumference index (ADCI) was introduced as WC*HC/NC. The statistical significance degree was chosen as p value smaller than 0.05. Body mass index values were 17.7±2.8, 24.5±3.3, 28.8±5.7, 31.4±8.0 kg/m2, for N-BMI, OB, MO, MetS groups, respectively. The corresponding values for ADCI were 165±35, 240±42, 270±55, and 298±62. Significant differences were obtained between BMI values of N-BMI and OB, MO, MetS groups (p=0.001). Obese group BMI values also differed from MO group BMI values (p=0.001). However, the increase in MetS group compared to MO group was not significant (p=0.091). For the new index, significant differences were obtained between N-BMI and OB, MO, MetS groups (p=0.001). Obese group ADCI values also differed from MO group ADCI values (p=0.015). A significant difference between MO and MetS groups was detected (p=0.043). The correlation coefficient value and the significance check of the correlation was found between BMI and ADCI as r=0.0883 and p=0.001 upon consideration of all participants. In conclusion, in spite of the strong correlation between BMI and ADCI values obtained when all groups were considered, ADCI, but not BMI, was the index, which was capable of differentiating cases with morbid obesity from cases with morbid obesity and MetS.

Keywords: anthropometry, body mass index, child, circumference, metabolic syndrome, obesity

Procedia PDF Downloads 42

Authors: D. F. Carvalho, A. O. Uscamayta, J. C. Guerrero, H. F. Oliveira, P. M. Azevedo-Marques

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The creation of vector contours slices (ROIs) on body silhouettes in oncologic patients is an important step during the radiotherapy planning in clinic and hospitals to ensure the accuracy of oncologic treatment. The radiotherapy planning of patients is performed by complex softwares focused on analysis of tumor regions, protection of organs at risk (OARs) and calculation of radiation doses for anomalies (tumors). These softwares are supplied for a few manufacturers and run over sophisticated workstations with vector processing presenting a cost of approximately twenty thousand dollars. The Brazilian project SIPRAD (Radiotherapy Planning System) presents a proposal adapted to the emerging countries reality that generally does not have the monetary conditions to acquire some radiotherapy planning workstations, resulting in waiting queues for new patients treatment. The SIPRAD project is composed by a set of integrated and interoperabilities softwares that are able to execute all stages of radiotherapy planning on simple personal computers (PCs) in replace to the workstations. The goal of this work is to present an image processing technique, computationally feasible, that is able to perform an automatic contour delineation in patient body silhouettes (SIPRAD-Body). The SIPRAD-Body technique is performed in tomography slices under grayscale images, extending their use with a greedy algorithm in three dimensions. SIPRAD-Body creates an irregular polyhedron with the Canny Edge adapted algorithm without the use of preprocessing filters, as contrast and brightness. In addition, comparing the technique SIPRAD-Body with existing current solutions is reached a contours similarity at least 78%. For this comparison is used four criteria: contour area, contour length, difference between the mass centers and Jaccard index technique. SIPRAD-Body was tested in a set of oncologic exams provided by the Clinical Hospital of the University of Sao Paulo (HCRP-USP). The exams were applied in patients with different conditions of ethnology, ages, tumor severities and body regions. Even in case of services that have already workstations, it is possible to have SIPRAD working together PCs because of the interoperability of communication between both systems through the DICOM protocol that provides an increase of workflow. Therefore, the conclusion is that SIPRAD-Body technique is feasible because of its degree of similarity in both new radiotherapy planning services and existing services.

Keywords: radiotherapy, image processing, DICOM RT, Treatment Planning System (TPS)

Procedia PDF Downloads 271

Authors: Melba Sheila D'Souza, Anandhi Amirtharaj, Shreedevi Balachandran

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Background: Type 2 diabetes has a significant impact on individuals’ health and well-being. Glycemic control may influence self-efficacy and self-care behaviors, and reduce the risk of complications among adults with type 2 diabetes. Type 2 diabetes has substantial morbidity and mortality and 60% of adults’ poor self-care. Glycemic control is associated with reported self-efficacy and self-care behavior. Adults with type 2 diabetes with less information were less likely to take diabetes self-care. Aim: To examine the relationship between glycemic control, demographic factors, clinical factors on self-efficacy, self-care behaviors among Omani adults with type 2 diabetes. Methods: A correlational, descriptive study was used. Omani adults with type 2 diabetes (n=140) were recruited from a public hospital in Oman. The data were collected during January-March 2015. Ethical approval was given by the college research and ethics committee, College of Nursing, and the Hospital, Sultan Qaboos University Data was collected on self-efficacy, self-care behaviors and glycemic control. The study was approved by the Institution Ethics and Research Committee. Bivariate and multivariate analyses were conducted. Results: Most adults had a fasting blood glucose >7.2mmol/L (90.7%), with the majority demonstrating ‘uncontrolled or poor HbA1c of > 8%’ (65%). Variance of self-care behavior (20.6%) and 31.3% of the variance of the self-efficacy was explained by the age, duration of diabetes, medication, HbA1c and prevention of activities of living. Adults with type 2 diabetes with poor glycemic control were more likely to have poor self-efficacy and poor self-care behaviors. Conclusion: This study confirms that self-efficacy model on outcome predicts self-efficacy and self-care behavior. Higher understanding of diabetes, prevention of normal daily activities, higher ability to fit diabetes life in a positive manner and high patient-physician communication were significant with self-efficacy and self-care behaviors. Hence, glycemic control has a high effect on improving self-care behaviors like diet, exercise, medication, foot care and self-efficacy among type 2 diabetes. Implications: Using these findings to improve self-efficacy, individualized self-care management is recommended for better self-efficacy and self-care behaviors among adults with type 2 diabetes.

Keywords: self-efficacy, self-care behaviors, self-care management, glycemic control, type 2 diabetes, nurse

Procedia PDF Downloads 382

Authors: Nahush Modak, Meena Pangarkar, Anand Pathak, Ankita Tamhane

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Background: Breast cancer is the prominent cause of cancer and mortality among women. This study was done to show the statistical analysis of a cohort of over 250 patients detected with breast cancer diagnosed by oncologists using Immunohistochemistry (IHC). IHC was performed by using ER; PR; HER2; Ki-67 antibodies. Materials and methods: Formalin fixed Paraffin embedded tissue samples were obtained by surgical manner and standard protocol was followed for fixation, grossing, tissue processing, embedding, cutting and IHC. The Ventana Benchmark XT machine was used for automated IHC of the samples. Antibodies used were supplied by F. Hoffmann-La Roche Ltd. Statistical analysis was performed by using SPSS for windows. Statistical tests performed were chi-squared test and Correlation tests with p<.01. The raw data was collected and provided by National Cancer Insitute, Jamtha, India. Result: Luminal B was the most prevailing molecular subtype of Breast cancer at our institute. Chi squared test of homogeneity was performed to find equality in distribution and Luminal B was the most prevalent molecular subtype. The worse prognostic indicator for breast cancer depends upon expression of Ki-67 and her2 protein in cancerous cells. Our study was done at p <.01 and significant dependence was observed. There exists no dependence of age on molecular subtype of breast cancer. Similarly, age is an independent variable while considering Ki-67 expression. Chi square test performed on Human epidermal growth factor receptor 2 (HER2) statuses of patients and strong dependence was observed in percentage of Ki-67 expression and Her2 (+/-) character which shows that, value of Ki depends upon Her2 expression in cancerous cells (p<.01). Surprisingly, dependence was observed in case of Ki-67 and Pr, at p <.01. This shows that Progesterone receptor proteins (PR) are over-expressed when there is an elevation in expression of Ki-67 protein. Conclusion: We conclude from that Luminal B is the most prevalent molecular subtype at National Cancer Institute, Jamtha, India. There was found no significant correlation between age and Ki-67 expression in any molecular subtype. And no dependence or correlation exists between patients’ age and molecular subtype. We also found that, when the diagnosis is Luminal A, out of the cohort of 257 patients, no patient shows >14% Ki-67 value. Statistically, extremely significant values were observed for dependence of PR+Her2- and PR-Her2+ scores on Ki-67 expression. (p<.01). Her2 is an important prognostic factor in breast cancer. Chi squared test for Her2 and Ki-67 shows that the expression of Ki depends upon Her2 statuses. Moreover, Ki-67 cannot be used as a standalone prognostic factor for determining breast cancer.

Keywords: breast cancer molecular subtypes , correlation, immunohistochemistry, Ki-67 and HR, statistical analysis

Procedia PDF Downloads 103

Authors: Sahraoui Halima, Dahani Ameur, Tigrine Abedelkader

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DigiMesh technology represents a pioneering advancement in wireless networking, offering cost-effective and energy-efficient capabilities. Its inherent simplicity and adaptability facilitate the seamless transfer of data between network nodes, extending the range and ensuring robust connectivity through autonomous self-healing mechanisms. In light of these advantages, this study introduces a medical platform harnessed with DigiMesh wireless network technology characterized by low power consumption, immunity to interference, and user-friendly operation. The primary application of this platform is the real-time, long-distance monitoring of Electrocardiogram (ECG) signals, with the added capacity for simultaneous monitoring of ECG signals from multiple patients. The experimental setup comprises key components such as Raspberry Pi, E-Health Sensor Shield, and Xbee DigiMesh modules. The platform is composed of multiple ECG acquisition devices labeled as Sensor Node 1 and Sensor Node 2, with a Raspberry Pi serving as the central hub (Sink Node). Two communication approaches are proposed: Single-hop and multi-hop. In the Single-hop approach, ECG signals are directly transmitted from a sensor node to the sink node through the XBee3 DigiMesh RF Module, establishing peer-to-peer connections. This approach was tested in the first experiment to assess the feasibility of deploying wireless sensor networks (WSN). In the multi-hop approach, two sensor nodes communicate with the server (Sink Node) in a star configuration. This setup was tested in the second experiment. The primary objective of this research is to evaluate the performance of both Single-hop and multi-hop approaches in diverse scenarios, including open areas and obstructed environments. Experimental results indicate the DigiMesh network's effectiveness in Single-hop mode, with reliable communication over distances of approximately 300 meters in open areas. In the multi-hop configuration, the network demonstrated robust performance across approximately three floors, even in the presence of obstacles, without the need for additional router devices. This study offers valuable insights into the capabilities of DigiMesh wireless technology for real-time ECG monitoring in healthcare applications, demonstrating its potential for use in diverse medical scenarios.

Keywords: DigiMesh protocol, ECG signal, real-time monitoring, medical platform

Procedia PDF Downloads 51

Authors: Ramona-Niculina Jurcau, Ioana-Marieta Jurcau, Dong Hun Kwak, Nicolae-Alexandru Colceriu

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Background: Academic environment led, in time, to the birth of some research subjects concluded with many publications. One of these issues is related to the learning stress. Thus far, the PubMed website displays an impressive number of papers related to the academic stress. Aims: Through this study, we aimed to evaluate the research concerning academic learning stress (ALS), by a retrospective analysis of PubMed publications. Methods: We evaluated the ALS, considering: a) different keywords as - ‘academic stress’ (AS), ‘academic stressors’ (ASs), ‘academic learning stress’ (ALS), ‘academic student stress’ (ASS), ‘academic stress college’ (ASC), ‘medical academic stress’ (MAS), ‘non-medical academic stress’ (NMAS), ‘student stress’ (SS), ‘nursing student stress’ (NS), ‘college student stress’ (CSS), ‘university student stress’ (USS), ‘medical student stress’ (MSS), ‘dental student stress’ (DSS), ‘non-medical student stress’ (NMSS), ‘learning students stress’ (LSS), ‘medical learning student stress’ (MLSS), ‘non-medical learning student stress’ (NMLSS); b) the year average for decades; c) some selection filters provided by PubMed website: Article types - Journal Article (JA), Clinical Trial (CT), Review (R); Species - Humans (H); Sex - Male (M) and Female (F); Ages - 13-18, 19-24, 19-44. Statistical evaluation was made on the basis of the Student test. Results: There were differences between keywords, referring to all filters. Nevertheless, for all keywords were noted the following: the majority of studies have indicated that subjects were humans; there were no important differences between the number of subjects M and F; the age of participants was mentioned only in some studies, predominating those with teenagers and subjects between 19-24 years. Conclusions: 1) PubMed publications document that concern for the research field of academic stress, lasts for 56 years and was materialized in more than 5.010 papers. 2) Number of publications in the field of academic stress varies depending on the selected keywords: those with a general framing (AS, ASs, ALS, ASS, SS, USS, LSS) are more numerous than those with a specific framing (ASC, MAS, NMAS, NS, CSS, MSS, DSS, NMSS, MLSS, NMLSS); those concerning the academic medical environment (MAS, NS, MSS, DSS, MLSS) prevailed compared to the non-medical environment (NMAS, NMSS, NMLSS). 3) Most of the publications are included at JA, of which a small percentage are CT and R. 4) Most of the academic stress studies were conducted with subjects both M and F, most aged under 19 years and between 19-24 years.

Keywords: academic stress, student stress, academic learning stress, medical student stress

Procedia PDF Downloads 533

Authors: Waepa Wanhussen

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The Ministry of Public Health has established policies accelerating health promotion to prevent public health problems in five border provinces of Thailand. One of these policies employs the religion to guide the community development and solve health issues consistent with the lifestyle and culture of those people. This policy is an important strategy to solve the problems due to the unrest and conflicts in the southern border provinces. This participatory action research aimed to develop mosques as healthy religion places in Narathiwat Province. In the development, the participatory action, consisting of 5 stages, was conducted from October 2012 - May 2013. Stage I: Conducting a survey for problems and needs for developing healthy religion places by employing community participation. Stage II: Analyzing problems and situations at a workshop containing informal interviews and group conversations with 200 participants (health providers at district level, Imams (the Muslim leaders), and community leaders). Stage III: Planning for developing healthy religion places by health providers, Imams, community leaders. Stage IV: Implementing the plan according to the conditions of problems and needs of the community in order to develop healthy religion places. Stage V: Evaluating the implementation by using the instrument, a criteria of being healthy religion place, for collecting data. Data were analyzed by using percentage. It was found that out of 630 mosques 575 (90.12%) passed the criteria of being a healthy religion place. Among these mosques, 190 mosques (30.15%) were in good and very good level, in which, after the implementation, the number of being good and very good healthy mosques increased by 22.58%. The researcher suggested that the developing sustainably healthy religion places require the participation of residences in the community and agencies such as local government, the Islamic Council of Narathiwat Province, and Council of Culture of Narathiwat Province. The healthy religion places can be used to strengthen and sustain health promotion and disease prevention in the community as health learning centers.

Keywords: healthy religion places, development of community participation, nursing informatics, health

Procedia PDF Downloads 269

Authors: Silvia Gastaldello, Maria Grillo, Luca Tassoni, Claudio Maran, Stefano Balbo

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Antioxidants are nowadays attractive not only for the countless benefits to the human and animal health, but also for the perspective of use as food preservative instead of synthetic chemical molecules. In this study, the radical scavenging activity of six protein extracts from pulse and oleaginous seeds was evaluated. The selected matrices are Pisum sativum (yellow pea from two different origins), Carthamus tinctorius (safflower), Helianthus annuus (sunflower), Lupinus luteus cv Mister (lupin) and Glycine max (soybean), since they are economically interesting for both human and animal nutrition. The seeds were grinded and proteins extracted from 20mg powder with a specific vegetal-extraction kit. Proteins have been quantified through Bradford protocol and scavenging activity was revealed using DPPH assay, based on radical DPPH (2,2-diphenyl-1-picrylhydrazyl) absorbance decrease in the presence of antioxidants molecules. Different concentrations of the protein extract (1, 5, 10, 50, 100, 500 µg/ml) were mixed with DPPH solution (DPPH 0,004% in ethanol 70% v/v). Ascorbic acid was used as a scavenging activity standard reference, at the same six concentrations of protein extracts, while DPPH solution was used as control. Samples and standard were prepared in triplicate and incubated for 30 minutes in dark at room temperature, the absorbance was read at 517nm (ABS30). Average and standard deviation of absorbance values were calculated for each concentration of samples and standard. Statistical analysis using t-students and p-value were performed to assess the statistical significance of the scavenging activity difference between the samples (or standard) and control (ABSctrl). The percentage of antioxidant activity has been calculated using the formula [(ABSctrl-ABS30)/ABSctrl]*100. The obtained results demonstrate that all matrices showed antioxidant activity. Ascorbic acid, used as standard, exhibits a 96% scavenging activity at the concentration of 500 µg/ml. At the same conditions, sunflower, safflower and yellow peas revealed the highest antioxidant performance among the matrices analyzed, with an activity of 74%, 68% and 70% respectively (p < 0.005). Although lupin and soybean exhibit a lower antioxidant activity compared to the other matrices, they showed a percentage of 46 and 36 respectively. All these data suggest the possibility to use undervalued edible matrices as antioxidants source. However, further studies are necessary to investigate a possible synergic effect of several matrices as well as the impact of industrial processes for a large-scale approach.

Keywords: antioxidants, DPPH assay, natural matrices, vegetal proteins

Procedia PDF Downloads 397

Authors: Prashantkumar Waghe, N. Prakash, N. D. Prasada, L. V. Lokesh, M. Vijay Kumar, Vinay Tikare

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Arsenic is a naturally occurring metalloid with potent toxic effects. It is ubiquitous in the environment and released from both natural and anthropogenic sources. It has the potential to cause various health hazards in exposed populations. Arsenic exposure through drinking water is considered as one of the most serious global environmental threats including Southeast Asia. The aim of present study was to evaluate the modulatory role of subacute exposure to sodium (meta) arsenite on the antinociceptive, anti-inflammatory and antipyretic responses mediated by meloxicam in rats. Rats were exposed to arsenic as sodium arsenite through drinking water for 28 days. A single dose of meloxicam (2 mg/kg b. wt.) was administered by oral gavage on the 29th day. The exact time of meloxicam administration depended on the type of test. Rats were divided randomly into 5 groups (n=6). Group I served as normal control and received arsenic free drinking water, while rats in group II were maintained similar to Group I but received meloxicam on 29th day. Groups III, IV and V were pre-exposed to arsenic through drinking water at 0.5, 5.0 and 50 ppm, respectively, for 28 days and was administered meloxicam next day and; pain and inflammation carried out by using formalin-induced nociception and carrageenan-induced inflammatory model(s), respectively by using standard protocol. For assessment of antipyretic effects, one more additional group (Group VI) was taken and given LPS @ 1.8 mg/kg b. wt. for induction of pyrexia (LPS control). Higher dose of arsenic inhibited the meloxicam mediated antinociceptive, anti-inflammatory and antipyretic responses. Further, meloxicam inhibited the arsenic induced level of tumor necrosis factor-α, inetrleukin-1β, interleukin -6 and COX2 mediated prostaglandin E2 in hind paw muscle. These results suggest a functional antagonism of meloxicam by arsenic. This may relate to arsenic mediated local release of tumor necrosis factor-α, inetrleukin-1β, interleukin -6 releases COX2 mediated prostaglandin E2. Based on the experimental study, it is concluded that sub-acute exposure to arsenic through drinking water aggravate pyrexia, inflammation and pain at environment relevant concentration and decrease the therapeutic efficacy of meloxicam at higher level of arsenite exposure. Thus, the observation made has clinical relevance in situations where animals are exposed to arsenite epidemic geographical locations.

Keywords: arsenic, analgesic activity, meloxicam, Wistar rats

Procedia PDF Downloads 162

Authors: Luke Taylor, Samantha J. Hall, Kenneth I. Cumming, Jakki Bardsley, Scott S. P. Wildman

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Medway School of Pharmacy, as part of an Equality Diversity and Inclusivity (EDI) initiative run by the University of Kent, decided to take steps to try and negate disparities in numeracy competencies within students undertaking the Master of Pharmacy degree in order to combat a trend in pharmacy students’ numerical abilities upon entry. This included a research driven project 1) to identify if pharmacy students are aware of weaknesses in their numeracy capabilities, and 2) recognise where their numeracy skillset is lacking. In addition to gaining this student perspective, a number of actions have been implemented to support students in improving their numeracy competencies. Reflective and quantitative analysis has shown promising improvements for the final year cohort of 2014/15 when compared to previous years. The method of involving student feedback into the structure of numeracy teaching/support has proven to be extremely beneficial to both students and teaching staff alike. Students have felt empowered and in control of their own learning requirements, leading to increased engagement and attainment. School teaching staff have received quality data to help improve existing initiatives and to innovate further in the area of numeracy teaching. In light of the recognised improvements, further actions are currently being trialled in the area of numeracy support. This involves utilising Virtual Learning Environment platforms to provide individualised support as a supplement to the increased numeracy mentoring (staff and peer) provided to students. Mentors who provide group or one-to-one sessions are now given significant levels of training in dealing with situations that commonly arise from mentoring schemes. They are also provided with continued support throughout the life of their degree. Following results from this study, Medway School of Pharmacy hopes to drive increasing numeracy standards within Pharmacy (primarily through championing peer mentoring) as well as other healthcare professions including Midwifery and Nursing.

Keywords: attainment, ethnicity, numeracy, pharmacy, support

Procedia PDF Downloads 217

Authors: Mustafa M. Donma, Orkide Donma

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Anthropometric measurements are essential for obesity studies. Waist circumference (WC) is the most frequently used measure, and along with hip circumference (HC), it is used in most equations derived for the evaluation of obese individuals. Morbid obesity is the most severe clinical form of obesity, and such individuals may also exhibit some clinical findings leading to metabolic syndrome (MetS). Then, it becomes a requirement to discriminate morbid obese children with (MOMetS+) and without (MOMetS-) MetS. Almost all obesity indices can differentiate obese (OB) children from children with normal body mass index (N-BMI). However, not all of them are capable of making this distinction. A recently introduced anthropometric obesity index, waist circumference + hip circumference/2 ((WC+HC)/2), was confirmed to differ OB children from those with N-BMI, however it has not been tested whether it will find clinical usage for the differential diagnosis of MOMetS+ and MOMetS-. This study was designed to find out the availability of (WC+HC)/2 for the purpose and to compare the possible preponderance of it over some other anthropometric or fat-based obesity indices. Forty-five MOMetS+ and forty-five MOMetS- children were included in the study. Participants have submitted informed consent forms. The study protocol was approved by the Non-interventional Ethics Committee of Tekirdag Namik Kemal University. Anthropometric measurements were performed. Body mass index (BMI), waist-to-hip circumference (W/H), (WC+HC)/2, trunk-to-leg fat ratio (TLFR), trunk-to-appendicular fat ratio (TAFR), trunk fat+leg fat/2 ((trunk+leg fat)/2), diagnostic obesity notation model assessment index-2 (D2I) and fat mass index (FMI) were calculated for both groups. Study data was analyzed statistically, and 0.05 for p value was accepted as the statistical significance degree. Statistically higher BMI, WC, (WC+HC)/2, (trunk+leg fat)/2 values were found in MOMetS+ children than MOMetS- children. No statistically significant difference was detected for W/H, TLFR, TAFR, D2I, and FMI between two groups. The lack of difference between the groups in terms of FMI and D2I pointed out the fact that the recently developed fat-based index; (trunk+leg fat)/2 gives much more valuable information during the evaluation of MOMetS+ and MOMetS- children. Upon evaluation of the correlations, (WC+HC)/2 was strongly correlated with D2I and FMI in both MOMetS+ and MOMetS- groups. Neither D2I nor FMI was correlated with W/H. Strong correlations were calculated between (WC+HC)/2 and (trunk+leg fat)/2 in both MOMetS- (r=0.961; p<0.001) and MOMetS+ (r=0.936; p<0.001) groups. Partial correlations between (WC+HC)/2 and (trunk+leg fat)/2 after controlling the effect of basal metabolic rate were r=0.726; p<0.001 in MOMetS- group and r=0.932; p<0.001 in MOMetS+ group. The correlation in the latter group was higher than the first group. In conclusion, recently developed anthropometric obesity index (WC+HC)/2 and fat-based obesity index (trunk+leg fat)/2 were of preponderance over the previously introduced classical obesity indices such as W/H, D2I and FMI during the differential diagnosis of MOMetS+ and MOMetS- children.

Keywords: children, hip circumference, metabolic syndrome, morbid obesity, waist circumference

Procedia PDF Downloads 263

Authors: M. A. Okezue, K. L. Clase, S. R. Byrn

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The requirement for maintaining data integrity in laboratory operations is critical for regulatory compliance. Automation of procedures reduces incidence of human errors. Quality control laboratories located in low-income economies may face some barriers in attempts to automate their processes. Since data from quality control tests on pharmaceutical products are used in making regulatory decisions, it is important that laboratory reports are accurate and reliable. Zinc Sulphate (ZnSO₄) tablets is used in treatment of diarrhea in pediatric population, and as an adjunct therapy for COVID-19 regimen. Unfortunately, zinc content in these formulations is determined titrimetrically; a manual analytical procedure. The assay for ZnSO4 tablets involves time-consuming steps that contain mathematical formulae prone to calculation errors. To achieve consistency, save costs, and improve data integrity, validated spreadsheets were developed to simplify the two critical steps in the analysis of ZnSO4 tablets: standardization of 0.1M Sodium Edetate (EDTA) solution, and the complexometric titration assay procedure. The assay method in the United States Pharmacopoeia was used to create a process flow for ZnSO₄ tablets. For each step in the process, different formulae were input into two spreadsheets to automate calculations. Further checks were created within the automated system to ensure validity of replicate analysis in titrimetric procedures. Validations were conducted using five data sets of manually computed assay results. The acceptance criteria set for the protocol were met. Significant p-values (p < 0.05, α = 0.05, at 95% Confidence Interval) were obtained from students’ t-test evaluation of the mean values for manual-calculated and spreadsheet results at all levels of the analysis flow. Right-first-time analysis and principles of data integrity were enhanced by use of the validated spreadsheet calculators in titrimetric evaluations of ZnSO₄ tablets. Human errors were minimized in calculations when procedures were automated in quality control laboratories. The assay procedure for the formulation was achieved in a time-efficient manner with greater level of accuracy. This project is expected to promote cost savings for laboratory business models.

Keywords: data integrity, spreadsheets, titrimetry, validation, zinc sulphate tablets

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Authors: Ruchi Garg

Abstract:

Background: Dr. Rajendra Prasad Centre for Ophthalmic Sciences, named after the first President of India, was established on the 10th of March, 1967 as a National Center for ophthalmic science to provide state-of-the-art patient care, expand human resources for medical education and undertake research to find solutions to eye health problems of national importance. The average number of cataract surgeries performed per month is 700 to 1000. Methods: Anticipating implementation in 50% cases hundred cases of cataract surgery were observed to study the existing system of surgical safety followed at Dr. R.P. Center and gap analysis done against the WHO surgical safety checklist for cataract surgery. A modified WHO surgical safety checklist for cataract surgery was developed and implemented in the center. Barriers in the implementation of the surgical safety checklist were also identified, and remedial measures were suggested. Results: Significant improvement was noticed in all the parameters after the introduction of the modified checklist. The additional points which were added in the modified surgical safety checklist were implemented in almost all the cases by the nursing staff. The overall mean compliance percentage before the implementation of the modified surgical safety checklist at Dr. R.P.C was 37%±10.1 (P=0.001). While after the introduction of the modified surgical safety checklist, the mean compliance has improved to 62.7%±10.3; the Wilcoxon rank sum test/Independent test is applied for each domain. Conclusions: The cataract procedure is the most common surgical procedure performed in the population in India. High volume and high turnover increase the potential for errors. Compliance with the surgical safety checklist before intervention was 32%. After intervention in the form of a focus group discussion and introduction of a modified surgical safety checklist has resulted in an increase in the compliance rate to 67%, this study revealed that changes or additional work are not happily accepted by the staff. After six months of intervention with the modified surgical safety checklist compliance rate was still high, this suggests that constant supervision and monitoring by senior staff can sustain the compliance rate.

Keywords: patient safety, hospital safety, quality, WHO surgical safety checklist

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