Search results for: skin and soft tissue infection

Authors: Jang-hyun Oh, Kyoung-ho Choi, Jea-sun Lee

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The outbreak of the COVID-19 pandemic brought reconsiderations and doubts about urban density as compact cities became epidemic hot spots. Density, though, provides an upside in that medical services required to protect citizens against the spread of disease are concentrated within compact cities, which helps reduce the mortality rate. Sociodemographic characteristics are also a crucial factor in determining the vulnerability of the population, and the purpose of this study is to empirically discover how these three urban factors affect the severity of the epidemic impacts. The study aimed to investigate the influential relationships between urban factors and epidemic impacts and provide answers to whether superb medical service in compact cities can scale down the impacts of COVID-19. SEM (Structural Equation Modeling) was applied as a suitable research method for verifying interrelationships between factors based on theoretical grounds. The study accounted for 144 municipalities in South Korea during periods from the first emergence of COVID-19 to December 31st, 2022. The study collected data related to infection and mortality cases from each municipality, and it holds significance as primary research that enlightens the aspects of epidemic impact concerning urban settings and investigates for the first time the mediated effects of medical service. The result of the evaluation shows that compact cities are most likely to have lower sociodemographic vulnerability and better quality of medical service, while cities with low density contain a higher portion of vulnerable populations and poorer medical services. However, the quality of medical service had no significant influence in reducing neither the infection rate nor the mortality rate. Instead, density acted as the major influencing factor in the infection rate, while sociodemographic vulnerability was the major determinant of the mortality rate. Thus, the findings strongly paraphrase that compact cities, although with high infection rates, tend to have lower mortality rates due to less vulnerability in sociodemographics, Whereas death was more frequent in less dense cities due to higher portions of vulnerable populations such as the elderly and low-income classes. Findings suggest an important lesson for post-pandemic urban planning-intrinsic characteristics of urban settings, such as density and population, must be taken into account to effectively counteract future epidemics and minimize the severity of their impacts. Moreover, the study is expected to contribute as a primary reference material for follow-up studies that further investigate related subjects, including urban medical services during the pandemic.

Keywords: urban planning, sociodemographic vulnerability, medical service, COVID-19, pandemic

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Authors: Muneesh Kumar, Rajesh Kumar, Sangeeta Devi

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Heavy metals are a major problem because they are toxic and tend to accumulate in living organisms. This study was carried out with the aims of studying on histopathology of Zn(SO4) toxicity on gill and liver tissues of catfish (Clarias batrachus) within the period of 96 h. Totally, 140 fishes with mean weight 50±10 g were stocked in 12 aquariums with capacity of 200 L water and divided in to 3 trails including control, 4 ppm and 8 ppm of Zn with 3 replicates. Tissue samples were fixed by bouin’s solution and sectioned in 7 μm based on histological regular method and stained with Hematoxylin and Eosin (H&E) method for microscopic study within the period of 96 h. Results showed some damaged such as hyperplasia, telangiectasis and edema, necrosis of second filaments, jerky movement, aneurism, hyperemia and fusion of second filaments in gills; and cell atrophy, necrosis, fatty degeneration, hyperemia and bile stagnation at different treatments in comparison with control. Gill and liver tissue damages were severed with the increase of Zn concentration and days. Therefore, Zn had acute toxicity effects on gill and liver tissues in Catfish at 5 and 10 ppm concentrations.

Keywords: gill, liver, histopathology, zinc, Clarias batrachus

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Authors: Calogero Lo Destro

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Numerous nations around the world are facing exceptional challenges in employing measures to stop the spread of COVID-19. Following the recommendations of the World Health Organization, a series of preventive measures have been adopted. However, individuals must comply with these rules and recommendations in order to make these measures effective. While COVID-19 was climaxing, it seemed of crucial importance to analyze which psychosocial factors contribute to the acceptance of such preventive behavior, thus favoring the management of COVID-19 worldwide health crisis. In particular, the identification of aspects related to obstacles and facilitation of adherence to social distancing has been considered crucial in the containment of the virus spread. Since the virus was firstly detected in China, Asian people could be considered a relevant outgroup targeted for exclusion. We also hypothesized social distance could be influenced by characteristics of the target, such as smiling or coughing. 260 participants participated in this research on a voluntary basis. They filled a survey designed to explore a series of COVID-19 measures (such as exposure to virus and fear of infection). We also assessed participants state and trait anxiety. The dependent variable was social distance, based on a measure of seating distance designed ad hoc for the present work. Our hypothesis that participants could report greater distance in response to Asian people was not confirmed. On the other hand, significantly lower distance in response to smiling compared to coughing targets was reported. Adopting a regression analysis model, we found that participants' social distance, in response to both coughing and smiling targets, was predicted by fear of infection and by the perception COVID-19 could become a pandemic. Social distance in response to the coughing target was also significantly and positively predicted by age and state anxiety. In summary, the present work has sought to identify a set of psychological variables, which may still be predictive of social distancing.

Keywords: COVID-19, social distancing, health, preventive behaviors, risk of infection

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Authors: Lanlan Xiao, Yang Liu, Shuo Chen, Bingmei Fu

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Most cancer-related deaths are due to metastasis. Metastasis is a complex, multistep processes including the detachment of cancer cells from the primary tumor and the migration to distant targeted organs through blood and/or lymphatic circulations. During hematogenous metastasis, the emigration of tumor cells from the blood stream through the vascular wall into the tissue involves arrest in the microvasculature, adhesion to the endothelial cells forming the microvessel wall and transmigration to the tissue through the endothelial barrier termed as extravasation. The narrow slit between endothelial cells that line the microvessel wall is the principal pathway for tumor cell extravasation to the surrounding tissue. To understand this crucial step for tumor hematogenous metastasis, we used Dissipative Particle Dynamics method to investigate an individual cell passing through a narrow slit numerically. The cell membrane was simulated by a spring-based network model which can separate the internal cytoplasm and surrounding fluid. The effects of the cell elasticity, cell shape and cell surface area increase, and slit size on the cell transmigration through the slit were investigated. Under a fixed driven force, the cell with higher elasticity can be elongated more and pass faster through the slit. When the slit width decreases to 2/3 of the cell diameter, the spherical cell becomes jammed despite reducing its elasticity modulus by 10 times. However, transforming the cell from a spherical to ellipsoidal shape and increasing the cell surface area only by 3% can enable the cell to pass the narrow slit. Therefore the cell shape and surface area increase play a more important role than the cell elasticity in cell passing through the narrow slit. In addition, the simulation results indicate that the cell migration velocity decreases during entry but increases during exit of the slit, which is qualitatively in agreement with the experimental observation.

Keywords: dissipative particle dynamics, deformability, surface area increase, cell migration

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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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Authors: Erfan Rahimi, Hadi Bahari Far, Mojgan Shikhpour

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Background: Urinary tract infection is one of the most common nosocomial infections, especially among women. E. coli is one of the main causes of urinary tract infections and one of the most common antibiotics to fight this bacterium is ampicillin. As conventional antibiotics led to bacterial antibiotic resistance, modification of the pure drugs can address this issue. The aim of this study was to prepare nanofluids containing carbon nanotubes conjugated with ampicillin to improve drug performance and reduce antibiotic resistance. Methods: Multi-walled carbon nanotubes (MWCNTs) were activated with thionyl chloride by reflux system and nanofluids containing antibiotics were prepared by ultrasonic method. The properties of the prepared nano-drug were investigated by general element analysis, infrared spectroscopy, Raman spectroscopy, scanning electron microscopy and transmission electron microscopy. After the treatment of the desired strain with nanofluid, microbial studies were performed to evaluate the antibacterial effects and molecular studies were carried out to measure the expression of the resistance gene AcrAB. Result: We have shown that the antimicrobial effect of ampicillin-functionalized MWCNTs at low concentrations performed better than that of the conventional drug in both resistant and ATCC strains. Also, a decrease in antibiotic resistance of bacteria treated with ampicillin-functionalized MWCNTs compared to the pure drug was observed. Also, ampicillin-functionalized MWCNTs downregulated the expression of AcrAB in treated bacteria. Conclusion: Because carbon nanotubes are capable of destroying the bacterial wall, which provides antibiotic resistance features in bacteria, their usage in the form of nanofluids can make lower dosages (about three times less) than that of the pure drug more effective. Additionally, the expression of the bacterial resistance gene AcrAB decreased, thereby reducing antibiotic resistance and improving drug performance against bacteria.

Keywords: urinary tract infection, antibiotic resistance, carbon nanotube, nanofluid

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Authors: Che Jusoh, Mohd Rahimi, Toby Mundel

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This study was designed to investigate the physiological and performance effects of a local Malaysian native starch (Metroxylin sago) on cycling in a hot (30°C) and humid (78% RH) environment. Eight male, non-heat acclimated, well-trained club cyclists (VO2max 65 ± 10 ml kg-1 min-1, peak aerobic power 397 ± 71 W) completed one familiarization and three experimental trials in our laboratory simulating cycling in environmental conditions of heat and humidity. Each trial consisted of 45 minutes at a fixed workload (55% VO2max) followed by a 15 minute time-trial (~75% VO2max). Sago in porridge form was consumed 1h before exercise (Pre), in gel form during exercise (Dur) and compared to a control trial (Con), using a random, cross-over design. Plasma glucose concentration did not differ between trials (P = 0.06) with an increase from 4.1 ± 0.6 to 6.1 ± 1.6 mmol-1 (Con), 4.8 ± 1.7 to 5.7 ± 0.4 mmol-1 (Pre) and 4.7 ± 0.8 to 6.9 ± 1.4 mmol-1 (Dur) from start to end of exercise. Plasma lactate increased (P = 0.02) from 1.6 ± 0.3 to 7.6 ± 2.2 mmol-1 (Con), 1.7 ± 0.5 to 7.3 ± 2.9 mmol-1 (Pre) and 1.6 ± 0.2 to 7.3 ± 1.8 mmol-1 (Dur) with no effect of trial (P = 0.74). No differences were found between trials for RER (P = 0.328) with values of 0.93 ± 0.05 (Con), 0.94 ± 0.04 (Pre) and 0.92 ± 0.04 (Dur). There were no differences between trials in rectal (P = 0.64) and skin (P = 0.56) temperatures; values reaching 39.1 ± 0.5°C (Con), 38.9 ± 0.4°C (Pre) and 39.1 ± 0.4°C (Dur) for rectal and 32.7 ± 1.2°C (Con), 32.8 ± 1.4°C (Pre) and 32.8 ± 1.8°C (Dur) for skin temperature, respectively. Heart rate (P = 0.07) also did not differ between trials but reached maximal values by the end of time-trial for all trials. Performance was unaffected by trial (P = 0.98) with the average work completed in 15 minutes being 221 ± 33 kJ (Con), 222 ± 31 kJ (Pre) and 219 ± 32 kJ (Dur), respectively. Therefore, the results of this investigation do not support consumption of sago, either before or during exercise, in altering the thermoregulatory, metabolic or performance responses in a hot and humid environment.

Keywords: hot and humid, physiology, time trial performance, thermoregulatory

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Authors: Hilary Modir, Kyle Dutton, Michelle Swab, Shabnam Asghari

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Since its emergence, the cutaneous manifestations of COVID-19 have been documented in the literature. However, the majority are case reports with significant limitations in appraisal quality, thus leaving the role of dermatological manifestations of COVID-19 erroneously underexplored. The primary aim of this review was to systematically examine clinical patterns of dermatological manifestations as reported in the literature. This study was designed as a systematic review of case reports. The inclusion criteria consisted of all published reports and articles regarding COVID-19 in English, from September 1st, 2019, until June 22nd, 2020. The population consisted of confirmed cases of COVID-19 with associated cutaneous signs and symptoms. Exclusion criteria included research in planning stages, protocols, book reviews, news articles, review studies, and policy analyses. With the collaboration of a librarian, a search strategy was created consisting of a mixture of keyword terms and controlled vocabulary. Electronic databases searched were MEDLINE via PubMed, EMBASE, CINAHL, Web of Science, LILACS, PsycINFO, WHO Global Literature on Coronavirus Disease, Cochrane Library, Campbell Collaboration, Prospero, WHO International Clinical Trials Registry Platform, Australian and New Zealand Clinical Trials Registry, U.S. Institutes of Health Ongoing Trials Register, AAD Registry, OSF preprints, SSRN, MedRxiV and BioRxiV. The study selection featured an initial pre-screening of titles and abstracts by one independent reviewer. Results were verified by re-examining a random sample of 1% of excluded articles. Eligible studies progressed for full-text review by two calibrated independent reviewers. Covidence was used to store and extract data, such as citation information and findings pertaining to COVID-19 and cutaneous signs and symptoms. Data analysis and summarization methodology reflect the framework proposed by PRISMA and recommendations set out by Cochrane and Joanna Brigg’s Institute for conducting systematic reviews. The Oxford Centre for Evidence-Based Medicine’s level of evidence was used to appraise the quality of individual studies. The literature search revealed a total of 1221 articles. After the abstract and full-text screening, only 95 studies met the eligibility criteria, proceeding to data extraction. Studies were divided into 58% case reports and 42% series. A total of 833 manifestations were reported in 723 confirmed COVID-19 cases. The most frequent lesions were 23% maculopapular, 15% urticarial and 13% pseudo-chilblains, with 46% of lesions reporting pruritus, 16% erythema, 14% pain, 12% burning sensation, and 4% edema. The most common lesion locations were 20% trunk, 19.5% lower limbs, and 17.7% upper limbs. The time to resolution of lesions was between one and twenty-one days. In conclusion, over half of the reported cutaneous presentations in COVID-19 positive patients were maculopapular, urticarial and pseudo-chilblains, with the majority of lesions distributed to the extremities and trunk. As this review’s sample size only contained COVID-19 confirmed cases with skin presentations, it becomes difficult to deduce the direct relationship between skin findings and COVID-19. However, it can be correlated that acute onset of skin lesions, such as chilblains-like, may be associated with or may warrant consideration of COVID-19 as part of the differential diagnosis.

Keywords: COVID-19, cutaneous manifestations, cutaneous signs, general dermatology, medical dermatology, Sars-Cov-2, skin and infectious disease, skin findings, skin manifestations

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Authors: Dada Kolawole Segun

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Transdermal drug delivery has gained popularity as a non-invasive method for controlled drug release compared to traditional delivery routes. Dissolvable transdermal patches have emerged as a promising platform for delivering a variety of drugs due to their ease of use. The objective of this research was to create and characterize dissolvable transdermal patches using various compositions and ratios of hyaluronic acid and zinc oxide nanoparticles. A micromolding technique was utilized to fabricate the patches, which were subsequently characterized using scanning electron microscopy, atomic force microscopy, and tensile strength testing. In vitro drug release studies were conducted to evaluate the drug release kinetics of the patches. The study found that the mechanical strength and dissolution properties of the patches were influenced by the hyaluronic acid and zinc oxide nanoparticle ratios used in the fabrication process. Moreover, the patches demonstrated controlled delivery of model drugs through the skin, highlighting their potential for transdermal drug delivery applications. The results suggest that dissolvable transdermal patches can be tailored to meet specific requirements for drug delivery applications using different compositions and ratios of hyaluronic acid and zinc oxide nanoparticles. This development has the potential to improve treatment outcomes and patient compliance in various therapeutic areas.

Keywords: transdermal drug delivery, characterization, skin permeation, biodegradable materials

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Authors: Shama Ranjan Barua, Tofazzal M. Rakib, Mohammad Alamgir Hossain, Tania Ferdushy, Sharmin Chowdhury

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Rotavirus is one of the main etiologies of neonatal diarrhea in bovine calves that causes significant economic loss in Bangladesh. The present study was carried out to investigate the pathology of neonatal enteritis in calves due to bovine rotavirus infection in south-eastern part of Bangladesh. Rotavirus was identified by using ELISA, RT-PCR (Reverse Transcription Polymerase Chain Reaction), real-time RT-PCR. We examined 12 dead calves with history of diarrhea during necropsy. Among 12 dead calves, in gross examination, 6 were found with pathological changes in intestine, 5 calves had congestion of small intestine and rest one had no distinct pathological changes. Intestinal contents and/or faecal samples of all dead calves were collected and examined to confirm the presence of bovine rotavirus A using Enzyme linked immunosorbant assay (ELISA), RT-PCR and real-time RT-PCR. Out 12 samples, 5 (42%) samples revealed presence of bovine rotavirus A in three diagnostic tests. The histopathological changes were found almost exclusively limited in the small intestine. The lesions of rotaviral enteritis ranged from slight to moderate shortening (atrophy) of villi in the jejunum and ileum with necrotic crypts. The villi were blunt and covered by immature epithelial cells. Infected cells, stained with Haematoxylin and Eosin staining method, showed characteristic syncytia and eosinophilc intracytoplasmic inclusion body. The presence of intracytoplasmic inclusion bodies in enterocytes is the indication of viral etiology. The presence of rotavirus in the affected tissues and/or lesions was confirmed by three different immunological and molecular tests. The findings of histopathological changes will be helpful in future diagnosis of rotaviral infection in dead calves.

Keywords: calves, diarrhea, pathology, rotavirus

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Authors: Mamata Mohanty, J. T. Shahu

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The in-situ deep mixing is an effective ground improvement technique which involves columnar inclusion into soft ground to increase its bearing capacity and reduce settlement. The first part of the study presents the results of unconfined compression on cement-admixed clay prepared at different cement content and subjected to varying curing periods. It is found that cement content is a prime factor controlling the strength of the cement-admixed clay. Besides cement content, curing period is important parameter that adds to the strength of cement-admixed clay. Increase in cement content leads to significant increase in Unconfined Compressive Strength (UCS) values especially at cement contents greater than 8%. The second part of the study investigated the bearing capacity of the clay ground improved by a group of end-bearing column using model tests under plain-strain condition. This study mainly focus to examine the effect of cement contents on the ultimate bearing capacity and failure stress of the improved clay ground. The study shows that the bearing capacity of the improved ground increases significantly with increase in cement contents of the soil-cement columns. A considerable increase in the stiffness of the model ground and failure stress was observed with increase in cement contents.

Keywords: bearing capacity, cement content, curing time, unconfined compressive strength, undrained shear strength

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Authors: Clara Franch de la Cal, Christopher J Morris, Michael McArthur

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Cystic fibrosis (CF) is an autosomal recessive genetic disorder characterized by abnormal transport of chloride and sodium across the lung epithelium, leading to thick and viscous secretions. Within which CF patients suffer from repeated bacterial pulmonary infections, with Pseudomonas aeru-ginosa (PA) eliciting the greatest inflammatory response, causing an irreversible loss of lung func-tion that determines morbidity and mortality. The cell wall of PA is a permeability barrier to many antibacterials and the rise of Mutli-Drug Resistant strains (MDR) is eroding the efficacy of the few remaining clinical options. In addition when PA infection becomes established it forms an antibi-otic-resistant biofilm, embedded in which are slow growing cells that are refractive to drug treat-ment. Making the development of new antibacterials a major challenge. This work describes the development of new type of nanoparticulate oligonucleotide antibacterial capable of tackling PA infections, including MDR strains. It is being developed to both block growth and prevent biofilm formation. These oligonucleotide therapeutics, Transcription Factor Decoys (TFD), act on novel genomic targets by capturing key regulatory proteins to block essential bacterial genes and defeat infection. They have been successfully transfected into a wide range of pathogenic bacteria, both in vitro and in vivo, using a proprietary delivery technology. The surfactant used self-assembles with TFD to form a nanoparticle stable in biological fluids, which protects the TFD from degradation and preferentially transfects prokaryotic membranes. Key challenges are to adapt the nanoparticle so it is active against PA in the context of biofilms and to formulate it for administration by inhalation. This would allow the drug to be delivered to the respiratory tract, thereby achieving drug concentrations sufficient to eradicate the pathogenic organisms at the site of infection.

Keywords: antibacterials, transcriptional factor decoys (TFDs), pseudomonas aeruginosa

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Authors: Elahe Najafizade, Ahmad Mohammad Alkhateeb, Seyed Ali Hossein Zahraei, Iman Dianat

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Introduction: Hangnails are short, torn, down parts of the skin surrounding the nails. At times they are very painful. The usual treatment advised is cutting the excess skin with clippers or scissors. To provide instant relief to the patients, we describe a simpler and more effective way to use surgical glue to paste them back into their original position. Method: The cream should not be on the heat; it is on the bain-marie. To achieve the desired emulsifier, 1 gram of borax was mixed in 10 grams of distilled water in a bain-marie until it melted, then stirred oserin, beeswax, and oil in the bain-marie until it melted. After that, 32 grams of distilled water was added little by little. We add and stir and gradually add the borax dissolved in 10 grams of distilled water. The bowl of cream was placed in a bowl of cold water and stirred until the cream was smooth. After that, we add gasoline, alcohol, or methylparaben preservatives. It should be noted that this amount of ingredients is enough for a 350-gram can (when we prepare the cream, we also add the extract). Result: The patient was a 40-year-old female with a hangnail problem that had been used several different creams and Vaseline, but the treatment was not useful, but after this cream was applied for treatment; the hangnail started to cure within one week, and complete treatment achieved after two weeks. Conclusion: Traditional methods with modification without using chemical substances somehow work better and safer, so research programs on them will be useful for less risky treatment procedures.

Keywords: nail, cream, formula, traditional medicine

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Authors: Ritu Karwasra, Surender Singh

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Inflammation is an important physiological response of the body’s self-defense system that helps in eliminating and protecting organism from harmful stimuli and in tissue repair. It is a highly regulated protective response which helps in eliminating the initial cause of cell injury, and initiates the process of repair. The present study was designed to evaluate the ameliorative effect of pomegranate rind extract on pain and inflammation. Hydroalcoholic standardized rind extract of pomegranate at doses 50, 100 and 200 mg/kg and indomethacin (3 mg/kg) was tested against eddy’s hot plate induced thermal algesia, carrageenan (acute inflammation) and Complete Freund’s Adjuvant (chronic inflammation) induced models in Wistar rats. Parameters analyzed were inhibition of paw edema, measurement of joint diameter, levels of GSH, TBARS, SOD, TNF-α, radiographic imaging, tissue histology and synovial expression of pro-inflammatory cytokine receptor (TNF-R1). Radiological and light microscopical analysis were carried out to find out the bone damage in CFA-induced chronic inflammatory model. Findings of the present study revealed that pomegranate rind extract at a dose of 200 mg/kg caused a significant (p<0.05) reduction in paw swelling in both the inflammatory models. Nociceptive threshold was also significantly (p<0.05) improved. Immunohistochemical analysis of TNF-R1 in CFA-induced group showed elevated level, whereas reduction in level of TNF-R1 was observed in pomegranate (200 mg/kg). Henceforth, we might say that pomegranate produced a dose-dependent reduction in inflammation and pain along with the reduction in levels of oxidative stress markers and tissue histology, and the effect was found to be comparable to that of indomethacin. Thus, it can be concluded that pomegranate is a potential therapeutic target in the pathogenesis of inflammation and pain, and punicalagin is the major constituents found in rind extract might be responsible for the activity.

Keywords: carrageenan, inflammation, nociceptive-threshold, pomegranate, histopathology

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Authors: Dean Robinson, Miriam Gublebank, Ella Sklan, Tali Tavor Re'em

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Alginate, a natural linear polysaccharide polymer extracted from brown seaweed, is extensively applied due to its biocompatibility, all- aqueous ease of handling, and relatively low costs. Alginate easily forms a hydrogel when crosslinked with a divalent ion, such as calcium. However, Alginate hydrogel holds low mechanical properties and is cell-inert. To overcome these drawbacks and to improve alginate as a bio-ink for bioprinting, we produced a new alginate matrix combined with spider silk, one of the most resilient, elastic, strong materials known to men. Recombinant spider silk biopolymer has a sponge-like structure and is known to be biocompatible and non-immunogenic. Our results indicated that combining synthetic spider-silk into bio-printed cell-seeded alginate hydrogels resulted in improved properties compared to alginate: improved mechanical properties of the matrix, achieving a tunable gel viscosity and high printability, alongside prolonged and higher cell viability in culture, probably due to the improved cell-matrix interactions. The new bio-ink was then used for bilayer bioprinting of epithelial and stromal endometrial cells. Such a co-culture model will be used for the formation of the complex endometrial tissue for studying the embryo implantation process.

Keywords: cell culture, tissue engineering, spider silk, alginate, bioprinting

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Authors: Naum Simanovsky, Vladimir Goldman, Michael Zaidman

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Background: The optimal algorithm for the management of symptomatic tarsal coalition is still under discussion in pediatric literature. It's debatable what surgical steps are essential to achieve the best outcome. Method: The investigators retrospectively reviewed the records of twelve patients with symptomatic tarsal coalition that were treated operatively between 2017 and 2019. Only painful flat feet were operated. Two patients were excluded from the study due to lack of sufficient follow-up. Ten of eleven feet were treated with the combination of calcaneal lengthening osteotomy (CLO) and resection of coalition (RC). Only one foot was operated with CLO alone. In half of our patients, Achilles lengthening was performed. For two children, medial plication was added. Short leg cast was applied to all children for 6-8 weeks, and soft shoe insoles for medial arch support were prescribed after. Demographic, clinical, and radiographic records were reviewed. The outcome was evaluated using American Orthopedic Foot and Ankle Society (AOFAS) Ankle Hindfoot Score. Results: There were seven boys and three girls. The mean age at the time of surgery was 13.9 (range 12 to 17) years, and the mean follow-up was 18 (range 8 to 34) months. The early complications included one superficial wound infection and dehiscence. Late complication includes two children with residual forefoot supination. None of our patients required additional operations during the follow-up period. All feet achieved complete deformity correction or dramatic improvement. In the last follow-up, seven feet were painless, and four children had some mild pain after intensive activities. All feet achieved excellent and good scoring on AOFAS. Conclusions: Many patients with talocalcaneal coalition also have rigid or stiff, painful, flat feet. For these patients, the resection of coalition with concomitant CLO can be safely recommended.

Keywords: Tarsal coalition, calcaneal lengthening osteotomy., flat foot, coalition resection

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Authors: Ibrahim Yakubu Seini, Oluwole Daniel Makinde

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MHD chemically reacting viscous fluid flow towards a vertical surface with slip and convective boundary conditions has been conducted. The temperature and the chemical species concentration of the surface and the velocity of the external flow are assumed to vary linearly with the distance from the vertical surface. The governing differential equations are modeled and transformed into systems of ordinary differential equations, which are then solved numerically by a shooting method. The effects of various parameters on the heat and mass transfer characteristics are discussed. Graphical results are presented for the velocity, temperature, and concentration profiles whilst the skin-friction coefficient and the rate of heat and mass transfers near the surface are presented in tables and discussed. The results revealed that increasing the strength of the magnetic field increases the skin-friction coefficient and the rate of heat and mass transfers toward the surface. The velocity profiles are increased towards the surface due to the presence of the Lorenz force, which attracts the fluid particles near the surface. The rate of chemical reaction is seen to decrease the concentration boundary layer near the surface due to the destructive chemical reaction occurring near the surface.

Keywords: boundary layer, surface slip, MHD flow, chemical reaction, heat transfer, mass transfer

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Authors: Leila Noori, Rosario Barone, Francesca Rappa, Antonella Marino Gammazza, Alessandra Maria Vitale, Giuseppe Donato Mangano, Giusy Sentiero, Filippo Macaluso, Kathryn H. Myburgh, Francesco Cappello, Federica Scalia

Abstract:

The neuromuscular system controls, directs, and allows movement of the body through the action of neural circuits, which include motor neurons, sensory neurons, and skeletal muscle fibers. Protein homeostasis of the involved cytotypes appears crucial to maintain the correct and prolonged functions of the neuromuscular system, and both neuronal cells and skeletal muscle fibers express significant quantities of protein chaperones, the molecular machinery responsible to maintain the protein turnover. Genetic mutations or defective post-translational modifications of molecular chaperones (i.e., genetic or acquired chaperonopathies) may lead to neuromuscular disorders called as neurochaperonopathies. The limited knowledge of the effects of the defective chaperones on skeletal muscle fibers and neurons impedes the progression of therapeutic approaches. A distinct genetic variation of CCT5 gene encoding for the subunit 5 of the chaperonin CCT (Chaperonin Containing TCP1; also known as TRiC, TCP1 Ring Complex) was recently described associated with severe distal motor neuropathy by our team. In this study, we investigated the histopathological abnormalities of the skeletal muscle biopsy of the pediatric patient affected by the mutation Leu224Val in the CCT5 subunit. We provide molecular and structural features of the diseased skeletal muscle tissue that we believe may be useful to identify undiagnosed cases of this rare genetic disorder. We investigated the histological abnormalities of the affected tissue via hematoxylin and eosin staining. Then we used immunofluorescence and qPCR techniques to explore the expression and distribution of CCT5 in diseased and healthy skeletal muscle tissue. Immunofluorescence and immunohistochemistry assays were performed to study the sarcomeric and structural proteins of skeletal muscle, including actin, myosin, tubulin, troponin-T, telethonin, and titin. We performed Western blot to examine the protein expression of CCT5 and some heat shock proteins, Hsp90, Hsp60, Hsp27, and α-B crystallin, along with the main client proteins of the CCT5, actin, and tubulin. Our findings revealed muscular atrophy, abnormal morphology, and different sizes of muscle fibers in affected tissue. The swollen nuclei and wide interfiber spaces were seen. Expression of CCT5 had been decreased and showed a different distribution pattern in the affected tissue. Altered expression, distribution, and bandage pattern were detected by confocal microscopy for the interested muscular proteins in tissue from the patient compared to the healthy control. Protein levels of the studied Hsps normally located at the Z-disk were reduced. Western blot results showed increased levels of the actin and tubulin proteins in the diseased skeletal muscle biopsy compared to healthy tissue. Chaperones must be expressed at high levels in skeletal muscle to counteract various stressors such as mechanical, oxidative, and thermal crises; therefore, it seems relevant that defects of molecular chaperones may result in damaged skeletal muscle fibers. So far, several chaperones or cochaperones involved in neuromuscular disorders have been defined. Our study shows that alteration of the CCT5 subunit is associated with the damaged structure of skeletal muscle fibers and alterations of chaperone system components and paves the way to explore possible alternative substrates of chaperonin CCT. However, further studies are underway to investigate the CCT mechanisms of action to design applicable therapeutic strategies.

Keywords: molecular chaperones, neurochaperonopathy, neuromuscular system, protein homeostasis

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Authors: Jianli Dong, Fangling Xu, Gengming Huang

Abstract:

Human endogenous retroviral elements (HERVs) comprise approximately 8% of the human genome. They are thought to be germline-integrated genetic remnants of retroviral infections. Although HERV sequences are highly defective, some, especially the K type (HERV-K), have been shown to be expressed and may have biological activities in the pathogenesis of cancer, chronic inflammation and autoimmune diseases. We found that HERV-K GAG and ENV proteins were strongly expressed in pleomorphic melanoma cells. We also detected a critical role of HERV-K ENV in mediating intercellular fusion and colony formation of melanoma cells. Interestingly, we found that levels of HERV-K GAG and ENV expression correlated with the activation of ERK and loss of p16INK4A in melanoma cells, and inhibition of MEK or CDK4, especially in combination, reduced HERV-K expression in melanoma cells. We also performed a reverse transcription-polymerase chain reaction (RT-PCR) assay using DNase I digestion to remove “contaminating” HERV-K genomic DNA and examined HERV-K RNA expression in plasma samples from HIV-1 infected individuals. We found a covariation between HERV-K RNA expression and CD4 cell counts in HIV-1 positive samples. Although a causal link between HERV-K activation and melanoma development, and between HERV-K activation, HIV-1 infection and CD4 cell count have yet to be determined, existing data support the further research efforts in HERV-K.

Keywords: CD4 cell, HERV-K, HIV-1, melanoma

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Authors: E. Saeedian, M. Shakerian, A. Zarif Sanayei, Z. Rakeb, F. N. Alizadeh, S. Sarshough, S. Sina

Abstract:

Radiological protection for plants and animals is an area of regulatory importance. Acute doses of 0.1 Gy/d (10 rad/d) or below are highly unlikely to produce permanent, measurable negative effects on populations or communities of plants or animals. The advancement of radio diagnostics for domestic animals, particularly dogs and cats, has gained popularity in veterinary medicine. As pets are considered to be members of the family worldwide, they are entitled to the same care and protection. It is important to have a system of radiological protection for nonhuman organisms that complies with the focus on human health as outlined in ICRP publication 19. The present study attempts to assess surface-skin entrance doses in small pets undergoing abdominal radio diagnostic procedures utilizing a direct measurements technique with a thermoluminescent dosimeter. These measurements allow the determination of the entrance skin dose (ESD) by calculating the amount of radiation absorbed by the skin during exposure. A group of Thirty TLD-100 dosimeters produced by Harshaw Company, each with repeatability greater than 95% and calibration using ¹³⁷Cs gamma source, were utilized to measure doses to ten small pets, including cats and dogs in the radiological department in a veterinary clinic in Shiraz, Iran. Radiological procedures were performed using a portable imaging unit (Philips Super M100, Philips Medical System, Germany) to acquire images of the abdomen; ten exams of abdomen images of different pets were monitored, measuring the thicknesses of the two projections (lateral and ventrodorsal) and the distance of the X-ray source from the surface of each pet during the exams. A group of two dosimeters was used for each pet which has been stacked on their skin on the abdomen region. The outcome of this study involved medical procedures with the same kVp, mAs, and nearly identical positions for different diagnostic X-ray procedures executed over a period of two months. The result showed the mean ESD value was 260.34±50.06 µGy due to the approximate size of pets. Based on the results, the ESD value is associated with animal size, and larger animals have higher values. If a procedure doesn't require repetition, the dose can be optimized. For smaller animals, the main challenge in veterinary radiology is the dose increase caused by repetitions, which is most noticeable in the ventrodorsal position due to the difficulty in immobilizing the animal. Animals are an area of regulatory importance. Acute doses of 0.1 Gy/d (10 rad/d) or below are highly unlikely to produce permanent, measurable negative effects on populations or communities of plants or animals. The advancement of radio diagnostics for domestic animals, particularly dogs and cats, has gained popularity in veterinary medicine. As pets are considered to be members of the family worldwide, they are entitled to the same care and protection. It is important to have a system of radiological protection for nonhuman organisms that complies with the focus on human health as outlined in ICRP publication 19. The present study attempts to assess surface-skin entrance doses in small pets undergoing abdominal radio diagnostic procedures utilizing direct measurements.

Keywords: direct dose measuring, dosimetry, radiation protection, veterinary medicine

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Authors: Evanka Madan, Madhu Puri, Dan Zilberstein, Rohini Muthuswami, Rentala Madhubala

Abstract:

The extensive interaction between the host and pathogen metabolic networks decidedly shapes the outcome of infection. Utilization of arginine by the host and pathogen is critical for determining the outcome of pathogenic infection. Infections with L. donovani, an intracellular parasite, will lead to an extensive competition of arginine between the host and the parasite donovani infection. One of the major amino acid (AA) sensing signaling pathways in mammalian cells are the mammalian target of rapamycin complex I (mTORC1) pathway. mTORC1, as a sensor of nutrient, controls numerous metabolic pathways. Arginine is critical for mTORC1 activation. SLC38A9 is the arginine sensor for the mTORC1, being activated during arginine sufficiency. L. donovani transport arginine via a high-affinity transporter (LdAAP3) that is rapidly up-regulated by arginine deficiency response (ADR) in intracellular amastigotes. This study, to author’s best knowledge, investigates the interaction between two arginine sensing systems that act in the same compartment, the lysosome. One is important for macrophage defense, and the other is essential for pathogen virulence. We hypothesize that the latter modulates lysosome arginine to prevent host defense response. The work presented here identifies an upstream regulatory role of LdAAP3 in regulating the expression of SLC38A9-mTORC1 pathway, and consequently, their function in L. donovani infected THP-1 cells cultured in 0.1 mM and 1.5 mM arginine. It was found that in physiological levels of arginine (0.1 mM), infecting THP-1 with Leishmania leads to increased levels of SLC38A9 and mTORC1 via an increase in the expression of RagA. However, the reversal was observed with LdAAP3 mutants, reflecting the positive regulatory role of LdAAP3 on the host SLC38A9. At the molecular level, upon infection, mTORC1 and RagA were found to be activated at the surface of phagolysosomes which was found to form a complex with phagolysosomal localized SLC38A9. To reveal the relevance of SLC38A9 under physiological levels of arginine, endogenous SLC38A9 was depleted and a substantial reduction in the expression of host mTORC1, its downstream active substrate, p-P70S6K1 and parasite LdAAP3, was observed, thereby showing that silencing SLC38A9 suppresses ADR. In brief, to author’s best knowledge, these results reveal an upstream regulatory role of LdAAP3 in manipulating SLC38A9 arginine sensing in host macrophages. Our study indicates that intra-macrophage survival of L. donovani depends on the availability and transport of extracellular arginine. An understanding of the sensing pathway of both parasite and host will open a new perspective on the molecular mechanism of host-parasite interaction and consequently, as a treatment for Leishmaniasis.

Keywords: arginine sensing, LdAAP3, L. donovani, mTORC1, SLC38A9, THP-1

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Authors: L. Kashyap, S. Jha, D. Shende, V. K. Mohan, P. Khanna, A. Aravindan, S. Kashyap, L. Singh, S. Aggarwal

Abstract:

Obesity is associated with a chronic inflammatory state. During surgery, there is an interplay between anaesthetic and surgical stress vis-a-vis the already present complex immune state. Moreover, the postoperative period is dictated by inflammation, which is crucial for wound healing and regeneration. An excess of inflammatory response might hamper recovery besides increasing the risk for infection and complications. There is definite evidence of the immunosuppressive role of inhaled anaesthetic agents. This immune modulation may be brought into effect directly by influencing the innate and adaptive immunity cells. The effects of propofol on immune mechanisms in has been widely elucidated because of its popularity. It reduces superoxide generation, elastase release, and chemotaxis. However, there is no unequivocal proof of one’s superiority over the other. Hence, an anaesthetic regimen with lesser inflammatory potential and specific to the obese patient is needed. OBESITA trial protocol (2019) by Sousa and co-workers in progress aims to test the hypothesis that anaesthesia with sevoflurane results in a weaker proinflammatory response compared to propofol, as evidenced by lower IL-6 and other biomarkers and an increased macrophage differentiation into M2 phenotype in adipose tissue. IL-6 was used as the objective parameter to evaluate inflammation as it is regulated by both surgery and anesthesia. It is the most sensitive marker of the inflammatory response to tissue damage since it is released within minutes by blood leukocytes. We hypothesized that maintenance of anaesthesia with propofol would lead to less inflammation than that with desflurane. Aims: The effect of two anaesthetic techniques, total intravenous anaesthesia (TIVA) with propofol and desflurane, on surgical stress response was evaluated. The primary objective was to compare serum interleukin-6 (IL-6) levels before and after surgery. Methods: In this prospective single-blinded randomized controlled trial undertaken, 30 obese patients (BMI>30 kg/m2) undergoing laparoscopic bariatric surgery under general anaesthesia were recruited. Patients were randomized to receive desflurane or TIVA using a target-controlled infusion for maintenance of anaesthesia. As a marker of inflammation, pre-and post-surgery IL-6 levels were compared. Results: After surgery, IL-6 levels increased significantly in both groups. The rise in IL-6 was less with TIVA than with desflurane; however, it did not reach significance. IL-6 rise post-surgery correlated positively with the complexity of procedure and duration of surgery and anaesthesia, rather than anaesthetic technique. Both groups did not differ in terms of intra-operative hemodynamic and respiratory variables, time to awakening, postoperative pulmonary complications, and duration of hospital stay. The incidence of nausea was significantly higher with desflurane than with TIVA. Conclusion: Inflammatory response did not differ as a function of anaesthetic technique when propofol and desflurane were compared. Also, patient and surgical variables dictated post-operative inflammation more than the anaesthetic factors. Further, larger sample size is needed to confirm or refute these findings.

Keywords: bariatric, biomarkers, inflammation, laparoscopy

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Authors: Recep Kesli, Onur Turkyilmaz, Cengiz Demir

Abstract:

Objective: Autoimmune collagen diseases occur with the immune reactions against the body’s own cell or tissues which cause inflammation and damage the tissues and organs. In this study, it was aimed to compare seropositivity rates and patterns of the anti-nuclear antibodies (ANA) in the diagnosis of four different autoimmune collagen tissue diseases (Rheumatoid Arthritis-RA, Systemic Lupus Erythematous-SLE, Scleroderma-SSc and Sjogren Syndrome-SS) with each other. Methods: One hundred eighty-eight patients applied to different clinics in Afyon Kocatepe University ANS Practice and Research Hospital between 11.07.2014 and 14.07.2015 that thought the different collagen disease such as RA, SLE, SSc and SS have participated in the study retrospectively. All the data obtained from the patients participated in the study were evaluated according to the included criteria. The historical archives belonging to the patients have been screened, assessed in terms of ANA positivity. The obtained data was analysed by using the descriptive statistics; chi-squared, Fischer's exact test. The evaluations were performed by SPSS 20.0 version and p < 0.05 level was considered as significant. Results: Distribution rates of the totally one hundred eighty-eight patients according to the diagnosis were found as follows: 82 (43.6%) were RA, 38 (20.2%) were SLE, 22 (11.7%) were SSc, and 46 (24.5%) were SS. Distribution of ANA positivity rates according to the collagen tissue diseases were found as follows; for RA were 54 (65,9 %), for SLE were 36 (94,7 %), for SSc were 18 (81,8 %), and for SS were 43 (93,5 %). Rheumatoid arthritis should be evaluated and classified as a different class among all the other investigated three autoimmune illnesses. ANA positivity rates were found as differently higher (91.5 %) in the SLE, SSc, and SS, from the RA (65.9 %). Differences at ANA positivity rates for RA and the other three diseases were found as statistically significant (p=0.015). Conclusions: Systemic autoimmune illnesses show broad spectrum. ANA positivity was found as an important predictor marker in the diagnosis of the rheumatologic illnesses. ANA positivity should be evaluated as more valuable and sensitive a predictor diagnostic marker in the laboratory findings of the SLE, SSc, and SS according to RA.

Keywords: antinuclear antibody (ANA), rheumatoid arthritis, scleroderma, Sjogren syndrome, systemic lupus Erythemotosus

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Authors: R. Pardo, P. Menendez, MA Gil-Olarte, S. Sanchez, E. García, R. Quintana, J. Martín

Abstract:

Introduction : Within oncoplastic breast techniques there is increased interest in immediate partial breast reconstruction. The volume resected is greater than that of conventional conservative techniques. Central tumours of the breast have classically been treated with a mastectomy with regard to oncological safety and cosmetic secondary effects after wide central resection of the nipple and breast tissue beneath. Oncological results for central quadrantectomy have a recurrence level, disease- free period and survival identical to mastectomy. Grissoti flap is an oncoplastic surgical technique that allows the surgeon to perform a safe central quadrantectomy with excellent cosmetic results. Material and methods: The Grissoti flap is a glandular cutaneous advancement rotation flap that can fill the defect in the central portion of the excised breast. If the inferior border is affected by tumour and further surgery is decided upon at the Multidisciplinary Team Meeting, it will be necessary to perform a mastectomy. All patients with a Grisotti flap undergoing surgery since 2009 were reviewed obtaining the following data: age, hystopathological diagnosis, size, operating time, volume of tissue resected, postoperative admission time, re-excisions due to positive margins affected by tumour, wound dehiscence, complications and recurrence. Analysis and results of sentinel node biopsy were also obtained. Results: 12 patients underwent surgery between 2009-2015. The mean age was 54 years (34-67) . All had a preoperative diagnosis of ductal infiltrative carcinoma of less than 2 cm,. Diagnosis was made with Ultrasound, Mamography or both . Magnetic resonance was used in 5 cases. No patients had preoperative positive axilla after ultrasound exploration. Mean operating time was 104 minutes (84-130). Postoperative stay was 24 hours. Mean volume resected was 159 cc (70-286). In one patient the surgical border was affected by tumour and a further procedure with resection of the affected border was performed as ambulatory surgery. The sentinel node biopsy was positive for micrometastasis in only two cases. In one case lymphadenectomy was performed in 2009. In the other, treated in 2015, no lymphadenectomy was performed as the patient had a favourable histopathological prognosis and the multidisciplinary team meeting agreed that lymphadenectomy was not required. No recurrence has been diagnosed in any of the patients who underwent surgery and they are all disease free at present. Conclusions: Conservative surgery for retroareolar central tumours of the breast results in good local control of the disease with free surgical borders, including resection of the nipple areola complex and pectoral major muscle fascia. Reconstructive surgery with the inferior Grissoti flap adequately fills the defect after central quadrantectomy with creation of a new cutaneous disc where a new nipple areola complex is reconstructed with a local flap or micropigmentation. This avoids the need for contralateral symmetrization. Sentinel Node biopsy can be performed without added morbidity. When feasible, the Grissoti flap will avoid skin-sparing mastectomy for central breast tumours that will require the use of an expander, prosthesis or myocutaneous flap, with all the complications of a more complex operation.

Keywords: Grisotti flap, oncoplastic surgery, central tumours, breast

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Authors: Bjorn-Ole Meyer, Dominik Marti, Peter E. Andersen

Abstract:

A multimodal imaging system, combining spectrally resolved multiphoton microscopy (MPM) and optical coherence microscopy (OCM) is demonstrated. MPM and OCM are commonly integrated into multimodal imaging platforms to combine functional and morphological information. The MPM signals, such as two-photon fluorescence emission (TPFE) and signals created by second harmonic generation (SHG) are biomarkers which exhibit information on functional biological features such as the ratio of pyridine nucleotide (NAD(P)H) and flavin adenine dinucleotide (FAD) in the classification of cancerous tissue. While the spectrally resolved imaging allows for the study of biomarkers, using a spectrometer as a detector limits the imaging speed of the system significantly. To overcome those limitations, an OCM setup was added to the system, which allows for fast acquisition of structural information. Thus, after rapid imaging of larger specimens, navigation within the sample is possible. Subsequently, distinct features can be selected for further investigation using MPM. Additionally, by probing a different contrast, complementary information is obtained, and different biomarkers can be investigated. OCM images of tissue and cell samples are obtained, and distinctive features are evaluated using MPM to illustrate the benefits of the system.

Keywords: optical coherence microscopy, multiphoton microscopy, multimodal imaging, two-photon fluorescence emission

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Authors: Susana Silva, Dora Martins

Abstract:

The recent political, economic, social technological and employment changes significantly affect the tourism organizations and consequently the changing nature of the employment experience of the tourism workforce. Such scene leads several researchers and labor analysts to reflect about what kinds of jobs, knowledge and competences are need to ensure the success to teach, to learning and to work on this sector. In recent years the competency-based approach in high education level has become of significant interest. On the one hand, this approach could leads to the forming of the key students’ competences which contribute their better preparation to the professional future and on the other hand could answer better to practical demands from tourism job market. The goals of this paper are (1) to understand the expectations of university tourism students in relation to the present and future tourism competences demands, (2) to identify the importance put on the soft skills, (3) to know the importance of high qualification to their future professional activity and (4) to explore the students perception about present and future tourist sector specificities. To this proposal, a questionnaire was designed and distributed to every students who participate on classes of Hospitality Management under degree and master from one public Portuguese university. All participants were invited, during December 2014 and September 2015, to answer the questionnaire at the moment and on presence of one researcher of this study. Fulfilled the questionnaire 202 students (72, 35,6% male and 130, 64.4% female), the mean age was 21,64 (SD=5,27), 91% (n=86) were undergraduate and 18 (9%) were master students. 80% (n=162) of our participants refers as a possibility to look for a job outside the country.42% (n=85) prefers to work in a medium-sized tourism units (with 50-249 employees). According to our participants the most valued skills in tourism are the domain of foreign languages (87.6%, n=177), the ability to work as a team (85%), the personal persistence (83%, n=168), the knowledge of the product/services provided (73.8%, n=149), and assertiveness (66.3%, n=134). 65% (n=131) refers the availability to look for a job in a home distance of 1000 kilometers and 59% (n=119) do not consider the possibility to work in another area than tourism. From the results of this study we are in the position of confirming the need for universities to maintain a better link with the professional tourism companies and to rethink some competences into their learning course model. Based on our results students, universities and companies could understand more deeply the motivations, expectations and competences need to build the future career who study and work on the tourism sector.

Keywords: human capital, employability, students’ competencies perceptions, soft skills, tourism

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Authors: Wei-Wen Hu, Yong-Zhi Zhong

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Depositing conductive polypyrrole (PPy) onto elastic polydimethylsiloxane (PDMS) substrate can obtain a highly stretchable conductive film, which can be used to construct a bioreactor to cyclically stretch and electrically stimulate surface cells. However, how to completely harvest these stimulated muscle tissue to repair damaged muscle is a challenge. To address this concern, N-isopropylacrylamide (NIPAAm), a monomer of temperature-sensitive polymer, was added during the polymerization of pyrrole on PDMS so that the resulting P(Py-co-NIPAAm)/PDMS should own both conductivity and thermo-sensitivity. Therefore, cells after stimulation can be completely harvested as cell sheets by reducing temperature. Mouse skeletal myoblast, C2C12 cells, were applied to examine our hypothesis. In electrical stimulation, C2C12 cells on P(Py-co-NIPAAm)/PDMS demonstrated the best myo-differentiation under the electric field of 1 V/cm. Regarding cyclic stretching, the strain equal to or higher than 9% can highly align C2C12 perpendicular to the stretching direction. The Western blotting experiments demonstrated that the cell sheets harvested by cooling reserved more extracellular matrix (ECM) than cells collected by the traditional trypsin digestion method. Immunostaining of myosin heavy chain protein (MHC) indicated that both mechanical and electrical stimuli effectively increased the number of myotubes and the differentiation ratio, and the myotubes can be aligned by cyclic stretching. Stimulated cell sheets can be harvested by cooling, and the alignment of myotubes was still maintained. These results suggested that the deposition of P(Py-co-NIPAAm) on PDMS can be applied to harvest intact cell sheets after cyclic stretching and electrical stimulation, which increased the feasibility of bioreactor for the application of tissue engineering and regenerative medicine.

Keywords: bioreactor, cell sheet, conductive polymer, cyclic stretching, electrical stimulation, muscle tissue engineering, myogenesis, thermosensitive hydrophobicity

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Authors: Le Jiang, Chua Jinxing

Abstract:

Introduction: The recent outbreak of Ebola virus disease in the west Africa has drawn global concern. With a high fatality rate and direct human-to-human transmission, it has spread between countries and caused great damages for patients and family who are affected. Being the designated hospital to manage epidemic outbreak in Singapore, Tan Tock Seng Hospital (TTSH) is facing great challenges in preparation and managing of potential outbreak of emerging infectious disease such as Ebola virus disease. Aim: We conducted an infection control drill in TTSH emergency department to assess the readiness of healthcare and allied health workers in managing suspected Ebola patients. It also helps to review current Ebola clinical protocol and work instruction to ensure more smooth and safe practice in managing Ebola patients in TTSH emergency department. Result: General preparedness level of staffs involved in managing Ebola virus disease in TTSH emergency department is not adequate. Knowledge deficits of staffs on Ebola personal protective equipment gowning and degowning process increase the risk of potential cross contamination in patient care. Loopholes are also found in current clinical protocol, such as unclear instructions and inaccurate information, which need to be revised to promote better staff performance in patient management. Logistic issues such as equipment dysfunction and inadequate supplies can lead to ineffective communication among teams and causing harm to patients in emergency situation. Conclusion: The infection control drill identified the need for more well-structured and clear clinical protocols to be in place to promote participants performance. In addition to quality protocols and guidelines, systemic training and annual refresher for all staffs in the emergency department are essential to prepare staffs for the outbreak of Ebola virus disease. Collaboration and communication with allied health staffs are also crucial for smooth delivery of patient care and minimising the potential human suffering, properties loss or injuries caused by disease. Therefore, more clinical drills with collaboration among various departments involved are recommended to be conducted in the future to monitor and assess readiness of TTSH emergency department in managing Ebola virus disease.

Keywords: ebola, emergency department, infection control drill, Tan Tock Seng Hospital

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Authors: Amirul Adlan, Robert A McCulloch, Neil Jenkins, MIchael Parry, Jonathan Stevenson, Lee Jeys

Abstract:

Background and Objectives: The current antibiotic prophylaxis for oncological patients is based upon evidence from primary arthroplasty despite significant differences in both patient group and procedure. The aim of this study was to compare the microbiology organisms responsible for PJI in patients who underwent two-stage revision for infected primary knee replacement with those of infected oncological endoprostheses of the lower limb in a single institution. This will subsequently guide decision making regarding antibiotic prophylaxis at primary implantation for oncological procedures and empirical antibiotics for infected revision procedures (where the infecting organism(s) are unknown). Patient and Methods: 118 patients were treated with two-stage revision surgery for infected knee arthroplasty and lower limb endoprostheses between 1999 and 2019. 74 patients had two-stage revision for PJI of knee arthroplasty, and 44 had two-stage revision of lower limb endoprostheses. There were 68 males and 50 females. The mean age for the knee arthroplasty cohort and lower limb endoprostheses cohort were 70.2 years (50-89) and 36.1 years (12-78), respectively (p<0.01). Patient host and extremity criteria were categorised according to the MSIS Host and Extremity Staging System. Patient microbiological culture, the incidence of polymicrobial infection and multi-drug resistance (MDR) were analysed and recorded. Results: Polymicrobial infection was reported in 16% (12 patients) from knee arthroplasty PJI and 14.5% (8 patients) in endoprostheses PJI (p=0.783). There was a significantly higher incidence of MDR in endoprostheses PJI, isolated in 36.4% of cultures, compared to knee arthroplasty PJI (17.2%) (p=0.01). Gram-positive organisms were isolated in more than 80% of cultures from both cohorts. Coagulase-negative Staphylococcus (CoNS) was the commonest gram-positive organism, and Escherichia coli was the commonest Gram-negative organism in both groups. According to the MSIS staging system, the host and extremity grade of knee arthroplasty PJI cohort were significantly better than endoprostheses PJI(p<0.05). Conclusion: Empirical antibiotic management of PJI in orthopaedic oncology is based upon PJI in arthroplasty despite differences in both host and microbiology. Our results show a significant increase in MDR pathogens within the oncological group despite CoNS being the most common infective organism in both groups. Endoprosthetic patients presented with poorer host and extremity criteria. These factors should be considered when managing this complex patient group, emphasising the importance of broad-spectrum antibiotic prophylaxis and preoperative sampling to ensure appropriate perioperative antibiotic cover.

Keywords: microbiology, periprosthetic Joint infection, knee arthroplasty, endoprostheses

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Authors: M. Yadegari, M. Nourbakhsh, N. Arbabzadeh

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The skeletal system injuries are of major importance. In addition, it is recommended to use materials for hard tissue repair in open or closed fractures. It is important to use complex minerals with a beneficial effect on hard tissue repair, stimulating cell growth in the bone. Materials that could help avoid bone fracture inflammatory reaction and speed up bone fracture repair are of utmost importance in the treatment of bone fractures. Similar to minerals, the inner eggshell membrane consists of carbohydrates, lipids, proteins with the high pH, high calcium absorptive capacity and with faster bone fracture repair ability. In the present radiographic survey, eggshell-derived bone graft substitutes were used for bone defect repair in 8 dog tibia, measuring bone density on the day of implant placement and 30 and 60 days after placement. In fact, the result of this study shows the difference in bone growth and misshapen bones between treatment and control sites. Cell growth was adequate in treatment sites and misshapen bones were less frequent here than in control sites.

Keywords: bone repair, eggshell powder, implant, radiography

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