Search results for: drinking water treatment plants

Authors: Rafiqul Hasan, A. S. M. Tanim Anwar, Mohammad Azizul Hakim

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Background: Chronic kidney disease (CKD) is a major public health problem that continues to increase in prevalence globally. The prevalence of chronic kidney disease is increasing day by day in low to middle income countries (LMICs). People living in LMICs have the highest need for renal replacement therapy (RRT) despite they have lowest access to various modalities of treatment. As continuous ambulatory peritoneal dialysis (CAPD) does not require advanced technologies, very much infrastructure, dialysis staff support, it should be an ideal form of RRT in LMICs, particularly for those living in remote areas. To authors knowledge there was scarcity of data regarding CAPD performance in remote area of Bangladesh. This study was aimed to report the characteristics and outcomes of CAPD in ESRD patients lived in least developed area of Bangladesh. Methods: This prospective study was conducted in Cox’sbazar Medical College Hospital, Cox’sbazar and Parkview hospital Ltd, Chattogram, Bangladesh. Data were collected by questionnaire from the patients of any age with end-stage renal disease (ESRD) who underwent CAPD in 2018–2021. The baseline characteristics, PD-related complication as well as patient and technique survivals were analyzed. Results: Out of 31 patients who underwent CAPD, 18 (58%) were male on the age range of 15–79 years. The mean follow-up duration was 18 months. Mortality was inversely related with the EF of echocardiography. The peritonitis rate was 0.48 episodes per patient per year. The 1, 3 and 4-year patient survival rates were 64.34% (95% CI = 52.5–81.5), 23.79% (95% CI = 17.9 – 57.4) and 3.22% (95% CI = 31.2–77.5) respectively. Conclusions: In this study, CAPD performance was poorer than usual reference. Cardiac compromised patient and inappropriate dwell might be the main contributing factors behind this scenario. The peritonitis rate was nearly similar to that of developed countries. CAPD was cost effective than HD in remote area. Some accessible measures may be taken to make CAPD a more acceptable RRT modality with improved outcomes in poor socioeconomic backgrounds.

Keywords: dialysis cost, peritoneal dialysis, peritonitis, CAPD, least developed area, remote area, Bangladesh

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Authors: Sisay Negash, Zebene Asfaw, Kibreselassie Daniel, Michael Zech

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A significant portion of the Ethiopian landscape features scattered trees that are deliberately managed in crop fields to enhance soil fertility and crop yield in which the compatibility of crops with these trees varies depending on location, tree species, and annual crop type. This study aimed to examine the effects of scattered Vachellia tortilis and Vachellia nilotica trees on selected physico-chemical properties of the soil, as well as the yield and yield components of sorghum in Ethiopia. Vachellia tortilis and Vachellia nilotica were selected on abundance occurrence and managed in crop fields. A randomized complete block design was used, with a distance from the tree canopy (middle, edge, and outside) as a treatment, and five trees of each species served as replications. Sorghum was planted up to 15 meters in the east, west, south, and north directions from the tree trunk to assess growth and yield. Soil samples were collected from the two tree species, three distance factors, three soil depths(0-20cm, 20-40cm, and 40-60cm), and five replications, totaling 45 samples for each tree species. These samples were analyzed for physical and chemical properties. The results indicated that both V. tortilis and V. nilotica significantly affected soil physico-chemical properties and sorghum yield. Specifically, soil moisture content, EC, total nitrogen, organic carbon, available phosphorus and potassium, CEC, sorghum plant height, panicle length, biomass, and yield decreased with increasing distance from the canopy. Conversely, bulk density and pH increased. Under the canopy, sorghum yield increased by 66.4% and 53.5% for V. tortilis and V. nilotica, respectively, due to higher soil moisture and nutrient availability. The study recommends promoting trees in crop fields, management options for new saplings, and further research on root decomposition and nutrient supply.

Keywords: canopy, crop yield, soil nutrient, soil organic matter, yield components

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Authors: D. A. S. Gamage, B. F. A. Basnayake, W. A. J. M. De Costa

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Agriculture plays an important and strategic role in the performance of Sri Lankan national economy. Rice is the staple food of Sri Lankans thus; rice cultivation is the major agricultural activity of the country. In Sri Lanka, out of the total rice production, a considerable amount of rice straw and rice husk goes wasted. Hence, there is a great potential of production of quality compost and rice husk charcoal. The concept of making rice straw compost and rice husk charcoal is practicable in Sri Lanka, where more than 40% of the farmers are engaged in rice cultivation. The application of inorganic nitrogen fertilizer has become a burden to the country. Rice husk charcoal as a coating material to retain N fertilizer is a suitable solution to gradually release nitrogenous compounds. Objective of this study was to produce rice husk charcoal coated urea as a slow releasing fertilizer with rice straw compost and to compare the leaching losses of nitrogen, phosphorus and potassium using leaching columns. Leaching column studies were prepared using 1.2 m tall PVC pipes with a diameter of 15 cm and a sampling port was attached to the bottom end of the column-cap. Leachates (100 ml/leaching column) were obtained from two sets of (each set has four leaching columns) leaching columns. The sampling was done once a week for 3 month period. Rice husk charcoal coated urea can potentially be used as a slow releasing nitrogen fertilizer which reduces leaching losses of urea. It also helps reduce the phosphate and potassium leaching. The cyclic effect of phosphate release is an important finding which could be the central issue in defining microbial behavior in soils. The fluctuations of phosphate may have cyclic effects of 28 days. In addition, rice straw compost and rice husk charcoal coating is less costly and contribute to mitigate pollution of water bodies by inorganic fertilizers.

Keywords: leaching, mitigate, rice husk charcoal, slow releasing fertilizer

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Authors: Nadwah Onwi, Puspa Maniam, Azmawanie A. Aziz, Fairus Mukhtar, Nor Azrita Mohamed Zin, Nurul Haslina Mohd Zin, Nurul Fatehah Ismail, Mohamad Safwan Yusoff, Susilidianamanalu Abd Rahman, Siti Munirah Harris, Maryam Aizuddin

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Objective: Malaysia has a growing number of individuals with complex communication needs (CCN). The initiation of augmentative and alternative communication (AAC) intervention may facilitate individuals with CCN to understand and express themselves optimally and actively participate in activities in their daily life. AAC is defined as multimodal use of communication ability to allow individuals to use every mode possible to communicate with others using a set of symbols or systems that may include the symbols, aids, techniques, and strategies. It is consequently critical to evaluate the deficits to inform treatment for AAC intervention. However, no known measurement tools are available to evaluate the user with CCN available locally. Design: A systematic review (SR) is designed to analyze the psychometric properties of AAC assessment for adolescents with CCN published in peer-reviewed journals. Tools are rated by the methodological quality of studies and the psychometric measurement qualities of each tool. Method: A literature search identifying AAC assessment tools with psychometrically robust properties and conceptual framework was considered. Two independent reviewers screened the abstracts and full-text articles and review bibliographies for further references. Data were extracted using standardized forms and study risk of bias was assessed. Result: The review highlights the psychometric properties of AAC assessment tools that can be used by speech-language therapists applicable to be used in the Malaysian context. The work outlines how systematic review methods may be applied to the consideration of published material that provides valuable data to initiate the development of Malay Language AAC assessment tools. Conclusion: The synthesis of evidence has provided a framework for Malaysia Speech-Language therapists in making an informed decision for AAC intervention in our standard operating procedure in the Ministry of Health, Malaysia.

Keywords: augmentative and alternative communication, assessment, adolescents, complex communication needs

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Authors: Tom Nakotte, Hongmei Luo

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Lead chalcogenide-based (PbS, PbSe, and PbTe) quantum dots (QDs) were synthesized for the purpose of implementing them in radiation detectors. Pb based materials have long been of interest for gamma and x-ray detection due to its high absorption cross section and Z number. The emphasis of the studies was on exploring how to control charge carrier transport within thin films containing the QDs. The properties of QDs itself can be altered by changing the size, shape, composition, and surface chemistry of the dots, while the properties of carrier transport within QD films are affected by post-deposition treatment of the films. The QDs were synthesized using colloidal synthesis methods and films were grown using multiple film coating techniques, such as spin coating and doctor blading. Current QD radiation detectors are based on the QD acting as fluorophores in a scintillation detector. Here the viability of using QDs in solid-state radiation detectors, for which the incident detectable radiation causes a direct electronic response within the QD film is explored. Achieving high sensitivity and accurate energy quantification in QD radiation detectors requires a large carrier mobility and diffusion lengths in the QD films. Pb chalcogenides-based QDs were synthesized with both traditional oleic acid ligands as well as more weakly binding oleylamine ligands, allowing for in-solution ligand exchange making the deposition of thick films in a single step possible. The PbS and PbSe QDs showed better air stability than PbTe. After precipitation the QDs passivated with the shorter ligand are dispersed in 2,6-difloupyridine resulting in colloidal solutions with concentrations anywhere from 10-100 mg/mL for film processing applications, More concentrated colloidal solutions produce thicker films during spin-coating, while an extremely concentrated solution (100 mg/mL) can be used to produce several micrometer thick films using doctor blading. Film thicknesses of micrometer or even millimeters are needed for radiation detector for high-energy gamma rays, which are of interest for astrophysics or nuclear security, in order to provide sufficient stopping power.

Keywords: colloidal synthesis, lead chalcogenide, radiation detectors, quantum dots

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Authors: Adam M. Pitz, Gillian L. Phillipson, Jayant E. Khanolkar, Andrew M. Middleton

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New emerging evidence suggests that the nose is the predominant route for entry of the SARS-CoV-2 virus into the host. A virucidal suspension test (conforming in principle to the European Standard EN14476) was conducted to determine whether a commercial liquid gel intranasal spray containing 1% of the mucoadhesive hydroxypropyl methylcellulose (HPMC) could inhibit the cellular infectivity of the SARS-CoV-2 coronavirus. Virus was added to the test product samples and to controls in a 1:8 ratio and mixed with one part bovine serum albumin as an interfering substance. The test samples were pre-equilibrated to 34 ± 2°C (representing the temperature of the nasopharynx) with the temperature maintained at 34 ± 2°C for virus contact times of 1, 5 and 10 minutes. Neutralized aliquots were inoculated onto host cells (Vero E6 cells, ATCC CRL-1586). The host cells were then incubated at 36 ± 2°C for a period of 7 days. The residual infectious virus in both test and controls was detected by viral-induced cytopathic effect. The 50% tissue culture infective dose per mL (TCID50/mL) was determined using the Spearman-Karber method with results reported as the reduction of the virus titer due to treatment with test product, expressed as log10. The controls confirmed the validity of the results with no cytotoxicity or viral interference observed in the neutralized test product samples. The HPMC formulation reduced SARS-CoV-2 titer, expressed as log10TCID50, by 2.30 ( ± 0.17), 2.60 ( ± 0.19), and 3.88 ( ± 0.19) with the respective contact times of 1, 5 and 10 minutes. The results demonstrate that this 1% HPMC gel formulation can reduce the cellular infectivity of the SARS-CoV-2 virus with an increasing viral inhibition observed with increasing exposure time. This 1% HMPC gel is well tolerated and can reside, when delivered via nasal spray, for up to one hour in the nasal cavity. We conclude that this intranasal gel spray with 1% HPMC repeat-dosed every few hours may offer an effective preventive or early intervention solution to limit the transmission and impact of the SARS-CoV-2 coronavirus.

Keywords: hydroxypropyl methylcellulose, mucoadhesive nasal spray, respiratory viruses, SARS-CoV-2

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Authors: Farah Naja, Mohamad Alameddine

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Background: The difficulty of compliance to therapeutic and lifestyle management of type 2 diabetes mellitus (T2DM) encourages patients to use complementary and alternative medicine (CAM) therapies. Little is known about the prevalence and mode of CAM use among diabetics in the Eastern Mediterranean Region in general and Lebanon in particular. Objective: To assess the prevalence and modes of CAM use among patients with T2DM residing in Beirut, Lebanon. Methods: A cross-sectional survey of T2DM patients was conducted on patients recruited from two major referral centers - a public hospital and a private academic medical center in Beirut. In a face-to-face interview, participants completed a survey questionnaire comprised of three sections: socio-demographic, diabetes characteristics and types and modes of CAM use. Descriptive statistics, univariate and multivariate logistic regression analyses were utilized to assess the prevalence, mode and correlates of CAM use in the study population. The main outcome in this study (CAM use) was defined as using CAM at least once since diagnosis with T2DM. Results: A total of 333 T2DM patients completed the survey (response rate: 94.6%). Prevalence of CAM use in the study population was 38%, 95% CI (33.1-43.5). After adjustment, CAM use was significantly associated with a “married” status, a longer duration of T2DM, the presence of disease complications, and a positive family history of the disease. Folk foods and herbs were the most commonly used CAM followed by natural health products. One in five patients used CAM as an alternative to conventional treatment. Only 7 % of CAM users disclosed the CAM use to their treating physician. Health care practitioners were the least cited (7%) as influencing the choice of CAM among users. Conclusion: The use of CAM therapies among T2DM patients in Lebanon is prevalent. Decision makers and care providers must fully understand the potential risks and benefits of CAM therapies to appropriately advise their patients. Attention must be dedicated to educating T2DM patients on the importance of disclosing CAM use to their physicians especially patients with a family history of diabetes, and those using conventional therapy for a long time.

Keywords: nutritional supplements, type 2 diabetes mellitus, complementary and alternative medicine (CAM), conventional therapy

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Authors: Breanna Macumber, Victor A. Huayamave, Emir A. Vela, Wangdo Kim, Tamara T. Chamber, Esteban Centeno

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Spina bifida is a type of neural tube defect that affects the nervous system and can lead to problems such as total leg paralysis. Treatment requires physical therapy and rehabilitation. Robotic exoskeletons have been used for rehabilitation to train muscle movement and assist in injury recovery; however, current models focus on the adult populations and not on the infant population. The proposed framework aims to couple a musculoskeletal infant model with a robotic exoskeleton using vacuum-powered artificial muscles to provide rehabilitation to infants affected by spina bifida. The study that drove the input values for the robotic exoskeleton used motion capture technology to collect data from the spontaneous kicking movement of a 2.4-month-old infant lying supine. OpenSim was used to develop the musculoskeletal model, and Inverse kinematics was used to estimate hip joint angles. A total of 4 kicks (A, B, C, D) were selected, and the selection was based on range, transient response, and stable response. Kicks had at least 5° of range of motion with a smooth transient response and a stable period. The robotic exoskeleton used a Vacuum-Powered Artificial Muscle (VPAM) the structure comprised of cells that were clipped in a collapsed state and unclipped when desired to simulate infant’s age. The artificial muscle works with vacuum pressure. When air is removed, the muscle contracts and when air is added, the muscle relaxes. Bench testing was performed using a 6-month-old infant mannequin. The previously developed exoskeleton worked really well with controlled ranges of motion and frequencies, which are typical of rehabilitation protocols for infants suffering with spina bifida. However, the random kicking motion in this study contained high frequency kicks and was not able to accurately replicate all the investigated kicks. Kick 'A' had a greater error when compared to the other kicks. This study has the potential to advance the infant rehabilitation field.

Keywords: musculoskeletal modeling, soft robotics, rehabilitation, pediatrics

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Authors: Aisha Khodijah Kholib Jati, Suharni Mohamad, Azlan Husin, Wan Suriana Wan Ab Rahman

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Introduction: Toxoplasmosis is caused by an obligate intracellular parasite, Toxoplasma gondii (T. gondii). It is commonly asymptomatic in normal individual, but it can be fatal to immunocompromised patients as it can lead to severe complications such as encephalitis, chorioetinitis and myocarditis. Objective: The aim of the study was to determine the seroprevalence of toxoplasmosis and its association with socio-demographic and behavioral characteristics among hemato-oncology patients in Hospital USM. Methods: In this cross-sectional study, 56 hemato-oncology patients were screened for immunoglobulin M (IgM) antibodies, immunoglobulin G (IgG) antibodies, and IgG avidity of T. gondii by using ELISA Kit (BioRad, USA). For anti-T. gondii IgG antibody, titer ≥ 9 IU/ml was considered as recent infection, while for IgM, ratio ≥ 1.00 was considered as reactive for the anti-T. gondii IgM antibodies. Low avidity index is considered as recent infection within 20 weeks while high avidity considered as past infection. T. gondii exposure, socio-demographic and behavioral characteristics was assessed by a questionnaire and interview. Results: A total of 28 (50.0%) hemato-oncology patients were seropositive for T. gondii antibodies. Out of that total, 27 (48.21%) patients were IgG+/IgM- and one patient (1.79%) was IgG+/IgM+ with high avidity index. Univariate analysis showed that age, gender, ethnicity, marital status, educational level, employment status, stem cell transplant, blood transfusion, close contact with cats, water supply, and consumption of undercooked meat were not significantly associated with Toxoplasma seropositivity rate. Discussion: The seropositivity rate of IgG anti-T. gondii was high among hemato-oncology patients in Hospital USM. With impaired immune system, these patients might have a severe consequence if the infection reactivated. Therefore, screening for anti-T. gondii may be considered in the future. Moreover, health programme towards healthy food and good hygiene practice need to be implemented.

Keywords: immunocompromised, seroprevalence, socio-demographic, toxoplasmosis

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Authors: Swarkar Sharma, Ekta Rai, Ankit Mahajan, Parvinder Kumar, Manoj K Dhar, Sushil Razdan, Kumarasamy Thangaraj, Carol Wise, Shiro Ikegawa M.D., K.K. Pandita M.D.

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Rare disorders are poorly understood hence, remain uncharacterized or patients are misdiagnosed and get poor medical attention. A rare mysterious skeletal disorder that remained unidentified for decades and rendered many people physically challenged and disabled for life has been reported in an isolated remote village ‘Arai’ of Poonch district of Jammu and Kashmir. This village is located deep in mountains and the population residing in the region is highly consanguineous. In our survey of the region, 70 affected people were reported, showing similar phenotype, in the village with a population of approximately 5000 individuals. We were able to collect samples from two multi generational extended families from the village. Through Whole Exome sequencing (WES), we identified a rare variation NM_003880.3:c.156C>A NP_003871.1:p.Cys52Ter, which results in introduction of premature stop codon in WISP3 gene. We found this variation perfectly segregating with the disease in one of the family. However, this variation was absent in other family. Interestingly, a novel splice site mutation at position c.643+1G>A of WISP3 gene, perfectly segregating with the disease was observed in the second family. Thus, exploiting WES and putting different evidences together (familial histories and genetic data, clinical features, radiological and biochemical tests and findings), the disease has finally been diagnosed as a very rare recessive hereditary skeletal disease “Progressive Pseudorheumatoid Arthropathy of Childhood” (PPAC) also known as “Spondyloepiphyseal Dysplasia Tarda with Progressive Arthropathy” (SEDT-PA). This genetic characterization and identification of the disease causing mutations will aid in genetic counseling, critically required to curb this rare disorder and to prevent its appearance in future generations in the population. Further, understanding of the role of WISP3 gene the biological pathways should help in developing treatment for the disorder.

Keywords: whole exome sequencing, Next Generation Sequencing, rare disorders

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Authors: Florence Awde

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In 2023, it was expected 350 parents in Arizona would have a child receive a cancer diagnosis (Welcome Arizona Cancer Foundation For Children, n.d.). The news of a child’s diagnosis with cancer can be overwhelming and confusing, especially for those lucky enough to lack a personal tie to the disease that takes approximately 1800 children’s lives each year in the United States (Deegan et al., n.d.). A parent’s beliefs, attitudes, and understandings surrounding cancer are vital for medical staff to provide adequate and culturally competent care for each patient, especially across cultural and ethnic lines in regions housing multicultural populations. Arizona's cultural/linguistic mosaic houses many White and Latino populations and English and Spanish speakers. Variations in insurance coverage, from those insured through public insurance programs (e.g., Medicaid) or private insurance plans (e.g., employee-sponsored insurance) versus those uninsured, also factor into health-seeking attitudes and behaviors. To further understand parental attitudes, understandings, and beliefs towards childhood cancer, 22 parents (11 of Latino ethnicity, 11 of White ethnicity) were interviewed on these facets of childhood cancer, despite 21 of the 22 never having a child receive a cancer diagnosis. The exploration of these perceptions across ethnic lines revealed a higher report of fear-orientated beliefs amongst Latino parents--hypothesized to be rooted in the starkly contrasting lack of belief in the possibility of recovering for children with cancer, compared to their white counterparts who displayed more optimism in the recovery process. Further, this study’s results lay the foundation for future scholarship to explore avenues of information dispersal to Latino parents that correct misconceptions of health outcomes and enable earlier intervention to be possible, ultimately correlating to better health and treatment outcomes by increasing parental health literacy rates for childhood cancer in the Phoenix Metropolitan.

Keywords: Childhood Cancer, Parental Beliefs, Parental Attitudes, Parental Understandings, Phoenix Metropolitan, Culturally Competent Care, Health Disparities, Health Inequities

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Authors: Wicleffe Musingarimi

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Currently, the rising energy demand as a result of an increase in the world’s population and the sustainable use of abundant natural resources are key issues facing many developed and developing countries including South Africa. Most of the energy to meet this growing demand comes from fossil fuel. Use of fossil fuels has led to environmental problems such air pollution, climate change, and acid rain. In addition, fossil fuels are facing continual depletion, which has led to the rise in oil prices, leading to the global economies melt down. Hence development of alternative clean and renewable energy source is a global priority. Renewable biomass from forest products, agricultural crops, and residues, as well as animal and municipal waste are promising alternatives. South Africa is one of the leading wine producers in the world; leading to a lot of winery waste (ww) being produced which can be used in anaerobic digestion (AD) to produce biogas. Biogas was produced from batch anaerobic digestion of zebra manure (zm) and batch anaerobic co-digestion of winery waste (ww) and zebra manure through water displacement. The batch digester with slurry of winery waste and zebra manure in the weight ratio of 1:2 was operated in a 1L container at 37°C for 30days. Co-digestion of winery waste and zebra manure produced higher amount of biogas as compared to zebra manure alone and winery waste alone. No biogas was produced by batch anaerobic digestion of winery waste alone. Chemical analysis of C/N ratio and total solids (TS) of zebra manure was 21.89 and 25.2 respectively. These values of C/N ratio and TS were quite high compared to values of other studied manures. Zebra manure also revealed unusually high concentration of Fe reaching 3600pm compared to other studies of manure. PCR with communal DNA of the digestate gave a positive hit for the presence of archaea species using standard archea primers; suggesting the presence of methanogens. Methanogens are key microbes in the production of biogas. Therefore, this study demonstrated the potential of zebra manure as an inoculum in the production of biogas.

Keywords: anaerobic digestion, biogas, co-digestion, methanogens

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Authors: Umamaheswari Shanmugam, Silvia Ronchi

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Software, artificial intelligence, and machine learning can improve healthcare through innovative and advanced technologies that can use the large amount and variety of data generated during healthcare services every day; one of the significant advantages of these new technologies is the ability to get experience and knowledge from real-world use and to improve their performance continuously. Healthcare systems and institutions can significantly benefit because the use of advanced technologies improves the efficiency and efficacy of healthcare. Software-defined as a medical device, is stand-alone software that is intended to be used for patients for one or more of these specific medical intended uses: - diagnosis, prevention, monitoring, prediction, prognosis, treatment or alleviation of a disease, any other health conditions, replacing or modifying any part of a physiological or pathological process–manage the received information from in vitro specimens derived from the human samples (body) and without principal main action of its principal intended use by pharmacological, immunological or metabolic definition. Software qualified as medical devices must comply with the general safety and performance requirements applicable to medical devices. These requirements are necessary to ensure high performance and quality and protect patients' safety. The evolution and the continuous improvement of software used in healthcare must consider the increase in regulatory requirements, which are becoming more complex in each market. The gap between these advanced technologies and the new regulations is the biggest challenge for medical device manufacturers. Regulatory requirements can be considered a market barrier, as they can delay or obstacle the device's approval. Still, they are necessary to ensure performance, quality, and safety. At the same time, they can be a business opportunity if the manufacturer can define the appropriate regulatory strategy in advance. The abstract will provide an overview of the current regulatory framework, the evolution of the international requirements, and the standards applicable to medical device software in the potential market all over the world.

Keywords: artificial intelligence, machine learning, SaMD, regulatory, clinical evaluation, classification, international requirements, MDR, 510k, PMA, IMDRF, cyber security, health care systems

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Authors: Dusittorn Ngamying

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This investigation of Mon Dance is focused on using in Pathum Thani Province’s tradition and has the following objectives: 1) to study the background of Mon dance in Pathum Thani Province; 2) to study Mon dance in Pathum Thani Province; 3) to study of using Mon Dance in Pathum Thani province’s tradition. This qualitative research was conducted in Pathum Thani provinces (the central of Thailand). Data was collected from a documentary study and field data by means of observation, interview and group discussion. Workshops were also held with a total of 100 attendees, comprised of 20 key informants, 40 casual informants and 40 general informants. Data was validated using a triangulation technique and findings are presented using descriptive analysis. The results of the studied showed that the historical background of Mon dance in Pathum Thani Province initiated during the war evacuation from Martaban (south of Burma) to settle down in Sam Khok, Pathum Thani Province in Ayutthaya period to Rattanakosin. The study found that Mon dance typically consists of 12 dancing process. The melodies have 12 songs. Piphat Mon (Mon traditional music ensemble) was used in the performance. The costume was dressed on Mon traditional. The performers were 6-12 women and depending on the employer’s demands. Length of the performance varied from the duration of music orchestration. Rituals and Customs were paying homage to teachers before the performance. The offerings were composed of flowers, incense sticks, candles, money gifts which were well arranged on a tray with pedestal, and also liquors, tobaccos and pure water for asking propitiousness. To using Mon Dance in Pathum Thani Province’s tradition, was found that it commonly performed in the funeral ceremonial tradition at present because the physical postures of the performance were graceful and exquisite as approved conservative. In addition, the value since the ancient time had believed that Mon Dance was the sacred thing considered as the dignity glorification especially for funeral ceremonies of the priest or royal hierarchy classes. However, Mon dance was continued to use in the traditions associated with Mon people activities in Pathum Thani Province, for instance, customary welcome for honor guest and Songkran Festival.

Keywords: Mon dance, Pathum Tani Province, tradition, triangulation technique

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Authors: Laura Vitola, Diana Bajare, Genadijs Sahmenko, Girts Bumanis

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About 8 % of CO2 emission in the world is produced by concrete industry therefore replacement of cement in concrete composition by additives with pozzolanic activity would give a significant impact on the environment. Material which contains silica SiO2 or amorphous silica SiO2 together with aluminum dioxide Al2O3 is called pozzolana type additives in the concrete industry. Pozzolana additives are possible to obtain from recycling industry and different production by-products such as processed bulb boric silicate (DRL type) and lead (LB type) glass, coal combustion bottom ash, utilized brick pieces and biomass ash, thus solving utilization problem which is so important in the world, as well as practically using materials which previously were considered as unusable. In the literature, there is no summarized method which could be used for quick waste-product pozzolana activity evaluation without the performance of wide researches related to the production of innumerable concrete contents and samples in the literature. Besides it is important to understand which parameters should be predicted to characterize the efficiency of waste-products. Simple methods of pozzolana activity increase for different types of waste-products are also determined. The aim of this study is to evaluate effectiveness of the different types of waste materials and industrial by-products (coal combustion bottom ash, biomass ash, waste glass, waste kaolin and calcined illite clays), and determine which parameters have the greatest impact on pozzolanic activity. By using materials, which previously were considered as unusable and landfilled, in concrete industry basic utilization problems will be partially solved. The optimal methods for treatment of waste materials and industrial by–products were detected with the purpose to increase their pozzolanic activity and produce substitutes for cement in the concrete industry. Usage of mentioned pozzolanic allows us to replace of necessary cement amount till 20% without reducing the compressive strength of concrete.

Keywords: cement substitutes, micro and nano fillers, pozzolanic properties, specific surface area, particle size, waste products

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Authors: Jin-Hyeong Park, Hong-Seok Kim, Jin-Hyeok Yim, Young-Ji Kim, Dong-Hyeon Kim, Jung-Whan Chon, Kun-Ho Seo

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Salmonella contamination in chicken samples can cause major health problems in humans. However, not only the effects of antibiotic treatment during growth but also the impacts of poultry slaughter line on the prevalence of Salmonella in final chicken meat sold to consumers are unknown. In this study, we compared the isolation rates and antimicrobial resistance of Salmonella between antibiotic-free, conventional, conventional Korean native retail chicken meat samples and clonal divergence of Salmonella isolates by multilocus sequence typing. In addition, the distribution of extended-spectrum β-lactamase (ESBL) genes in ESBL-producing Salmonella isolates was analyzed. A total of 72 retail chicken meat samples (n = 24 antibiotic-free broiler [AFB] chickens, n = 24 conventional broiler [CB] chickens, and n = 24 conventional Korean native [CK] chickens) were collected from local retail markets in Seoul, South Korea. The isolation rates of Salmonella were 66.6% in AFB chickens, 45.8% in CB chickens, and 25% in CK chickens. By analyzing the minimum inhibitory concentrations of β -lactam antibiotics with the disc-diffusion test, we found that 81.2% of Salmonella isolates from AFB chickens, 63.6% of isolates from CB chickens, and 50% of isolates from CK chickens were ESBL producers; all ESBL-positive isolates had the CTX-M-15 genotype. Interestingly, all ESBL-producing Salmonella were revealed as ST16 by multilocus sequence typing. In addition, all CTX-M-15-positive isolates had the genetic platform of blaCTX-M gene (IS26-ISEcp1-blaCTX-M-15-IS903), to the best of our knowledge, this is the first report in Salmonella around the world. The Salmonella ST33 strain (S. Hadar) isolated in this study has never been reported in South Korea. In conclusion, our findings showed that antibiotic-free retail chicken meat products were also largely contaminated with ESBL-producing Salmonella and that their ESBL genes and genetic platforms were the same as those isolated from conventional retail chicken meat products.

Keywords: antibiotic-free poultry, conventional poultry, multilocus sequence typing, extended-spectrum β-lactamase, antimicrobial resistance

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Authors: Recep Kesli, Gulsah Asik, Cengiz Demir, Onur Turkyilmaz

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Objective: Stenotrophomonas maltophilia (S. maltophilia) has recently emerged as an important nosocomial microorganism. Treatment of invasive infections caused by this organism is problematic because this microorganism is usually resistant to a wide range of commonly used antimicrobials. We aimed to evaluate clinical isolates of S. maltophilia in respect to sampling sites and antimicrobial resistant. Method: During a two years period (October 2013 and September 2015) eighteen samples collected from the intensive care unit (ICU) patients hospitalized in Afyon Kocatepe University, ANS Practice and Research Hospital. Identification of the bacteria was determined by conventional methods and automated identification system-VITEK 2 (bio-Mérieux, Marcy l’toile, France). Antibacterial resistance tests were performed by Kirby Bauer disc (Oxoid, England) diffusion method following the recommendations of CLSI. Results: Eighteen S. maltophilia strains were identified as the causative agents of different infections. The main type of infection was lower respiratory tract infection (83,4 %); three patients (16,6 %) had bloodstream infection. While, none of the 18 S. maltophilia strains were found to be resistant against to trimethoprim sulfametaxasole (TMP-SXT) and levofloxacine, eight strains 66.6 % were found to be resistant against ceftazidim. Conclusion: The isolation of S.maltophilia starains resistant to TMP-SXT is vital. In order to prevent or minimize infections due to S. maltophilia such precuations should be utilized: Avoidance of inappropriate antibiotic use, prolonged implementation of foreign devices, reinforcement of hand hygiene practices and the application of appropriate infection control practices. Microbiology laboratories also may play important roles in controlling S. maltophilia infections by monitoring the prevalence, continuously, the provision of local antibiotic resistance paterns data and the performance of synergistic studies also may help to guide appropirate antimicrobial therapy choices.

Keywords: Stenotrophomonas maltophilia, trimethoprim-sulfamethoxazole, antimicrobial resistance, Stenotrophomonas spp.

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Authors: María Graciela Aguayo, Laura Reyes, Claudia Oviedo, José Navarrete, Liset Gómez, Hugo Torres

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Most wood species used in construction deteriorate when exposed to environmental conditions that favor wood-degrading organisms’ growth. Therefore, chemical protection by impregnation allows more efficient use of forest resources extending the wood useful life. A wood protection treatment which has attracted considerable interest in the scientific community during the last decade is wood impregnation with nano compounds. Radiata pine is the main wood species used in the Chilean construction industry, with total availability of 8 million m³ sawn timber. According to the requirements of the American Wood Protection Association (AWPA) and the Chilean Standards (NCh) radiata pine timber used in construction must be protected due to its low natural durability. In this work, the impregnation with copper nanoparticles (CuNP) was studied in terms of penetration and its protective effect against wood rot fungi. Two concentrations: 1 and 3 g/L of NPCu were applied by impregnation on radiata pine sapwood. Test penetration under AWPA A3-91 standard was carried out, and wood decay tests were performed according to EN 113, with slight modifications. The results of penetration for 1 g/L CuNP showed an irregular total penetration, and the samples impregnated with 3 g/L showed a total penetration with uniform concentration (blue color in all cross sections). The impregnation wood mass losses due to fungal exposure were significantly reduced, regardless of the concentration of the solution or the fungus. In impregnated wood samples, exposure to G. trabeum resulted ML values of 2.70% and 1.19% for 1 g/L and 3 g/L CuNP, respectively, and exposure to P. placenta resulted in 4.02% and 0.70%-ML values for 1 g/L and 3 g/L CuNP, respectively. In this study, the penetration analysis confirmed a uniform distribution inside the wood, and both concentrations were effective against the tested fungi, giving mass loss values lower than 5%. Therefore, future research in wood preservatives should focus on new nanomaterials that are more efficient and environmentally friendly. Acknowledgments: CONICYT FONDEF IDeA I+D 2019, grant number ID19I10122.

Keywords: copper nanoparticles, fungal degradation, radiata pine wood, wood preservation

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Authors: Samson Abayomi Olasoju, Olufemi Adekunle, Titilope Edun, Johnson Owoseni

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Science offers opportunities for revolutionizing human activities, enriched by input from scientific research and technology. Biotechnology is a major force for development in developing countries such as Nigeria. It is found to contribute to solving human problems like water and food insecurity that impede national development and threaten peace wherever it is applied. This review identified the problems of agricultural biotechnology in Nigeria. On the part of rural farmers, there is a lack of adequate knowledge or awareness of biotechnology despite the fact that they constitute the bulk of Nigerian farmers. On part of the government, the problems include: lack of adequate implementation of government policy on bio-safety and genetically modified products, inadequate funding of education as well as research and development of products related to biotechnology. Other problems include: inadequate infrastructures (including laboratory), poor funding and lack of national strategies needed for development and running of agricultural biotechnology. In spite of all the challenges associated with agricultural biotechnology, its prospects still remain great if Nigeria is to meet with the food needs of the country’s ever increasing population. The introduction of genetically engineered products will lead to the high productivity needed for commercialization and food security. Insect, virus and other related diseases resistant crops and livestock are another viable area of contribution of biotechnology to agricultural production. In conclusion, agricultural biotechnology will not only ensure food security, but, in addition, will ensure that the local farmers utilize appropriate technology needed for large production, leading to the prosperity of the farmers and national economic growth, provided government plays its role of adequate funding and good policy implementation.

Keywords: biosafety, biotechnology, food security, genetic engineering, genetic modification

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Authors: Yaniv Knop, Alva Peled

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Over the past few years there has been a growing interest in the development of Portland Composite Cement, by partial replacement of the clinker with mineral additives. The motivations to reduce the clinker content are threefold: (1) Ecological - due to lower emission of CO2 to the atmosphere; (2) Economical - due to cost reduction; and (3) Scientific\Technology – improvement of performances. Among the mineral additives being used and investigated, limestone is one of the most attractive, as it is considered natural, available, and with low cost. The goal of the research is to develop green cement, by partial replacement of the clinker with limestone powder while improving the performances of the cement paste. This work studied blended cements with three limestone powder particle diameters: smaller than, larger than, and similarly sized to the clinker particle. Blended cement with limestone consisting of one particle size distribution and limestone consisting of a combination of several particle sizes were studied and compared in terms of hydration rate, hydration degree, and water demand to achieve normal consistency. The performances of these systems were also compared with that of the original cement (without added limestone). It was found that the ability to replace an active material with an inert additive, while achieving improved performances, can be obtained by increasing the packing density of the cement-based particles. This may be achieved by replacing the clinker with limestone powders having a combination of several different particle size distributions. Mathematical and physical models were developed to simulate the setting history from initial to final setting time and to predict the packing density of blended cement with limestone having different sizes and various contents. Besides the effect of limestone, as inert additive, on the packing density of the blended cement, the influence of the limestone particle size on three different chemical reactions were studied; hydration of the cement, carbonation of the calcium hydroxide and the reactivity of the limestone with the hydration reaction products. The main results and developments will be presented.

Keywords: packing density, hydration degree, limestone, blended cement

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Authors: Georgios Pardalis, Krushna Mahapatra, Brijesh Mainali

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Compared to other sectors, the residential and service sector in Sweden is responsible for almost 40% of the national final energy use and faces great challenges towards achieving reduction of energy intensity. The one- and two-family (henceforth 'detached') houses, constituting 60% of the residential floor area and using 32 TWh for space heating and hot water purposes, offers significant opportunities for improved energy efficiency. More than 80% of those houses are more than 35 years of old and a large share of them need major renovations. However, the rate of energy renovations for such houses is significantly low. The renovation market is dominated by small and medium-sized local companies (SMEs), who mostly offer individual solutions. A one-stop-shop business framework, where a single actor collaborates with other actors and coordinates them to offer a full package for holistic renovations, may speed up the rate of renovation. Such models are emerging in some European countries. This paper aims to understand the willingness of the SMEs to adopt a one-stop-shop business framework. Interviews were conducted with 13 SMEs in Kronoberg county in Sweden, a geographic region known for its initiatives towards sustainability and energy efficiency. The examined firms seem reluctant to adopt one-stop-shop for nonce due to the perceived risks they see in such a business move and due to their characteristics, although they agree that such a move will advance their position in the market and their business volume. By using threat-rigidity and prospect theory, we illustrate how this type of companies can move from being reluctant to adopt one-stop-shop framework to its adoption. Additionally, with the use of behavioral theory, we gain deeper knowledge on those exact reasons preventing those firms from adopting the one-stop-shop framework.

Keywords: construction SMEs, innovation adoption, one-stop-shop, perceived risks

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Authors: Muhammad Irfan, Guillermo Requena, Jan Haubrich

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Adhesively bonded aluminum joints are common in automotive and aircraft industries and are one of the enablers of lightweight construction to minimize the carbon emissions during transportation for a sustainable life. This study is focused on the effects of two thermal processing routes, i.e., by direct and induction heating, and their parameters on void formation in PA6 bonded aluminum EN-AW6082 joints. The joints were characterized microanalytically as well as by lap shear experiments. The aging resistance of the joints was studied by accelerated aging tests at 80°C hot water. It was found that the processing of single lap joints by direct heating in a convection oven causes the formation of a large number of voids in the bond line. The formation of voids in the convection oven was due to longer processing times and was independent of any surface pretreatments of the metal as well as the processing temperature. However, when processing at low temperatures, a large number of small-sized voids were observed under the optical microscope, and they were larger in size but reduced in numbers at higher temperatures. An induction heating process was developed, which not only successfully reduced or eliminated the voids in PA6 bonded joints but also reduced the processing times for joining significantly. Consistent with the trend in direct heating, longer processing times and higher temperatures in induction heating also led to an increased formation of voids in the bond line. Subsequent single lap shear tests revealed that the increasing void contents led to a 21% reduction in lap shear strengths (i.e., from ~47 MPa for induction heating to ~37 MPa for direct heating). Also, there was a 17% reduction in lap shear strengths when the consolidation temperature was raised from 220˚C to 300˚C during induction heating. However, below a certain threshold of void contents, there was no observable effect on the lap shear strengths as well as on hydrothermal aging resistance of the joints consolidated by the induction heating process.

Keywords: adhesive, aluminium, convection oven, induction heating, mechanical properties, nylon6 (PA6), pretreatment, void

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Authors: Mohammed Sghir Taleb

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Introduction The date palm (Phoenix dactylifera L.) represents an essential element of the oasis ecosystem for Saharan and pre-Saharan regions of Morocco. It plays an important role, not only due to its economic importance, but also its ecological adaptation to, firstly, to ensure necessary protection for crops against underlying warm and dry sales, and secondly to contribute to the fight against desertification. This is one of the oldest cultivated plant species best adapted to difficult climatic conditions of the Saharan and pre-Saharan regions, because of its ecological requirements and economically most suitable for investing in oasis agriculture. Methodology The methodology is mainly based on a literature review of principal theses and projects for the conservation of flora and vegetation. Results The date palm has multiple uses. Indeed, it produces fruits rich in nutrients, provides a multitude of secondary products and generates needed revenue for the survival of oasis populations. In Morocco, the development and modernization of the date palm sector face, both upstream and downstream of the industry, several major constraints. In addition to climate constraints (prolonged drought), in its environment (lack of water resources), to the incessant invasion of disease Bayoud, Moroccan palm ecosystem suffers from a low level of technical and traditional practices prevail and traditional, from the choice of variety and site preparation up to harvesting and recycling of products. Conclusion The date palm plays an important role in the socioeconomic development of local and national level. However, this ecosystem however, is subject to numerous degradation factors caused by anthropogenic action and climate change. to reverse the trends, several programs have been developed by Morocco for the restoration of degraded areas and the development of the Phoenix dactylifera ecosystem to meet the needs of local populations and the development of the national economy.

Keywords: efforts, flora, ecosystem, forest, conservation, Morocco

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Authors: Kazuyuki Takase, Yoshihisa Hiraki, Gaku Takase, Isamu Kudo

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One of the most important issue is to ensure the safety of long-term waste storage containers in which fuel debris and radioactive materials are accumulated. In this case, hydrogen generated by water decomposition by radiation is accumulated in the container for a long period of time, so it is necessary to reduce the concentration of hydrogen in the container. In addition, a condition that any power supplies from the outside of the container are unnecessary is requested. Then, radioactive waste storage containers with the passive autocatalytic recombiner (PAR) would be effective. The radioactive waste storage container with PAR was used for moving the fuel debris of the Three Mile Island Unit 2 to the storage location. However, the effect of PAR is not described in detail. Moreover, the reduction of hydrogen concentration during the long-term storage period was performed by the venting system, which was installed on the top of the container. Therefore, development of a long-term storage container with PAR was started with the aim of safely storing fuel debris picked up at the Fukushima Daiichi Nuclear Power Plant for a long period of time. A fundamental experiment for reducing the concentration of hydrogen which generates in a nuclear waste long-term storage container was carried out using a small-scale container with PAR. Moreover, the circulation flow behavior of hydrogen in the small-scale container resulting from the natural convection by the decay heat was clarified. In addition, preliminary numerical analyses were performed to predict the experimental results regarding the circulation flow behavior and the reduction of hydrogen concentration in the small-scale container. From the results of the present study, the validity of the container with PAR was experimentally confirmed on the reduction of hydrogen concentration. In addition, it was predicted numerically that the circulation flow behavior of hydrogen in the small-scale container is blocked by steam which generates by chemical reaction of hydrogen and oxygen.

Keywords: hydrogen behavior, reduction of concentration, long-term storage container, small-scale, PAR, experiment, analysis

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Authors: S. M. Ali, S. I. Mohamed

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Reduction of feed cost for broiler production is at most importance in decreasing the cost of production. The objectives of this study were to evaluate the use of synthetic amino acids (L-lysine – DL-methionine) instead of super concentrate and groundnut cake versus meat powder as protein sources. A total of 180 male broiler chicks (Cobb – strain) at 15 day of age (DOA) were selected according to their average body weight (380 g) from a broiler chicks flock at Elbashair Farm. The chicks were randomly divided into six groups of 30 chicks. Each group was further sub divided into three replicates with 10 birds. Six experimental diets were formulated. The first diet contained groundnut cake and super concentrate as the control (GNC + C); in the second diet, meat powder and super concentrate (MP + C) were used. The third diet contained groundnut cake and amino acids (GNC + AA); the forth diet contained meat powder and amino acids (MP + AA). The fifth diet contained groundnut cake, meat powder and super concentrate (GNC + MP + C) and the sixth diet contained groundnut cake, meat powder and amino acids (GNC + MP + AA). The formulated rations were randomly assigned for the different sub groups in a completely randomized design of six treatments and three replicates. Weekly feed intake, body weight and mortality were recorded and body weight gain and feed conversion ratio were calculated. At the end of the experiment (49 DOA), nine birds from each treatment were slaughtered. Live body weight, carcass weight, head, shank, and some internal organs (gizzard, heart, liver, small intestine, and abdominal fat pad) weights were taken. For the overall experimental period the (GNC + C +MP) consumed significantly (P≤0.01) the highest cumulative feed while the (MP + AA) group consumed the lowest amount of feed. The (GNC + C) and the (GNC + AA) groups had the heaviest live body weight while (MP + AA) had the lowest live body weight. The overall FCR was significantly (P≤0.01) the best for (GNC + AA) group while the (MP + AA) reported the worst FCR. However, the (GNC + AA) had significantly (P≤0.01) the lowest AFP. The (GNC + MP + Con) group had the highest dressing % while the (MP + AA) group had the lowest dressing %. It is concluded that amino acids can be used instead of super concentrate in broiler feeding with perfect performance and less cost and that meat powder is not advisable to be used with amino acids.

Keywords: broiler chickens, DL-lysine, methionine, performance

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Authors: Tarek Elnimr, Reda Morsy, Assem El Fert, Aziza Ismail

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Hepatitis is an inflammation of the liver. The condition can be self-limiting or can progress to fibrosis, cirrhosis or liver cancer. Disease caused by the hepatitis virus, the virus can cause hepatitis infection, ranging in severity from a mild illness lasting a few weeks to a serious, lifelong illness. A growing body of evidence indicates that many trace elements play important roles in a number of carcinogenic processes that proceed with various mechanisms. To examine the status of trace elements during the development of hepatic carcinoma, we determined the iron, copper, zinc and selenium levels in some biological samples of patients at different stages of viral hepatic disease. We observed significant changes in the iron, copper, zinc and selenium levels in the biological samples of patients hepatocellular carcinoma, relative to those of healthy controls. The mean hair, nail, RBC, serum and whole blood copper levels in patients with hepatitis virus were significantly higher than that of the control group. In contrast the mean iron, zinc, and selenium levels in patients having hepatitis virus were significantly lower than those of the control group. On the basis of this study, we identified the impact of natural supplements to improve the treatment of viral liver damage, using the level of some trace elements such as, iron, copper, zinc and selenium, which might serve as biomarkers for increases survival and reduces disease progression. Most of the elements revealed diverse and random distribution in the samples of the donor groups. The correlation study pointed out significant disparities in the mutual relationships among the trace elements in the patients and controls. Principal component analysis and cluster analysis of the element data manifested diverse apportionment of the selected elements in the scalp hair, nail and blood components of the patients compared with the healthy counterparts.

Keywords: hepatitis, hair, nail, blood components, trace element, nutrition therapy, multivariate analysis, correlation, ICP-MS

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Authors: Selim Kara, Ertan Arda, Fahrettin Dolastir, Önder Pekcan

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Biomaterials and thin film coatings play a fundamental role in medical, food and pharmaceutical industries. Carrageenan is a linear sulfated polysaccharide extracted from algae and seaweeds. To date, such biomaterials have been used in many smart drug delivery systems due to their biocompatibility and antimicrobial activity properties. Poly (N-isopropylacrylamide) (PNIPAm) gels and copolymers have also been used in medical applications. PNIPAm shows lower critical solution temperature (LCST) property at about 32-34 °C which is very close to the human body temperature. Below and above the LCST point, PNIPAm gels exhibit distinct phase transitions between swollen and collapsed states. A special class of gels are microgels which can react to environmental changes significantly faster than microgels due to their small sizes. Quartz crystal microbalance (QCM) measurement technique is one of the attractive techniques which has been used for monitoring the thin-film formation process. A sensitive QCM system was designed as to detect 0.1 Hz difference in resonance frequency and 10-7 change in energy dissipation values, which are the measures of the deposited mass and the film rigidity, respectively. PNIPAm microgels with the diameter around few hundred nanometers in water were produced via precipitation polymerization process. 5 MHz quartz crystals with functionalized gold surfaces were used for the deposition of the carrageenan molecules and microgels in the solutions which were slowly pumped through a flow cell. Interactions between charged carrageenan and microgel particles were monitored during the formation of the film layers, and the Sauerbrey masses of the deposited films were calculated. The critical phase transition temperatures around the LCST were detected during the heating and cooling cycles. It was shown that it is possible to monitor the interactions between PNIPAm microgels and biopolymer molecules, and it is also possible to specify the critical phase transition temperatures by using a QCM system.

Keywords: carrageenan, phase transitions, PNIPAm microgels, quartz crystal microbalance (QCM)

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Authors: Sanja Jovanovic, Aleksandar Simic, Ognjan Skrobic, Dragan Masulovic, Aleksandra Djuric-Stefanovic

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Introduction: Achalasia is an idiopathic primary esophageal motility disorder characterized by esophageal peristalsis and impaired swallow-induced relaxation of the lower esophageal sphincter (LES). It is a rare disease that affects both genders with an incidence of 1/100.000 and a prevalence rate of 10/100,000 per year. Objective: Laparoscopic Heller myotomy (LHM) represents a therapy of choice for patients with achalasia, providing excellent outcomes. The aim of this study was to evaluate the significance of computed tomography (CT) in analyzing achalasia subtypes and timed barium esophagogram (TBE) in evaluation of LHM success, as a part of standardized diagnostic protocol. Method: Fifty-one patients with achalasia, confirmed by manometric studies, in addition to standardized diagnostic methods, underwent CT and TBE. CT was done with multiplanar reconstruction, measuring the wall thickness above the esophago-gastric junction in the axial plane. TBE was performed preoperatively and two days postoperatively swallowing low-density barium sulfate, and plane upright frontal films were performed 1, 2 and 5 minutes after the ingestion. In all patients, LHM was done, and pre and postoperative height and weight of the barium column were compared. Results: According to CT findings we divided patients into 3 subtypes of achalasia according to wall thickness: < 4mm as subtype one, between 4 - 9mm as II, and > 10 mm as subtype 3. Correlation of manometric results, as a reference values, and CT findings indicated CT sensitivity of 90% and specificity of 70 % in establishing subtypes of achalasia. The preoperative values of TBE at 1, 2 and 5 minutes were: median barium column height 17.4 ± 7.4, 15.9 ± 6.2 and 13.9 ± 6.2 cm; median column width 5 ± 1.5, 4.7 ± 1.6 and 4.5 ± 1.8 cm respectively. LHM significantly reduced these values (height 7 ± 4.6, 5.8 ± 4.2, 3.7 ± 3.4 cm; width 2.9 ± 1.3, 2.6 ± 1.3 and 2.4 ± 1.4 cm), indicating the quantitative estimates of emptying as excellent (p value < 0.01). Conclusion: CT has high sensitivity and specificity in evaluation of achalasia subtypes, and can be introduced as an additional method for standardized evaluation of these patients. The quantitative assessment of TBE based on measurements of the barium column is an accurate and beneficial method, which adequately estimates esophageal emptying success of LHM.

Keywords: achalasia, computed tomography, esophagography, myotomy

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Authors: Breanna Macumber, Victor A. Huayamave, Emir A. Vela, Wangdo Kim, Tamara T. Chamber, Esteban Centeno

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Spina bifida is a type of neural tube defect that affects the nervous system and can lead to problems such as total leg paralysis. Treatment requires physical therapy and rehabilitation. Robotic exoskeletons have been used for rehabilitation to train muscle movement and assist in injury recovery; however, current models focus on the adult populations and not on the infant population. The proposed framework aims to couple a musculoskeletal infant model with a robotic exoskeleton using vacuum-powered artificial muscles to provide rehabilitation to infants affected by spina bifida. The study that drove the input values for the robotic exoskeleton used motion capture technology to collect data from the spontaneous kicking movement of a 2.4-month-old infant lying supine. OpenSim was used to develop the musculoskeletal model, and Inverse kinematics was used to estimate hip joint angles. A total of 4 kicks (A, B, C, D) were selected, and the selection was based on range, transient response, and stable response. Kicks had at least 5° of range of motion with a smooth transient response and a stable period. The robotic exoskeleton used a Vacuum-Powered Artificial Muscle (VPAM) the structure comprised of cells that were clipped in a collapsed state and unclipped when desired to simulate infant’s age. The artificial muscle works with vacuum pressure. When air is removed, the muscle contracts and when air is added, the muscle relaxes. Bench testing was performed using a 6-month-old infant mannequin. The previously developed exoskeleton worked really well with controlled ranges of motion and frequencies, which are typical of rehabilitation protocols for infants suffering with spina bifida. However, the random kicking motion in this study contained high frequency kicks and was not able to accurately replicate all the investigated kicks. Kick 'A' had a greater error when compared to the other kicks. This study has the potential to advance the infant rehabilitation field.

Keywords: musculoskeletal modeling, soft robotics, rehabilitation, pediatrics

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Authors: S. Sreeja, Radhakrishnan R. Nair, Noble Gracious, Sreeja S. Nair, M. Radhakrishna Pillai

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Background: Tacrolimus is a potent immunosuppressant clinically used for the long term treatment of antirejection of transplanted organs in liver and kidney transplant recipients though dose optimization is poorly managed. However, So far no study has been carried out on the South Indian kidney transplant patients. The objective of this study is to evaluate the potential influence of a functional polymorphism in CYP3A5*3 gene on tacrolimus physiological availability/dose ratio in South Indian renal transplant patients. Materials and Methods: Twenty five renal transplant recipients receiving tacrolimus were enrolled in this study. Their body weight, drug dosage, and therapeutic concentration of Tacrolimus were observed. All patients were on standard immunosuppressive regime of Tacrolimus-Mycophenolate mofetil along with steroids on a starting dose of Tac 0.1 mg/kg/day. CYP3A5 genotyping was performed by PCR followed with RFLP. Conformation of RFLP analysis and variation in the nucleotide sequence of CYP3A5*3 gene were determined by direct sequencing using a validated automated generic analyzer. Results: A significant association was found between tacrolimus per dose/kg/d and CYP3A5 gene (A6986G) polymorphism in the study population. The CYP3A5 *1/*1, *1/*3 and *3/*3 genotypes were detected in 5 (20 %), 5 (20 %) and 15 (60 %) of the 25 graft recipients, respectively. CYP3A5*3 genotypes were found to be a good predictor of tacrolimus Concentration/Dose ratio in kidney transplant recipients. Significantly higher L/D was observed among non-expressors 9.483 ng/mL(4.5- 14.1) as compared with the expressors 5.154 ng/mL (4.42-6.5 ) of CYP3A5. Acute rejection episodes were significantly higher for CYP3A5*1 homozygotes compared to patients with CYP3A5*1/*3 and CYP3A5*3/*3 genotypes (40 % versus 20 % and 13 %, respectively ). The dose normalized TAC concentration (ng/ml/mg/kg) was significantly lower in patients having CYP3A5*1/*3 polymorphism. Conclusion: This is the first study to extensively determine the effect of CYP3A5*3 genetic polymorphism on tacrolimus pharmacokinetics in South Indian renal transplant recipients and also shows that majority of our patients carry mutant allele A6986G in CYP3A5*3 gene. Identification of CYP3A5 polymorphism prior to transplantation could contribute to evaluate the appropriate initial dosage of tacrolimus for each patient.

Keywords: kidney transplant patients, CYP3A5 genotype, tacrolimus, RFLP

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