Search results for: clearance halftime
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 189

Search results for: clearance halftime

69 Experiences of HIV Positive Serostatus Disclosure to Sexual Partner Among Individuals in Discordant Couples in Mbarara City, Southwestern Uganda

Authors: Humphrey Atwijukiire, Gladys Nakidde, Anne Tweheyo Otwine, Jane Kabami

Abstract:

Experiences of HIV Positive Serostatus Disclosure to Sexual Partner Among Individuals in Discordant Couples in Mbarara City, Southwestern Uganda Introduction: Disclosure of HIV status is key in HIV management. Despite many studies on serostatus disclosure, there is a gap in experiences regarding HIV status disclosure among discordant couples. This study explored the lived experiences of serostatus disclosure among discordant couples in Mbarara City, South Western Uganda. Methods: We conducted 12 in-depth interviews using translated interview guide, and audio recorders. Participants were purposively enrolled in the study. The study was conducted at three public health facilities in Mbarara City. Data was analyzed using thematic content analysis. Approval for this research was obtained from Mbarara University Research Ethics Committee and administrative clearance from city clerk of Mbarara City. Results: The mean age of participants was 38 years. An equal number of males (six) and females participated. Most of them had at least secondary level education, only three had primary education. Experienced benefits of HIV serostatus disclosure included: social support and care; decisions regarding health, fertility, and child bearing; sharing information on HIV prevention and protection; positive living; and, ease of HIV disclosure. The challenges included: misunderstandings in the families. Conclusion: Socially, psychologically and financially PLWHIV have benefited from their negative partners. Health wise, they have been supported, and cared for, but some have faced challenges, such as family misunderstandings. Couple HIV counseling and testing by a trained health worker is beneficial in HIV care and could mitigate the challenges related HIV serostatus disclosure.

Keywords: discordant couples, disclosure, experiences, HIV

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68 Effects of Corruption and Logistics Performance Inefficiencies on Container Throughput: The Latin America Case

Authors: Fernando Seabra, Giulia P. Flores, Karolina C. Gomes

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Trade liberalizations measures, as import tariff cuts, are not a sufficient trigger for trade growth. Given that price margins are narrow, traders and cargo operators tend to opt out of markets where the process of goods clearance is slow and costly. Excess paperwork and slow customs dispatch not only lead to institutional breakdowns and corruption but also to increasing transaction cost and trade constraints. The objective of this paper is, therefore, two-fold: First, to evaluate the relationship between institutional and infrastructural performance indexes and trade growth in container throughput; and, second, to investigate the causes for differences in container demurrage and detention fees in Latin American countries (using other emerging countries as benchmarking). The analysis is focused on manufactured goods, typically transported by containers. Institutional and infrastructure bottlenecks and, therefore, the country logistics efficiency – measured by the Logistics Performance Index (LPI, World Bank-WB) – are compared with other indexes, such as the Doing Business index (WB) and the Corruption Perception Index (Transparency International). The main results based on the comparison between Latin American countries and the others emerging countries point out in that the growth in containers trade is directly related to LPI performance. It has also been found that the main hypothesis is valid as aspects that more specifically identify trade facilitation and corruption are significant drivers of logistics performance. The exam of port efficiency (demurrage and detention fees) has demonstrated that not necessarily higher level of efficiency is related to lower charges; however, reductions in fees have been more significant within non-Latin American emerging countries.

Keywords: corruption, logistics performance index, container throughput, Latin America

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67 Selection of a Potential Starter Culture for Milk Fermentation

Authors: Stephen Olusanmi Akintayo, Ilesanmi Fadahunsi

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The ability of Lactic acid bacteria (LAB) to grow and survive in milk is being exploited in industrial and biotechnological applications. Although considerable studies have been reported on the fermentation of milk, however, not so much work has been documented on the selection of LAB strains from milk of the Nigerian local cattle breeds for their starter culture potentials. A total of 110 LAB were isolated from raw milk of Sokoto gudali cattle breed. The isolates were screened for their proteolytic activities on skimmed milk media with isolates A07, F06 and A01 showing the highest zone of clearance of 18.5mm, 18.5mm, and 18.0mm respectively and were selected for the studies of their growth in different constituents of milk. A01, F06, and A07 were identified as Pediococcus acidilactici, Lactococcus raffinolactis, and Leuconostoc mesenteriodes respectively using cultural, biochemical, physiological and molecular characterization techniques. Leuconostoc mesenteriodes showed the highest growth in all the milk components that were used in this study. The three LAB species selected showed a growth range of 6.46 log cfu/ml to 10.91 log cfu/ml in lactose with Leuconostoc mesenteriodes showing the highest growth of 10.91 log cfu/ml while Pediococcus acidilactici recorded the lowest growth of 9.78 log cfu/ml. In medium containing leucine as the only amino acid, the viable counts of Pediococcus acidilactici, Lactococcus raffinolactis and Leuconostoc mesenteriodes in log cfu/ml at zero hour were 6.39, 6.36 and 6.38 respectively which increased to 9.31 log cfu/ml, 9.21 log cfu/ml, 9.92 log cfu/ml respectively after 24 hours. Similarly, in all other substrates (casein, lysine, glutamic acid, aspartic acid, stearic acid and oleic acid ) tested in this study, Leuconostoc mesenteriodes showed the highest growth. It was observed that the highest quantity of lactic acid (15.31mg/ml) was produced by Leuconostoc mesenteriodes. The same trend was also observed in the production of diacetyl and hydrogen peroxide by the three tested microorganisms. Due to its ability to grow maximally in milk components, Leuconostoc mesenteriodes shows potential as starter culture for milk fermentation.

Keywords: Leuconostoc mesenteriodes, lactic acid bacteria, Sokoto gudali, starter culture

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66 'It’s a Very, Very New Old South Africa…': Exploring Some Race, Corruption and Protest Issues in Zakes Mda’s 'Our Lady of Benoni'

Authors: Bongani Clearance Thela

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It seems that theatre remains a practical method for mobilising people and their ideologies; and South African literature has strengthened over the years as a result of the events which took place during both the Apartheid and Post-Apartheid eras. Hence, the problem noted in this study is that, generally, many people seem to believe that the issues which were a concern during Apartheid times in South Africa no longer exist in Post-Apartheid South Africa, whereas, it is seems that they still do. Post-Apartheid playwrights such as Zakes Mda among others, explore these issues in their works. There are common themes between the two periods, for this reason, distinction can only be drawn in terms of the context. Therefore, this study explores solutions offered by the themes of protest, corruption and race in Zakes Mda’s Our Lady of Benoni. The study uses real events and Mda’s play to reveal that there is a reinvention of Apartheid times’ issues into Post-Apartheid times’ issues. Moreover, the theme of race is explored with reference to class issues. Also, the study aims at highlighting some distinctions between the Apartheid period and Post-Apartheid period as shown by the playwright, Zakes Mda’s fictitious version as seen in some of his characters in the play. Theatre in general has always protested, it is either against an issue or for an issue; therefore, this paper will also explore the various ways in which the theme of protest is undertaken in the study of theatre. Respectively, the paper looks in the literal protest found in Mda’s Our Lady of Benoni in order to provide critical understanding with regard to the notion undertaken in this study. The paper goes on to provide an alternative discussion of the theme of protest; it critically evaluates issues such as corruption and race in terms of class that the playwright, Mda addresses in his play. In conclusion, this paper will use other relevant examples other than Mda’s drama, Our Lady of Benoni, in order to prove that there is a reinvention of Apartheid issues in Post-Apartheid issues in South Africa.

Keywords: protest, corruption, race, class

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65 Nitrate-Induced Biochemical and Histopathological Changes in the Kidney of Rats: Attenuation by Hyparrhenia hirta

Authors: Hanen Bouaziz, Moez Rafrafi, Ghada Ben Salah, Kamel Jamoussi, Tahia Boudawara, Najiba Zeghal

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The present study investigated the protective role of Hyparrhenia hirta against sodium nitrate (NaNO3)-induced nephrotoxicity. A high-performance liquid chromatography coupled with a mass spectrometer (HPLC-MS) method was developed to separate and identify flavonoids in Hyparrhenia hirta. Seven flavonoids were identified as 3-O-methylquercetin, luteolin-7-O-glucoside, luteolin, apigenin-7-O-glucoside, apigenin-8-C-glucoside, luteolin-8-C-glucoside and luteolin-6-C-glucoside. Wistar rats were randomly divided into three groups: a control group and two treated groups during 50 days with NaNO3 administered either alone in drinking water or co-administered with Hyparrhenia hirta. NaNO3 treatment induced a significant increase in plasma levels of creatinine, urea and uric while urinary level decreased significantly. Nephrotoxicity induced by NaNO3 was characterized by significant increase in creatinine clearance. In parallel, a significant increase in malondialdehyde level along with a concomitant decrease in total glutathione content and superoxide dismutase, catalase and glutathione peroxidase activities were observed in the kidney after NaNO3 treatment. The histopathological changes in kidney after NaNO3 administration were shrunken. There were renal tubule cell degeneration and infiltration of mononuclear cells. Most glomeruli revealed shrinkage, a wide capsular space and a peri-glomerular mononuclear cells infiltration. Hyparrhenia hirta supplementation showed a remarkable amelioration of the abnormalities cited above. The results concluded that the treatment with Hyparrhenia hirta had a significant role in protecting the animals from nitrate-induced kidney dysfunction.

Keywords: flavonoids, hyparrhenia hirta, kidney, nitrate toxicity, oxidative stress, rat

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64 Hematuria Following Magnesium Sulfate Administration in a Pregnant Patient with Renal Tubular Acidosis

Authors: Jan Gayl Barcelon, N. Gorgonio

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Renal tubular acidosis, a medical condition that involves the accumulation of acid in the body due to failure of the kidneys to maintain normal urine and blood pH, is rarely encountered in pregnancy. The effect of renal tubular acidosis in pregnancy is not fully established. It may worsen during pregnancy and cause maternal and fetal morbidity. A 30-year-old primigravida was diagnosed with renal tubular acidosis at age 7, but due to uncontrolled disease progression, she developed rickets at age 10. She was first seen in our institution at eight weeks gestation and maintained on bicarbonate and potassium supplementation. At 26 weeks gestation, she was diagnosed with polyhydramnios, causing on and off irregular uterine contractions. At 30 weeks gestation, despite oral Nifedipine, premature labor was uncontrolled; hence she was admitted for tocolysis. With elevated creatinine (123 umol/L) and a normal blood urea nitrogen level (6.70 mmol/L), she was referred to Nephrology Service, which cleared the patient prior to MgSO₄ drip. Dosing of 4g MgSO₄ over 20 minutes followed by a maintenance of 2g/hour x 24 hours for neuroprotection and tocolysis was ordered. Two hours after MgSO₄ drip initiation, hematuria developed with adequate urine output. The infusion was immediately stopped. The serum magnesium level was high normal at 6.7 mEq/L. After 4 hours of renal clearance, the repeat serum magnesium level was normal (2.7 mEq/L) and with clear urine output. The patient was then given Nifedipine 30mg/tab, 3x a day which controlled the uterine contractions. At 37 weeks gestation, the patient delivered via primary low transverse Cesarean Section to a live female with a birthweight of 2470gm, appropriate for gestational age. The use of MgSO₄ for the control of premature labor in patients with chronic renal disease secondary to renal tubular can cause hematuria.

Keywords: hematuria, magnesium sulfate, premature labor, renal tubular acidosis

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63 Causes of Death in Neuromuscular Disease Patients: 15-Year Experience in a Tertiary Care Hospital

Authors: Po-Ching Chou, Wen-Chen Liang, I. Chen Chen, Jong-Hau Hsu, Yuh-Jyh Jong

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Background:Cardiopulmonary complications seem to cause high morbidity and mortality in patients with neuromuscular diseases (NMD) but so far there is no domestic data reported in Taiwan. We, therefore attempted to analyze the factors to cause the death in NMD patients from our cohort. Methods:From 1998 to 2013, we retrospectively collected the information of the NMD patients treated and followed up in Kaohsiung Medical University Hospital. Forty-two patients with NMD who expired during these fifteen years were enrolled. The medical records of these patients were reviewed and the causes of death and the associated affecting factors were analyzed. Results:Eighteen patients with NMD (mean age=13.3, SD=12.4) with complete medical record and detailed information were finally included in this study, including spinal muscular atrophy (SMA) (n=9, 7/9: type 1), Duchenne muscular dystrophy (n=6), congenital muscular dystrophy (n=1), carnitine acyl-carnitine translocase (CACT) deficiency (n=1) and spinal muscular atrophy with respiratory distress (SMARD)(n=1). The place of death was in ICU (n=11, 61%), emergency room (n=3, 16.6%) or home (n=4, 22.2%). For SMA type 1 patients, most of them (71.4%, 5/7) died in emergency room or home and the other two expired during an ICU admission. The causes of death included acute respiratory failure due to pneumonia (n=13, 72.2 %), ventilator failure or dislocation (n=2, 11.1%), suffocation/choking (n=2, 11.1%), and heart failure with hypertrophic cardiomyopathy (n=1, 5.55%). Among the 15 patients died of respiratory failure or choking, 73.3% of the patients (n=11) received no ventilator care at home. 80% of the patients (n=12) received no cough assist at home. The patient died of cardiomyopathy received no medications for heart failure until the last admission. Conclusion: Respiratory failure and choking are the leading causes of death in NMD patients. Appropriate respiratory support and airway clearance play the critical role to reduce the mortality.

Keywords: neuromuscular disease, cause of death, tertiary care hospital, medical sciences

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62 The Development of an Agent-Based Model to Support a Science-Based Evacuation and Shelter-in-Place Planning Process within the United States

Authors: Kyle Burke Pfeiffer, Carmella Burdi, Karen Marsh

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The evacuation and shelter-in-place planning process employed by most jurisdictions within the United States is not informed by a scientifically-derived framework that is inclusive of the behavioral and policy-related indicators of public compliance with evacuation orders. While a significant body of work exists to define these indicators, the research findings have not been well-integrated nor translated into useable planning factors for public safety officials. Additionally, refinement of the planning factors alone is insufficient to support science-based evacuation planning as the behavioral elements of evacuees—even with consideration of policy-related indicators—must be examined in the context of specific regional transportation and shelter networks. To address this problem, the Federal Emergency Management Agency and Argonne National Laboratory developed an agent-based model to support regional analysis of zone-based evacuation in southeastern Georgia. In particular, this model allows public safety officials to analyze the consequences that a range of hazards may have upon a community, assess evacuation and shelter-in-place decisions in the context of specified evacuation and response plans, and predict outcomes based on community compliance with orders and the capacity of the regional (to include extra-jurisdictional) transportation and shelter networks. The intention is to use this model to aid evacuation planning and decision-making. Applications for the model include developing a science-driven risk communication strategy and, ultimately, in the case of evacuation, the shortest possible travel distance and clearance times for evacuees within the regional boundary conditions.

Keywords: agent-based modeling for evacuation, decision-support for evacuation planning, evacuation planning, human behavior in evacuation

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61 Development of a Humanized Anti-CEA Antibody for the Near Infrared Optical Imaging of Cancer

Authors: Paul J Yazaki, Michael Bouvet, John Shively

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Surgery for solid gastrointestinal (GI) cancers such as pancreatic, colorectal, and gastric adenocarcinoma remains the mainstay of curative therapy. Complete resection of the primary tumor with negative margins (R0 resection), its draining lymph nodes, and distant metastases offers the optimal surgical benefit. Real-time fluorescence guided surgery (FGS) promises to improve GI cancer outcomes and is rapidly advancing with tumor-specific antibody conjugated fluorophores that can be imaged using near infrared (NIR) technology. Carcinoembryonic Antigen (CEA) is a non-internalizing tumor antigen validated as a surface tumor marker expressed in >95% of colorectal, 80% of gastric, and 60% of pancreatic adenocarcinomas. Our humanized anti-CEA hT84.66-M5A (M5A) monoclonal antibody (mAb)was conjugated with the NHS-IRDye800CW fluorophore and shown it can rapidly and effectively NIRoptical imageorthotopically implanted human colon and pancreatic cancer in mouse models. A limitation observed is that these NIR-800 dye conjugated mAbs have a rapid clearance from the blood, leading to a narrow timeframe for FGS and requiring high doses for effective optical imaging. We developed a novel antibody-fluorophore conjugate by incorporating a PEGylated sidearm linker to shield or mask the IR800 dye’s hydrophobicity which effectively extended the agent’s blood circulation half-life leading to increased tumor sensitivity and lowered normal hepatic uptake. We hypothesized that our unique anti-CEA linked to the fluorophore, IR800 by PEGylated sidewinder, M5A-SW-IR800 will become the next generation optical imaging agent, safe, effective, and widely applicable for intraoperative image guided surgery in CEA expressing GI cancers.

Keywords: optical imaging, anti-CEA, cancer, fluorescence-guided surgery

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60 Diagnosis and Resolution of Intermittent High Vibration Spikes at Exhaust Bearing of Mitsubishi H-25 Gas Turbine using Shaft Vibration Analysis and Detailed Root Cause Analysis

Authors: Fahad Qureshi

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This paper provides detailed study on the diagnosis of intermittent high vibration spikes at exhaust bearing (Non-Drive End) of Mitsubishi H-25 gas turbine installed in a petrochemical plant in Pakistan. The diagnosis is followed by successful root cause analysis of the issue and recommendations for improving the reliability of machine. Engro Polymer and Chemicals (EPCL), a Chlor Vinyl complex, has a captive power plant consisting of one combined cycle power plant (CCPP), having two gas turbines each having 25 MW capacity (make: Hitachi) and one extraction condensing steam turbine having 15 MW capacity (make: HTC). Besides, one 6.75 MW SGT-200 1S gas turbine (make: Alstom) is also available. In 2018, the organization faced an issue of intermittent high vibration at exhaust bearing of one of H-25 units having tag GT-2101 A, which eventually led to tripping of machine at configured securities. Since the machine had surpassed 64,000 running hours and major inspection was also due, so bearings inspection was performed. Inspection revealed excessive coke deposition at labyrinth where evidence of rotor rub was also present. Bearing clearance was also at upper limit, and slight babbitt (soft metal) chip off was observed at one of its pads so it was preventively replaced. The unit was restated successfully and exhibited no abnormality until October 2020, when these spikes reoccurred, leading to machine trip. Recurrence of the issue within two years indicated that root cause was not properly addressed, so this paper furthers the discussion on in-depth analysis of findings and establishes successful root cause analysis, which captured significant learnings both in terms of machine design deficiencies and gaps in operation & maintenance (O & M) regime. Lastly, revised O& M regime along with set of recommendations are proposed to avoid recurrence.

Keywords: exhaust side bearing, Gas turbine, rubbing, vibration

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59 Determinants of Stone Free Status After a Single Session of Flexible Ureteroscopy with Laser Lithotripsy for Renal Calculi

Authors: Mohamed Elkoushy, Sameer Munshi, Waseem Tayeb

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Background: Flexible ureteroscopy (fURS) has dramatically improved the minimally invasive management of complex nephrolithiasis. fUR is increasingly being used as the first-line treatment for patients with renal stones. Stone-free status (SFS) is the primary goal in the management of patients with urolithiasis. However, substantial variations exist in the reported SFS following fURS. Objectives: This study determines the predictors of SFS after a single session of fURS with holmium laser lithotripsy (HLL) for renal calculi. Methods: A retrospective review of prospectively collected data was performed for all consecutive patients undergoing fURS and HLL for renal calculi at a tertiary care center. Patients with previous ipsilateral URS for the same stones were excluded. All patients underwent JJ ureteral stent insertion at the end of the procedure. SFS was defined as the presence of no residuals or ≤4-mm non-obstructing stone and was assessed by CT/KUB imaging after 3-4 weeks post-operatively. Multivariate logistic regression was used to detect possible predictors of SFS. Results: A total of 212 patients were included with a mean age of 52.3±8.3 years and a stone burden <20 mm (49.1%), 20-30 mm (41.0%) and >30 mm (9.9%). Overall SFS after a single session of fURS was 71.7%, 92% and 52% for stones less and larger than 20 mm, respectively. Patients with stones> 20 mm need retreatment with a mean number of 1.8 (1.3-2.7) fURS. SFS was significantly associated with male gender, stone bulk <20 mm (95.7% vs. 56.2%), non-lower pole stones, hydronephrotic kidney, low stone intensity, ureteral access sheath, and preoperative stenting. SFS was associated with a lower readmission rate (5.9% vs. 38.9%) and urinary tract infections (3.8% vs. 25.9%). In multivariate regression analysis, SFS maintains its significant association with low stone burden of <20 mm (OR: 5.21), stone intensity <600 HFU (OR: 2.87), and non-lower caliceal stones (OR: 3.84). Conclusion: Best results after a single-session fURS for renal stone were obtained for the stone burden of less than 20 mm and low stone attenuation. Lower calyceal stones may influence stone clearance and need a different approach than fURS, especially for higher stone burden.

Keywords: ureteroscopy, kidney stone, lithotripsy, stone-free, predictors

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58 Pharmacokinetic Modeling of Valsartan in Dog following a Single Oral Administration

Authors: In-Hwan Baek

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Valsartan is a potent and highly selective antagonist of the angiotensin II type 1 receptor, and is widely used for the treatment of hypertension. The aim of this study was to investigate the pharmacokinetic properties of the valsartan in dogs following oral administration of a single dose using quantitative modeling approaches. Forty beagle dogs were randomly divided into two group. Group A (n=20) was administered a single oral dose of valsartan 80 mg (Diovan® 80 mg), and group B (n=20) was administered a single oral dose of valsartan 160 mg (Diovan® 160 mg) in the morning after an overnight fast. Blood samples were collected into heparinized tubes before and at 0.5, 1, 1.5, 2, 2.5, 3, 4, 6, 8, 12 and 24 h following oral administration. The plasma concentrations of the valsartan were determined using LC-MS/MS. Non-compartmental pharmacokinetic analyses were performed using WinNonlin Standard Edition software, and modeling approaches were performed using maximum-likelihood estimation via the expectation maximization (MLEM) algorithm with sampling using ADAPT 5 software. After a single dose of valsartan 80 mg, the mean value of maximum concentration (Cmax) was 2.68 ± 1.17 μg/mL at 1.83 ± 1.27 h. The area under the plasma concentration-versus-time curve from time zero to the last measurable concentration (AUC24h) value was 13.21 ± 6.88 μg·h/mL. After dosing with valsartan 160 mg, the mean Cmax was 4.13 ± 1.49 μg/mL at 1.80 ± 1.53 h, the AUC24h was 26.02 ± 12.07 μg·h/mL. The Cmax and AUC values increased in proportion to the increment in valsartan dose, while the pharmacokinetic parameters of elimination rate constant, half-life, apparent of total clearance, and apparent of volume of distribution were not significantly different between the doses. Valsartan pharmacokinetic analysis fits a one-compartment model with first-order absorption and elimination following a single dose of valsartan 80 mg and 160 mg. In addition, high inter-individual variability was identified in the absorption rate constant. In conclusion, valsartan displays the dose-dependent pharmacokinetics in dogs, and Subsequent quantitative modeling approaches provided detailed pharmacokinetic information of valsartan. The current findings provide useful information in dogs that will aid future development of improved formulations or fixed-dose combinations.

Keywords: dose-dependent, modeling, pharmacokinetics, valsartan

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57 Predictive Value of Hepatitis B Core-Related Antigen (HBcrAg) during Natural History of Hepatitis B Virus Infection

Authors: Yanhua Zhao, Yu Gou, Shu Feng, Dongdong Li, Chuanmin Tao

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The natural history of HBV infection could experience immune tolerant (IT), immune clearance (IC), HBeAg-negative inactive/quienscent carrier (ENQ), and HBeAg-negative hepatitis (ENH). As current biomarkers for discriminating these four phases have some weaknesses, additional serological indicators are needed. Hepatits B core-related antigen (HBcrAg) encoded with precore/core gene contains denatured HBeAg, HBV core antigen (HBcAg) and a 22KDa precore protein (p22cr), which was demonstrated to have a close association with natural history of hepatitis B infection, but no specific cutoff values and diagnostic parameters to evaluate the diagnostic efficacy. This study aimed to clarify the distribution of HBcrAg levels and evaluate its diagnostic performance during the natural history of infection from a Western Chinese perspective. 294 samples collected from treatment-naïve chronic hepatitis B (CHB) patients in different phases (IT=64; IC=72; ENQ=100, and ENH=58). We detected the HBcrAg values and analyzed the relationship between HBcrAg and HBV DNA. HBsAg and other clinical parameters were quantitatively tested. HBcrAg levels of four phases were 9.30 log U/mL, 8.80 log U/mL, 3.00 log U/mL, and 5.10 logU/mL, respectively (p < 0.0001). Receiver operating characteristic curve analysis demonstrated that the area under curves (AUCs) of HBcrAg and quantitative HBsAg at cutoff values of 9.25 log U/mL and 4.355 log IU/mL for distinguishing IT from IC phases were 0.704 and 0.694, with sensitivity 76.39% and 59.72%, specificity 53.13% and 79.69%, respectively. AUCs of HBcrAg and quantitative HBsAg at cutoff values of 4.15 log U/mlmL and 2.395 log IU/mlmL for discriminating between ENQ and ENH phases were 0.931 and 0.653, with sensitivity 87.93% and 84%, specificity 91.38% and 39%, respectively. Therefore, HBcrAg levels varied significantly among four natural phases of HBV infection. It had higher predictive performance than quantitative HBsAg for distinguishing between ENQ-patients and ENH-patients and similar performance with HBsAg for the discrimination between IT and IC phases, which indicated that HBcrAg could be a potential serological marker for CHB.

Keywords: chronic hepatitis B, hepatitis B core-related antigen, hepatitis B surface antigens, hepatitis B virus

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56 Feasibility Study on Hybrid Multi-Stage Direct-Drive Generator for Large-Scale Wind Turbine

Authors: Jin Uk Han, Hye Won Han, Hyo Lim Kang, Tae An Kim, Seung Ho Han

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Direct-drive generators for large-scale wind turbine, which are divided into AFPM(Axial Flux Permanent Magnet) and RFPM(Radial Flux Permanent Magnet) type machine, have attracted interest because of a higher energy density in comparison with gear train type generators. Each type of the machines provides distinguishable geometrical features such as narrow width with a large diameter for the AFPM-type machine and wide width with a certain diameter for the RFPM-type machine. When the AFPM-type machine is applied, an increase of electric power production through a multi-stage arrangement in axial direction is easily achieved. On the other hand, the RFPM-type machine can be applied by using its geometric feature of wide width. In this study, a hybrid two-stage direct-drive generator for 6.2MW class wind turbine was proposed, in which the two-stage AFPM-type machine for 5 MW was composed of two models arranged in axial direction with a hollow shape topology of the rotor with annular disc, the stator and the main shaft mounted on coupled slew bearings. In addition, the RFPM-type machine for 1.2MW was installed at the empty space of the rotor. Analytic results obtained from an electro-magnetic and structural interaction analysis showed that the structural weight of the proposed hybrid two-stage direct-drive generator can be achieved as 155tonf in a condition satisfying the requirements of structural behaviors such as allowable air-gap clearance and strength. Therefore, it was sure that the 6.2MW hybrid two-stage direct-drive generator is competitive than conventional generators. (NRF grant funded by the Korea government MEST, No. 2017R1A2B4005405).

Keywords: AFPM-type machine, direct-drive generator, electro-magnetic analysis, large-scale wind turbine, RFPM-type machine

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55 Adsorptive Membrane for Hemodialysis: Potential, Future Prospection and Limitation of MOF as Nanofillers

Authors: Musawira Iftikhar

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The field of membrane materials is the most dynamic due to the constantly evolving requirements advancement of materials, to address challenges such as biocompatibility, protein-bound uremic toxins, blood coagulation, auto-immune responses, oxidative stress, and poor clearance of uremic toxins. Hemodialysis is a membrane filtration processes that is currently necessary for daily living of the patients with ESRD. Tens of millions of people with ESRD have benefited from hemodialysis over the past 60–70 years, both in terms of safeguarding life and a longer lifespan. Beyond challenges associated with the efficiency and separative properties of the membranes, ensuring hemocompatibility, or the safe circulation of blood outside the body for four hours every two days, remains a persistent challenge. This review explores the ongoing field of metal–Organic Frameworks (MOFs) and their applications in hemodialysis, offering a comprehensive examination of various MOFs employed to address challenges inherent in traditional hemodialysis methodologies. this This review included includes the experimental work done with various MOFs as a filler such as UiO-66, HKUST-1, MIL-101, and ZIF-8, which together lead to improved adsorption capacities for a range of uremic toxins and proteins. Furthermore, this review highlights how effectively MOF-based hemodialysis membranes remove a variety of uremic toxins, including p-cresol, urea, creatinine, and indoxyl sulfate and potential filler choices for the future. Future research efforts should focus on refining synthesis techniques, enhancing toxin selectivity, and investigating the long-term durability of MOF-based membranes. With these considerations, MOFs emerge as transformative materials in the quest to develop advanced and efficient hemodialysis technologies, holding the promise to significantly enhance patient outcomes and redefine the landscape of renal therapy.

Keywords: membrane, hemodailysis, metal organic frameworks, seperation, protein adsorbtion

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54 Regulating Transnational Corporations and Protecting Human Rights: Analyzing the Efficiency of International Legal Framework

Authors: Stellina Jolly

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July 18th to August 19th 2013 has gone down in the history of India for undertaking the country’s first environment referendum. The Supreme Court had ruled that the Vedanta Group's bauxite mining project in the Niyamgiri Hills of Orissa will have to get clearance from the gram sabha, which will consider the cultural and religious rights of the tribals and forest dwellers living in Rayagada and Kalahandi districts. In the Niyamgiri hills, people of small tribal hamlets were asked to voice their opinion on bauxite mining in their habitat. The ministry has reiterated its stand that mining cannot be allowed on the Niyamgiri hills because it will affect the rights of the Dongria Kondhs. The tribal person who occupies the Niyamgiri Hills in Eastern India accomplished their first success in 2010 in their struggle to protect and preserve their existence, culture and land against Vedanta a London-based mining giant. In August, 2010 Government of India revoked permission for Vedanta Resources to mine bauxite from hills in Orissa State where the Dongria Kondh live as forest dwellers. This came after various protests and reports including amnesty report wherein it highlighted that an alumina refinery in eastern India operated by a subsidiary of mining company. Vedanta was accused of causing air and water pollution that threatens the health of local people and their access to water. The abuse of human rights by corporate is not a new issue it has occurred in Africa, Asia and other parts of the world. Paper focuses on the instances and extent of human right especially in terms of environment violations by corporations. Further Paper details on corporations and sustainable development. Paper finally comes up with certain recommendation including call for a declaration by United Nations on Corporate environment Human Rights Liability.

Keywords: environment, corporate, human rights, sustainable development

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53 Needle Track Technique In Strabismus Surgery

Authors: Seema Dutt Bandhu, Yashi Bansal, Tania Moudgil, Barinder Kaur

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Introduction: Scleral perforation during the passage of suture needle is a known complication of strabismus surgery. The present study was conducted to evolve a safe and easy technique of passing the suture needle through the sclera. A scleral tunnel was created with a 26-guage needle through which the suture needle was passed. The rest of the steps of strabismus surgery were carried out as usual. Material and Methods: After taking clearance from the Institutional Ethics Committee, an interventional study was carried out on twenty patients. The scleral tunnel technique was performed on the patients of strabismus after taking written informed consent. Before passing the suture needle through the sclera during strabismus surgery, a tunnel through approximately half the thickness of the sclera was created with the help of a bent 26-gauge needle. The suture needle was then passed through this tunnel. Rest of the steps of the surgery were carried out in the conventional manner. In a control group of same number of patients, the surgery was performed in the conventional method. Both the groups were followed up for any complications. Ease of passing suture and surgeons’ satisfaction with the technique was noted on a 10-point Likert scale. Results: None of the patients in either group suffered from any complications. Four surgeons participated in the study. The average Likert scale score of the surgeons for satisfaction with the technique was 4.5 on a scale of 5. The score for ease of passage of suture needle was 5 on a score of 5. Discussion: Scleral perforation during passing the sutures through the sclera is a known complication of strabismus surgery. Incidence reported is 7.8% It occurs due to inappropriate engagement of the scleral tissue or passage of the suture needle along a wrong axis during the process of passing the suture needle. The needle track technique eases the passage of passing the suture needle through the sclera as the engagement of the scleral tissue can be done with greater control with a 26-guage needle. The surgeons have reported that they are highly satisfied with the technique and they have reported that the technique eased the passage of the suture needle through the sclera.

Keywords: suture, scleral tunnel, strabismus, scleral perforation

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52 Tripeptide Inhibitor: The Simplest Aminogenic PEGylated Drug against Amyloid Beta Peptide Fibrillation

Authors: Sutapa Som Chaudhury, Chitrangada Das Mukhopadhyay

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Alzheimer’s disease is a well-known form of dementia since its discovery in 1906. Current Food and Drug Administration approved medications e.g. cholinesterase inhibitors, memantine offer modest symptomatic relief but do not play any role in disease modification or recovery. In last three decades many small molecules, chaperons, synthetic peptides, partial β-secretase enzyme blocker have been tested for the development of a drug against Alzheimer though did not pass the 3rd clinical phase trials. Here in this study, we designed a PEGylated, aminogenic, tripeptidic polymer with two different molecular weights based on the aggregation prone amino acid sequence 17-20 in amyloid beta (Aβ) 1-42. Being conjugated with poly-ethylene glycol (PEG) which self-assembles into hydrophilic nanoparticles, these PEGylated tripeptides constitute a very good drug delivery system crossing the blood brain barrier while the peptide remains protected from proteolytic degradation and non-specific protein interactions. Moreover, being completely aminogenic they would not raise any side effects. These peptide inhibitors were evaluated for their effectiveness against Aβ42 fibrillation at an early stage of oligomer to fibril formation as well as preformed fibril clearance via Thioflavin T (ThT) assay, dynamic light scattering analyses, atomic force microscopy and scanning electron microscopy. The inhibitors were proved to be safe at a higher concentration of 20µM by the reduction assay of 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) dye. Moreover, SHSY5Y neuroblastoma cells have shown a greater survivability when treated with the inhibitors following Aβ42 fibril and oligomer treatment as compared with the control Aβ42 fibril and/or oligomer treated neuroblastoma cells. These make the peptidic inhibitors a promising compound in the aspect of the discovery of alternative medication for Alzheimer’s disease.

Keywords: Alzheimer’s disease, alternative medication, amyloid beta, PEGylated peptide

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51 Total Plaque Area in Chronic Renal Failure

Authors: Hernán A. Perez, Luis J. Armando, Néstor H. García

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Background and aims Cardiovascular disease rates are very high in patients with renal failure (CRF), but the underlying mechanisms are incompletely understood. Traditional cardiovascular risk factors do not explain the increased risk, and observational studies have observed paradoxical or absent associations between classical risk factors and mortality in dialysis patients. A large randomized controlled trial, the 4D Study, the AURORA and the ALERT study found that statin therapy in CRF do not reduce cardiovascular events. These results may be the results of ‘accelerated atherosclerosis’ observed on these patients. The objective of this study was to investigate if carotid total plaque area (TPA), a measure of carotid plaque burden growth is increased at progressively lower creatinine clearance in patients with CRF. We studied a cohort of patients with CRF not on dialysis, reasoning that risk factor associations might be more easily discerned before end stage renal disease. Methods: The Blossom DMO Argentina ethics committee approved the study and informed consent from each participant was obtained. We performed a cohort study in 412 patients with Stage 1, 2 and 3 CRF. Clinical and laboratory data were obtained. TPA was determined using bilateral carotid ultrasonography. Modification of Diet in Renal Disease estimation formula was used to determine renal function. ANOVA was used when appropriate. Results: Stage 1 CRF group (n= 16, 43±2yo) had a blood pressure of 123±2/78±2 mmHg, BMI 30±1, LDL col 145±10 mg/dl, HbA1c 5.8±0.4% and had the lowest TPA 25.8±6.9 mm2. Stage 2 CRF (n=231, 50±1 yo) had a blood pressure of 132±1/81±1 mmHg, LDL col 125±2 mg/dl, HbA1c 6±0.1% and TPA 48±10mm2 ( p< 0.05 vs CRF stage 1) while Stage 3 CRF (n=165, 59±1 yo) had a blood pressure of 134±1/81±1, LDL col 125±3 mg/dl, HbA1c 6±0.1% and TPA 71±6mm2 (p < 0.05 vs CRF stage 1 and 2). Conclusion: Our data indicate that TPA increases along the renal function deterioration, and it is not related with the LDL cholesterol and triglycerides levels. We suggest that mechanisms other than the classics are responsible for the observed excess of cardiovascular disease in CKD patients and finally, determination of total plaque area should be used to measure effects of antiatherosclerotic therapy.

Keywords: hypertension, chronic renal failure, atherosclerosis, cholesterol

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50 Development of Ketorolac Tromethamine Encapsulated Stealth Liposomes: Pharmacokinetics and Bio Distribution

Authors: Yasmin Begum Mohammed

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Ketorolac tromethamine (KTM) is a non-steroidal anti-inflammatory drug with a potent analgesic and anti-inflammatory activity due to prostaglandin related inhibitory effect of drug. It is a non-selective cyclo-oxygenase inhibitor. The drug is currently used orally and intramuscularly in multiple divided doses, clinically for the management arthritis, cancer pain, post-surgical pain, and in the treatment of migraine pain. KTM has short biological half-life of 4 to 6 hours, which necessitates frequent dosing to retain the action. The frequent occurrence of gastrointestinal bleeding, perforation, peptic ulceration, and renal failure lead to the development of other drug delivery strategies for the appropriate delivery of KTM. The ideal solution would be to target the drug only to the cells or tissues affected by the disease. Drug targeting could be achieved effectively by liposomes that are biocompatible and biodegradable. The aim of the study was to develop a parenteral liposome formulation of KTM with improved efficacy while reducing side effects by targeting the inflammation due to arthritis. PEG-anchored (stealth) and non-PEG-anchored liposomes were prepared by thin film hydration technique followed by extrusion cycle and characterized for in vitro and in vivo. Stealth liposomes (SLs) exhibited increase in percent encapsulation efficiency (94%) and 52% percent of drug retention during release studies in 24 h with good stability for a period of 1 month at -20°C and 4°C. SLs showed about maximum 55% of edema inhibition with significant analgesic effect. SLs produced marked differences over those of non-SL formulations with an increase in area under plasma concentration time curve, t₁/₂, mean residence time, and reduced clearance. 0.3% of the drug was detected in arthritic induced paw with significantly reduced drug localization in liver, spleen, and kidney for SLs when compared to other conventional liposomes. Thus SLs help to increase the therapeutic efficacy of KTM by increasing the targeting potential at the inflammatory region.

Keywords: biodistribution, ketorolac tromethamine, stealth liposomes, thin film hydration technique

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49 Investigating the Antimicrobial Activity of Essential Oil Derived from Pistacia atlantica Gum against Extensively Drug-Resistant Gram-Negative Acinetobacter baumannii

Authors: Zhala Ahmad, Zainab Lazim, Haider Hamzah

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Bacterial resistance is a pressing global health issue, with multidrug-resistant (MDR), extensively drug-resistant (XDR), and pandrug-resistant (PDR) strains to pose a serious threat. In this context, researchers are investigating effective, safe, and affordable metabolites to combat these pathogens. This study focuses on gum essential oil (GEO) extracted from Pistacia atlantica and its activity and the mechanism of action against XDR Gram-negative Acinetobacter baumannii. GEO was extracted by hydrodistillation and analyzed using GC-MS. Eleven A. baumannii isolates were collected from the ward environment of Burn and Plastic Surgery Hospital in Al Sulaymaniyah City, Iraq. They were identified using the VITEK 2 system, 16S rRNA gene, and confirmed with the blaₒₓₐ₋₅₁ gene; A. baumannii ATCC 19606 was used as a reference strain. The isolates were identified as resistant to twelve different antibiotics spanning six distinct antibiotic classes while showing susceptibility to tetracycline and trimethoprim. Over 40 chemical constituents were detected in the gum's essential oils, with α-pinene being the most abundant. GEO was found to inhibit the growth of A. baumannii isolates; the minimum inhibitory concentration (MIC) of GEO was 2.5 µl/ml. GEO induced protein leakage, phosphate, and potassium ion efflux, distorted cell morphology, and cell death in the tested bacteria. GEO exhibited bacterial clearance and anti-adhesion activity using Band-Aids. This study's findings suggest that GEO could be used as a potential alternative treatment for infectious diseases caused by XRD pathogens, shedding further light on the importance of GEO in biomedical applications. Future studies must focus on generating clinically feasible sources of GEO for testing in small animal models before proceeding to human trials, ensuring safe and effective translation from the laboratory to the clinic.

Keywords: antibiotic resistance, Acinetobacter baumannii, essential oils, Pistacia atlantica, alpha-pinene

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48 Effectiveness of High-Intensity Interval Training in Overweight Individuals between 25-45 Years of Age Registered in Sports Medicine Clinic, General Hospital Kalutara

Authors: Dimuthu Manage

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Introduction: The prevalence of obesity and obesity-related non-communicable diseases are becoming a massive health concern in the whole world. Physical activity is recognized as an effective solution for this matter. The published data on the effectiveness of High-Intensity Interval Training (HIIT) in improving health parameters in overweight and obese individuals in Sri Lanka is sparse. Hence this study is conducted. Methodology: This is a quasi-experimental study that was conducted at the Sports medicine clinic, General Hospital, Kalutara. Participants have engaged in a programme of HIIT three times per week for six weeks. Data collection was based on precise measurements by using structured and validated methods. Ethical clearance was obtained. Results: Registered number for the study was 48, and only 52% have completed the study. The mean age was 32 (SD=6.397) years, with 64% males. All the anthropometric measurements which were assessed (i.e. waist circumference(P<0.001), weight(P<0.001) and BMI(P<0.001)), body fat percentage(P<0.001), VO2 max(P<0.001), and lipid profile (ie. HDL(P=0.016), LDL(P<0.001), cholesterol(P<0.001), triglycerides(P<0.010) and LDL: HDL(P<0.001)) had shown statistically significant improvement after the intervention with the HIIT programme. Conclusions: This study confirms HIIT as a time-saving and effective exercise method, which helps in preventing obesity as well as non-communicable diseases. HIIT ameliorates body anthropometry, fat percentage, cardiopulmonary status, and lipid profile in overweight and obese individuals markedly. As with the majority of studies, the design of the current study is subject to some limitations. The first is the study focused on a correlational study. If it is a comparative study, comparing it with other methods of training programs would have given more validity. Although the validated tools used to measure variables and the same tools used in pre and post-exercise occasions with the available facilities, it would have been better to measure some of them using gold-standard methods. However, this evidence should be further assessed in larger-scale trials using comparative groups to generalize the efficacy of the HIIT exercise program.

Keywords: HIIT, lipid profile, BMI, VO2 max

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47 Effect of Anionic Lipid on Zeta Potential Values and Physical Stability of Liposomal Amikacin

Authors: Yulistiani, Muhammad Amin, Fasich

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A surface charge of the nanoparticle is a very important consideration in pulmonal drug delivery system. The zeta potential (ZP) is related to the surface charge which can predict stability of nanoparticles as nebules of liposomal amikacin. Anionic lipid such as 1,2-dipalmitoyl-sn-glycero-3-phosphatidylglycerol (DPPG) is expected to contribute to the physical stability of liposomal amikacin and the optimal ZP value. Suitable ZP can improve drug release profiles at specific sites in alveoli as well as their stability in dosage form. This study aimed to analyze the effect of DPPG on ZP values and physical stability of liposomal amikacin. Liposomes were prepared by using the reserved phase evaporation method. Liposomes consisting of DPPG, 1,2-dipalmitoyl-sn-glycero-3-phosphatidylcholine (DPPC), cholesterol and amikacin were formulated in five different compositions 0/150/5/100, 10//150/5/100, 20/150/5/100, 30/150/5/100 and 40/150/5/100 (w/v) respectively. A chloroform/methanol mixture in the ratio of 1 : 1 (v/v) was used as solvent to dissolve lipids. These systems were adjusted in the phosphate buffer at pH 7.4. Nebules of liposomal amikacin were produced by using the vibrating nebulizer and then characterized by the X-ray diffraction, differential scanning calorimetry, particle size and zeta potential analyzer, and scanning electron microscope. Amikacin concentration from liposome leakage was determined by the immunoassay method. The study revealed that presence of DPPG could increase the ZP value. The addition of 10 mg DPPG in the composition resulted in increasing of ZP value to 3.70 mV (negatively charged). The optimum ZP value was reached at -28.780 ± 0.70 mV and particle size of nebules 461.70 ± 21.79 nm. Nebulizing process altered parameters such as particle size, conformation of lipid components and the amount of surface charges of nanoparticles which could influence the ZP value. These parameters might have profound effects on the application of nebules in the alveoli; however, negatively charge nanoparticles were unexpected to have a high ZP value in this system due to increased macrophage uptake and pulmonal clearance. Therefore, the ratio of liposome 20/150/5/100 (w/v) resulted in the most stable colloidal system and might be applicable to pulmonal drug delivery system.

Keywords: anionic lipid, dipalmitoylphosphatidylglycerol, liposomal amikacin, stability, zeta potential

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46 Ergonomic Adaptations in Visually Impaired Workers - A Literature Review

Authors: Kamila Troper, Pedro Mestre, Maria Lurdes Menano, Joana Mendonça, Maria João Costa, Sandra Demel

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Introduction: Visual impairment is a problem that has an influence on hundreds of thousands of people all over the world. Although it is possible for a Visually Impaired person to do most jobs, the right training, technological assistance, and emotional support are essential. Ergonomics be able to solve many of the problems/issues with the relative ease of positioning, lighting and design of the workplace. A little forethought can make a tremendous difference to the ease with which a person with an impairment function. Objectives: Review the main ergonomic adaptation measures reported in the literature in order to promote better working conditions and safety measures for the visually impaired. Methodology: This was an exploratory-descriptive, qualitative literature systematic review study. The main databases used were: PubMed, BIREME, LILACS, with articles and studies published between 2000 and 2021. Results: Based on the principles of the theoretical references of ergonomic analysis of work, the main restructuring of the physical space of the workstations were: Accessibility facilities and assistive technologies; A screen reader that captures information from a computer and sends it in real-time to a speech synthesizer or Braille terminal; Installations of software with voice recognition, Monitors with enlarged screens; Magnification software; Adequate lighting, magnifying lenses in addition to recommendations regarding signage and clearance of the places where the visually impaired pass through. Conclusions: Employability rates for people with visual impairments(both those who are blind and those who have low vision)are low and continue to be a concern to the world and for researchers as a topic of international interest. Although numerous authors have identified barriers to employment and proposed strategies to remediate or circumvent those barriers, people with visual impairments continue to experience high rates of unemployment.

Keywords: ergonomic adaptations, visual impairments, ergonomic analysis of work, systematic review

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45 Lung Icams and Vcam-1 in Innate and Adaptive Immunity to Influenza Infections: Implications for Vaccination Strategies

Authors: S. Kozlovski, S.W. Feigelson, R. Alon

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The b2 integrin ligands ICAM-1 ICAM-2 and the endothelial VLA-4 integrin ligand VCAM-1 are constitutively expressed on different lung vessels and on high endothelial venules (HEVs), the main portal for lymphocyte entry from the blood into lung draining lymph nodes. ICAMs are also ubiquitously expressed by many antigen-presenting leukocytes and have been traditionally suggested as critical for the various antigen-specific immune synapses generated by these distinct leukocytes and specific naïve and effector T cells. Loss of both ICAM-1 and ICAM-2 on the lung vasculature reduces the ability to patrol monocytes and Tregs to patrol the lung vasculature at a steady state. Our new findings suggest, however, that in terms of innate leukocyte trafficking into the lung lamina propria, both constitutively expressed and virus-induced vascular VCAM-1 can functionally compensate for the loss of these ICAMs. In a mouse model for influenza infection, neutrophil and NK cell recruitment and clearance of influenza remained normal in mice deficient in both ICAMs. Strikingly, mice deficient in both ICAMs also mounted normal influenza-specific CD8 proliferation and differentiation. In addition, these mice normally combated secondary influenza infection, indicating that the presence of ICAMs on conventional dendritic cells (cDCs) that present viral antigens are not required for immune synapse formation between these APCs and naïve CD8 T cells as previously suggested. Furthermore, long-lasting humoral responses critical for protection from a secondary homosubtypic influenza infection were also normal in mice deficient in both ICAM-1 and ICAM-2. Collectively, our results suggest that the expression of ICAM-1 and ICAM-2 on lung endothelial and epithelial cells, as well as on DCs and B cells, is not critical for the generation of innate or adaptive anti-viral immunity in the lungs. Our findings also suggest that endothelial VCAM-1 can substitute for the functions of vascular ICAMs in leukocyte trafficking into various lung compartments.

Keywords: emigration, ICAM-1, lymph nodes, VCAM-1

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44 Multi-Scale Modelling of the Cerebral Lymphatic System and Its Failure

Authors: Alexandra K. Diem, Giles Richardson, Roxana O. Carare, Neil W. Bressloff

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Alzheimer's disease (AD) is the most common form of dementia and although it has been researched for over 100 years, there is still no cure or preventive medication. Its onset and progression is closely related to the accumulation of the neuronal metabolite Aβ. This raises the question of how metabolites and waste products are eliminated from the brain as the brain does not have a traditional lymphatic system. In recent years the rapid uptake of Aβ into cerebral artery walls and its clearance along those arteries towards the lymph nodes in the neck has been suggested and confirmed in mice studies, which has led to the hypothesis that interstitial fluid (ISF), in the basement membranes in the walls of cerebral arteries, provides the pathways for the lymphatic drainage of Aβ. This mechanism, however, requires a net reverse flow of ISF inside the blood vessel wall compared to the blood flow and the driving forces for such a mechanism remain unknown. While possible driving mechanisms have been studied using mathematical models in the past, a mechanism for net reverse flow has not been discovered yet. Here, we aim to address the question of the driving force of this reverse lymphatic drainage of Aβ (also called perivascular drainage) by using multi-scale numerical and analytical modelling. The numerical simulation software COMSOL Multiphysics 4.4 is used to develop a fluid-structure interaction model of a cerebral artery, which models blood flow and displacements in the artery wall due to blood pressure changes. An analytical model of a layer of basement membrane inside the wall governs the flow of ISF and, therefore, solute drainage based on the pressure changes and wall displacements obtained from the cerebral artery model. The findings suggest that an active role in facilitating a reverse flow is played by the components of the basement membrane and that stiffening of the artery wall during age is a major risk factor for the impairment of brain lymphatics. Additionally, our model supports the hypothesis of a close association between cerebrovascular diseases and the failure of perivascular drainage.

Keywords: Alzheimer's disease, artery wall mechanics, cerebral blood flow, cerebral lymphatics

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43 Effect of Simulation on Anxiety and Knowledge among Novice Nursing Students

Authors: Suja Karkada, Jayanthi Radhakrishnan, Jansi Natarajan, Gerald, Amandu Matua, Sujatha Shanmugasundaram

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Simulation-based learning is an educational strategy designed to simulate actual clinical situations in a safe environment. Globally, simulation is recognized by several landmark studies as an effective teaching-learning method. A systematic review of the literature on simulation revealed simulation as a useful strategy in creating a learning environment which contributes to knowledge, skills, safety, and confidence. However, to the best of the author's knowledge, there are no studies on assessing the anxiety of the students undergoing simulation. Hence the researchers undertook a study with the aim to evaluate the effectiveness of simulation on anxiety and knowledge among novice nursing students. This quasi-experimental study had a total sample of 69 students (35- Intervention group with simulation and 34- Control group with case scenario) consisting of all the students enrolled in the Fundamentals of Nursing Laboratory course during Spring 2016 and Fall 2016 semesters at a college of nursing in Oman. Ethical clearance was obtained from the Institutional Review Board (IRB) of the college of nursing. Informed consent was obtained from every participant. Study received the Dean’s fund for research. The data were collected regarding the demographic information, knowledge and anxiety levels before and after the use of simulation and case scenario for the procedure nasogastric tube feeding in intervention and control group respectively. The intervention was performed by four faculties who were the core team members of the course. Results were analyzed in SPSS using descriptive and inferential statistics. Majority of the students’ in intervention (82.9%) and control (89.9%) groups were equal to or below the age of 20 years, were females (71%), 76.8% of them were from rural areas and 65.2% had a GPA of more than 2.5. The selection of the samples to either the experimental or the control group was from a homogenous population (p > 0.05). There was a significant reduction of anxiety among the students of control group (t (67) = 2.418, p = 0.018) comparing to the experimental group, indicating that simulation creates anxiety among Novice nursing students. However, there was no significant difference in the mean scores of knowledge. In conclusion, the study was useful in that it will help the investigators better understand the implications of using simulation in teaching skills to novice students. Since previous studies with students indicate better knowledge acquisition; this study revealed that simulation can increase anxiety among novice students possibly it is the first time they are introduced to this method of teaching.

Keywords: anxiety, knowledge, novice students, simulation

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42 Rehabilitation of Dilapidated Buildings in Morocco: Turning Urban Challenges into Opportunities

Authors: Derradji A., Ben El Mamoun M., Zakaria E., Charadi I. Anrur

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The issue of dilapidated buildings represents a significant opportunity for constructive and beneficial interventions in Morocco. Faced with challenges associated with aging constructions and rapid urbanization, the country is committed to developing innovative strategies aimed at revitalizing urban areas and enhancing the sustainability of infrastructure, thereby ensuring citizens' safety. Through targeted investments in the renovation and modernization of existing buildings, Morocco aims to stimulate job creation, boost the local economy, and improve the quality of life for residents. Additionally, the integration of sustainable construction standards and the strengthening of regulations will promote resilient and environmentally friendly urban development. In this proactive perspective, LABOTEST has been commissioned by the National Agency for Urban Renewal (ANRUR) to conduct an in-depth study. This study focuses on the technical expertise of 1800 buildings identified as dilapidated in the prefectures of Rabat and Skhirat-Témara following an initial clearance operation. The primary objective of this initiative is to conduct a comprehensive diagnosis of these buildings and define the necessary interventions to eliminate potential risks while ensuring appropriate treatment. The article presents the adopted intervention methodology, taking into account the social dimensions involved, as well as the results of the technical expertise. These results include the classification of buildings according to their degree of urgency and recommendations for appropriate conservatory measures. Additionally, different pathologies are identified and accompanied by specific treatment proposals for each type of building. Since this study, the adopted approach has been generalized to the entire territory of Morocco. LABOTEST has been solicited by other cities such as Casablanca, Chefchaouen, Ouazzane, Azilal, Bejaad, and Demnate. This extension of the initiative demonstrates Morocco's commitment to addressing urban challenges in a proactive and inclusive manner. These efforts also illustrate the endeavors undertaken to transform urban challenges into opportunities for sustainable development and socio-economic progress for the entire population.

Keywords: building, dilapidated, rehabilitation, Morocco

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41 Ethanol Precipitation and Characterization of L-Asparaginase from Aspergillus oryzae

Authors: L. L. Tundisi, A. Pessoa Jr., E. B. Tambourgi, E. Silveira, P. G. Mazzola

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L-asparaginase (L-ASNase) is the gold standard treatment for acute lymphoblastic leukemia that mainly affects pediatric patients; treatment increases survival from 20% to 90%. The characterization of other L-Asparaginases, apart from the most used from Escherichia coli and Erwinia chrysanthemi, has been reported, but the choice of the most appropriate is still under debate. This choice should be based on its pharmacokinetics, immune hypersensitivity, doses, prices, pharmacodynamics. The main factors influencing the antileukemic activity of ASNase are enzymatic activity, Km, glutaminase activity, clearance of the enzyme and development of resistance. However, most of the commercialized enzyme present an intrinsic glutaminase activity, which is responsible for some side effects. In this study, glutaminase free asparaginase produced from Aspergillus oryzae was precipitated in different percentages of ethanol (0–80%), until optimum ethanol concentration of 60% (w/w) was found. Following, precipitation of crude L-ASNase was performed in a single step, using 60% (w/w) ethanol, under constant agitation and temperature. It presented activity of 135.45 U/mg and after gel filtration chromatography with Sephadex G-the enzymatic activity was 322.02 U/mg. The apparent molecular mass of the purified L-ASNase fraction was estimated by 10% SDS-PAGE. Proteins were stained with Coomassie Brilliant Blue R-250. The molar mass range was from 10 kDa to 250 kDa. L-ASNase from Aspergillus oryzae was characterized aiming possible therapeutic use. Four different buffers (phosphate-citrate buffer pH 2.6 to 5.8; phosphate buffer pH 5.8 to 7.4; Tris - HCl pH 7.4 to 9.0; and carbonate buffer pH 9.8 to 10.6) were used to measure the optimum pH for L-ASNase activity. The optimum temperature for enzyme activity was measured at optimal pH conditions (Tris-HCl and phosphate buffer, pH 7.4) at different temperatures ranging from 5 to 55°C. All activities were calculated by quantifying the free ammonia, using the Nessler reagent. The kinetic parameters calculation, e.g. Michaelis-Menten constant (Km), maximum velocity (Vmax) and Hills coefficient (n), were performed by incubating the enzyme in different concentrations of the substrate at optimum conditions of pH and fitted on Hill’s equation. This glutaminase free asparaginase showed a low Km (3.39 mM and 3.81 mM) and enzymatic activity of 135.45 U/mg after precipitation with ethanol. After gel filtration chromatography it rose to 322.02 U/mg. Optimum activity was found between pH 5.8 - 9.0, best activity results with phosphate buffer pH 7.4 and Tris-HCl pH 7.4 and showed activity from 5°C to 55°C. These results indicate that L-ASNase from A. oryzae has the potential for human use.

Keywords: biopharmaceuticals, bioprocessing, bioproducts, biotechnology, enzyme activity, ethanol precipitation

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40 Preliminary Evaluation of Decommissioning Wastes for the First Commercial Nuclear Power Reactor in South Korea

Authors: Kyomin Lee, Joohee Kim, Sangho Kang

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The commercial nuclear power reactor in South Korea, Kori Unit 1, which was a 587 MWe pressurized water reactor that started operation since 1978, was permanently shut down in June 2017 without an additional operating license extension. The Kori 1 Unit is scheduled to become the nuclear power unit to enter the decommissioning phase. In this study, the preliminary evaluation of the decommissioning wastes for the Kori Unit 1 was performed based on the following series of process: firstly, the plant inventory is investigated based on various documents (i.e., equipment/ component list, construction records, general arrangement drawings). Secondly, the radiological conditions of systems, structures and components (SSCs) are established to estimate the amount of radioactive waste by waste classification. Third, the waste management strategies for Kori Unit 1 including waste packaging are established. Forth, selection of the proper decontamination and dismantling (D&D) technologies is made considering the various factors. Finally, the amount of decommissioning waste by classification for Kori 1 is estimated using the DeCAT program, which was developed by KEPCO-E&C for a decommissioning cost estimation. The preliminary evaluation results have shown that the expected amounts of decommissioning wastes were less than about 2% and 8% of the total wastes generated (i.e., sum of clean wastes and radwastes) before/after waste processing, respectively, and it was found that the majority of contaminated material was carbon or alloy steel and stainless steel. In addition, within the range of availability of information, the results of the evaluation were compared with the results from the various decommissioning experiences data or international/national decommissioning study. The comparison results have shown that the radioactive waste amount from Kori Unit 1 decommissioning were much less than those from the plants decommissioned in U.S. and were comparable to those from the plants in Europe. This result comes from the difference of disposal cost and clearance criteria (i.e., free release level) between U.S. and non-U.S. The preliminary evaluation performed using the methodology established in this study will be useful as a important information in establishing the decommissioning planning for the decommissioning schedule and waste management strategy establishment including the transportation, packaging, handling, and disposal of radioactive wastes.

Keywords: characterization, classification, decommissioning, decontamination and dismantling, Kori 1, radioactive waste

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