Search results for: nuclear medicine
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2302

Search results for: nuclear medicine

832 Citrullinated Myelin Basic Protein Mediated Inflammation in Astrocytes

Authors: Lali Shanshiashvili, Marika Chikviladze, Nino Mamulashvili, Maia Sepashvili, Nana Narmania, David Mikeladze

Abstract:

Purpose: During demyelinating inflammatory diseases and after the damage of the myelin sheet, myelin-derived proteins, including myelin basic protein (MBP), are secreted into the extracellular space. MBP shows extensive post-translational modifications, including the deimination of arginine residues. Deiminated MBP is structurally less ordered, susceptible to proteolytic attack, and more immunogenic than the unmodified one. It is hypothesized that MBP could change the inflammatory response in astrocytes. Methods: MBP was isolated and purified from bovine brain white matter. Primary astrocyte cultures were prepared from whole brains of 2-day-old Wistar rats. For evaluation of glutamate uptake/release in astrocytes following treatment of cells with MBP charge isomers, Glutamate Assay Kit was used. The expression of EAAT-2 (excitatory amino acid transporters), peroxisome proliferator-activated receptor gamma (PPAR- γ), inhibitor of nuclear factor kappa B (IkB), and high mobility group protein B1 (HMGB1) in astrocytes were assayed by Western Blot analysis. Results: This study investigated the action of deiminated isomer (C8) on the cultured primary astrocytes and compared its effects with the effects of unmodified C1 isomers. The study found that C8 and C1 MBP differently act on the uptake and release of glutamate in astrocytes: nonmodified C1 MBP increases the uptake of glutamate and does not change the release, whereas C8 decreases the release of glutamate but does not alter the uptake. Nevertheless, both isomers increased the expression of PPAR-γ and EAAT2 in the same intensity. However, immunostaining and Western Blots of cell lysates showed a decrease of IkB and increased expression of HMGB1 after the treatment of astrocytes by C8. Moreover, in the presence of C8, astrocytes release more nitric oxide than unmodified C1 isomers. Conclusion: These data suggest that the deiminated isomer of MBP evokes an inflammatory response and enhances the ability of astrocytes to release proinflammatory mediators through activation of NF-kB after the breakdown of myelin sheets. Acknowledgment: This research was supported by the SRNSF Georgia RF17_534 grant.

Keywords: myelin basic protein, glutamate, deimination, astrocytes, inflammation

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831 Incidence, Pattern and Risk Factors of Congenial Heart Diseases in Neonates in a Tertiary Care Hospital, Egyptian Study

Authors: Gehan Hussein, Hams Ahmad, Baher Matta, Yasmeen Mansi, Mohamad Fawzi

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Background: Congenital heart disease (CHD) is a common problem worldwide with variable incidence in different countries. The exact etiology is unknown, suggested to be multifactorial. We aimed to study the incidence of various CHD in a neonatal intensive care unit (NICU) in a tertiary care hospital in Egypt and the possible associations with variable risk factors. Methods: Prospective study was conducted over a period of one year (2013 /2014) at NICU KasrAlAini School of Medicine, Cairo University. Questionnaire about possible maternal and/or paternal risk factors for CHD, clinical examination, bedside echocardiography were done. Cases were classified into groups: group 1 without CHD and group 2 with CHD. Results: from 723 neonates admitted to NICU, 180 cases were proved to have CHD, 58 % of them were males. patent ductus arteriosus(PDA) was the most common CHD (70%), followed by an atrial septal defect (ASD8%), while Fallot tetralogy and single ventricle were the least common (0.45 %) for each. CHD was found in 30 % of consanguineous parents Maternal age ≥ 35 years at the time of conception was associated with increased incidence of PDA (p= 0.45 %). Maternal diabetes and insulin intake were significantly associated with cases of CHD (p=0.02 &0.001 respectively), maternal hypertension and hypothyroidism were both associated with VSD, but the difference did not reach statistical significance (P=0.36 &0.44respectively). Maternal passive smoking was significantly associated with PDA (p=0.03). Conclusion: The most frequent CHD in the studied population was PDA, followed by ASD. Maternal conditions as diabetes was associated with VSD occurrence.

Keywords: NICU, risk factors, congenital heart disease, echocardiography

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830 Molluscicidal Activity of Some Aqueous and Organic Extract from Some Asteraceae

Authors: Lineda Rouissat-Dahane, Abdelkrim Cheriti, Abbderazak Marouf, Reddy Kandappa H., Govender Patrick

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Natural phytochemicals extracted from folk herbal have drawn much attention in complementary and alternative medicine, and the plant kingdom is considered for developing new molluscicide. The aqueous and acetone extract of the aerial parts of some Asteraceae (Anvillea radiata, Bubonium graveolens, Launaea arborescens, Launaea nudicaulis and Warionia saharae) were investigated for its molluscicidal activity against Lymnaea acuminata showed significant molluscicidal activity with a median lethal concentration (LC50) of aqueous extract (8,178mg/ml) and organic extract 0.002μg/mL, which was indicated higher potency than the positive control, (LC50=100mg /mL for aqueous extract ; LC50=11.6 μg/mL for organic extract). Among the extract and their fractions, those of aerial parts of Launaea nudicaulis and Warionia saharae were found to exhibit significant molluscicidal activities. Among different solvent fractions of the acetone extract of Warionia saharae, the dichloromethane (DCM) soluble fraction showed the most potent molluscicidal activity against Lymnaea acuminata. Plants in species Anvillea radiata, Bubonium graveolens, Launaea arborescens, Launaea nudicaulis, and Warionia saharae produce a great variety of Flavonoids, Glucoside flavonoids, and Saponins that confer natural resistance against several pests. Most extracts were found to exhibit significant molluscicidal activity.

Keywords: acetone extract, aqueous extract, Asteraceae, molluscicidal activity, Lymnaea acuminata

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829 Performance Study of Neodymium Extraction by Carbon Nanotubes Assisted Emulsion Liquid Membrane Using Response Surface Methodology

Authors: Payman Davoodi-Nasab, Ahmad Rahbar-Kelishami, Jaber Safdari, Hossein Abolghasemi

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The high purity rare earth elements (REEs) have been vastly used in the field of chemical engineering, metallurgy, nuclear energy, optical, magnetic, luminescence and laser materials, superconductors, ceramics, alloys, catalysts, and etc. Neodymium is one of the most abundant rare earths. By development of a neodymium–iron–boron (Nd–Fe–B) permanent magnet, the importance of neodymium has dramatically increased. Solvent extraction processes have many operational limitations such as large inventory of extractants, loss of solvent due to the organic solubility in aqueous solutions, volatilization of diluents, etc. One of the promising methods of liquid membrane processes is emulsion liquid membrane (ELM) which offers an alternative method to the solvent extraction processes. In this work, a study on Nd extraction through multi-walled carbon nanotubes (MWCNTs) assisted ELM using response surface methodology (RSM) has been performed. The ELM composed of diisooctylphosphinic acid (CYANEX 272) as carrier, MWCNTs as nanoparticles, Span-85 (sorbitan triooleate) as surfactant, kerosene as organic diluent and nitric acid as internal phase. The effects of important operating variables namely, surfactant concentration, MWCNTs concentration, and treatment ratio were investigated. Results were optimized using a central composite design (CCD) and a regression model for extraction percentage was developed. The 3D response surfaces of Nd(III) extraction efficiency were achieved and significance of three important variables and their interactions on the Nd extraction efficiency were found out. Results indicated that introducing the MWCNTs to the ELM process led to increasing the Nd extraction due to higher stability of membrane and mass transfer enhancement. MWCNTs concentration of 407 ppm, Span-85 concentration of 2.1 (%v/v) and treatment ratio of 10 were achieved as the optimum conditions. At the optimum condition, the extraction of Nd(III) reached the maximum of 99.03%.

Keywords: emulsion liquid membrane, extraction of neodymium, multi-walled carbon nanotubes, response surface method

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828 Nutritional Evaluation and the Importance of Traditional Vegetables That Sustain the Indigenous People of Malaysia

Authors: Rachel Thomas Tharmabalan

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The growing unease over the matter of food security in the world is the result of a maturing realization that the genetic base of most human caloric intake from plants is dangerously narrow. Malaysia’s tropical rainforests have the potential to contribute to diet diversification and provide a source of nutrient-rich food as the Orang Asli communities in Malaysia have relied almost entirely on the jungle for food, fodder, medicine and fuel antithetical to what is happening today. This segregation of the Orang Asli from traditional lands and resources leads to severe loss of knowledge of biodiversity. In order to preserve these wild edibles, four different types of vegetables that are frequently consumed by the Orang Asli which consists of Rebu, Meranti, Saya and Pama were selected. These vegetables were then analysed to determine its proximate and mineral content to help ascertain claims and reaffirm the impact it can play in ensuring food and nutrition security, in addition to combating chronic diseases. From the results obtained, the Meranti had the highest crude fiber, iron and calcium content. Other minerals such as potassium, magnesium and copper were also found in varying content. These wild edibles could also contribute to education and bring awareness to younger generations as well as urban populations to start consuming more of these in their daily life as it could prevent various chronic diseases in Malaysia.

Keywords: food and nutrition security, Orang Asli, underutilized plants, wild edible food systems

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827 Cytogenetic Investigation of Patients with Disorder of Sexual Development Using G-Banding Karyotype and Fluorescence In situ Hybridization

Authors: Riksa Parikrama, Bremmy Laksono, Dadang S. H. Effendi

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Disorder of sexual development (DSD) covers various conditions with a specific term such as Klinefelter syndrome, Turner syndrome, androgen insensitivity syndrome, and many more. The techniques to accurately diagnose those conditions has developed extensively. However, conventional karyotype and fluorescence in situ hybridization (FISH) are still widely used in many genetic laboratories as the basic method to determine chromosomal condition of DSD patients. Cytogenetic study was conducted on 36 DSD patients in Cell Culture and Cytogenetics Laboratory, Faculty of Medicine Universitas Padjadjaran, Indonesia. Most of the patients referred to the laboratory diagnosed with primary amenorrhea, hypospadias, micropenis, genitalia ambiguity, or congenital adrenal hyperplasia. The study used G-banding technique to acquire complete karyotype and followed by FISH as either confirmation or comparison method. Among 36 patients, G-banding karyotype and FISH results showed that two were diagnosed with 45, X (Turner syndrome); three with 47, XXY (Klinefelter syndrome); five with 46, XX DSD; 22 with 46, XY DSD; and four with 46,XY complete androgen insensitivity syndrome. G-banding karyotype analysis were paired with FISH using X and Y chromosome probe produced similar results. The present analysis showed that FISH is a reliable method to attain a rapid and accurate chromosome analysis result of DSD patients. Nevertheless, conventional karyotype technique is still vital if other condition appeared in DSD patients in order to get more detailed karyotype result which FISH method cannot achieve.

Keywords: chromosome, DSD, FISH, karyotype

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826 Prognostic and Predictive Value of Tumor: Infiltrating Lymphocytes in Triple Negative Breast Cancer

Authors: Wooseok Byon, Eunyoung Kim, Junseong Kwon, Byung Joo Song, Chan Heun Park

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Background/Purpose: Previous preclinical and clinical data suggest that increased lymphocytic infiltration would be associated with good prognosis and benefit from immunogenic chemotherapy especially in triple-negative breast cancer (TNBC). We investigated a single-center experience of TNBC and relationship with lymphocytic infiltration. Methods: From January 2004 to December 2012, at the Department of Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, we retrospectively reviewed 897 breast cancer patients-clinical outcomes, clinicopathological characteristics, breast cancer subtypes. And we reviewed lymphocytic infiltration of TNBC specimens by two pathologists. Statistical analysis of risk factors associated with recurrence was performed. Results: A total of 897 patients, 76 were TNBC (8.47%). Mean age of TNBC patients were 50.95 (SD10.42) years, mean follow-up periods was 40.06 months. We reviewed 49 slides, and there were 8 recurrent breast cancer patients (16.32%), and 4 patients were expired (8.16%). There were 9 lymphocytic predominant breast cancers (LPBC)-carcinomas with either intratumoral lymphocytes in >60% of tumor cell nests. 1 patient of LPBC was recurred and 8 were not. In multivariate logistic regression, the odds ratio of lymphocytic infiltration was 0.59 (p=0.643). Conclusion: In a single-center experience of TNBC, the lymphocytic infiltration in tumor cell nest might be a good trend on the prognosis but there was not statistically significant.

Keywords: tumor-infiltrating lymphocytes, triple negative breast cancer, medical and health sciences

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825 Stature Prediction from Anthropometry of Extremities among Jordanians

Authors: Amal A. Mashali, Omar Eltaweel, Elerian Ekladious

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Stature of an individual has an important role in identification, which is often required in medico-legal practice. The estimation of stature is an important step in the identification of dismembered remains or when only a part of a skeleton is only available as in major disasters or with mutilation. There is no published data on anthropological data among Jordanian population. The present study was designed in order to find out relationship of stature to some anthropometric measures among a sample of Jordanian population and to determine the most accurate and reliable one in predicting the stature of an individual. A cross sectional study was conducted on 336 adult healthy volunteers , free of bone diseases, nutritional diseases and abnormalities in the extremities after taking their consent. Students of Faculty of Medicine, Mutah University helped in collecting the data. The anthropometric measurements (anatomically defined) were stature, humerus length, hand length and breadth, foot length and breadth, foot index and knee height on both right and left sides of the body. The measurements were typical on both sides of the bodies of the studied samples. All the anthropologic data showed significant relation with age except the knee height. There was a significant difference between male and female measurements except for the foot index where F= 0.269. There was a significant positive correlation between the different measures and the stature of the individuals. Three equations were developed for estimation of stature. The most sensitive measure for prediction of a stature was found to be the humerus length.

Keywords: foot index, foot length, hand length, humerus length, stature

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824 Synthesis of Modified Cellulose for the Capture of Uranyl Ions from Aqueous Solutions

Authors: Claudia Vergara, Oscar Valdes, Jaime Tapia, Leonardo Santos

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The poly(amidoamine) dendrimers (PAMAM) are a class of material introduced by D. Tomalia. Modifications of the PAMAM dendrimer with several functional groups have attracted the attention for new interesting properties and new applications in many fields such as chemistry, physics, biology, and medicine. However, in the last few years, the use of dendrimers in environmental applications has increased due to pollution concerns. In this contribution, we report the synthesis of three new PAMAM derivates modified with asparagine aminoacid supported in cellulose: PG0-Asn (PAMAM-asparagine), PG0-Asn-Trt (with trityl group) and PG0-Asn-Boc-Trt (with tert-butyl oxycarbonyl group). The functionalization of generation 0 PAMAM dendrimer was carried out by amidation reaction by using an EDC/HOBt protocol. In a second step, functionalized dendrimer was covalently supported to the cellulose surface and used to study the capture of uranyl ions from aqueous solution by fluorescence spectroscopy. The structure and purity of the desired products were confirmed by conventional techniques such as FT-IR, MALDI, elemental analysis, and ESI-MS. Batch experiments were carried out to determine the affinity of uranyl ions with the dendrimer in aqueous solution. Firstly, the optimal conditions for uranyl capture were obtained, where the optimum pH for the removal was 6, the contact time was 4 hours, the initial concentration of uranyl was 100 ppm, and the amount of the adsorbent to be used was 2.5 mg. PAMAM significantly increased the capture of uranyl ions with respect to cellulose as the starting substrate, reaching 94.8% of capture (PG0), followed by 91.2% corresponding to PG0-Asn-Trt, then 70.3% PG0-Asn and 24.2% PG0-Asn-Boc-Trt. These results show that the PAMAM dendrimer is a good option to remove uranyl ions from aqueous solutions.

Keywords: asparagine, cellulose, PAMAM dendrimer, uranyl ions

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823 A Computational Fluid Dynamics Simulation of Single Rod Bundles with 54 Fuel Rods without Spacers

Authors: S. K. Verma, S. L. Sinha, D. K. Chandraker

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The Advanced Heavy Water Reactor (AHWR) is a vertical pressure tube type, heavy water moderated and boiling light water cooled natural circulation based reactor. The fuel bundle of AHWR contains 54 fuel rods arranged in three concentric rings of 12, 18 and 24 fuel rods. This fuel bundle is divided into a number of imaginary interacting flow passage called subchannels. Single phase flow condition exists in reactor rod bundle during startup condition and up to certain length of rod bundle when it is operating at full power. Prediction of the thermal margin of the reactor during startup condition has necessitated the determination of the turbulent mixing rate of coolant amongst these subchannels. Thus, it is vital to evaluate turbulent mixing between subchannels of AHWR rod bundle. With the remarkable progress in the computer processing power, the computational fluid dynamics (CFD) methodology can be useful for investigating the thermal–hydraulic characteristics phenomena in the nuclear fuel assembly. The present report covers the results of simulation of pressure drop, velocity variation and turbulence intensity on single rod bundle with 54 rods in circular arrays. In this investigation, 54-rod assemblies are simulated with ANSYS Fluent 15 using steady simulations with an ANSYS Workbench meshing. The simulations have been carried out with water for Reynolds number 9861.83. The rod bundle has a mean flow area of 4853.0584 mm2 in the bare region with the hydraulic diameter of 8.105 mm. In present investigation, a benchmark k-ε model has been used as a turbulence model and the symmetry condition is set as boundary conditions. Simulation are carried out to determine the turbulent mixing rate in the simulated subchannels of the reactor. The size of rod and the pitch in the test has been same as that of actual rod bundle in the prototype. Water has been used as the working fluid and the turbulent mixing tests have been carried out at atmospheric condition without heat addition. The mean velocity in the subchannel has been varied from 0-1.2 m/s. The flow conditions are found to be closer to the actual reactor condition.

Keywords: AHWR, CFD, single-phase turbulent mixing rate, thermal–hydraulic

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822 Decision-making in the provision of Accessible Veterinary Care

Authors: Ellen Bryant, Virginia Behmer, Rebecca Garbed, Jeanette O’Quin, Dana Howard

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As it currently stands, veterinary care in the United States is not accessible to everyone, and veterinarians regularly face cases of clients who are unable to provide necessary care to their animals regardless of the client’s desire to do so. There is currently limited research into how veterinarians address these issues of access to care. It is apparent that veterinarians regularly utilize funding or offer discounted services to treat cases that otherwise would go without care. With need currently exceeding the amount of funds and services available, veterinarians are tasked with deciding which cases are most deserving of assistance. This mixed methods study distributed a survey to companion animal veterinarians practicing in the United States to identify current trends in how these professionals apply principles of distributive justice in the scope of veterinary medicine. Ethical frameworks identified in human bioethics research into distributive justice were presented, along with demographic questions, to identify relationships between veterinarian priorities and the scope of their practice/respective roles/geographic region. By surveying veterinarians across a wide range of specialties, practice types, and clientele this study was able to assess how priorities and opinions shift based on external factors as well as among the respondents themselves. Participants were asked not only to choose how to distribute aid between different clients and case scenarios, but also asked directly which is the best way to distribute aid when need exceeds the resources available.

Keywords: access to veterinary care, bioethics, decision-making, distributive justice, subsidized care

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821 Assessing Psycho-Social Stressors for Chronically Infected Hepatitis C Virus Patients in Egypt

Authors: Ammal M. Metwally, Dalia M. Elmosalami, Walaa A. Fouad, Abla G. Khalifa, Lobna A. El Etreby, Mohamed AbdelRahman

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People with hepatitis C are likely to experience psychological distress related to adjustment issues following diagnosis. Objective: The study was conducted to determine the psycho-social stressors accompanying Hepatitis C virus (HCV) chronic infection. The study focused on immediate and later on reactions to being diagnosed as infected HCV patients. Effect of HCV on disruption of patients’ relationships in term of family relationship and friendship, employment and financial status was assessed. The magnitude and causes of the social stigma and its relation to awareness about illness, level of education were also assessed. Methods: During this study the subjective experiences of people having HCV was explored through a designed questionnaire targeted 540 cases; 359 males and 181 females from ten out of 21 National Treatment Reference Centers of National Hepatology and Tropical Medicine Research Institutes of Ministry of Health (MOH) hospitals. The study was conducted along a period of six months from September 2011 to March 2012. Results: The study revealed that the financial problems are the commonest problems faced by 75.5 % of the cases. More than 70% of the cases suffered from immediate sadness versus 67.4% suffered from worry. Social stigma was reported by 13 % of HCV +patients, the majority of which were females. Conclusions: Exploring the psychosocial consequences of HCV infection can act as pressing motivators for behavior change needed for limiting HCV endemicity in Egypt.

Keywords: Egypt, HCV infection, psycho-social adjustment, stigma

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820 Synthesis, Structural and Vibrational Studies of a New Lacunar Apatite: LIPB2CA2(PO4)3

Authors: A. Chari, A. El Bouari, B. Orayech, A. Faik, J. M. Igartua

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The phosphate is a natural resource of great importance in Morocco. In order to exploit this wealth, synthesis and studies of new a material based phosphate, were carried out. The apatite structure present o lot of characteristics, One of the main characteristics is to allow large and various substitutions for both cations and anions. Beside their biological importance in hard tissue (bone and teeth), apatites have been extensively studied for their potential use as fluorescent lamp phosphors or laser host materials.The apatite have interesting possible application fields such as in medicine as materials of bone filling, coating of dental implants, agro chemicals as artificial fertilizers. The LiPb2Ca2(PO4)3 was synthesized by the solid-state method, its crystal structure was investigated by Rietveld analysis using XRPD data. This material crystallizes with a structure of lacunar apatite anion deficit. The LiPb2Ca2(PO4)3 is hexagonal apatite at room temperature, adopting the space group P63/m (ITA No. 176), Rietveld refinements showed that the site 4f is shared by three cations Ca, Pb and Li. While the 6h is occupied by the Pb and Li cations. The structure can be described as built up from the PO4 tetrahedra and the sixfold coordination cavities, which delimit hexagonal tunnels along the c-axis direction. These tunnels are linked by the cations occupying the 4 f sites. Raman and Infrared spectroscopy analyses were carried out. The observed frequencies were assigned and discussed on the basis of unit-cell group analysis and by comparison to other apatite-type materials.

Keywords: apatite, Lacunar, crystal structure, Rietveldmethod, LiPb2Ca2(PO4)3, Phase transition

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819 Optimal Beam for Accelerator Driven Systems

Authors: M. Paraipan, V. M. Javadova, S. I. Tyutyunnikov

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The concept of energy amplifier or accelerator driven system (ADS) involves the use of a particle accelerator coupled with a nuclear reactor. The accelerated particle beam generates a supplementary source of neutrons, which allows the subcritical functioning of the reactor, and consequently a safe exploitation. The harder neutron spectrum realized ensures a better incineration of the actinides. The almost generalized opinion is that the optimal beam for ADS is represented by protons with energy around 1 GeV (gigaelectronvolt). In the present work, a systematic analysis of the energy gain for proton beams with energy from 0.5 to 3 GeV and ion beams from deuteron to neon with energies between 0.25 and 2 AGeV is performed. The target is an assembly of metallic U-Pu-Zr fuel rods in a bath of lead-bismuth eutectic coolant. The rods length is 150 cm. A beryllium converter with length 110 cm is used in order to maximize the energy released in the target. The case of a linear accelerator is considered, with a beam intensity of 1.25‧10¹⁶ p/s, and a total accelerator efficiency of 0.18 for proton beam. These values are planned to be achieved in the European Spallation Source project. The energy gain G is calculated as the ratio between the energy released in the target to the energy spent to accelerate the beam. The energy released is obtained through simulation with the code Geant4. The energy spent is calculating by scaling from the data about the accelerator efficiency for the reference particle (proton). The analysis concerns the G values, the net power produce, the accelerator length, and the period between refueling. The optimal energy for proton is 1.5 GeV. At this energy, G reaches a plateau around a value of 8 and a net power production of 120 MW (megawatt). Starting with alpha, ion beams have a higher G than 1.5 GeV protons. A beam of 0.25 AGeV(gigaelectronvolt per nucleon) ⁷Li realizes the same net power production as 1.5 GeV protons, has a G of 15, and needs an accelerator length 2.6 times lower than for protons, representing the best solution for ADS. Beams of ¹⁶O or ²⁰Ne with energy 0.75 AGeV, accelerated in an accelerator with the same length as 1.5 GeV protons produce approximately 900 MW net power, with a gain of 23-25. The study of the evolution of the isotopes composition during irradiation shows that the increase in power production diminishes the period between refueling. For a net power produced of 120 MW, the target can be irradiated approximately 5000 days without refueling, but only 600 days when the net power reaches 1 GW (gigawatt).

Keywords: accelerator driven system, ion beam, electrical power, energy gain

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818 The Applications of Four Fingers Theory: The Proof of 66 Acupoints under the Human Elbow and Knee

Authors: Chih-I. Tsai, Yu-Chien. Lin

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Through experiences of clinical practices, it is discovered that locations on the body at a level of four fingerbreadth above and below the joints are the points at which muscles connect to tendons, and since the muscles and tendons possess opposite characteristics, muscles are full of blood but lack qi, while tendons are full of qi but lack blood, these points on our body become easily blocked. It is proposed that through doing acupuncture or creating localized pressure to the areas four fingerbreadths above and below our joints, with an elastic bandage, we could help the energy, also known as qi, to flow smoothly in our body and further improve our health. Based on the Four Fingers Theory, we understand that human height is 22 four fingerbreadths. In addition, qi and blood travel through 24 meridians, 50 times each day, and they flow through 6 cun with every human breath. We can also understand the average number of human heartbeats is 75 times per minute. And the function of qi-blood circulation system in Traditional Chinese Medicine is the same as the blood circulation in Western Medical Science. Informed by Four Fingers Theory, this study further examined its applications in acupuncture practices. The research question is how Four Fingers Theory proves what has been mentioned in Nei Jing that there are 66 acupoints under a human’s elbow and knee. In responding to the research question, there are 66 acupoints under a human’s elbow and knee. Four Fingers Theory facilitated the creation of the acupuncture naming and teaching system. It is expected to serve as an approachable and effective way to deliver knowledge of acupuncture to the public worldwide.

Keywords: four fingers theory, meridians circulation, 66 acupoints under human elbow and knee, acupuncture

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817 Ethnomedicinal Assets of Plants Collected from Nasarawa State, North Central Nigeria

Authors: Enock E. Goler, Emmanuel H. Kwon-Ndung, Gbenga F. Akomolafe, Terna T. Paul, Markus Musa, Joshua I. Waya, James H. Okogbaa

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An ethno-medicinal survey of plants used in treating various diseases and ailments was carried out in the study area of Nasarawa State, North Central Nigeria to obtain information on their uses and potentials. The ethno-medicinal survey was administered through structured questionnaires among local inhabitants from areas with high plant density and diversity within the various Local Government Areas of the State. A total of 84 (Eighty four) plant species belonging to 45 (Forty five) families were found to be useful in treatment of various ailments such as diabetes, measles, fever, asthma, jaundice, pneumonia, sexually transmitted diseases (STDs), aches, diarrhea, cough, arthritis, yellow fever, typhoid, erectile dysfunction and excessive bleeding. Different parts of the plant such as the roots, leaves and stems are used in preparing herbal remedies which could be from dry or freshly collected plants. The main methods of preparation are decoction or infusion, while in some cases the plant parts used are consumed directly. Residents in the study areas find the herbal remedy cheaper and more accessible and claimed that there are no side effects compared to orthodox medicine. This study has confirmed the need towards the conscious conservation of plant genetic resources in order to ensure sustained access to these ethno-medicinal plant materials.

Keywords: ethno-medicinal, Nasarawa, plants, survey

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816 Inverted Geometry Ceramic Insulators in High Voltage Direct Current Electron Guns for Accelerators

Authors: C. Hernandez-Garcia, P. Adderley, D. Bullard, J. Grames, M. A. Mamun, G. Palacios-Serrano, M. Poelker, M. Stutzman, R. Suleiman, Y. Wang, , S. Zhang

Abstract:

High-energy nuclear physics experiments performed at the Jefferson Lab (JLab) Continuous Electron Beam Accelerator Facility require a beam of spin-polarized ps-long electron bunches. The electron beam is generated when a circularly polarized laser beam illuminates a GaAs semiconductor photocathode biased at hundreds of kV dc inside an ultra-high vacuum chamber. The photocathode is mounted on highly polished stainless steel electrodes electrically isolated by means of a conical-shape ceramic insulator that extends into the vacuum chamber, serving as the cathode electrode support structure. The assembly is known as a dc photogun, which has to simultaneously meet the following criteria: high voltage to manage space charge forces within the electron bunch, ultra-high vacuum conditions to preserve the photocathode quantum efficiency, no field emission to prevent gas load when field emitted electrons impact the vacuum chamber, and finally no voltage breakdown for robust operation. Over the past decade, JLab has tested and implemented the use of inverted geometry ceramic insulators connected to commercial high voltage cables to operate a photogun at 200kV dc with a 10 cm long insulator, and a larger version at 300kV dc with 20 cm long insulator. Plans to develop a third photogun operating at 400kV dc to meet the stringent requirements of the proposed International Linear Collider are underway at JLab, utilizing even larger inverted insulators. This contribution describes approaches that have been successful in solving challenging problems related to breakdown and field emission, such as triple-point junction screening electrodes, mechanical polishing to achieve mirror-like surface finish and high voltage conditioning procedures with Kr gas to extinguish field emission.

Keywords: electron guns, high voltage techniques, insulators, vacuum insulation

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815 Patient Support Program in Pharmacovigilance: Foster Patient Confidence and Compliance

Authors: Atul Khurana, Rajul Rastogi, Hans-Joachim Gamperl

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The pharmaceutical companies are getting more inclined towards patient support programs (PSPs) which assist patients and/or healthcare professionals (HCPs) in more desirable disease management and cost-effective treatment. The utmost objective of these programs is patient care. The PSPs may include financial assistance to patients, medicine compliance programs, access to HCPs via phone or online chat centers, etc. The PSP has a crucial role in terms of customer acquisition and retention strategies. During the conduct of these programs, Marketing Authorisation Holder (MAH) may receive information related to concerned medicinal products, which is usually reported by patients or involved HCPs. This information may include suspected adverse reaction(s) during/after administration of medicinal products. Hence, the MAH should design PSP to comply with regulatory reporting requirements and avoid non-compliance during PV inspection. The emergence of wireless health devices is lowering the burden on patients to manually incorporate safety data, and building a significant option for patients to observe major swings in reference to drug safety. Therefore, to enhance the adoption of these programs, MAH not only needs to aware patients about advantages of the program, but also recognizes the importance of time of patients and commitments made in a constructive manner. It is indispensable that strengthening the public health is considered as the topmost priority in such programs, and the MAH is compliant to Pharmacovigilance (PV) requirements along with regulatory obligations.

Keywords: drug safety, good pharmacovigilance practice, patient support program, pharmacovigilance

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814 A Questionnaire Survey Reviewing Radiographers' Knowledge of Computed Tomography Exposure Parameters

Authors: Mohammad Rawashdeh, Mark McEntee, Maha Zaitoun, Mostafa Abdelrahman, Patrick Brennan, Haytham Alewaidat, Sarah Lewis, Charbel Saade

Abstract:

Despite the tremendous advancements that have been generated by Computed Tomography (CT) in the field of diagnosis, concerns have been raised about the potential cancer induction risk from CT because of the exponentially increased use of it in medicine. This study aims at investigating the application and knowledge of practicing radiographers in Jordan about CT radiation. In order to collect the primary data of this study, a questionnaire was designed and distributed by social media using a snow-balling sampling method. The respondents (n=54) have answered 36 questions including the questions about their demographic information, knowledge about Diagnostic Reference Levels (DRLs), CT exposure and adaptation of pediatric patients exposure. The educational level of the respondents was either at a diploma degree (35.2%) or bachelor (64.8%). The results of this study have indicated a good level of general knowledge between radiographers about the relationship between image quality, exposure parameters, and patient dose. The level of knowledge related to DRL was poor where less than 7.4 percent of the sample members were able to give specific values for a number of common anatomical fields, including abdomen, brain, and chest. Overall, Jordanian radiographers need to gain more knowledge about the expected levels of the dose when applying good practice. Additional education on DRL or DRL inclusion in educational programs is highlighted.

Keywords: computed tomography, CT scan, DRLs, exposure parameters, image quality, radiation dose

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813 Prevention of COVID-19 Using Herbs and Natural Products

Authors: Nada Alqadri, Omaima Nasir

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Natural compounds are an important source of potential inhibitors; they have a lot of pharma potential with less adverse effects. The effective antiviral activities of natural products have been proved in different studies. The outbreak of COVID-19 in Wuhan, Hubei, in December 2019, coronavirus has had a significant impact on people's health and lives. Based on previous studies, natural products can be introduced as preventive and therapeutic agents in the fight against COVID-19; considering that no food or supplement has been authorized to prevent COVID-19, individuals continue to search for and consume specific herbs, foods, and commercial supplements for this purpose. This study will be aimed to estimate the uses of herbal and natural products during the COVID-19 infection to determine their usage reasons and evaluate their potential side effects. An online cross-sectional survey of different participants will be conducted and will be a focus on respondents’ chronic disease histories, socio-dmographic characteristics, and frequency and trends of using these products. Descriptive and univariate analyses will be performed to determine prevalence and associations between various products used and respondents’ socio-demographic data. Relationships will be tested using Pearson’s chi-square test or an exact probability test. Our main findings will give evidence of beneficial uses of natural products and herbal medicine as prophylactic and will be a vigorous approach to stop or at least slow down COVID-19 infection and transmission. This will be of great interest of public health, and the results of our study will lend health officials better control on the current pandemic.

Keywords: COVID-19, herbs, natural products, saudi arabia

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812 The Efficacy of Andrographis paniculata and Chromolaena odorata Plant Extract against Malaria Parasite

Authors: Funmilola O. Omoya, Abdul O. Momoh

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Malaria constitutes one of the major health problems in Nigeria. One of the reasons attributed for the upsurge was the development of resistance of Plasmodium falciparum and the emergence of multi-resistant strains of the parasite to anti-malaria drugs. A continued search for other effective, safe and cheap plant-based anti-malaria agents thus becomes imperative in the face of these difficulties. The objective of this study is therefore to evaluate the in vivo anti-malarial efficacy of ethanolic extracts of Chromolaena odorata and Androgaphis paniculata leaves. The two plants were evaluated for their anti-malaria efficacy in vivo in a 4-day curative test assay against Plasmodium berghei strain in mice. The group treated with 500mg/ml dose of ethanolic extract of A. paniculata plant showed parasite suppression with increase in Packed Cell Volume (PCV) value except day 3 which showed a slight decrease in PCV value. During the 4-day curative test, an increase in the PCV values, weight measurement and zero count of Plasmodium berghei parasite values was recorded after day 3 of drug administration. These results obtained in group treated with A. paniculata extract showed anti-malarial efficacy with higher mortality rate in parasitaemia count when compared with Chromolaena odorata group. These results justify the use of ethanolic extracts of A. paniculata plant as medicinal herb used in folklore medicine in the treatment of malaria.

Keywords: anti-malaria, curative, plant-based anti-malaria agents, biology

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811 Intestinal Parasites Detected by Fecal Examination in Cats in the Konya Province, Turkey

Authors: Nermin Isik, Ozlem Derinbay Ekici

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The cat is one of the potential hosts for parasitic zoonoses, such as Toxocara cati, Ancylostoma braziliense, A. tubaeforme, Uncinaria stenocephala, Cryptosporidium sp, Giardia sp. This study was performed to determine the prevalence and intensity of intestinal parasites in household cats in Konya, Turkey. In this study, a total of 100 stool samples with different ages and sex were used as a material. They were examined for infections with endoparasites by the use of native, Fulleborn flotation and Benedek sedimentation methods in University of Selcuk, Faculty of Veterinary Medicine, Department of Parasitology. The overall prevalence of intestinal parasites was 15%. A total of 6 parasite species was recorded: Giardia sp (6%), Toxocara cati (4%), Isospora sp (3%), Joyeuxiella pasqualei, Taenia sp (1%), Trichuris sp (1%). The most common intestinal parasites in cats were Giardia sp (6%) and Toxocara cati (4%). Younger cats up to 1 year of age were more frequently infected with endoparasites than animals over 1 year of age (p < 0.05). Giardia sp and Toxocara cati were detected significantly more often in younger than 1 year of age (p < 0.05). In fecal examination, Toxocara cati, Ancylostoma sp. Joyeuxiella pasqualei, Dipylidium caninum, Trichuris sp were found in cats in Turkey. In this study, based on microscopic and macroscopic fecal examinations, Giardia sp (6%), Toxocara cati (4%), Isospora sp (3%), Joyeuxiella pasqualei (%2), Taenia sp (1%), Trichuris sp (1%) was detected in cats. In conclusion, zoonotic intestinal parasites in household cats such as Giardia sp and Toxocara cati should be considered more seriously and it is necessary to take precautions against these infections. Cats should be routinely checked by faecal examination for endoparasite infections.

Keywords: cat, intestinal parasites, faecal, Turkey

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810 The Effectiveness of Treating Anxiety with Reiki

Authors: Erika Humphreys

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The effectiveness of treating anxiety with Reiki is explored within ten quantitative studies. The methodology utilized for a critical appraisal and systematic review of the literature is explained with inclusion and exclusion criteria. The theoretical framework for the project is grounded in the work of Hildegard Peplau, whose nursing theory based on the therapeutic use of self is foundational for Reiki implementation. A thorough critique of the literature is conducted for key components of robustness and believability. This critique is conducted using a structured guide addressing synthesized strengths and weaknesses of the body of literature. A synthesis of the literature explores the findings of the studies. This synthesis reports on Reiki’s effectiveness in treating anxiety within a variety of patient settings and populations, its effect on subscales of anxiety, physiological manifestations of anxiety, and pain associated with anxiety. Cultural considerations affecting Reiki’s potential effectiveness are discussed. Gaps in the literature are examined, including the studies’ narrow sample population, lack of participant exclusionary factors for controlled outcome data, and the lack of studies across time. Implications for future research are discussed with recommendations for expanded research that includes a broader variety of settings, age groups, and patient diagnoses, including anxiety disorders, for research data that is transferable. Implications for further practice for the advanced practice registered nurse (APRN) are explored, with the potential benefits for both providers and patients, including improved patient satisfaction and expansion of provider treatment modalities.

Keywords: Reiki, anxiety, complementary alternative medicine, pandemic

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809 The Impact of Civilian Syrian War on Human Wellbeing as Inflected by Depression General Status Among Patients Treated in Royal Medical Services, Jordan

Authors: Zeyad Suleiman Bataineh

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Introduction: civilian wars are associated with severe humanitarian effects that include loss of individuals and properties. Psychological dimensions are also included depression. Objectives: the main objectives of the present study were to investigate the depression level among Syrian patients who visited internal medicine clinics and other related variables. Methods and subjects: this study was conducted based on cross sectional study design. A total of 175 patients were involved. Patients were asked to fill a questionnaire to assess the level of depression that include demographic variables such as gender, age, educational level, and social status. Beck Aaron scale for depression was used. Participation in this study was voluntary, and all patients were informed about their rights to withdraw from the study without being negatively affected. Data were entered into excel spreading sheet for all participants. SPSS version 21 was used to analyze data. Data were described as means, the standard deviation for linear variables, frequencies, and percentages for categorical variables. The relationships between variables were evaluated using independent t test and One Way ANOVA test. Significance was considered at α≤0.05. Results: Depression was found in 152 (87%) of participants. The majority of participants with depression had moderate to severe depression. Depression was significantly associated gender, age, educational level, and social status (p<0.05). Conclusion: psychological rehabilitation is required for patients who experienced civilian wars.

Keywords: mental health, deprssion, health system, psychological dimension

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808 Transcriptome Analysis of Protestia brevitarsis seulensis with Focus On Wing Development and Metamorphosis in Developmental Stages

Authors: Jihye Hwang, Eun Hwa Choi, Su Youn Baek, Bia Park, Gyeongmin Kim, Chorong Shin, Joon Ha Lee, Jae-Sam Hwang, Ui Wook Hwang

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White-spotted flower chafers are widely distributed in Asian countries and traditionally used for the treatment of chronic fatigue, blood circulation, and paralysis in the oriental medicine field. The evolution and development of insect wings and metamorphosis remain under-discovered subjects in arthropod evolutionary researches. Gene expression abundance analyses along with developmental stages based on the large-scale RNA-seq data are also still rarely done. Here we report the de novo assembly of a Protestia brevitarsis seulensis transcriptome along four different developmental stages (egg, larva, pupa, and adult) to explore its development and evolution of wings and metamorphosis. The de novo transcriptome assembly consists of 23,551 high-quality transcripts and is approximately 96.7% complete. Out of 8,545 transcripts, 5,183 correspond to the possible orthologs with Drosophila melanogaster. As a result, we could found 265 genes related to wing development and 19 genes related to metamorphosis. The comparison of transcript expression abundance with different developmental stages revealed developmental stage-specific transcripts especially working at the stage of wing development and metamorphosis of P. b. seulensis. This transcriptome quantification along the developmental stages may provide some meaningful clues to elucidate the genetic modulation mechanism of wing development and metamorphosis obtained during the insect evolution.

Keywords: white-spotted flower chafers, transcriptomics, RNA-seq, network biology, wing development, metamorphosis

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807 Identification of Nutrient Sensitive Signaling Pathways via Analysis of O-GlcNAcylation

Authors: Michael P. Mannino, Gerald W. Hart

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The majority of glucose metabolism proceeds through glycolytic pathways such as glycolysis or pentose phosphate pathway, however, about 5% is shunted through the hexosamine biosynthetic pathway, producing uridine diphosphate N-acetyl glucosamine (UDP-GlcNAc). This precursor can then be incorporated into complex oligosaccharides decorating the cell surface or remain as an intracellular post-translational-modification (PTM) of serine/threonine residues (O-GlcNAcylation, OGN), which has been identified on over 4,000 cytosolic or nuclear proteins. Intracellular OGN has major implications on cellularprocesses, typically by modulating protein localization, protein-protein interactions, protein degradation, and gene expression. Additionally, OGN is known to have an extensive cross-talk with phosphorylation, be in a competitive or cooperative manner. Unlike other PTMs there are only two cycling enzymes that are capable of adding or removing the GlcNAc moiety, O-linked N-aceytl glucosamine Transferase (OGT) and O-linked N-acetyl glucoamidase (OGA), respectively. The activity of OGT has been shown to be sensitive to cellular UDP-GlcNAc levels, even changing substrate affinity. Owing to this and that the concentration of UDP-GlcNAc is related to the metabolisms of glucose, amino acid, fatty acid, and nucleotides, O-GlcNAc is often referred to as a nutrient sensing rheostat. Indeed OGN is known to regulate several signaling pathways as a result of nutrient levels, such as insulin signaling. Dysregulation of OGN is associated with several disease states such as cancer, diabetes, and neurodegeneration. Improvements in glycomics over the past 10-15 years has significantly increased the OGT substrate pool, suggesting O-GlcNAc’s involvement in a wide variety of signaling pathways. However, O-GlcNAc’s role at the receptor level has only been identified in a case-by-case basis of known pathways. Examining the OGN of the plasma membrane (PM) may better focus our understanding of O-GlcNAc-effected signaling pathways. In this current study, PM fractions were isolated from several cell types via ultracentrifugation, followed by purification and MS/MS analysis in several cell lines. This process was repeated with or without OGT/OGA inhibitors or with increased/decreased glucose levels in media to ascertain the importance of OGN. Various pathways are followed up on in more detailed studies employing methods to localize OGN at the PM specifically.

Keywords: GlcNAc, nutrient sensitive, post-translational-modification, receptor

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806 Attitude and Practice of Family Physicians in Giving Smoking Cessation Advice at King Abdul-Aziz Medical City for National Guard, Riyadh

Authors: Mohammed Alateeq, Abdulaziz Alrshoud

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Objectives: To examine the attitude and practice of family physicians in giving smoking cessation advice at King Abdul-Aziz Medical City for National Guard, Riyadh. Methods: Cross sectional study using validated self-reported questionnaire that distributed to all family physicians and primary health care doctors at the four main family medicine and primary health care centers, KAMC, Riyadh. Results: 73 physicians are contributed in this study. 28 (38.4%) physicians were from (KASHM ALAN) clinic, 26 (35.6%) physicians were from (UM ALHAMAM) Clinic. 13 (17.8%) physicians were from (ISKAN) clinic. 6 (8.2%) physicians were from the Employee Health Clinic. 73 (100%) of the target population agreed that giving brief smoking cessation advice is part of their duties. 67 (91.7%) agreed that Presence of hospital guidelines and special clinics for smoking cessation will encourage them to provide advice. Only 5 (6.84%) received training courses (1-4 weeks) in smoking cessation interventions. Conclusion: Most of the target population agreed that brief smoking cessation advice is part of their duties. Also, they agreed that Presence of hospital guidelines and special clinics for smoking cessation will encourage them to provide advice although most of them did not received a formal training in smoking cessation advice.

Keywords: advice, attitude, cessation, family physicians, smoking

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805 Human Lens Metabolome: A Combined LC-MS and NMR Study

Authors: Vadim V. Yanshole, Lyudmila V. Yanshole, Alexey S. Kiryutin, Timofey D. Verkhovod, Yuri P. Tsentalovich

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Cataract, or clouding of the eye lens, is the leading cause of vision impairment in the world. The lens tissue have very specific structure: It does not have vascular system, the lens proteins – crystallins – do not turnover throughout lifespan. The protection of lens proteins is provided by the metabolites which diffuse inside the lens from the aqueous humor or synthesized in the lens epithelial layer. Therefore, the study of changes in the metabolite composition of a cataractous lens as compared to a normal lens may elucidate the possible mechanisms of the cataract formation. Quantitative metabolomic profiles of normal and cataractous human lenses were obtained with the combined use of high-frequency nuclear magnetic resonance (NMR) and ion-pairing high-performance liquid chromatography with high-resolution mass-spectrometric detection (LC-MS) methods. The quantitative content of more than fifty metabolites has been determined in this work for normal aged and cataractous human lenses. The most abundant metabolites in the normal lens are myo-inositol, lactate, creatine, glutathione, glutamate, and glucose. For the majority of metabolites, their levels in the lens cortex and nucleus are similar, with the few exceptions including antioxidants and UV filters: The concentrations of glutathione, ascorbate and NAD in the lens nucleus decrease as compared to the cortex, while the levels of the secondary UV filters formed from primary UV filters in redox processes increase. That confirms that the lens core is metabolically inert, and the metabolic activity in the lens nucleus is mostly restricted by protection from the oxidative stress caused by UV irradiation, UV filter spontaneous decomposition, or other factors. It was found that the metabolomic composition of normal and age-matched cataractous human lenses differ significantly. The content of the most important metabolites – antioxidants, UV filters, and osmolytes – in the cataractous nucleus is at least ten fold lower than in the normal nucleus. One may suppose that the majority of these metabolites are synthesized in the lens epithelial layer, and that age-related cataractogenesis might originate from the dysfunction of the lens epithelial cells. Comprehensive quantitative metabolic profiles of the human eye lens have been acquired for the first time. The obtained data can be used for the analysis of changes in the lens chemical composition occurring with age and with the cataract development.

Keywords: cataract, lens, NMR, LC-MS, metabolome

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804 Exploring Spiritual Needs of Taiwanese Inpatients with Advanced Cancer and Their Family Caregivers

Authors: Szu Mei Hsiao

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This study explores the spiritual needs of inpatients with advanced cancer and their family caregivers in one southern regional teaching hospital in Taiwan and elucidates the differences and similarities of spiritual needs between them. Little research reports the different phases of spiritual needs and the potential impact of Chinese cultural values on the spiritual needs. Qualitative inquiry was used. Twenty-one patients with advanced cancer and twenty-two family caregivers were recruited. During hospitalization, all participants identified spiritual needs both the palliative phase and the dying phase: (a) the need to foster faith/confidence and hope for medicine and/or God; (b) to understand the meaning and values of life; (c) to experience more reciprocal human love and forgiveness; and (d) to obey God’s/Heaven will. Furthermore, the differences of spiritual needs between patients with advanced cancer and their family caregivers are as follows: (a) family caregivers emphasized the need to inform relatives and say goodbye in order to die peacefully; (b) patients highlighted a need to maintain a certain physical appearance in order to preserve their dignity; nurture one’s willpower; learn about the experiences of cancer survivors; and identify one’s own life experience for understanding the meaning and values of life. Moreover, the dissimilarity of spiritual needs is that the patients pointed out the need to understand God’s will during the palliative treatment phase. However, the family caregivers identified the need to forgive each other, and inform relatives and say goodbye to patients in the dying phase. This research has shown that the needs of meaning/values of life and facing death peacefully are different between two groups. Health professionals will be encouraged to detect and to develop individualized care strategies to meet spiritual needs.

Keywords: advanced cancer, Chinese culture, family caregivers, qualitative research, spiritual needs

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803 Clinical Pharmacology Throughout the World: A View from Global Health

Authors: Ragy Raafat Gaber Attaalla

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Despite having the greatest rates of mortality and morbidity in the world, low- and middle-income (LMIC) nations trail high-income nations in terms of the number of clinical trials, the number of qualified researchers, and the amount of research information specific to their people. Health inequities and the use of precision medicine may be hampered by a lack of local genomic data, clinical pharmacology and pharmacometrics competence, and training opportunities. These issues can be solved by carrying out health care infrastructure development, which includes data gathering and well-designed clinical pharmacology training in LMICs. It will be advantageous if there is international cooperation focused at enhancing education and infrastructure and promoting locally motivated clinical trials and research. This paper outlines various instances where clinical pharmacology knowledge could be put to use, including pharmacogenomic opportunities that could lead to better clinical guideline recommendations. Examples of how clinical pharmacology training can be successfully implemented in LMICs are also provided, including clinical pharmacology and pharmacometrics training programmes in Africa and a Tanzanian researcher's personal experience while on a training sabbatical in the United States. These training initiatives will profit from advocacy for clinical pharmacologists' employment prospects and career development pathways, which are gradually becoming acknowledged and established in LMICs. The advancement of training and research infrastructure to increase clinical pharmacologists' knowledge in LMICs would be extremely beneficial because they have a significant role to play in global health.

Keywords: low- and middle-income, clinical pharmacology, pharmacometrics, career development pathways

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