Search results for: systemic inflamatory response syndrome

Authors: Antonio Munar-Frau, Sascha Klismoch, Manfred Schmolz, Federico Hernandez-Alfaro, Jordi Caballe-Serrano

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Introduction: Biocompatibility of biomaterials has been proposed as one of the main criteria for treatment success. For guided bone regeneration (GBR), barrier membranes present a conflict given the number of origins and modifications of these materials. The biologic response to biomaterials is orchestrated by a series of events leading to the integration or rejection of the biomaterial, posing questions such as if a longer occlusive property may trigger an inflammatory reaction. Whole blood cultures are a solution to study the immune response to drugs or biomaterials during the first 24-48 hours. The aim of this study is to determine the early immune response of different origins and chemical modifications of barrier membranes. Materials & Methods: 5 different widely used barrier membranes were included in this study: Acellular dermal matrix (AlloDerm, LifeCell®), Porcine Peritoneum (BioGide, Geistlich Pharma®), Porcine Pericardium (Jason, Botiss Biomaterials GmbH®), Porcine Cross-linked collagen (Ossix Plus, Datum Dental®) and d-PTFE (Cytoplast TXT, Osteogenics Biomedical®). Blood samples were extracted from 3 different healthy donors and incubated with the different samples of barrier membranes for 24 hours. After the incubation time, serum samples were obtained and analyzed by means of biocompatibility assays taking into account 42 markers. Results: In an early stage of the inflammatory response, the Acellular dermal matrix, porcine peritoneum and porcine cross-linked collagen expressed similar patterns of cytokine expression with a great manifestation of ENA 78. Porcine pericardium and d-PTFE presented similar cytokine activation, especially for MMP-3 and MMP-9, although other cytokines were highlighted with lower expression. For the later immune response, Porcine peritoneum and acellular dermal matrix MCP-1 and IL-15 were evident. Porcine pericardium, porcine cross-linked collagen and d-PTFE presented a high expression of IL-16 and lower manifestation of other cytokines. Different behaviors depending on an earlier or later stage of the inflammation process were observed. Barrier membrane inflammatory expression does not only differ depending on the origin, variables such as treatment of the collagen and polymers may also have a great impact on the cytokine expression of the studied barrier membranes during inflammation. Conclusions: Surface treatment and modifications might affect the biocompatibility of the membranes, as different cytokine expressions were evidently depending on the origin of the biomaterial. This study is only a brushstroke regarding the biocompatibility of materials, as it is one of the pioneer studies for ex vivo barrier membranes assays. Studies regarding surface modification are needed in order to clarify mystifications of barrier membrane science.

Keywords: biomaterials, bone regeneration, biocompatibility, inflammation

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Authors: P. M. Kundu, L. R. Singo, J. O. Odiyo

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Luvuvhu River catchment in South Africa experiences floods resulting from heavy rainfall of intensities exceeding 15 mm per hour associated with the Inter-tropical Convergence Zone (ITCZ). The generation of runoff is triggered by the rainfall intensity and soil moisture status. In this study, remote sensing and GIS techniques were used to analyze the hydrologic response to land cover changes. Runoff was calculated as a product of the net precipitation and a curve number coefficient. It was then routed using the Muskingum-Cunge method using a diffusive wave transfer model that enabled the calculation of response functions between start and end point. Flood frequency analysis was determined using theoretical probability distributions. Spatial data on land cover was obtained from multi-temporal Landsat images while data on rainfall, soil type, runoff and stream discharges was obtained by direct measurements in the field and from the Department of Water. A digital elevation model was generated from contour maps available at http://www.ngi.gov.za. The results showed that land cover changes had impacted negatively to the hydrology of the catchment. Peak discharges in the whole catchment were noted to have increased by at least 17% over the period while flood volumes were noted to have increased by at least 11% over the same period. The flood time to peak indicated a decreasing trend, in the range of 0.5 to 1 hour within the years. The synergism between remotely sensed digital data and GIS for land surface analysis and modeling was realized, and it was therefore concluded that hydrologic modeling has potential for determining the influence of changes in land cover on the hydrologic response of the catchment.

Keywords: catchment, digital elevation model, hydrological model, routing, runoff

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Authors: Mustafa Cam, Nedim Ongun, Ufuk Kutluana

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Introduction: Restless LegsSyndrome (RLS) is a common, under-recognized disorder disrupts sleep and diminishes quality of life (1). The most common conditions highly associated with RLS include renalfailure, iron and folic acid deficiency, peripheral neuropathy, pregnancy, celiacdisease, Crohn’sdiseaseandrarelymalignancy (2).Despite a clear relation between low peripheral iron and increased prevalence and severity of RLS, the prevalence and clinical significance of RLS in iron-deficientanemic populations is unknown (2). We report here a case of RLS due to iron deficiency in the setting of neuroendocrinetumor. Report of Case: A 35 year-old man was referred to our clinic with general weakness, weight loss (10 kg in 2 months)and 2-month history of uncomfortable sensations in his legs with urge to move, partially relieved by movement. The symptoms were presented very day, worsening in the evening; the discomfort forced the patient to getup and walk around at night. RLS was severe, with a score of 22 at the International RLS ratingscale. The patient had no past medical history. The patient underwent a complete set of blood analyses and the following ab normal values were found (normal limitswithinbrackets): hemoglobin 9.9 g/dl (14-18), MCV 70 fL (80-94), ferritin 3,5 ng/mL (13-150). Brain and spinemagnetic resonance imaging was normal. The patient consultated with gastroenterology clinic and gastointestinal systemendoscopy was performed for theetiology of the iron deficiency anemia. After the gastricbiopsy, results allowed us to reach the diagnosis of neuroen docrine tumor and the patient referred to oncology clinic. Discussion: The first important consideration from this case report is that the patient was referred to our clinic because of his severe RLS symptoms dramatically reducing his quality of life. However, our clinical study clearly demonstrated that RLS was not the primary disease. Considering the information available for this patient, we believe that the most likely possibility is that RLS was secondary to iron deficiency, a very well-known and established cause of RLS in theliterature (3,4). Neuroendocrine tumors (NETs) are rare epithelial neoplasms with neuroendocrine differentiation that most commonly originate in the lungs and gastrointestinal tract (5). NETs vary widely in their clinical presentation; symptoms are often nonspecific and can be mistaken for those of other more common conditions (6). 50% of patients with reported disease stage have either regional or distant metastases at diagnosis (7). Accurate and earlier NET diagnosis is the first step in shortening the time to optimal care and improved outcomes for patients (8). The most important message from this case report is that RLS symptoms can sometimes be thesign of a life-threatening condition. Conclusion: Careful and complete collection of clinical and laboratory data should be carried out in RLS patients. Inparticular, if RLS onset coincides with weight loss and iron deficieny anemia, gastricendos copy should be performed. It is known about that malignancy is a rare etiology in RLS patients and to our knowledge; it is the first case with neuro endocrine tumor presenting with RLS.

Keywords: neurology, neuroendocrine tumor, restless legs syndrome, sleep

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Authors: S. K. Hashemi, M. A. Bradford, H. R. Valipour

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The Recent collapse of bridges has raised the awareness about safety and robustness of bridges subjected to extreme loading scenarios such as intentional/unintentional blast loads. The air blast generated by the explosion of bombs or fuel tankers leads to high-magnitude short-duration loading scenarios that can cause severe structural damage and loss of critical structural members. Hence, more attentions need to put towards bridge structures to develop guidelines to increase the resistance of such structures against the probable blast. Recent advancements in numerical methods have brought about the viable and cost effective facilities to simulate complicated blast scenarios and subsequently provide useful reference for safeguarding design of critical infrastructures. In the previous studies common bridge responses to blast load, the traffic load is sometimes not included in the analysis. Including traffic load will increase the axial compression in bridge piers especially when the axial load is relatively small. Traffic load also can reduce the uplift of girders and deck when the bridge experiences under deck explosion. For more complicated structures like cable-stayed or suspension bridges, however, the effect of traffic loads can be completely different. The tension in the cables increase and progressive collapse is likely to happen while traffic loads exist. Accordingly, this study is an attempt to simulate the effect of traffic load cases on the maximum local and global response of an entire cable-stayed bridge subjected to blast loadings using LS-DYNA explicit finite element code. The blast loads ranged from small to large explosion placed at different positions above the deck. Furthermore, the variation of the traffic load factor in the load combination and its effect on the dynamic response of the bridge under blast load is investigated.

Keywords: blast, cable-stayed bridge, LS-DYNA, numerical, traffic load

Procedia PDF Downloads 331

Authors: R. Komsa-Penkova, G. Golemanov, G. Georgieva, K. Popovski, N. Slavov, P. Ivanov, K. Kovacheva, S. Rathee, E. Konova, A. Blajev

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Leptin and PAI-1 are important cytokines and may play a role in the regulation of PCOS development. PCOS is frequently associated with obesity, high BMI index and consequently with increased risk of metabolic disorders. The aim of the present study was to evaluate PAI-1 levels, genetic influence of the carriage of 675 4G/5G polymorphism in PAI-1 gene and leptin as a marker of obesity in the development of PCOS. Methods: Genotyping in 84 patients with PCOS and PCO and 100 healthy control subjects to detect single nucleotide deletion 675 G in the promoter of PAI-1 gene. The present study provides evidence that SNP 4G in the PAI-1 gene is associated with early pregnancy losses in patients with polycystosis. Further to this, there is a correlation between leptin levels, PAI-1 levels and BMI in the patients with PCOS, which confirms the role of obesity as a risk factor for PCOS.

Keywords: carriage of 675 4G/5G polymorphism, PCOS, early pregnancy losses, PAI-1 gene

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Authors: Akbar Salimi, Mehdi Moghimi

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Goal: Today, the cooperative and systemic work is of importance and guarantees higher efficiency. This research was done with the aim of understanding the guidelines for co-op between police and the national media in order to reduce the juvenile delinquency. Method: This research is applied in terms of goal and of a compound type, which was done through a descriptive-analytical methodology. The data were collected through field surveys and documents. The statistical population included the professors of a higher education center in the area of education affairs, where as many as 36 people were randomly selected. The data collection procedure was by way of interview and researcher made questionnaire. Findings and results: Problems caused by the national media in the area of adolescents are categorized in three levels of production, broadcasting and consumption and elimination and reduction of the problems entail a set of estimations and predictions and also some education which the police forces has the capability to operationalize them. Thus, three hypotheses were defined and by conducting t and Friedman tests, all three hypotheses were confirmed and their rating was identified.

Keywords: management, media, TV, adolscents, delinquency

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Authors: H. Akbari Khorami, P. Wild, N. Djilali

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This paper reports on the response of a fiber-optic sensing probe to small concentrations of hydrogen peroxide (H2O2) vapor at room temperature. H2O2 has extensive applications in industrial and medical environments. Conversely, H2O2 can be a health hazard by itself. For example, H2O2 induces cellular damage in human cells and its presence can be used to diagnose illnesses such as asthma and human breast cancer. Hence, development of reliable H2O2 sensor is of vital importance to detect and measure this species. Ferric ferrocyanide, referred to as Prussian blue (PB), was deposited on the tip of a multimode optical fiber through the single source precursor technique and served as an indicator of H2O2 in a spectroscopic manner. Sensing tests were performed in H2O2-H2O vapor mixtures with different concentrations of H2O2. The results of sensing tests show the sensor is able to detect H2O2 concentrations in the range of 50.6 ppm to 229.5 ppm. Furthermore, the sensor response to H2O2 concentrations is linear in a log-log scale with the adjacent R-square of 0.93. This sensing behavior allows us to detect and quantify the concentration of H2O2 in the vapor phase.

Keywords: chemical deposition, fiber-optic sensor, hydrogen peroxide vapor, prussian blue

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Authors: Xianping Du, Runlu Miao, Guanjun Zhang, Libo Cao, Feng Zhu

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Current vehicle safety standards and human body injury criteria were established based on the biomechanical response of Euro-American human body, without considering the difference in the body anthropometry and injury characteristics among different races, particularly the East Asian people with smaller body size. Absence of such race specific design considerations will negatively influence the protective performance of safety products for these populations, and weaken the accuracy of injury thresholds derived. To resolve these issues, in this study, we aim to develop a race specific finite element model to simulate the impact response of the lower extremity of a 50th percentile East Asian (Chinese) male. The model was built based on medical images for the leg of an average size Chinese male and slightly adjusted based on the statistical data. The model includes detailed anatomic features and is able to simulate the muscle active force. Thirteen biomechanical tests available in the literature were used to validate its biofidelity. Using the validated model, a pedestrian-car impact accident taking place in China was re-constructed computationally. The results show that the newly developed lower leg model has a good performance in predicting dynamic response and tibia fracture pattern. An additional comparison on the fracture tolerance of the East Asian and Euro-American lower limb suggests that the current injury criterion underestimates the degree of injury of East Asian human body.

Keywords: lower limb, East Asian body characteristics, traffic accident reconstruction, finite element analysis, injury tolerance

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Authors: Seyed Sadegh Naseralavi, Sohrab Nemati, Ehsan Khojastehfar, Sadegh Balaghi

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In the present research, various formulations of wavelet transform are applied on acceleration time history of earthquake. The mentioned transforms decompose the strong ground motion into low and high frequency parts. Since the high frequency portion of strong ground motion has a minor effect on dynamic response of structures, the structure is excited by low frequency part. Consequently, the seismic response of structure is predicted consuming one half of computational time, comparing with conventional time history analysis. Towards reducing the computational effort needed in seismic optimization of structure, seismic optimization of a shear frame structure is conducted by applying various forms of mentioned transformation through genetic algorithm.

Keywords: time history analysis, wavelet transform, optimization, earthquake

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Authors: Yann Jean Tan, Hui Meng Er, Choy Sin Lee, Shew Fung Wong, Wen Huei Lim

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Griseofulvin is a long standing fungistatic agent against dermatophytosis. Nevertheless, it has several drawbacks such as poor and highly variable bio availability, long duration of treatment, systemic side effects and drug interactions. Targeted treatment for the superficial skin infection, dermatophytosis via topical route could be beneficial. Nevertheless, griseofulvin is only available in the form of oral preparation. Hence, it generates interest in developing a topical formulation for griseofulvin, by using lipid nano particle as the vehicle. Lipid nanoparticle is a submicron colloidal carrier with a core that is solid in nature (lipid). It has combined advantages of various traditional carriers and is a promising vehicle for topical delivery. The griseofulvin loaded lipid nano particles produced using high pressure homogenization method were characterized and investigated for its skin targeting effect in vitro. It has a mean particle size of 179.8±4.9 nm with polydispersity index of 0.306±0.011. Besides, it showed higher skin permeation and better skin targeting effect compared to the griseofulvin suspension.

Keywords: lipid nanoparticles, griseofulvin, topical, dermatophytosis

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Authors: Dagmara A. Niedziela, Mark P. Murphy, Orla M. Keane, Finola C. Leonard

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Staphylococcus aureus is the most frequent cause of clinical and subclinical bovine mastitis in Ireland. Mastitis caused by S. aureus is often chronic and tends to recur after antibiotic treatment. This may be due to several virulence factors, including attributes that enable the bacterium to internalize into bovine mammary epithelial cells, where it may evade antibiotic treatment, or evade the host immune response. Four bovine-adapted lineages (CC71, CC97, CC151 and ST136) were identified among a collection of Irish S. aureus mastitis isolates. Genotypic variation of mastitis-causing strains may contribute to different presentations of the disease, including differences in milk somatic cell count (SCC), the main method of mastitis detection. The objective of this study was to investigate the influence of bacterial strain and lineage on host immune response, by employing cell culture methods in vitro as well as an in vivo infection model. Twelve bovine adapted S. aureus strains were examined for internalization into bovine mammary epithelial cells (bMEC) and their ability to induce an immune response from bMEC (using qPCR and ELISA). In vitro studies found differences in a variety of virulence traits between the lineages. Strains from lineages CC97 and CC71 internalized more efficiently into bovine mammary epithelial cells (bMEC) than CC151 and ST136. CC97 strains also induced immune genes in bMEC more strongly than strains from the other 3 lineages. One strain each of CC151 and CC97 that differed in their ability to cause an immune response in bMEC were selected on the basis of the above in vitro experiments. Fourteen first-lactation Holstein-Friesian cows were purchased from 2 farms on the basis of low SCC (less than 50 000 cells/ml) and infection free status. Seven cows were infected with 1.73 x 102 c.f.u. of the CC97 strain (Group 1) and another seven with 5.83 x 102 c.f.u. of the CC151 strain (Group 2). The contralateral quarter of each cow was inoculated with PBS (vehicle). Clinical signs of infection (temperature, milk and udder appearance, milk yield) were monitored for 30 days. Blood and milk samples were taken to determine bacterial counts in milk, SCC, white blood cell populations and cytokines. Differences in disease presentation in vivo between groups were observed, with two animals from Group 2 developing clinical mastitis and requiring antibiotic treatment, while one animal from Group 1 did not develop an infection for the duration of the study. Fever (temperature > 39.5⁰C) was observed in 3 animals from Group 2 and in none from Group 1. Significant differences in SCC and bacterial load between groups were observed in the initial stages of infection (week 1). Data is also being collected on cytokines and chemokines secreted during the course of infection. The results of this study suggest that a strain from lineage CC151 may cause more severe clinical mastitis, while a strain from lineage CC97 may cause mild, subclinical mastitis. Diversity between strains of S. aureus may therefore influence the clinical presentation of mastitis, which in turn may influence disease detection and treatment needs.

Keywords: Bovine mastitis, host immune response, host-pathogen interactions, Staphylococcus aureus

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Authors: Konstantinos G. Kostinakis, Manthos K. Papadopoulos, Asimina M. Athanatopoulou

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An important area of research in seismic risk analysis is the evaluation of expected seismic damage of structures under a specific earthquake ground motion. Several conventional intensity measures of ground motion have been used to estimate their damage potential to structures. Yet, none of them was proved to be able to predict adequately the seismic damage of any structural system. Therefore, alternative advanced intensity measures which take into account not only ground motion characteristics but also structural information have been proposed. The adequacy of a number of advanced earthquake intensity measures in prediction of structural damage of 3D R/C buildings under seismic excitation which attacks the building with arbitrary incident angle is investigated in the present paper. To achieve this purpose, a symmetric in plan and an asymmetric 5-story R/C building are studied. The two buildings are subjected to 20 bidirectional earthquake ground motions. The two horizontal accelerograms of each ground motion are applied along horizontal orthogonal axes forming 72 different angles with the structural axes. The response is computed by non-linear time history analysis. The structural damage is expressed in terms of the maximum interstory drift as well as the overall structural damage index. The values of the aforementioned seismic damage measures determined for incident angle 0° as well as their maximum values over all seismic incident angles are correlated with 9 structure-specific ground motion intensity measures. The research identified certain intensity measures which exhibited strong correlation with the seismic damage of the two buildings. However, their adequacy for estimation of the structural damage depends on the response parameter adopted. Furthermore, it was confirmed that the widely used spectral acceleration at the fundamental period of the structure is a good indicator of the expected earthquake damage level.

Keywords: damage indices, non-linear response, seismic excitation angle, structure-specific intensity measures

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Authors: Tamrat Tesfaye, Bruce Sithole

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Box-Behnken Response surface methodology was used to determine the optimum processing conditions that give maximum extraction yield and whiteness index from mango seed. The steeping time ranges from 2 to 12 hours and slurring of the steeped seed in sodium metabisulphite solution (0.1 to 0.5 w/v) was carried out. Experiments were designed according to Box-Behnken Design with these three factors and a total of 15 runs experimental variables of were analyzed. At linear level, the concentration of sodium metabisulphite had significant positive influence on percentage yield and whiteness index at p<0.05. At quadratic level, sodium metabisulphite concentration and sodium metabisulphite concentration2 had a significant negative influence on starch yield; sodium metabisulphite concentration and steeping time*temperature had significant (p<0.05) positive influence on whiteness index. The adjusted R2 above 0.8 for starch yield (0.906465) and whiteness index (0.909268) showed a good fit of the model with the experimental data. The optimum sodium metabisulphite concentration, steeping hours, and temperature for starch isolation with maximum starch yield (66.428%) and whiteness index (85%) as set goals for optimization with the desirability of 0.91939 was 0.255w/v concentration, 2hrs and 50 °C respectively. The determined experimental value of each response based on optimal condition was statistically in accordance with predicted levels at p<0.05. The Mango seeds are the by-products obtained during mango processing and possess disposal problem if not handled properly. The substitution of food based sizing agents with mango seed starch can contribute as pertinent resource deployment for value-added product manufacturing and waste utilization which might play significance role of food security in Ethiopia.

Keywords: mango, synthetic sizing agent, starch, extraction, textile, sizing

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Authors: S. Nazhan, Hassan K. Al-Musawi, Khalid A. Humood

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This paper reports on an experimental investigation into the influence of current modulation on the properties of a vertical-cavity surface-emitting laser (VCSEL) with a direct square wave modulation. The optical output power response, as a function of the pumping current, modulation frequency, and amplitude, is measured for an 850 nm VCSEL. We demonstrate that modulation frequency and amplitude play important roles in reducing the VCSEL’s power consumption for optical generation. Indeed, even when the biasing current is below the static threshold, the VCSEL emits optical power under the square wave modulation. The power consumed by the device to generate light is significantly reduced to > 50%, which is below the threshold current, in response to both the modulation frequency and amplitude. An operating VCSEL device at low power is very desirable for less thermal effects, which are essential for a high-speed modulation bandwidth.

Keywords: vertical-cavity surface-emitting lasers, VCSELs, optical power generation, power consumption, square wave modulation

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Authors: Natcha Lueangapapong, Chariya Chuthapisith, Lunliya Thampratankul

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Background: There is a need to find an appropriate tool to help healthcare providers determine sleep problems in children for early diagnosis and management. The Japanese Sleep Questionnaire for Preschoolers (JSQ-P) is a parent-reported sleep questionnaire that has good psychometric properties and can be used in the context of Asian culture, which is likely suitable for Thai children. Objectives: This study aimed to translate and validate the Japanese Sleep Questionnaire for Preschoolers (JSQ-P) into a Thai version and to evaluate factors associated with sleep disorders in preschoolers. Methods: After approval by the original developer, the cross-cultural adaptation process of JSQ-P was performed, including forward translation, reconciliation, backward translation, and final approval of the Thai version of JSQ-P (TH-JSQ-P) by the original creator. This study was conducted between March 2021 and February 2022. The TH-JSQ-P was completed by 2,613 guardians whose children were aged 2-6 years twice in 10-14 days to assess its reliability and validity. Content validity was measured by an index of item-objective congruence (IOC) and a content validity index (CVI). Face validity, content validity, structural validity, construct validity (discriminant validity), criterion validity and predictive validity were assessed. The sensitivity and specificity of the TH-JSQ-P were also measured by using a total JSQ-P score cutoff point 84, recommended by the original JSQ-P and each subscale score among the clinical samples of obstructive sleep apnea syndrome. Results: Internal consistency reliability, evaluated by Cronbach’s α coefficient, showed acceptable reliability in all subscales of JSQ-P. It also had good test-retest reliability, as the intraclass correlation coefficient (ICC) for all items ranged between 0.42-0.84. The content validity was acceptable. For structural validity, our results indicated that the final factor solution for the Th-JSQ-P was comparable to the original JSQ-P. For construct validity, age group was one of the clinical parameters associated with some sleep problems. In detail, parasomnias, insomnia, daytime excessive sleepiness and sleep habits significantly decreased when the children got older; on the other hand, insufficient sleep was significantly increased with age. For criterion validity, all subscales showed a correlation with the Epworth Sleepiness Scale (r = -0.049-0.349). In predictive validity, the Epworth Sleepiness Scale was significantly a strong factor that correlated to sleep problems in all subscales of JSQ-P except in the subscale of sleep habit. The sensitivity and specificity of the total JSQ-P score were 0.72 and 0.66, respectively. Conclusion: The Thai version of JSQ-P has good internal consistency reliability and test-retest reliability. It passed 6 validity tests, and this can be used to evaluate sleep problems in preschool children in Thailand. Furthermore, it has satisfactory general psychometric properties and good reliability and validity. The data collected in examining the sensitivity of the Thai version revealed that the JSQ-P could detect differences in sleep problems among children with obstructive sleep apnea syndrome. This confirmed that the measure is sensitive and can be used to discriminate sleep problems among different children.

Keywords: preschooler, questionnaire, validation, Thai version

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Authors: Nathalie Bolding, Marta Montero, Joaquim Cevallos, Juan F. Martin-Lazaro

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Background: Inhaled epoprostenol (iEPO) have been shown to improve PaO2:FiO2 (PF) in combination with bronchodilators (BD). However, there is not an available device to deliver these two therapies concomitantly. We describe a new method to provide this therapy successfully. Objective: To evaluate the response to continuous nebulization of iEPO and intermittent nebulization of Salbutamol/Ipratropium bromide in adults with severe respiratory failure through a double mesh nebulisation in tandem. Methods: This observational study included two mechanical ventilated adults under hourly ventilatory, gasometrical and clinical measurements during 48h. Both had severe respiratory failure treated with continuous iEPO (50 – 200 micrograms/h) and BD (Salbutamol 2.5 mg and Ipratropium bromide 500 mcg every 6 hours) through double mesh nebulisation (Aerogen solo®) placed in tandem in the dry side of the humidificator. The primary endpoints were the variables associated with a positive response to this tandem nebulised therapy (PaFiO2 index, ROX index). Secondary endpoints were laboratory (ABG) clinical and ventilatory variables. Statistical analysis (SPSS v29) included linear regression and ANOVA. Results: The patients included (n=2) survived, both extubated, one after ECMO therapy. Severe acute respiratory failure had a positive response rate to continuous iEPO and intermittent BD: PaFiO2 increased (7.40 to 30.91; P75: 27%) as well as ROX index (2.91 to 11.43; P75: 33%). There was a linear correlation of improvement between iEPO with PaFiO2 (ANOVA, r=0.393, p<0.002) and ROX (r=0.419, p<0.001). iEPO+BD therapy did not show any complications. Conclusion: Continuous and intermittent mesh tandem nebulisation can be effectively delivered with this method with a positive effect in ventilatory parameters without observed complications. Randomised studies will be able to provide reassurance in this new therapy.

Keywords: tandem, mesh, nebulisers, pulmonary, vasoldilators, bronchodilators, respiratory, failure

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Authors: Maria Konstadinou, Etienne Alderlieste, Anderson Peccin da Silva, Ben Arntz, Leonard van der Bijl, Wouter Verschueren

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The shear strength and compression properties of stiff Boom clay from Belgium at the depth of about 30 m has been investigated by means of cone penetration and laboratory testing. The latter consisted of index classification, constant rate of strain, direct, simple shear, and unconfined compression tests. The Boom clay samples exhibited strong swelling tendencies. The suction pressure was measured via different procedures and has been compared to the expected in-situ stress. The undrained shear strength and OCR profile determined from CPTs is not compatible with the experimental measurements, which gave significantly lower values. The observed response can be attributed to the presence of pre-existing discontinuities, as shown in microscale CT scans of the samples. The results of this study demonstrate that the microstructure of the clay prior to testing has an impact on the mechanical behaviour and can cause inconsistencies in the comparison of the laboratory test results with in-situ data.

Keywords: boom clay, laboratory testing, overconsolidation ratio, stress-strain response, swelling, undrained shear strength

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Authors: Yiming Jin, Ping Dong

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The primary resonance of a pipeline close to a plane boundary is investigated in this paper. Based on classic Van der Pol equation and added a nonlinear item, a new wake oscillator model is proposed to predict the vortex-induced vibration (VIV) of a circular cylinder close to a plane boundary. Then, with the multi-scale method, the approximate solution for the case of the primary resonance is obtained. Besides, to study the characteristic of the primary resonance, the effects of the mass ration, frequency, damp ratio and gap ratio on the frequency-response curves of the pipeline are analysed. On the whole, the trend of the numerical results match up with that of the experimental data well and the mass ration, frequency, damp ratio and gap ratio play an important role in the vortex-induced vibration (VIV) of a circular cylinder close to a plane boundary, especially, the smaller is the mass ratio, the larger impact the gap ratio has on the frequency-response curves of the primary resonance.

Keywords: primary resonance, gap ratio, vortex-induced vibration, multi-scale method

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Authors: Fahad Javed, Tasneem Akhter, Maria Zafar, Adnan Shafique

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Evaluation and quantification of techniques is critical element of research and development of technology. Simulations and models play an important role in providing the tools for such assessments. When we look at technologies which impact or is dependent on an average Joe consumer then modeling the socio-economic and psychological aspects of the consumer also gain an importance. For feed in tariff for home consumers which is being deployed for average consumer may force many consumers to be adapters of the technology. Understanding how consumers will adapt this technologies thus hold as much significance as evaluating how the techniques would work in consumer agnostic scenarios. In this paper we first build the case for simulators which accommodate socio-economic realities of the consumers to evaluate smart grid technologies, provide a glossary of data that can aid in this effort and present an abstract model to capture and simulate consumers' adaptation and behavioral response to smart grid technologies. We provide a case study to express the power of such simulators.

Keywords: smart grids, simulation, socio-economic parameters, feed in tariff (FiT), forecasting

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Authors: M. G. Nasuruddin, S. Ishak

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In anthropological medicine (traditional therapeutic healing) symbolic interface are used to connect with the cognitive and metacognitive mechanisms to activate conscious and unconscious response of patients or other recipients. At the same time they are used to communicate with the inhabitants of the nether world to whom are ascribed almost all cases of psychosomatic illness. The symbols, which are cultural specific, are divided into verbal and non-verbal forms of communication. The verbal forms are chanting of mantra and doa and the invocation to invoke the spirits while the non-verbal ones are the physical materials such as the offerings, props and decorative elements, music, movements, olfactory sensation and the performance space. The process of communication through these symbols is affected by the Shaman who is a link or intermediary between the healer (Shaman) and the patients and between the healer and the spirits of the nether world. The paper also examines the scientific perspective of the traditional healing through the use of these symbols. The response to these symbols as external stimuli is embedded in the genes that are linked to the hereditary factor in the person’s DNA. When the patients are tuned in to external stimuli such as music, chanting and singing (sonic orders), it can triggers a response from the brain, which may activate its inner pharmacy by releasing drugs such as dopamine and/or opiodsto ameliorate pain and counter depression, anxiety and create a feel good feeling. These symbols act like placebo, evoking the power of the mind over the body and triggering the innate self-healing energy. At the same time they could also be used as nocebo, for example black magic, which has the opposite effect of placebo. In whatever capacity they operate these symbols, which are either visual or auditory, is an integral part of anthropological medicine. For they communicate and conjure emotional responses that are conducive to healing by activating the internal brain pharmacy.

Keywords: communication, healing, placebo, nacebo, symbol

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Authors: Kanika Arora, Madhu Bala

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The small intestine epithelium is highly sensitive and major targets of ionizing radiation. Radiation causes gastrointestinal toxicity either by direct deposition of energy or indirectly (inflammation or bystander effects) generating free radicals and reactive oxygen species. Oxidative stress generated as a result of radiation causes active inflammation within the intestinal mucosa leading to structural and functional impairment of gut epithelial barrier. As a result, there is a loss of tolerance to normal dietary antigens and commensal flora together with exaggerated response to pathogens. Dysbiosis may therefore thought to play a role in radiation enteropathy and can contribute towards radiation induced bowel toxicity. Lactobacilli residing in the gut shares a long conjoined evolutionary history with their hosts and by doing so these organisms have developed an intimate and complex symbiotic relationships. The objective behind this study was to look for the strains with varying resistance to ionizing radiation and to see whether the niche of the bacteria is playing any role in radiation resistance property of bacteria. In this study, we have isolated the Lactobacillus spp. from probiotic preparation and murine gastrointestinal tract, both of which were supposed to be the important source for its isolation. Biochemical characterization did not show a significant difference in the properties, while a significant preference was observed in carbohydrate utilization capacity by the isolates. Effect of ionizing radiations induced by Co60 gamma radiation (10 Gy) on lactobacilli cells was investigated. A cellular survival curve versus absorbed doses was determined. Radiation resistance studies showed that the response of isolates towards cobalt-60 gamma radiation differs from each other and significant decrease in survival was observed in a dose-dependent manner. Thus the present study revealed that the property of radioresistance in Lactobacillus depends upon the source from where they have been isolated.

Keywords: dysbiosis, lactobacillus, mitigation, radiation

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Authors: Prarthana Gowda, Tushar Sakorikar, Siva K. Reddy, Darim B. Ferry, Abha Misra

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Graphene, a two-dimensional carbon allotrope has demonstrated excellent electrical, mechanical and optical properties. A tunable band gap of grapheme demonstrated broad band absorption of light with a response time of picoseconds, however it suffers a fast recombination of the photo generated carriers. Many reports have explored to overcome this problem; in this presentation, we discuss defect induced enhanced photoresponse in a few layer graphene (FLG) due to exposure of infrared (IR) radiation. The two and four-fold enhancement in the photocurrent is achieved by addition of multiwalled carbon nano tubes (MWCNT) to an FLG surface and also creating the wrinkles in the FLG (WG) respectively. In our study, it is also inferred that the photo current generation is highly dependent on the morphological defects on the graphene. It is observed that the FLG (without defects) generates the photo current instantaneously, and after a prolonged exposure to the IR radiation decays the generation rate. Importantly, the presence of MWCNT on FLG enhances the stability and WG presented both stable as well as enhanced photo response.

Keywords: graphene, multiwalled carbon nano tubes, wrinkled graphene, photo detector, photo current

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Authors: Zohreh Afsharmand, Sokhanguei Yahya

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A growing body of literature suggests that that low-grade systemic inflammation associated to obesity plays a key role in the pathogenic mechanism of several disorders. In this study, the effect of 6 weeks aerobic training on IL-6 and IL-1B as inflammatory cytokine were investigated in adult obese women. For this purpose, 26 sedentary adult obese women were divided into exercise and control groups (n=12). Pre and post training of mentioned cytokines were measured in two groups. Student’s t-tests for paired samples were performed to determine whether there were significant within-group changes in the outcomes. A p value less than 0.05 was considered statistically significant. There were no statistically significant differences between the exercise and control groups with regard to anthropometrical markers or inflammatory cytokines. Despite the significant decrease in all anthropometrical markers, no significant differences were found in serum IL-6 and IL-1B by aerobic training with compared to baseline. Our findings indicate that aerobic training intervention for a short time is not associated with the anti-inflammatory property in obese women.

Keywords: aerobic training, cytokine, inflammation, obesity

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Authors: Jenny Fairthorne, Yuka Mori, Helen Leonard

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Background: Primary care-givers of children with autism spectrum disorder (ASD) or intellectual disability (ID) have poorer health and quality of life (QoL) than primary care-givers (hereafter referred to as just care-givers) of typically developing children. We aimed to review original research which described factors impacting the health of care-givers of children with ASD or ID and to discuss how these factors might influence care-giver health. Methods: We searched Web of Knowledge, Medline, Scopus and Google Scholar using selections of words from each of three groups. The first comprised terms associated with ASD and ID and included autism, pervasive development disorder, intellectual disability, mental retardation, disability, disabled, Down and Asperger. The second included terms related to health such as depression, physical, mental, psychiatric, psychological and well-being. The third was terms related to care-givers such as mother, parent and care-giver. We included an original paper in our review if it was published between 1st January 1990 and 31st December, 2016, described original research in a peer-reviewed journal and was written in English. Additional criteria were that the research used a study population of 15 persons or more; described a risk or protective factor for the health of care-givers of a child with ASD, ID or a sub-type (such as ASD with ID or Down syndrome). Using previous research, we developed a simple and objective five-level tool to assess the strength of evidence provided by the reviewed papers. Results: We retained 33 papers. Factors impacting primary care-giver health included child behaviour, level of support, socio-economic status (SES) and diagnostic issues. Challenging child behaviour, the most commonly identified risk factor for poorer care-giver health and QoL was reported in ten of the studies. A higher level of support was associated with improved care-giver health and QoL. For example, substantial evidence indicated that family support reduced care-giver burden in families with a child with ASD and that family and neighbourhood support was associated with improved care-giver mental health. Higher socio-economic status (SES) was a protective factor for care-giver health and particularly maternal health. Diagnostic uncertainty and an unclear prognosis are factors which can cause the greatest concern to care-givers of children with ASD and those for whom a cause of their child’s ID has not been identified. We explain how each of these factors might impact caregiver health and how they might act differentially in care-givers of children with different types of ASD or ID (such as Down syndrome and ASD without ID). Conclusion: Care-givers of children with ASD may be more likely to experience many risk factors and less likely to experience the protective factors we identified for poorer mental health. Interventions to reduce risk factors and increase protective factors could pave the way for improved care-giver health. For example, workshops to train care-givers to better manage challenging child behaviours and earlier diagnosis of ASD (and particularly ASD without ID) would seem likely to improve care-giver well-being. Similarly, helping to expand support networks might reduce care-giver burden and stress leading to improved health.

Keywords: autism, caregivers, health, intellectual disability, mothers, review

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Authors: O. M. van den Broek

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This article examines how large German companies have responded to the 2014 refugee crisis. It challenges the assumption that the historical legacy of implicit CSR in Germany would lead to low levels of business response through CSR channels. Instead, and building on institutional CSR and the converging forces of globalization, this article argues that the urgency of a humanitarian crisis creates incentives, in the absence of formal institutional arrangement, for explicit CSR responses. This explorative research encompasses the 53 German companies presented on 2015 Forbes2000. A qualitative content analysis of corporate websites was supplemented with inquiry e-mails. Results indicate considerable evidence for the main hypothesis, showing a vast majority of companies responding to the refugee crisis. Levels of engagement varied, depending on the phase of the crisis, from core-business activities to non-integrated action. The high level of partnerships with the state and other non-state actors indicates a quest for enhanced legitimacy in the face of an absent democratic mandate.

Keywords: corporate social responsibility (CSR), implicit versus explicit CSR, public-private partnerships, European refugee crisis

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Authors: Barbara Pemberton

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Now that people of all faiths are experiencing suffering due to many global issues, shared narratives may provide common ground in which true understanding of each other may take root. This paper will consider the all too common problem of suffering and address how adherents of the three great monotheistic religions seek understanding and the appropriate believer’s response from the same story found within their respective sacred texts. Most scholars from each of these three traditions—Judaism, Christianity, and Islam— consider the writings of the Tanakh/Old Testament to at least contain divine revelation. While they may not agree on the extent of the revelation or the method of its delivery, they do share stories as well as a common desire to glean God’s message for God’s people from the pages of the text. One such shared story is that of Job, the servant of Yahweh--called Ayyub, the prophet of Allah, in the Qur’an. Job is described as a pious, righteous man who loses everything—family, possessions, and health—when his faith is tested. Three friends come to console him. Through it, all Job remains faithful to his God who rewards him by restoring all that was lost. All three hermeneutic communities consider Job to be an archetype of human response to suffering, regarding Job’s response to his situation as exemplary. The story of Job addresses more than the distribution of the evil problem. At stake in the story is Job’s very relationship to his God. Some exegetes believe that Job was adapted into the Jewish milieu by a gifted redactor who used the original ancient tale as the “frame” for the biblical account (chapters 1, 2, and 4:7-17) and then enlarged the story with the complex center section of poetic dialogues creating a complex work with numerous possible interpretations. Within the poetic center, Job goes so far as to question God, a response to which Jews relate, finding strength in dialogue—even in wrestling with God. Muslims only embrace the Job of the biblical narrative frame, as further identified through the Qur’an and the prophetic traditions, considering the center section an errant human addition not representative of a true prophet of Islam. The Qur’anic injunction against questioning God also renders the center theologically suspect. Christians also draw various responses from the story of Job. While many believers may agree with the Islamic perspective of God’s ultimate sovereignty, others would join their Jewish neighbors in questioning God, not anticipating answers but rather an awareness of his presence—peace and hope becoming a reality experienced through the indwelling presence of God’s Holy Spirit. Related questions are as endless as the possible responses. This paper will consider a few of the many Jewish, Christian, and Islamic insights from the ancient story, in hopes adherents within each tradition will use it to better understand the other faiths’ approach to suffering.

Keywords: suffering, Job, Qur'an, tanakh

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Authors: Bita Mashayekhi, Azadeh Maddahi, Arash Tahriri

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The purpose of this paper is developing a model for audit quality, with regard to the contextual and environmental attributes of the audit profession in Iran. For this purpose, using an exploratory approach, and because of the special attributes of the auditing profession in Iran in terms of the legal environment, regulatory and supervisory mechanisms, audit firms size, and etc., we used grounded theory approach as a qualitative research method. Therefore, we got the opinions of the experts in the auditing and capital market areas through unstructured interviews. As a result, the authors revealed the determinants of audit quality, and by using these determinants, developed an Integrated Audit Quality Model, including causal conditions, intervening conditions, context, as well as action strategies related to AQ and their consequences. In this research, audit quality is studied using a systemic approach. According to this approach, the quality of inputs, processes, and outputs of auditing determines the quality of auditing, therefore, the quality of all different parts of this system is considered.

Keywords: audit quality, integrated audit quality model, demand for audit service, supply of audit, grounded theory

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Authors: Siddharth Vishwakarma, Danie Shajie A., Mishra H. N.

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Milk powder becomes very useful in the low milk supply area but the exact amount to add for one glass of milk and the handling is difficult. So, the idea of instant soluble milk tablet comes into existence for its high solubility and easy handling. The moisture content of milk tablets is increased by the direct addition of water with no additives for binding. The variation of the tensile strength of instant soluble milk tablets and the flowability of milk powder with the moisture content is analyzed and optimized for the highest tensile strength of instant soluble milk tablets and flowability, above a particular value of milk powder using response surface methodology. The flowability value is necessary for ease in quantifying the milk powder, as a feed, in the designed tablet making machine. The instant soluble nature of milk tablets purely depends upon the disintegration characteristic of tablets in water whose study is under progress. Conclusions: The optimization results are very useful in the commercialization of milk tablets.

Keywords: flowability, milk powder, response surface methodology, tablet making machine, tensile strength

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Authors: Suliman Al-Fayoumi, Sherri Amberg, Huafeng Zhou, Jack W. Singer, James P. Dean

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Pacritinib is an oral kinase inhibitor with specificity for JAK2, FLT3, IRAK1, and CSF1R. In clinical studies, pacritinib was well tolerated with clinical activity in patients with myelofibrosis. The most frequent adverse events (AEs) observed with pacritinib are gastrointestinal (diarrhea, nausea, and vomiting; mostly grade 1-2 in severity) and typically resolve within 2 weeks. A human ADME mass balance study demonstrated that pacritinib is predominantly cleared via hepatic metabolism and biliary excretion (>85% of administered dose). The major hepatic metabolite identified, M1, is not thought to materially contribute to the pharmacological activity of pacritinib. Hepatic diseases are known to impair hepatic blood flow, drug-metabolizing enzymes, and biliary transport systems and may affect drug absorption, disposition, efficacy, and toxicity. This phase 1 study evaluated the pharmacokinetics (PK) and safety of pacritinib and the M1 metabolite in study subjects with mild, moderate, or severe hepatic impairment (HI) and matched healthy subjects with normal liver function to determine if pacritinib dosage adjustments are necessary for patients with varying degrees of hepatic insufficiency. Study participants (aged 18-85 y) were enrolled into 4 groups based on their degree of HI as defined by Child-Pugh Clinical Assessment Score: mild (n=8), moderate (n=8), severe (n=4), and healthy volunteers (n=8) matched for age, BMI, and sex. Individuals with concomitant renal dysfunction or progressive liver disease were excluded. A single 400 mg dose of pacritinib was administered to all participants. Blood samples were obtained for PK evaluation predose and at multiple time points postdose through 168 h. Key PK parameters evaluated included maximum plasma concentration (Cmax), time to Cmax (Tmax), area under the plasma concentration time curve (AUC) from hour zero to last measurable concentration (AUC0-t), AUC extrapolated to infinity (AUC0-∞), and apparent terminal elimination half-life (t1/2). Following treatment, pacritinib was quantifiable for all study participants at 1 h through 168 h postdose. Systemic pacritinib exposure was similar between healthy volunteers and individuals with mild HI. However, there was a significant difference between those with moderate and severe HI and healthy volunteers with respect to peak concentration (Cmax) and plasma exposure (AUC0-t, AUC0-∞). Mean Cmax decreased by 47% and 57% respectively in participants with moderate and severe HI vs matched healthy volunteers. Similarly, mean AUC0-t decreased by 36% and 45% and mean AUC0-∞ decreased by 46% and 48%, respectively in individuals with moderate and severe HI vs healthy volunteers. Mean t1/2 ranged from 51.5 to 74.9 h across all groups. The variability on exposure ranged from 17.8% to 51.8% across all groups. Systemic exposure of M1 was also significantly decreased in study participants with moderate or severe HI vs. healthy participants and individuals with mild HI. These changes were not significantly dissimilar from the inter-patient variability in these parameters observed in healthy volunteers. All AEs were grade 1-2 in severity. Diarrhea and headache were the only AEs reported in >1 participant (n=4 each). Based on these observations, it is unlikely that dosage adjustments would be warranted in patients with mild, moderate, or severe HI treated with pacritinib.

Keywords: pacritinib, myelofibrosis, hepatic impairment, pharmacokinetics

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Authors: Lucas Aerre, Wallesson Faria, Roberto Pimentel, Juliana Santos

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An extremely disturbing and irritating element in the lives of people and organizations is the noise, the consequences that can bring us has a lot of connection with human health as well as financial and economic aspects. In order to improve the efficiency of buildings in Brazil in general, a performance standard was created, NBR 15.575 in which all buildings are seen in a more systemic and peculiar way, while following the requirements of the standard. The acoustic performance present in these buildings is one such requirement. Based on this, the present work was elaborated with the objective of evaluating through acoustic measurements the acoustic performance of vertical internal fences that are under the incidence of aerial noise of a building in the city of Brasilia-DF. A short theoretical basis is made and soon after the procedures of measurement are described through the control method established by the standard, and its results are evaluated according to the parameters of the same. The measurement performed between rooms of the same unit, presented a standardized sound pressure level difference (D nT, w) equal to 40 dB, thus being classified within the minimum performance required by the standard in question.

Keywords: airborne noise, performance standard, soundproofing, vertical seal

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