Search results for: heart disease
3117 Bacterial Decontamination of Nurses' White Coats by Application of Antimicrobial Finish
Authors: Priyanka Gupta, Nilanjana Bairagi, Deepti Gupta
Abstract:
New pathogenic strains of microbes are continually emerging and resistance of bacteria to antibiotics is growing. Hospitals in India have a high burden of infections in their intensive care units and general wards. Rising incidence of hospital infections is a matter of great concern in India. This growth is often attributed to the absence of effective infection control strategies in healthcare facilities. Government, therefore, is looking for cost effective strategies that are effective against HAIs. One possible method is by application of an antimicrobial finish on the uniform. But there are limited studies to show the effect of antimicrobial activity of antimicrobial finish treated nurses’ uniforms in a real hospital set up. This paper proposes a prospective non-destructive sampling technique, based on the use of a detachable fabric patch, to assess the effectiveness of silver based antimicrobial agent across five wards in a tertiary care government hospital in Delhi, India. Fabrics like polyester and polyester cotton blend fabric which are more prevalent for making coats were selected for the study. Polyester and polyester cotton blend fabric was treated with silver based antimicrobial (AM) finish. At the beginning of shift, a composite patch of untreated and treated fabric respectively was stitched on the abdominal region on the left and right side of the washed white coat of participating nurse. At the end of the shift, the patch was removed and taken for bacterial sampling on Brain Heart Infusion (BHI) plates. Microbial contamination on polyester and blend fabrics after 6 hours shift was compared in Brain Heart Infusion broth (BHI). All patches treated with silver based antimicrobial agent showed decreased bacterial counts. Percent reduction in the bacterial colonies after the antimicrobial treatment in both fabrics was 81.0 %. Antimicrobial finish was equally effective in reducing microbial adhesion on both fabric types. White coats of nurses become progressively contaminated during clinical care. Type of fabric used to make the coat can affect the extent of contamination which is higher on polyester cotton blend as compared to 100% polyester. The study highlights the importance of silver based antimicrobial finish in the area of uniform hygiene. Bacterial load can be reduced by using antimicrobial finish on hospital uniforms. Hospital staff uniforms endowed with antimicrobial properties may be of great help in reducing the occurrence and spread of infections.Keywords: antimicrobial finish, bacteria, infection control, silver, white coat
Procedia PDF Downloads 2153116 The Impacts of the COVID-19 Pandemic on Social Activities and Residential Areas
Authors: Asghar Motea Noparvar
Abstract:
According to the World Health Organization (WHO), the coronavirus disease (COVID-19), which has been characterized as a pandemic since December 2019, is attacking societies in terms of different ways. It means that this is much more than a crisis that is related to human health. It is a human, economic and social crisis. Since December 2019, not only some significant transformations have happened in human life, but also there has been some mental health, daily life activities, and even urban space changes. The purpose of this study is to mention some tangible transformations in society by applying two main restrictions such as “lock down” and “social distancing,” and how people took refuge in their homes and fit every activity there. How this pandemic has been transforming human life and social activities is the main issue of this study. In order to gather the information, review the impacts of COVID-19 on social life by revising the literature and considering the “Risk Society” theory, which is gotten credited by a German sociologist, Ulrich Beck. Additionally, COVID-19 not only had a direct impact on health but also had significant impacts on the economy, education, tourism, the environment, and the construction industry. Therefore, the pandemic caused a disruption in the whole urban system. In this study, the main focused point is the transformation of activities and residential areas. In order to achieve this finding, the literature review is analyzed in the case of COVID-19 and its impacts on social life. To sum up, it can be concluded that a pandemic can change social life along with other transformations that it is able to do.Keywords: infectious disease, COVID-19, social activities, residential areas, transformation
Procedia PDF Downloads 903115 Estimating the Receiver Operating Characteristic Curve from Clustered Data and Case-Control Studies
Authors: Yalda Zarnegarnia, Shari Messinger
Abstract:
Receiver operating characteristic (ROC) curves have been widely used in medical research to illustrate the performance of the biomarker in correctly distinguishing the diseased and non-diseased groups. Correlated biomarker data arises in study designs that include subjects that contain same genetic or environmental factors. The information about correlation might help to identify family members at increased risk of disease development, and may lead to initiating treatment to slow or stop the progression to disease. Approaches appropriate to a case-control design matched by family identification, must be able to accommodate both the correlation inherent in the design in correctly estimating the biomarker’s ability to differentiate between cases and controls, as well as to handle estimation from a matched case control design. This talk will review some developed methods for ROC curve estimation in settings with correlated data from case control design and will discuss the limitations of current methods for analyzing correlated familial paired data. An alternative approach using Conditional ROC curves will be demonstrated, to provide appropriate ROC curves for correlated paired data. The proposed approach will use the information about the correlation among biomarker values, producing conditional ROC curves that evaluate the ability of a biomarker to discriminate between diseased and non-diseased subjects in a familial paired design.Keywords: biomarker, correlation, familial paired design, ROC curve
Procedia PDF Downloads 2403114 An Unusual Presentation of Plasmacytoid Urothelial Carcinoma of the Bladder - A Case Report and Literature Review
Authors: Bharti Arora, Michael Chen, Steven Lun
Abstract:
Plasmacytoid urothelial carcinoma (PUC) of the bladder is a rare and aggressive subtype of urothelial carcinoma that usually presents at an advanced clinical stage, has a predilection for early metastatic potential and is associated with poor prognosis. The first reported case of PUC was in 1991 and approximately 100 cases were reported in the literature worldwide. We present a case of a 43 year old female presenting with a 3-month history of urgency and frequency. Failing medical management of her urinary symptoms with anticholinergic medication, she underwent a diagnostic cystoscopy which revealed an erythematous and indurated bladder. Bladder biopsies of these regions revealed plasmacytoid urothelial carcinoma. Pre-operative staging scans were clear of any metastatic disease and the patient subsequently underwent a radical cystectomy and pelvic clearance with the formation of ileal conduit for urinary diversion. Histology confirmed plasmacytoid urothelial carcinoma with involvement of right upper vagina and focally positive margins in soft tissue at right and left sides of bladder. She received adjuvant chemotherapy but passed away within a year from disease progression. PUC can present atypically and our case highlights the role of cystoscopy in patients with persistent urinary symptoms. By reviewing the literature on PUC, we aim to raise awareness and improve understanding of this rare bladder cancer subtype amongst urologists.Keywords: urology, bladder cancer, plasmacytoid urothelial cancer, literature review
Procedia PDF Downloads 1503113 First Documented Anesthesia with Use of Low Doses of Tiletamine-Zolazepam Combination in Ovoviparous Amazon Tree Boa Undergoing Emergency Coeliotomy-Case Report
Authors: Krzysztof Buczak, Sonia Lachowska, Pawel Kucharski, Agnieszka Antonczyk
Abstract:
Tiletamine - zolazepam combination is increasingly used in veterinary anaesthesiology in wild animals, including snakes. The available literature shows a lack of information about anesthesia in this mixture in ovoviviparous snakes. The studies show the possibility of using the combination at a dose of 20 mg/kg or more for snake immobilization. This paper presents an anesthetic protocol with the use of a combination of tiletamine - zolazepam at the dose of 10 mg/kg intramuscularly and maintenance with inhalant anesthesia with isoflurane in pure oxygen. The objective of this study was to evaluate the usefulness of the anesthetic protocol to proceed with coeliotomy in Amazon Tree Boa. The patient was a five years old bicolor female Amazon Tree Boa (Corallus hortulanus) with dystocia. The clinical examination reveals significant emaciation (bodyweight 520g), high degree of dehydration, heart rate (HR = 60 / min), pale mucous membranes and poor reactivity. Meloxicam (1 mg/kg) and tramadol (10 mg/kg) were administered subcutaneously and the patient was placed in an incubator with access to fresh oxygen. Four hours later, the combination of tiletamine - zolazepam (10 mg/kg) was administered intramuscularly for induction of anesthesia. The snake was intubated and connected to inhalant anesthesia equipment. For maintenance, the anesthesia isoflurane in pure oxygen was used due to apnea, which occurs 30 minutes after the induction semi-closed system was attached and the ventilator was turned on (PCV system, four breaths per minute, 8 cm of H2O). Cardiopulmonary parameters (HR, RR, SPO2, ETCO2, ETISO) were assessed throughout the procedure. During the entire procedure, the operating room was heated to a temperature of 26 degrees Celsius. Additionally, the hose was placed on a heating mat, which maintained a temperature of 30 degrees Celsius. For 15 minutes after induction, the loss of muscle tone was observed from the head to the tail. Induction of general anesthesia was scored as good because of the possibility of intubation. During the whole procedure, the heart rate was at the rate of 58 beats per minute (bpm). Ventilation parameters were stable throughout the procedure. The recovery period lasts for about 4 hours after the end of general anesthesia. The muscle tension returned from tail to head. The snake started to breathe spontaneously within 1,5 hours after the end of general anesthesia. The protocol of general anesthesia with the combination of tiletamine- zolazepam with a dose of 10 mg/kg is useful for proceeding with the emergency coeliotomy in maintenance with isoflurane in oxygen. Further study about the impact of the combination of tiletamine- zolazepam for the recovery period is needed.Keywords: anesthesia, corallus hortulanus, ovoviparous, snake, tiletamine, zolazepam
Procedia PDF Downloads 2463112 Unidentified Remains with Extensive Bone Disease without a Clear Diagnosis
Authors: Patricia Shirley Almeida Prado, Selma Paixão Argollo, Maria De Fátima Teixeira Guimarães, Leticia Matos Sobrinho
Abstract:
Skeletal differential diagnosis is essential in forensic anthropology in order to differentiate skeletal trauma from normal osseous variation and pathological processes. Thus, part of forensic anthropological field is differentiate skeletal criminal injuries from the normal skeletal variation (bone fusion or nonunion, transitional vertebrae and other non-metric traits), non-traumatic skeletal pathology (myositis ossificans, arthritis, bone metastasis, osteomyelitis) from traumatic skeletal pathology (myositis ossificans traumatic) avoiding misdiagnosis. This case shows the importance of effective pathological diagnosis in order to accelerate the identification process of skeletonized human remains. THE CASE: An unidentified skeletal remains at the medico legal institute Nina Rodrigues-Salvador, of a male young adult (29 to 40 years estimated) showing a massive heterotopic ossification on its right tibia at upper epiphysis and adjacent articular femur surface; an extensive ossification on the right clavicle (at the sternal extremity) also presenting an heterotopic ossification at right scapulae (upper third of scapulae lateral margin and infraglenoid tubercule) and at the head of right humerus at the shoulder joint area. Curiously, this case also shows an unusual porosity in certain vertebrae´s body and in some tarsal and carpal bones. Likewise, his left fifth metacarpal bones (right and left) showed a healed fracture which led both bones distorted. Based on identification, of pathological conditions in human skeletal remains literature and protocols these alterations can be misdiagnosed and this skeleton may present more than one pathological process. The anthropological forensic lab at Medico-legal Institute Nina Rodrigues in Salvador (Brazil) adopts international protocols to ancestry, sex, age and stature estimations, also implemented well-established conventions to identify pathological disease and skeletal alterations. The most compatible diagnosis for this case is hematogenous osteomyelitis due to following findings: 1: the healed fracture pattern at the clavicle showing a cloaca which is a pathognomonic for osteomyelitis; 2: the metacarpals healed fracture does not present cloaca although they developed a periosteal formation. 3: the superior articular surface of the right tibia shows an extensive inflammatory healing process that extends to adjacent femur articular surface showing some cloaca at tibia bone disease. 4: the uncommon porosities may result from hematogenous infectious process. The fractures probably have occurred in a different moments based on the healing process; the tibia injury is more extensive and has not been reorganized, while metacarpals and clavicle fracture is properly healed. We suggest that the clavicle and tibia´s fractures were infected by an existing infectious disease (syphilis, tuberculosis, brucellosis) or an existing syndrome (Gorham’s disease), which led to the development of osteomyelitis. This hypothesis is supported by the fact that different bones are affected in diverse levels. Like the metacarpals that do not show the cloaca, but then a periosteal new bone formation; then the unusual porosities do not show a classical osteoarthritic processes findings as the marginal osteophyte, pitting and new bone formation, they just show an erosive process without bone formation or osteophyte. To confirm and prove our hypothesis we are working on different clinical approaches like DNA, histopathology and other image exams to find the correct diagnostic.Keywords: bone disease, forensic anthropology, hematogenous osteomyelitis, human identification, human remains
Procedia PDF Downloads 3253111 Navigating the VUCA World with a Strong Heart and Mind: How to Build Passion and Character
Abstract:
The paper presents the PASSION Programme designed by a government school in Singapore, guided by national goals as well as research-based pedagogies that aims to nurture students to become lifelong learners with the strength of character. The design and enactment of the integrated approach to develop in students good character, resilience and social-emotional well-being, future readiness, and active citizenship is guided by a set of principles that amalgamates Biesta’s domains of purposes of education and authentic learning. Data in terms of evidence of students’ learning and students’ feedback were collected, analysed, and suggests that the learning experience benefitted students by boosting their self-confidence, self-directed and collaborative learning skills, as well as empathy.Keywords: lifelong learning, character and citizenship education, education and career guidance, 21CC, teaching and learning empathy
Procedia PDF Downloads 1463110 Altered Network Organization in Mild Alzheimer's Disease Compared to Mild Cognitive Impairment Using Resting-State EEG
Authors: Chia-Feng Lu, Yuh-Jen Wang, Shin Teng, Yu-Te Wu, Sui-Hing Yan
Abstract:
Brain functional networks based on resting-state EEG data were compared between patients with mild Alzheimer’s disease (mAD) and matched patients with amnestic subtype of mild cognitive impairment (aMCI). We integrated the time–frequency cross mutual information (TFCMI) method to estimate the EEG functional connectivity between cortical regions and the network analysis based on graph theory to further investigate the alterations of functional networks in mAD compared with aMCI group. We aimed at investigating the changes of network integrity, local clustering, information processing efficiency, and fault tolerance in mAD brain networks for different frequency bands based on several topological properties, including degree, strength, clustering coefficient, shortest path length, and efficiency. Results showed that the disruptions of network integrity and reductions of network efficiency in mAD characterized by lower degree, decreased clustering coefficient, higher shortest path length, and reduced global and local efficiencies in the delta, theta, beta2, and gamma bands were evident. The significant changes in network organization can be used in assisting discrimination of mAD from aMCI in clinical.Keywords: EEG, functional connectivity, graph theory, TFCMI
Procedia PDF Downloads 4313109 Role of Apolipoprotein E Polymorphism on the Onset of Inflammatory Bowel Disease in Saudi Patients
Authors: Ebtissam Saleh Al-Meghaiseeb, Abdulaziz Al Masood, Abdulrahman Al-Robayan, Reem Al-Amro, Misbahul Arfin, Abdulrahman Al Asmari
Abstract:
Objective: The objective of this study was to evaluate the role of apolipoprotein E (APOE) polymorphism on the onset of inflammatory bowel disease (IBD) in Saudi patients. Methods: APOE gene was genotyped to evaluate the frequencies of the alleles and genotypes in Saudi subjects, including IBD patients (n=200) and matched controls (n=200), using APOE StripAssayTM kit (ViennaLab Labordiagnostika GmbH, Vienna, Austria). Results: The frequencies of alleles and genotypes of APOE differed in patients and controls. The APOE allele ε2 and ε4, genotype ε2/ε3 and ε2/ε4 were significantly higher in the IBD patients than the healthy controls. The frequencies of ε3 allele and ε3/ε3 genotype were higher in the control group as compared to patients. The higher prevalence of allele ε2 and ε4 allele in patients compared to that in controls suggested that ε2 and ε4 alleles may increase the risk of IBD. Results also indicated that APOE ε4 allele was associated with early age at onset of IBD. On the other hand, the decreased frequencies of ε3 allele and ε3/ε3 genotype in patients as compared to those in the controls suggested a protective effect of APOE ε3 for IBD susceptibility. In this study, the frequency distribution of APOE alleles and genotypes was not affected by the gender or type of IBD (familial or sporadic). Conclusion: This study indicates that APOE polymorphism plays a significant role in developing IBD and early age of onset in Saudi patients. However, further studies with large-size sample are warranted to confirm this relationship.Keywords: APOE, polymorphism, IBD, saudis
Procedia PDF Downloads 1133108 Elevated Celiac Antibodies and Abnormal Duodenal Biopsies Associated with IBD Markers: Possible Role of Altered Gut Permeability and Inflammation in Gluten Related Disorders
Authors: Manav Sabharwal, Ruda Rai Md, Candace Parker, James Ridley
Abstract:
Wheat is one of the most commonly consumed grains worldwide, which contains gluten. Nowadays, gluten intake is considered to be a trigger for GRDs, including Celiac disease (CD), a common genetic disease affecting 1% of the US population, non-celiac gluten sensitivity (NCGS) and wheat allergy. NCGS is being recognized as an acquired gluten-sensitive enteropathy that is prevalent across age, ethnic and geographic groups. The cause of this entity is not fully understood, and recent studies suggest that it is more common in participants with irritable bowel syndrome (IBS), with iron deficiency anemia, symptoms of fatigue, and has considerable overlap in symptoms with IBS and Crohn’s disease. However, these studies were lacking in availability of complete serologies, imaging tests and/or pan-endoscopy. We performed a prospective study of 745 adult patients who presented to an outpatient clinic for evaluation of chronic upper gastro-intestinal symptoms and subsequently underwent an upper endoscopic (EGD) examination as standard of care. Evaluation comprised of comprehensive celiac antibody panel, inflammatory bowel disease (IBD) serologic markers, duodenal biopsies and Small Bowel Video Capsule Endoscopy (VCE), when available. At least 6 biopsy specimens were obtained from the duodenum and proximal jejunum during EGD, and CD3+ Intraepithelial lymphocytes (IELs) and villous architecture were evaluated by a single experienced pathologist, and VCE was performed by a single experienced gastroenterologist. Of the 745 patients undergoing EGD, 12% (93/745) patients showed elevated CD3+ IELs in the duodenal biopsies. 52% (387/745) completed a comprehensive CD panel and 7.2% (28/387) were positive for at least 1 CD antibody (Tissue transglutaminase (tTG), being the most common antibody in 65% (18/28)). Of these patients, 18% (5/28) showed increased duodenal CD3+ IELs, but 0% showed villous blunting or distortion to meet criteria for CD. Surprisingly, 43% (12/28) were positive for at 1 IBD serology (ASCA, ANCA or expanded IBD panel (LabCorp)). Of these 28 patients, 29% (8/28) underwent a SB VCE, of which 100 % (8/8) showed significant jejuno-ileal mucosal lesions diagnostic for IBD. Findings of abnormal CD antibodies (7.2%, 28/387) and increased CD3+ IELs on duodenal biopsy (12%, 93/745) were observed frequently in patients with UGI symptoms undergoing EGD in an outpatient clinic. None met criteria for CD, and a high proportion (43%, 12/28) showed evidence of overlap with IBD. This suggests a potential causal link of acquired GRDs to underlying inflammation and gut mucosal barrier disruption. Further studies to investigate a role for abnormal antigen presentation of dietary gluten to gut associated lymphoid tissue as a cause are justified. This may explain a high prevalence of GRDs in the population and correlation with IBS, IBD and other gut inflammatory disorders.Keywords: celiac, gluten sensitive enteropathy, lymphocitic enteritis, IBS, IBD
Procedia PDF Downloads 1693107 The Role of Chemerin and Myostatin after Physical Activity
Authors: M. J. Pourvaghar, M. E. Bahram
Abstract:
Obesity and overweight is one of the most common metabolic disorders in industrialized countries and in developing countries. One consequence of pathological obesity is cardiovascular disease and metabolic syndrome. Chemerin is an adipocyne that plays a role in the regulation of the adipocyte function and the metabolism of glucose in the liver and musculoskeletal system. Most likely, chemerin is involved in obesity-related disorders such as type 2 diabetes and cardiovascular disease. Aerobic exercises reduce the level of chemerin and cause macrophage penetration into fat cells and inflammatory factors. Several efforts have been made to clarify the cellular and molecular mechanisms of hypertrophy and muscular atrophy. Myostatin, a new member of the TGF-β family, is a transforming growth factor β that its expression negatively regulates the growth of the skeletal muscle; and the increase of this hormone has been observed in conditions of muscular atrophy. While in response to muscle overload, its levels decrease after the atrophy period, TGF-β is the most important cytokine in the development of skeletal muscle. Myostatin plays an important role in muscle control, and animal and human studies show a negative role of myostatin in the growth of skeletal muscle. Separation of myostatin from Golgi begins on the ninth day of the onset period and continues until birth at all times of muscle growth. Higher levels of myostatin are found in obese people. Resistance training for 10 weeks could reduce levels of plasma myostatin.Keywords: chemerin, myostatin, obesity, physical activity
Procedia PDF Downloads 3093106 The Creation of a Yeast Model for 5-oxoproline Accumulation
Authors: Pratiksha Dubey, Praveen Singh, Shantanu Sen Gupta, Anand K. Bachhawat
Abstract:
5-oxoproline (pyroglutamic acid) is a cyclic lactam of glutamic acid. In the cell, it can be produced by several different pathways and is metabolized into glutamate with the help of the 5-oxoprolinase enzyme (OPLAH or OXP1). The inhibition of 5-oxoprolinase enzyme in mammals was found to result in heart failure and is thought to be a consequence of oxidative stress [1]. To analyze the consequences of 5-oxoproline accumulation more clearly, we are generating models for 5-oxoproline accumulation in yeast. The 5-oxoproline accumulation model in yeast is being developed by two different strategies. The first one is by overexpression of the mouse -glutamylcyclotransferase enzyme. It degrades -glu-met dipeptide into 5-oxoproline and methionine taken by the cell from the medium. The second strategy is by providing high concentration of 5-oxoproline externally to the yeast cells. The intracellular 5-oxoproline levels in both models are being evaluated. In addition, the metabolic and cellular consequences are being investigated.Keywords: 5-oxoproline, pyroglutamic acid, yeast, genetics
Procedia PDF Downloads 873105 Tip60’s Novel RNA-Binding Function Modulates Alternative Splicing of Pre-mRNA Targets Implicated in Alzheimer’s Disease
Authors: Felice Elefant, Akanksha Bhatnaghar, Keegan Krick, Elizabeth Heller
Abstract:
Context: The severity of Alzheimer’s Disease (AD) progression involves an interplay of genetics, age, and environmental factors orchestrated by histone acetyltransferase (HAT) mediated neuroepigenetic mechanisms. While disruption of Tip60 HAT action in neural gene control is implicated in AD, alternative mechanisms underlying Tip60 function remain unexplored. Altered RNA splicing has recently been highlighted as a widespread hallmark in the AD transcriptome that is implicated in the disease. Research Aim: The aim of this study was to identify a novel RNA binding/splicing function for Tip60 in human hippocampus and impaired in brains from AD fly models and AD patients. Methodology/Analysis: The authors used RNA immunoprecipitation using RNA isolated from 200 pooled wild type Drosophila brains for each of the 3 biological replicates. To identify Tip60’s RNA targets, they performed genome sequencing (DNB-SequencingTM technology, BGI genomics) on 3 replicates for Input RNA and RNA IPs by Tip60. Findings: The authors' transcriptomic analysis of RNA bound to Tip60 by Tip60-RNA immunoprecipitation (RIP) revealed Tip60 RNA targets enriched for critical neuronal processes implicated in AD. Remarkably, 79% of Tip60’s RNA targets overlap with its chromatin gene targets, supporting a model by which Tip60 orchestrates bi-level transcriptional regulation at both the chromatin and RNA level, a function unprecedented for any HAT to date. Since RNA splicing occurs co-transcriptionally and splicing defects are implicated in AD, the authors investigated whether Tip60-RNA targeting modulates splicing decisions and if this function is altered in AD. Replicate multivariate analysis of transcript splicing (rMATS) analysis of RNA-Seq data sets from wild-type and AD fly brains revealed a multitude of mammalian-like AS defects. Strikingly, over half of these altered RNAs were bonafide Tip60-RNA targets enriched for in the AD-gene curated database, with some AS alterations prevented against by increasing Tip60 in fly brain. Importantly, human orthologs of several Tip60-modulated spliced genes in Drosophila are well characterized aberrantly spliced genes in human AD brains, implicating disruption of Tip60’s splicing function in AD pathogenesis. Theoretical Importance: The authors' findings support a novel RNA interaction and splicing regulatory function for Tip60 that may underlie AS impairments that hallmark AD etiology. Data Collection: The authors collected data from RNA immunoprecipitation experiments using RNA isolated from 200 pooled wild type Drosophila brains for each of the 3 biological replicates. They also performed genome sequencing (DNBSequencingTM technology, BGI genomics) on 3 replicates for Input RNA and RNA IPs by Tip60. Questions: The question addressed by this study was whether Tip60 has a novel RNA binding/splicing function in human hippocampus and whether this function is impaired in brains from AD fly models and AD patients. Conclusions: The authors' findings support a novel RNA interaction and splicing regulatory function for Tip60 that may underlie AS impairments that hallmark AD etiology.Keywords: Alzheimer's disease, cognition, aging, neuroepigenetics
Procedia PDF Downloads 763104 Knowledge, Attitude, and Practice Among Diabetic Patients About Diabetic Foot Disease in Khartoum State Primary Health Care Centers, November 2022
Authors: Abrar Noorain, Zeinab Amara, Sulaf Abdelaziz
Abstract:
Background: Diabetic foot disease imposes a financial burden on diabetic patients and healthcare services. In Sudan, diabetic foot ulcer prevalence reached 18.1%. This study aims to assess the knowledge, attitudes, and practices and the correlation between the level of foot care knowledge and self-care practices among diabetic patients in Sudan. Methodology: In a cross-sectional study involving 262 patients with type 1 and type 2 diabetes attending diabetic clinics in three primary care centers in Khartoum, Sudan, during September to November 2022, information regarding participants sociodemographic status, foot care knowledge, attitudes, and practices was gathered using a validated, structured questionnaire in a face-to-face interview method. These data were analyzed using the statistical package for the social sciences (SPSS) 22. Results: The patients’ mean age was 54.9 years, with a female predominance (56%). Of the participants, 37% had diabetes mellitus for over ten years. On the topic of foot care, 35.5% of patients showed good knowledge, and 76% were aware of the risk of reduced foot sensation. In relation to nail care, only 19% knew how to cut nails correctly. Conclusion: Knowledge, attitudes, and practices about diabetic foot care are substandard. There is a positive correlation between foot care knowledge and self-care practices. Hence, educating diabetic patients with foot care knowledge through an awareness program and the characteristics of diabetic shoes may improve self-care practices.Keywords: DM, DFD, DFU, PHC, SPSS
Procedia PDF Downloads 733103 RNA Antisense Coat Protein Showing Promising Effects against Cotton Leaf Curl Disease in Pakistani Cotton
Authors: Zunnu Raen Akhtar
Abstract:
Cotton Leaf Curl Disease (CLCuD) is from Gemini virus and is transmitted through whiteflies in cotton. Transgenic cotton containing Antisense Coat Protein (ACP) has been found to show better results against CLCuD in cotton. In current research, Antisense Coat Protein was inserted in cotton plants to observe resistance developed in the cotton plants against CLCuD. T1 generation of plants were observed for its expression in plants. Tests were carried out to observe the expression of Antisense Coat Protein using Polymerase Chain Reaction (PCR) technique and by southern blotting. Whiteflies showing positive Cotton Leaf Curl Virus (CLCV) were reared and released in bioassay on ACP expressing cotton plants under laboratory as well as confined semi-field conditions. Results confirmed the expression of AC protein in PCR and southern blotting. Further laboratory results showed that cotton plants expressing AC protein showed rare incidence of CLCuD infection as compared to control. In the confined semi-field, similar results were observed in AC protein expressing cotton as compared to control. These results explicitly show that ACP can help to tackle the CLCuD issue in the future and further studies on biochemical processes involved in these plants and effects of ACP induction on non-target organisms should also be studied for eco-system.Keywords: cotton, white flies, antisense coat protein, CLCV
Procedia PDF Downloads 1843102 Cardiac Arrest after Cardiac Surgery
Authors: Ravshan A. Ibadov, Sardor Kh. Ibragimov
Abstract:
Objective. The aim of the study was to optimize the protocol of cardiopulmonary resuscitation (CPR) after cardiovascular surgical interventions. Methods. The experience of CPR conducted on patients after cardiovascular surgical interventions in the Department of Intensive Care and Resuscitation (DIR) of the Republican Specialized Scientific-Practical Medical Center of Surgery named after Academician V. Vakhidov is presented. The key to the new approach is the rapid elimination of reversible causes of cardiac arrest, followed by either defibrillation or electrical cardioversion (depending on the situation) before external heart compression, which may damage sternotomy. Careful use of adrenaline is emphasized due to the potential recurrence of hypertension, and timely resternotomy (within 5 minutes) is performed to ensure optimal cerebral perfusion through direct massage. Out of 32 patients, cardiac arrest in the form of asystole was observed in 16 (50%), with hypoxemia as the cause, while the remaining 16 (50%) experienced ventricular fibrillation caused by arrhythmogenic reactions. The age of the patients ranged from 6 to 60 years. All patients were evaluated before the operation using the ASA and EuroSCORE scales, falling into the moderate-risk group (3-5 points). CPR was conducted for cardiac activity restoration according to the American Heart Association and European Resuscitation Council guidelines (Ley SJ. Standards for Resuscitation After Cardiac Surgery. Critical Care Nurse. 2015;35(2):30-38). The duration of CPR ranged from 8 to 50 minutes. The ARASNE II scale was used to assess the severity of patients' conditions after CPR, and the Glasgow Coma Scale was employed to evaluate patients' consciousness after the restoration of cardiac activity and sedation withdrawal. Results. In all patients, immediate chest compressions of the necessary depth (4-5 cm) at a frequency of 100-120 compressions per minute were initiated upon detection of cardiac arrest. Regardless of the type of cardiac arrest, defibrillation with a manual defibrillator was performed 3-5 minutes later, and adrenaline was administered in doses ranging from 100 to 300 mcg. Persistent ventricular fibrillation was also treated with antiarrhythmic therapy (amiodarone, lidocaine). If necessary, infusion of inotropes and vasopressors was used, and for the prevention of brain edema and the restoration of adequate neurostatus within 1-3 days, sedation, a magnesium-lidocaine mixture, mechanical intranasal cooling of the brain stem, and neuroprotective drugs were employed. A coordinated effort by the resuscitation team and proper role allocation within the team were essential for effective cardiopulmonary resuscitation (CPR). All these measures contributed to the improvement of CPR outcomes. Conclusion. Successful CPR following cardiac surgical interventions involves interdisciplinary collaboration. The application of an optimized CPR standard leads to a reduction in mortality rates and favorable neurological outcomes.Keywords: cardiac surgery, cardiac arrest, resuscitation, critically ill patients
Procedia PDF Downloads 533101 Experimental Investigation of the Effect of Temperature on A PEM Fuel Cell Performance
Authors: Remzi Şahin, Sadık Ata, Kevser Dincer
Abstract:
In this study, performance of proton exchange membrane (PEM) fuel cell was experimentally investigated. The efficiency of energy conversion in PEM fuel cells is dependent on the catalytic activities of the catalysts used in the cathode and anode of membrane electrode assemblies. Membrane is considered the heart of PEM fuel cells without which they cannot produce electricity. PEM fuel cell performance increased with coating carbon nanotube (CNT). CNT show a unique combination of stiffness, strength, and tenacity compared to other fiber materials which usually lack one or more of these properties. Two different experiments were performed and the membrane performance has been determined by repeating the two experiments that were done before coating. The purposes of these experiments are the observation of power change due to a temperature change in the same voltage value.Keywords: carbon nanotube (CNT), proton exchange membrane (PEM), fuel cell, spin method
Procedia PDF Downloads 3823100 Portrayal of Kolkata(the former capital of India) in the ‘Kolkata Trilogy’- A Comparative Study of the Films by Mrinal Sen and Satyajit Ray
Authors: Ronit Chakraborty
Abstract:
Kolkata, formerly known as Calcutta, is the capital of West Bengal state and the former capital of India (1722-1911) of British India. Located at the heart of Hugli river (one of the main channels of Ganges river), the city is the heart of the state, which forms a base for commerce, transport and manufacture. The large and vibrant city thrives amidst the economic, social and political issues arising from the pages of history to the contemporary times. The unique nature, grandeurs, public debates on tea-stalls and obviously the charismatic scenic beauty and heritage keep the city to be criticized in all horizons, across the world. Movies in India are a big source of knowledge, which can be used as a powerful tool for political mobilization and to indirectly communicate with voters since cinema can be used as a tool of propaganda as it has a wide range of public interests. History proves the fact that films produced in India have been apt enough in making public interests be deeply portrayed through their content in a versatile manner. Such is the portrayal of India’s first capital, Kolkata and its ultimate truth being organizingly laid over by the trilogy of two international fame directors-Mrinal Sen and Satyajit Ray, through their ‘magnum opus- the ‘Kolkata trilogy’. Mrinal Sen’s Interview(1971), Calcutta 71(1972), Padatik(The Guerilla Fighter)(1973) and Satyajit Ray’s Pratidwandi (The Adversary)(1970), Seemabaddha(Company Limited)(1971), Jana Aranya(1976). These films picturized the contemporary Kolkata trends, issues and crises arising amidst the political set-up both by the positive and negative variables attributing to the day-to-day happenings of the city. The movies have been set amidst the turmoil that the nation was going through during Indira Gandhi’s declaration of Emergency, resulting from the general sense of disillusionment that prevailed during that time. Ray wasn't affiliated to any political party and his films largely contributed towards the contemporary conditions prevailing in the society. Mrinal Sen, being a Marxist was in constant search of the bitter truth that the society had to offer through his lens under the prevailing darkness through his trilogy. The research paper attempts to widely view and draw a comparative study of the overall description of the city of Kolkata as portrayed by Sen and Ray in their respective trilogies. By the usage of the visual content analysis method, the researcher has explored the six movies; both the trilogies of Mrinal Sen and Satyajit Ray and tried to analyse the differences as well as the similarities pertaining to understand India’s first capital city Kolkata in various dimensions along with its circumference.Keywords: Kolkata, trilogy, Satyajit Ray, Mrinal Sen, films, comparative study
Procedia PDF Downloads 2573099 Impact of COVID-19 Disease on Reproductive Health in Women
Authors: Mikailzade Parvin, Gurbanova Jamila, Alizade Samaya, Hasanova Afat
Abstract:
It is known that in March 2020, the World Health Organization (WHO) declared a global pandemic of the 2019 coronovirus disease COVID-19, caused by the severe acute respiratory syndrome coronovirus (SARS-CoV-2). In this period, ensuring the safety of pregnancy and childbirth has become one of the necessary issues. The measures taken in this direction naturally consisted of strengthening and improving preventive measures among pregnant women. It should be noted that the lethality of SARS-CoV-2 infection among women reached 25%. The relevance of studying the effect of COVID-19 on reproductive health in women is due to its wide spread worldwide, severe clinical course, and the occurrence of numerous complications or lethality. It is of urgent importance to study the impact of the mentioned coronavirus infection on the health of pregnant women and the serious complications caused by it.Taking these into account, 230 pregnant women infected with the COVID-19 virus infection were registered. The average age of the pregnant women included in the study was: 29.24±6.0. The diagnosis of corona virus infection was made on the basis of polymerase chain reaction (PCR), serological tests (IgG, IgM). In 57.4% of cases, bilateral pneumonia was recorded in pregnant women and confirmed on the basis of radiological (RH) examination. RH examination revealed pneumonia with infiltrate in the lungs. Among clinical symptoms in pregnant women infected with COVID-19 virus infection: in 86 (37.4%) cases, symptoms such as high fever (t-39.0oC), shortness of breath, fatigue, and hypoxia were noted in pregnant women. A decrease in SpO2 to a minimal level was recorded. Laboratory-instrumental examinations were carried out. The obtained results showed: the average limit of D-dimer was 0.8±0.5; prothrombin time 13.2±1.1 seconds; INR 0.98±0.08, prothrombin index 104.3±19.5%, EHS - 34.8±13.6 mm/s. It should be noted that respiratory distress syndrome (RDS), premature birth, malformed and extremely malformed newborns, asphyxia or hypoxia have been reported in infants born to pregnant women infected with the coronavirus disease.Thus, from the obtained indicators, it is known that pregnant women infected with the virus have a high risk of serious illness and death for both themselves and their babies. It has been proven that the majority of babies born to SARS-CoV-2 positive mothers have a negative impact on their health.Keywords: Covid 19, reproductive health, preqnancy, premature birth
Procedia PDF Downloads 873098 Frankie Adams’s Sexuality in the Member of the Wedding: Focusing on Musical References
Authors: Saori Iwatsuka
Abstract:
In The Member of the Wedding, Carson McCullers starts with the words, “It happened,” without telling the reader what happens to a twelve-year-old protagonist, Frankie Adams. The reader feels confused and incomprehensible. However, he or she later realizes that the confusing phrase is connected to the scene where Frankie feels “the thing happened” after listening to the melodic lines of jazz and blues. Yet, the reader cannot really comprehend what happens to Frankie and feels puzzled till the end. And the story ends with Frankie’s words, “I am simply mad about . . .” Implying her queer desire for her new friend Mary Littlejohn, McCullers never tells the reader whom Frankie is mad about. Despite McCullers’s ambiguous way of depicting Frankie’s sexuality, recent critics and reviewers have come to discuss her sexuality as anti-heterosexual because Frankie expresses her hatred for Barney, whom she has had some type of sexual encounter, and feels wrong with her brother Jarvis’s wedding. After giving up her sexual desire for Jarvis’s bride, Janice, Frankie changes her name to Frances, becomes engrossed with Michelangelo, and enjoys reading Tennyson’s poetry with Mary. Michelangelo and Tennyson are well-known homosexual artists, which suggests that Frankie has an anti-heterosexual orientation. As McCullers does not precisely describe Frankie’s sexuality, the reader can only assume it by connecting fragmentary descriptions. However, this discussion is more clarified to show Frankie’s sexuality because analyzing the musical references of jazz and blues and interpreting them from a musicological viewpoint will illuminate it. In her works, McCullers frequently uses musical references and descriptions, which have a significant and psychological impact on the protagonists and portrays their bodily reactions to the impact to reveal what the reader cannot see on the surface. Thus, in this story, too, Frankie’s bodily reaction to music is portrayed to cue her feelings. After seeing the chimney swifts, known as monogamous birds, Frankie feels “a jazz sadness,” quivers her nerves and stiffens her heart. After listening to Berenice’s “dark jazz voice,” Frankie feels dizzy and throws a knife because Berenice’s voice jazzes (excites) her heart that beats in her head. Calming herself, she fantasizes that Jarvis, Jarvis’s bride, Janice, and herself are members of “the we of me.” Then in the evening, listening to the blues and jazz being played by a black horn player somewhere in her neighborhood, Frankie realizes “the thing happened” and discovers “a new feeling.” Following the musical references “jazz” and “blues” and examining them from the viewpoint of musicology and terminology leads the reader to explore what “it” is in “it happened” and what her “new feeling” is when “the thing happened” with the blues tune breaking off. Those discussions will illuminate Frankie’s sexuality. As McCullers does not clearly name her sexuality, this paper uses the word queer to express Frankie’s anti-sexual orientation.Keywords: jazz and blues, musical references, queer sexuality, “we of me”
Procedia PDF Downloads 893097 Effect of Grafting and Rain Shelter Technologies on Performance of Tomato (Lycopersicum esculentum Mill.)
Authors: Evy Latifah, Eli Korlina, Hanik Anggraeni, Kuntoro Boga, Joko Mariyono
Abstract:
During the rainy season, the tomato plants are vulnerable to various diseases. A disease that attacks the leaves of tomato plants (foliar diseases) such as late blight (Phytophtora infestans) and spotting bacteria (bacterial spot / Xanthomonas sp.) In addition, there is a disease that attacks the roots such as fusarium and bacterial wilt. If not immediately anticipated, it will decrease the quality and quantity of crop yields. In fact, it can lead to crop failure. The aim of this research is to know the production of tomato grafting by using Timoty and CLN 3024 tomatoes at rain shelter during rainy season in lowland. Data were analyzed using analysis of variance and tested further by Least Significant Difference (LSD) level of 5 %. The parameters measured were plant height (cm), stem diameter (cm), number of fruit space, canopy extended, number of branches, number of productive branches, and the number of stem segments. The results show at the beginning of growth until the end of the treatment without grafting with relative rain shelter displays the highest plant height. This was followed by extensive crop canopy. For tomato grafting and non-grafting using rain shelter able to produce the number of branches and number of productive branches at most. While at the end of the growth in the number of productive branches generated as much. Highest production of tomatoes produced by tomato dig rafting to use the shelter.Keywords: field trail, wet and dry season, production, diseases, rain shelter
Procedia PDF Downloads 2283096 Afrikan Natural Medicines: An Innovation-Based Model for Medicines Production, Curriculum Development and Clinical Application
Authors: H. Chabalala, A. Grootboom, M. Tang
Abstract:
The innovative development, production, and clinical utilisation of African natural medicines requires frameworks from systematisation, innovation, registration. Afrika faces challenges when it comes to these sectors. The opposite is the case as is is evident in ancient Asian (Traditional Chinese Medicine and Indian Ayurveda and Siddha) medical systems, which are interfaced into their respective national health and educational systems. Afrikan Natural Medicines (ANMs) are yet to develop systematisation frameworks, i.e. disease characterisation and medicines classification. This paper explores classical medical systems drawn from Afrikan and Chinese experts in natural medicines. An Afrikological research methodology was used to conduct in-depth interviews with 20 key respondents selected through purposeful sampling technique. Data was summarised into systematisation frameworks for classical disease theories, patient categorisation, medicine classification, aetiology and pathogenesis of disease, diagnosis and prognosis techniques and treatment methods. It was discovered that ancient Afrika had systematic medical cosmologies, remnants of which are evident in most Afrikan cultural health practices. Parallels could be drawn from classical medical concepts of antiquity, like Chinese Taoist and Indian tantric health systems. Data revealed that both the ancient and contemporary ANM systems were based on living medical cosmologies. The study showed that African Natural Healing Systems have etiological systems, general pathogenesis knowledge, differential diagnostic techniques, comprehensive prognosis and holistic treatment regimes. Systematisation models were developed out of these frameworks, and this could be used for evaluation of clinical research, medical application including development of curriculum for high-education. It was envisaged that frameworks will pave way towards the development, production and commercialisation of ANMs. This was piloted in inclusive innovation, technology transfer and commercialisation of South African natural medicines, cosmeceuticals, nutraceuticals and health infusions. The central model presented here in will assist in curriculum development and establishment of Afrikan Medicines Hospitals and Pharmaceutical Industries.Keywords: African Natural Medicines, Indigenous Knowledge Systems, Medical Cosmology, Clinical Application
Procedia PDF Downloads 1293095 Incidence of Cancer in Patients with Alzheimer's Disease: A 11-Year Nationwide Population-Based Study
Authors: Jun Hong Lee
Abstract:
Background: Alzheimer`s disease (AD) I: creases with age and is characterized by the premature progressive loss of neuronal cell. In contrast, cancer cells have inappropriate cell proliferation and resistance to cell death. Objective: We evaluated the association between cancer and AD and also examined the specific types of cancer. Patients and Methods/Material and Methods: This retrospective, nationwide, longitudinal study used National Health Insurance Service – Senior cohort (NHIS-Senior) 2002-2013, which was released by the KNHIS in 2016, comprising 550,000 random subjects who were selected from over than 60. The study included a cohort of 4,408 patients who were first diagnoses as AD between 2003 and 2005. To match each dementia patient, 19,150 subjects were selected from the database by Propensity Score Matching. Results: We enrolled 4,790 patients for analysis in this cohort and the prevalence of AD was higher in female (19.29%) than in male (17.71%). A higher prevalence of AD was observed in the 70-84 year age group and in the higher income status group. A total of 540 cancers occurred within the observation interval. Overall cancer was less frequent in those with AD (12.25%) than in the control (18.46%), with HR 0.704 (95% Confidence Intervals (CIs)=0.0.64-0.775, p-Value < 0.0001). Conclusion: Our data showed a decreased incidence of overall cancers in patients with AD similar to previous studies. Patients with AD had a significantly decreased risk of colon & rectum, lung and stomach cancer. This finding lower than but consistent with Western countries. We need further investigation of genetic evidence linking AD to cancer.Keywords: Alzheimer, cancer, nationwide, longitudinal study
Procedia PDF Downloads 1783094 Atherosclerotic Plagues and Immune Microenvironment: From Lipid-Lowering to Anti-inflammatory and Immunomodulatory Drug Approaches in Cardiovascular Diseases
Authors: Husham Bayazed
Abstract:
A growing number of studies indicate that atherosclerotic coronary artery disease (CAD) has a complex pathogenesis that extends beyond cholesterol intimal infiltration. The atherosclerosis process may involve an immune micro-environmental condition driven by local activation of the adaptive and innate immunity arrays, resulting in the formation of atherosclerotic plaques. Therefore, despite the wide usage of lipid-lowering agents, these devastating coronary diseases are not averted either at primary or secondary prevention levels. Many trials have recently shown an interest in the immune targeting of the inflammatory process of atherosclerotic plaques, with the promised improvement in atherosclerotic cardiovascular disease outcomes. This recently includes the immune-modulatory drug “Canakinumab” as an anti-interleukin-1 beta monoclonal antibody in addition to "Colchicine,” which's established as a broad-effect drug in the management of other inflammatory conditions. Recent trials and studies highlight the importance of inflammation and immune reactions in the pathogenesis of atherosclerosis and plaque formation. This provides an insight to discuss and extend the therapies from old lipid-lowering drugs (statins) to anti-inflammatory drugs (colchicine) and new targeted immune-modulatory therapies like inhibitors of IL-1 beta (canakinumab) currently under investigation.Keywords: atherosclerotic plagues, immune microenvironment, lipid-lowering agents, and immunomodulatory drugs
Procedia PDF Downloads 693093 Protective Role of Phycobiliproteins in ROS-Associated Physiological Anomalies
Authors: Ravi Raghav Sonani, Niraj Kumar Singh, Jitendra Kumar, Datta Madamwar
Abstract:
Phycobiliproteins (PBPs) are light harvesting proteins showing very strong absorbance and fluorescence in the visible range of the solar spectrum. Phycoerythrin (PE) and phycocyanin (PC) are majorly found PBPs in the cyanobacteria and red algae. In the present study, we have investigated the reactive oxygen species (ROS)-averting capacity of purified PE and PC of cyanobacterial origin. Furthermore, the possibility - whether the ROS-averting potential of PBPs can be explored in the therapeutics of oxidative stress associated physiological anomalies including aging and neurodegenerative diseases. The nematode Caenorhabditis elegans has been used as model organism in this study. PE and PC treatment moderated normal aging and associated physiological functionalities like pharyngeal pumping and locomotion of C. elegans. Moreover, PE-treatment enhanced the stress (oxidative and heat) tolerance upon PE and PC treatment. Specifically, PE treatment was also noted to moderate the progression of Alzheimer’s disease in transgenic C. elegans CL4176. However, PC-treatment curtailed the polyQ aggregation mediated proteotoxicity in C. elegans AM141 (Huntington disease model) under stressed (paraquat stress) as well as normal conditions. The effectiveness of PE and PC in expanding the lifespan of mutant C. elegans knockout for some up- (daf 16) and down- (daf-2 and age-1) stream regulators of insulin/IGF-1 signalling (IIS) shows the independency of their effects from DAF-2–AGE-1–DAF-16 signalling pathway. In conclusion, the present report demonstrates the anti-aging and neuro-protective potential of cyanobacterial PE and PC.Keywords: phycobiliproteins, aging, alzheimer, huntington, C. elegans
Procedia PDF Downloads 3903092 An Insight into the Interaction Study of a WhiB Protein and its Binding Partner
Authors: Sonam Kumari
Abstract:
Tuberculosis is the deadliest disease worldwide. Millions of people lose their lives every year due to this disease. It has turned lethal due to the erratic nature of its causative organism, Mycobacterium tuberculosis (Mtb). Mtb tends to enter into an inactive, dormant state and emerge to replicating state upon encountering favorable conditions. The mechanism by which Mtb switches from the dormant state to the replicative form is still poorly characterized. Proteome studies have given us an insight into the role of certain proteins in giving stupendous virulence to Mtb, but numerous dotsremain unconnected and unaccounted. The WhiB family of proteins is one such protein that is associated with developmental processes in actinomycetes. Mtb has seven such proteins (WhiB1 to WhiB7). WhiB proteins are transcriptional regulators; they regulate various essential genes of Mtbby binding to their promoter DNA. Biophysical parameters of the effect of DNA binding on WhiB proteins has not yet been appropriately characterized. Interaction with DNA induces conformational changes in the WhiB proteins, confirmed by steady-state fluorescence and circular dichroism spectroscopy. ITC has deduced thermodynamic parameters and the binding affinity of the interaction. Since these transcription factors are highly unstable in vitro, their stability and solubility were enhanced by the co-expression of molecular chaperones. The present study findings help determine the conditions under which the WhiB proteins interact with their interacting partner and the factors that influence their binding affinity. This is crucial in understanding their role in regulating gene expression in Mtbandin targeting WhiB proteins as a drug target to cure TB.Keywords: mycobacterium tuberculosis, TB, whiB proteins, ITC
Procedia PDF Downloads 973091 Factors Associated with Hand Functional Disability in People with Rheumatoid Arthritis: A Systematic Review and Best-Evidence Synthesis
Authors: Hisham Arab Alkabeya, A. M. Hughes, J. Adams
Abstract:
Background: People with Rheumatoid Arthritis (RA) continue to experience problems with hand function despite new drug advances and targeted medical treatment. Consequently, it is important to identify the factors that influence the impact of RA disease on hand function. This systematic review identified observational studies that reported factors that influenced the impact of RA on hand function. Methods: MEDLINE, EMBASE, CINAL, AMED, PsychINFO, and Web of Science database were searched from January 1990 up to March 2017. Full-text articles published in English that described factors related to hand functional disability in people with RA were selected following predetermined inclusion and exclusion criteria. Pertinent data were thoroughly extracted and documented using a pre-designed data extraction form by the lead author, and cross-checked by the review team for completion and accuracy. Factors related to hand function were classified under the domains of the International Classification of Functioning, Disability, and Health (ICF) framework and health-related factors. Three reviewers independently assessed the methodological quality of the included articles using the quality of cross-sectional studies (AXIS) tool. Factors related to hand function that was investigated in two or more studies were explored using a best-evidence synthesis. Results: Twenty articles form 19 studies met the inclusion criteria from 1,271 citations; all presented cross-sectional data (five high quality and 15 low quality studies), resulting in at best limited evidence in the best-evidence synthesis. For the factors classified under the ICF domains, the best-evidence synthesis indicates that there was a range of body structure and function factors that were related with hand functional disability. However, key factors were hand strength, disease activity, and pain intensity. Low functional status (physical, emotional and social) level was found to be related with limited hand function. For personal factors, there is limited evidence that gender is not related with hand function; whereas, conflicting evidence was found regarding the relationship between age and hand function. In the domain of environmental factors, there was limited evidence that work activity was not related with hand function. Regarding health-related factors, there was limited evidence that the level of the rheumatoid factor (RF) was not related to hand function. Finally, conflicting evidence was found regarding the relationship between hand function and disease duration and general health status. Conclusion: Studies focused on body structure and function factors, highlighting a lack of investigation into personal and environmental factors when considering the impact of RA on hand function. The level of evidence which exists was limited, but identified that modifiable factors such as grip or pinch strength, disease activity and pain are the most influential factors on hand function in people with RA. The review findings suggest that important personal and environmental factors that impact on hand function in people with RA are not yet considered or reported in clinical research. Well-designed longitudinal, preferably cohort, studies are now needed to better understand the causality between personal and environmental factors and hand functional disability in people with RA.Keywords: factors, hand function, rheumatoid arthritis, systematic review
Procedia PDF Downloads 1483090 Integration of a Protective Film to Enhance the Longevity and Performance of Miniaturized Ion Sensors
Authors: Antonio Ruiz Gonzalez, Kwang-Leong Choy
Abstract:
The measurement of electrolytes has a high value in the clinical routine. Ions are present in all body fluids with variable concentrations and are involved in multiple pathologies such as heart failures and chronic kidney disease. In the case of dissolved potassium, although a high concentration in the blood (hyperkalemia) is relatively uncommon in the general population, it is one of the most frequent acute electrolyte abnormalities. In recent years, the integration of thin films technologies in this field has allowed the development of highly sensitive biosensors with ultra-low limits of detection for the assessment of metals in liquid samples. However, despite the current efforts in the miniaturization of sensitive devices and their integration into portable systems, only a limited number of successful examples used commercially can be found. This fact can be attributed to a high cost involved in their production and the sustained degradation of the electrodes over time, which causes a signal drift in the measurements. Thus, there is an unmet necessity for the development of low-cost and robust sensors for the real-time monitoring of analyte concentrations in patients to allow the early detection and diagnosis of diseases. This paper reports a thin film ion-selective sensor for the evaluation of potassium ions in aqueous samples. As an alternative for this fabrication method, aerosol assisted chemical vapor deposition (AACVD), was applied due to cost-effectivity and fine control over the film deposition. Such a technique does not require vacuum and is suitable for the coating of large surface areas and structures with complex geometries. This approach allowed the fabrication of highly homogeneous surfaces with well-defined microstructures onto 50 nm thin gold layers. The degradative processes of the ubiquitously employed poly (vinyl chloride) membranes in contact with an electrolyte solution were studied, including the polymer leaching process, mechanical desorption of nanoparticles and chemical degradation over time. Rational design of a protective coating based on an organosilicon material in combination with cellulose to improve the long-term stability of the sensors was then carried out, showing an improvement in the performance after 5 weeks. The antifouling properties of such coating were assessed using a cutting-edge quartz microbalance sensor, allowing the quantification of the adsorbed proteins in the nanogram range. A correlation between the microstructural properties of the films with the surface energy and biomolecules adhesion was then found and used to optimize the protective film.Keywords: hyperkalemia, drift, AACVD, organosilicon
Procedia PDF Downloads 1233089 God in Jesus, a Daimonion in Socrates and Their Respective Divine Communication
Authors: Yip-Mei Loh
Abstract:
Jesus and Socrates shared a remarkable gift; a channel of inner spiritual communication, to afford them truthful guidance in their respective religious discourse. Jesus is part of the Trinity; he is the Son, the Son of God. In mortal life he is the son of a carpenter. He called on all peoples to repent of their sins but fell foul of the authorities and was crucified. Socrates was an ancient Greek philosopher and the son of an artisan. His mission is to drive the Athenians to investigate truth, but he too incurs the displeasure of fellow citizens, to the extent of execution. The accusations made against them centre around, in Jesus’ case, proclaiming himself the Son of God, with the means to pardon, and in Socrates’, that a daimonion, an inner voice, speaks to him in his heart. Jesus talks with God directly through prayer, as the pneuma of God, i.e. to pneuma to hagion, or Holy Spirit, is with him. Socrates seems to enter what we would now think of as a trance-like condition, wherein he communicates with his inner daimonion, who directs him to take courage on the righteous path.Keywords: daimonion, God, Holy Spirit, pneuma, truth
Procedia PDF Downloads 1883088 Characterization of the Blood Microbiome in Rheumatoid Arthritis Patients Compared to Healthy Control Subjects Using V4 Region 16S rRNA Sequencing
Authors: D. Hammad, D. P. Tonge
Abstract:
Rheumatoid arthritis (RA) is a disabling and common autoimmune disease during which the body's immune system attacks healthy tissues. This results in complicated and long-lasting actions being carried out by the immune system, which typically only occurs when the immune system encounters a foreign object. In the case of RA, the disease affects millions of people and causes joint inflammation, ultimately leading to the destruction of cartilage and bone. Interestingly, the disease mechanism still remains unclear. It is likely that RA occurs as a result of a complex interplay of genetic and environmental factors including an imbalance in the microorganism population inside our body. The human microbiome or microbiota is an extensive community of microorganisms in and on the bodies of animals, which comprises bacteria, fungi, viruses, and protozoa. Recently, the development of molecular techniques to characterize entire bacterial communities has renewed interest in the involvement of the microbiome in the development and progression of RA. We believe that an imbalance in some of the specific bacterial species in the gut, mouth and other sites may lead to atopobiosis; the translocation of these organisms into the blood, and that this may lead to changes in immune system status. The aim of this study was, therefore, to characterize the microbiome of RA serum samples in comparison to healthy control subjects using 16S rRNA gene amplification and sequencing. Serum samples were obtained from healthy control volunteers and from patients with RA both prior to, and following treatment. The bacterial community present in each sample was identified utilizing V4 region 16S rRNA amplification and sequencing. Bacterial identification, to the lowest taxonomic rank, was performed using a range of bioinformatics tools. Significantly, the proportions of the Lachnospiraceae, Ruminococcaceae, and Halmonadaceae families were significantly increased in the serum of RA patients compared with healthy control serum. Furthermore, the abundance of Bacteroides and Lachnospiraceae nk4a136_group, Lachnospiraceae_UGC-001, RuminococcaceaeUCG-014, Rumnococcus-1, and Shewanella was also raised in the serum of RA patients relative to healthy control serum. These data support the notion of a blood microbiome and reveal RA-associated changes that may have significant implications for biomarker development and may present much-needed opportunities for novel therapeutic development.Keywords: blood microbiome, gut and oral bacteria, Rheumatoid arthritis, 16S rRNA gene sequencing
Procedia PDF Downloads 132