Search results for: severe acute respiratory infections

Authors: James D. Beauchemin

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This study tested whether youth mental health care quality, operationalized as the extent to which youth and families experienced system-of-care principles in service interactions with providers, varied by level of youth need after adjusting for sociodemographic and treatment factors. The relationship of quality to clinical outcomes was also examined. Using administrative data and cross-sectional surveys from a stratified random sample of 1,124 caregivers of youths ages 5 to 20 within a statewide system-of-care, adjusted analyses indicated youths with the most intensive needs were significantly less likely to experience high-quality care (51% vs. 63%, p=0.016), with marked deficits on 6 of 9 items. Receipt of lower-quality care predicted less improvement in youth functioning. Despite considerable effort to develop systems-of-care for youths with the most severe mental health needs, these data suggest quality disparities remain for the most impaired youths. Policy and intervention development may be needed to improve the quality of care for this population.

Keywords: system-of-care, adherence, mental health, youth

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Authors: Jeet Chakraborty, Sanjay Dutta

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Antibiotic resistance by bacteria has proved to be a severe threat to mankind in recent times, and this fortifies an urgency to design and develop potent antibacterial small molecules/compounds with nonconventional mechanisms than the conventional ones. DNA carries the genetic signature of any organism, and bacteria maintain their genomic DNA inside the cell in a well-regulated compact form with the help of various nucleoid associated proteins like HU, HNS, etc. These proteins control various fundamental processes like gene expression, replication, etc., inside the cell. Alteration of the native DNA structure of bacteria can lead to severe consequences in cellular processes inside the bacterial cell that ultimately result in the death of the organism. The change in the global DNA structure by small molecules initiates a plethora of cellular responses that have not been very well investigated. Echinomycin and Triostin-A are biologically active Quinoxaline small molecules that typically consist of a quinoxaline chromophore attached with an octadepsipeptide ring. They bind to double-stranded DNA in a sequence-specific way and have high activity against a wide variety of bacteria, mainly against Gram-positive ones. To date, few synthetic quinoxaline scaffolds were synthesized, displaying antibacterial potential against a broad scale of pathogenic bacteria. QNOs (Quinoxaline N-oxides) are known to target DNA and instigate reactive oxygen species (ROS) production in bacteria, thereby exhibiting antibacterial properties. The divergent role of Quinoxaline small molecules in medicinal research qualifies them for the evaluation of their antimicrobial properties as a potential candidate. The previous study from our lab has given new insights on a 6-nitroquinoxaline derivative 1d as an intercalator of DNA, which induces conformational changes in DNA upon binding.7 The binding event observed was dependent on the presence of a crucial benzyl substituent on the quinoxaline moiety. This was associated with a large induced CD (ICD) appearing in a sigmoidal pattern upon the interaction of 1d with dsDNA. The induction of DNA superstructures by 1d at high Drug:DNA ratios was observed that ultimately led to DNA condensation. Eviction of invitro-assembled nucleosome upon treatment with a high dose of 1d was also observed. In this work, monoquinoxaline derivatives of 1d were synthesized by various modifications of the 1d scaffold. The set of synthesized 6-nitroquinoxaline derivatives along with 1d were all subjected to antibacterial evaluation across five different bacteria species. Among the compound set, 3a displayed potent antibacterial activity against Staphylococcus aureus bacteria. 3a was further subjected to various biophysical studies to check whether the DNA structural alteration potential was still intact. The biological response of S. aureus cells upon treatment with 3a was studied using various cell biology processes, which led to the conclusion that 3d can initiate DNA damage in the S. aureus cells. Finally, the potential of 3a in disrupting preformed S.aureus and S.epidermidis biofilms was also studied.

Keywords: DNA structural change, antibacterial, intercalator, DNA superstructures, biofilms

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Authors: Yu Zhao, Shinsuke Kato, Jianing Zhao

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Particles exhausted from cars have an adverse impacts on human health. The study developed a three-dimensional particle dispersion numerical model including particle coagulation to simulate the particle concentration distribution under idling conditions in a residential underground garage. The simulation results demonstrate that particle disperses much faster in the vertical direction than that in horizontal direction. The enhancement of particle dispersion in the vertical direction due to the increase of cars with engine running is much stronger than that in the car exhaust direction. Particle dispersion from each pair of adjacent cars has little influence on each other in the study. Average particle concentration after 120 seconds exhaust is 1.8-4.5 times higher than the initial total particles at ambient environment. Particle pollution in the residential underground garage is severe.

Keywords: dispersion, idling conditions, particle concentration, residential underground garage

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Authors: Nora Alkharji, Wafa Fallatah

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Introduction: One of the major issues to consider when is deciding on what to feed a baby is the quality of the food itself. Whilst commercially prepared infant formulas are a nutritious alternative to breast milk, and even contain some vitamins and nutrients, most major medical organizations consider breastfeeding the best nutritional option for babies. Choosing whether to breastfeed or formula feed your baby is one of the first decisions expectant parents will make. The American Academy of Pediatrics (AAP) is in agreement with other organizations such as the American Medical Association (AMA), the American Dietetic Association (ADA), and the World Health Organization (WHO) in recommending breastfeeding as the best nutrition for babies and best suited for a baby's digestive system. In addition, breastfeeding helps in the combatting of infections, prevention of allergies, and protection against various chronic conditions. The decision to breastfeed or formula feed one’s baby is a very personal one. However, certain points need to be clarified regarding the nutritional value of breastfeeding versus formula feeding to allow for informed decision-making. Methodology: -A formal debate about whether to breastfeed or formula feed babies as the better choice. -There will be two debaters, both lactation consultants -Arguments will be based on evidence-based medicine -Duration period of debated: 45 min Result: Clarification and heightened awareness of the benefits of breastfeeding. Conclusion: This debate will make the choice between breastfeeding or formula feeding a relatively easy one to make by both health worker and parents.

Keywords: breastmilk, formula milk, nutritional, comparison

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Authors: Xin Zhao

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3D printing is used in creating bone grafts of various architectures by printing materials in a layer-by-layer manner. Traditionally, to make materials printable, heating up or dissolving materials in organic solvents have been used, compromising their capability in loading biomolecules. Photocrosslinkable materials which are initially liquid and printable, and solidified upon light exposure are therefore developed. However, the existing photocrosslinkable materials are either too soft to bear load or non-degradable with potential long-term biocompatibility problems. Here, photocrosslinkable nanocomposite ink is developed composed of poly (lactide-co-propylene glycol-co-lactide) dimethacrylate (PmLnDMA) and hydroxyethyl methacrylate-functionalized hydroxyapatite nanoparticles (nHAMA) mimicking the hairy setae of gecko that can strongly interact with its surroundings to bear high load. Incorporation of nHAMA into PmLnDMA endows the nanocomposite ink with several advantages in (1) improved organic/inorganic interfacial compatibility to increase mechanical strength, (2) readily modulated rheological behaviors, wettability, and biodegradation, (3) enhanced osteoconductivity and osteoinductivity. Moreover, the ink can be rapidly crosslinked upon light exposure, load, and long-term release growth factors, and be printed into 3D bone scaffolds of various shapes and structures according to the patients’ needs. Altogether, this innovation will benefit patients all over the world who suffer from bone fractures, tumors, infections.

Keywords: photocrosslinkable nanocomposite, 3D printing, bone ink, personalized medicine

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Authors: Amel Ourici

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An electrical machine failure that is not identified in an initial stage may become catastrophic and it may suffer severe damage. Thus, undetected machine faults may cascade in it failure, which in turn may cause production shutdowns. Such shutdowns are costly in terms of lost production time, maintenance costs, and wasted raw materials. Doubly fed induction generators are used mainly for wind energy conversion in MW power plants. This paper presents a detection of an inter turn stator fault in a doubly fed induction machine whose stator and rotor are supplied by two pulse width modulation (PWM) inverters. The method used in this article to detect this fault, is based on Park’s Vector Approach, using a neural network.

Keywords: doubly fed induction machine, PWM inverter, inter turn stator fault, Park’s vector approach, neural network

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Authors: Hugo d’Albert, Udo Lindemann

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The number of automotive electronic systems that allow realizing new functions, like driver assistance systems, has been increasing extremely in the last decade. Although they bring several benefits, their malfunctions can lead to severe consequences, such as personal injury of road users. Functional safety is an approach to identify these critical malfunctions and arrange technical systems that include only tolerable risk. This approach is– in comparison with other technical areas– relatively new in the automotive sector. For a long time, the automotive systems have based on mechanical components and approved principles, like robust design. With a growing number of electric and electronic components in the modern cars and realizing by software of the system functions, the need for new standards and methods to assure the functional safety has arisen. This paper described the current state of engineering for safety in automotive sector and discusses new directions to meet the challenges of the future.

Keywords: automotive systems, functional safety, quality engineering, quality management

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Authors: Ghorbanali Mohammadi

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Background: Due to the widespread outbreak of the COVID-19 virus, a large number of people become infected with the disease every day and go to hospitals. The acute condition of this disease has caused the death of many people. Since all the stages of treatment for these people happen in the hospitals, nurses are at the forefront of the fight against this virus. This causes nurses to suffer from physical and mental health problems. Methods: Physical and mental problems in nurses were assessed using the Depression, Anxiety and Stress Scale (DASS-42) of Lovibond (1995) and the Nordic Questionnaire. Results: 90 nurses from emergency, intensive care, and coronary care units were examined, and a total of 180 questionnaires were collected and evaluated. It was found that 37.78%, 47.78%, and 21.11% of nurses have symptoms of depression, anxiety, and stress, respectively. 40% of the nurses had physical problems. In total, 65.17% of them were involved in one or more mental or physical illnesses. Conclusions: Of the three units surveyed, the nurses in intensive care, emergency room, and coronary care units worked more than ten hours a day. Examining the interaction of physical and mental health problems indicated that physical problems can aggravate mental problems.

Keywords: depression anxiety and stress scale of Lovibond, nordic questionnaire, mental health of nurses, physical health problems in nurses

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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: Syeda Kiran Shahzadi, Nasir Mahmood, Muhammad Abdul Qadir

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In the current research, three recombinant human interferon alpha-2b proteins (two modified and one normal form) were produced and Pegylated with an aim to produce more effective drugs against viral infections and cancers. The modified recombinant human interferon alpha-2b proteins were produced by site-directed modifications of interferon alpha 2b gene, targeting the amino acids at positions ‘R23’ and ‘H34’. The resulting chemically modified and unmodified forms of human interferon alpha 2b were conjugated with methoxy-polyethylene glycol propanealdehyde (400 KDa) and methoxy-polyethylene glycol succinimidyl succinate (400 KDa). Pegylation of normal and modified forms of Interferon alpha-2b prolong their release time and enhance their efficacy. The conjugation of PEG with modified and unmodified human interferon alpha 2b protein drugs was also characterized with 1H-NMR, HPLC, and SDS-PAGE. Antiproliferative assays of modified and unmodified forms of drugs were performed in cell based bioassays using MDBK cell lines. The results indicated that experimentally produced recombinant human interferon alpha-2b proteins were biologically active and resulted in significant inhibition of cell growth.

Keywords: protein refolding, antiproliferative activities, biomedical applications, human interferon alpha-2b, pegylation, mPEG-propionaldehyde, site directed mutagenesis, E. coli expression

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Authors: Syed M. Shahid, Rozeena Shaikh, Syeda N. Nawab, Abid Azhar

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Diabetes mellitus (DM) is a prevalent non-communicable disease worldwide. DM may lead to many vascular complications like hypertension, nephropathy, retinopathy, neuropathy and foot infections. Pathogenesis of diabetic nephropathy (DN) is implicated by the polymorphisms in genes encoding the specific components of renin angiotensin aldosterone system (RAAS) which include angiotensinogen (AGT), angiotensin-II receptor and angiotensin converting enzyme (ACE) genes. This study was designed to explore the possible association of AG (M268T) polymorphism in the patients of diabetes and nephropathy in Pakistan. Study subjects included 100 controls, 260 diabetic patients without renal insufficiency and 190 diabetic nephropathy patients with persistent albuminuria. Fasting blood samples were collected from all the subjects after getting institutional ethical approval and informed consent. The biochemical estimations, PCR amplification and direct sequencing for the specific region of AGT gene was carried out. A significantly high frequency of TT genotype and T allele of AGT (M268T) was observed in the patients of diabetes with nephropathy as compared to controls and diabetic patients without any known renal impairment. The TT genotype and T allele of AGT (M268T) polymorphism may be considered as a genetic risk factor for the development and progression of nephropathy in diabetes. Further cross sectional population studies would be of help to establish and confirm the observed possible association of AGT gene variations with development of nephropathy in diabetes.

Keywords: RAAS, AGT (M268T), diabetes, nephropathy

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Authors: Shruti Motiwale, Xianlin Zhou, Reuben H. Kraft

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Military and sports personnel are often required to wear heavy helmets for extended periods of time. This leads to excessive cyclic loads on the neck and an increased chance of injury. Computational models offer one approach to understand and predict the time progression of disc degeneration under severe cyclic loading. In this paper, we have applied an analytic non-linear damage evolution model to estimate damage evolution in an intervertebral disc due to cyclic loads over decade-long time periods. We have also proposed a novel strategy for inclusion of recovery in the damage model. Our results show that damage only grows 20% in the initial 75% of the life, growing exponentially in the remaining 25% life. The analysis also shows that it is crucial to include recovery in a damage model.

Keywords: cervical spine, computational biomechanics, damage evolution, intervertebral disc, continuum damage mechanics

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Authors: Mohammad Moeini, Mehrdad Ghyabi, Kiarash Mohtasham Dolatshahi

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This paper investigates seismic soil-pile interaction using the Beam on Nonlinear Winkler Foundation (BNWF) approach. Three soil types are considered to cover all the possible responses, as well as nonlinear site response analysis using finite element method in OpenSees platform. Excitations at each elevation that are output of the site response analysis are used as the input excitation to the soil pile system implementing multi-support excitation method. Spectral intensities of acceleration show that the extent of the response in sand is more severe than that of clay, in addition, increasing the PGA of ground strong motion will affect the sandy soil more, in comparison with clayey medium, which is an indicator of the sensitivity of soil-pile systems in sandy soil.

Keywords: BNWF method, multi-support excitation, nonlinear site response analysis, seismic soil-pile interaction

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Authors: Robert E. Kenney, Richard B. Aguilar, Efrain Antunez, Gregory Schor-Haskin, Rafael Rey, Catie Falcon, Luis Arce

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This study sought to explore the effect of Sarapin injections on chronic knee pain (CKP). Many adults suffer from CKP which is most often attributed to osteoarthritis. Current treatment regimens for CKP involve the use NSAIDS medications, injections with steroids/analgesic, platelet rich plasma injections, or orthopedic surgical interventions. Sarapin is a commercially available homeopathic aqueous extract from the pitcher plant. Studies on the use of Sarapin as a treatment for cervical, thoracic, and lumbosacral facet joint nerve blocks have been performed with mixed results. There is little available evidence on the use of Sarapin in CKP. This study examines the effect of a series of 3 weekly injections of aqueous Sarapin in 95 elderly patients with CKP in a primary care setting. Cano Health, a primary care group, identified 95 successive patients with CKP from its multimodal physiotherapy program for chronic pain. Patients underwent evaluation by a clinician, underwent diagnostic Xrays of the knees, and the treatment plan with three weekly Sarapin injections was discussed. A pain and functional limitation survey (a modified Lower Extremity Functional Scale (mLEFS)) was administered prior to initiating treatment (Entry Survey (ES)). Each patient received an intraarticular injection of 2 cc of aqueous Sarapin with 1cc 1% lidocaine during weeks 1, 2 and 3. The mLEFS was administered again at week 4, one week after the third Sarapin injection (Exit Survey (ExS)). Demographics: Mean Age 62 +/- 9.8; 73% female; 89% Hispanic/Latino; mean time between ES and ExS was 27.5 +/-8.2 days. Survey: The mLEFS was based on a published Lower Extremity Functional Scale and each patient rated their pain or functional limitation from 0 (no difficulty) to 5 (severe difficulty) for 10 questions. Answers were summed and compared. Maximum score for severe difficulty would be 50 points. Results: Mean pain/functional scores: ES was 30.3 +/-12.1 and ExS was 19.5 +/- 12.5. This represents a relative improvement of 35.7% (P<0.00001). A total of 81% (77/95) of the patients showed improvement in symptoms at week four as assessed by the mLEFS. There were 11 patients who reported an increase in their survey scores while 7 patients reported no change. When evaluating the cohort that reported improvement, the ES was 30.9 +/-11.4 and ExS was 16.3 +/-9.8 yielding a 47.2% relative improvement (P<0.00001). Injections were well tolerated, and no adverse events were reported. Conclusions: In this cohort of 95 elderly patients with CKP, treatment with 3 weekly injections of Sarapin significantly improved pain and function as assessed by a mLEFS survey. The majority (81%) of patients responded positively to therapy, 12% had worsening symptoms and 7% reported no change. The use of intraarticular injections of Sarapin for CKP was shown to be an effective modality of treatment. Sarapin’s low cost, tolerability, and ease of use make it an attractive alternative to NSAIDS, steroids, PRP or surgical intervention for this common debilitating condition.

Keywords: Sarapin, intraarticular, chronic knee pain, osteoarthritis

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Authors: Sadaf Abbas, HimGauri Sabnis

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Introduction: Peripartum cardiomyopathy is a rare but potentially life-threatening condition that presents as heart failure during the last month of pregnancy or within five months postpartum. The incidence of postpartum cardiomyopathy ranges from 1 in 1300 to 1 in 15,000 pregnancies. Risk factors include multiparty, advanced maternal age, multiple pregnancies, pre-eclampsia, and chronic hypertension. Study: A 30-year-old Para3+0 presented to the Emergency Department of St’Marry Hospital, Isle of Wight, on the seventh day postpartum, with acute shortness of breath (SOB), chest pain, cough, and a temperature of 38 degrees. The risk factors were smoking and class II obesity (BMI of 40.62). The patient had mild pre-eclampsia in the last pregnancy and was on labetalol and aspirin during an antenatal period, which was stopped postnatally. There was also a history of pre-eclampsia and haemolysis, elevated liver enzymes, low platelets (HELLP syndrome) in previous pregnancies, which led to preterm delivery at 35 weeks in the second pregnancy, and the first baby was stillborn at 24 weeks. On assessment, there was a national early warning score (NEWS score) of 3, persistent tachycardia, and mild crepitation in the lungs. Initial investigations revealed an enlarged heart on chest X-ray, and a CT pulmonary angiogram indicated bilateral basal pulmonary congestion without pulmonary embolism, suggesting fluid overload. Laboratory results showed elevated CRP and normal troponin levels initially, which later increased, indicating myocardial involvement. Echocardiography revealed a severely dilated left ventricle with an ejection fraction (EF) of 31%, consistent with severely impaired systolic function. The cardiology team reviewed the patient and admitted to the Coronary Care Unit. As sign and symptoms were suggestive of fluid overload and congestive cardiac failure, management was done with diuretics, beta-blockers, angiotensin-converting enzyme inhibitors (ACE inhibitors), proton pump inhibitors, and supportive care. During admission, there was complications such as acute kidney injury, but then recovered well. Chest pain had resolved following the treatment. After being admitted for eight days, there was an improvement in the symptoms, and the patient was discharged home with a further plan of cardiac MRI and genetic testing due to a family history of sudden cardiac death. Regular appointment has been made with the Cardiology team to follow-up on the symptoms. Since discharge, the patient made a good recovery. A cardiac MRI was done, which showed severely impaired left ventricular function, ejection fraction (EF) of 38% with mild left ventricular dilatation, and no evidence of previous infarction. Overall appearance is of non-ischemic dilated cardiomyopathy. The main challenge at the time of admission was the non-availability of a cardiac radiology team, so the definitive diagnosis was delayed. The long-term implications include risk of recurrence, chronic heart failure, and, consequently, an effect on quality of life. Therefore, regular follow-up is critical in patient’s management. Conclusions: Peripartum cardiomyopathy is one of the cardiovascular diseases whose causes are still unknown yet and, in some cases, are uncontrolled. By raising awareness about the symptoms and management of this complication it will reduce morbidity and mortality rates and also the length of stay in the hospital.

Keywords: cardiomyopathy, cardiomegaly, pregnancy, puerperium

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Authors: Desiree David

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South Africa has one of the highest rates of HIV infection in the world, with a sizable percentage of the population living with HIV. A substantial number of new infections occur as a result of sexual activity. South African courts have awarded civil claims for damages as a result of the transmission of HIV as a result of non-disclosure by the HIV-positive sexual partner, and more recently, the criminal courts have also convicted and sentenced individuals accused of infecting others as a result of sexual activity. This paper will analyse some case law from South African court cases that have dealt with criminal convictions for the transmission of HIV, and the potential for more widespread prosecutions of these cases. It will also address the desirability of this trend in light of the social public health system, as well as human rights concerns surrounding this highly contentious issue. This will be done by considering some applicable provisions of the Bill of Rights such as the right to privacy and equality, as espoused in the Constitution of the Republic of South Africa. The paper further addresses the experience of other jurisdictions such as Canada, Singapore, Lesotho and Uganda, by analyzing case law, and consider the pitfalls of criminalizing a wide spectrum of sexual conduct that could result in the transmission of HIV. The paper concludes with a proposal that the issue of criminalizing the transmission of HIV cannot be addressed by the criminal justice system alone, as to do so could result in harsh consequences for those living with HIV. As such individuals may be burdened with additional responsibilities that could potentially impact on the rights of the individual. This may ultimately result in injustice for those living with HIV.

Keywords: criminalization, HIV, human rights, South Africa

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Authors: Supalak Fakkhum, Wannita Pochanakul

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This research is qualitative research that aims to study the application of local wisdom in health care of early childhood at Ban Nam Chieo Community, Laem Ngop, Trat Province. The target is one folk medicine healer and 45 parents who have children or grandchildren aged between 0-5 years. The folk medicine healer was interviewed and observed during early childhood health care practice. Parents were interviewed. The results showed that local wisdom in health care of early childhood are as follows: 1. Local wisdom about early childhood diseases: It is believed that the disease was determined while the child was still in the womb, in the third month of pregnancy. When a child is born, they will have La, La-ong and Saang diseases, which are URI (upper respiratory infection) and DI (diarrhea) diseases. Supernatural aspect is also considered. 2. The treatment is chosen to match the symptoms of the disease. Caring for early childhood includes psychological therapy by rituals and spells. 3. For local wisdom concerning prevention and health promotion, parents normally bring their child to folk medicine healers for “throat paint” as an act of protection and health promotion. Folk healers often prescribe food according to belief and local wisdom.

Keywords: local wisdom, early childhood, folk medicine, healer

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Authors: Noopur Anand, Amit Gupta

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Sewage divers are the workers involved in cleaning and maintaining of the sewerage lines by entering through manholes. The working conditions of sewage divers in India are more challenging than in other countries. Though India has legal acts framed to ensure protection of the divers called 'The Prohibition of Employment of Manual Scavengers and their Rehabilitation Act, 2013' by Ministry of Law and Justice but these are usually not implemented. Further, the divers are not even provided with safety gear like mask, eyewear, helmet, safety suit, safety belt, gloves, and shoes because of lack of initiative among the agencies/individuals employing them and low awareness of importance of the protective gear amongst workers themselves. Several reports and studies show that because of the non-availability of safety gear, many sewage workers get infected and many of them retire even before attaining superannuation and about 70% of the manual scavengers die while on job. Though there are neoprene safety suits, costing only a few thousand, available in the market which can suffice but is beyond the buying capacity of the sewage diver and agencies/individuals employing them are reluctant to procure it as they find it expensive. In absence of safety suits, the divers get exposed to the parasites, viruses, and disease-causing germs present in the sewage. The research was undertaken with the objective of developing an affordable safety-suit which would save diver from coming into direct contact with the sewage thus preventing infections and diseases. The low cost of the suit may also motivate their employers to procure them for sewage divers.

Keywords: manhole cleaner, manual scavenger, prototype, low-cost safety-suit

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Authors: Abdul Rohim Tualeka, Erick Caravan K. Betekeneng, Ramdhoni Zuhro, Reko Triyono, M. Sahri

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It has been widely reported incidence caused by acute and chronic effects of exposure to ammonia in the working environment in Indonesia, but ammonia concentration was found to be below the threshold value. The purpose of this study was to determine the safety limit concentration of ammonia in the working environment through the expression of CD8 as a reference for determining the threshold value of ammonia in the working environment. This research was a laboratory experimental with post test only control group design using experimental animals as subjects experiment. From homogeneity test results indicated that the weight of white rats exposed and control groups had a homogeneous variant with a significant level of p (0.701) > α (0.05). Description of the average breathing rate is 0.0013 m³/h. Average weight rats based group listed exposure is 0.1405 kg. From the calculation IRS CD8, CD8 highest score in the doses contained 0.0154, with the location of the highest dose of ammonia without any effect on the lungs of rats is 0.0154 mg/kg body weight of mice. Safe Human Dose (SHD) ammonia is 0.002 mg/kg body weight workers. The conclusion of this study is the safety limit concentration of ammonia gas in the working environment of 0,025 ppm.

Keywords: ammonia, CD8, rats, safe limits concentration

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Authors: Muhammad Younis Laghari

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Microbial communities play the most important role in aquatic ecosystems. These microbes have a great role in fish growth and aquaculture production. Unfortunately, the farmers are unaware of these useful creatures. Nowadays, the trend of fish farming is developed to re-circulatory aquaculture system (RAS) to increase production and reduce the investment/management cost to increase the profit. However, sometimes, it has been observed that even the growth of fish is decreased in RAS without apparent changes in water quality. There is a great importance of microorganisms in aquaculture, where they occur naturally. However, they can be added artificially by applying different roles. Even these microbes play an important role in the degradation of organic matter and recycling nutrients, along with nutritional support to fish. Even some microorganisms may protect fish and larvae against diseases. But if not managed/utilized properly, they may cause to infect or kill the fish and their larvae. However, manipulating the microbes and monitoring them in aquaculture systems hold great potential to assess and improve the water quality as well as to control the development of microbial infections. While there is an utmost need for research to determine the microbiomes of healthy aquaculture systems, we also need to develop authentic methods for the successful manipulation of microbes as well as engineer these microbiomes. Hence, we should develop a plan to utilize and get full advantage from these microbial interactions for the successful management of aquaculture through advanced research and technology.

Keywords: aquaculture, ecology system, degradation, microbes, nutrient recycling, water quality

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Authors: Yousif Mohamed Y. Abdallah

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This is an experimental study deals with detection, measurement and analysis of the periodic physiological organ motion during external beam radiotherapy; to improve the accuracy of the radiation field placement, and to reduce the exposure of healthy tissue during radiation treatments. The importance of this study is to detect the maximum path of the mobile structures during radiotherapy delivery, to define the planning target volume (PTV) and irradiated volume during both inspiration and expiration period and to verify the target volume. In addition to its role to highlight the importance of the application of Intense Guided Radiotherapy (IGRT) methods in the field of radiotherapy. The results showed (body contour was equally (3.17 + 0.23 mm), for left lung displacement reading (2.56 + 0.99 mm) and right lung is (2.42 + 0.77 mm) which the radiation oncologist to take suitable countermeasures in case of significant errors. In addition, the use of the image registration technique for automatic position control is predicted potential motion. The motion ranged between 2.13 mm and 12.2 mm (low and high). In conclusion, individualized assessment of tumor mobility can improve the accuracy of target areas definition in patients undergo Sterostatic RT for stage I, II and III lung cancer (NSCLC). Definition of the target volume based on a single CT scan with a margin of 10 mm is clearly inappropriate.

Keywords: respiratory motion, external beam radiotherapy, image processing, lung

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Authors: Young-Ji Kim, Jin-Hyeong Park, Hong-Seok Kim, Jung-Whan Chon, Kwang-Yeop Kim, Dong-Hyeon Kim, Il-Byeong Kang, Da-Na Jeong, Jin-Hyeok Yim, Ho-Seok Jang, Kwang-Young Song, Kun-Ho Seo

Abstract:

Stenotrophomonas maltophilia is one of the emerging opportunistic pathogens, and also known to have extensive drug resistance intrinsically including carbepenems which is last resort for most serious infections. One possible way for S. maltophilia to infect human is via wastewater treatment plant (WWTP). In the period between October 2016 and February 2017, effluent samples of WWTP from 3 different pig farms were collected once a month and screened for isolation of S. maltophilia. Total 16 strains of S. maltophilia were isolated and, the antibiotic susceptibility phenotypes were determined by Vitek 2 system for 16 antibiotics, ampicillin (AMP), amoxicillin/clavulanic acid (AMC), piperacillin/tazobactam (TZP), cefazolin (CZ), cefoxitin (FOX), cefotaxime (CTX), ceftazidime (CAZ), cefepime (FEP), aztreonam (AZT), ertapenem (ETP), imipenem (IMP), amikacin (AK), gentamicin (GN), ciprofloxacin (CIP), tigecycline (TGC) and trimethoprim/sulfamethoxazole (SXT). All isolates showed high resistance to AMP (100%), CZ (100%), FOX (100%), CTX (100%), CAZ (100%), FEP (94%), AZT (100%), ETP (100%), IMP (100%), AK (100%), GN (100%) whereas were susceptible to CIP (0%), TGC (0%), SXT (6%). All strains harbored at least one of the antibiotic resistance determinant such as spgM, rmlA, and rpfF. Some isolates had similar MLST (multilocus sequence typing) types with clinical isolates, suggesting WWTP could have potential role in the transmission of S. maltophilia to aquatic environment and, possibly, to humans.

Keywords: Stenotrophomonas maltophilia, Carbapenem resistance, waste water treatment plant, pig farm

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Authors: M. Błoch, P. Karpiński, P. Gasperowicz, R. Płoski, A. Lebioda, P. Skiba, A. Rozensztrauch, D. Patkowski, R. Śmigiel

Abstract:

Introduction: The cause of the isolated form of esophageal atresia has been yet unknown. Objectives: The primary objective of this study was to indicate epigenetic factors which may play an important role in the etiopathogenesis of esophageal atresia. Methods: We recruited a group of 6 pairs of twins, among whom one of the twins developed EA. The selection of such a group for testing allows for excluding external factors (e.g., infections, drugs, toxins) as the cause of the birth defect. The analyzes were performed with the use of genetic material isolated from the whole blood and esophagus tissue of a patient with EA. The reduced representation bisulphite sequencing (RRBS) technique was used to study the change in the genomic imprinting -a change in the expression of genes, which may be the epigenetic cause of EA. Results: In the course of the analyzes, significant hypomethylation and hypermethylation regions were identified. 65 genes with probably increased expression and 65 with decreased expression were selected. These genes have not been marked in literature as possibly pathogenic in esophageal atresia. However, their participation in the pathogenesis of esophageal atresia cannot be clearly excluded. Conclusion: We suggest a role of hypomethylation or hypermethylation of selected genes as one of the possible epigenetic factors in EA pathogenesis. The use of the RRBS technique in the search for the cause of EA is pioneer research; therefore, it seems necessary to extend the research group to new patients with EA. Acknowledgment: The work was supported by the National Science Centre, Poland, under research project 2016/21/N/NZ5/01927.

Keywords: esophageal atresia, epigenetics, embryonic development, surgery, genes expression, twins

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Authors: Novutry Siregar, Afdal, Emilzon Taslim

Abstract:

Hyaline Membrane Disease (HMD) is the main cause of respiratory failure in preterm neonates caused by surfactant deficiency. Nasal Continuous Positive Airway Pressure (NCPAP) is the therapy for HMD. The success of therapy is determined by gestational age, birth weight, HMD grade, time of NCAP administration, and time of breathing frequency recovery. The aim of this research is to identify the predictive factor of NCPAP therapy success in preterm neonates with HMD. This study used a cross-sectional design by using medical records of patients who were treated in the Perinatology of the Pediatric Department of Dr. M. Djamil Padang Central Hospital from January 2015 to December 2017. The samples were eighty-two neonates that were selected by using the total sampling technique. Data analysis was done by using the Chi-Square Test and the Multiple Logistic Regression Prediction Model. The results showed the success rate of NCPAP therapy reached 53.7%. Birth weight (p = 0.048, OR = 3.34 95% CI 1.01-11.07), HMD grade I (p = 0.018, OR = 4.95 CI 95% 1.31-18.68), HMD grade II (p = 0.044, OR = 5.52 95% CI 1.04-29.15), and time of breathing frequency recovery (p = 0,000, OR = 13.50 95% CI 3.58-50, 83) are the predictive factors of NCPAP therapy success in preterm neonates with HMD. The most significant predictive factor is the time of breathing frequency recovery.

Keywords: predictive factors, the success of therapy, NCPAP, preterm neonates, HMD

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Authors: Ece Kök Yetimoğlu, Soner Çubuk, Neşe Taşci, M. Vezir Kahraman

Abstract:

Lead(II) is one of the most toxic environmental pollutants in the world, due to its high toxicity and non-biodegradability. Lead exposure causes severe risks to human health such as central brain damages, convulsions, kidney damages, and even death. To determine lead(II) in environmental or biological samples, scientists use atomic absorption spectrometry (AAS), inductively coupled plasma mass spectrometry (ICPMS), fluorescence spectrometry and electrochemical techniques. Among these systems the fluorescence spectrometry and fluorescent chemical sensors have attracted considerable attention because of their good selectivity and high sensitivity. The fluorescent polymers usually contain covalently bonded fluorophores. In this study imidazole based UV cured polymeric film was prepared and designed to act as a fluorescence chemo sensor for lead (II) analysis. The optimum conditions such as influence of pH value and time on the fluorescence intensity of the sensor have also been investigated. The sensor was highly sensitive with a detection limit as low as 1.87 × 10−8 mol L-1 and it was successful in the determination of Pb(II) in water samples.

Keywords: fluorescence, lead(II), photopolymerization, polymeric sensor

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Authors: I. Mentziou, C. Delezos, D. Krikidis, A. Nestoridou, G. Boskou

Abstract:

Introduction: The systems of production and distribution of meals can have a significant impact on the food intake of hospital patients who are likely to develop malnutrition. In hospitals, the consequences of food borne infections can range from annoying to life-threatening for a patient, since they can lead up to death in vulnerable groups Aim: The aim of the present study was the evaluation of food safety management systems implementation, as well as the general evaluation of the total quality management systems in Greek hospitals. Methods: This is a multifocal study on the implementation and evaluation of the food safety management systems in the Greek hospitals of Attica region. Eleven hospitals from the city of Athens were chosen for this purpose. The sample was derived from the high rank personnel of the nutritional department (dietician, head-chef, food technologist, public health inspector). Tailor made questionnaires on hygiene regulations were used as tools for the interviews. Results: Overall, 30 employees in the field of hospital nutrition participated. Most of the replies implied that almost always the hygiene regulations are implemented. Nevertheless, only 30% stated that there is a Hazard Analysis Critical Control Points HACCP system (HACCP) in the hospital. In a small number of questionnaires there were proposals for changes by the staff. Conclusion: Measurement of the opinion of the personnel about the provided food services within a hospital can further lead to continuous improvement of the hospital nutrition.

Keywords: evaluation, food service, HACCP, hospital, personnel

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Authors: Taekyun Kim, Jongho Park, Jinwoong Choi, Sun-Kyu Park

Abstract:

Recently, the abnormal climate phenomenon has enlarged due to the global warming. As a result, temperature variation is increasing and the term is being prolonged, frequency of high and low temperature is increasing by heat wave and severe cold. Especially for reinforced concrete structure, the corrosion of reinforcement has occurred by concrete crack due to temperature change and the durability of the structure that has decreased by concrete crack. Accordingly, the textile reinforced concrete (TRC) which does not corrode due to using textile is getting the interest and the investigation of TRC is proceeding. The study of TRC structure behavior has proceeded, but the characteristic study of the concrete used in TRC is insufficient. Therefore, characteristic of the concrete by changing mixing ratio is studied in this paper. As a result, mixing ratio with different water-binder ratio has influenced to the strength of concrete. Also, as the water-binder ratio has decreased, strength of concrete has increased.

Keywords: concrete, mixing ratio, textile, TRC

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Authors: Vakhtang Geladze, Nana Bolashvili, Nino Machavariani, Tamazi Karalashvili, Nino Chikhradze, Davit Kartvelishvili

Abstract:

Fresh water deficit is one of the most important global problems today. In the countries with scarce water resources, they often become a reason of armed conflicts. The peaceful settlement of relations connected with management and water consumption issues within and beyond the frontiers of the country is an important guarantee of the region stability. The said problem is urgent in Georgia as well because of its water objects are located at the borders and the transit run-off that is 12% of the total one. Fresh water resources are the major natural resources of Georgia. Despite of this, water supply of population at its Eastern part is an acute issue. Southeastern part of the country has been selected to carry out the research. This region is notable for deficiency of water resources in the country. The region tends to desertification which aggravates fresh water problem even more and presumably may lead to migration of local population from the area. The purpose of study was creation geographical information system (GIS) of water resources. GIS contains almost all layers of different content (water resources, springs, channels, hydrological stations, population water supply, etc.). The results of work provide an opportunity to identify the resource potential of the mentioned region, control and manage it, carry out monitoring and plan regional economy.

Keywords: desertification, GIS, irrigation, water resources

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Authors: Manjiri A. More, Manisha M. Bhosale

Abstract:

Agriculture is the backbone of Indian economy and India is one of the world’s largest producers of Rice. Today, paddy crop is facing a severe problem of insect pests and is attacked by more than 100 species of insects, among those 20 species cause economic damage. Rice is the staple food of people of panhala tehasil, Kolhapur, Maharashtra, India. During June 2017 to September 2017 efforts were made to study the diversity of insect pests associated with the paddy crop in the study region. The collection and preservation of the specimens were done by following standard procedure and the identification was done with the help standard literature, taxonomic keys, and webography. In all, 6 species were recorded as pests of paddy in which order Lepidoptera was dominant with 2 species, while orders Diptera, Orthoptera, Hemiptera, and Coleoptera were represented by 1 species each respectively. The results of the present investigation will be helpful for formulating control strategies against these paddy pests.

Keywords: diversity, insect pests, Panhala, staple

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Authors: Ali Ahmed Ali Al-Juboori, H. Zhu, D. Wexler, H. Li, C. Lu, J. McLeod, S. Pannila, J. Barnes

Abstract:

A number of studies have focused on the formation mechanics of white etching layer and its origin in the railway operation. Until recently, the following hypotheses consider the precise mechanics of WELs formation: (i) WELs are the result of thermal process caused by wheel slip; (ii) WELs are mechanically induced by severe plastic deformation; (iii) WELs are caused by a combination of thermo-mechanical process. The mechanisms discussed above lead to occurrence of white etching layers on the area of wheel and rail contact. This is because the contact patch which is the active point of the wheel on the rail is exposed to highest shear stresses which result in localised severe plastic deformation; and highest rate of heat caused by wheel slipe during excessive traction or braking effort. However, if the WELs are not on the running band area, it would suggest that there is another cause of WELs formation. In railway system, particularly electrified railway, arcing phenomenon has been occurring more often and regularly on the rails. In electrified railway, the current is delivered to the train traction motor via contact wires and then returned to the station via the contact between the wheel and the rail. If the contact between the wheel and the rail is temporarily losing, due to dynamic vibration, entrapped dirt or water, lubricant effect or oxidation occurrences, high current can jump through the gap and results in arcing. The other resources of arcing also include the wheel passage the insulated joint and lightning on a train during bad weather. During the arcing, an extensive heat is generated and speared over a large area of top surface of rail. Thus, arcing is considered another heat source in the rail head (rather than wheel slipe) that results in microstructural changes and white etching layer formation. A head hardened (HH) rail steel, cut from a curved rail truck was used for the investigation. Samples were sectioned from a depth of 10 mm below the rail surface, where the material is considered to be still within the hardened layer but away from any microstructural changes on the top surface layer caused by train passage. These samples were subjected to electrical discharges by using Gas Tungsten Arc Welding (GTAW) machine. The arc current was controlled and moved along the samples surface in the direction of travel, as indicated by an arrow. Five different conditions were applied on the surface of the samples. Samples containing pre-existed WELs, taken from ex-service rail surface, were also considered in this study for comparison. Both simulated and ex-serviced WELs were characterised by advanced methods including SEM, TEM, TKD, EDS, XRD. Samples for TEM and TKFD were prepared by Focused Ion Beam (FIB) milling. The results showed that both simulated WELs by electrical arcing and ex-service WEL comprise similar microstructure. Brown etching layer was found with WELs and likely induced by a concurrent tempering process. This study provided a clear understanding of new formation mechanics of WELs which contributes to track maintenance procedure.

Keywords: white etching layer, arcing, brown etching layer, material characterisation

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