Search results for: clinical deterioration prediction
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 6285

Search results for: clinical deterioration prediction

4515 A Study on the Personality Traits of Students Who Have Chosen Medicine as Their Career

Authors: Khairani Omar, Shalinawati Ramli, Nurul Azmawati Mohamed, Zarini Ismail, Nur Syahrina Rahim, Nurul Hayati Chamhuri

Abstract:

Choosing a career which matches a student’s personality traits is one of the key factors for future work satisfaction. This is because career satisfaction is at the highest when it is in line with one’s personality strength, values and attitudes. Personality traits play a major role in determining the success of a student in the medical course. In the pre-clinical years, medical theories are being emphasized, thus, conscientious students would perform better than those with lower level of this trait. As the emphasis changes in the clinical years during which patient interaction is important, personality traits which involved interpersonal values become more essential for success. The aim of this study was to determine the personality traits of students who had chosen medicine as their career. It was a cross-sectional study conducted at the Islamic Science University of Malaysia. The respondents consisted of 81 students whose age ranged between 20-21 years old. A set of personality assessment inventory index which has been validated for the local context was used to determine the students’ personality traits. The instrument assessed 15 personality traits namely: aggressive, analytical, autonomy, creativity, extrovert, intellectual, motivation, diversity, resiliency, self-criticism, control, helpful, support, structured and achievement. The scores ranged between 1-100%, and they were categorized into low (1-30%), moderate (40-60%) and high scores (70-100%). The respondents were Year 3 pre-clinical medical students and there were more female students (69%) compared to male students (31%). Majority of them were from middle-income families. Approximately 70% of both parents of the respondents had tertiary education. Majority of the students had high scores in autonomy, creativity, diversity, helpful, structured and achievement. In other words, more than 50% of them scored high (70-100%) in these traits. Scoring high in these traits was beneficial for the medical course. For aggressive trait, 54% of them had moderate scores which is compatible for medicine as this indicated an inclination to being assertive. In the analytical and intellectual components, only 40% and 25% had high scores respectively. These results contradicted the usual expectation of medical students whereby they are expected to be highly analytical and intellectual. It would be an added value if the students had high scores in being extrovert as this reflects on good interpersonal values, however, the students had approximately similar scores in all categories of this trait. Being resilient in the medical school is important as the course is difficult and demanding. The students had good scores in this component in which 46% had high scores while 39% had moderate scores. In conclusion, by understanding their personality traits, strengths and weaknesses, the students will have an opportunity to improve themselves in the areas they lack. This will help them to become better doctors in future.

Keywords: career, medical students, medicine, personality traits

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4514 Phenotype Prediction of DNA Sequence Data: A Machine and Statistical Learning Approach

Authors: Mpho Mokoatle, Darlington Mapiye, James Mashiyane, Stephanie Muller, Gciniwe Dlamini

Abstract:

Great advances in high-throughput sequencing technologies have resulted in availability of huge amounts of sequencing data in public and private repositories, enabling a holistic understanding of complex biological phenomena. Sequence data are used for a wide range of applications such as gene annotations, expression studies, personalized treatment and precision medicine. However, this rapid growth in sequence data poses a great challenge which calls for novel data processing and analytic methods, as well as huge computing resources. In this work, a machine and statistical learning approach for DNA sequence classification based on $k$-mer representation of sequence data is proposed. The approach is tested using whole genome sequences of Mycobacterium tuberculosis (MTB) isolates to (i) reduce the size of genomic sequence data, (ii) identify an optimum size of k-mers and utilize it to build classification models, (iii) predict the phenotype from whole genome sequence data of a given bacterial isolate, and (iv) demonstrate computing challenges associated with the analysis of whole genome sequence data in producing interpretable and explainable insights. The classification models were trained on 104 whole genome sequences of MTB isoloates. Cluster analysis showed that k-mers maybe used to discriminate phenotypes and the discrimination becomes more concise as the size of k-mers increase. The best performing classification model had a k-mer size of 10 (longest k-mer) an accuracy, recall, precision, specificity, and Matthews Correlation coeffient of 72.0%, 80.5%, 80.5%, 63.6%, and 0.4 respectively. This study provides a comprehensive approach for resampling whole genome sequencing data, objectively selecting a k-mer size, and performing classification for phenotype prediction. The analysis also highlights the importance of increasing the k-mer size to produce more biological explainable results, which brings to the fore the interplay that exists amongst accuracy, computing resources and explainability of classification results. However, the analysis provides a new way to elucidate genetic information from genomic data, and identify phenotype relationships which are important especially in explaining complex biological mechanisms.

Keywords: AWD-LSTM, bootstrapping, k-mers, next generation sequencing

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4513 Phenotype Prediction of DNA Sequence Data: A Machine and Statistical Learning Approach

Authors: Darlington Mapiye, Mpho Mokoatle, James Mashiyane, Stephanie Muller, Gciniwe Dlamini

Abstract:

Great advances in high-throughput sequencing technologies have resulted in availability of huge amounts of sequencing data in public and private repositories, enabling a holistic understanding of complex biological phenomena. Sequence data are used for a wide range of applications such as gene annotations, expression studies, personalized treatment and precision medicine. However, this rapid growth in sequence data poses a great challenge which calls for novel data processing and analytic methods, as well as huge computing resources. In this work, a machine and statistical learning approach for DNA sequence classification based on k-mer representation of sequence data is proposed. The approach is tested using whole genome sequences of Mycobacterium tuberculosis (MTB) isolates to (i) reduce the size of genomic sequence data, (ii) identify an optimum size of k-mers and utilize it to build classification models, (iii) predict the phenotype from whole genome sequence data of a given bacterial isolate, and (iv) demonstrate computing challenges associated with the analysis of whole genome sequence data in producing interpretable and explainable insights. The classification models were trained on 104 whole genome sequences of MTB isoloates. Cluster analysis showed that k-mers maybe used to discriminate phenotypes and the discrimination becomes more concise as the size of k-mers increase. The best performing classification model had a k-mer size of 10 (longest k-mer) an accuracy, recall, precision, specificity, and Matthews Correlation coeffient of 72.0 %, 80.5 %, 80.5 %, 63.6 %, and 0.4 respectively. This study provides a comprehensive approach for resampling whole genome sequencing data, objectively selecting a k-mer size, and performing classification for phenotype prediction. The analysis also highlights the importance of increasing the k-mer size to produce more biological explainable results, which brings to the fore the interplay that exists amongst accuracy, computing resources and explainability of classification results. However, the analysis provides a new way to elucidate genetic information from genomic data, and identify phenotype relationships which are important especially in explaining complex biological mechanisms

Keywords: AWD-LSTM, bootstrapping, k-mers, next generation sequencing

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4512 Genetic Diversity and Molecular Basis of Carbapenem Resistance in Acinetobacter Baumannii Isolates from Cattle

Authors: Minhas Alam, Muhammad Hidayat Rasool, Mohsin Khurshid, Bilal Aslam

Abstract:

Acinetobacter baumannii is a notorious bacterial pathogen that is an emerging nightmare in clinical settings and is mainly involved in severe nosocomial infections. However, the data related to carbapenem-resistant A. baumannii (CRAB) from veterinary settings is limited, especially in developing countries like Pakistan. To investigate the genetic diversity and molecular basis of carbapenem resistance in Acinetobacter baumannii isolates from Cattle, a total of 1960 samples were collected from cattle from Punjab, Pakistan. The isolates were analyzed by routine microbiological procedures and confirmed by polymerase chain reaction (PCR). The isolates were further screened for antimicrobial susceptibility and the presence of multiple antimicrobial-resistant determinants by PCR. Multilocus sequence typing (MLST) was performed. The results of the current study revealed that the overall prevalence of A. baumannii in cattle was 3.28% (65/1980). Among cattle 27.7% (18/65) were found CRAB strains. The CRAB isolates harbor class D β- lactamases genes, e-g, blaOXA-23 and blaOXA-51, 94.4% (17/18). CRAB isolates carry class B β- lactamases gene blaIMP, and only one isolate carries the blaNDM-1 gene. The MLST results of CRAB isolates from cattle demonstrated 5 STs and one new ST. The commonly found sequence types in CRAB isolates were ST2 (n=10, 55.5%), followed by ST642 (n=5, 27.8%) and ST600 & ST889 (n=1, 5.55%). The presence of CRAB isolates in cattle indicates an alarming situation in Punjab, Pakistan. Immediate control measures should be taken to stop the transmission of CRAB isolates within cattle, to the environment, and to clinical settings.

Keywords: acinetobacter baumannii, carbapenemases, veterinary, drug resistance

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4511 Comparative Evaluation of EBT3 Film Dosimetry Using Flat Bad Scanner, Densitometer and Spectrophotometer Methods and Its Applications in Radiotherapy

Authors: K. Khaerunnisa, D. Ryangga, S. A. Pawiro

Abstract:

Over the past few decades, film dosimetry has become a tool which is used in various radiotherapy modalities, either for clinical quality assurance (QA) or dose verification. The response of the film to irradiation is usually expressed in optical density (OD) or net optical density (netOD). While the film's response to radiation is not linear, then the use of film as a dosimeter must go through a calibration process. This study aimed to compare the function of the calibration curve of various measurement methods with various densitometer, using a flat bad scanner, point densitometer and spectrophotometer. For every response function, a radichromic film calibration curve is generated from each method by performing accuracy, precision and sensitivity analysis. netOD is obtained by measuring changes in the optical density (OD) of the film before irradiation and after irradiation when using a film scanner if it uses ImageJ to extract the pixel value of the film on the red channel of three channels (RGB), calculate the change in OD before and after irradiation when using a point densitometer, and calculate changes in absorbance before and after irradiation when using a spectrophotometer. the results showed that the three calibration methods gave readings with a netOD precision of doses below 3% for the uncertainty value of 1σ (one sigma). while the sensitivity of all three methods has the same trend in responding to film readings against radiation, it has a different magnitude of sensitivity. while the accuracy of the three methods provides readings below 3% for doses above 100 cGy and 200 cGy, but for doses below 100 cGy found above 3% when using point densitometers and spectrophotometers. when all three methods are used for clinical implementation, the results of the study show accuracy and precision below 2% for the use of scanners and spectrophotometers and above 3% for precision and accuracy when using point densitometers.

Keywords: Callibration Methods, Film Dosimetry EBT3, Flat Bad Scanner, Densitomete, Spectrophotometer

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4510 Fear and Anxiety among School Age Children Undergoing Dental Treatment in an Oral Health Unit

Authors: Maha Ibrahim Mohamed Khalifa

Abstract:

Background: Dental fear and anxiety lead to avoidance of dental treatment and deterioration of oral health. Aim of the study: To assess the levels of fear and anxiety among school-age children undergoing dental treatment. Setting: The study was conducted in Outpatient Dental Clinics at Benha Teaching Hospital. Research design: A descriptive research design was utilized to conduct the study. Sample: A purposive sample of 60 school-age children and their mothers attending at the previously mentioned setting was included. Tools: Three tools were used: Tool one: A structured interviewing questionnaire for Personal characteristics of children and their mothers. Tool two: Dental Subscale of Children's Fear Survey Schedule (CFSS-DS). Tool three: Modified Dental Anxiety Scale (MDAS). Results: It was illustrated that more than two-fifths (43.3%) of children had maximum fear and more than half of children (53.3%) had maximal anxiety. Conclusion: Many school-age children undergoing dental treatment suffer from high levels of fear and anxiety. Recommendations: The study recommended further research should be conducted to assess levels of fear and anxiety among children undergoing dental treatments and preferable nursing interventions for reducing their fears and anxieties.

Keywords: fear, anxiety, children, dental treatment

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4509 Prediction of Formation Pressure Using Artificial Intelligence Techniques

Authors: Abdulmalek Ahmed

Abstract:

Formation pressure is the main function that affects drilling operation economically and efficiently. Knowing the pore pressure and the parameters that affect it will help to reduce the cost of drilling process. Many empirical models reported in the literature were used to calculate the formation pressure based on different parameters. Some of these models used only drilling parameters to estimate pore pressure. Other models predicted the formation pressure based on log data. All of these models required different trends such as normal or abnormal to predict the pore pressure. Few researchers applied artificial intelligence (AI) techniques to predict the formation pressure by only one method or a maximum of two methods of AI. The objective of this research is to predict the pore pressure based on both drilling parameters and log data namely; weight on bit, rotary speed, rate of penetration, mud weight, bulk density, porosity and delta sonic time. A real field data is used to predict the formation pressure using five different artificial intelligence (AI) methods such as; artificial neural networks (ANN), radial basis function (RBF), fuzzy logic (FL), support vector machine (SVM) and functional networks (FN). All AI tools were compared with different empirical models. AI methods estimated the formation pressure by a high accuracy (high correlation coefficient and low average absolute percentage error) and outperformed all previous. The advantage of the new technique is its simplicity, which represented from its estimation of pore pressure without the need of different trends as compared to other models which require a two different trend (normal or abnormal pressure). Moreover, by comparing the AI tools with each other, the results indicate that SVM has the advantage of pore pressure prediction by its fast processing speed and high performance (a high correlation coefficient of 0.997 and a low average absolute percentage error of 0.14%). In the end, a new empirical correlation for formation pressure was developed using ANN method that can estimate pore pressure with a high precision (correlation coefficient of 0.998 and average absolute percentage error of 0.17%).

Keywords: Artificial Intelligence (AI), Formation pressure, Artificial Neural Networks (ANN), Fuzzy Logic (FL), Support Vector Machine (SVM), Functional Networks (FN), Radial Basis Function (RBF)

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4508 Ultra-deformable Drug-free Sequessome™ Vesicles (TDT 064) for the Treatment of Joint Pain Following Exercise: A Case Report and Clinical Data

Authors: Joe Collins, Matthias Rother

Abstract:

Background: Oral non-steroidal anti-inflammatory drugs (NSAIDs) are widely used for the relief of joint pain during and post-exercise. However, oral NSAIDs increase the risk of systemic side effects, even in healthy individuals, and retard recovery from muscle soreness. TDT 064 (Flexiseq®), a topical formulation containing ultra-deformable drug-free Sequessome™ vesicles, has demonstrated equivalent efficacy to oral celecoxib in reducing osteoarthritis-associated joint pain and stiffness. TDT 064 does not cause NSAID-related adverse effects. We describe clinical study data and a case report on the effectiveness of TDT 064 in reducing joint pain after exercise. Methods: Participants with a pain score ≥3 (10-point scale) 12–16 hours post-exercise were randomized to receive TDT 064 plus oral placebo, TDT 064 plus oral ketoprofen, or ketoprofen in ultra-deformable phospholipid vesicles plus oral placebo. Results: In the 168 study participants, pain scores were significantly higher with oral ketoprofen plus TDT 064 than with TDT 064 plus placebo in the 7 days post-exercise (P = 0.0240) and recovery from muscle soreness was significantly longer (P = 0.0262). There was a low incidence of adverse events. These data are supported by clinical experience. A 24-year-old male professional rugby player suffered a traumatic lisfranc fracture in March 2014 and underwent operative reconstruction. He had no relevant medical history and was not receiving concomitant medications. He had undergone anterior cruciate ligament reconstruction in 2008. The patient reported restricted training due to pain (score 7/10), stiffness (score 9/10) and poor function, as well as pain when changing direction and running on consecutive days. In July 2014 he started using TDT 064 twice daily at the recommended dose. In November 2014 he noted reduced pain on running (score 2-3/10), decreased morning stiffness (score 4/10) and improved joint mobility and was able to return to competitive rugby without restrictions. No side effects of TDT 064 were reported. Conclusions: TDT 064 shows efficacy against exercise- and injury-induced joint pain, as well as that associated with osteoarthritis. It does not retard muscle soreness recovery after exercise compared with an oral NSAID, making it an alternative approach for the treatment of joint pain during and post-exercise.

Keywords: exercise, joint pain, TDT 064, phospholipid vesicles

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4507 Comparative Study of Gonadotropin Hormones and Sperm Parameters in Two Age Groups

Authors: G. Murtaza, H. Faiza, M. Rafiq, S. Gul, F. Raza, Sarwat Anjum

Abstract:

Our objective was to investigate whether and how extensively there is a correlation between aging in men, gonadotropin hormone regulation, and a decline in sperm parameters and whether it is possible to identify an age limit beyond which the decrease in sperm feature and hormonal regulation reaches statistical significance. A total of one hundred and twenty men (age: 20–50 years) were divided into two groups; each group contained 60 males (Group A with a young age of 20–35 years and Group B with an older age of 36–50 years) who visited the Center for Reproductive Medicine (CRM) in Peshawar General Hospital (PGH) Peshawar, Pakistan. Clinical assessment and sperm analysis were investigated. Hormone testing and semen analysis were carried out in accordance with World Health Organization (WHO) guidelines. Hormone tests, sperm morphology, and the total motile spermatozoa count (TMS) were computed. SPSS 20.0 (SPSS Inc., Chicago, IL, USA) was used for the statistical analysis. It was observed that the testosterone levels in Group A (mean = 3.770) and Group B (mean = 3.995) were comparable, with a significant P-value <0.005 in both age groups. Furthermore, similar levels are shown by follicle-stimulating hormone (FSH) (Group A mean = 19.73, Group B mean = 15.64) and luteinizing hormone (LH) (Group A mean = 12.25, Group B mean = 11.93) in both groups, with a significant P = <0.005. Sperm concentrations were most similar in Group A, with a mean of 4.44, and in Group B, with a mean of 4.42 and a significant P value of 0.005 in both groups. Additionally, it was discovered that sperm motility was higher in Group A, with a mean of 22.40 and a P-value of 0.052, which was non-significant when compared to Group B. Morphological differences were also observed in both age groups. This research found that advancing in male age does not affect sex hormone regulation; in contrast, the fraction of motile and morphologically normal spermatozoa decreases as male age increases, with the strongest evidence being when the age exceeds 40 years. To clarify the causes and clinical implications of these correlations, more research is necessary.

Keywords: gonadotropins, motility, spermatozoa, testosterone

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4506 Histopathological Effects of Trichodiniasis in Farmed Freshwater Rainbow Trout, Oncorhynchus mykiss, in West of Iran

Authors: Zahra Khoshnood, Reza Khoshnood

Abstract:

The aim of present study was to monitor the presence of Trichodina sp. in Rainbow trout, Oncorhynchus mykiss collected from various fish farms in the western provinces of Iran during January, 2013- January, 2014. Out of 675 sampled fish 335, (49.16%) were infested with Trichodina. The highest prevalence was observed in the spring and winter followed by autumn and summer. In general, the intensity of infection was low except in cases where outbreaks of Trichodiniasis endangered the survival of fish in some ponds. In light infestation Trichodina is usually present on gills, fins and skin of apparently healthy fish. Clinical signs of Trichodiniasis only appear on fish with heavy infections and cases of moderate ones that are usually exposed to one or more stress factors including, rough handling during transportation from ponds, overcrowdness, malnutrition, high of free ammonia and low of oxygen concentration. Clinical signs of Trichodiniasis in sampled fish were sluggish movement, loss of appetite, black coloration, necrosis and ulcer on different parts of the body, detached scales and excessive accumulation of mucous in gill pouches. The most obvious histopathological changes in diseased fish were sloughing of the epidermal layer, aggregation of leucocytes and melanine-carrying cells (between the dermis and hypodermis) and proliferative changes including hyperplasia and hypertrophy of the epithelial lining cells of gill filaments which resulted in fusion of secondary lamellae. Control of Trichodiniasis, has been achieved by formalin bath treatment at a concentration of 250 ppm for one hour.

Keywords: gill, histopathology, rainbow trout, Trichodina

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4505 Comparing the Effects of Ondansetron and Acupressure in PC6 Point on Postoperative Nausea and Vomiting in Patients Undergone Elective Cesarean Section: A Randomized Clinical Trial

Authors: Nasrin Galehdar, Sedigheh Nadri, Elham Nazari, Isan Darvishi, Abouzar Mohammadi

Abstract:

Background and aim:Nausea and vomiting are complications of cesarean section. The pharmacological and non-pharmacological approaches were applied to decrease postoperative nausea and vomiting. The aim of the present study was to compare the effects of Ondansetron and acupressure on postoperative nausea and vomiting in patients undergone an elective cesarean section. Materials and method: The study was designed as a randomized clinical trial. A total of 120 patients were allocated to two equal groups. Four mgs of Ondansetron was administered for the Ondansetron group after clamping the umbilical cord. The acupressure bracelets were fastened in the PC6 point for acupressure group for 15 minutes. The patients were monitored in terms of incidence, severity, and episodes of nausea and vomiting. The data obtained were analyzed by SPSS software version 18 with a significance level of 0.05. Results: There was no significant statistical difference in nausea severity among the groups intra-operatively, in the recovery and surgery wards. The incidence and episodes of vomiting were significantly higher in patients undergone acupressure intra-operatively, in the recovery and surgery wards (P< 0.05). No significant effect of acupressure was reported in reducing postoperative nausea and vomiting. Conclusion: No significant effect of acupressure was reported in reducing postoperative nausea and vomiting. Thus, it is suggested to perform the studies with larger size and comparing the effects of acupressure with other antiemetic medications.

Keywords: ondansetron, acupressure, nausea, vomiting

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4504 Experimental and Theoratical Methods to Increase Core Damping for Sandwitch Cantilever Beam

Authors: Iyd Eqqab Maree, Moouyad Ibrahim Abbood

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The purpose behind this study is to predict damping effect for steel cantilever beam by using two methods of passive viscoelastic constrained layer damping. First method is Matlab Program, this method depend on the Ross, Kerwin and Unger (RKU) model for passive viscoelastic damping. Second method is experimental lab (frequency domain method), in this method used the half-power bandwidth method and can be used to determine the system loss factors for damped steel cantilever beam. The RKU method has been applied to a cantilever beam because beam is a major part of a structure and this prediction may further leads to utilize for different kinds of structural application according to design requirements in many industries. In this method of damping a simple cantilever beam is treated by making sandwich structure to make the beam damp, and this is usually done by using viscoelastic material as a core to ensure the damping effect. The use of viscoelastic layers constrained between elastic layers is known to be effective for damping of flexural vibrations of structures over a wide range of frequencies. The energy dissipated in these arrangements is due to shear deformation in the viscoelastic layers, which occurs due to flexural vibration of the structures. The theory of dynamic stability of elastic systems deals with the study of vibrations induced by pulsating loads that are parametric with respect to certain forms of deformation. There is a very good agreement of the experimental results with the theoretical findings. The main ideas of this thesis are to find the transition region for damped steel cantilever beam (4mm and 8mm thickness) from experimental lab and theoretical prediction (Matlab R2011a). Experimentally and theoretically proved that the transition region for two specimens occurs at modal frequency between mode 1 and mode 2, which give the best damping, maximum loss factor and maximum damping ratio, thus this type of viscoelastic material core (3M468) is very appropriate to use in automotive industry and in any mechanical application has modal frequency eventuate between mode 1 and mode 2.

Keywords: 3M-468 material core, loss factor and frequency, domain method, bioinformatics, biomedicine, MATLAB

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4503 Structural Strength Evaluation and Wear Prediction of Double Helix Steel Wire Ropes for Heavy Machinery

Authors: Krunal Thakar

Abstract:

Wire ropes combine high tensile strength and flexibility as compared to other general steel products. They are used in various application areas such as cranes, mining, elevators, bridges, cable cars, etc. The earliest reported use of wire ropes was for mining hoist application in 1830s. Over the period, there have been substantial advancement in the design of wire ropes for various application areas. Under operational conditions, wire ropes are subjected to varying tensile loads and bending loads resulting in material wear and eventual structural failure due to fretting fatigue. The conventional inspection methods to determine wire failure is only limited to outer wires of rope. However, till date, there is no effective mathematical model to examine the inter wire contact forces and wear characteristics. The scope of this paper is to present a computational simulation technique to evaluate inter wire contact forces and wear, which are in many cases responsible for rope failure. Two different type of ropes, IWRC-6xFi(29) and U3xSeS(48) were taken for structural strength evaluation and wear prediction. Both ropes have a double helix twisted wire profile as per JIS standards and are mainly used in cranes. CAD models of both ropes were developed in general purpose design software using in house developed formulation to generate double helix profile. Numerical simulation was done under two different load cases (a) Axial Tension and (b) Bending over Sheave. Different parameters such as stresses, contact forces, wear depth, load-elongation, etc., were investigated and compared between both ropes. Numerical simulation method facilitates the detailed investigation of inter wire contact and wear characteristics. In addition, various selection parameters like sheave diameter, rope diameter, helix angle, swaging, maximum load carrying capacity, etc., can be quickly analyzed.

Keywords: steel wire ropes, numerical simulation, material wear, structural strength, axial tension, bending over sheave

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4502 Modeling and Prediction of Hot Deformation Behavior of IN718

Authors: M. Azarbarmas, J. M. Cabrera, J. Calvo, M. Aghaie-Khafri

Abstract:

The modeling of hot deformation behavior for unseen conditions is important in metal-forming. In this study, the hot deformation of IN718 has been characterized in the temperature range 950-1100 and strain rate range 0.001-0.1 s-1 using hot compression tests. All stress-strain curves showed the occurrence of dynamic recrystallization. These curves were implemented quantitatively in mathematics, and then constitutive equation indicating the relationship between the flow stress and hot deformation parameters was obtained successfully.

Keywords: compression test, constitutive equation, dynamic recrystallization, hot working

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4501 Prediction of Crack Propagation in Bonded Joints Using Fracture Mechanics

Authors: Reza Hedayati, Meysam Jahanbakhshi

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In this work, Fracture Mechanics is used to predict crack propagation in the adhesive jointing aluminum and composite plates. Three types of loadings and two types of glass-epoxy composite sequences: [0/90]2s and [0/45/-45/90]s are considered for the composite plate. Therefore 2*3=6 cases are considered and their results are compared. The debonding initiation load, complete debonding load, crack face profile and load-displacement diagram have been compared for the six cases.

Keywords: fracture, adhesive joint, debonding, APDL, LEFM

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4500 Pill-Box Dispenser as a Strategy for Therapeutic Management: A Qualitative Evaluation

Authors: Bruno R. Mendes, Francisco J. Caldeira, Rita S. Luís

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Population ageing is directly correlated to an increase in medicine consumption. Beyond the latter and the polymedicated profile of elderly, it is possible to see a need for pharmacotherapeutic monitoring due to cognitive and physical impairment. In this sense, the tracking, organization and administration of medicines become a daily challenge and the pill-box dispenser system a solution. The pill-box dispenser (system) consists in a small compartmentalized container to unit dose organization, which means a container able to correlate the patient’s prescribed dose regimen and the time schedule of intake. In many European countries, this system is part of pharmacist’s role in clinical pharmacy. Despite this simple solution, therapy compliance is only possible if the patient adheres to the system, so it is important to establish a qualitative and quantitative analysis on the perception of the patient on the benefits and risks of the pill-box dispenser as well as the identification of the ideal system. The analysis was conducted through an observational study, based on the application of a standardized questionnaire structured with the numerical scale of Likert (5 levels) and previously validated on the population. The study was performed during a limited period of time and under a randomized sample of 188 participants. The questionnaire consisted of 22 questions: 6 background measures and 16 specific measures. The standards for the final comparative analysis were obtained through the state-of-the-art on the subject. The study carried out using the Likert scale afforded a degree of agreement and discordance between measures (Sample vs. Standard) of 56,25% and 43,75%, respectively. It was concluded that the pill-box dispenser has greater acceptance among a younger population, that was not the initial target of the system. However, this allows us to guarantee a high adherence in the future. Additionally, it was noted that the cost associated with this service is not a limiting factor for its use. The pill-box dispenser system, as currently implemented, demonstrates an important weakness regarding the quality and effectiveness of the medicines, which is not understood by the patient, revealing a significant lack of literacy when it concerns with medicine area. The characteristics of an ideal system remain unchanged, which means that the size, appearance and availability of information in the pill-box continue to be indispensable elements for the compliance with the system. The pill-box dispenser remains unsuitable regarding container size and the type of treatment to which it applies. Despite that, it might be a future standard for clinical pharmacy, allowing a differentiation of the pharmacist role, as well as a wider range of applications to other age groups and treatments.

Keywords: clinical pharmacy, medicines, patient safety, pill-box dispenser

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4499 Moroccan Human Ecological Behavior: Grounded Theory Approach

Authors: Dalal Tarfaoui, Salah Zkim

Abstract:

Today, environmental sustainability is everyone’s concern as it contributes in many aspects to a country's development. Morocco is also aware of the increasing threats to its natural resources. Accordingly, many projects and research have been discussed pointing mainly to water security, pollution, desertification, and land degradation, but few studies bothered to dig into the human demeanor to disclose its ecological behavior. Human behavior is accountable for environment deterioration in the first place, but we keep fighting the symptoms instead of limiting the root causes. In the conceptual framework highlighted in the present article, semi-structured interviews have been conducted using a grounded theory approach. Initially this study will serve as a pilot study and a cornerstone to approve a bigger project now in progress. Beyond the existing general ecological measures (GEM), this study has chosen the grounded theory approach to bring out firsthand insights, and probe to which extent an ecological dimension exists in Morocco as a developing country. The discourse of the ecological behavior within the Moroccan context is seen in more realist, social, and community philosophy. The study has revealed an appreciative ecological behavior that is unfortunately repressed by variables beyond people’s control, which would prevent the people’s environmental good intentions to be translated into real ecological actions.

Keywords: ecological behavior, ecological dimension, variables beyond people’s control, Morocco

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4498 Analysis of the Effect of Food Veils on the Preservation of Button and Oyster Mushrooms, Case Study: Zein Corn Coating

Authors: Mohamad Javad Shakouri, Hamid Tavakkolipour, Mahdis Jamshidi Tehranian

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The inclination toward using food coatings is increasing daily, due to containing natural elements and not producing environmental pollution. Food coatings are uniform and thin layers of natural substances that cover the food product and act as a barrier against moisture, oxygen, and substances dissolved in food. Using food coatings on fruits and vegetables can delay water dissipation, losing aroma, decolorization, and improve the appearance of the product, and in general, preserve and protect the quality of fresh produce. When fruits and vegetables grow, they are equipped with a natural shield, called cuticle– a layer of wax. Washing the products, after harvest, the cuticle – this protective coating – is removed. In order to replace the cuticle, we can use an edible protective coating. This coating delays dehydration and deterioration and hence increases the life of the product while keeping its moisture. In this study, it was concluded that using food coatings, such as corn zein, carrageenan, and starch can have a substantial effect on the quantitative and qualitative preservation of food products, such as fruits, vegetables, and mushrooms.

Keywords: food coating, corn zein, button and oyster mushrooms, ascorbic and citric acids

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4497 Clove Essential Oil Improves Lipid Peroxidation and Antioxidant Activity in Tilapia Fish Fillet Cooked by Grilling and Microwaving

Authors: E. Oskoueian, E. Maroufyan, Y. M. Goh, E. Ramezani-Fard, M. Ebrahimi

Abstract:

The fish meat plays an important role in the human health as it contains high quality protein. The tilapia fish considered as the third largest group of farmed fish. The oxidative deterioration of fish meat may occur during the cooking process. The proper cooking process and using natural antioxidant to prevent oxidation and enhance the quality of the tilapia fish fillet is necessary. Hence, this research was carried out to evaluate the potential of clove essential oil to prevent lipid peroxidation and enhance the antioxidant activity of tilapia fish fillet cooked using microwave and griller. The results showed that cooking using microwave significantly (p < 0.05) increased the lipid peroxidation and decreased the DPPH and ferric reducing activity power of the fish fillet as compared to grilling. The fortification of fish fillet using clove essential oil prevented from lipid peroxidation and enhanced the antioxidant activity of the fish fillet significantly (p < 0.05). Consequently, fortification of tilapia fish fillet using clove essential oil followed by cooking using griller to have high quality cooked fish meat is recommended.

Keywords: antioxidant activity, fillet, fish, fortification, lipid peroxidation

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4496 PEINS: A Generic Compression Scheme Using Probabilistic Encoding and Irrational Number Storage

Authors: P. Jayashree, S. Rajkumar

Abstract:

With social networks and smart devices generating a multitude of data, effective data management is the need of the hour for networks and cloud applications. Some applications need effective storage while some other applications need effective communication over networks and data reduction comes as a handy solution to meet out both requirements. Most of the data compression techniques are based on data statistics and may result in either lossy or lossless data reductions. Though lossy reductions produce better compression ratios compared to lossless methods, many applications require data accuracy and miniature details to be preserved. A variety of data compression algorithms does exist in the literature for different forms of data like text, image, and multimedia data. In the proposed work, a generic progressive compression algorithm, based on probabilistic encoding, called PEINS is projected as an enhancement over irrational number stored coding technique to cater to storage issues of increasing data volumes as a cost effective solution, which also offers data security as a secondary outcome to some extent. The proposed work reveals cost effectiveness in terms of better compression ratio with no deterioration in compression time.

Keywords: compression ratio, generic compression, irrational number storage, probabilistic encoding

Procedia PDF Downloads 294
4495 Use of Simulation in Medical Education: Role and Challenges

Authors: Raneem Osama Salem, Ayesha Nuzhat, Fatimah Nasser Al Shehri, Nasser Al Hamdan

Abstract:

Background: Recently, most medical schools around the globe are using simulation for teaching and assessing students’ clinical skills and competence. There are many obstacles that could face students and faculty when simulation sessions are introduced into undergraduate curriculum. Objective: The aim of this study is to obtain the opinion of undergraduate medical students and our faculty regarding the role of simulation in undergraduate curriculum, the simulation modalities used, and perceived barriers in implementing stimulation sessions. Methods: To address the role of simulation, modalities used, and perceived challenges to implementation of simulation sessions, a self-administered pilot tested questionnaire with 18 items using a 5 point Likert scale was distributed. Participants included undergraduate male medical students (n=125) and female students (n=70) as well as the faculty members (n=14). Result: Various learning outcomes are achieved and improved through the technology enhanced simulation sessions such as communication skills, diagnostic skills, procedural skills, self-confidence, and integration of basic and clinical sciences. The use of high fidelity simulators, simulated patients and task trainers was more desirable by our students and faculty for teaching and learning as well as an evaluation tool. According to most of the students,' institutional support in terms of resources, staff and duration of sessions was adequate. However, motivation to participate in the sessions and provision of adequate feedback by the staff was a constraint. Conclusion: The use of simulation laboratory is of great benefit to the students and a great teaching tool for the staff to ensure students learning of the various skills.

Keywords: simulators, medical students, skills, simulated patients, performance, challenges, skill laboratory

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4494 Surgical Skills in Mulanje

Authors: Nick Toossi, Joseph Hartland

Abstract:

Background: Malawi is an example of a low resource setting which faces a chronic shortage of doctors and other medical staff. This shortfall is made up for by clinical officers (COs), who are para-medicals trained for 4 years. The literature suggests to improve outcomes surgical skills training specifically should be promoted for COs in district and mission hospitals. Accordingly, the primary author was tasked with developing a basic surgical skills teaching package for COs of Mulanje Mission Hospital (MMH), Malawi, as part of a 4th year medical student External Student Selected Component field trip. MMH is a hospital based in the South of Malawi near the base of Mulanje Mountain and works in an extremely isolated environment with some of the poorest communities in the country. Traveling to Malawi the medical student author performed an educational needs assessment to develop and deliver a bespoke basic surgical skills teaching package. Methodology: An initial needs assessment identified the following domains: basic surgical skills (instrument naming & handling, knot tying, suturing principles and suturing techniques) and perineal repair. Five COs took part in a teaching package involving an interactive group simulation session, overseen by senior clinical officers and surgical trainees from the UK. Non-organic and animal models were used for simulation practice. This included the use of surgical skills boards to practice knot tying and ox tongue to simulate perineal repair. All participants spoke and read English. The impact of the session was analysed in two different ways. The first was via a pre and post Single Best Answer test and the second a questionnaire including likert’s scales and free text response questions. Results: There was a positive trend in pre and post test scores on competition of the course. There was increase in the mean confidence of learners before and after the delivery of teaching in basic surgical skills and simulated perineal repair, especially in ‘instrument naming and handling’. Whilst positively received it was discovered that learners desire more frequent surgical skills teaching sessions in order to improve and revise skills. Feedback suggests that the learners were not confident in retaining the skills without regular input. Discussion: Skills and confidence were improved as a result of the teaching provided. Learner's written feedback suggested there was an overall appetite for regular surgical skills teaching in the clinical environment and further opportunities to allow for deliberate self-practice. Surgical mentorship schemes facilitating supervised theatre time among trainees and lead surgeons along with improving access to surgical models/textbooks were some of the simple suggestions to improve surgical skills and confidence among COs. Although, this study is limited by population size it is reflective of the small, isolated and low resource environment in which this healthcare is delivered. This project does suggest that current surgical skills packages used in the UK could be adapted for employment in low resource settings, but it is consistency and sustainability that staff seek above all in their on-going education.

Keywords: clinical officers, education, Malawi, surgical skills

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4493 Tuberculous Osteomyelitis Mimicking Tumours and Tumour-Like Lesions of Bone: Clinico-Radiologic Study of 22 Patients

Authors: Parveen Kundu, Zile Singh, Kunika Kundu, Swaran Kaur

Abstract:

Context: Tuberculous osteomyelitis is a relatively uncommon condition that can present with various clinical and radiological features, often mimicking bone tumors or tumor-like lesions. In endemic countries like India, tuberculosis should be considered as a potential differential diagnosis for lytic bone lesions. This study aimed to highlight the different presentations of tuberculosis that can mimic tumors or tumor-like lesions in bone and emphasize the successful outcome of antitubercular therapy (ATT) in treating these cases. Research Aim: The main objective of this research was to explore the varied presentations of tuberculosis that mimic bone tumors or tumor-like lesions both clinically and radiologically, focusing on different bones. The study aimed to raise awareness among clinicians about this possibility and highlight the importance of histopathological confirmation before initiating treatment for lytic bone lesions. Methodology: This study utilized a retrospective review of 22 patients with suspected lytic bone lesions, who were subsequently diagnosed with tuberculous osteomyelitis through histopathological examination. The cases were collected over a period of ten years. Eleven cases required curettage for extensive lesions with sequestrations, while all 22 patients received 12 months of antitubercular therapy. Findings: The study included 14 male and 8 female patients, ranging in age from 3 to 61 years, with an average age of 22.05. The clinical and radiological presentations varied, with examples including bone cysts in the metaphyseal area of long bones, lesions resembling chondroblastomas, giant cell tumors, and osteoid osteoma, as well as multifocal lytic lesions resembling metastasis or multiple myeloma. One patient had lesions in both the clavicle and hand. Lesions mimicking chondromas were also observed in the phalanges of the hand and foot metatarsal. All patients showed resolution of the lesions and no residual disability following ATT. Theoretical Importance: This study highlights the importance of considering tuberculosis as a potential differential diagnosis for lytic bone lesions, particularly in endemic regions. It emphasizes the need for histopathological confirmation to accurately diagnose tuberculous osteomyelitis, as this is considered the gold standard. Data Collection and Analysis Procedures: Data for this study were collected retrospectively from medical records and radiological images of the 22 patients. The cases were analyzed based on clinical presentation, radiological findings, and histopathological confirmation. The outcomes of antitubercular therapy were also assessed. The data were summarized and presented descriptively. Question Addressed: This study aimed to address the question of how tuberculosis can mimic different bone tumors and tumor-like lesions clinically and radiologically. It also aimed to assess the successful outcome of antitubercular therapy in treating these cases. Conclusion: Tuberculous osteomyelitis can present with varied clinical and radiological features, often mimicking bone tumors or tumor-like lesions. Clinicians should consider tuberculosis as a potential diagnosis for lytic bone lesions, especially in endemic areas. Histopathological confirmation is essential for accurate diagnosis. Antitubercular therapy is an effective treatment for tuberculous osteomyelitis, leading to the resolution of the lesions with no residual disability.

Keywords: tuberculosis, tumor, curettage, bone

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4492 Evaluation of Antibiotic Resistance and Extended-Spectrum β-Lactamases Production Rates of Gram Negative Rods in a University Research and Practice Hospital, 2012-2015

Authors: Recep Kesli, Cengiz Demir, Onur Turkyilmaz, Hayriye Tokay

Abstract:

Objective: Gram-negative rods are a large group of bacteria, and include many families, genera, and species. Most clinical isolates belong to the family Enterobacteriaceae. Resistance due to the production of extended-spectrum β-lactamases (ESBLs) is a difficulty in the handling of Enterobacteriaceae infections, but other mechanisms of resistance are also emerging, leading to multidrug resistance and threatening to create panresistant species. We aimed in this study to evaluate resistance rates of Gram-negative rods bacteria isolated from clinical specimens in Microbiology Laboratory, Afyon Kocatepe University, ANS Research and Practice Hospital, between October 2012 and September 2015. Methods: The Gram-negative rods strains were identified by conventional methods and VITEK 2 automated identification system (bio-Mérieux, Marcy l’etoile, France). Antibiotic resistance tests were performed by both the Kirby-Bauer disk-diffusion and automated Antimicrobial Susceptibility Testing (AST, bio-Mérieux, Marcy l’etoile, France) methods. Disk diffusion results were evaluated according to the standards of Clinical and Laboratory Standards Institute (CLSI). Results: Of the totally isolated 1.701 Enterobacteriaceae strains 1434 (84,3%) were Klebsiella pneumoniae, 171 (10%) were Enterobacter spp., 96 (5.6%) were Proteus spp., and 639 Nonfermenting gram negatives, 477 (74.6%) were identified as Pseudomonas aeruginosa, 135 (21.1%) were Acinetobacter baumannii and 27 (4.3%) were Stenotrophomonas maltophilia. The ESBL positivity rate of the totally studied Enterobacteriaceae group were 30.4%. Antibiotic resistance rates for Klebsiella pneumoniae were as follows: amikacin 30.4%, gentamicin 40.1%, ampicillin-sulbactam 64.5%, cefepime 56.7%, cefoxitin 35.3%, ceftazidime 66.8%, ciprofloxacin 65.2%, ertapenem 22.8%, imipenem 20.5%, meropenem 20.5 %, and trimethoprim-sulfamethoxazole 50.1%, and for 114 Enterobacter spp were detected as; amikacin 26.3%, gentamicin 31.5%, cefepime 26.3%, ceftazidime 61.4%, ciprofloxacin 8.7%, ertapenem 8.7%, imipenem 12.2%, meropenem 12.2%, and trimethoprim-sulfamethoxazole 19.2 %. Resistance rates for Proteus spp. were: 24,3% meropenem, 26.2% imipenem, 20.2% amikacin 10.5% cefepim, 33.3% ciprofloxacin and levofloxacine, 31.6% ceftazidime, 20% ceftriaxone, 15.2% gentamicin, 26.6% amoxicillin-clavulanate, and 26.2% trimethoprim-sulfamethoxale. Resistance rates of P. aeruginosa was found as follows: Amikacin 32%, gentamicin 42 %, imipenem 43%, merpenem 43%, ciprofloxacin 50%, levofloxacin 52%, cefepim 38%, ceftazidim 63%, piperacillin/tacobactam 85%, for Acinetobacter baumannii; Amikacin 53.3%, gentamicin 56.6 %, imipenem 83%, merpenem 86%, ciprofloxacin 100%, ceftazidim 100%, piperacillin/tacobactam 85 %, colisitn 0 %, and for S. malthophilia; levofloxacin 66.6 % and trimethoprim/sulfamethoxozole 0 %. Conclusions: This study showed that resistance in Gram-negative rods was a serious clinical problem in our hospital and suggested the need to perform typification of the isolated bacteria with susceptibility testing regularly in the routine laboratory procedures. This application guided to empirical antibiotic treatment choices truly, as a consequence of the reality that each hospital shows different resistance profiles.

Keywords: antibiotic resistance, gram negative rods, ESBL, VITEK 2

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4491 Predicting Automotive Interior Noise Including Wind Noise by Statistical Energy Analysis

Authors: Yoshio Kurosawa

Abstract:

The applications of soundproof materials for reduction of high frequency automobile interior noise have been researched. This paper presents a sound pressure prediction technique including wind noise by Hybrid Statistical Energy Analysis (HSEA) in order to reduce weight of acoustic insulations. HSEA uses both analytical SEA and experimental SEA. As a result of chassis dynamo test and road test, the validity of SEA modeling was shown, and utility of the method was confirmed.

Keywords: vibration, noise, road noise, statistical energy analysis

Procedia PDF Downloads 351
4490 Cognitive Footprints: Analytical and Predictive Paradigm for Digital Learning

Authors: Marina Vicario, Amadeo Argüelles, Pilar Gómez, Carlos Hernández

Abstract:

In this paper, the Computer Research Network of the National Polytechnic Institute of Mexico proposes a paradigmatic model for the inference of cognitive patterns in digital learning systems. This model leads to metadata architecture useful for analysis and prediction in online learning systems; especially on MOOc's architectures. The model is in the design phase and expects to be tested through an institutional of courses project which is going to develop for the MOOc.

Keywords: cognitive footprints, learning analytics, predictive learning, digital learning, educational computing, educational informatics

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4489 Filtration Efficacy of Reusable Full-Face Snorkel Masks for Personal Protective Equipment

Authors: Adrian Kong, William Chang, Rolando Valdes, Alec Rodriguez, Roberto Miki

Abstract:

The Pneumask consists of a custom snorkel-specific adapter that attaches a snorkel-port of the mask to a 3D-printed filter. This full-face snorkel mask was designed for use as personal protective equipment (PPE) during the COVID-19 pandemic when there was a widespread shortage of PPE for medical personnel. Various clinical validation tests have been conducted, including the sealing capability of the mask, filter performance, CO2 buildup, and clinical usability. However, data regarding the filter efficiencies of Pneumask and multiple filter types have not been determined. Using an experimental system, we evaluated the filtration efficiency across various masks and filters during inhalation. Eighteen combinations of respirator models (5 P100 FFRs, 4 Dolfino Masks) and filters (2091, 7093, 7093CN, BB50T) were evaluated for their exposure to airborne particles sized 0.3 - 10.0 microns using an electronic airborne particle counter. All respirator model combinations provided similar performance levels for 1.0-micron, 3.0-micron, 5.0-micron, 10.0-microns, with the greatest differences in the 0.3-micron and 0.5-micron range. All models provided expected performances against all particle sizes, with Class P100 respirators providing the highest performance levels across all particle size ranges. In conclusion, the modified snorkel mask has the potential to protect providers who care for patients with COVID-19 from increased airborne particle exposure.

Keywords: COVID-19, PPE, mask, filtration, efficiency

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4488 Investigations of Flame Retardant Properties of Beneficiated Huntite and Hydromagnesite Mineral Reinforced Polymer Composites

Authors: H. Yilmaz Atay

Abstract:

Huntite and hydromagnesite minerals have been used as additive materials to achieve incombustible material due to their inflammability property. Those fire retardants materials can help to extinguish in the early stages of fire. Thus dispersion of the flame can be prevented even if the fire started. Huntite and hydromagnesite minerals are known to impart fire-proofing of the polymer composites. However, the additives used in the applications led to deterioration in the mechanical properties due to the usage of high amount of the powders in the composites. In this study, by enriching huntite and hydromagnesite, it was aimed to use purer minerals to reinforce the polymer composites. Thus, predictably, using purer mineral will lead to use lower amount of mineral powders. By this manner, the minerals free from impurities by various processes were added to the polymer matrix with different loading level and grades. Different types of samples were manufactured, and subsequently characterized by XRD, SEM-EDS, XRF and flame-retardant tests. Tensile strength and elongation at break values were determined according to loading levels and grades. Besides, a comparison on the properties of the polymer composites produced by using of minerals with and without impurities was performed. As a result of the work, it was concluded that it is required to use beneficiated minerals to provide better fire-proofing behaviors in the polymer composites.

Keywords: flame retardant, huntite and hydromagnesite, mechanical property, polymer composites

Procedia PDF Downloads 241
4487 Predicting the Lack of GDP Growth: A Logit Model for 40 Advanced and Developing Countries

Authors: Hamidou Diallo, Marianne Guille

Abstract:

This paper identifies leading triggers of deficient episodes in terms of GDP growth based on a sample of countries at different stages of development over 1994-2017. Using logit models, we build early warning systems (EWS), and our results show important differences between developing countries (DCs) and advanced economies (AEs). For AEs, the main predictors of the probability of entering in a GDP growth deficient episode are the deterioration of external imbalances and the vulnerability of fiscal position while DCs face different challenges that need to be considered. The key indicators for them are first, the low ability to pay their debts, and second, their belonging or not to a common currency area. We also build homogeneous pools of countries inside AEs and DCs. The evolution of the proportion of AE countries in the riskiest pool is marked first, by three distinct peaks just after the high-tech bubble burst, the global financial crisis, and the European sovereign debt crisis, and second by a very low minimum level in 2006 and 2007. In contrast, the situation of DCs is characterized first by the relative stability of this proportion and then by an upward trend from 2006, that can be explained by a more unfavorable socio-political environment leading to shortcomings in the fiscal consolidation.

Keywords: currency area, early warning system, external imbalances, fiscal vulnerability, GDP growth, public debt

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4486 The Contribution of Genetic Polymorphisms of Tumor Necrosis Factor Alpha and Vascular Endothelial Growth Factor into the Unfavorable Clinical Course of Ulcerative Colitis

Authors: Y. I. Tretyakova, S. G. Shulkina, T. Y. Kravtsova, A. A. Antipova, N. Y. Kolomeets

Abstract:

The research aimed to assess the functional significance of tumor necrosis factor-alpha (TNF-α) gene polymorphism at the -308G/A (rs1800629) region and vascular endothelial growth factor A (VEGFA) gene polymorphism at the -634G/C (rs 2010963) region in the development of ulcerative colitis (UC), focusing on patients from the Perm region, Russia. We examined 70 UC patients and 50 healthy donors during the active phase of the disease. Our focus was on TNF-α and VEGF concentration in the blood serum, as well as TNF-α and VEGFA gene polymorphisms at the -308G/А and -634G/C regions, respectively. We found that TNF-α and VEGF levels were significantly higher in patients with severe UC and high endoscopic activity compared to those with milder forms of the disease and low endoscopic activity. These tests could serve as additional non-invasive markers for assessing mucosal damage in the large intestine of UC patients. The frequency of allele variations in the TNF-α gene -308G/A (rs1800629) revealed a significantly higher occurrence of the unfavorable homozygote AA in UC patients compared to donors. Additionally, the major allele G and the allele pair GG were more frequent in patients with mild to moderate disease and 1-2 degree of endoscopic activity than in those with severe UC and 3-4 degree of endoscopic activity (χ2=14.19; p=0.000). We also observed a mutant allele A and the unfavorable homozygote AA associated with severe progressive UC. The occurrence of the mutant allele increased the risk of severe UC by 5 times (OR 5.03; CI 12.07-12.21). We did not find any significant differences in the frequency of the CC homozygote (χ2=1.02; p=0.6; OR=1.32) and the mutant allele C of the VEGFA gene -634G/C (rs 2010963) (χ2=0.01; p=0.913; OR=0.97) between groups of UC patients and healthy individuals. However, we detected that the mutant allele C and the unfavorable homozygote CC of the VEGFA gene were associated with more severe endoscopic changes in the colonic mucosa of UC patients (χ2=25,76; р=0,000; OR=0,15). The presence of the mutant allele increased the risk of severe UC by 6 times (OR 6,78; CI 3,13–14,7). We found a direct correlation between TNF-α and VEGFA gene polymorphisms, increased production of the same factors, disease severity, and endoscopic activity (р=0.000). Therefore, the presence of the mutant allele A and homozygote AA of the TNF-α gene at the -308G/A region and the mutant allele C and homozygote CC of the VEGFA gene at the -634G/C region are associated with risks related to an unfavorable clinical course of UC, frequent recurrences, and rapid progression. These findings should be considered when making prognoses regarding the clinical course of the disease and selecting treatment strategies. The presence of the homozygote AA in the TNF-α gene (rs1800629) is considered a sign of genetic predisposition to UC.

Keywords: gene polymorphism, TNF-α, ulcerative colitis, VEGF

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