Search results for: antimicrobial sensitivity
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2666

Search results for: antimicrobial sensitivity

776 Stochastic Optimization of a Vendor-Managed Inventory Problem in a Two-Echelon Supply Chain

Authors: Bita Payami-Shabestari, Dariush Eslami

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The purpose of this paper is to develop a multi-product economic production quantity model under vendor management inventory policy and restrictions including limited warehouse space, budget, and number of orders, average shortage time and maximum permissible shortage. Since the “costs” cannot be predicted with certainty, it is assumed that data behave under uncertain environment. The problem is first formulated into the framework of a bi-objective of multi-product economic production quantity model. Then, the problem is solved with three multi-objective decision-making (MODM) methods. Then following this, three methods had been compared on information on the optimal value of the two objective functions and the central processing unit (CPU) time with the statistical analysis method and the multi-attribute decision-making (MADM). The results are compared with statistical analysis method and the MADM. The results of the study demonstrate that augmented-constraint in terms of optimal value of the two objective functions and the CPU time perform better than global criteria, and goal programming. Sensitivity analysis is done to illustrate the effect of parameter variations on the optimal solution. The contribution of this research is the use of random costs data in developing a multi-product economic production quantity model under vendor management inventory policy with several constraints.

Keywords: economic production quantity, random cost, supply chain management, vendor-managed inventory

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775 Characterization of the State of Pollution by Nitrates in the Groundwater in Arid Zones Case of Eloued District (South-East of Algeria)

Authors: Zair Nadje, Attoui Badra, Miloudi Abdelmonem

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This study aims to assess sensitivity to nitrate pollution and monitor the temporal evolution of nitrate contents in groundwater using statistical models and map their spatial distribution. The nitrate levels observed in the waters of the town of El-Oued differ from one aquifer to another. Indeed, the waters of the Quaternary aquifer are the richest in nitrates, with average annual contents varying from 6 mg/l to 85 mg/l, for an average of 37 mg/l. These levels are higher than the WHO standard (50 mg/l) for drinking water. At the water level of the Terminal Complex (CT) aquifer, the annual average nitrate levels vary from 14 mg/l to 37 mg/l, with an average of 18 mg/l. In the Terminal Complex, excessive nitrate levels are observed in the central localities of the study area. The spatial distribution of nitrates in the waters of the Quaternary aquifer shows that the majority of the catchment points of this aquifer are subject to nitrate pollution. This study shows that in the waters of the Terminal Complex aquifer, nitrate pollution evolves in two major areas. The first focus is South-North, following the direction of underground flow. The second is West-East, progressing towards the East zone. The temporal distribution of nitrate contents in the water of the Terminal Complex aquifer in the city of El-Oued showed that for decades, nitrate contents have suffered a decline after an increase. This evolution of nitrate levels is linked to demographic growth and the rapid urbanization of the city of El-Oued.

Keywords: anthropogenic activities, groundwater, nitrates, pollution, arid zones city of El-Oued, Algeria

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774 An Criterion to Minimize FE Mesh-Dependency in Concrete Plate Subjected to Impact Loading

Authors: Kwak, Hyo-Gyung, Gang, Han Gul

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In the context of an increasing need for reliability and safety in concrete structures under blast and impact loading condition, the behavior of concrete under high strain rate condition has been an important issue. Since concrete subjected to impact loading associated with high strain rate shows quite different material behavior from that in the static state, several material models are proposed and used to describe the high strain rate behavior under blast and impact loading. In the process of modelling, in advance, mesh dependency in the used finite element (FE) is the key problem because simulation results under high strain-rate condition are quite sensitive to applied FE mesh size. It means that the accuracy of simulation results may deeply be dependent on FE mesh size in simulations. This paper introduces an improved criterion which can minimize the mesh-dependency of simulation results on the basis of the fracture energy concept, and HJC (Holmquist Johnson Cook), CSC (Continuous Surface Cap) and K&C (Karagozian & Case) models are examined to trace their relative sensitivity to the used FE mesh size. To coincide with the purpose of the penetration test with a concrete plate under a projectile (bullet), the residual velocities of projectile after penetration are compared. The correlation studies between analytical results and the parametric studies associated with them show that the variation of residual velocity with the used FE mesh size is quite reduced by applying a unique failure strain value determined according to the proposed criterion.

Keywords: high strain rate concrete, penetration simulation, failure strain, mesh-dependency, fracture energy

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773 Electrochemical Study of Ti-O Modified Electrode towards Tyrosinase Catalytic Activity

Authors: Riya Thomas, Denis Music, Tautgirdas Ruzgas

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The detection of tyrosinase holds considerable interest in the domains of food nutrition and human health due to its significant role in causing a detrimental effect on the colour, flavour, and nutritional value of food as well as in the synthesis of melanin causing skin melanoma. Compared to other conventional analytical techniques, electrochemical (EC) sensors are highly promising owing to their quick response, great sensitivity, ease of use, and low cost. Particularly, titania nanoparticle-based electrochemical sensors have drawn special attention in identifying several biomolecules including enzymes, antibodies, and receptors, owing to their enhanced electrocatalytic activity and electron-accepting properties. In this study, Ti-O film-modified electrode is fabricated using reactive magnetron sputtering, and its affinity towards tyrosinase is examined via electrochemical methods. To comprehend the physiochemical and surface properties-governed electrocatalytic activity of modified electrodes, Ti-O films are grown under various compositional ranges and deposition temperature, and their corresponding electrochemical activity towards tyrosinase is studied. Further, to understand the underlying atomistic mechanisms and electronic-scale electrochemical characteristics, density functional theory (DFT) is employed. The main goal of the current work is to determine the correlation between macroscopic measurements and the underlying atomic properties to improve the tyrosinase activity on Ti-O surfaces. Moreover, this work offers an intriguing new perspective on the use of Ti-O-modified electrodes to detect tyrosinase in the areas of clinical diagnosis, skincare, and food science.

Keywords: density functional theory, electrochemical sensor, Ti-O film, tyrosinase

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772 Optimizing Groundwater Pumping for a Complex Groundwater/Surface Water System

Authors: Emery A. Coppola Jr., Suna Cinar, Ferenc Szidarovszky

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Over-pumping of groundwater resources is a serious problem world-wide. In addition to depleting this valuable resource, hydraulically connected sensitive ecological resources like wetlands and surface water bodies are often impacted and even destroyed by over-pumping. Effectively managing groundwater in a way that satisfy human demand while preserving natural resources is a daunting challenge that will only worsen with growing human populations and climate change. As presented in this paper, a numerical flow model developed for a hypothetical but realistic groundwater/surface water system was combined with formal optimization. Response coefficients were used in an optimization management model to maximize groundwater pumping in a complex, multi-layered aquifer system while protecting against groundwater over-draft, streamflow depletion, and wetland impacts. Pumping optimization was performed for different constraint sets that reflect different resource protection preferences, yielding significantly different optimal pumping solutions. A sensitivity analysis on the optimal solutions was performed on select response coefficients to identify differences between wet and dry periods. Stochastic optimization was also performed, where uncertainty associated with changing irrigation demand due to changing weather conditions are accounted for. One of the strengths of this optimization approach is that it can efficiently and accurately identify superior management strategies that minimize risk and adverse environmental impacts associated with groundwater pumping under different hydrologic conditions.

Keywords: numerical groundwater flow modeling, water management optimization, groundwater overdraft, streamflow depletion

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771 Formulation of Value Added Beff Meatballs with the Addition of Pomegranate (Punica granatum) Extract as a Source of Natural Antioxident

Authors: M. A. Hashem, I. Jahan

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The experiment was conducted to find out the effect of different levels of Pomegranate (Punica granatum) extract and synthetic antioxidant BHA (Beta Hydroxyl Anisole) on fresh and preserved beef meatballs in order to make functional food. For this purpose, ground beef samples were divided into five treatment groups. They were treated as control group, 0.1% synthetic antioxidant group, 0.1%, 0.2% and 0.3% pomegranate extract group as T1, T2, T3, T4 and T5 respectively. Proximate analysis, sensory tests (color, flavor, tenderness, juiciness, overall acceptability), cooking loss, pH value, free fatty acids (FFA), thiobarbituric acid values (TBARS), peroxide value (POV) and microbiological examination were determined in order to evaluate the effect of pomegranate extract as natural antioxidant and antimicrobial activities compared to BHA (Beta Hydroxyl Anisole) at first day before freezing and for maintaining meatballs qualities on the shelf life of beef meat balls stored for 60 days under frozen condition. Freezing temperature was -20˚C. Days of intervals of experiment were on 0, 15th, 30th and 60th days. Dry matter content of all the treatment groups differ significantly (p<0.05). On the contrary, DM content increased significantly (p<0.05) with the advancement of different days of intervals. CP content of all the treatments were increased significantly (p<0.05) among the different treatment groups. EE and Ash content were decreased significantly (p<0.05) at different treatment levels. FFA values, TBARS, POV were decreased significantly (p<0.05) at different treatment levels. Color, odor, tenderness, juiciness, overall acceptability decreased significantly (p<0.05) at different days of intervals. Raw PH, cooked pH were increased at different treatment levels significantly (p<0.05). The cooking loss (%) at different treatment levels were differ significantly (p<0.05). TVC (logCFU/g), TCC (logCFU/g) and TYMC (logCFU/g) was decreased significantly (p<0.05) at different treatment levels and at different days of intervals comparison to control. Considering CP, tenderness, juiciness, overall acceptability, cooking loss, FFA, POV, TBARS value and microbial analysis it can be concluded that pomegranate extract at 0.1%, 0.2% and 0.3% can be used instead of synthetic antioxidant BHA in beef meatballs. On the basis of sensory evaluation, nutrient quality, physicochemical properties, biochemical analysis and microbial analysis 0.3% Pomegranate extract can be recommended for formulation of value added beef meatball enriched with natural antioxidant.

Keywords: antioxidant, pomegranate, BHA, value added meat products

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770 High Aspect Ratio Micropillar Array Based Microfluidic Viscometer

Authors: Ahmet Erten, Adil Mustafa, Ayşenur Eser, Özlem Yalçın

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We present a new viscometer based on a microfluidic chip with elastic high aspect ratio micropillar arrays. The displacement of pillar tips in flow direction can be used to analyze viscosity of liquid. In our work, Computational Fluid Dynamics (CFD) is used to analyze pillar displacement of various micropillar array configurations in flow direction at different viscosities. Following CFD optimization, micro-CNC based rapid prototyping is used to fabricate molds for microfluidic chips. Microfluidic chips are fabricated out of polydimethylsiloxane (PDMS) using soft lithography methods with molds machined out of aluminum. Tip displacements of micropillar array (300 µm in diameter and 1400 µm in height) in flow direction are recorded using a microscope mounted camera, and the displacements are analyzed using image processing with an algorithm written in MATLAB. Experiments are performed with water-glycerol solutions mixed at 4 different ratios to attain 1 cP, 5 cP, 10 cP and 15 cP viscosities at room temperature. The prepared solutions are injected into the microfluidic chips using a syringe pump at flow rates from 10-100 mL / hr and the displacement versus flow rate is plotted for different viscosities. A displacement of around 1.5 µm was observed for 15 cP solution at 60 mL / hr while only a 1 µm displacement was observed for 10 cP solution. The presented viscometer design optimization is still in progress for better sensitivity and accuracy. Our microfluidic viscometer platform has potential for tailor made microfluidic chips to enable real time observation and control of viscosity changes in biological or chemical reactions.

Keywords: Computational Fluid Dynamics (CFD), high aspect ratio, micropillar array, viscometer

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769 The Impact of Large-Scale Wind Energy Development on Islands’ Interconnection to the Mainland System

Authors: Marina Kapsali, John S. Anagnostopoulos

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Greek islands’ interconnection (IC) with larger power systems, such as the mainland grid, is a crucial issue that has attracted a lot of interest; however, the recent economic recession that the country undergoes together with the highly capital intensive nature of this kind of projects have stalled or sifted the development of many of those on a more long-term basis. On the other hand, most of Greek islands are still heavily dependent on the lengthy and costly supply chain of oil imports whilst the majority of them exhibit excellent potential for wind energy (WE) applications. In this respect, the main purpose of the present work is to investigate −through a parametric study which varies both in wind farm (WF) and submarine IC capacities− the impact of large-scale WE development on the IC of the third in size island of Greece (Lesbos) with the mainland system. The energy and economic performance of the system is simulated over a 25-year evaluation period assuming two possible scenarios, i.e. S(a): without the contribution of the local Thermal Power Plant (TPP) and S(b): the TPP is maintained to ensure electrification of the island. The economic feasibility of the two options is investigated in terms of determining their Levelized Cost of Energy (LCOE) including also a sensitivity analysis on the worst/reference/best Cases. According to the results, Lesbos island IC presents considerable economic interest for covering part of island’s future electrification needs with WE having a vital role in this challenging venture.

Keywords: electricity generation cost, levelized cost of energy, mainland grid, wind energy rejection

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768 Programmed Cell Death in Datura and Defensive Plant Response toward Tomato Mosaic Virus

Authors: Asma Alhuqail, Nagwa Aref

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Programmed cell death resembles a real nature active defense in Datura metel against TMV after three days of virus infection. Physiological plant response was assessed for asymptomatic healthy and symptomatic infected detached leaves. The results indicated H2O2 and Chlorophyll-a as the most potential parameters. Chlorophyll-a was considered the only significant predictor variant for the H2O2 dependent variant with a P value of 0.001 and R-square of 0.900. The plant immune response was measured within three days of virus infection using the cutoff value of H2O2 (61.095 lmol/100 mg) and (63.201 units) for the tail moment in the Comet Assay. Their percentage changes were 255.12% and 522.40% respectively which reflects the stress of virus infection in the plant. Moreover, H2O2 showed 100% specificity and sensitivity in the symptomatic infected group using the receiver-operating characteristic (ROC). All tested parameters in the symptomatic infected group had significant correlations with twenty-five positive and thirty-one negative correlations where the P value was <0.05 and 0.01. Chlorophyll-a parameter had a crucial role of highly significant correlation between total protein and salicylic acid. Contrarily, this correlation with tail moment unit was (r = _0.930, P <0.01) where the P value was < 0.01. The strongest significant negative correlation was between Chlorophyll-a and H2O2 at P < 0.01, while moderate negative significant correlation was seen for Chlorophyll-b where the P value < 0.05. The present study discloses the secret of the three days of rapid transient production of activated oxygen species (AOS) that was enough for having potential quantitative physiological parameters for defensive plant response toward the virus.

Keywords: programmed cell death, plant–adaptive immune response, hydrogen peroxide (H2O2), physiological parameters

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767 A Comprehensive Characterization of Cell-free RNA in Spent Blastocyst Medium and Quality Prediction for Blastocyst

Authors: Huajuan Shi

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Background: The biopsy of the preimplantation embryo may increase the potential risk and concern of embryo viability. Clinically discarded spent embryo medium (SEM) has entered the view of researchers, sparking an interest in noninvasive embryo screening. However, one of the major restrictions is the extremelty low quantity of cf-RNA, which is difficult to efficiently and unbiased amplify cf-RNA using traditional methods. Hence, there is urgently need to an efficient and low bias amplification method which can comprehensively and accurately obtain cf-RNA information to truly reveal the state of SEM cf-RNA. Result: In this present study, we established an agarose PCR amplification system, and has significantly improved the amplification sensitivity and efficiency by ~90 fold and 9.29 %, respectively. We applied agarose to sequencing library preparation (named AG-seq) to quantify and characterize cf-RNA in SEM. The number of detected cf-RNAs (3533 vs 598) and coverage of 3' end were significantly increased, and the noise of low abundance gene detection was reduced. The increasing percentage 5' end adenine and alternative splicing (AS) events of short fragments (< 400 bp) were discovered by AG-seq. Further, the profiles and characterizations of cf-RNA in spent cleavage medium (SCM) and spent blastocyst medium (SBM) indicated that 4‐mer end motifs of cf-RNA fragments could remarkably differentiate different embryo development stages. Significance: This study established an efficient and low-cost SEM amplification and library preparation method. Not only that, we successfully described the characterizations of SEM cf-RNA of preimplantation embryo by using AG-seq, including abundance features fragment lengths. AG-seq facilitates the study of cf-RNA as a noninvasive embryo screening biomarker and opens up potential clinical utilities of trace samples.

Keywords: cell-free RNA, agarose, spent embryo medium, RNA sequencing, non-invasive detection

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766 Development of Generally Applicable Intravenous to Oral Antibiotic Switch Therapy Criteria

Authors: H. Akhloufi, M. Hulscher, J. M. Prins, I. H. Van Der Sijs, D. Melles, A. Verbon

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Background: A timely switch from intravenous to oral antibiotic therapy has many advantages, such as reduced incidence of IV-line related infections, a decreased hospital length of stay and less workload for healthcare professionals with equivalent patient safety. Additionally, numerous studies have demonstrated significant decreases in costs of a timely intravenous to oral antibiotic therapy switch, while maintaining efficacy and safety. However, a considerable variation in iv to oral antibiotic switch therapy criteria has been described in literature. Here, we report the development of a set of iv to oral switch criteria that are generally applicable in all hospitals. Material/methods: A RAND-modified Delphi procedure, which was composed of 3 rounds, was used. This Delphi procedure is a widely used structured process to develop consensus using multiple rounds of questionnaires within a qualified panel of selected experts. The international expert panel was multidisciplinary and composed out of clinical microbiologists, infectious disease consultants and clinical pharmacists. This panel of 19 experts appraised 6 major intravenous to oral antibiotic switch therapy criteria and operationalized these criteria using 41 measurable conditions extracted from the literature. The procedure to select a concise set of iv to oral switch criteria included 2 questionnaire rounds and a face-to-face meeting. Results: The procedure resulted in the selection of 16 measurable conditions, which operationalize 6 major intravenous to oral antibiotic switch therapy criteria. The following 6 major switch therapy criteria were selected: (1) Vital signs should be good or improving when bad. (2) Signs and symptoms related to the infection have to be resolved or improved. (3) The gastrointestinal tract has to be intact and functioning. (4) The oral route should not be compromised. (5) Absence of contra-indicated infections. (6) An oral variant of the antibiotic with good bioavailability has to exist. Conclusions: This systematic stepwise method which combined evidence and expert opinion resulted in a feasible set of 6 major intravenous to oral antibiotic switch therapy criteria operationalized by 16 measurable conditions. This set of early antibiotic iv to oral switch criteria can be used in daily practice in all adult hospital patients. Future use in audits and as rules in computer assisted decision support systems will lead to improvement of antimicrobial steward ship programs.

Keywords: antibiotic resistance, antibiotic stewardship, intravenous to oral, switch therapy

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765 Intramuscular Heat Shock Protein 72 and Heme Oxygenase-1 mRNA are Reduced in Patients with Type 2 Diabetes Evidence That Insulin Resistance is Associated with a Disturbed Antioxidant Defense Mechanism

Authors: Ghibeche Abderrahmane

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To examine whether genes associated with cellular defense against oxidative stress are associated with insulin sensitivity, patients with type 2 diabetes (n=7) and age-matched (n=5) and young (n=9) control subjects underwent a euglycemic-hyperinsulinemic clamp for 120 min. Muscle samples were obtained before and after the clamp and analyzed for heat shock protein (HSP)72 and heme oxygenase (HO)-1 mRNA, intramuscular triglyceride content, and the maximal activities of β-hyroxyacyl-CoA dehydrogenase (β-HAD) and citrate synthase (CS). Basal expression of both HSP72 and HO-1 mRNA were lower (P < 0.05) by 33 and 55%, respectively, when comparing diabetic patients with age-matched and young control subjects, with no differences between the latter groups. Both basal HSP72 (r = 0.75, P < 0.001) and HO-1 (r = 0.50,P < 0.05) mRNA expression correlated with the glucose infusion rate during the clamp. Significant correlations were also observed between HSP72 mRNA and both β-HAD (r = 0.61, P < 0.01) and CS (r = 0.65, P < 0.01). HSP72 mRNA was induced (P < 0.05) by the clamp in all groups. Although HO-1 mRNA was unaffected by the clamp in both the young and age-matched control subjects, it was increased (P < 0.05) ∼70-fold in the diabetic patients after the clamp. These data demonstrate that genes involved in providing cellular protection against oxidative stress are defective in patients with type 2 diabetes and correlate with insulin-stimulated glucose disposal and markers of muscle oxidative capacity. The data provide new evidence that the pathogenesis of type 2 diabetes involves perturbations to the antioxidant defense mechanism within skeletal muscle.

Keywords: euglycemic-hyperinsulinemic, HSP72, mRNA, diabete

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764 Effect of Climate Change on Groundwater Recharge in a Sub-Humid Sub-Tropical Region of Eastern India

Authors: Suraj Jena, Rabindra Kumar Panda

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The study region of the reported study was in Eastern India, having a sub-humid sub-tropical climate and sandy loam soil. The rainfall in this region has wide temporal and spatial variation. Due to lack of adequate surface water to meet the irrigation and household demands, groundwater is being over exploited in that region leading to continuous depletion of groundwater level. Therefore, there is an obvious urgency in reversing the depleting groundwater level through induced recharge, which becomes more critical under the climate change scenarios. The major goal of the reported study was to investigate the effects of climate change on groundwater recharge and subsequent adaptation strategies. Groundwater recharge was modelled using HELP3, a quasi-two-dimensional, deterministic, water-routing model along with global climate models (GCMs) and three global warming scenarios, to examine the changes in groundwater recharge rates for a 2030 climate under a variety of soil and vegetation covers. The relationship between the changing mean annual recharge and mean annual rainfall was evaluated for every combination of soil and vegetation using sensitivity analysis. The relationship was found to be statistically significant (p<0.05) with a coefficient of determination of 0.81. Vegetation dynamics and water-use affected by the increase in potential evapotranspiration for large climate variability scenario led to significant decrease in recharge from 49–658 mm to 18–179 mm respectively. Therefore, appropriate conjunctive use, irrigation schedule and enhanced recharge practices under the climate variability and land use/land cover change scenarios impacting the groundwater recharge needs to be understood properly for groundwater sustainability.

Keywords: Groundwater recharge, climate variability, Land use/cover, GCM

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763 The Value of Serum Procalcitonin in Patients with Acute Musculoskeletal Infections

Authors: Mustafa Al-Yaseen, Haider Mohammed Mahdi, Haider Ali Al–Zahid, Nazar S. Haddad

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Background: Early diagnosis of musculoskeletal infections is of vital importance to avoid devastating complications. There is no single laboratory marker which is sensitive and specific in diagnosing these infections accurately. White blood cell count, erythrocyte sedimentation rate, and C-reactive protein are not specific as they can also be elevated in conditions other than bacterial infections. Materials Culture and sensitivity is not a true gold standard due to its varied positivity rates. Serum Procalcitonin is one of the new laboratory markers for pyogenic infections. The objective of this study is to assess the value of PCT in the diagnosis of soft tissue, bone, and joint infections. Patients and Methods: Patients of all age groups (seventy-four patients) with a diagnosis of musculoskeletal infection are prospectively included in this study. All patients were subjected to White blood cell count, erythrocyte sedimentation rate, C-reactive protein, and serum Procalcitonin measurements. A healthy non infected outpatient group (twenty-two patients) taken as a control group and underwent the same evaluation steps as the study group. Results: The study group showed mean Procalcitonin levels of 1.3 ng/ml. Procalcitonin, at 0.5 ng/ml, was (42.6%) sensitive and (95.5%) specific in diagnosing of musculoskeletal infections with (positive predictive value of 87.5% and negative predictive value of 48.3%) and (positive likelihood ratio of 9.3 and negative likelihood ratio of 0.6). Conclusion: Serum Procalcitonin, at a cut – off of 0.5 ng/ml, is a specific but not sensitive marker in the diagnosis of musculoskeletal infections, and it can be used effectively to rule in the diagnosis of infection but not to rule out it.

Keywords: procalcitonin, infection, labratory markers, musculoskeletal

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762 Microstructure and Hardness Changes on T91 Weld Joint after Heating at 560°C

Authors: Suraya Mohamad Nadzir, Badrol Ahmad, Norlia Berahim

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T91 steel has been used as construction material for superheater tubes in sub-critical and super critical boiler. This steel was developed with higher creep strength property as compared to conventional low alloy steel. However, this steel is also susceptible to materials degradation due to its sensitivity to heat treatment especially Post Weld Heat Treatment (PWHT) after weld repair process. Review of PWHT process shows that the holding temperature may different from one batch to other batch of samples depending on the material composition. This issue was reviewed by many researchers and one of the potential solutions is the development of weld repair process without PWHT. This process is possible with the use of temper bead welding technique. However, study has shown the hardness value across the weld joint with exception of PWHT is much higher compare to recommended hardness value. Based on the above findings, a study to evaluate the microstructure and hardness changes of T91 weld joint after heating at 560°C at varying duration was carried out. This study was carried out to evaluate the possibility of self-tempering process during in-service period. In this study, the T91 weld joint was heat-up in air furnace at 560°C for duration of 50 and 150 hours. The heating process was controlled with heating rate of 200°C/hours, and cooling rate about 100°C/hours. Following this process, samples were prepared for the microstructure examination and hardness evaluation. Results have shown full tempered martensite structure and acceptance hardness value was achieved after 50 hours heating. This result shows that the thin component such as T91 superheater tubes is able to self-tempering during service hour.

Keywords: T91, weld-joint, tempered martensite, self-tempering

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761 Impact of Obesity on Outcomes in Breast Reconstruction: A Systematic Review and Meta-Analysis

Authors: Adriana C. Panayi, Riaz A. Agha, Brady A. Sieber, Dennis P. Orgill

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Background: Increased rates of both breast cancer and obesity have resulted in more women seeking breast reconstruction. These women may be at increased risk for perioperative complications. A systematic review was conducted to assess the outcomes in obese women who have undergone breast reconstruction following mastectomy. Methods: Cochrane, PUBMED and EMBASE electronic databases were screened and data was extracted from included studies. The clinical outcomes assessed were surgical complications, medical complications, length of postoperative hospital stay, reoperation rate and patient satisfaction. Results: 33 studies met the inclusion criteria for the review and 29 provided enough data to be included in the meta-analysis (71368 patients, 20061 of which were obese). Obese women were 2.3 times more likely to experience surgical complications (95 percent CI 2.19 to 2.39; P < 0.00001), 2.8 times more likely to have medical complications (95 percent CI 2.41 to 3.26; P < 0.00001) and had a 1.9 times higher risk of reoperation (95 percent CI 1.75 to 2.07; P < 0.00001). The most common complication, wound dehiscence, was 2.5 times more likely in obese women (95 percent CI 1.80 to 3.52; P < 0.00001). Sensitivity analysis confirmed that obese women were more likely to experience surgical complications (RR 2.36, 95% CI 2.22–2.52; P < 0.00001). Conclusions: This study provides evidence that obesity increases the risk of complications in both implant and autologous reconstruction. Additional prospective and observational studies are needed to determine if weight reduction prior to reconstruction reduces the perioperative risks associated with obesity.

Keywords: autologous reconstruction, breast cancer, breast reconstruction, literature review, obesity, oncology, prosthetic reconstruction

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760 Characterization of Erodibility Using Soil Strength and Stress-Strain Indices for Soils in Some Selected Sites in Enugu State

Authors: C. C. Egwuonwu, N. A. A. Okereke, K. O. Chilakpu, S. O. Ohanyere

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In this study, initial soil strength indices (qu) and stress-strain characteristics, namely failure strain (ϵf), area under the stress-strain curve up to failure (Is) and stress-strain modulus between no load and failure (Es) were investigated as potential indicators for characterizing the erosion resistance of two compacted soils, namely sandy clay loam (SCL) and clay loam (CL) in some selected sites in Enugu State, Nigeria. The unconfined compressive strength (used in obtaining strength indices) and stress-strain measurements were obtained as a function of moisture content in percentage (mc %) and dry density (γd). Test were conducted over a range of 8% to 30% moisture content and 1.0 g/cm3 to 2.0 g/cm3 dry density at applied loads of 20, 40, 80, 160 and 320 kPa. Based on the results, it was found out that initial soil strength alone was not a good indicator of erosion resistance. For instance, in the comparison of exponents of mc% and γd for jet index or erosion resistance index (Ji) and the strength measurements, qu and Es agree in signs for mc%, but are opposite in signs for γd. Therefore, there is an inconsistency in exponents making it difficult to develop a relationship between the strength parameters and Ji for this data set. In contrast, the exponents of mc% and γd for Ji and ϵf and Is are opposite in signs, there is potential for an inverse relationship. The measured stress-strain characteristics, however, appeared to have potential in providing useful information on erosion resistance. The models developed for the prediction of the extent or the susceptibility of soils to erosion and subjected to sensitivity test on some selected sites achieved over 90% efficiency in their functions.

Keywords: characterization of erodibility, selected sites in Enugu state, soil strength, stress-strain indices

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759 Effects of Virtual Reality on Relieving Postoperative Pain in Surgical Patients: A Systematic Review and Meta-Analysis

Authors: Lingyu Ding, Hongxia Hua, Hanfei Zhu, Jinling Lu, Qin Xu

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Background: Postoperative pain is a prevalent problem leading to many adverse outcomes in surgical patients. Virtual reality (VR) is an emerging non-pharmacological method of postoperative pain relief, but the effects of it are not clear. This review aimed to explore the effects of VR on relieving postoperative pain. Methods: We searched PubMed, Embase, Web of Science, and other databases from inception to November 2019 to get the eligible studies. Meta-analyses were conducted to compare VR and usual care for relieving postoperative pain. Subgroup analyses and sensitivity analyses were performed to explain the heterogeneity. Results: Overall, 8 randomized control trials (RCTs) enrolling 723 participants were included. Our results demonstrated that the patients receiving the VR intervention had lower postoperative pain scores than those receiving the usual care. One subgroup analysis revealed that VR could relieve postoperative pain both in minor surgery and major surgery. Another subgroup analysis demonstrated a significant reduction in postoperative pain among patients receiving VR during the intraoperative and the postoperative periods. However, there was no significant postoperative pain relief when receiving VR during the preoperative period. Additionally, significant improvements in postoperative satisfaction were reported in two studies. However, another two studies included found that VR could not affect physiological parameters related to pain. Conclusion: Applying VR can relieve postoperative pain effectively. The type of surgery and timing of using VR are the main sources of heterogeneity. More rigorous studies about the relationship between VR and postoperative pain relief will be needed.

Keywords: meta-analysis, postoperative pain, systematic review, virtual reality

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758 A 7 Dimensional-Quantitative Structure-Activity Relationship Approach Combining Quantum Mechanics Based Grid and Solvation Models to Predict Hotspots and Kinetic Properties of Mutated Enzymes: An Enzyme Engineering Perspective

Authors: R. Pravin Kumar, L. Roopa

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Enzymes are molecular machines used in various industries such as pharmaceuticals, cosmetics, food and animal feed, paper and leather processing, biofuel, and etc. Nevertheless, this has been possible only by the breath-taking efforts of the chemists and biologists to evolve/engineer these mysterious biomolecules to work the needful. Main agenda of this enzyme engineering project is to derive screening and selection tools to obtain focused libraries of enzyme variants with desired qualities. The methodologies for this research include the well-established directed evolution, rational redesign and relatively less established yet much faster and accurate insilico methods. This concept was initiated as a Receptor Rependent-4Dimensional Quantitative Structure Activity Relationship (RD-4D-QSAR) to predict kinetic properties of enzymes and extended here to study transaminase by a 7D QSAR approach. Induced-fit scenarios were explored using Quantum Mechanics/Molecular Mechanics (QM/MM) simulations which were then placed in a grid that stores interactions energies derived from QM parameters (QMgrid). In this study, the mutated enzymes were immersed completely inside the QMgrid and this was combined with solvation models to predict descriptors. After statistical screening of descriptors, QSAR models showed > 90% specificity and > 85% sensitivity towards the experimental activity. Mapping descriptors on the enzyme structure revealed hotspots important to enhance the enantioselectivity of the enzyme.

Keywords: QMgrid, QM/MM simulations, RD-4D-QSAR, transaminase

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757 Label Free Detection of Small Molecules Using Surface-Enhanced Raman Spectroscopy with Gold Nanoparticles Synthesized with Various Capping Agents

Authors: Zahra Khan

Abstract:

Surface-Enhanced Raman Spectroscopy (SERS) has received increased attention in recent years, focusing on biological and medical applications due to its great sensitivity as well as molecular specificity. In the context of biological samples, there are generally two methodologies for SERS based applications: label-free detection and the use of SERS tags. The necessity of tagging can make the process slower and limits the use for real life. Label-free detection offers the advantage that it reports direct spectroscopic evidence associated with the target molecule rather than the label. Reproducible, highly monodisperse gold nanoparticles (Au NPs) were synthesized using a relatively facile seed-mediated growth method. Different capping agents (TRIS, citrate, and CTAB) were used during synthesis, and characterization was performed. They were then mixed with different analyte solutions before drop-casting onto a glass slide prior to Raman measurements to see which NPs displayed the highest SERS activity as well as their stability. A host of different analytes were tested, both non-biomolecules and biomolecules, which were all successfully detected using this method at concentrations as low as 10-3M with salicylic acid reaching a detection limit in the nanomolar range. SERS was also performed on samples with a mixture of analytes present, whereby peaks from both target molecules were distinctly observed. This is a fast and effective rapid way of testing samples and offers potential applications in the biomedical field as a tool for diagnostic and treatment purposes.

Keywords: gold nanoparticles, label free, seed-mediated growth, SERS

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756 Performance of the Aptima® HIV-1 Quant Dx Assay on the Panther System

Authors: Siobhan O’Shea, Sangeetha Vijaysri Nair, Hee Cheol Kim, Charles Thomas Nugent, Cheuk Yan William Tong, Sam Douthwaite, Andrew Worlock

Abstract:

The Aptima® HIV-1 Quant Dx Assay is a fully automated assay on the Panther system. It is based on Transcription-Mediated Amplification and real time detection technologies. This assay is intended for monitoring HIV-1 viral load in plasma specimens and for the detection of HIV-1 in plasma and serum specimens. Nine-hundred and seventy nine specimens selected at random from routine testing at St Thomas’ Hospital, London were anonymised and used to compare the performance of the Aptima HIV-1 Quant Dx assay and Roche COBAS® AmpliPrep/COBAS® TaqMan® HIV-1 Test, v2.0. Two-hundred and thirty four specimens gave quantitative HIV-1 viral load results in both assays. The quantitative results reported by the Aptima Assay were comparable those reported by the Roche COBAS AmpliPrep/COBAS TaqMan HIV-1 Test, v2.0 with a linear regression slope of 1.04 and an intercept on -0.097. The Aptima assay detected HIV-1 in more samples than the Roche assay. This was not due to lack of specificity of the Aptima assay because this assay gave 99.83% specificity on testing plasma specimens from 600 HIV-1 negative individuals. To understand the reason for this higher detection rate a side-by-side comparison of low level panels made from the HIV-1 3rd international standard (NIBSC10/152) and clinical samples of various subtypes were tested in both assays. The Aptima assay was more sensitive than the Roche assay. The good sensitivity, specificity and agreement with other commercial assays make the HIV-1 Quant Dx Assay appropriate for both viral load monitoring and detection of HIV-1 infections.

Keywords: HIV viral load, Aptima, Roche, Panther system

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755 Quality of Life Assessment across the Cancer Continuum: Understanding the Role of an Exercise Rehabilitation Programme

Authors: Bernat-Carles Serdà Ferrer, Arantza Del Valle Gómez

Abstract:

The Quality of Life (QoL) paradigm is multidimensional, dynamic and modular and its definition differs across the cancer continuum. The challenge in the interpretation of QoL data in clinical research is that QoL is influenced by psychological phenomena such as adaptation to illness. This research aims to obtain a valid and sensitive assessment of QoL change over the continuum disease, and to evaluate a rehabilitation programme aimed at inverting the observed decrease in QoL when patients return to daily living activities. The sample comprised 66 men. Patients were first assessed to establish a baseline (P1-diagnosis). This was followed by a post-test (P2-discharge) and a then-test measurement (P3-retrospective evaluation) and after returning home patients were randomized in experimental and control groups. The experimental group attended a rehabilitation programme over 24 weeks (P4). Results show that from baseline to post-test, QoL decreased significantly. The recalibration then-test confirmed a low QoL in all periods evaluated. Significant differences between the experimental and control groups prove the positive effect of the Exercise Rehabilitation Programme (ERP) on QoL. Understanding the real dynamic of QoL over time would help to adapt rehabilitation programmes by improving sensitivity and efficacy and provide professionals with a more accurate perception of the impact of treatment and side effects on patients’ QoL. Our results underline the importance of changing the approach adopted by health professionals towards one of watchful waiting on patients’ QoL until their complete recovery in daily life.

Keywords: exercise, prostate cancer, quality of life, rehabilitation programme, response shift

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754 Traditional Farming Practices and Climate Change Adaptation among the Dumagats of Tanay, Rizal and Their Implications to the Delivery of Extension and Advisory Services

Authors: Janika Vien K. Valsorable, Filma C. Calalo

Abstract:

Climate change is one of the most damaging and serious environmental threats worldwide being faced today. While almost everyone highly depends and puts their trust on what technology, innovations, and initiatives from hard-core science can do to cope with the changing climate, there are still people who find hope on indigenous knowledge systems. The study aimed to analyze the traditional farming practices of the Dumagats in Tanay, Rizal and how these relate to their adaptation and mitigation of climate change. The analysis is based on interviews with 17 members of the Dumagat tribe specifically residing in Barangay Cuyambay, San Andres, and Mamuyao, and supported by Key Informant Interview and Focus Group Discussion as well as document reviews. Results of the study showed that the Dumagats adopt indigenous knowledge systems and their high sensitivity and resilience to climate change aid them in their farming system and activities. These traditional farming practices are exemplified from land preparation to planting, fertilizer application, weed and pest management, harvesting and post-harvest activities. Owing to their dependence upon, and close relationship with the environment and its resources, the Dumagats have learned to interpret and react to the impacts of climate change in creative ways, drawing on their traditional knowledge to cope with the impending changes. With the increasing trend at all levels of government to service the needs of rural communities, there is the need for the extension to contextualize advisory service delivery for indigenous communities.

Keywords: climate change, Dumagat tribe, indigenous knowledge systems, traditional farming practices

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753 Design and Construction of a Device to Facilitate the Stretching of a Plantiflexors Muscles in the Therapy of Rehabilitation for Patients with Spastic Hemiplegia

Authors: Nathalia Andrea Calderon Lesmes, Eduardo Barragan Parada, Diego Fernando Villegas Bermudez

Abstract:

Spasticity in the plantiflexor muscles as a product of stroke (CVA-Cerebrovascular accident) restricts the mobility and independence of the affected people. Commonly, physiotherapists are in charge of manually performing the rehabilitation therapy known as Sustained Mechanical Stretching, rotating the affected foot of the patient in the sagittal plane. However, this causes a physical wear on the professional because it is a fatiguing movement. In this article, a mechanical device is developed to implement this rehabilitation therapy more efficiently. The device consists of a worm-crown mechanism that is driven by a crank to gradually rotate a platform in the sagittal plane of the affected foot, in order to achieve dorsiflexion. The device has a range of sagittal rotation up to 150° and has velcro located on the footplate that secures the foot. The design of this device was modeled by using CAD software and was checked structurally with a general purpose finite element software to be sure that the device is safe for human use. As a measurement system, a goniometer is used in the lateral part of the device and load cells are used to measure the force in order to determine the opposing torque exerted by the muscle. Load cells sensitivity is 1.8 ± 0.002 and has a repeatability of 0.03. Validation of the effectiveness of the device is measured by reducing the opposition torque and increasing mobility for a given patient. In this way, with a more efficient therapy, an improvement in the recovery of the patient's mobility and therefore in their quality of life can be achieved.

Keywords: biomechanics, mechanical device, plantiflexor muscles, rehabilitation, spastic hemiplegia, sustained mechanical stretching

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752 Spatial Analysis of Flood Vulnerability in Highly Urbanized Area: A Case Study in Taipei City

Authors: Liang Weichien

Abstract:

Without adequate information and mitigation plan for natural disaster, the risk to urban populated areas will increase in the future as populations grow, especially in Taiwan. Taiwan is recognized as the world's high-risk areas, where an average of 5.7 times of floods occur per year should seek to strengthen coherence and consensus in how cities can plan for flood and climate change. Therefore, this study aims at understanding the vulnerability to flooding in Taipei city, Taiwan, by creating indicators and calculating the vulnerability of each study units. The indicators were grouped into sensitivity and adaptive capacity based on the definition of vulnerability of Intergovernmental Panel on Climate Change. The indicators were weighted by using Principal Component Analysis. However, current researches were based on the assumption that the composition and influence of the indicators were the same in different areas. This disregarded spatial correlation that might result in inaccurate explanation on local vulnerability. The study used Geographically Weighted Principal Component Analysis by adding geographic weighting matrix as weighting to get the different main flood impact characteristic in different areas. Cross Validation Method and Akaike Information Criterion were used to decide bandwidth and Gaussian Pattern as the bandwidth weight scheme. The ultimate outcome can be used for the reduction of damage potential by integrating the outputs into local mitigation plan and urban planning.

Keywords: flood vulnerability, geographically weighted principal components analysis, GWPCA, highly urbanized area, spatial correlation

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751 Improving Psychological Safety in Teaching and Social Organizations in Finland

Authors: Eija Raatikainen

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The aim of the study is to examine psychological safety in the context of change in working life and continuous learning in social- and educational organizations. The participants in the study are social workers and vocational teachers working as employees and supervisors in the capital region of Finland (public and private sectors). Research data has been collected during 2022-2023 using the qualitative method called empathy-based stories (MEBS). Research participants were asked to write short stories about situations related to their work and work community. As researchers, we created and varied the framework narratives (MEBS) in line with the aim of the study and theoretical background. The data were analyzed with content analysis. According to the results, the barriers and prerequisites for psychological safety at work could be located in four different working culture dimensions. The work culture dimensions were named as follows: 1) a work culture focusing on interaction and emotional culture between colleagues, 2) communal work culture, 3) a work culture that enables learning, and 4) a work culture focused on structures and operating models. All these have detailed elements of barriers and prerequisites of psychological safety at work. The results derived from the enlivening methods can be utilized when working with the work community and have discussed psychological safety at work. Also, the method itself (MEBS) can prevent open discussion and reflection on psychological safety at work because of the sensitivity of the topic. Method aloud to imagine, not just talk and share your experiences directly. Additionally, the results of the study can offer one tool or framework while developing phycological safety at work.

Keywords: psychological safety, empathy, empathy-based stories, working life

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750 Use of a Chagas Urine Nanoparticle Test (Chunap) to Correlate with Parasitemia Levels in T. cruzi/HIV Co-Infected Patients

Authors: Yagahira E. Castro-Sesquen, Robert H. Gilman, Carolina Mejia, Daniel E. Clark, Jeong Choi, Melissa J. Reimer-Mcatee, Rocio Castro, Jorge Flores, Edward Valencia-Ayala, Faustino Torrico, Ricardo Castillo-Neyra, Lance Liotta, Caryn Bern, Alessandra Luchini

Abstract:

Early diagnosis of reactivation of Chagas disease in HIV patients could be lifesaving; however, in Latin American the diagnosis is performed by detection of parasitemia by microscopy which lacks sensitivity. To evaluate if levels of T. cruzi antigens in urine determined by Chunap (Chagas urine nanoparticle test) are correlated with parasitemia levels in T. cruzi/HIV co-infected patients. T. cruzi antigens in urine of HIV patients (N=55: 31 T. cruzi infected and 24 T. cruzi serology negative) were concentrated using hydrogel particles and quantified by Western Blot and a calibration curve. The percentage of Chagas positive patients determined by Chunap compared to blood microscopy, qPCR, and ELISA was 100% (6/6), 95% (18/19) and 74% (23/31), respectively. Chunap specificity was 91.7%. Linear regression analysis demonstrated a direct relationship between parasitemia levels (determined by qPCR) and urine T. cruzi antigen concentrations (p<0.001). A cut-off of > 105 pg was chosen to determine patients with reactivation of Chagas disease (6/6). Urine antigen concentration was significantly higher among patients with CD4+ lymphocyte counts below 200/mL (p=0.045). Chunap shows potential for early detection of reactivation and with appropriate adaptation can be used for monitoring Chagas disease status in T. cruzi/HIV co-infected patients.

Keywords: antigenuria, Chagas disease, Chunap, nanoparticles, parasitemia, poly N-isopropylacrylamide (NIPAm)/trypan blue particles (polyNIPAm/TB), reactivation of Chagas disease.

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749 FDX1, a Cuproptosis-Related Gene, Identified as a Potential Target for Human Ovarian Aging

Authors: Li-Te Lin, Chia-Jung Li, Kuan-Hao Tsui

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Cuproptosis, a newly identified cell death mechanism, has attracted attention for its association with various diseases. However, the genetic interplay between cuproptosis and ovarian aging remains largely unexplored. This study aims to address this gap by analyzing datasets related to ovarian aging and cuproptosis. Spatial transcriptome analyses were conducted in the ovaries of both young and aged female mice to elucidate the role of FDX1. Comprehensive bioinformatics analyses, facilitated by R software, identified FDX1 as a potential cuproptosis-related gene with implications for ovarian aging. Clinical infertility biopsies were examined to validate these findings, showing consistent results in elderly infertile patients. Furthermore, pharmacogenomic analyses of ovarian cell lines explored the intricate association between FDX1 expression levels and sensitivity to specific small molecule drugs. Spatial transcriptome analyses revealed a significant reduction in FDX1 expression in aging ovaries, supported by consistent findings in biopsies from elderly infertile patients. Pharmacogenomic investigations indicated that modulating FDX1 could influence drug responses in ovarian-related therapies. This study pioneers the identification of FDX1 as a cuproptosis-related gene linked to ovarian aging. These findings not only contribute to understanding the mechanisms of ovarian aging but also position FDX1 as a potential diagnostic biomarker and therapeutic target. Further research may establish FDX1's pivotal role in advancing precision medicine and therapies for ovarian-related conditions.

Keywords: cuproptosis, FDX1, ovarian aging, biomarker

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748 Baseline Data from Specialist Obesity Clinic in a Large Tertiary Care Facility, Karachi, Pakistan

Authors: Asma Ahmed, Farah Khalid, Sahlah Sohail, Saira Banusokwalla, Sabiha Banu, Inaara Akbar, Safia Awan, Syed Iqbal Azam

Abstract:

Background and Objectives: The level of knowledge regarding obesity as a disease condition and health-seeking behavior regarding its management is grossly lacking. We present data from our multidisciplinary obesity clinic at the large tertiary care facility in Karachi, Pakistan, to provide baseline profiles and outcomes of patients attending these clinics. Methods: 260 who attended the obesity clinic between June 2018 to March 2020 were enrolled in this study. The analysis included descriptive and ROC analysis to identify the best cut-offs of theanthropometric measurements to diagnose obesity-related comorbid conditions. Results: The majority of the studied population were women (72.3%) and employed(43.7%) with a mean age of 35.5 years. Mean BMIwas 37.4, waist circumference was 112.4 cm, visceral fat was 11.7%, and HbA1C was 6.9%. The most common comorbidities were HTN & D.M (33 &31%, respectively). The prevalence of MetS was 16.3% in patients and was slightly higher in males. Visceral fat was the main factor in predicting D.M (0.750; 95% CI: 0.665, 0.836) and MetS (0.709; 95% CI: 0.590, 0.838) compared to total body fat, waist circumference, and BMI. The risk of predicting DM &MetS for the visceral fat above 9.5% in women had the highest sensitivity (80% for D.M & 79% for MetS) and an NPV (92.75% for D.M & 95% for MetS). Conclusions: This study describes and establishes characteristics of these obese individuals, which can help inform clinical practices. These practices may involve using visceral fat for earlier identification and counseling-based interventions to prevent more severe surgical interventions down the line.

Keywords: obesity, metabolic syndrome, tertiary care facility, BMI, waist circumference, visceral fat

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747 Comparison of Mini-BESTest versus Berg Balance Scale to Evaluate Balance Disorders in Parkinson's Disease

Authors: R. Harihara Prakash, Shweta R. Parikh, Sangna S. Sheth

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The purpose of this study was to explore the usefulness of the Mini-BESTest compared to the Berg Balance Scale in evaluating balance in people with Parkinson's Disease (PD) of varying severity. Evaluation were done to obtain (1) the distribution of patients scores to look for ceiling effects, (2) concurrent validity with severity of disease, and (3) the sensitivity & specificity of separating people with or without postural response deficits. Methods and Material: Seventy-seven(77) people with Parkinson's Disease were tested for balance deficits using the Berg Balance Scale, Mini-BESTest. Unified Parkinson’s Disease Rating Scale (UPDRS) III and the Hoehn & Yahr (H&Y) disease severity scales were used for classification. Materials used in this study were case record sheet, chair without arm rests or wheels, Incline ramp, stopwatch, a box, 3 meter distance measured out and marked on the floor with tape [from chair]. Statistical analysis used: Multiple Linear regression was carried out of UPDRS jointly on the two scores for the Berg and Mini-BESTest. Receiver operating characteristic curves for classifying people into two groups based on a threshold for the H&Y score, to discriminate between mild PD versus more severe PD.Correlation co-efficient to find relativeness between the two variables. Results: The Mini-BESTest is highly correlated with the Berg (r = 0.732,P < 0.001), but avoids the ceiling compression effect of the Berg for mild PD (skewness −0.714 Berg, −0.512 Mini-BESTest). Consequently, the Mini-BESTest is more effective than the Berg for predicting UPDRS Motor score (P < 0.001 Mini-BESTest versus P = 0.72 Berg), and for discriminating between those with and without postural response deficits as measured by the H&Y (ROC).

Keywords: balance, berg balance scale, MINI BESTest, parkinson's disease

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