Search results for: surgical site infection

Authors: Jephte Sompud, Emily A. Gilbert, Andy Russel Mojiol, Cynthia B. Sompud, Alim Biun

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Naturally regenerated acacia forest and secondary indigenous forest forms some of the urban forests in Sabah. Naturally regenerated acacia trees are usually seen along the road that exists as forest islands. Acacia tree is not an indigenous tree species in Sabah that was introduced in the 1960’s as fire breakers that eventually became one of the preferred trees for forest plantation for paper and pulp production. Due to its adaptability to survive even in impoverished soils and poor-irrigated land, this species has rapidly spread throughout Sabah through natural regeneration. Currently, there is a lack of study to investigate the bird population in the naturally regenerated acacia forest. This study is important because it shed some light on the role of naturally regenerated acacia forest on bird’s population, as bird is known to be a good bioindicator forest health. The aim of this study was to document the bird’s population in naturally regenerated acacia forest with that adjacent secondary indigenous forest. The study site for this study was at Universiti Malaysia Sabah (UMS) Campus. Two forest types in the campus were chosen as a study site, of which were naturally regenerated Acacia Forest and adjacent secondary indigenous forest, located at the UMS Hill. A total of 21 sampling days were conducted in each of the forest types. The method used during this study was solely mist nets with three pockets. Whenever a bird is caught, it is extracted from the net to be identified and measurements were recorded in a standard data sheet. Mist netting was conducted from 6 morning until 5 evening. This study was conducted between February to August 2014. Birds that were caught were ring banded to initiate a long-term study on the understory bird’s population in the Campus The data was analyzed using descriptive analysis, diversity indices, and t-test. The bird population diversity at naturally regenerated Acacia forest with those at the secondary indigenous forest was calculated using two common indices, of which were Shannon-Wiener and Simpson diversity index. There were 18 families with 33 species that were recorded from both sites. The number of species recorded at the naturally regenerated acacia forest was 26 species while at the secondary indigenous forest were 19 species. The Shannon diversity index for Naturally Regenerated Acacia Forest and secondary indigenous forests were 2.87 and 2.46. The results show that there was very significantly higher species diversity at the Naturally Regenerated Acacia Forest as opposed to the secondary indigenous forest (p<0.001). This suggests that Naturally Regenerated Acacia forest plays an important role in urban bird conservation. It is recommended that Naturally Regenerated Acacia Forests should be considered as an established urban forest conservation area as they do play a role in biodiversity conservation. More future studies in Naturally Regenerated Acacia Forest should be encouraged to determine the status and value of biodiversity conservation of this ecosystem.

Keywords: naturally regenerated acacia forest, bird population diversity, Universiti Malaysia Sabah, biodiversity conservation

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Authors: Shirin Jalili, Ramin Ghasemi Shayan

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Atrial fibrillation is the foremost common arrhythmia around the world, with expanding recurrence famous with age. Thromboembolic occasions and strokes are the number one cause of mortality and morbidity. For patients who don't react to restorative treatment for rate and beat control, the maze method offers an elective treatment mediation. pharmaco-medical treatment for atrial fibrillation is pointed at the control of rate or cadence, intrusive treatment for atrial fibrillation is pointed at cadence control. An obtrusive approach may comprise of percutaneous catheter treatment, surgery, or a crossover approach. Since the maze method is recognized as the foremost successful way to dispense with AF, combining the maze strategy amid major cardiac surgeries has been received in clinical hone. the maze strategy, moreover known as Cox¬maze iii or the ‘cut¬and¬sew’ method, involves making different incisions within the atria to make an arrangement of scars that dispose of each potential zone of re¬entry. The electrical drive is constrained through a maze of scars that coordinates the electrical drive from the sinus node to the av node. By settling the headstrong period between ranges of scar, re¬entry is disposed of. in this article, we evaluate the Maze surgery method that's the surgical method of choice for the treatment of restorative atrial fibrillation.

Keywords: atrial fibrillation, congenital heart disease, procedure, maze surgery, treatment

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Authors: Benjamin J. Kuo, Silvia D. Vaca, Joao Ricardo Nickenig Vissoci, Catherine A. Staton, Linda Xu, Michael Muhumuza, Hussein Ssenyonjo, John Mukasa, Joel Kiryabwire, Lydia Nanjula, Christine Muhumuza, Henry E. Rice, Gerald A. Grant, Michael M. Haglund

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Background: Traumatic Brain Injury (TBI) is disproportionally concentrated in low- and middle-income countries (LMICs), with the odds of dying from TBI in Uganda more than 4 times higher than in high income countries (HICs). The disparities in the injury incidence and outcome between LMICs and resource-rich settings have led to increased health outcomes research for TBIs and their associated risk factors in LMICs. While there have been increasing TBI studies in LMICs over the last decade, there is still a need for more robust prospective registries. In Uganda, a trauma registry implemented in 2004 at the Mulago National Referral Hospital (MNRH) showed that RTI is the major contributor (60%) of overall mortality in the casualty department. While the prior registry provides information on injury incidence and burden, it’s limited in scope and doesn’t follow patients longitudinally throughout their hospital stay nor does it focus specifically on TBIs. And although these retrospective analyses are helpful for benchmarking TBI outcomes, they make it hard to identify specific quality improvement initiatives. The relationship among epidemiology, patient risk factors, clinical care, and TBI outcomes are still relatively unknown at MNRH. Objective: The objectives of this study are to describe the processes of care and determine risk factors predictive of poor outcomes for TBI patients presenting to a single tertiary hospital in Uganda. Methods: Prospective data were collected for 563 TBI patients presenting to a tertiary hospital in Kampala from 1 June – 30 November 2016. Research Electronic Data Capture (REDCap) was used to systematically collect variables spanning 8 categories. Univariate and multivariate analysis were conducted to determine significant predictors of mortality. Results: 563 TBI patients were enrolled from 1 June – 30 November 2016. 102 patients (18%) received surgery, 29 patients (5.1%) intended for surgery failed to receive it, and 251 patients (45%) received non-operative management. Overall mortality was 9.6%, which ranged from 4.7% for mild and moderate TBI to 55% for severe TBI patients with GCS 3-5. Within each TBI severity category, mortality differed by management pathway. Variables predictive of mortality were TBI severity, more than one intracranial bleed, failure to receive surgery, high dependency unit admission, ventilator support outside of surgery, and hospital arrival delayed by more than 4 hours. Conclusions: The overall mortality rate of 9.6% in Uganda for TBI is high, and likely underestimates the true TBI mortality. Furthermore, the wide-ranging mortality (3-82%), high ICU fatality, and negative impact of care delays suggest shortcomings with the current triaging practices. Lack of surgical intervention when needed was highly predictive of mortality in TBI patients. Further research into the determinants of surgical interventions, quality of step-up care, and prolonged care delays are needed to better understand the complex interplay of variables that affect patient outcome. These insights guide the development of future interventions and resource allocation to improve patient outcomes.

Keywords: care continuum, global neurosurgery, Kampala Uganda, LMIC, Mulago, prospective registry, traumatic brain injury

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Authors: Ezzati Givi M., Ezzatigivi N., Eimani H.

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Trigeminal Neuralgia (TN) consists of painful attacks often triggered with general activities, which cause impairment and disability. The first line of treatment consists of pharmacotherapy. However, the occurrence of many side-effects limits its application. Acute pain relief is crucial for titrating oral drugs and making time for neurosurgical intervention. This study aimed to examine the long-term anesthetic effect of QX-314 and capsaicin in trigeminal neuralgia using an animal model. TN was stimulated by surgical constriction of the infraorbital nerve in rats. After seven days, anesthesia infiltration was done, and the duration of mechanical allodynia was compared. Thirty-five male Wistar rats were randomly divided into seven groups as follows: control (normal saline); lidocaine (2%); QX314 (30 mM); lidocaine (2%)+QX314 (15 mM); lidocaine (2%)+QX314 (22 mM); lidocaine (2%)+QX314 (30 mM); and lidocaine (2%)+QX314 (30 mM) +capsaicin (1μg). QX314 in combination with lidocaine significantly increased the duration of anesthesia, which was dose-dependent. The combination of lidocaine+QX314+capsaicin could significantly increase the duration of anesthesia in trigeminal neuralgia. In the present study, we demonstrated that the combination of QX-314 with lidocaine and capsaicin produced a long-lasting, reversible local anesthesia and was superior to lidocaine alone in the fields of the duration of trigeminal neuropathic pain blockage.

Keywords: trigeminal neuralgia, capsaicin, lidocaine, long-lasting

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Authors: Philip Eappen, Narasimha Rao Vajjhala

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This chapter examines how healthcare organizations harnessed innovative healthcare informatics to navigate the challenges posed by the COVID-19 pan-demic, addressing critical needs and improving care delivery. The pandemic's un-precedented demands necessitated the adoption of new and advanced tools to manage healthcare operations more effectively. Informatics solutions played a crucial role in facilitating the smooth functioning of healthcare systems during this crisis and are anticipated to remain central to future healthcare management. Technologies such as telemedicine helped healthcare professionals minimize ex-posure to COVID-19 patients, thereby reducing infection risks within healthcare facilities. This chapter explores a range of informatics applications utilized worldwide, including telemedicine, AI-driven solutions, big data analytics, drones, robots, and digital platforms for drug delivery, all of which enabled re-mote patient care and enhanced healthcare accessibility and safety during the pan-demic.

Keywords: healthcare informatics, COVID-19 Pandemic, telemedicine, AI-driven healthcare, big data analytics, remote patient care, digital health platforms

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Authors: Adrian Sebastian, Chris Gillespie

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We describe a case of diffuse rectal involvement with cap polyposis, manifesting with a protein-losing colopathy and occurring in the setting of advanced mechanical pelvic floor dysfunction. A 59-year-old male with a 5-year history of persistent excessive flatulence, defecatory difficulties, and diarrhea. He had extensive cap polyposis of the entire rectum endoscopically. His symptoms progressed to severe fecal incontinence with mucus leakage, pelvic pain, weight loss, and hypoalbuminemia. Clinical examination exhibited severe perineal descent, a large rectocele, poor anal squeeze, and a poor defecatory technique. After a trial of nonoperative therapies addressing his defecatory dysfunction, and Helicobacter pylori eradication, surgical resection was offered due to severe symptoms with ongoing incontinence and protein loss with no other reasonable options. A robotic abdominoperineal resection with a permanent colostomy was performed, followed by an uncomplicated recovery. Our observation of coexisting mechanical pelvic floor changes in this patient lends weight to the concept of a prolapse-related phenomenon in the pathophysiology of this rare condition.

Keywords: cap polyposis, pelvic dysfunction, fecal incontinence, case report

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Authors: Deanna Ruano-Meas, Laura Shenkman

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Variances are seen in the way healthcare personnel (HCP) don and doff PPE risking contamination to self and others. By standardizing practice, variances in technique decrease, and so does the risk of contamination. To implement this change, the Model for Improvement will be used. A system change will be developed that will outline the role of the organizational leader’s support of HCP in the proper donning and doffing of PPE. Interventions will include environmental surveys to assess the safety and work situation ensuring a permissible environment, plan audits to confirm consistency, and the assessment of PPE wear for standardization. The change will also include an educational plan that will involve instruction of the current guidelines recommended by the Centers for Disease Control and Prevention (CDC) to all pertinent HCP, and the incorporation of PPE education in yearly educational training. The goal is a standardized practice and a reduced risk of contamination through education and organizational support. Personal protective equipment has had recent attention with the coming of the SARS-CoV-2. The realization that proper technique is important to decreasing contamination of pathogens has led to the revising of current processes.

Keywords: donning and doffing, HAI, infection control, PPE

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Authors: Huda Qari, I. A. Hassan

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The brown alga Padina boryanawas was used for bioassay of polycyclic aromatic hydrocarbons (PAHs) accumulation at the seashore of Jeddah city. PAHs were determined in the coastal water and algal tissues by GC-MS. Acenaphthene (Ace) and dibenzo (a,h) anthracene (dB(a,h)An) were the main PAHs in seawater (50.02 and 46.18) and algal tissues (64.67 and 72.45), respectively. The ratios of low molecular weight/high molecular weight hydrocarbons (1.76 – 1.44), fluoranthene/pyrene (1.57 – 1.52) and phenanthrene/anthracene (0.86 – 0.67) in seawater and algal tissues, respectively, indicated the origin of the PAHs to be mainly petrogenic. This study has demonstrated the utility of using Padina boryanawas as a biomonitor of PAH contamination and bioavailability in the coastal waters.

Keywords: polycyclic aromatic hydrocarbons, Padina boryanawas, bioaccumulation, waste water

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Authors: B. Bouadjemi, S. Bentata, W. Benstaali, A. Souidi, A. Abbad, T. Lantri, Z. Aziz, A. Zitouni

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The electronic and magnetic structures of double perovskite Ba2MnMoO6 are systematically investigated using the first principle method of the Full Potential Linear Augmented Plane Waves Plus the Local Orbitals (FP-LAPW+LO) within the Local Spin Density Approximation (LSDA) and the Generalized Gradient Approximation (GGA). In order to take into account the strong on-site Coulomb interaction, we included the Hubbard correlation terms: LSDA+U and GGA+U approaches. Whereas half-metallic ferromagnetic character is observed due to dominant Mn spin-up and Mo spin-down contributions insulating ground state is obtained. The LSDA+U and GGA+U calculations yield better agreement with the theoretical and the experimental results than LSDA and GGA do.

Keywords: electronic structure, double perovskite, first principles, Ba2MnMoO6, half-metallic

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Authors: Soma Banerjee, Aamen Talukdar, Argha Mandal, Dipankar Chaudhuri

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Japanese Encephalitis is a major infectious disease with nearly half the world’s population living in areas where it is prevalent. Currently, treatment for it involves only supportive care and symptom management through vaccination. Due to the lack of antiviral drugs against Japanese Encephalitis Virus (JEV), the quest for such agents remains a priority. For these reasons, simulation studies of drug targets against JEV are important. Towards this purpose, docking experiments of the kinase inhibitors were done against the chosen target NS3 helicase as it is a nucleoside binding protein. Previous efforts regarding computational drug design against JEV revealed some lead molecules by virtual screening using public domain software. To be more specific and accurate regarding finding leads, in this study a proprietary software Schrödinger-GLIDE has been used. Druggability of the pockets in the NS3 helicase crystal structure was first calculated by SITEMAP. Then the sites were screened according to compatibility with ATP. The site which is most compatible with ATP was selected as target. Virtual screening was performed by acquiring ligands from databases: KinaseSARfari, KinaseKnowledgebase and Published inhibitor Set using GLIDE. The 25 ligands with best docking scores from each database were re-docked in XP mode. Protein structure alignment of NS3 was performed using VAST against MMDB, and similar human proteins were docked to all the best scoring ligands. The low scoring ligands were chosen for further studies and the high scoring ligands were screened. Seventy-three ligands were listed as the best scoring ones after performing HTVS. Protein structure alignment of NS3 revealed 3 human proteins with RMSD values lesser than 2Å. Docking results with these three proteins revealed the inhibitors that can interfere and inhibit human proteins. Those inhibitors were screened. Among the ones left, those with docking scores worse than a threshold value were also removed to get the final hits. Analysis of the docked complexes through 2D interaction diagrams revealed the amino acid residues that are essential for ligand binding within the active site. Interaction analysis will help to find a strongly interacting scaffold among the hits. This experiment yielded 21 hits with the best docking scores which could be investigated further for their drug like properties. Aside from getting suitable leads, specific NS3 helicase-inhibitor interactions were identified. Selection of Target modification strategies complementing docking methodologies which can result in choosing better lead compounds are in progress. Those enhanced leads can lead to better in vitro testing.

Keywords: antivirals, docking, glide, high-throughput virtual screening, Japanese encephalitis, ns3 helicase

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Authors: Ahmad Gharaei, Javad Mirdar Harijani

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The freshwater crab family (Potamidae Ortmann, 1896) is a big group and varies over 500 species in 74 genuses. This family distributed in South Europe, South Africa, East and South-east Asian. Iran's Sistan region located in the South East and recently after a decade of drought in the international wetland of Hamoon, in fact, the aquatic fauna in the Chahnimeh’s water reservoirs had taken refuge. This paper reports the second site for Potamon Potamios, in the southern half of the Iran. The specimens were collected from the shallow water in reservoir banks with muddy bottom in July 2010. The morphological features, habitat and systematic, are described.

Keywords: freshwater crab, potamon potamios, sistan, Iran

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Authors: Othman E. Othman, Amira M. Nowier, Medhat El-Denary

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Camels play an important socio-economic role within the pastoral and agricultural system in the dry and semidry zones of Asia and Africa. Camels are economically important animals in Egypt where they are dual purpose animals (meat and milk). The analysis of chemical composition of camel milk showed that the total protein contents ranged from 2.4% to 5.3% and it is divided into casein and whey proteins. The casein fraction constitutes 52% to 89% of total camel milk protein and it divided into 4 fractions namely αs1, αs2, β and κ-caseins which are encoded by four tightly genes. In spite of the important role of casein genes and the effects of their genetic polymorphisms on quantitative traits and technological properties of milk, the studies for the detection of genetic polymorphism of camel milk genes are still limited. Due to this fact, this work focused - using PCR-RFP and sequencing analysis - on the identification of genetic polymorphisms and SNPs of two casein genes in Maghrabi camel breed which is a dual purpose camel breed in Egypt. The amplified fragments at 488-bp of the camel κ-CN gene were digested with AluI endonuclease. The results showed the appearance of three different genotypes in the tested animals; CC with three digested fragments at 203-, 127- and 120-bp, TT with three digested fragments at 203-, 158- and 127-bp and CT with four digested fragments at 203-, 158-, 127- and 120-bp. The frequencies of three detected genotypes were 11.0% for CC, 48.0% for TT and 41.0% for CT genotypes. The sequencing analysis of the two different alleles declared the presence of a single nucleotide polymorphism (C→T) at position 121 in the amplified fragments which is responsible for the destruction of a restriction site (AG/CT) in allele T and resulted in the presence of two different alleles C and T in tested animals. The nucleotide sequences of κ-CN alleles C and T were submitted to GenBank with the accession numbers; KU055605 and KU055606, respectively. The primers used in this study amplified 942-bp fragments spanning from exon 4 to exon 6 of camel αS1-Casein gene. The amplified fragments were digested with two different restriction enzymes; SmlI and AluI. The results of SmlI digestion did not show any restriction site whereas the digestion with AluI endonuclease revealed the presence of two restriction sites AG^CT at positions 68^69 and 631^632 yielding the presence of three digested fragments with sizes 68-, 563- and 293-bp.The nucleotide sequences of this fragment from camel αS1-Casein gene were submitted to GenBank with the accession number KU145820. In conclusion, the genetic characterization of quantitative traits genes which are associated with the production traits like milk yield and composition is considered an important step towards the genetic improvement of livestock species through the selection of superior animals depending on the favorable alleles and genotypes; marker assisted selection (MAS).

Keywords: genetic polymorphism, SNP polymorphism, Maghrabi camels, κ-Casein gene, αS1-Casein gene

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Authors: Aleena Rena Onozuka, Patompong Satapornpong

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Introduction: In a Human Leukocyte Antigen (HLA)’s immune response, HLA alleles (HLA class I and class II) play a crucial role in fighting against pathogens. HLA-B*15:01 allele had a significant association with asymptomatic COVID-19 infection (p-value = 5.67 x 10-5 ; OR = 2.40 and 95% CI = 1.54 - 3.64). There was also a notable linkage between HLA-B*51:01 allele and critically ill patients with COVID-19 (p-value = 0.007 and OR = 3.38). This study has described the distribution of HLA marker alleles in Thais and sub-groups. Objective: We want to investigate the prevalence of HLA-B*15:01 and HLA-B*51:01 alleles in the Thai population. Materials and Methods: 200 healthy Thai population were included in this study from the College of Pharmacy, Rangsit University. HLA-B alleles were genotyped using the sequence-specific oligonucleotides process (PCR-SSOs). Results: We found out that HLA-B*46:01 (12.00%), HLA-B*15:02 (9.25%), HLA-B*40:01 (6.50%), HLA-B*13:01 (6.25%), and HLA-B* 38:02 (5.50%) alleles were more common than other alleles in Thai population. HLA-B*46:01 and HLA-B*15:02 were the most common allele found across four regions. Moreover, the frequency of HLA-B*15:01 and HLA-B*51:01 alleles were similarly distributed in Thai population (0.50, 5.25 %) and (p-value > 0.05), respectively. The frequencies of HLA-B*15:01 and HLA-B*51:01 alleles were not significantly different from other populations compared to the Thai population. Conclusions: We can screen for HLA-B*15:01 and HLA-B*51:01 alleles to determine the symptoms of COVID-19 since they are universal HLA-B markers. Importantly, the database of HLA markers indicates the association between HLA frequency and populations. However, we need further research on larger numbers of COVID-19 patients and in different populations.

Keywords: HLA-B*15:01, HLA-B*51:01, COVID-19, HLA-B alleles

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Authors: Uma Maheshwari V., Rajanikanth Aluvalu, Kumar Gautam

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The COVID-19 disease is a highly contagious viral infection with major worldwide health implications. The global economy suffers as a result of COVID. The spread of this pandemic disease can be slowed if positive patients are found early. COVID-19 disease prediction is beneficial for identifying patients' health problems that are at risk for COVID. Deep learning and machine learning algorithms for COVID prediction using X-rays have the potential to be extremely useful in solving the scarcity of doctors and clinicians in remote places. In this paper, a convolutional neural network (CNN) with deep layers is presented for recognizing COVID-19 patients using real-world datasets. We gathered around 6000 X-ray scan images from various sources and split them into two categories: normal and COVID-impacted. Our model examines chest X-ray images to recognize such patients. Because X-rays are commonly available and affordable, our findings show that X-ray analysis is effective in COVID diagnosis. The predictions performed well, with an average accuracy of 99% on training photographs and 88% on X-ray test images.

Keywords: deep CNN, COVID–19 analysis, feature extraction, feature map, accuracy

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Authors: Mohammad Al-Refai, Majed Wakid

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Introduction: Soil-transmitted diseases (STD) are caused by intestinal worms that are transmitted via various routes into the human body resulting in various clinical manifestations. The intestinal worms causing these infections are known as soil transmitted helminths (STH), including Hook worms, Ascaris lumbricoides (A. lumbricoides), Trichuris trichiura (T. trichiura), and Strongyloides sterocoralis (S. sterocoralis). Objectives: The aim of this study was to investigate the prevalence of STH among newly arrived expatriate labors in Jeddah city, Saudi Arabia, using three different techniques (direct smears, sedimentation concentration, and real-time PCR). Methods: A total of 188 stool specimens were collected and investigated at the parasitology laboratory in the Special Infectious Agents Unit at King Fahd Medical Research Center, King Abdulaziz University in Jeddah, Saudi Arabia. Microscopic examination of wet mount preparations using normal saline and Lugols Iodine was carried out, followed by the formal ether sedimentation method. In addition, real-time PCR was used as a molecular tool to detect several STH and hookworm speciation. Results: Out of 188 stool specimens analyzed, in addition to STH parasite, several other types were detected. 9 samples (4.79%) were positive for Entamoeba coli, 7 samples (3.72%) for T. trichiura, 6 samples (3.19%) for Necator americanus, 4 samples (2.13%) for S. sterocoralis, 4 samples (2.13%) for A. lumbricoides, 4 samples (2.13%) for E. histolytica, 3 samples (1.60%) for Blastocystis hominis, 2 samples (1.06%) for Ancylostoma duodenale, 2 samples (1.06%) for Giardia lamblia, 1 sample (0.53%) for Iodamoeba buetschlii, 1 sample (0.53%) for Hymenolepis nana, 1 sample (0.53%) for Endolimax nana, and 1 sample (0.53%) for Heterophyes heterophyes. Out of the 35 infected cases, 26 revealed single infection, 8 with double infections, and only one triple infection of different STH species and other intestinal parasites. Higher rates of STH infections were detected among housemaids (11 cases) followed by drivers (7 cases) when compared to other occupations. According to educational level, illiterate participants represent the majority of infected workers (12 cases). The majority of workers' positive cases were from the Philippines. In comparison between laboratory techniques, out of the 188 samples screened for STH, real-time PCR was able to detect the DNA in (19/188) samples followed by Ritchie sedimentation technique (18/188), and direct wet smear (7/188). Conclusion: STH infections are a major public health issue to healthcare systems around the world. Communities must be educated on hygiene practices and the severity of such parasites to human health. As far as drivers and housemaids come to close contact with families, including children and elderlies. This may put family members at risk of developing serious side effects related to STH, especially as the majority of workers were illiterate, lacking the basic hygiene knowledge and practices. We recommend the official authority in Jeddah and around the kingdom of Saudi Arabia to revise the standard screening tests for newly arrived workers and enforce regular follow-up inspections to minimize the chances of the spread of STH from expatriate workers to the public.

Keywords: expatriate labors, Jeddah, prevalence, soil transmitted helminths

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Authors: Nuhi Arslani, Aleks Brumec

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Adhesive small bowel obstruction (ASBO) accounts for 20% of emergency surgical procedures and intraabdominal adhesions account for 65% of such cases. In a 10-year post-operative period of abdominal surgery patients, around 35% of them will be readmitted because of ASBO. The first step in approaching ASBOs is using the Bologna guidelines, which include a thorough initial evaluation to diagnose or rule out an ASBO and then proceed with either further imaging studies or emergency surgery, which can be either open or laparoscopic. The contraindications for a laparoscopic approach include hemodynamic instability of the patient and infections in the peritoneum or port sites. Studies have shown that a laparoscopic approach to adhesiolysis is linked with a significantly smaller risk of readmissions and reoperations as well as with faster recovery time and fewer postoperative infections, but has a higher risk of bowel injuries, so a careful selection of patients is required. Although studies favor a laparoscopic approach, many countries still prefer a laparotomy, often because a laparoscopic approach requires surgeons to be highly skilled in the procedure. In the US and UK, between 50 and 60% of surgeons would approach an ASBO with laparoscopy, while in Italy, this number is around 15% and it is most likely similar in Slovenia. We believe that in the right cases and in the right patients, a laparoscopic approach can be equally feasible for treating ASBOs and is associated with fewer intraoperative and postoperative complications.

Keywords: adhesive small bowel obstruction, laparoscopy, adhesions, adhesiolysis

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Authors: Azazhu Wassie

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This study tried to evaluate the maximum design flood for appurtenance structure design using the given climatological and hydrological data analysis on the referenced study area. The maximum design flood is determined by using flood frequency analysis. Using this method, the peak discharge is 32,583.67 m3/s, but the data is transferred because the dam site is not on the gauged station. Then the peak discharge becomes 38,115 m3/s. The study was conducted in June 2023. This dam is built across a river to create a reservoir on its upstream side for impounding water. The water stored in the reservoir is used for various purposes, such as irrigation, hydropower, navigation, fishing, etc. The total average volume of annual runoff is estimated to be 115.1 billion m3. The total potential of the land for irrigation development can go beyond 3 million ha.

Keywords: dam design, flow duration curve, peak flood, rainfall, reservoir capacity, risk and reliability

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Authors: Omar Farahat Hassanein, A. Samer Ezeldin

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The construction industry is a very dynamic field. Every day new technologies and methods are developing to fasten the process and increase its efficiency. Hence, if a project uses fewer resources, it will be more efficient. This paper examines the recycling of concrete construction and demolition (C&D) waste to reuse it as aggregates in on-site applications for construction projects in Egypt and possibly in the Middle East. The study focuses on a stationary plant setting. The machinery set-up used in the plant is analyzed technically and financially. The findings are gathered and grouped to obtain a comprehensive cost-benefit financial model to demonstrate the feasibility of establishing and operating a concrete recycling plant. Furthermore, a detailed business plan including the time and hierarchy is proposed.

Keywords: construction wastes, recycling, sustainability, financial model, concrete recycling, concrete life cycle

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Authors: Abdallah Ghoul, Bachir Ouamri, Ismail Khalil Bousserhane

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In this paper, we have developed a sliding mode controller for PUMA 600 manipulator robot, to control the remote robot a teleoperation system was developed. This system includes two sites, local and remote. The sliding mode controller is installed at the remote site. The client asks for a position through an interface and receives the real positions after running of the task by the remote robot. Both sites are interconnected via the Internet. In order to verify the effectiveness of the sliding mode controller, that is compared with a classic PID controller. The developed approach is tested on a virtual robot. The results confirmed the high performance of this approach.

Keywords: internet, manipulator robot, PID controller, remote control, sliding mode, teleoperation

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Authors: Ehsan A. Yahia, Ayman E. El-Sharkawey, Magda M. Bayoumi

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Background: Wound dressings perform a crucial role in cutaneous wound management due to their ability to protect wounds and promote dermal and epidermal tissue regeneration. Aim: To evaluate the effectiveness of using hydrogel/nano silver-based dressing vs. traditional dressing on diabetic foot wound healing. Methods: Sixty patients with type-2 diabetes hospitalized for diabetic foot wound treatment were recruited from selected Surgical departments. A prospective randomized control study was carried. Results: The results showed that the percentage of a reduction rate of the ulcer by the third week of the treatment in the hydrogel/nano silver-based dressing group was higher (15.11%) than in the traditional wound dressing group (33.44%). Moreover, the mean ulcer size "sq mm" in the hydrogel/nano silver-based dressing group recognized a faster healing rate (15.11±7.89) and considerably lesser in comparison to the traditional in the third week (21.65±8.4). Conclusion: The hydrogel/nanosilver-based dressing showed better results than traditional dressing in managing diabetic ulcer foot.

Keywords: diabetes, wound care, diabetic foot, wound dressing, hydrogel nanosilver

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Authors: Benedetta Caglioti

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The ecclesiastical complex of San Paolo in Ferrara represents a monument of great historical, religious and architectural importance. Its long and articulated story, over time, is already manifested by the mere reading of its planimetric and altimetric configuration, apparently unitary but, in reality, marked by modifications and repeated additions, even of high quality. It follows, in terms of protection, restoration and enhancement, a commitment of due respect for how the ancient building was built and enriched over its centuries of life. Hence a rigorous methodological approach, while being aware of the fact that every monument, in order to live and make use of the indispensable maintenance, must always be enjoyed and visited, therefore it must enjoy, in the right measure and compatibly with its nature, the possibility of improvements and functional, distributive, technological adjustments and related to the safety of people and things. The methodological approach substantiates the different elements of the project (such as distribution functionality, safety, structural solidity, environmental comfort, the character of the site, building and urban planning regulations, financial resources and materials, the same organization methods of the construction site) through the guiding principles of restoration, defined for a long time: the 'minimum intervention,' the 'recognisability' or 'distinguishability' of old and new, the Physico-chemical and figurative 'compatibility,' the 'durability' and the, at least potential, 'reversibility' of what is done, leading to the definition of appropriate "critical choices." The project tackles, together with the strictly functional ones, also the directly conservative and restoration issues, of a static, structural and material technology nature, with special attention to precious architectural surfaces, In order to ensure the best architectural quality through conscious enhancement, the project involves a redistribution of the interior and service spaces, an accurate lighting system inside and outside the church and a reorganization of the adjacent urban space. The reorganization of the interior is designed with particular attention to the issue of accessibility for people with disabilities. To accompany the community to regain possession of the use of the church's own space, already in its construction phase, the project proposal has hypothesized a permeability and flexibility in the management of the works such as to allow the perception of the found Monument to gradually become more and more familiar at the citizenship. Once the interventions have been completed, it is expected that the Church of San Paolo, second in importance only to the Cathedral, from which it is a few steps away, will be inserted in an already existing circuit of use of the city which over the years has systematized the different aspects of culture, the environment and tourism for the creation of greater awareness in the perception of what Ferrara can offer in cultural terms.

Keywords: conservation, accessibility, regeneration, urban space

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Authors: Xianghe Dai, Dennis Lam, Therese Sheehan, Naveed Rehman, Jie Yang

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Concrete is one of the most used construction materials that may be made onsite as fresh concrete and then placed in formwork to produce the desired shapes of structures. It has been recognized that the raw materials and mix proportion of concrete dominate the mechanical characteristics of hardened concrete, and the curing method and environment applied to the concrete in early stages of hardening will significantly influence the concrete properties, such as compressive strength, durability, permeability etc. In construction practice, there are various curing methods to maintain the presence of mixing water throughout the early stages of concrete hardening. They are also beneficial to concrete in hot weather conditions as they provide cooling and prevent the evaporation of water. Such methods include ponding or immersion, spraying or fogging, saturated wet covering etc. Also there are various curing methods that may be implemented to decrease the level of water lost which belongs to the concrete surface, such as putting a layer of impervious paper, plastic sheeting or membrane on the concrete to cover it. In the concrete material laboratory, accelerated strength gain methods supply the concrete with heat and additional moisture by applying live steam, coils that are subject to heating or pads that have been warmed electrically. Currently when determining the mechanical parameters of a concrete, the concrete is usually sampled from fresh concrete on site and then cured and tested in laboratories where standardized curing procedures are adopted. However, in engineering practice, curing procedures in the construction sites after the placing of concrete might be very different from the laboratory criteria, and this includes some standard curing procedures adopted in the laboratory that can’t be applied on site. Sometimes the contractor compromises the curing methods in order to reduce construction costs etc. Obviously the difference between curing procedures adopted in the laboratory and those used on construction sites might over- or under-estimate the real concrete quality. This paper presents the effect of three typical curing methods (air curing, water immersion curing, plastic film curing) and of maintaining concrete in steel moulds on the compressive strength development of normal concrete. In this study, Portland cement with 30% fly ash was used and different curing periods, 7 days, 28 days and 60 days were applied. It was found that the highest compressive strength was observed from concrete samples to which 7-day water immersion curing was applied and from samples maintained in steel moulds up to the testing date. The research results implied that concrete used as infill in steel tubular members might develop a higher strength than predicted by design assumptions based on air curing methods. Wrapping concrete with plastic film as a curing method might delay the concrete strength development in the early stages. Water immersion curing for 7 days might significantly increase the concrete compressive strength.

Keywords: compressive strength, air curing, water immersion curing, plastic film curing, maintaining in steel mould, comparison

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Authors: C. I. Boshoff, S. Steenkamp-Jonker

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Cystic echinococcosis (CE), caused by Echinococcus granulosus is an important parasitic infection in livestock worldwide, with severe zoonotic potential. It is important to understand the variability of Echinococcus granulosus, as genotype variations may influence lifecycle patterns, development rate, and transmission. Cystic Echinococcus samples were collected from domestic animals in Eastern Cape Province, South Africa. A molecular study was performed on 14 hydatid cysts obtained from caprine, ovine and bovine livers in order to determine the Echinococcus granulosus strain present in these hosts. The sequencing of the mitochondrial cytochrome C oxidase subunit I (coxI) gene of the hydatid cysts produced sequences of 400 bp for each sample analysed. These sequences were aligned with those present in GenBank and a phylogenetic tree was constructed. Based on coxI genotype the isolates could be grouped into E. granulosus sensu stricto. The findings of the study represent a pilot molecular study on Echinococcus from domestic animals undertaken in South Africa.

Keywords: Echinococcus granulosus, genotypes, livestock, South Africa

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Authors: Sireethorn Nimitvilai, Ussanee Poolvivatchaikarn, Nuchanart Tomeun

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Objective: To determine the simple laboratory parameters to predict disease severity among COVID-19 patients in resource-limited settings. Material and methods: A retrospective cohort study was conducted at Nakhonpathom Hospital, a 722-bed tertiary care hospital, with an average of 50,000 admissions per year, during April 15 and May 15, 2021. Eligible patients were adults aged ≥ 15 years who were hospitalized with COVID-19. Baseline characteristics, comorbid conditions ad laboratory findings at admission were collected. Predictive factors for severe COVID-19 infection were analyzed. Result: There were 207 patients (79 male and 128 female) and the mean age was 46.7 (16.8) years. Of these, 39 cases (18.8%) were severe and 168 (81.2%) cases were non-severe. Factors associated with severe COVID-19 were neutrophil to lymphocyte ratio ≥ 4 (OR 8.1, 95%CI 2.3-20.3, P < 0.001) and C-reactive protein to albumin ratio ≥ 10 (OR 3.49, 95%CI 1.3-9.1, p 0.01). Conclusions: Complete blood counts, C-reactive protein and albumin are simple, inexpensive, widely available tests and can be used to predict severe COVID-19 in resource-limited settings.

Keywords: COVID-19, predictor of severity, resource-limiting settings, simple laboratory parameters

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Authors: Camilla Trevor, Matthew K. Higgins, Andrea Gonzalez-Munoz, Mark Carrington

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Trypanosomiasis is a devastating disease affecting both humans and livestock in sub-Saharan Africa. The diseases are caused by infection with African trypanosomes, protozoa transmitted by tsetse flies. Treatment currently relies on the use of chemotherapeutics with ghastly side effects. Here, we describe the development of effective antibody-drug conjugates that target the T. brucei transferrin receptor. The receptor is essential for trypanosome growth in a mammalian host but there are approximately 12 variants of the transferrin receptor in the genome. Two of the most divergent variants were used to generate recombinant monoclonal immunoglobulin G using phage display and we identified cross-reactive antibodies that bind both variants using phage ELISA, fluorescence resonance energy transfer assays and surface plasmon resonance. Fluorescent antibodies were used to demonstrate uptake into trypanosomes in culture. Toxin-conjugated antibodies were effective at killing trypanosomes at sub-nanomolar concentrations. The approach of using antibody-drug conjugates has proven highly effective.

Keywords: antibody-drug conjugates, phage display, transferrin receptor, trypanosomes

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Authors: Suchao Donpudsa, Suwattana Visetnan, Anchalee Tassanakajon, Vichien Rimphanitchayakit

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The Single Wap Domain (SWD) is a type III crustin antimicrobial peptide whose function is to defense the host animal against the bacterial infection by means of antimicrobial and antiproteinase activities. A study of LvSWD from Litopenaeus vannamei is reported herein about its activities and function against bacteria, particularly the Vibrio parahaemolyticus AHPND (VPAHPND) that causes acute hepatopancreatic necrosis disease. The over-expressed mature recombinant (r)LvSWD exhibits antimicrobial activity against both Gram-positive and Gram-negative bacteria, especially VPAHPND. With four times the MIC of rLvSWD, the treated post larval shrimp infected by VPAHPND is able to survive longer with the 50% survival rate as long as 78 h as compared to 36 h of the infected shrimp without rLvSWD. To a certain extent, we have demonstrated that the rLvSWD can be applied to protect the post larval shrimp.

Keywords: crustin, Litopenaeus vannamei, Vibrio parahaemolyticus AHPND, antimicrobial activity

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Authors: Pietro Mortini, Marco Losa

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Objective: Resection of large lesions growing into the third ventricle remains a demanding surgery, sometimes at risk of severe post-operative complications. Transcallosal and transcortical routes were considered as approaches of choice to access the third ventricle, however neurological consequences like memory loss have been reported. We report clinical results of the previously described combined interhemispheric sub-commissural translaminaterminalis approach (CISTA) for the resection of large lesions located in the third ventricle. Methods: Authors conducted a retrospective analysis on 10 patients, who were operated through the CISTA, for the resection of lesions growing into the third ventricle. Results: Total resection was achieved in all cases. Cognitive worsening occurred only in one case. No perioperative deaths were recorded and, at last follow-up, all patients were alive. One year after surgery 80% of patients had an excellent outcome with a KPS 100 and Glasgow Outcome score (GOS) Conclusion: The CISTA represents a safe and effective alternative to transcallosal and transcortical routes to resect lesions growing into the third ventricle. It allows for a multiangle trajectory to access the third ventricle with a wide working area free from critical neurovascular structures, without any section of the corpus callosum, the anterior commissure and the fornix.

Keywords: craniopharingioma, surgery, sub-commissural translaminaterminalis approach (CISTA),

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Authors: N. Demertzis, J. L. Bowen

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Sepsis is a complex and rapidly evolving condition, resulting from uncontrolled prolonged activation of host immune system due to pathogenic insult. The aim of this study is the development of a multiplex electrochemical sensing platform, capable of detecting both pathogen associated and host immune markers to enable the rapid and definitive diagnosis of sepsis. A combination of aptamers and molecular imprinting approaches have been employed to generate sensing systems for lipopolysaccharide (LPS), c-reactive protein (CRP) and procalcitonin (PCT). Gold working electrodes were mechanically polished and electrochemically cleaned with 0.1 M sulphuric acid using cyclic voltammetry (CV). Following activation, a self-assembled monolayer (SAM) was generated, by incubating the electrodes with a thiolated anti-LPS aptamer / dithiodibutiric acid (DTBA) mixture (1:20). 3-aminophenylboronic acid (3-APBA) in combination with the anti-LPS aptamer was used for the development of the hybrid molecularly imprinted sensor (apta-MIP). Aptasensors, targeting PCT and CRP were also fabricated, following the same approach as in the case of LPS, with mercaptohexanol (MCH) replacing DTBA. In the case of the CRP aptasensor, the SAM was formed following incubation of a 1:1 aptamer: MCH mixture. However, in the case of PCT, the SAM was formed with the aptamer itself, with subsequent backfilling with 1 μM MCH. The binding performance of all systems has been evaluated using electrochemical impedance spectroscopy. The apta-MIP’s polymer thickness is controlled by varying the number of electropolymerisation cycles. In the ideal number of polymerisation cycles, the polymer must cover the electrode surface and create a binding pocket around LPS and its aptamer binding site. Less polymerisation cycles will create a hybrid system which resembles an aptasensor, while more cycles will be able to cover the complex and demonstrate a bulk polymer-like behaviour. Both aptasensor and apta-MIP were challenged with LPS and compared to conventional imprinted (absence of aptamer from the binding site, polymer formed in presence of LPS) and non-imprinted polymers (NIPS, absence of LPS whilst hybrid polymer is formed). A stable LPS aptasensor, capable of detecting down to 5 pg/ml of LPS was generated. The apparent Kd of the system was estimated at 17 pM, with a Bmax of approximately 50 pM. The aptasensor demonstrated high specificity to LPS. The apta-MIP demonstrated superior recognition properties with a limit of detection of 1 fg/ml and a Bmax of 100 pg/ml. The CRP and PCT aptasensors were both able to detect down to 5 pg/ml. Whilst full binding performance is currently being evaluated, there is none of the sensors demonstrate cross-reactivity towards LPS, CRP or PCT. In conclusion, stable aptasensors capable of detecting LPS, PCT and CRP at low concentrations have been generated. The realisation of a multiplex panel such as described herein, will effectively contribute to the rapid, personalised diagnosis of sepsis.

Keywords: aptamer, electrochemical impedance spectroscopy, molecularly imprinted polymers, sepsis

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Authors: Sean Bryner S. Rey, Eric Tanjutco

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Modular execution strategies are performed to address the various challenges of any projects and are implemented on each project phase that covers Engineering, Procurement, Fabrication and Construction. It was until the recent years that the intent to surpass mechanical modularization approach were conceptualized to give solution to much greater demands of project components such as site location and adverse weather condition, material sourcing, construction schedule, safety risks and overall plot layout and allocation. The intent of this paper is to introduce the 3rd Generation Modular Execution with an overview of its advantages on project execution and will give emphasis on Engineering, Construction, Operation and Maintenance. Most importantly, the paper will present the key differentiator of 3rd Gen modular execution against other conventional project execution and the merits it bears for the industry.

Keywords: 3rd generation modular, process block, construction, operation & maintenance

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Authors: Sarwan Dhir, Suma Basak, Dipika Parajulee

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Alfalfa is renowned for its nutritional and biopharmaceutical value as a perennial forage legume. However, establishing a rapid plant regeneration protocol using somatic embryogenesis and efficient transformation frequency are the crucial prerequisites for gene editing in alfalfa. This study was undertaken to establish and improve the protocol for somatic embryogenesis and subsequent plant regeneration. The experiments were conducted in response to natural sensitivity using various antibiotics such as cefotaxime, carbenicillin, gentamycin, hygromycin, and kanamycin. Using 3-week-old leaf tissue, somatic embryogenesis was initiated on Gamborg’s B5 basal (B5H) medium supplemented with 3% maltose, 0.9µM Kinetin, and 4.5µM 2,4-D. Embryogenic callus (EC) obtained from the B5H medium exhibited a high rate of somatic embryo formation (97.9%) after 3 weeks when the cultures were placed in the dark. Different developmental stages of somatic embryos and cotyledonary stages were then transferred to Murashige and Skoog’s (MS) basal medium under light, resulting in a 94% regeneration rate of plantlets. Our results indicate that leaf segments can grow (tolerate) up to 450 mg/L of cefotaxime and 400 mg/L of carbenicillin in the culture medium. However, the survival threshold for hygromycin at 12.5 mg/L, kanamycin at 250 mg/L, gentamycin at 50 mg/L, and timentin (300 mg/L). The experiment to improve the protocol for achieving efficient transient gene expression in alfalfa through genetic transformation with the Agrobacterium tumefaciens pCAMBIA1304 vector was also conducted. The vector contains two reporter genes such as β-glucuronidase (GUS) and green fluorescent protein (GFP), along with a selectable hygromycin B phosphotransferase gene (HPT), all driven under the CaMV 35s promoter. Various transformation parameters were optimized using 3-week-old in vitro-grown plantlets. The different parameters such as types of explant, leaf ages, preculture days, segment sizes, wounding types, bacterial concentrations, infection periods, co-cultivation periods, different concentrations of acetosyringone, silver nitrate, and calcium chloride were optimized for transient gene expression. The transient gene expression was confirmed via histochemical GUS and GFP visualization under fluorescent microscopy. The data were analyzed based on the semi-quantitative observation of the percentage and number of blue GUS spots on different days of agro-infection. The highest percentage of GUS positivity (76.2%) was observed in 3-week-old leaf segments wounded using a scalpel blade of 11 size- after 3 days of post-incubation at a bacterial concentration of 0.6, with 2 days of preculture, 30 min of bacterial-leaf segment co-cultivation, with the addition of 150 µM acetosyringone, 4 mM calcium chloride, and 75 µM silver nitrate. Our results suggest that various factors influence T-DNA delivery in the Agrobacterium-mediated transformation of alfalfa. The stable gene expression in the putative transgenic tissue was confirmed using PCR amplification of both marker genes, indicating that gene expression in explants was not solely due to Agrobacterium, but also from transformed cells. The improved protocol could be used for generating transgenic alfalfa plants using genome editing techniques such as CRISPR/Cas9.

Keywords: Medicago sativa l. (Alfalfa), agrobacterium tumefaciens, β-glucuronidase, green fluorescent protein, transient gene

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