Search results for: skin elasticity

Authors: Venkata Buddharaju, Irene Mccarron, Hazel Alba

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Introduction: Male external catheters (MECs) are commonly used to collect and drain urine. MECs are increasingly used in acute care, long-term acute care hospitals, and nursing facilities, and in other patients as an alternative to invasive urinary catheters to reduce catheter-associated urinary tract infections (CAUTI).MECs are also used to avoid the need for incontinence pads and diapers. Most of the Male External Catheters are held in place by skin adhesive, with the exception of a few, which uses a foam strap clamp around the penile shaft. The adhesive condom catheters typically stay for 24 hours or less. It is also a common practice that extra skin adhesive tape is wrapped around the condom catheter for additional security of the device. The fixed nature of the adhesive will not allow the normal skin expansion of penile size over time. The adhesive can cause skin irritation, redness, erosion, and skin damage. Acanthus condom catheter (ACC) is a patented, specially designed, stretchable silicone catheter without adhesive, adapts to the size and contour of the penis. It is held in place with a single elastic strap that wraps around the lower back and tied to the opposite catheter ring holescriss cross. It can be reused for up to 5 days on the same patient after daily cleaning and washingpotentially reducing cost. Methods: The study was conducted from September 17th to October 8th, 2020. The nursing staff was educated and trained on how to use and reuse the catheter. After identifying five (5) appropriate patients, the catheter was placed and maintained by nursing staff. The data on the ease of use, leak, and skin damage were collected and reported by nurses to the nursing education department of the hospital for analysis. Setting: RML Chicago, long-term acute care hospital, an affiliate of Loyola University Medical Center, Chicago, IL USA. Results: The data showed that the catheter was easy to apply, remove, wash and reuse, without skin problems or urine infections. One patient had used for 16 days after wash, reuse, and replacement without any urine leak or skin issues. A minimal leak was observed on two patients. Conclusion: Acanthus condom catheter was easy to use, functioned well with minimal or no leak during use and reuse. The skin was intact in all patients studied. There were no urinary tract infections in any of the studied patients.

Keywords: CAUTI, male external catheter, reusable, skin adhesive

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Authors: A. H. Yehia, M. M. Rashwan, K. A. Assaf, K. Abd el Samee

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The aim of this work is to use an environmental, cheap; organic non-traditional admixture to improve the structural behavior of sustainable reinforced concrete beams contains different ratios of recycled concrete aggregate. The used admixture prepared by using wastes from vegetable oil industry. Under and over reinforced concrete beams made from natural aggregate and different ratios of recycled concrete aggregate were tested under static load until failure. Eight beams were tested to investigate the performance and mechanism effect of admixture on improving deformation characteristics, modulus of elasticity and toughness of tested beams. Test results show efficiency of organic admixture on improving flexural behavior of beams contains 20% recycled concrete aggregate more over the other ratios.

Keywords: deflection, modulus of elasticity, non-traditional admixture, recycled concrete aggregate, strain, toughness, under and over reinforcement

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Authors: Savita Dixit

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Rutin is the bioactive flavonoid isolated from the straw part of Triticum aestivum and possess various pharmacological applications. The aim of this study is to evaluate the chemopreventive potential of rutin in an experimental skin carcinogenesis mice model system. Skin tumor was induced by topical application of 7, 12-dimethyl benz(a) anthracene (DMBA) and promoted by croton oil in Swiss albino mice. To assess the chemopreventive potential of rutin, it was orally administered at a concentration of (200 mg/kg and 400 mg/kg body weight) continued three times weekly for 16th weeks. The development of skin carcinogenesis was assessed by histopathological analysis. Reductions in tumor size and cumulative number of papillomas were seen due to rutin treatment. Average latent period was significantly increased as compared to carcinogen-treated control. Rutin produced a significant decrease in the activity of serum enzyme serum glutamate oxalate transaminase (SGOT), serum glutamate pyruvate transaminase (SGPT), alkaline phosphatase (ALP) and bilirubin when compared with the control. They significantly increased the levels of enzyme involved in oxidative stress glutathione (GSH), superoxide dismutase (SOD) and catalase. The elevated level of lipid peroxidase in the control group was significantly inhibited by rutin administration. The results of the present study suggest the chemopreventive effect of rutin in DMBA and croton oil-induced skin carcinogenesis in swiss albino mice and one of the probable reasons would be its antioxidant potential.

Keywords: chemoprevention, papilloma, rutin, skin carcinogenesis

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Authors: Elucir Gir, Laelson Rochelle Milanês Sousa, Renata Karina Reis, Soraia Assad Nasbine Rabeh, Mayra Gonçalves Menegueti, Ana Cristina de Oliveira e Silva, Sheila Araújo Teles

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Context and significance: Nursing team professionals faced challenges in combating the COVID-19 pandemic around the world. They were subjected to exhausting workloads and prolonged use of Personal Protective Equipment. Using N95 masks for long periods of time can cause skin changes. In this context, health professionals who worked on the front lines of fighting the pandemic were more exposed to possible physical and psychological changes. Objective: The aim of the study was to analyze the factors associated with skin lesions resulting from the use of N95 masks among nursing team professionals. Method: The study was carried out in all regions of Brazil from October to December 2020, with professionals from the nursing team who worked in health care during the COVID-19 pandemic. Participants were recruited via social media, and information was collected electronically and stored on the Survey Monkey platform. Descriptive statistics were used to characterize the sample, association tests (Chi-square), with a statistical significance level of p < 0.05. Factors associated with skin lesions resulting from the use of an N95 mask were determined by Binary Logistic Regression, with a significance level of 5% (α = 0.05). Results: 8,405 nursing professionals participated in the study, 5,492 nurses (65.3%), 2,747 nursing technicians (32.7%), and 7,084 females (84.3%). Female nursing team professionals were 1.4 times more likely to develop skin lesions due to the use of N95 masks when compared to males (OR 1.4 [CI95% 1.22 – 1.59] p < 0.001). The following protective factors were identified: nursing technician (ORA 0.608 [CI95% 0.43 – 0.86] p = 0.005) and not having provided assistance in field hospitals for COVID-19 (0.73 [CI95% 0.65-0.81] p<0.000). Conclusion: It was concluded that female nursing team professionals were more likely to have skin changes related to the use of N95 masks. The need for intervention studies is emphasized in order to explore measures to prevent these types of injuries. Descritores: Nursing professionals; COVID-19; SARS-CoV-2; Brazil.

Keywords: nursing professionals, COVID-19, SARS-CoV-2, Brazil

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Authors: Stefaan Carpentier, Aya Al Masri, Fabrice Leroy, Thibault Julien, Safoin Aktaou, Malorie Martin, Fouad Maaloul

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Introduction: During an 'Interventional Radiology (IR)' procedure, the patient's skin-dose may become very high for a burn, necrosis, and ulceration to appear. In order to prevent these deterministic effects, a prediction of the peak skin-dose for the patient is important in order to improve the post-operative care to be given to the patient. The objective of this study is to estimate, before the intervention, the patient dose for ‘Chronic Total Occlusion (CTO)’ procedures by selecting relevant clinical indicators. Materials and methods: 103 procedures were performed in the ‘Interventional Cardiology (IC)’ department using a Siemens Artis Zee image intensifier that provides the Air Kerma of each IC exam. Peak Skin Dose (PSD) was measured for each procedure using radiochromic films. Patient parameters such as sex, age, weight, and height were recorded. The complexity index J-CTO score, specific to each intervention, was determined by the cardiologist. A correlation method applied to these indicators allowed to specify their influence on the dose. A predictive model of the dose was created using multiple linear regressions. Results: Out of 103 patients involved in the study, 5 were excluded for clinical reasons and 2 for placement of radiochromic films outside the exposure field. 96 2D-dose maps were finally used. The influencing factors having the highest correlation with the PSD are the patient's diameter and the J-CTO score. The predictive model is based on these parameters. The comparison between estimated and measured skin doses shows an average difference of 0.85 ± 0.55 Gy for doses of less than 6 Gy. The mean difference between air-Kerma and PSD is 1.66 Gy ± 1.16 Gy. Conclusion: Using our developed method, a first estimate of the dose to the skin of the patient is available before the start of the procedure, which helps the cardiologist in carrying out its intervention. This estimation is more accurate than that provided by the Air-Kerma.

Keywords: chronic total occlusion procedures, clinical experimentation, interventional radiology, patient's peak skin dose

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Authors: Pennisi Stefania, Giuffrida Graziella, Coppa Federica, Iannello Giulia, Cartelli Simone, Lo Faro Riccardo, Ferruggia Greta, Brundo Maria Violetta

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Tissue engineering aims to develop advanced medical devices to restore normal functions of damaged tissue. These devices, even more effective than conventional methods, are called skin substitutes and are configured as drugs to be applied to the damaged area, to heal extensive and deep wounds which could otherwise lead to chronic wounds lasting over time. Among the variety of commercially available skin substitutes, those that have proven to be most effective are those consisting of a bilayer scaffold. The aim of our research was to design a skin substitute which can promote cell proliferation, cell migration and angiogenesis, and which can guarantee timely closure of the wound with satisfactory aesthetic results, in order to avoid the patient excessive pain, risk of contracting infections and long-term hospitalization. The product was tested in vitro using the Scratch Assay. The assay was carried out both on the matrix modified with hyaluronic acid and on the matrix based only on collagen. In both cases, after 48 hours of exposure the wound scratch was almost completely closed in treated cells compared to untreated control.

Keywords: collagen, hyaluronic acid, scratch- wound-healing assay, tissue regeneration

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Authors: Mohammad F. Bostanudin, Tan S. Fei, Azwan M. Lazim

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Toward the development of colloidal systems that are able to enhance permeation across the skin, a material combining the non-toxic and non-immunogenic of dextran with alkylglycerols permeation enhancing property has been designed. To this purpose, a range of butylglyceryl dextrans (DEX-OX4) were synthesized via functionalization with n-butylglycidyl ether and the successful functionalization was confirmed by NMR and FT-IR spectroscopies, along with GPC with a degree of modification in the range 6.3–35.7 %. A reduced viscosity and an increased molecular weight of DEX-OX4 were also recorded when compared to that of the native dextran. DEX-OX4 was further formulated into nanocarriers and loaded with α-arbutin prior to be investigated for their particle size, morphology, stability, loading ability, and release profiles. The resulting nanoparticles were found to be close-to-spherical and relatively stable at pH 5 and 7, with size 180–220 nm (ζ-potential -22 to -25 mV), and a loading degree of 11.7 %. Lack of toxicity at application-relevant concentrations and increased permeation across skin biological membrane model were demonstrated by nanoparticles in-vitro results against immortalized skin human keratinocytes cells (HaCaT).

Keywords: butylglycerols, dextran, nanoparticles, transdermal

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Authors: Ali Kurşun, Emre Kara, Erhan Çetin, Şafak Aksoy, Ahmet Kesimli

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In this study, thermal elastic stress distribution occurred on long hollow cylinders made of functionally graded material (FGM) was analytically defined under thermal, mechanical and thermo mechanical loads. In closed form solutions for elastic stresses and displacements are obtained analytically by using the infinitesimal deformation theory of elasticity. It was assumed that elasticity modulus, thermal expansion coefficient and density of cylinder materials could change in terms of an exponential function as for that Poisson’s ratio was constant. A gradient parameter n is chosen between - 1 and 1. When n equals to zero, the disc becomes isotropic. Circumferential, radial and longitudinal stresses in the FGMs cylinders are depicted in the figures. As a result, the gradient parameters have great effects on the stress systems of FGMs cylinders.

Keywords: functionally graded materials, thermoelasticity, thermomechanical load, hollow cylinder.

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Authors: Hyo-Su Lim, Ye-Eun Song, Eun-Bi Lee, Sang-Yoon Lee, Young-Il Seo, Jin-Pyo Kim, Nam-Kyu Park

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If we analogize any physical external force given to victims in many crimes including violence, it would be possible not only to presume mutual action between victims and suspects, but to make a deduction of more various facts in cases. Therefore, the aim of this study is to identify criminal tools through secretion on clothes by using amino acid reagents such as Ninhydrin, DFO(1,8-dizafluoren-9-one), 1,2 – IND (1,2-indanedione) which are reacting to skin secretion. For more effective collecting condition, porcine skin which is physiologically similar to human was used. Although there were little differences of shape identification according to sensitivity, amino acid reagents were able to identify the fist, foot, and baseball bat. Furthermore, we conducted the experiments for developmental variations through change over time setting up 5-weeks period including first damage as variation factor, and developing materials in each action through certain reagents. Specimen level of development depending on change over time was identified. As a result, each of initial level of development was seen no changes.

Keywords: hit marks, amino acid reagents, porcine skin, criminal tool

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Authors: Manisha, Manisha Mathur, Jay K. Desai, Shesh Asopa, Manisha Mehra

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The present study was carried out for the comprehensive analysis of lumpy skin disease (LSD) in cattle and to elucidate the histopathology of vital organs in natural outbreaks. Lumpy skin disease (LSD) is a viral infection that primarily affects cattle. It is caused by a Capri pox virus and is characterized by the formation of skin nodules or lesions. For this study, a postmortem of 20 cows who died of Lumpy skin disease in different regions of Rajasthan was conducted. This study aimed to examine a cow's external and internal organs to confirm if lumpy skin disease was the cause of death. Accurate diagnosis is essential for improving disease surveillance, understanding the disease's progression, and informing control measures. Pathological examinations reveal virus-induced changes across organs, while histopathological analyses provide crucial insights into the disease's pathogenesis, aiding in the development of advanced diagnostics and effective prevention strategies. Histopathological examination of nodular skin lesions revealed edema, hyperemia, acanthosis, severe hydropic degeneration/ballooning degeneration, and hyperkeratosis in the epidermis. In the lungs, congestion, oedema, emphysema, and atelectasis were observed grossly. Microscopically changes were suggestive of interstitial pneumonia, suppurative pneumonia, bronchopneumonia post pneumonic fibrosis, and stage of resolution. Grossely liver showed congestion and necrotic foci microscopically in most of the cases, and the liver showed acute viral hepatitis. Microscopically in kidneys, multifocal interstitial nephritis was observed. There was marked interstitial inflammation and zonal fibrosis with cystically dilated tubules and bowman's capsules. Microscopically, most of the heart tissue section showed normal histology with few sarcocysts in between cardiac muscles. In some cases, loss of cross striation, sarcoplasmic vacuolation, fregmentation, and disintegration of cardiac fibres were observed. The present study revealed the characteristic gross and histopathological changes in different organs in natural cases of lumpy skin disease. Further, the disease was confirmed based on the molecular diagnosis and transmission electron microscopy of capripox infection in the affected cattle in the study area.

Keywords: Capripoxvirus, lumpy skin disease, polymerage chain reaction, transmission electron microscopy

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Authors: Gladys Abiemwense Ibhaze, Anthony Henry Ekeocha, Adebowale Noah Fajemisin, Tope Oke, Caroline Tosin Alade,

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The study was conducted to evaluate the silage quality and acceptability of ensiled avocado pear skin (APS) with cassava peel (CSP) and brewers’ grain (BG) using eighteen (18) West African Dwarf goats with an average weight of 7.0±1.5 kg. The experimental diets; 1) 50% cassava peel+ 50% brewers’ grain, 2) 50% brewers’ grain+ 50% avocado pear skin, 3) 50% cassava peel +25% brewers’ grain+ 25% avocado pear skin were ensiled for 21 days. The experimental design was a completely randomized design (CRD). The chemical composition of the diets was investigated. The acceptability of the diets was evaluated for twelve (12) days. Results obtained showed that the crude protein content ranged from 12.18 – 12.47%, crude fiber (15.99-22.67%). Results obtained showed that diet 1 had the least pH value (4.0), followed by diet 3 (4.5) and diet 2 (5.2). All diets were firm in texture and maintained their initial color. The temperature ranged from 27-29 ⁰C with diet 2 having the highest temperature of 29 ⁰C. Acceptability of experimental diets varied (p < 0.05) significantly. Dry matter intake ranged from (426.22-686.73g/day) with animals on a diet one recording the highest dry matter intake. The coefficient of preference and percentage preference, also differed (p <0.05) significantly among the diets. Diet 1 had a coefficient of preference greater than unity. However, this was not significantly (p>0.05) different from diet two but differed from diet 3. Conclusively, APS could be included in goats’ diets in the absence of CSP during feed scarcity provided a rich source of protein is available.

Keywords: avocado pear skin, Brewers' grain, Cassava peel, preference

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Authors: Fisaha Asmelash

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The processing of textiles to achieve a desired handle is a crucial aspect of finishing technology. Softeners can enhance the properties of textiles, such as softness, smoothness, elasticity, hydrophilicity, antistatic properties, and soil release properties, depending on the chemical nature used. However, human skin is sensitive to rough textiles, making softeners increasingly important. Although synthetic softeners are available, they are often expensive and can cause allergic reactions on human skin. This paper aims to extract a natural softener from Ricinus communis and produce an eco-friendly and user-friendly alternative due to its 100% herbal and organic nature. Crushed Ricinus communis seeds were soaked in a mechanical oil extractor for one hour with a 100g cotton fabric sample. The defatted cake or residue obtained after the extraction of oil from the seeds, also known as Ricinus communis meal, was obtained by filtering the raffinate and then dried at 1030c for four hours before being stored under laboratory conditions for the softening process. The softener was applied directly to 100% cotton fabric using the padding process, and the fabric was tested for stiffness, crease recovery, and drape ability. The effect of different concentrations of finishing agents on fabric stiffness, crease recovery, and drape ability was also analyzed. The results showed that the change in fabric softness depends on the concentration of the finish used. As the concentration of the finish was increased, there was a decrease in bending length and drape coefficient. Fabrics with a high concentration of softener showed a maximum decrease in drape coefficient and stiffness, comparable to commercial softeners such as silicon. The highest decrease in drape coefficient was found to be comparable with commercial softeners, silicon. Maximum increases in crease recovery were seen in fabrics treated with Ricinus communis softener at a concentration of 30gpl. From the results, the extracted softener proved to be effective in the treatment of 100% cotton fabric

Keywords: ricinus communis, crease recovery, drapability, softeners, stiffness

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Authors: Ghazanfari Masoumeh, Hajimohammadi Bahador, Eskandari Soheyl, Karimian Khosroshahi Nader

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Consumption of ready to cook meat products such as hamburgers, sausages and etc is being increased in the worldwide specially in the big cities , so safety and quality required for food products is very important and vital for consumers with consideration of meat price and increasing demands for meat products, possibility of substitution of cheep and unauthorized textures such as undesirable enclosures animals (massacre, lung tissue, breast of spleen, the organs abdominal cavity, gizzard chicken, skin, etc. ) have increased in the recent years, in this study 30 industrial and 30 handmade hamburgers in fast food restaurants detected out of Iranian national standard for hamburger No. 2304 in using the unauthorized textures. The purpose of this study was to determine using of chicken skin in produced hamburgers from chicken meat in Tehran base on histology methods. The rates of skin used were, 2 % in industrial and 9 % in handmade formula samples. Statistically using the unauthorized textures had significant higher rate in handmade (P < 0.05) in compare with the industrial samples. The results showed the handmade hamburgers with higher adulteration rate and non-compliance with the hamburger national standard could be a potentially health hazard.

Keywords: histology, adulteration, unauthorized textures, undesirable enclosures animals

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Authors: Geng Xiangren, Liu Lei, Gui Ye-Wei, Tang Wei, Wang An-ling

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The malfunction of thermal protection system (TPS) caused by aerodynamic heating is a latent trouble to aircraft structure safety. Accurately predicting the structure temperature field is quite important for the TPS design of hypersonic vehicle. Since Thornton’s work in 1988, the coupled method of aerodynamic heating and heat transfer has developed rapidly. However, little attention has been paid to the influence of structural deformation on aerodynamic heating and structural temperature field. In the flight, especially the long-endurance flight, the structural deformation, caused by the aerodynamic heating and temperature rise, has a direct impact on the aerodynamic heating and structural temperature field. Thus, the coupled interaction cannot be neglected. In this paper, based on the method of static aero-thermo-elasticity, considering the influence of aero-thermo-elasticity deformation, the aerodynamic heating and heat transfer coupled results of hypersonic vehicle wing model were calculated. The results show that, for the low-curvature region, such as fuselage or center-section wing, structure deformation has little effect on temperature field. However, for the stagnation region with high curvature, the coupled effect is not negligible. Thus, it is quite important for the structure temperature prediction to take into account the effect of elastic deformation. This work has laid a solid foundation for improving the prediction accuracy of the temperature distribution of aircraft structures and the evaluation capacity of structural performance.

Keywords: aerothermoelasticity, elastic deformation, structural temperature, multi-field coupling

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Authors: Sudhir Kumar, V. R. Sinha

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Water in oil topical microemulsions of 5-FU were developed and optimized using face centered central composite design. Topical w/o microemulsion of 5-FU were prepared using sorbitan monooleate (Span 80), polysorbate 80 (Tween 80), with different oils such as oleic acid (OA), triacetin (TA), and isopropyl myristate (IPM). The ternary phase diagrams designated the microemulsion region and face centered central composite design helped in determining the effects of selected variables viz. type of oil, smix ratio and water concentration on responses like drug content, globule size and viscosity of microemulsions. The CCD design exhibited that the factors have statistically significant effects (p<0.01) on the selected responses. The actual responses showed excellent agreement with the predicted values as suggested by the CCD with lower residual standard error. Similarly, the optimized values were found within the range as predicted by the model. Furthermore, other characteristics of microemulsions like pH, conductivity were investigated. For the optimized microemulsion batch, ex-vivo skin flux, skin irritation and retention studies were performed and compared with marketed 5-FU formulation. In ex vivo skin permeation studies, higher skin retention of drug and minimal flux was achieved for optimized microemulsion batch then the marketed cream. Results confirmed the actual responses to be in agreement with predicted ones with least residual standard errors. Controlled release of drug was achieved for the optimized batch with higher skin retention of 5-FU, which can further be utilized for the treatment of many dermatological disorders.

Keywords: 5-FU, central composite design, microemulsion, ternanry phase diagram

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Authors: Li-Hsueh Chen

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Efficient operation is more and more important for managers of hotels. Unlike the manufacturing industry, hotels cannot store their products. In addition, many hotels provide room service, and food and beverage service simultaneously. When efficiencies of hotels are evaluated, the internal structure should be considered. Hence, based on the operational characteristics of hotels, this study proposes a DEA model to simultaneously assess the efficiencies among the room production division, food and beverage production division, room service division and food and beverage service division. However, not only the enhancement of efficiency but also the adjustment of scale can improve the performance. In terms of the adjustment of scale, scale elasticity or returns to scale can help to managers to make decisions concerning expansion or contraction. In order to construct a reasonable approach to measure the efficiencies and scale elasticities of hotels, this study builds an alternative variable-returns-to-scale-based two-stage network DEA model with the combination of parallel and series structures to explore the scale elasticities of the whole system, room production division, food and beverage production division, room service division and food and beverage service division based on the data of international tourist hotel industry in Taiwan. The results may provide valuable information on operational performance and scale for managers and decision makers.

Keywords: efficiency, scale elasticity, network data envelopment analysis, international tourist hotel

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Authors: Christopher Giehl, Anja Allabar, Daniela Ehgartner

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Rotational rheometry is standard practice for the viscosity measurement of molten glass, neglecting the viscoelastic properties of this material, especially at temperatures approaching the glass transition. Oscillatory rheometry serves as a powerful toolbox for glass melt characterization beyond viscosity measurements. Heating and cooling rates and the time-dependent visco-elastic behavior influence the temperature where materials undergo the glass transition. This study presents quantitative thermo-mechanical visco-elasticity measurements on three samples in the Na-K-Al-Si-O system. The measurements were performed with a Furnace Rheometer System combined with an air-bearing DSR 502 measuring head (Anton Paar) and a Pt90Rh10 measuring geometry. Temperature ramps were conducted in rotation and oscillation, and the (complex) viscosity values were compared to calculated viscosity values based on sample composition. Furthermore, temperature ramps with different frequencies were conducted, also revealing the frequency-dependence of the shear loss modulus G’’ and the shear storage modulus G’. Here, lower oscillatory frequency results in lower glass transition temperature, as defined by the G’-G’’ crossover point. This contribution demonstrates that oscillatory rheometry serves as a powerful toolbox beyond viscosity measurements, as it considers the visco-elasticity of glass melts quantifying viscous and elastic moduli. Further, it offers a strong definition of Tg beyond the 10^12 Pas concept, which cannot be utilized with rotational viscometry data.

Keywords: frequency dependent glass transition, Na-K-Al-Si-O glass melts, oscillatory rheometry, visco-elasticity

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Authors: Haidy Weliam Megaly Gouda

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Dermatology is often a neglected specialty in low-resource settings despite the high morbidity associated with skin disease. This becomes even more significant when associated with HIV infection, as dermatological conditions are more common and aggressive in HIV-positive patients. African countries have the highest HIV infection rates, and skin conditions are frequently misdiagnosed and mismanaged because of a lack of dermatological training and educational material. The frequent lack of diagnostic tests in the African setting renders basic clinical skills all the more vital. This project aimed to improve the diagnosis and treatment of skin disease in the HIV population in a district hospital in Malawi. A basic dermatological clinical tool was developed and produced in collaboration with local staff and based on available literature and data collected from clinics. The aim was to improve diagnostic accuracy and provide guidance for the treatment of skin disease in HIV-positive patients. A literature search within Embassy, Medline and Google Scholar was performed and supplemented through data obtained from attending 5 Antiretroviral clinics. From the literature, conditions were selected for inclusion in the resource if they were described as specific, more prevalent, or extensive in the HIV population or have more adverse outcomes if they develop in HIV patients. Resource-appropriate treatment options were decided using Malawian Ministry of Health guidelines and textbooks specific to African dermatology. After the collection of data and discussion with local clinical and pharmacy staff, a list of 15 skin conditions was included, and a booklet was created using the simple layout of a picture, a diagnostic description of the disease and treatment options. Clinical photographs were collected from local clinics (with full consent of the patient) or from the book ‘Common Skin Diseases in Africa’ (permission granted if fully acknowledged and used in a not-for-profit capacity). This tool was evaluated by the local staff alongside an educational teaching session on skin disease. This project aimed to reduce uncertainty in diagnosis and provide guidance for appropriate treatment in HIV patients by gathering information into one practical and manageable resource. To further this project, we hope to review the effectiveness of the tool in practice.

Keywords: prevalence and pattern of skin diseases, impact on quality of life, rural Nepal, interventions, quality switched ruby laser, skin color river blindness, clinical signs, circularity index, grey level run length matrix, grey level co-occurrence matrix, local binary pattern, object detection, ring detection, shape identification

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Authors: Sathyaseelan Subramaniam, Jacqueline Bober, Jennifer Chao, Shahriar Zehtabchi

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Background: Emergency physicians frequently evaluate skin and soft tissue infections in order to differentiate abscess from cellulitis. This helps determine which patients will benefit from incision and drainage. Our objective was to determine the operating characteristics of point-of-care ultrasound (POCUS) compared to clinical examination in identifying abscesses in emergency department (ED) patients with features of skin and soft tissue infections. Methods: We performed a comprehensive search in the following databases: Medline, Web of Science, EMBASE, CINAHL and Cochrane Library. Trials were included if they compared the operating characteristics of POCUS with clinical examination in identifying skin and soft tissue abscesses. Trials that included patients with oropharyngeal abscesses or that requiring abscess drainage in the operating room were excluded. The presence of an abscess was determined by pus drainage. No pus seen on incision or resolution of symptoms without pus drainage at follow up, determined the absence of an abscess. Quality of included trials was assessed using GRADE criteria. Operating characteristics of POCUS are reported as sensitivity, specificity, positive likelihood (LR+) and negative likelihood (LR-) ratios and the respective 95% confidence intervals (CI). Summary measures were calculated by generating a hierarchical summary receiver operating characteristic model (HSROC). Results: Out of 3203 references identified, 5 observational studies with 615 patients in aggregate were included (2 adults and 3 pediatrics). We rated the quality of 3 trials as low and 2 as very low. The operating characteristics of POCUS and clinical examination in identifying soft tissue abscesses are presented in the table. The HSROC for POCUS revealed a sensitivity of 96% (95% CI = 89-98%), specificity of 79% (95% CI = 71-86), LR+ of 4.6 (95% CI = 3.2-6.8), and LR- of 0.06 (95% CI = 0.02-0.2). Conclusion: Existing evidence indicates that POCUS is useful in identifying abscesses in ED patients with skin or soft tissue infections.

Keywords: abscess, point-of-care ultrasound, pocus, skin and soft tissue infection

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Authors: Sheikha Turki Alketbi

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Objectives: 1. Documenting the spontaneous resolution of AML following the initiation of anti-TB therapy. 2. Presenting an uncommon type of relapse in Acute Myeloid Leukemia. 3. Highlighting the role of immune markers in the diagnosis of Leukemia cutis. 4. Exploring and highlighting the possibility of skin relapse as the exclusive manifestation, even when skin involvement is known secondary manifestation in AML. Background: Spontaneous remission of Acute Myeloid Leukemia (AML) is a rare phenomenon that has only been reported in some case reports, usually following severe infections. Some studies have described the occurrence of tuberculosis (TB) infection with AML, usually after starting chemotherapy. Spontaneous resolution of AML after starting anti TB therapy (ATT), without starting chemotherapy has never been described in the literature. Moreover, Leukemia cutis is another rare skin manifestation of Acute Myeloid Leukemia as a result of infiltration of the skin or subcutaneous tissue by leukemic cells, in which can present during, precedes, after or independently of systemic leukemia. Methods: Here, we present a case of a 13-year-old male who presented with fever, weight loss, lethargy, epistaxis, bruising and dry cough and was later diagnosed with AML. Before initiating leukemia treatment, the patient was tested for TB and was found to have active TB infection. His leukemia treatment was postponed to clear the TB infection and he was commenced on ATT. Two months later, repeat blood film and bone marrow biopsy showed resolution of his AML. The patient remained in remission for 1 month, after which he presented with symmetrical blue purple well-defined round indurated plaques on the chest and thighs. Our differentials were leukemia cutis and Kaposi sarcoma. Results: Skin Biopsy with immune markers done, showed a picture of Acute Myeloid Leukemia. Immunohistochemistry (IHC) showed neoplastic cells diffusely and strongly positive for LCA, CD2, CD31, MPO, CD117, Lysozymes and TDT, and moderately positive for CD34, CD99, CD43 and CD6 And patchy for CD68. Ki67 showed 60% proliferation index. They were negative for the remaining markers. This suggested acute myeloid leukemia (AML). Conclusion: In summary, we present a rare case of TB with AML that resolved after treatment of TB with ATT but relapsed later as leukemia cutis. While skin involvement might occur as a secondary manifestation of AML, Skin relapse could be the only one.

Keywords: Leukemia cutis, Leukemia relapse, Acute Myeloid Leukemia, spontaneous resolution of AML

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Authors: P. Pasomboon, P. Chumnanpuen, T. E-kobon

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Hyaluronic acid (HA) consists of linear heteropolysaccharides repeat of D-glucuronic acid and N-acetyl-D-glucosamine. HA has various useful properties to maintain skin elasticity and moisture, reduce inflammation, and lubricate the movement of various body parts without causing immunogenic allergy. HA can be found in several animal tissues as well as in the capsule component of some bacteria including Pasteurella multocida. This study aimed to modify a genome-scale metabolic model of Escherichia coli using computational simulation and flux analysis methods to predict HA productivity under different carbon sources and nitrogen supplement by the addition of two enzymes (GLMU2 and HYAD) from P. multocida to improve the HA production under the specified amount of carbon sources and nitrogen supplements. Result revealed that threonine and aspartate supplement raised the HA production by 12.186%. Our analyses proposed the genome-scale metabolic model is useful for improving the HA production and narrows the number of conditions to be tested further.

Keywords: Pasteurella multocida, Escherichia coli, hyaluronic acid, genome-scale metabolic model, bioinformatics

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Authors: F. Farzan Nasab, H. J. M. Geijselaers, I. Baran, A. De Boer

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A method is introduced for the coupled skin-rib optimization of a wing box where mass minimization is the objective and local buckling is the constraint. The structure is made of composite materials where continuity of plies in multiple adjacent panels (blending) has to be satisfied. Blending guarantees the manufacturability of the structure; however, it is a highly challenging constraint to treat and has been under debate in recent research in the same area. To fulfill design guidelines with respect to symmetry, balance, contiguity, disorientation and percentage rule of the layup, a reference for the stacking sequences (stacking sequence table or SST) is generated first. Then, an innovative fully gradient-based optimization approach in relation to a specific SST is introduced to obtain the optimum thickness distribution all over the structure while blending is fulfilled. The proposed optimization approach aims to turn the discrete optimization problem associated with the integer number of plies into a continuous one. As a result of a wing box deflection, a rib is subjected to load values which vary nonlinearly with the amount of deflection. The bending stiffness of a skin affects the wing box deflection and thus affects the load applied to a rib. This indicates the necessity of a coupled skin-rib optimization approach for a more realistic optimized design. The proposed method is examined with the optimization of the layup of a composite stiffened skin and rib of a wing torsion box subjected to in-plane normal and shear loads. Results show that the method can successfully prescribe a valid design with a significantly cheap computation cost.

Keywords: blending, buckling optimization, composite panels, wing torsion box

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Authors: Oya Umit Yemisci, Nur Saracgil Cosar, Tubanur Ozturk Sisman, Selin Ozen

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Chronic autoimmune thyroiditis (AIT) may result in a wide spectrum of reversible abnormalities in the neuromuscular function. Usually, proximal muscle-related symptoms and neuropathic findings such as mild axonal peripheral neuropathy have been reported. Sympathetic skin responses are useful in evaluating sudomotor activity of the unmyelinated sympathetic fibers of the autonomic nervous system. Neurocognitive impairment may also be a prominent feature of hypothyroidism, particularly in elderly patients. Electromyographic reaction times as a highly sensitive parameter provides. Objective data concerning cognitive and motor functions. The aim of this study was to evaluate peripheral nerve functions, sympathetic skin response and electroneuromyographic (ENMG) reaction times in euthyroid and subclinically hypothyroid patients with a diagnosis of AIT and compare to those of a control group. Thirty-five euthyroid, 19 patients with subclinical hypothyroidism and 35 age and sex-matched healthy subjects were included in the study. Motor and sensory nerve conduction studies, sympathetic skin responses recorded from hand and foot by stimulating contralateral median nerve and simple reaction times by stimulating tibial nerve and recording from extensor indicis proprius muscle were performed to all patients and control group. Only median nerve sensory conduction velocities of the forearm were slower in patients with AIT compared to the control group (p=0.019). Otherwise, nerve conduction studies and sympathetic skin responses showed no significant difference between the patients and the control group. However, reaction times were shorter in the healthy subjects compared to AIT patients. Prolongation in the reaction times may be considered as a parameter reflecting the alterations in the cognitive functions related to the primary disease process in AIT. Combining sympathetic skin responses with more quantitative tests such as cardiovascular tests and sudomotor axon reflex testing may allow us to determine higher rates of involvement of the autonomic nervous system in AIT.

Keywords: sympathetic skin response, simple reaction time, chronic autoimmune thyroiditis

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Authors: Syazwani Ramli, Norhidayu Muhamad Zain

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Nowadays, the use of gelatin as biomaterials in tissue engineering are evolving especially in skin graft and wound dressing applications. Towards year 2018, Malaysia is in the way of planning to get the halal certification for biomedical device in order to cater the needs of Muslims and non-Muslims in Malaysia. However, the use of gelatins in tissue engineering are mostly derived from non-halal sources. Currently, gelatin production mostly comes from mammalian gelatin sources. Moreover, within these past years, just a few studies of the uses of gelatin in tissue engineering from halal perspective has been studied. Thus, this paper aims to give overview of the use of gelatin from different sources from halal perspectives. This review also discussing the current status of halal for the emerging biomedical devices. In addition, the different sources of gelatin used in tissue engineering are being identified and provides better alternatives for halal gelatin. Cold- water fish skin gelatin could be an effective alternative to substitute the mammalian sources. Therefore, this review is important because the information about the halal biomedical devices will delighted Muslim consumers and give better insight of halal gelatin in tissue engineering application.

Keywords: biomedical device, gelatin, halal, skin graft, tissue engineering

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Authors: R. Pilafkan, M. Kaffash Irzarahimi, S. F. Asbaghian Namin

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The biaxial buckling behavior of single-layered graphene sheets (SLGSs) is studied in the present work. To consider the size-effects in the analysis, Eringen’s nonlocal elasticity equations are incorporated into classical plate theory (CLPT). A Generalized Differential Quadrature Method (GDQM) approach is utilized and numerical solutions for the critical buckling loads are obtained. Then, molecular dynamics (MD) simulations are performed for a series of zigzag SLGSs with different side-lengths and with various boundary conditions, the results of which are matched with those obtained by the nonlocal plate model to numerical the appropriate values of nonlocal parameter relevant to each type of boundary conditions.

Keywords: biaxial buckling, single-layered graphene sheets, nonlocal elasticity, molecular dynamics simulation, classical plate theory

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Authors: Hritwik Ghosh, Irfan Sadiq Rahat, Sachi Nandan Mohanty, J. V. R. Ravindra

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In the rapidly evolving landscape of medical diagnostics, the early detection and accurate classification of skin cancer remain paramount for effective treatment outcomes. This research delves into the transformative potential of Artificial Intelligence (AI), specifically Deep Learning (DL), as a tool for discerning and categorizing various skin conditions. Utilizing a diverse dataset of 3,000 images representing nine distinct skin conditions, we confront the inherent challenge of class imbalance. This imbalance, where conditions like melanomas are over-represented, is addressed by incorporating class weights during the model training phase, ensuring an equitable representation of all conditions in the learning process. Our pioneering approach introduces a hybrid model, amalgamating the strengths of two renowned Convolutional Neural Networks (CNNs), VGG16 and ResNet50. These networks, pre-trained on the ImageNet dataset, are adept at extracting intricate features from images. By synergizing these models, our research aims to capture a holistic set of features, thereby bolstering classification performance. Preliminary findings underscore the hybrid model's superiority over individual models, showcasing its prowess in feature extraction and classification. Moreover, the research emphasizes the significance of rigorous data pre-processing, including image resizing, color normalization, and segmentation, in ensuring data quality and model reliability. In essence, this study illuminates the promising role of AI and DL in revolutionizing skin cancer diagnostics, offering insights into its potential applications in broader medical domains.

Keywords: artificial intelligence, machine learning, deep learning, skin cancer, dermatology, convolutional neural networks, image classification, computer vision, healthcare technology, cancer detection, medical imaging

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Authors: U. Umadevi, T. Umakanthan

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Globally, mycotic dermatitis is very common but there is no single proven specific allopathic treatment regimen. In this study, domestic animals with skin diseases of different age and breed from geographically varied regions of Tamil Nadu state, India were employed. Most of them have had previous treatment with native and allopathic medicines without success. Clinically, the skin lesions were found to be mild to severe. The trial animals were treated with poly herbal formulation (ointment) prepared using the indigenous medicinal plants – viz Andrographis paniculata, Lawsonia inermis and Madhuca longifolia. Allopathic antifungal drugs and ointments, povidone iodine and curabless (Terbinafine HCl, Ofloxacin, Ornidazole, Clobetasol propionate) were used in control. Comparatively, trial animals were found to have lesser course of treatment time and higher recovery rate than control. In Ethnoveterinary, this combination was tried for the first time. This herbal formulation is economical and an alternative for skin diseases.

Keywords: allopathic drugs, dermatitis, domestic animals, poly herbal formulation

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Authors: Jiang Zhenbo, Ishikura Ryohei, Yasufuku Noriyuki

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Improvement of soft clay deposits by the combination of surface stabilization and floating type cement-treated columns is one of the most popular techniques worldwide. On the basis of one dimensional consolidation model, a time-dependent skin friction model for the column-soil interaction is proposed. The nonlinear relationship between column shaft shear stresses and effective vertical pressure of the surrounding soil can be described in this model. The influence of column-soil surface roughness can be represented using a roughness coefficient R, which plays an important role in the design of column length. Based on the homogenization method, a part of floating type improved ground will be treated as an unimproved portion, which with a length of αH1 is defined as a time-dependent equivalent skin friction length. The compression settlement of this unimproved portion can be predicted only using the soft clay parameters. Apart from calculating the settlement of this composited ground, the load transfer mechanism is discussed utilizing model tests. The proposed model is validated by comparing with calculations and laboratory results of model and ring shear tests, which indicate the suitability and accuracy of the solutions in this paper.

Keywords: floating type improved foundation, time-dependent skin friction, roughness, consolidation

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Authors: Sheam-Chyun Lin, Wei-Kai Chen, Hung-Cheng Yen, Yung-Jen Cheng, Yu-Cheng Chen

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Result from the constant dwindle in natural resources, the alternative way to reduce the costs in our daily life would be urgent to be found in the near future. As the ancient technique based on the theory of solar chimney since roman times, the double-skin façade are simply composed of two large glass panels in purpose of daylighting and also natural ventilation in the daytime. Double-skin façade is generally installed on the exterior side of buildings as function as the window, so there’s always a huge amount of passive solar energy the façade would receive to induce the airflow every sunny day. Therefore this article imposes a domestic double-skin window for residential usage and attempts to improve the volume flow rate inside the cavity between the panels by the frame geometry design, the installation of outlet guide plate and the solar energy collection system. Note that the numerical analyses are applied to investigate the characteristics of flow field, and the boundary conditions in the simulation are totally based on the practical experiment of the original prototype. Then we redesign the prototype from the knowledge of the numerical results and fluid dynamic theory, and later the experiments of modified prototype will be conducted to verify the simulation results. The velocities at the inlet of each case are increase by 5%, 45% and 15% from the experimental data, and also the numerical simulation results reported 20% improvement in volume flow rate both for the frame geometry design and installation of outlet guide plate.

Keywords: solar energy, double-skin façades, thermal buoyancy, fluid machinery

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Authors: Abdulaziz Alakeel, Abdulrahman Alomair, Mohammed Fouda

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Introduction: Methotrexate (MTX) is an antimetabolite used to treat multiple conditions, including neoplastic diseases, severe psoriasis, and rheumatoid arthritis. Skin cancer is the out-of-control growth of abnormal cells in the epidermis, the outermost skin layer, caused by unrepaired DNA damage that triggers mutations. These mutations lead the skin cells to multiply rapidly and form malignant tumors. The aim of this review is to evaluate the risk of skin cancer associated with the use of methotrexate and to suggest regulatory recommendations if required. Methodology: Signal Detection team at Saudi Food and Drug Authority (SFDA) performed a safety review using National Pharmacovigilance Center (NPC) database as well as the World Health Organization (WHO) VigiBase, alongside with literature screening to retrieve related information for assessing the causality between skin cancer and methotrexate. The search conducted in July 2020. Results: Four published articles support the association seen while searching in literature, a recent randomized control trial published in 2020 revealed a statistically significant increase in skin cancer among MTX users. Another study mentioned methotrexate increases the risk of non-melanoma skin cancer when used in combination with immunosuppressant and biologic agents. In addition, the incidence of melanoma for methotrexate users was 3-fold more than the general population in a cohort study of rheumatoid arthritis patients. The last article estimated the risk of cutaneous malignant melanoma (CMM) in a cohort study shows a statistically significant risk increase for CMM was observed in MTX exposed patients. The WHO database (VigiBase) searched for individual case safety reports (ICSRs) reported for “Skin Cancer” and 'Methotrexate' use, which yielded 121 ICSRs. The initial review revealed that 106 cases are insufficiently documented for proper medical assessment. However, the remaining fifteen cases have extensively evaluated by applying the WHO criteria of causality assessment. As a result, 30 percent of the cases showed that MTX could possibly cause skin cancer; five cases provide unlikely association and five un-assessable cases due to lack of information. The Saudi NPC database searched to retrieve any reported cases for the combined terms methotrexate/skin cancer; however, no local cases reported up to date. The data mining of the observed and the expected reporting rate for drug/adverse drug reaction pair is estimated using information component (IC), a tool developed by the WHO Uppsala Monitoring Centre to measure the reporting ratio. Positive IC reflects higher statistical association, while negative values translated as a less statistical association, considering the null value equal to zero. Results showed that a combination of 'Methotrexate' and 'Skin cancer' observed more than expected when compared to other medications in the WHO database (IC value is 1.2). Conclusion: The weighted cumulative pieces of evidence identified from global cases, data mining, and published literature are sufficient to support a causal association between the risk of skin cancer and methotrexate. Therefore, health care professionals should be aware of this possible risk and may consider monitoring any signs or symptoms of skin cancer in patients treated with methotrexate.

Keywords: methotrexate, skin cancer, signal detection, pharmacovigilance

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