Search results for: clinical laboratory results

Authors: Natcha Lueangapapong, Chariya Chuthapisith, Lunliya Thampratankul

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Background: There is a need to find an appropriate tool to help healthcare providers determine sleep problems in children for early diagnosis and management. The Japanese Sleep Questionnaire for Preschoolers (JSQ-P) is a parent-reported sleep questionnaire that has good psychometric properties and can be used in the context of Asian culture, which is likely suitable for Thai children. Objectives: This study aimed to translate and validate the Japanese Sleep Questionnaire for Preschoolers (JSQ-P) into a Thai version and to evaluate factors associated with sleep disorders in preschoolers. Methods: After approval by the original developer, the cross-cultural adaptation process of JSQ-P was performed, including forward translation, reconciliation, backward translation, and final approval of the Thai version of JSQ-P (TH-JSQ-P) by the original creator. This study was conducted between March 2021 and February 2022. The TH-JSQ-P was completed by 2,613 guardians whose children were aged 2-6 years twice in 10-14 days to assess its reliability and validity. Content validity was measured by an index of item-objective congruence (IOC) and a content validity index (CVI). Face validity, content validity, structural validity, construct validity (discriminant validity), criterion validity and predictive validity were assessed. The sensitivity and specificity of the TH-JSQ-P were also measured by using a total JSQ-P score cutoff point 84, recommended by the original JSQ-P and each subscale score among the clinical samples of obstructive sleep apnea syndrome. Results: Internal consistency reliability, evaluated by Cronbach’s α coefficient, showed acceptable reliability in all subscales of JSQ-P. It also had good test-retest reliability, as the intraclass correlation coefficient (ICC) for all items ranged between 0.42-0.84. The content validity was acceptable. For structural validity, our results indicated that the final factor solution for the Th-JSQ-P was comparable to the original JSQ-P. For construct validity, age group was one of the clinical parameters associated with some sleep problems. In detail, parasomnias, insomnia, daytime excessive sleepiness and sleep habits significantly decreased when the children got older; on the other hand, insufficient sleep was significantly increased with age. For criterion validity, all subscales showed a correlation with the Epworth Sleepiness Scale (r = -0.049-0.349). In predictive validity, the Epworth Sleepiness Scale was significantly a strong factor that correlated to sleep problems in all subscales of JSQ-P except in the subscale of sleep habit. The sensitivity and specificity of the total JSQ-P score were 0.72 and 0.66, respectively. Conclusion: The Thai version of JSQ-P has good internal consistency reliability and test-retest reliability. It passed 6 validity tests, and this can be used to evaluate sleep problems in preschool children in Thailand. Furthermore, it has satisfactory general psychometric properties and good reliability and validity. The data collected in examining the sensitivity of the Thai version revealed that the JSQ-P could detect differences in sleep problems among children with obstructive sleep apnea syndrome. This confirmed that the measure is sensitive and can be used to discriminate sleep problems among different children.

Keywords: preschooler, questionnaire, validation, Thai version

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Authors: Bipul Behari Saha, Sunil Kumar Singh, P. Padmaja, Kamlesh Vishwakarma

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Dissipation study of tebuconazole in alluvial, black and deep-black clayey soils collected from paddy, mango and peanut cropland of tropical agro-climatic zone of India at three concentration levels were carried out for monitoring the water contamination through persisted residual toxicity. The soil-slurry samples were analyzed by capillary GC-NPD methods followed by ultrasound-assisted extraction (UAE) technique and cleanup process. An excellent linear relationship between peak area and concentration obtained in the range 1 to 50 μgkg-1. The detection (S/N, 3 ± 0.5) and quantification (S/N, 7.5 ± 2.5) limits were 3 and 10 μgkg-1 respectively. Well spiked recoveries were achieved from 96.28 to 99.33 % at levels 5 and 20 μgkg-1 and method precision (% RSD) was ≤ 5%. The soils dissipation of tebuconazole was fitted in first order kinetic-model with half-life between 34.48 to 48.13 days. The soil organic-carbon (SOC) content correlated well with the dissipation rate constants (DRC) of the fungicide Tebuconazole. An increase in the SOC content resulted in faster dissipation. The results indicate that the soil organic carbon and tebuconazole concentrations plays dominant role in dissipation processes. The initial concentration illustrated that the degradation rate of tebuconazole in soils was concentration dependent.

Keywords: cropland soil, dissipation, laboratory incubation, tebuconazole

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Authors: Keivan Jamshidi, Afshin Zahedi

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Acrylamide (ACR) has been shown to cause neurotoxic effects in humans and neurotoxic, genotoxic, reproductive, and carcinogenic effects in laboratory animals. To investigate the nephrotoxic effect of Acrylamide (ACR), 50 adult male rats (Wistar, approximately 250 g) housed in polycarbonate boxes as 5 per each, and randomly assigned in 5 groups including 4 exposure groups as A, B, C, and D groups of rats (10 rats per exposure group., total) and were exposed to 0.5, 5, 50, 100 mg/kg ACR per day×11days i.p. respectively. The remaining 10 rats were housed in group (E) as control group. Control rats received daily i.p. injections of 0.9% saline (3ml/kg). On day 12, four rats, were randomly selected, perfused , dissected and proper samples were collected from their kidneys. Results of histopathological studies based on H&E technique did show no morphologic changes in kidneys of rats belong to groups A, B and E, while moderate to severe morphologic changes including glomerular hypercellularity, global pattern of proliferative glomerulonephritis, occupation of capsular space, tubular cell swelling and hyaline cast formation, were observed in different stained sections obtained from the kidneys of rats belong to group, C, and D. This finding, beside neurotoxic, reproductive and carcinogenic effects, seems to indicate for the first time another important aspect of toxic effect of ACR, i.e., acute nephrotoxicity.

Keywords: acrylamide, nephrotoxicity, glomerulonephritis, rats

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Authors: Wei-Chih Huang, Pei-Lung Chung, Ching-Heng Lin, Hsuan-Chia Yang, Der-Ming Liou

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Background: In-Hospital Cardiac Arrest (IHCA) threaten life of the inpatients, cause serious effect to patient safety, quality of inpatients care and hospital service. Health providers must identify the signs of IHCA early to avoid the occurrence of IHCA. This study will consider the potential association between early signs of IHCA and the essence of patient care provided by nurses and other professionals before an IHCA occurs. The aim of this study is to identify significant associations between nursing interventions and abnormal early evaluation results of IHCA that can assist health care providers in monitoring inpatients at risk of IHCA to increase opportunities of IHCA early detection and prevention. Materials and Methods: This study used one of the data mining techniques called association rules mining to compute associations between nursing interventions and abnormal early evaluation results of IHCA. The nursing interventions and abnormal early evaluation results of IHCA were considered to be co-occurring if nursing interventions were provided within 24 hours of last being observed in abnormal early evaluation results of IHCA. The rule based methods were utilized 23.6 million electronic medical records (EMR) from a medical center in Taipei, Taiwan. This dataset includes 733 concepts of nursing interventions that coded by clinical care classification (CCC) codes and 13 early evaluation results of IHCA with binary codes. The values of interestingness and lift were computed as Q values to measure the co-occurrence and associations’ strength between all in-hospital patient care measures and abnormal early evaluation results of IHCA. The associations were evaluated by comparing the results of Q values and verified by medical experts. Results and Conclusions: The results show that there are 4195 pairs of associations between nursing interventions and abnormal early evaluation results of IHCA with their Q values. The indication of positive association is 203 pairs with Q values greater than 5. Inpatients with high blood sugar level (hyperglycemia) have positive association with having heart rate lower than 50 beats per minute or higher than 120 beats per minute, Q value is 6.636. Inpatients with temporary pacemaker (TPM) have significant association with high risk of IHCA, Q value is 47.403. There is significant positive correlation between inpatients with hypovolemia and happened abnormal heart rhythms (arrhythmias), Q value is 127.49. The results of this study can help to prevent IHCA from occurring by making health care providers early recognition of inpatients at risk of IHCA, assist with monitoring patients for providing quality of care to patients, improve IHCA surveillance and quality of in-hospital care.

Keywords: in-hospital cardiac arrest, patient safety, nursing intervention, association rule mining

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Authors: Hatem A. El-Mezayen, Ahmed Abdelmajeed, Fatehya Metwally, Usama Elsaly, Salwa Atef

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Tumor metastasis involves the dissemination of malignant cells into the basement membrane and vascular system contributes to the circulating pool of these markers. In this context our aim has been focused on development of a non-invasive. Circulating tumor cells (CTCs) represent a unique liquid biopsy carrying comprehensive biological information of the primary tumor. Herein, we sought to develop a novel score based on the combination of the most significant CTCs biomarkers with and routine laboratory tests for accurate detection of metastatic breast cancer. Methods: Cytokeratin 18 (CK18), Cytokeratin 19 (CK19), and CA15.3 were assayed in metastatic breast cancer (MBC) patients (75), non-MBC patients (50) and healthy control (20). Results: Areas under receiving operating curve (AUCs) were calculated and used for construction on novel score. A novel score named MBC-CTCs = CA15.3 (U/L) × 0.08 + CK 18 % × 2.9 + CK19 × 3.1– 510. That function correctly classified 87% of metastatic breast cancer at cut-off value = 0.55. (i.e great than 0.55 indicates patients with metastatic breast cancer and less than 0.55 indicates patients with non-metastatic breast cancer). Conclusion: MBC-CTCs is a novel, non-invasive and simple can applied to discriminate patients with metastatic breast cancer.

Keywords: metastatic breast cancer, circulating tumor cells, cytokeratin, EpiCam

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Authors: Taylin L. Peoples, Lauren Lewis, Sebastian G. Risco, Devin Mills

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The impact of problematic drinking (PD) on the health of U.S. adults continues to be a concerning issue. Additionally, the U.S. Surgeon General recently highlighted the isolation epidemic, bringing attention to the significant and detrimental impact of loneliness. Research has found PD to be associated with deficits in feeling connection towards others. This suggests that one consequence of the isolation epidemic is the greater severity of PD. Further, PD has long been associated with three dark personality traits (i.e., narcissism, Machiavellianism, psychopathy), which may be explained by interpersonal factors but has yet to be examined. Therefore, the present study assessed the extent to which thwarted belongingness (TB) and perceived burdensomeness (PB) explain the relationship between dark personality traits and PD. Data was collected from 606 US adults reporting alcohol consumption. The participants completed the Interpersonal Needs Questionnaire, the Short Dark Triad scale, and the Alcohol Use Disorders Identification Test. Results from a path analysis supported the hypothesis that dark traits are associated with more severe PD through both PB and TB. The present results underscore the role of connection to others, as defined by TB and PB, in facilitating the relationship between dark personality traits and PD. Future research is needed in this area to develop preventative strategies and policies as well as clinical interventions. In sum, the findings offer a novel perspective on the intersection of personality traits, PB and TB, and PD.

Keywords: problem drinking, personality, dark traits, dark traid, thwarted belonginess, perceived burdensomeness

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Authors: Lina, Arlends Chris, Bagus Mulyawan, Agus B. Dharmawan

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Blood cell analysis plays a significant role in the diagnosis of human health. As an alternative to the traditional technique conducted by laboratory technicians, this paper presents an automatic white blood cell (leukocyte) detection system using Image Stitching and Color Overlapping Windows. The advantage of this method is to present a detection technique of white blood cells that are robust to imperfect shapes of blood cells with various image qualities. The input for this application is images from a microscope-slide translation video. The preprocessing stage is performed by stitching the input images. First, the overlapping parts of the images are determined, then stitching and blending processes of two input images are performed. Next, the Color Overlapping Windows is performed for white blood cell detection which consists of color filtering, window candidate checking, window marking, finds window overlaps, and window cropping processes. Experimental results show that this method could achieve an average of 82.12% detection accuracy of the leukocyte images.

Keywords: color overlapping windows, image stitching, leukocyte detection, white blood cell detection

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Authors: H. A. Lopez-Aguilar, E. A. Huerta-Reynoso, J. A. Gomez, J. A. Duarte-Moller, A. Perez-Hernandez

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Environmental performance of artisanal brick manufacture was studied by Lifecycle Assessment (LCA) methodology and Computational Fluid Dynamics (CFD) analysis in Mexico. The main objective of this paper is to evaluate the environmental impact during artisanal brick manufacture. LCA cradle-to-gate approach was complemented with CFD analysis to carry out an Environmental Impact Assessment (EIA). The lifecycle includes the stages of extraction, baking and transportation to the gate. The functional unit of this study was the production of a single brick in Chihuahua, Mexico and the impact categories studied were carcinogens, respiratory organics and inorganics, climate change radiation, ozone layer depletion, ecotoxicity, acidification/ eutrophication, land use, mineral use and fossil fuels. Laboratory techniques for fuel characterization, gas measurements in situ, and AP42 emission factors were employed in order to calculate gas emissions for inventory data. The results revealed that the categories with greater impacts are ecotoxicity and carcinogens. The CFD analysis is helpful in predicting the thermal diffusion and contaminants from a defined source. LCA-CFD synergy complemented the EIA and allowed us to identify the problem of thermal efficiency within the system.

Keywords: LCA, CFD, brick, artisanal

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Authors: Behnam Shakerian, Negin Razavi

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The pathogenesis of coronary artery disease is multifactorial. The epicardial fat pad is a localized fat depot lying between the myocardium and the visceral layer of the pericardium. The mechanisms through which epicardial fat pad can cause atherosclerosis are complex. The epicardial fat pad can surround the coronary arteries and contributes to the development and progression of coronary artery disease. Methods: we selected 50 patients who underwent coronary artery angiography for the evaluation of coronary artery disease that results were positive for coronary artery disease. All patients underwent an echocardiographic examination after coronary angiography to measure epicardial fat pad thickness. The epicardial fat pad was defined as an echo-free space between the myocardium's outer wall and the pericardium's visceral layer. Results: The epicardial fat pad was measured on the right ventricle apex in 46 patients. Sixty- five percent of the studied patients were male. The most common vessel with stenosis was the left anterior descending artery. A significant correlation was observed between epicardial fat pad thickness and the severity of coronary artery disease. Discussions: The epicardial fat pad provides a horizon on the pathophysiology of cardiovascular diseases. It directly contributes to the development and progression of coronary artery disease by causing inflammation and endothelial damage. Further investigations are needed to determine whether medical treatment can reduce the mass of epicardial fat pad and can help to improve atherosclerosis. Conclusion: The epicardial fat pad measurement could be used as an indicator of coronary arteries’ atherosclerosis. Therefore, thickness measurement of the epicardial fat pad in the clinical practice could be of assistance in identifying patients at risk and if required, undergoing supplementary diagnosis with coronary angiography.

Keywords: epicardial, fat pad, coronary artery disease, echocardiography

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Authors: Charintorn Suwannawong, Tananpon Yavilas, Sopida Boonaneksap, Chotika Viriyarattanasak, Chairath Tangduangdee

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With increasing aging population and health conscious consumers, the demand for health promoting products such as functional foods, dietary supplements, and nutraceutical products has continuously increased in Thailand. Nevertheless, the strategic framework for regulatory functional food developments in Thailand is still unclear. The objective of this study was to survey stakeholders’ perspectives on three scopes, consisting of 1) the current status 2) obstacles, and 3) future trend for the development and production of functional foods in Thailand. A survey was conducted by interviewing ten experts from governmental organization, industrial sector and academic institute. The obtained results show that there is no established definition for functional foods in Thailand. There is a variety of raw materials that are capable to be potential ingredients for functional food production in Thailand and exported to global market. However, the scaling up technology into a commercial production is limited. Moreover, there is a need to establish the infrastructures, such as testing laboratory, and regulatory standards for quality control and ensuring product safety. This information is useful for government in the development of the strategic framework and policy statement on improvement of functional food industry in Thailand.

Keywords: functional foods, interview, perspective, Thailand

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Authors: Clara Tramuta, Lucia Decastelli, Elisa Barcucci, Sandra Fragassi, Samantha Lupi, Enrico Arletti, Melissa Bizzarri, Daniela Manila Bianchi

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Introdution: Food allergies occurs, in the Western World, 2% of adults and up to 8% of children. The protection of allergic consumers is guaranted, in Eurrope, by Regulation (EU) No 1169/2011 of the European Parliament which governs the consumer's right to information and identifies 14 food allergens to be mandatory indicated on the label. Among these, mustard is a popular spice added to enhance the flavour and taste of foods. It is frequently present as an ingredient in spice blends, marinades, salad dressings, sausages, and other products. Hypersensitivity to mustard is a public health problem since the ingestion of even low amounts can trigger severe allergic reactions. In order to protect the allergic consumer, high performance methods are required for the detection of allergenic ingredients. Food safety laboratories rely on validated methods that detect hidden allergens in food to ensure the safety and health of allergic consumers. Here we present the test results for the validation and accreditation of a Real time PCR assay (RT-PCR: SPECIALfinder MC Mustard, Generon), for the detection of mustard traces in food. Materials and Methods. The method was tested on five classes of food matrices: bakery and pastry products (chocolate cookies), meats (ragù), ready-to-eat (mixed salad), dairy products (yogurt), grains, and milling products (rice and barley flour). Blank samples were spiked starting with the mustard samples (Sinapis Alba), lyophilized and stored at -18 °C, at a concentration of 1000 ppm. Serial dilutions were then prepared to a final concentration of 0.5 ppm, using the DNA extracted by ION Force FAST (Generon) from the blank samples. The Real Time PCR reaction was performed by RT-PCR SPECIALfinder MC Mustard (Generon), using CFX96 System (BioRad). Results. Real Time PCR showed a limit of detection (LOD) of 0.5 ppm in grains and milling products, ready-to-eat, meats, bakery, pastry products, and dairy products (range Ct 25-34). To determine the exclusivity parameter of the method, the ragù matrix was contaminated with Prunus dulcis (almonds), peanut (Arachis hypogaea), Glycine max (soy), Apium graveolens (celery), Allium cepa (onion), Pisum sativum (peas), Daucus carota (carrots), and Theobroma cacao (cocoa) and no cross-reactions were observed. Discussion. In terms of sensitivity, the Real Time PCR confirmed, even in complex matrix, a LOD of 0.5 ppm in five classes of food matrices tested; these values are compatible with the current regulatory situation that does not consider, at international level, to establish a quantitative criterion for the allergen considered in this study. The Real Time PCR SPECIALfinder kit for the detection of mustard proved to be easy to use and particularly appreciated for the rapid response times considering that the amplification and detection phase has a duration of less than 50 minutes. Method accuracy was rated satisfactory for sensitivity (100%) and specificity (100%) and was fully validated and accreditated. It was found adequate for the needs of the laboratory as it met the purpose for which it was applied. This study was funded in part within a project of the Italian Ministry of Health (IZS PLV 02/19 RC).

Keywords: allergens, food, mustard, real time PCR

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Authors: Robert E. Kenney, Efrain Antunez, Samuel Nodal, Ameer Malik, Richard B. Aguilar

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Physician burnout has gained much attention during the COVID pandemic. After-hours workload, HCC coding, HEDIS metrics, and clinical documentation negatively impact career satisfaction. These and other influences have increased the rate of physicians leaving the workforce. In addition, roughly 1% of the entire physician workforce will be retiring earlier than expected based on pre-pandemic trends. The two Medical Specialties with the highest rates of burnout are Family Medicine and Primary Care. With a predicted shortage of primary care physicians looming, the need to address physician burnout is crucial. Commonly reported issues leading to clinician burnout are clerical documentation requirements, increased time working on Electronic Health Records (EHR) after hours, and a decrease in work-life balance. Clinicians experiencing burnout with physical and emotional exhaustion are at an increased likelihood of providing lower quality and less efficient patient care. This may include a lack of suitable clinical documentation, medication reconciliation, clinical assessment, and treatment plans. While the annual baseline turnover rates of physicians hover around 6-7%, the COVID pandemic profoundly disrupted the delivery of healthcare. A report found that 43% of physicians switched jobs during the initial two years of the COVID pandemic (2020 and 2021), tripling the expected average annual rate to 21.5 %/yr. During this same time, an average of 4% and 1.5% of physicians retired or left the workforce for a non-clinical career, respectively. The report notes that 35.2% made career changes for a better work-life balance and another 35% reported the reason as being unhappy with their administration’s response to the pandemic. A physician-led primary care-focused health organization, Cano Health (CH), based out of Florida, sought to preemptively address this problem by implementing several supportive measures. Working with >120 clinics and >280 PCPs from Miami to Tampa and Orlando, managing nearly 120,000 Medicare Advantage lives, CH implemented a number of changes to assist with the clinician’s workload. Supportive services such as after hour and home visits by APRNs, in-clinic care managers, and patient educators were implemented. In 2021, assistive Artificial Intelligence Software (AIS) was integrated into the EHR platform. This AIS converts free text within PDF files into a usable (copy-paste) format facilitating documentation. The software also systematically and chronologically organizes clinical data, including labs, medical records, consultations, diagnostic images, medications, etc., into an easy-to-use organ system or chronic disease state format. This reduced the excess time and documentation burden required to meet payor and CMS guidelines. A clinician Documentation Support team was employed to improve the billing/coding performance. The effects of these newly designed workflow interventions were measured via analysis of clinician turnover from CH’s hiring and termination reporting software. CH’s annualized average clinician turnover rate in 2020 and 2021 were 17.7% and 12.6%, respectively. This represents a 30% relative reduction in turnover rate compared to the reported national average of 21.5%. Retirement rates during both years were 0.1%, demonstrating a relative reduction of >95% compared to the national average (4%). This model successfully promoted the retention of clinicians in a Value-Based Care setting.

Keywords: clinician burnout, COVID-19, value-based care, burnout, clinician retirement

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Authors: Lisa Bennett, Cynthia Walters, Cynthia Argani, Andy Satin, Geeta Sood, Kerri Huber, Lisa Grubb, Woodrow Noble, Melissa Eichelberger, Darlene Zinalabedini, Eric Ausby, Jeffrey Snyder, Kevin Kirchoff

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Background: Surgical site infections (SSIs) within the obstetric population pose a variety of complications, creating clinical and personal challenges for the new mother and her neonate during the postpartum period. Our journey to achieve compliance with the SSI core measure for cesarean sections revealed many opportunities to improve these outcomes. Objective: Achieve and sustain core measure compliance keeping surgical site infection rates below the national benchmark pooled mean of 1.8% in post-operative patients, who delivered via cesarean section at the Johns Hopkins Bayview Medical Center. Methods: A root cause analysis was performed and revealed several environmental, pharmacologic, and clinical practice opportunities for improvement. A multidisciplinary approach led by the OB Safety Nurse, OB Medical Director, and Infectious Disease Department resulted in the implementation of fourteen interventions over a twenty-month period. Interventions included: post-operative dressing changes, standardizing operating room attire, broadening pre-operative antibiotics, initiating vaginal preps, improving operating room terminal cleaning, testing air quality, and re-educating scrub technicians on technique. Results: Prior to the implementation of our interventions, the SSI quarterly rate in Obstetrics peaked at 6.10%. Although no single intervention resulted in dramatic improvement, after implementation of all fourteen interventions, the quarterly SSI rate has subsequently ranged from to 0.0% to 2.70%. Significance: Taking an introspective look at current practices can reveal opportunities for improvement which previously were not considered. Collectively the benefit of these interventions has shown a significant decrease in surgical site infection rates. The impact of this quality improvement project highlights the synergy created when members of the multidisciplinary team work in collaboration to improve patient safety, and achieve a high quality of care.

Keywords: cesarean section, surgical site infection, collaboration and teamwork, patient safety, quality improvement

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Authors: R. N. Khare, J. P. Sahu, Rajesh Kumar Tamrakar

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Tests were conducted to determine the property of soil with variation of H2SO4 content for soils under different stage. The soils had varying amounts of plasticity’s ranging from low to high plasticity. The unsaturated soil behavior was investigated for different conditions, covering a range of compactive efforts and water contents. The soil characteristic curves were more sensitive to changes in compaction effort than changes in compaction water content. In this research paper two types of water (Ground water Ph =7.9, Turbidity= 13 ppm; Cl =2.1mg/l and surface water Ph =8.65; Turbidity=18.5; Cl=1mg/l) were selected of Bhilai Nagar, State-Chhattisgarh, India which is mixed with a certain type of soil. Results shows that by the presence of ground water day by day the particles are becoming coarser in 7 days thereafter its size reduces; on the other hand by the presence of surface water the courser particles are disintegrating, finer particles are accumulating and also the dry density is reduces. Plasticity soils retained the smallest water content and the highest plasticity soils retained the highest water content at a specified suction. In addition, soil characteristic for soils to be compacted in the laboratory and in the field are still under process for analyzing the bearing capacity. The bearing capacity was reduced 2 to 3 times in the presence of H2SO4.

Keywords: soil compaction, H2SO4, soil water, water conditions

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Authors: Donald Kushon, Jyoti Pillai

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Psychogenic Non-epileptic Seizure Disorder (PNES) is a challenging clinical problem for the neurologist. This study explores the benefits of on-site collaboration between psychiatry and neurology in the management of PNES. A 3 month period at a university hospital seizure clinic is described detailing specific management approaches taken as a result of this collaboration. This study describes four areas of interest: (1. After the video EEG results confirm the diagnosis of PNES, the presentation of the diagnosis of PNES to the patient. (2. The identification of co-morbid psychiatric illness (3. Treatment with specific psychotherapeutic interventions (including Cognitive Behavioral Therapy) and psychopharmacologic interventions (primarily SSRIs) and (4. Preliminary treatment outcomes.

Keywords: cognitive behavioral therapy (CBT), psychogenic non-epileptic seizure disorder (PNES), selective serotonin reuptake inhibitors (SSRIs), video electroencephalogram (VEEG)

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Authors: Roshanak Farjad, Amirhossein Hosseini

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Fecal incontinence (FI) is a stressful condition for children and their parents that may affect the patient’s psychological well-being. Evaluating the patients’ psychological status may help physicians manage the disease effectively. This study aimed to assess the emotional and behavioral disturbances in children with FI who were referred to the pediatric gastroenterology clinic in Mofid Children’s Hospital from April 2021 to 2022. This cross-sectional study included children (over four years old) with chronic constipation and fecal incontinence. The diagnosis of chronic constipation and FI were made according to Rome-IV criteria. The Child Behavior Checklist (CBCL) evaluated patients’ emotional, behavioral, and social problems. One hundred one patients with a mean age of 7.96 years were enrolled in the study; 67.32% were males. According to CBCL, 12% (12 patients) indicated emotional and behavioral problems, with CBCL scores in the clinical or at-risk range. We detected anxious/depressed problems in five (4.95%), withdrawn/depressed problems in eight (7.92%), somatic complaints in seven (6.93%), social problems in eight (7.92%), thought problems in nine (8.91%), attention problems in seven (6.93%), rule-breaking behavior in two (1.98%), and aggressive behavior in nine (8.91%) patients. The risk of internalizing and externalizing disorders was reported in four (3.96%) and five (4.95%) patients. Also, eight (7.92%) and seven (6.93%) patients had clinical symptoms of internalizing and externalizing disorders, respectively. There was no significant relationship between patients’ age and gender with the CBCL scores in any subscales. However, there was a significant difference in the total score among the age groups (P = 0.04). The relatively high prevalence of emotional, behavioral, and social problems in our study corroborates the importance of psychological screening of children with FI during the treatment process.

Keywords: chronic constipation, child behavior checklist (CBCL), fecal incontinence, rome-IV criteria

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Authors: Gia Lam Le, Dennis T. Bergado, Thi Ngoc Truc Nguyen

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This study focuses on behaviors of improved soft clay using prefabricated vertical drain (PVD) combined with vacuum and electro-osmotic preloading. Large-scale consolidations of reconstituted soft Bangkok clay were conducted for PVD improvement with vacuum (vacuum-PVD), and vacuum combined with heat (vacuum-thermo-PVD). The research revealed that vacuum-thermo-PVD gives high efficiency of the consolidation rate compared to the vacuum-PVD. In addition, the magnitude of settlement of the specimen improved by the vacuum-thermo-PVD is higher than the vacuum-PVD because the assistance of heat causes the collapse of the clay structure. Particularly, to reach 90% degree of consolidation, the thermal-vacuum-PVD reduced about 58% consolidation time compared to the vacuum-PVD. The increase in consolidation rate is resulted from the increase in horizontal coefficient of consolidation, Ch, the reduction of the smear effect expressed by the ratio of the horizontal hydraulic conductivity in the undisturbed zone, kh, and the horizontal hydraulic conductivity in the smeared zone, ks. Furthermore, the shear strength, Su, increased about 100% when compared using the vacuum-thermal-PVD to the vacuum PVD. In addition, numerical simulations gave reasonable results compared to the laboratory data.

Keywords: PVD improvement, vacuum preloading, prefabricated vertical drain, thermal PVD

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Authors: S. Benbellil-Tafoughalt, J. M. Koene

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Growth strategies are often plastic and influenced by environmental conditions. Terrestrial gastropods are particularly affected by seasonal and climatic variables, and growth rate and size at maturity are key traits in their life history. Therefore, we investigated juvenile growth of Helix aperta snails under four combinations of temperature and photoperiod using two sets of young snails, born in the laboratory from adults collected in either the autumn (aestivating snails) or spring (active snails). Parental snails were collected from Bakaro (Northeastern Algeria). Higher temperature increased adult size and reduced time to reproduction. Long day photoperiod also increased the final body weight, but had no effect on the length of the growth period. The season of birth had significant effects on length of the growth period and weight of hatchings, whereas this weight difference disappeared by adulthood. The spring snails took less time to develop and reached similar adult body weight as the autumn snails. These differences may be due to differences in egg size or quality between the snails from different seasons. More rapid growth in spring snails results in larger snails entering aestivation, a period with size-related mortality in this species.

Keywords: growth, Hélix aperta, photoperiod, temperature

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Authors: P. O. Ughachukwu, P. O. Okonkwo, P. C. Unekwe, J. O. Ogamba

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Background: The prevalence of hepatitis B viral infection is high worldwide with liver cirrhosis and hepatocellular carcinoma as important complications. Cases of poor antibody response to hepatitis B vaccination abound. Immunosuppression, especially from glucocorticoids, is often cited as a cause of poor antibody response and there are documented evidences of irrational administration of glucocorticoids to children and adults. The study was, therefore, designed to find out if administration of glucocorticoids affects immune response to vaccination against hepatitis B in mice. Methods: Mice of both sexes were randomly divided into 2 groups. Daily intramuscular methylprednisolone injections, (15 mg kg-1), were given to the test group while sterile deionized water (0.1ml) was given to control mice for 30 days. On day 6 all mice were given 2 μg (0.1ml) hepatitis B vaccine and a booster dose on day 27. On day 34, blood samples were collected and analyzed for anti-HBs titres using enzyme-linked immunosorbent assay (ELISA). Statistical analysis was done using Graph Pad Prism 5.0 and the results taken as statistically significant at p value < 0.05. Results: There were positive serum anti-HBs responses in all mice groups but the differences in titres were not statistically significant. Conclusions: At the dosages and length of exposure used in this study, methylprednisolone injection did not significantly inhibit anti-HBs response in mice following immunization against hepatitis B virus. By extrapolation, methylprednisolone, when used in the usual clinical doses and duration of therapy, is not likely to inhibit immune response to hepatitis B vaccinations in man.

Keywords: anti-HBs, hepatitis B vaccine, immune response, methylprednisolone, mice

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Authors: Fatimah A. Alhomaid

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The present study was planned to investigate the role of molecular changes and immunohistochemical in early detection of liver cancer in Saudi patients. our results were carried out on 54 patients liver cancer. We obtained our data from laboratory in King Khalid University Hospital. The specimens were taken (54) patients with liver cancer 34 male and 14 female and 2 control. The average age of varied from 37-85 years. The tumor was diagnosed as grade I in tow patients (male and female) and grade 2 in 45 patients (28 male and 17 female) while the grade 3 in 4 patients (all males). The specimens were processed for haematoxylin and eosin staining, immunohistochemical technique and flow cytometry analysis. Our study noted that most patients had adenocarcinoma which characterized by presence of signet-ring cells were very clear in advanced patients with adenocarcinoma. Our sections in adenocarcinoma in grade 2 and stage 3 had an increase in signet ring cells,an increase in the acini of glands and an increase in number of lymphocytes which spread to the muscular layer. With advancing the disease, there were haemorrhage in blood and increase in lymphocytes and increase in the number of nuclei in the tubular glands. Our study was carried on 48 patients, immunohistochemical diagnosis (CK20, PCNA, P53) and the analysis of DNA content by flow cytometry technique. Our study indicated that the presence of correlation between the immunohistochemical analysis for P53 and the grades. The reaction of P53 appeared as strong in nucleus in grades &stage 3 and appeared in other sections as dark brown pigment. Our study indicated that the absence of correlation between the immunohistochemical analysis for PCAN and the grades. In our sections there were strong reaction in the more 80% of nuclei in grade 1& stage 2. Our study indicated that the presence of correlation between the immunohistochemical analysis for CK20 and the grades. Our results indicated the presence of positive reaction in cytoplasm varied from weak to moderate in grade 3 & stage 4. Concerning the Flow cytometry technique our results indicated that the presence of correlation between the DNA and different stages of liver cancer.

Keywords: cancer, CK20, DNA, cytometry analysis, liver, immunohistochemical, molecular changes, PCNA, p53

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Authors: Antarip Bhattacharya, Dhritiman Maitra

Abstract:

Primary hyperparathyroidism (PHPT) is the most common cause of hypercalcemia due to autonomous production of parathormone (PTH) and the third most common endocrine disorder. Upto 2% of postmenopausal women could have this condition. Primary hyperparathyroidism is characterized by hypercalcemia with a high or insufficiently suppressed level of parathyroid hormone and is caused by a solitary parathyroid adenoma in 85-90% of patients. PHPT may also be caused by parathyroid hyperplasia (involving multiple glands) or parathyroid carcinoma. Associated morbidities and sequelae include decreased bone mineral density, fractures, kidney stones, hypertension, cardiac comorbidities and psychiatric disorder which entail huge costs for treatment. In the year 2021, by virtue of running a Breast and Endocrine Surgery clinic in a Tier 1 city at a tertiary care hospital, the opportunity to be associated with patients of hyperparathyroidism came our way. Here, we shall describe the spectrum of clinical presentations and customisation of treatment for parathyroid diseases with reference to the above patients. A retrospective analysis of the data of all patients presenting with symptoms of parathyroid diseases was made and classified according to the cause. 13 patients had presented with symptoms of hyperparathyroidism and each case presented with unique symptoms and necessitated detailed evaluation. The treatment or surgery offered to each patient was tailored to his/her individual disease and led to favourable outcomes. Diseases affecting parathyroid are not as rare as we believe. Each case merits detailed clinical evaluation, investigations and tailoring of suitable treatment with regard to medical management and extent of surgery. Intra-operative frozen section/iOPTH monitoring are really useful adjuncts for intra-operative decision making.

Keywords: hyperparathyroidism, parathyroid adenoma, parathyroid surgery, PTH

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Authors: Alireza Jalalvand, Maryam Saleh, Somayeh Behjat Khatouni, Zahra Bahri Najafi, Foroozan Fatahinia, Narges Ismailzadeh, Behrokh Farahmand

Abstract:

Object: In the last two decades, the recent outbreak of Coronavirus (SARS-CoV-2) imposed a global pandemic in the world. Despite the increasing prevalence of the disease, there are no effective drugs to treat it. A suitable and rapid way to afford an effective drug and treat the global pandemic is a computational drug study. This study used molecular docking methods to examine the potential inhibition of over 50 antiviral drugs against three fundamental proteins of SARS-CoV-2. METHODS: Through a literature review, three important proteins (a key protease, RNA-dependent RNA polymerase (RdRp), and spike) were selected as drug targets. Three-dimensional (3D) structures of protease, spike, and RdRP proteins were obtained from the Protein Data Bank. Protein had minimal energy. Over 50 antiviral drugs were considered candidates for protein inhibition and their 3D structures were obtained from drug banks. The Autodock 4.2 software was used to define the molecular docking settings and run the algorithm. RESULTS: Five drugs, including indinavir, lopinavir, saquinavir, nelfinavir, and remdesivir, exhibited the highest inhibitory potency against all three proteins based on the binding energies and drug binding positions deduced from docking and hydrogen-bonding analysis. Conclusions: According to the results, among the drugs mentioned, saquinavir and lopinavir showed the highest inhibitory potency against all three proteins compared to other drugs. It may enter laboratory phase studies as a dual-drug treatment to inhibit SARS-CoV-2.

Keywords: covid-19, drug repositioning, molecular docking, lopinavir, saquinavir

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Authors: Pascal Mwenge, Tumisang Seodigeng

Abstract:

The increase in urbanisation in South Africa has led to an increase in water demand and a decline in freshwater supply. Despite this, poor water usage is still a major challenge in South Africa, for instance, freshwater is still used for non-drinking applications. The freshwater shortage can be alleviated by using other sources of water for non-portable purposes such as greywater treated with activated biochar produced from agricultural waste. The success of activated biochar produced from agricultural waste to treat greywater can be both economically and environmentally beneficial. Greywater treated with activated biochar produced from agricultural waste is considered a cost-effective wastewater treatment.  This work was aimed at determining the ability of activated biochar to remove Total Suspended Solids (TSS), Ammonium (NH₄-N), Nitrate (NO₃-N), and Chemical Oxygen Demand (COD) from greywater. The experiments were carried out in 800 ml laboratory plastic cylinders used as filter columns. 2.5 cm layer of gravel was used at the bottom and top of the column to sandwich the activated biochar material. Activated biochar (200 g and 400 g) was loaded in a column and used as a filter medium for greywater. Samples were collected after a week and sent for analysis. Four types of greywater were treated: Kitchen, floor cleaning water, shower and laundry water. The findings showed: 95% removal of TSS, 76% of NO₃-N and 63% of COD on kitchen greywater and 85% removal of NH₄-N on bathroom greywater, as highest removal of efficiency of the studied pollutants. The results showed that activated biochar produced from agricultural waste reduces a certain amount of pollutants from greywater. The results also indicated the ability of activated biochar to treat greywater for onsite non-potable reuse purposes.

Keywords: activated biochar produced from agriculture waste, ammonium, NH₄-N, chemical oxygen demand, COD, greywater, nitrate, NO₃-N, total suspended solids, TSS

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Authors: Doris Fovwe Ogeleka, L. E. Tudararo-Aherobo, F. E. Okieimen

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The ecological effects of oil spill in the environment were studied in Warri riverine areas of Ubeji and Jeddo, Delta State. In the two communities, water and sediment samples were analysed for organics (polyaromatic hydrocarbon; total petroleum hydrocarbon (TPH)) and heavy metals (lead, copper, zinc, iron and chromium). The American Public Health Association (APHA) and the American Society for Testing and Materials (ASTM) methods were employed for the laboratory test. The results indicated that after a long period of oil spill (above one year), there were still significant concentrations (p<0.05) of organics indicating hydrocarbon pollution. Mean concentrations recorded for TPH in Ubeji and Jeddo waters were 23.60 ± 1.18 mg/L and 29.96 ± 0.14 mg/L respectively while total PAHs was 0.009 ± 0.002 mg/L and 0.008 ± 0.001 mg/L. Mean concentrations of TPH in the sediment was 48.83 ± 1.49 ppm and 1093 ± 74 ppm in the above order while total PAHs was 0.012 ± 0.002 ppm and 0.026 ± 0.004 ppm. Low concentrations were recorded for most of the heavy metals in the water and sediment. The observed concentrations of hydrocarbons in the study areas should provide the impetus for regulatory surveillance of oil discharged intentionally/unintentionally into the Warri riverine waters and sediment since hydrocarbon released into the environment sorb to the sediment particles where they cause harm to organisms in the sediment and overlying waters.

Keywords: crude oil, PAHs, TPH, oil spillage, water, sediment

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Authors: Prasanna Ramachandran, Kareem Graham, Helena Kiefel, Sunit Jain, Todd DeSantis

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Microbes that reside inside the mammalian GI tract, commonly referred to as the gut microbiome, have been shown to have therapeutic effects in animal models of disease. We hypothesize that specific proteins produced by these microbes are responsible for this activity and may be used directly as therapeutics. To speed up the discovery of these key proteins from the big-data metagenomics, we have applied machine learning techniques. Using amino acid sequences of known epitopes and their corresponding binding partners, protein interaction descriptors (PID) were calculated, making a positive interaction set. A negative interaction dataset was calculated using sequences of proteins known not to interact with these same binding partners. Using Random Forest and positive and negative PID, a machine learning model was trained and used to predict interacting versus non-interacting proteins. Furthermore, the continuous variable, cosine similarity in the interaction descriptors was used to rank bacterial therapeutic candidates. Laboratory binding assays were conducted to test the candidates for their potential as therapeutics. Results from binding assays reveal the accuracy of the machine learning prediction and are subsequently used to further improve the model.

Keywords: protein-interactions, machine-learning, metagenomics, microbiome

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Authors: A. Dinelka Panagoda, Bathiya Bandara, Chamod Wijetunga, Chathura Malinda, Lakmal Rupasinghe, Chethana Liyanapathirana

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This research takes us forward with the concepts of Federated Learning and Software-Defined Networking (SDN) to introduce an efficient malware detection technique and provide a mitigation mechanism to give birth to a resilient and automated healthcare sector network system by also adding the feature of extended privacy preservation. Due to the daily transformation of new malware attacks on hospital Integrated Clinical Environment (ICEs), the healthcare industry is at an undefinable peak of never knowing its continuity direction. The state of blindness by the array of indispensable opportunities that new medical device inventions and their connected coordination offer daily, a factor that should be focused driven is not yet entirely understood by most healthcare operators and patients. This solution has the involvement of four clients in the form of hospital networks to build up the federated learning experimentation architectural structure with different geographical participation to reach the most reasonable accuracy rate with privacy preservation. While the logistic regression with cross-entropy conveys the detection, SDN comes in handy in the second half of the research to stack up the initial development phases of the system with malware mitigation based on policy implementation. The overall evaluation sums up with a system that proves the accuracy with the added privacy. It is no longer needed to continue with traditional centralized systems that offer almost everything but not privacy.

Keywords: software-defined network, federated learning, privacy, integrated clinical environment, decentralized learning, malware detection, malware mitigation

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Authors: Hamzeh Awad

Abstract:

Disability is considered to be a worldwide complex phenomenon which rising at a phenomenal rate and caused by many different factors. Chronic diseases such as cardiovascular disease and diabetes can lead to mobility disability in particular and disability in general. The ICF is an integrative bio-psycho-social model of functioning and disability and considered by the World Health Organization (WHO) to be a reference for disability classification using its categories and core set to classify disorder’s functional limitations. Specialist programs at Sultan Bin Abdul Aziz Humanitarian City (SBAHC) are providing both inpatient and outpatient services have started to implement the ICF and use it as a problem solving tool in Rehab. Diabetes is leading contributing factor for disability and considered epidemic in several Gulf countries including the Kingdom of Saudi Arabia (KSA), where its prevalence continues to increase dramatically. Metabolic disorders, mainly diabetes are not well covered in Rehab field. The purpose of this study is present to research and clinical rehabilitation field of DREAM and ICF as a framework in clinical and research setting in Rehab service. Also, shed the light on using the ICF as problem solving tool at SBAHC. There are synergies between disability causes and wider public health priorities in relation to both chronic disease and disability prevention. Therefore, there is a need for strong advocacy and understanding of the role of ICF as a reference in Rehab settings in Middle East if we wish to seize the opportunity to reverse current trends of acquired disability in the region.

Keywords: international classification of functioning, disability and health (ICF), prototype, rehabilitation and diabetes

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Authors: Alia Ali, Azeem Taj, Muhammed Joher Amin, Farrukh Iqbal, Zafar Iqbal

Abstract:

Background: Hypertension is commonly found in patients with Diabetic Kidney Disease (DKD). Microalbuminuria is the first clinical sign of involvement of kidneys in patients with type 2 diabetes. Uncontrolled hypertension induces a higher risk of cardiovascular events, including death, increasing proteinuria and progression to kidney disease. Objectives: To determine the correlation between microalbuminuria and hypertension and their association with other risk factors in type 2 diabetic patients. Methods: One hundred and thirteen type 2 diabetic patients were screened for microalbuminuria and raised blood pressure, attending the diabetic clinic of Shaikh Zayed Hospital, Lahore, Pakistan. The study was conducted from November 2012 to June 2013. Results: Patients were divided into two groups. Group 1, those with normoalbuminuria (n=63) and Group 2, those having microalbuminuria (n=50). Group 2 patients showed higher blood pressure values as compared to Group 1. The results were statistically significant and showed poor glycemic control as a contributing risk factor. Conclusion: The study concluded that there is high frequency of hypertension among type 2 diabetics but still much higher among those having microalbuminuria. So, early recognition of renal dysfunction through detection of microalbuminuria and to start treatment without any delay will confer future protection from end-stage renal disease as well as hypertension and its complications in type 2 diabetic patients.

Keywords: hypertension, microalbuminuria, diabetic kidney disease, type 2 Diabetes mellitus

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Authors: Samaneh Abolli, Mahdi Ahmadi Nasab, Kamyar Yaghmaeian, Mahmood Alimohammadi

Abstract:

The quality of drinking water, in addition to the presence of physicochemical parameters, depends on the type and geographical location of water sources. In this study, groundwater quality was investigated by sampling total dissolved solids (TDS), electrical conductivity (EC), total hardness (TH), Cl, Ca²⁺, and Mg²⁺ parameters in 13 sites, and 40 water samples were sent to the laboratory. Electrometric, titration, and spectrophotometer methods were used. In the next step, the water quality index (WQI) was used to investigate the impact and weight of each parameter in the groundwater. The results showed that only the mean of magnesium ion (40.88 mg/l) was lower than the guidelines of World Health Organization (WHO). Interpreting the WQI based on the WHO guidelines showed that the statuses of 21, 11, and 7 samples were very poor, poor, and average quality, respectively, and one sample had excellent quality. Among the studied parameters, the means of EC (2,087.49 mS/cm) and Cl (1,015.87 mg/l) exceeded the global and national limits. Classifying water quality of TH was very hard (87.5%), hard (7.5%), and moderate (5%), respectively. Based on the geographical distribution, the drinking water index in sites 4 and 11 did not have acceptable quality. Chloride ion was identified as the responsible pollutant and the most important ion for raising the index. The outputs of statistical tests and Spearman correlation had significant and direct correlation (p < 0.05, r > 0.7) between TDS, EC, and chloride, EC and chloride, as well as TH, Ca²⁺, and Mg²⁺.

Keywords: water quality index, groundwater, chloride, GIS, Garmsar

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Authors: Jihee Jang, Seowon Yoon, Gaeun Son, Minjung Kang, Joon Yeon Choeh, Kee-Hong Choi

Abstract:

Background: Self-report multiple choice questionnaires have been widely utilized to quantitatively measure one’s personality and psychological constructs. Despite several strengths (e.g., brevity and utility), self-report multiple-choice questionnaires have considerable limitations in nature. With the rise of machine learning (ML) and Natural language processing (NLP), researchers in the field of psychology are widely adopting NLP to assess psychological constructs to predict human behaviors. However, there is a lack of connections between the work being performed in computer science and that psychology due to small data sets and unvalidated modeling practices. Aims: The current article introduces the study method and procedure of phase II, which includes the interview questions for the five-factor model (FFM) of personality developed in phase I. This study aims to develop the interview (semi-structured) and open-ended questions for the FFM-based personality assessments, specifically designed with experts in the field of clinical and personality psychology (phase 1), and to collect the personality-related text data using the interview questions and self-report measures on personality and psychological distress (phase 2). The purpose of the study includes examining the relationship between natural language data obtained from the interview questions, measuring the FFM personality constructs, and psychological distress to demonstrate the validity of the natural language-based personality prediction. Methods: The phase I (pilot) study was conducted on fifty-nine native Korean adults to acquire the personality-related text data from the interview (semi-structured) and open-ended questions based on the FFM of personality. The interview questions were revised and finalized with the feedback from the external expert committee, consisting of personality and clinical psychologists. Based on the established interview questions, a total of 425 Korean adults were recruited using a convenience sampling method via an online survey. The text data collected from interviews were analyzed using natural language processing. The results of the online survey, including demographic data, depression, anxiety, and personality inventories, were analyzed together in the model to predict individuals’ FFM of personality and the level of psychological distress (phase 2).

Keywords: personality prediction, psychological distress prediction, natural language processing, machine learning, the five-factor model of personality

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