Search results for: chronic stable angina

Authors: Valerii Dashuk

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The usage of the confidence intervals in economics and econometrics is widespread. To be able to investigate a random variable more thoroughly, joint tests are applied. One of such examples is joint mean-variance test. A new approach for testing such hypotheses and constructing confidence sets is introduced. Exploring both the value of the random variable and its deviation with the help of this technique allows checking simultaneously the shift and the probability of that shift (i.e., portfolio risks). Another application is based on the normal distribution, which is fully defined by mean and variance, therefore could be tested using the introduced approach. This method is based on the difference of probability density functions. The starting point is two sets of normal distribution parameters that should be compared (whether they may be considered as identical with given significance level). Then the absolute difference in probabilities at each 'point' of the domain of these distributions is calculated. This measure is transformed to a function of cumulative distribution functions and compared to the critical values. Critical values table was designed from the simulations. The approach was compared with the other techniques for the univariate case. It differs qualitatively and quantitatively in easiness of implementation, computation speed, accuracy of the critical region (theoretical vs. real significance level). Stable results when working with outliers and non-normal distributions, as well as scaling possibilities, are also strong sides of the method. The main advantage of this approach is the possibility to extend it to infinite-dimension case, which was not possible in the most of the previous works. At the moment expansion to 2-dimensional state is done and it allows to test jointly up to 5 parameters. Therefore the derived technique is equivalent to classic tests in standard situations but gives more efficient alternatives in nonstandard problems and on big amounts of data.

Keywords: confidence set, cumulative distribution function, hypotheses testing, normal distribution, probability density function

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Authors: Vichayada Laohapiboolkul

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Introduction: As the legal use of cannabis is being widely accepted throughout the world, medical cannabis has been explored in order to become an alternative cure for patients. Tetrahydrocannabinol (THC) and Cannabidiol (CBD) are natural cannabinoids found in the Cannabis plant which is proved to have positive treatment for various diseases and symptoms such as chronic pain, neuropathic pain, spasticity resulting from multiple sclerosis, reduce cancer-associated pain, autism spectrum disorders (ASD), dementia, cannabis and opioid dependence, psychoses/schizophrenia, general social anxiety, posttraumatic stress disorder, anorexia nervosa, attention-deficit hyperactivity disorder, and Tourette's disorder. Regardless of all the medical benefits, THC, if not metabolized, can lead to mild up to severe adverse drug reactions (ADR). The enzyme CYP2C19 was found to be one of the metabolizers of THC. However, the suballele CYP2C19*2 manifests as a poor metabolizer which could lead to higher levels of THC than usual, possibly leading to various ADRs. Objective: The aim of this study was to investigate the distribution of CYP2C19, specifically CYP2C19*2, genes in Thai patients treated with medical cannabis along with adverse drug reactions. Materials and Methods: Clinical data and EDTA whole blood for DNA extraction and genotyping were collected from patients for this study. CYP2C19*2 (681G>A, rs4244285) genotyping was conducted using the Real-time PCR (ABI, Foster City, CA, USA). Results: There were 42 medical cannabis-induced ADRs cases and 18 medical cannabis tolerance controls who were included in this study. A total of 60 patients were observed where 38 (63.3%) patients were female and 22 (36.7%) were male, with a range of age approximately 19 - 87 years. The most apparent ADRs for medical cannabis treatment were dry mouth/dry throat (76.7%), followed by tachycardia (70%), nausea (30%) and a few arrhythmias (10%). In the total of 27 cases, we found a frequency of 18 CYP2C19*1/*1 alleles (normal metabolizers, 66.7%), 8 CYP2C19*1/*2 alleles (intermediate metabolizers, 29.6%) and 1 CYP2C19*2/*2 alleles (poor metabolizers, 3.7%). Meanwhile, 63.6% of CYP2C19*1/*1, 36.3% and 0% of CYP2C19*1/*2 and *2/*2 in the tolerance controls group, respectively. Conclusions: This is the first study to confirm the distribution of CYP2C19*2 allele and the prevalence of poor metabolizer genes in Thai patients who received medical cannabis for treatment. Thus, CYP2C19 allele might serve as a pharmacogenetics marker for screening before initiating treatment.

Keywords: medical cannabis, adverse drug reactions, CYP2C19, tetrahydrocannabinol, poor metabolizer

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Authors: Sonia Barbouchi, Meriem Samcha

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Scale deposition during water injection into aquifer of oil reservoirs is a serious problem experienced in the oil production industry. One of the primary causes of scale formation and injection well plugging is mixing two waters which are incompatible. Considered individually, the waters may be quite stable at system conditions and present no scale problems. However, once they are mixed, reactions between ions dissolved in the individual waters may form insoluble products. The purpose of this study is to identify the causes of well plugging in a southern Tunisian oilfield, where fresh water has been injected into the producing wells to counteract the salinity of the formation waters and inhibit the deposition of halite. X-ray diffraction (XRD) mineralogical analysis has been carried out on scale samples collected from the blocked well. Two samples collected from both formation water and injected water were analysed using inductively coupled plasma atomic emission spectroscopy, ion chromatography and other standard laboratory techniques. The results of complete waters analysis were the typical input parameters, to determine scaling tendency. Saturation indices values related to CaCO3, CaSO4, BaSO4 and SrSO4 scales were calculated for the water mixtures at different share, under various conditions of temperature, using a computerized scale prediction model. The compatibility study results showed that mixing the two waters tends to increase the probability of barite deposition. XRD analysis confirmed the compatibility study results, since it proved that the analysed deposits consisted predominantly of barite with minor galena. At the studied temperatures conditions, the tendency for barite scale is significantly increasing with the increase of fresh water share in the mixture. The future scale inhibition and removal strategies to be implemented in the concerned oilfield are being derived in a large part from the results of the present study.

Keywords: compatibility study, produced water, scaling, water injection

Procedia PDF Downloads 162

Authors: Mimoza Canga, Irene Malagnino, Gresa Baboci, Edit Xhajanka, Vito Antonio Malagnino

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Background: Diabetes mellitus is regarded as a very problematic chronic disease that has an effect on a considerable number of people around the world and it is straightforwardly associated with the oral health condition of the patients. Objective: The objective of this study is to analyze and evaluate the impact of diabetes mellitus on oral health. Materials and methods: In the present research were taken into consideration 300 patients with an age range of 11 to 80 years old. The study sample was composed of 191 males, respectively 63.7% of them and 109 females 36.3% of the participants. We divided them into seven age groups: 11-20, 21-30, 31-40, 41-50, 51-60, 61-70, and 71-80 years.This descriptive and analytical research was designed as a longitudinal study. Statistical analysis was performed using IBM SPSS 23.0 statistics. Results: The majority of patients participating in the study belonged to the age range from 41 to 50 years old, precisely 20.7% of them, while 27% of the patients were from 51 to 60 years old. Based on the present research, it resulted that 24.4% of the participant had high blood sugar values 250-300 mg/dl, whereas 19 % of the patients had very high blood sugar values 300-350 mg/dl. Based on the results of the current study, it was observed that 83.7% of patients were affected by gingivitis. In the current study, the significant finding is that 22% of patients had more than 7 teeth with dental caries and 21% of them had 5-7 teeth with dental caries, whereas 29% of the patients had 4-5 dental caries and the remaining 28% of them had 1-3 dental caries. The present study showed that most of the patients, 27% of them had lost more than 7 teeth and 22% of the participants had lost 5-7 teeth, whereas 31% of the patients had lost 4-5 teeth and only 20 % of them had lost 1-3 teeth. This study proved that high blood sugar values had a direct impact on the manifestation of gingivitis and there it was a strong correlation between them with P-value = .001. A strong correlation was found out between dental caries and high blood sugar values with P-value ˂.001. Males with diabetes mellitus were more affected by dental caries and this was proved by the P-value= .02, in comparison to females P-value=.03. The impact of high blood sugar values affects missing teeth and the correlation between them was statistically significant with P-value ˂ .001. Conclusion: The results of this study suggest that diabetes mellitus is a possible risk factor in oral health for the reason that Albanian patients over 51 years old, respectively 43% of them have over 5 teeth with dental caries as compared with 49% of the patients who had over 5 missing teeth, whereas the majority 83.7% of them suffered from gingivitis. This study asserts that patients who do not have periodical check-ups of diabetes mellitus are at significant risk of oral diseases.

Keywords: dental caries, diabetes mellitus, gingivitis, missing teeth

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Authors: O. Davies, K. Veravalli, P. Panwalkar, M. Tofighi, P. Butterick, B. Healy, A. Mofidi

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Vancomycin resistant enterococcus infection is a condition that usually impacts ICUs, transplant, dialysis, and cancer units, often as a nosocomial infection. After an outbreak in the acute trauma and orthopaedic unit in Morriston hospital, we aimed to access the conditions that predispose VRE infections in our unit. Thirteen cases of VRE infection and five cases of VRE colonisations were identified in patients who were treated for orthopaedic care between 1/1/2020 and 1/11/2021. Cases were reviewed to identify predisposing factors, specifically looking at age, presenting condition and treatment, presence of infection and antibiotic care, active haemo-oncological condition, long term renal dialysis, previous hospitalisation, VRE predisposition, and clearance (PREVENT) scores, and outcome of care. The presenting condition, treatment, presence of postoperative infection, VRE scores, age was compared between colonised and the infected cohort. VRE type in both colonised and infection group was Enterococcus Faecium in all but one patient. The colonised group had the same age (T=0.6 P>0.05) and sex (2=0.115, p=0.74), presenting condition and treatment which consisted of peri-femoral fixation or arthroplasty in all patients. The infected group had one case of myelodysplasia and four cases of chronic renal failure requiring dialysis. All of the infected patient had sustained an infected complication of their fracture fixation or arthroplasty requiring reoperation and antibiotics. The infected group had an average VRE predisposition score of 8.5 versus the score of 3 in the colonised group (F=36, p<0.001). PREVENT score was 7 in the infected group and 2 in the colonised group(F=153, p<0.001). Six patients(55%) succumbed to their infection, and one VRE infection resulted in limb loss. In the orthopaedic cohort, VRE infection is a nosocomial condition that has peri-femoral predilection and is seen in association with immunosuppression or renal failure. The VRE infection cohort has been treated for infective complication of original surgery weeks prior to VRE infection. Based on our findings, we advise avoidance of infective complications, change of practice in use of antibiotics and use radical surgery and surveillance for VRE infections beyond infective precautions. PREVENT score shows that the infected group are unlikely to clear their VRE in the future but not the colonised group.

Keywords: surgical site infection, enterococcus, orthopaedic surgery, vancomycin resistance

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Authors: Muhittin Karaman, Murat Budakoglu

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In this study, derivation of lake bathymetry was evaluated using the high resolution Worldview-2 multispectral images in the very shallow hypersaline Lake Acıgöl which does not have a stable water table due to the wet-dry season changes and industrial usage. Every year, a great part of the lake water budget has been consumed for the industrial salt production in the evaporation ponds, which are generally located on the south and north shores of Lake Acıgöl. Therefore, determination of the water level changes from a perspective of remote sensing-based lake water by bathymetry studies has a great importance in the sustainability-control of the lake. While the water table interval is around 1 meter between dry and wet season, dissolved ion concentration, salinity and turbidity also show clear differences during these two distinct seasonal periods. At the same time, with the satellite data acquisition (June 9, 2013), a field study was conducted to collect the salinity values, Secchi disk depths and turbidity levels. Max depth, Secchi disk depth and salinity were determined as 1,7 m, 0,9 m and 43,11 ppt, respectively. Eight-band Worldview-2 image was corrected for atmospheric effects by ATCOR technique. For each sampling point in the image, mean reflectance values in 1*1, 3*3, 5*5, 7*7, 9*9, 11*11, 13*13, 15*15, 17*17, 19*19, 21*21, 51*51 pixel reflectance neighborhoods were calculated separately. A unique image has been derivated for each matrix resolution. Spectral values and depth relation were evaluated for these distinct resolution images. Correlation coefficients were determined for the 1x1 matrix: 0,98, 0,96, 0,95 and 0,90 for the 724 nm, 831 nm, 908 nm and 659 nm, respectively. While 15x5 matrix characteristics with 0,98, 0,97 and 0,97 correlation values for the 724 nm, 908 nm and 831 nm, respectively; 51x51 matrix shows 0,98, 0,97 and 0,96 correlation values for the 724 nm, 831 nm and 659 nm, respectively. Comparison of all matrix resolutions indicates that RedEdge band (724 nm) of the Worldview-2 satellite image has the best correlation with the saline shallow lake of Acıgöl in-situ depth.

Keywords: bathymetry, Worldview-2 satellite image, ATCOR technique, Lake Acıgöl, Denizli, Turkey

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Authors: Simon B. N. Thompson

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Early indicator of neurological disease has been proposed by the expanded Thompson Cortisol Hypothesis which suggests that yawning is linked to rises in cortisol levels. Cortisol is essential to the regulation of the immune system and pathological yawning is a symptom of multiple sclerosis (MS). Electromyography activity (EMG) in the jaw muscles typically rises when the muscles are moved – extended or flexed; and yawning has been shown to be highly correlated with cortisol levels in healthy people. It is likely that these elevated cortisol levels are also seen in people with MS. The possible link between EMG in the jaw muscles and rises in saliva cortisol levels during yawning were investigated in a randomized controlled trial of 60 volunteers aged 18-69 years who were exposed to conditions that were designed to elicit the yawning response. Saliva samples were collected at the start and after yawning, or at the end of the presentation of yawning-provoking stimuli, in the absence of a yawn, and EMG data was additionally collected during rest and yawning phases. Hospital Anxiety and Depression Scale, Yawning Susceptibility Scale, General Health Questionnaire, demographic, and health details were collected and the following exclusion criteria were adopted: chronic fatigue, diabetes, fibromyalgia, heart condition, high blood pressure, hormone replacement therapy, multiple sclerosis, and stroke. Significant differences were found between the saliva cortisol samples for the yawners, t (23) = -4.263, p = 0.000, as compared with the non-yawners between rest and post-stimuli, which was non-significant. There were also significant differences between yawners and non-yawners for the EMG potentials with the yawners having higher rest and post-yawning potentials. Significant evidence was found to support the Thompson Cortisol Hypothesis suggesting that rises in cortisol levels are associated with the yawning response. Further research is underway to explore the use of cortisol as a potential diagnostic tool as an assist to the early diagnosis of symptoms related to neurological disorders. Bournemouth University Research & Ethics approval granted: JC28/1/13-KA6/9/13. Professional code of conduct, confidentiality, and safety issues have been addressed and approved in the Ethics submission. Trials identification number: ISRCTN61942768. http://www.controlled-trials.com/isrctn/

Keywords: cortisol, electromyography, neurology, yawning

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Authors: Kunal K. S., Shwetashri K. R., Keerthan G., Ajinkya R.

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Background: Normal pressure hydrocephalus is a condition caused by abnormal accumulation of cerebrospinal fluid (CSF) within the brain resulting in enlarged cerebral ventricles due to a disruption of CSF formation, absorption, or flow. Over the course of time, ventriculoperitoneal shunt under general anesthesia has become a standard of care. Yet only a finite number of centers have started the inclusion of regional anesthesia techniques for the such patient cohort. Stem Case: We report a case of a 75-year-old male with underlying aortic sclerosis and cardiomyopathy who presented with complaints of confusion, forgetfulness, and difficulty in walking. Neuro-imaging studies revealed disproportionally enlarged subarachnoid space hydrocephalus (DESH). The baseline blood pressure was 116/67 mmHg with a heart rate of 106 beats/min and SpO2 of 96% on room air. The patient underwent smooth induction followed by sonographically guided superficial cervical plexus block and transverse abdominis plane block. Intraoperative pain indices were monitored with Analgesia nociceptive index monitor (ANI, MdolorisTM) and surgical plethysmographic index (SPI, GE Healthcare, Helsinki, FinlandTM). These remained stable during the application of the block and the entire surgical duration. No significant hemodynamic response was observed during the tunneling of the skin by the surgeon. The patient underwent a smooth recovery and emergence. Conclusion: Our decision to incorporate peripheral nerve blockade in conjunction with general anesthesia resulted in opioid-sparing anesthesia and decreased post-operative analgesic requirement by the patient. This blockade was successful in suppressing intraoperative stress responses. Our patient recovered adequately and underwent an uncomplicated post-operative stay.

Keywords: desh, NPH, VP shunt, cervical plexus block, transversus abdominis plane block

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Authors: Joyce K. Anastasi, Bernadette Capili

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Community Engagement Strategies to Assist with the Development of an RCT Among People Living with HIV Our research team focuses on developing and testing protocols to manage chronic symptoms. For many years, our team designed and implemented symptom management studies for people living with HIV (PLWH). We identify symptoms that are not curative and are not adequately controlled by conventional therapies. As an exemplar, we describe how we successfully engaged PLWH in developing and refining our research feasibility protocol for distal sensory peripheral neuropathy (DSP) associated with HIV. With input from PLWH with DSP, our research received National Institutes of Health (NIH) research funding support. Significance: DSP is one of the most common neurologic complications in HIV. It is estimated that DSP affects 21% to 50% of PLWH. The pathogenesis of DSP in HIV is complex and unclear. Proposed mechanisms include cytokine dysregulation, viral protein-produced neurotoxicity, and mitochondrial dysfunction associated with antiretroviral medications. There are no FDA-approved treatments for DSP in HIV. Purpose: Aims: 1) to explore the impact of DSP on the lives of PLWH, 2) to identify patients’ perspectives on successful treatments for DSP, 3) to identify interventions considered feasible and sensitive to the needs of PLWH with DSP, and 4) to obtain participant input for protocol/study design. Description of Process: We conducted a needs assessment with PLWH with DSP. From our needs assessment, we learned from the patients’ perspective detailed descriptions of their symptoms; physical functioning with DSP; self-care remedies tried, and desired interventions. We also asked about protocol scheduling, instrument clarity, study compensation, study-related burdens, and willingness to participate in a randomized controlled trial (RCT) with a placebo and a waitlist group. Implications: We incorporated many of the suggestions learned from the need assessment. We developed and completed a feasibility study that provided us with invaluable information that informed subsequent NIH-funded studies. In addition to our extensive clinical and research experience working with PLWH, learning from the patient perspective helped in developing our protocol and promoting a successful plan for recruitment and retention of study participants.

Keywords: clinical trial development, peripheral neuropathy, traditional medicine, HIV, AIDS

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Authors: Devender Sharma, Shweta Goyal

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Sustainable development is a key to protect the environment for a secure future. Accelerated carbonation curing is a comparatively new technique for curing of concrete which involves sequestration of carbon dioxide gas into the precast concrete, resulting in improvement of the properties of concrete. This paper presents the results of a study to evaluate the effect of carbonation curing on cement mortars incorporating cement kiln dust (CKD) as partial replacement of cement. The mortar specimens were prepared by replacing cement with CKD in varying percentages of 0-50% by the weight of cement. The specimens were subjected to 12 hour carbonation curing, followed by sealed packing till testing age. The results were compared with the normal curing procedure, in which the specimens were water cured till the testing age. Compressive strength and microstructure of the mix were studied. It was noted that on increasing the percentage of CKD up to 10% by the weight of the cement, no considerable change was observed in the compressive strength. But as the percentage of CKD was further increased, there was a decrease in compressive strength, with strength decreasing up to 40% when 50% of the cement was replaced with CKD. The decrease in strength is due to the lesser lime content in CKD as compared to cement. High ettringite formation was observed in mixes with high percentages of CKD, thus indicating a decrease in the compressive strength. With carbonation curing, an early age strength gain was observed in mortars, even with higher percentages of CKD. The early strength of the carbonation cured mixes was found to be greater than water cured mixes irrespective of the percentage of CKD. 7 days and 28 days compressive strength of the mix was comparable for both the carbonation cured and water cured specimen. The increase in compressive strength can be attributed to the conversion of unstable Ca(OH)2 into stable CaCO3, which causes densification of the mix. CaCO3 precipitation and greater CSH gel formation was clearly observed in the SEM images of carbonation cured specimen, indicating higher compressive strength. Thus, carbonation curing can be used as an efficient method to enhance the properties of concrete.

Keywords: carbonation, cement kiln dust, compressive strength, microstructure

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Authors: Yu-Ching Cheng, Yi-Kai Juan, Daniel Castro

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Energy consumption of buildings has been an increasing concern for researchers and practitioners in the last decade. Sustainable building renovation can reduce energy consumption and carbon dioxide emissions; meanwhile, it also can extend existing buildings useful life and facilitate environmental sustainability while providing social and economic benefits to the society. School buildings are different from other designed spaces as they are more crowded and host the largest portion of daily activities and occupants. Strategies that focus on reducing energy use but also improve the students’ learning environment becomes a significant subject in sustainable school buildings development. A decision model is developed in this study to solve complicated and large-scale combinational, discrete and determinate problems such as school renovation projects. The task of this model is to automatically search for the most cost-effective (lower cost and higher quality) renovation strategies. In this study, the search process of optimal school building renovation solutions is by nature a large-scale zero-one programming determinate problem. A* is suitable for solving deterministic problems due to its stable and effective search process, and genetic algorithms (GA) provides opportunities to acquire global optimal solutions in a short time via its indeterminate search process based on probability. These two algorithms are combined in this study to consider trade-offs between renovation cost and improved quality, this decision model is able to evaluate current school environmental conditions and suggest an optimal scheme of sustainable school buildings renovation strategies. Through adoption of this decision model, school managers can overcome existing limitations and transform school buildings into spaces more beneficial to students and friendly to the environment.

Keywords: decision model, school buildings, sustainable renovation, genetic algorithm, A* search algorithm

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Authors: Novita Linda Akbar, Elmeida Effendy, Mustafa M. Amin

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Background: The most common of psychotic disorders is schizophrenia. Vitamin D is made from sunlight, and in the skin from UVB radiation from sunlight. If people with Vitamin D deficiency is common severe mental illness such as schizophrenia.Schizophrenia is a chronic mental illness characterised by positive symptoms and negatives symptoms, such as hallucinations and delusions, flat affect and lack of motivation we can found. In patients with Schizophrenia maybe have several environmental risk factors for schizophrenia, such as season of birth, latitude, and climate has been linked to vitamin D deficiency. There is also relationship between the risk of schizophrenia and latitude, and with an increased incidence rate of schizophrenia seen at a higher latitude. Methods: This study was an analytical study, conducted in BLUD RS Jiwa Propinsi Sumatera Utara and RSUD Deli Serdang, the period in May 2016 and ended in June 2016 with a sample of the study 60 sample (20 patients live in the Highland and Lowland, 20 healthy controls). Inclusion criteria were schizophrenic patients both men and women, aged between 18 to 60 years old, acute phase no agitation or abstinence antipsychotic drugs for two weeks, live in the Highland and Lowland, and willing to participate this study. Exclusion criteria were history of other psychotic disorders, comorbidities with other common medical condition, a history of substance abuse. Sample inspection for serum vitamin D using ELFA method. Statistical analysis using numeric comparative T-independent test. Results: The results showed that average levels of vitamin D for a group of subjects living in areas of high land was 227.6 ng / mL with a standard deviation of 86.78 ng / mL, the lowest levels of vitamin D is 138 ng / mL and the highest 482 ng / mL. In the group of subjects who settled in the low lands seem mean vitamin D levels higher than the mountainous area with an average 237.8 ng / mL with a standard deviation of 100.16 ng / mL. Vitamin D levels are lowest and the highest 138-585 ng / mL. Conclusion and Suggestion: The results of the analysis using the Mann Whitney test showed that there were no significant differences between the mean for the levels of vitamin D based on residence subject with a value of p = 0.652.

Keywords: latitude, schizophrenia, Vitamin D, Sumatera Utara

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Authors: Igor A. Bessmertny, Bidru C. Enkomaryam

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Active involving patients and communities in health decisions can improve both people’s health and the healthcare system. Adopting artificial intelligence can lead to more accurate and complete patient record management. This review aims to identify the current state of researches conducted using artificial intelligence techniques to improve patient engagement and wellbeing, medical domains used in patient engagement context, and lastly, to assess opportunities and challenges for patient engagement in the wellness process. A search of peer-reviewed publications, reviews, conceptual analyses, white papers, author’s manuscripts and theses was undertaken. English language literature published in 2013– 2022 period and publications, report and guidelines of World Health Organization (WHO) were also assessed. About 281 papers were retrieved. Duplicate papers in the databases were removed. After application of the inclusion and exclusion criteria, 41 papers were included to the analysis. Patient counseling in preventing adverse drug events, in doctor-patient risk communication, surgical, drug development, mental healthcare, hypertension & diabetes, metabolic syndrome and non-communicable chronic diseases are implementation areas in healthcare where patient engagement can be implemented using artificial intelligence, particularly machine learning and deep learning techniques and tools. The five groups of factors that potentially affecting patient engagement in safety are related to: patient, health conditions, health care professionals, tasks and health care setting. Active involvement of patients and families can help accelerate the implementation of healthcare safety initiatives. In sub-Saharan Africa, using digital technologies like artificial intelligence in patient engagement context is low due to poor level of technological development and deployment. The opportunities and challenges available to implement patient engagement strategies vary greatly from country to country and from region to region. Thus, further investigation will be focused on methods and tools using the potential of artificial intelligence to support more simplified care that might be improve communication with patients and train health care professionals.

Keywords: artificial intelligence, patient engagement, machine learning, patient involvement

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Authors: R. H. Begaydarova, B. Zh. Kultanov, B. T. Esilbaeva, G. E. Nasakaeva, Y. Yukhnevich, G. K. Alshynbekova, A. E. Dyusembaeva

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Background: The level of middle molecules of peptides (MMP) allows to evaluate the severity and prognosis of the disease and is a criterion for the effectiveness of the treatment. The detection the products of lipidperoxidation cascade, such as conjugated dienes, malondialdehyde in biological material, has an important role in the development of pathogenesis, the diagnosis and prognosis in different parasitic diseases. Purpose of the study was to evaluate the state of endogenous intoxication and indicators of lipid peroxidation in patients with giardiasis before and after treatment. Materials and methods: Endogenous intoxication was evaluated in patients with giardiasis in the level of middle molecules of peptides (MMP) in the blood. The amount of MMP and products of lipid peroxidation were determined in the blood of 198 patients with giardiasis, 129 of them were women (65%), 69 were men (35%). The MMP level was detected for comparison in the blood of 84 healthy volunteers. The lipid peroxidation were determined in 40 healthy men and women without giardiasis and history of chronic diseases. Data were processed by conventional methods of variation statistics, we calculated the arithmetic mean (M) and standard dispersion (m). t-test (t) was used to assess differences. Results: The level of MMP in the blood was significantly higher in patients with giardiasis in comparison with group of healthy men and women. MMP concentration in the blood of women with Giardia was 2.5 times greater than that of the comparison groups of women. The level of MMP exceeds more than 6 times in men with giardiasis. The decrease in the intensity of endogenous intoxication was two weeks after antigiardia therapy, both men and women. According to the study, a statistically significant increase in the level of all the studied parameters lipid peroxidation cascade was observed in the blood of men with giardiasis, with the exception of the total primary production (NGN). The treatment of giardiasis helped to stabilize the level of almost all metabolites of lipid peroxidation cascade. The exception was level of malondialdehyde, it was significantly elevated to compare with the control group and after treatment. Conclusion: Thus, the MMP level was significantly higher in blood of patients with giardiasis than in comparison group. This is evidence of severe endogenous intoxication caused by giardia infection. The accumulation of primary and secondary products of lipid peroxidation was observed in the blood of men and women. These processes tend to be more active in men than in women. Antigiardiasis therapy contributed to the normalization of almost all the studied indicators of lipid peroxidation in the blood of participants, except the level malondialdehyde in the blood of men.

Keywords: enzymes of antioxidant protection, giardiasis, blood, treatment

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Authors: L. Shafiq, A. Rigby

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All polyethylene processes are highly exothermic, and the safe removal of the heat of reaction is a fundamental issue in the process design. In slurry and gas processes, the velocity of the polymer particles in the reactor and external coolers can be very high, and under certain conditions, this can lead to static charging of these particles. Such static charged polymer particles may start building up on the reactor wall, limiting heat transfer, and ultimately leading to severe reactor fouling and forced reactor shut down. Statsafe™ is an FDA approved anti-fouling additive currently used around the world for polyolefin production as an anti-fouling additive. The unique polymer chemistry aids static discharge, which prevents the build-up of charged polyolefin particles, which could lead to fouling. Statsafe™ is being used and trailed in gas, slurry, and a combination of these technologies around the world. We will share data to demonstrate how the use of Statsafe™ allows more stable operation at higher solids level by eliminating static, which would otherwise prevent closer packing of particles in the hydrocarbon slurry. Because static charge generation depends also on the concentration of polymer particles in the slurry, the maximum slurry concentration can be higher when using Statsafe™, leading to higher production rates. The elimination of fouling also leads to less downtime. Special focus will be made on the impact anti-static additives have on catalyst performance within the polymerization process and how this has been measured. Lab-scale studies have investigated the effect on the activity of Ziegler Natta catalysts when anti-static additives are used at various concentrations in gas and slurry, polyethylene and polypropylene processes. An in-depth gas phase study investigated the effect of additives on the final polyethylene properties such as particle size, morphology, fines, bulk density, melt flow index, gradient density, and melting point.

Keywords: anti-static additives, catalyst performance, FDA approved anti-fouling additive, polymerisation

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Authors: Niharul Alam

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The development of energy efficient, economic and eco-friendly synthetic protocols for metal nanoparticles (NPs) with tailor-made structural properties and biocompatibility is a highly cherished goal for researchers working in the field of nanoscience and nanotechnology. In this context, green chemistry is highly relevant and the 12 principles of Green Chemistry can be explored to develop such synthetic protocols which are practically implementable. One of the most promising green chemical synthetic methods which can serve the purpose is biogenic synthetic protocol, which utilizes non-toxic multifunctional reactants derived from natural, biological sources ranging from unicellular organisms to higher plants that are often characterized as “medicinal plants”. Over the past few years, a plethora of medicinal plants have been explored as the source of this kind of multifunctional green chemical agents. In this presentation, we focus on the syntheses of stable monometallic Au and Ag NPs and also bimetallic Au/Ag alloy NPs with highly efficient catalytic property using aqueous extract of leaves of Indian Curry leaf plat (Murraya koenigii Spreng.; Fam. Rutaceae) as green multifunctional agents which is extensively used in Indian traditional medicine and cuisine. We have also studied the interaction between the synthesized metal NPs and surface-adsorbed fluorescent moieties, quercetin and quercetin glycoside which are its chemical constituents. This helped us to understand the surface property of the metal NPs synthesized by this plant based biogenic route and to predict a plausible mechanistic pathway which may help in fine-tuning green chemical methods for the controlled synthesis of various metal NPs in future. We observed that simple experimental parameters e.g. pH and temperature of the reaction medium, concentration of multifunctional agent and precursor metal ions play important role in the biogenic synthesis of Au NPs with finely tuned structures.

Keywords: green multifunctional agent, metal nanoparticles, biogenic synthesis

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Authors: Estifanos H. Zeru

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Introduction: Epidemiological research is important to draw need-based rational public health policy. However, research on child and adolescent mental health in low and middle income countries, where socioeconomic, political, cultural, biological and other mental health hazards are in abundance, is almost nonexistent. To the author's knowledge, there is no published research in this field in Eritrea, whose child and adolescent population constitutes 53% of its total population. Study Aims and Objectives: The objective of this study was to determine the prevalence and patterns of DSM-IV psychiatric disorders and identify their socio-demographic correlates among children and adolescents in Mendefera, Eritrea. The study aims to provide local information to public health policymakers to guide policy in service development. Methodology: In a cross-sectional two stage procedure, both the Parent and Child versions of the SDQ were used to screen 314 children and adolescents aged 4-17 years, recruited by a multi-stage random sampling method. All parents/adult guardians also completed a socio-demographic questionnaire. All children and adolescents who screened positive for any of the SDQ abnormality sub-classes were selected for the second stage interview, which was conducted using the K-SADS-PL 2009 Working Draft version to generate specific DSM-IV diagnoses. All data gathered was entered into CSPro version 6.2 and was then transported in to and analyzed using SPSS version 20 for windows. Results: Prevalence of DSM-IV psychiatric disorders was found to be 13.1%. Adolescents 11-17 years old and males had higher prevalence than children 4-10 years old and females, respectively. Behavioral disorders were the commonest disorders (9.9%), followed by affective disorders (3.2%) and anxiety disorders (2.5). Chronic medical illness in the child, poor academic performance, difficulties with teachers in school, psychopathology in a family member and parental conflict were found to be independently associated with these disorders. Conclusion: Prevalence of child and adolescent psychiatric disorders in Eritrea is high. Promotion, prevention, treatment, and rehabilitation for child and adolescent mental health services need to be made widely available in the country. The socio-demographic correlates identified by this study can be targeted for intervention. The need for further research is emphasized.

Keywords: adolescents, children, correlates, DSM-IV psychiatric disorders, Eritrea, K-SAD-PL 2009, prevalence and correlates, SDQ

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Authors: T. S. Beerenahally, S. Amruthavalli, C. M. Munegowda, Leelavathi, Nagarathna

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Introduction: In majority of urban India, the health system is split between different authorities being responsible for the health care of urban population. We believe that, apart from poor awareness and financial barriers to care, there are other health system barriers which affect quality and access to care for people with diabetes. In this paper, we attempted to identify health system complexity that determines access to public health system for diabetes care in KG Halli, a poor urban neighborhood in Bengaluru. The KG Halli has been a locus of a health systems research from 2009 to 2015. Methodology: The source of data is from the observational field-notes written by research team as part of urban health action research project (UHARP). Field notes included data from the community and the public primary care center. The data was generated by the community health assistants and the other research team members during regular home visits and interaction with individuals who self-reported to be diabetic over four years as part of UHARP. Results: It emerged during data analysis that the patients were not keen on utilizing primary public health center for many reasons. Patient has felt that the service provided at the center was not integrated. There was lack of availability of medicines, with a regular stock out of medicines in a year and laboratory service for investigation was limited. Many of them said that the time given by the providers was not sufficient and there was also a feeling of providers not listening to them attentively. The power dynamics played a huge role in communication. Only the consultation was available for free of cost at the public primary care center. The patient had to spend for the investigations and the major portion for medicine. Conclusion: Diabetes is a chronic disease that poses an important emerging public health concern. Most of the financial burden is borne by the family as the public facilities have failed to provide free care in India. Our study indicated various factors including individual beliefs, stigma and financial constraints affecting compliance to diabetes care.

Keywords: diabetes care, disintegrated health system, quality of care, urban health

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Authors: Data Collete Bob-Manuel

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In light of global financial crisis in 2007-2008 various factors including board diversity, succession planning and board evaluation have been identified as essential ingredients in ensuring board effectiveness. The composition and structure of the board is of outmost importance in assessing a board’s ability and success in achieving its objectives. Following the corporate frauds and accounting scandals such as Enron, WorldCom, Parmalat, Oceanic Bank Nigeria and AfriBank Nigeria, there has been a notable amount of research about the effectiveness of the board of directors in the corporate governance of firms. The need to have an effective board cannot be over emphasized as it results in a more stable and thriving company. There has been an overarching need in the business world for a more diverse workforce and board of directors. Big corporations like Texaco, Ford Motors and DuPont have stated how diversity at every level of the workforce including the board of directors has been cited as a vital element for a company to succeed. Developed countries are also seeking for companies to have a more diverse board. For instance Norway has implemented a 60:40 board ratio to all companies. In West Africa, particularly Nigeria, the topic of diversity has received little attention as most studies conducted have focused on the gender aspect of diversity, which results found to have a negative impact on firm performance. This paper seeks to examine four variables of diversity; age, ethnicity, gender and skills to weigh the positive or negative impact the variables have on firm performance, based on evidence from the Nigerian Financial sector. Information used for this study will be gathered from financial statements and annual reports so as to enable the researcher to reflect on past years to know what is being done differently today. The findings of this study will help the researcher to develop a working definition for ethnicity with regards to the West African context where the issue of “tribe” is a sensitive topic.

Keywords: Board of Directors, Board Diversity, Firm Performance, Nigeria

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Authors: Ahmad Ali Shahid, Mukhtar Ahmed

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The demand for long staple fiber having better strength and length is increasing with the introduction of modern spinning and weaving industry in Pakistan. Work on gene discovery from developing cotton fibers has helped to identify dozens of genes that take part in cotton fiber development and several genes have been characterized for their role in fiber development. Sucrose synthase (SuS) is a key enzyme in the metabolism of sucrose in a plant cell, in cotton fiber it catalyzes a reversible reaction, but preferentially converts sucrose and UDP into fructose and UDP-glucose. UDP-glucose (UDPG) is a nucleotide sugar act as a donor for glucose residue in many glycosylation reactions and is essential for the cytosolic formation of sucrose and involved in the synthesis of cell wall cellulose. The study was focused on successful Agrobacterium-mediated stable transformation of SuS gene in pCAMBIA 1301 into cotton under a CaMV35S promoter. Integration and expression of the gene were confirmed by PCR, GUS assay, and real-time PCR. Young leaves of SuS overexpressing lines showed increased total soluble sugars and plant biomass as compared to non-transgenic control plants. Cellulose contents from fiber were significantly increased. SEM analysis revealed that fibers from transgenic cotton were highly spiral and fiber twist number increased per unit length when compared with control. Morphological data from field plants showed that transgenic plants performed better in field conditions. Incorporation of genes related to cotton fiber length and quality can provide new avenues for fiber improvement. The utilization of this technology would provide an efficient import substitution and sustained production of long-staple fiber in Pakistan to fulfill the industrial requirements.

Keywords: agrobacterium-mediated transformation, cotton fiber, sucrose synthase gene, staple length

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Authors: Mohd Sabri Minhat, Nurul Adilla Mohd Subha

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The 1MWth PUSPATI TRIGA Reactor (RTP) in Malaysia Nuclear Agency has been operating more than 35 years. The existing core power control is using conventional controller known as Feedback Control Algorithm (FCA). It is technically challenging to keep the core power output always stable and operating within acceptable error bands for the safety demand of the RTP. Currently, the system could be considered unsatisfactory with power tracking performance, yet there is still significant room for improvement. Hence, a new design core power control is very important to improve the current performance in tracking and regulating reactor power by controlling the movement of control rods that suit the demand of highly sensitive of nuclear reactor power control. In this paper, the proposed Model Predictive Control (MPC) law was applied to control the core power. The model for core power control was based on mathematical models of the reactor core, MPC, and control rods selection algorithm. The mathematical models of the reactor core were based on point kinetics model, thermal hydraulic models, and reactivity models. The proposed MPC was presented in a transfer function model of the reactor core according to perturbations theory. The transfer function model-based predictive control (TFMPC) was developed to design the core power control with predictions based on a T-filter towards the real-time implementation of MPC on hardware. This paper introduces the sensitivity functions for TFMPC feedback loop to reduce the impact on the input actuation signal and demonstrates the behaviour of TFMPC in term of disturbance and noise rejections. The comparisons of both tracking and regulating performance between the conventional controller and TFMPC were made using MATLAB and analysed. In conclusion, the proposed TFMPC has satisfactory performance in tracking and regulating core power for controlling nuclear reactor with high reliability and safety.

Keywords: core power control, model predictive control, PUSPATI TRIGA reactor, TFMPC

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Authors: Pranav Gulati, Isha Sharma

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Hypertension and hypotension are known to have repercussions on the health of an individual, with hypertension contributing to an increased probability of risk to cardiovascular diseases and hypotension resulting in syncope. This prompts the development of a non-invasive, non-intrusive, continuous and cuff-less blood pressure monitoring system to detect blood pressure variations and to identify individuals with acute and chronic heart ailments, but due to the unavailability of such devices for practical daily use, it becomes difficult to screen and subsequently regulate blood pressure. The complexities which hamper the steady monitoring of blood pressure comprises of the variations in physical characteristics from individual to individual and the postural differences at the site of monitoring. We propose to develop a continuous, comprehensive cardio-analysis tool, based on reflective photoplethysmography (PPG). The proposed device, in the form of an eyewear captures the PPG signal and estimates the systolic and diastolic blood pressure using a sensor positioned near the temporal artery. This system relies on regression models which are based on extraction of key points from a pair of PPG wavelets. The proposed system provides an edge over the existing wearables considering that it allows for uniform contact and pressure with the temporal site, in addition to minimal disturbance by movement. Additionally, the feature extraction algorithms enhance the integrity and quality of the extracted features by reducing unreliable data sets. We tested the system with 12 subjects of which 6 served as the training dataset. For this, we measured the blood pressure using a cuff based BP monitor (Omron HEM-8712) and at the same time recorded the PPG signal from our cardio-analysis tool. The complete test was conducted by using the cuff based blood pressure monitor on the left arm while the PPG signal was acquired from the temporal site on the left side of the head. This acquisition served as the training input for the regression model on the selected features. The other 6 subjects were used to validate the model by conducting the same test on them. Results show that the developed prototype can robustly acquire the PPG signal and can therefore be used to reliably predict blood pressure levels.

Keywords: blood pressure, photoplethysmograph, eyewear, physiological monitoring

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Authors: Ivonne N. Pérez-Sánchez. María L. Rascón- Gasca, Angélica Riveros-Rosas, Rebeca Robles García

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Introduction: Primary caregivers of cancer patients have health problems related to their lack of time, stress, and fiscal strain. Their health problems could affect their patients’ health and also increase the expenses in public health. Aim: To describe self-care and risk behaviors in a sample of Mexican primary caregiver and the relation of these behaviors with emotional distress (caregiver burden, anxiety and depression symptoms), coping and sociodemographic variables. Method: Participated in this study 173 caregivers of a third level reference medical facility (age: M=49.4, SD=13.5) females 78%, males 22%, 57.5% were caregivers of patients with terminal cancer (CPTC), and 40.5% were caregivers of patients on oncology treatment (CPOT). Results: The 75.7% of caregivers reported to have had health problem in last six months as well as several symptoms which were related to emotional distress, these symptoms were more frequently between CPTC and female caregivers. A half (47.3%) of sample reported have had difficulties in caring their health; these difficulties were related to emotional distress and lower coping, more affected caregivers were who attend male patients and CPTC. The 76.8% of caregivers had health problems in last six months, but 26.5% of them waited to search medical care until they were very sick, and 11% didn't do it. Also, more than a half of sample (56.1%) admitted to have risk behaviors as drink alcohol, smoke or overeating for feeling well, these caregivers showed high emotional distress and lower coping. About caregivers healthy behaviors, 80% of them had a hobby; 27.2% do exercise usually and between 12% to 60% did medical checkups (glucose tests, blood pressure and cholesterol tests, eye exams and watched their weight), these caregivers had lower emotional distress and high coping, some variables related health behaviors were: care only one patient or a female patient and be a CPOT, social support, high educational level and experience as a caregiver in past. The half of caregivers were worrying to develop cancer in the future; this idea was 2.5 times more frequent in caregiver with problems to care their health. Conclusions: The results showed a big proportion of caregivers with medical problems. High emotional distress and low coping were related to physical symptoms, risk behaviors, and low self-care; poor self-care was frequently even in caregiver who have chronic illness.

Keywords: cancer, primary caregiver, risk behaviors, self-care

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Authors: Aditya Kumar

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One of the most fascinating properties of various insects and plant surfaces in nature is their water-repellent (superhydrophobicity) capability. The nature offers new insights to learn and replicate the same in designing artificial superhydrophobic structures for a wide range of applications such as micro-fluidics, micro-electronics, textiles, self-cleaning surfaces, anti-corrosion, anti-fingerprint, oil/water separation, etc. In general, artificial superhydrophobic surfaces are synthesized by creating roughness and then treating the surface with low surface energy materials. In this work, various super-hydrophobic coatings on metallic surfaces (aluminum, steel, copper, steel mesh) were synthesized by chemical etching process using different etchants and fatty acid. Also, SiO2 nano/micro-particles embedded polyethylene, polystyrene, and poly(methyl methacrylate) superhydrophobic coatings were synthesized on glass substrates. Also, the effect of process parameters such as etching time, etchant concentration, and particle concentration on wettability was studied. To know the applications of the coatings, surface morphology, contact angle, self-cleaning, corrosion-resistance, and water-repellent characteristics were investigated at various conditions. Furthermore, durabilities of coatings were also studied by performing thermal, ultra-violet, and mechanical stability tests. The surface morphology confirms the creation of rough microstructures by chemical etching or by embedding particles, and the contact angle measurements reveal the superhydrophobic nature. Experimentally it is found that the coatings have excellent self-cleaning, anti-corrosion and water-repellent nature. These coatings also withstand mechanical disturbances such surface bending, adhesive peeling, and abrasion. Coatings are also found to be thermal and ultra-violet stable. Additionally, coatings are also reproducible. Hence aforesaid durable superhydrophobic surfaces have many potential industrial applications.

Keywords: superhydrophobic, water-repellent, anti-corrosion, self-cleaning

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Authors: Gulay Oncu Ince, Sibel Karakaya

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Food is a worldwide concern. Among the factors that have influences on human health, food, nutrition and life style have been regarded as the most important factors since they can be intervened. While some parts of the world has been faced with food shortages and hence, chronic metabolic diseases, the other part of the world have been emerged from over consumption of food. Both situations can result in shorter life expectancy and represent a major global health problem. Hunger, satiety and appetite sensation form a balance ensures the operation of feeding behavior between food intake and energy consumption. Satiety is one of the approaches that is effective in ensuring weight control and avoid eating more in the postprandial period. By manipulating the microstructure of food macro and micronutrient bioavailability may be increased or reduced. For the food industry appearance, texture, taste structural properties as well as the gastrointestinal tract behavior of the food after the consumption is becoming increasingly important. Also, this behavior has been the subject of several researches in recent years by the scientific community. Numerous studies have been published about changing the food matrix in order to increase expected impacts. In this study, yogurts were enriched with caseinomacropeptide (CMP), whey protein (WP), CMP and sodium alginate (SA), and WP + SA in order to produce goat yogurts having different food matrices. SDS Page profiles of the samples after in vitro digestion and viscosities of the stomach digesta at different share rates were determined. Energy values were 62.11kcal/100 g, 70.27 kcal/100 g, 70.61 kcal/100 g, 71.20 kcal/100 g and 71.67 kcal/100 g for control, CMP added WP added, WP + SA added, and CMP + SA added yogurts respectively. The results of viscosity analysis showed that control yogurt had the lowest viscosity value and this was followed by CMP added, WP added, CMP + SA added and WP + SA added yogurts, respectively. Protein contents of the stomach and duedonal digests of the samples after subjected to two different in vitro digestion methods were changed between 5.34-5.91 mg protein / g sample and 16.93-19.75 mg protein /g of sample, respectively. Viscosity measurements of the stomach digests showed that CMP + SA added yogurt displayed the highest viscosity value in both in vitro digestion methods. There were differences between the protein profiles of the stomach and duedonal digests obtained by two different in vitro digestion methods (p<0.05).

Keywords: caseinomacropeptide, protein profile, whey protein, yogurt

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Authors: Shin Ku Kim, Yun Ah Oh, Eun Hee Seo, Chang Min Dae, Yun Jung Bae

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Objectives: The commonly used PRESS technique in magnetic resonance spectroscopy (MRS) has a limitation of incomplete water suppression. The recently developed sLASER technique is known for its improved effectiveness in suppressing water signal. However, no prior study has compared both sequences in a normal human brain. In this study, we firstly aimed to compare the performances of both techniques in brain MRS. Materials and methods: From January 2023 to July 2023, thirty healthy participants (mean age 38 years, 17 male, 13 female) without underlying neurological diseases were enrolled in this study. All participants underwent single-voxel MRS using both PRESS and sLASER techniques on 3T MRI. Two regions-of-interest were allocated in the left medial thalamus and left parietal white matter (WM) by a single reader. The SpectroView Analysis (SW5, Philips, Netherlands) provided automatic measurements, including signal-to-noise ratio (SNR) and peak_height of water, N-acetylaspartate (NAA)-water/Choline (Cho)-water/Creatine (Cr)-water ratios, and NAA-Cr/Cho-Cr ratios. The measurements from PRESS and sLASER techniques were compared using paired T-tests and Bland-Altman methods, and the variability was assessed using coefficients of variation (CV). Results: SNR and peak_heights of the water were significantly lower with sLASER compared to PRESS (left medial thalamus, sLASER SNR/peak_height 2092±475/328±85 vs. PRESS 2811±549/440±105); left parietal WM, 5422±1016/872±196 vs. 7152±1305/1150±278; all, P<0.001, respectively). Accordingly, NAA-water/Cho-water/Cr-water ratios and NAA-Cr/Cho-Cr ratios were significantly higher with sLASER than with PRESS (all, P< 0.001, respectively). The variabilities of NAA-water/Cho-water/Cr-water ratios and Cho-Cr ratio in the left medial thalamus were lower with sLASER than with PRESS (CV, sLASER vs. PRESS, 19.9 vs. 58.1/19.8 vs. 54.7/20.5 vs. 43.9 and 11.5 vs. 16.2) Conclusion: The sLASER technique demonstrated enhanced background water suppression, resulting in increased signals and reduced variability in brain metabolite measurements of MRS. Therefore, sLASER could offer a more precise and stable method for identifying brain metabolites.

Keywords: Magnetic resonance spectroscopy, Brain, sLASER, PRESS

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Authors: Navpreet Kaur, Himkusha Thakur, Nirmal Prabhakar

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One of the most publicized and controversial issue in crop production is the use of agrichemicals- also known as pesticides. This is evident in many reports that Organophosphate (OP) insecticides, among the broad range of pesticides are mainly involved in acute and chronic poisoning cases. Therefore, detection of OPs is very necessary for health protection, food and environmental safety. In our study, a nanocomposite of poly (3,4 ethylenedioxythiophene) (PEDOT) and multi-walled carbon nanotubes (MWCNTs) has been deposited electrochemically onto the surface of fluorine doped tin oxide sheets (FTO) for the analysis of malathion OP. The -COOH functionalization of MWCNTs has been done for the covalent binding with amino groups of AChE enzyme. The use of PEDOT-MWCNT films exhibited an excellent conductivity, enables fast transfer kinetics and provided a favourable biocompatible microenvironment for AChE, for the significant malathion OP detection. The prepared PEDOT-MWCNT/FTO and AChE/PEDOT-MWCNT/FTO nano-biosensors were characterized by Fourier transform infrared spectrometry (FTIR), Field emission-scanning electron microscopy (FE-SEM) and electrochemical studies. Electrochemical studies were done using Cyclic Voltammetry (CV) or Differential Pulse Voltammetry (DPV) and Electrochemical Impedance Spectroscopy (EIS). Various optimization studies were done for different parameters including pH (7.5), AChE concentration (50 mU), substrate concentration (0.3 mM) and inhibition time (10 min). The detection limit for malathion OP was calculated to be 1 fM within the linear range 1 fM to 1 µM. The activity of inhibited AChE enzyme was restored to 98% of its original value by 2-pyridine aldoxime methiodide (2-PAM) (5 mM) treatment for 11 min. The oxime 2-PAM is able to remove malathion from the active site of AChE by means of trans-esterification reaction. The storage stability and reusability of the prepared nano-biosensor is observed to be 30 days and seven times, respectively. The application of the developed nano-biosensor has also been evaluated for spiked lettuce sample. Recoveries of malathion from the spiked lettuce sample ranged between 96-98%. The low detection limit obtained by the developed nano-biosensor made them reliable, sensitive and a low cost process.

Keywords: PEDOT-MWCNT, malathion, organophosphates, acetylcholinesterase, nano-biosensor, oxime (2-PAM)

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Authors: Pei-Ru Yang, Yu-Chen Lin, Jia-Min Wu

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Background: A 58-year-old man with a history of osteoporosis and diabetes presented with chronic pain in his left knee due to severe knee joint degeneration. The knee replacement surgery was recommended by the doctor. But the patient suffered from low pain tolerance and wondered if virtual reality could relieve acute postoperative wound pain. Methods: We used the PICO (patient, intervention, comparison, and outcome) approach to generate indexed keywords and searched systematic review articles from 2017 to 2021 on the Cochran Library, PubMed, and Clinical Key databases. Results: The initial literature results included 38 articles, including 12 Cochrane library articles and 26 PubMed articles. One article was selected for further analysis after removing duplicates and off-topic articles. The eight trials included in this article were published between 2013 and 2019 and recruited a total of 723 participants. The studies, conducted in India, Lebanon, Iran, South Korea, Spain, and China, included adults who underwent hemorrhoidectomy, dental surgery, craniotomy or spine surgery, episiotomy repair, and knee surgery, with a mean age (24.1 ± 4.1 to 73.3 ± 6.5). Virtual reality is an emerging non-drug postoperative analgesia method. The findings showed that pain control was reduced by a mean of 1.48 points (95% CI: -2.02 to -0.95, p-value < 0.0001) in minor surgery and 0.32 points in major surgery (95% CI: -0.53 to -0.11, p-value < 0.03), and the overall postoperative satisfaction has improved. Discussion: Postoperative pain is a common clinical problem in surgical patients. Research has confirmed that virtual reality can create an immersive interactive environment, communicate with patients, and effectively relieve postoperative pain. However, virtual reality requires the purchase of hardware and software and other related computer equipment, and its high cost is a disadvantage. We selected the best literature based on clinical questions to answer the patient's question and used share decision making (SDM) to help the patient make decisions based on the clinical situation after knee replacement surgery to improve the quality of patient-centered care.

Keywords: knee replacement surgery, postoperative pain, share decision making, virtual reality

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Authors: Sylwia Sumińska, Łukasz Kapica, Grzegorz Szczepański

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Introduction: Cognitive skills are a crucial part of everyday functioning. Cognitive skills include perception, attention, language, memory, executive functions, and higher cognitive skills. With the aging of societies, there is an increasing percentage of people whose cognitive skills decline. Cognitive skills affect work performance. The appropriate diagnosis of a worker’s cognitive skills reduces the risk of errors and accidents at work which is also important for senior workers. The study aimed to prepare new cognitive tests for adults aged 20-60 and assess the psychometric properties of the tests. The project responds to the need for reliable and accurate methods of assessing cognitive performance. Computer tests were developed to assess psychomotor performance, attention, and working memory. Method: Two hundred eighty people aged 20-60 will participate in the study in 4 age groups. Inclusion criteria for the study were: no subjective cognitive impairment, no history of severe head injuries, chronic diseases, psychiatric and neurological diseases. The research will be conducted from February - to June 2022. Cognitive tests: 1) Measurement of psychomotor performance: Reaction time, Reaction time with selective attention component; 2) Measurement of sustained attention: Visual search (dots), Visual search (numbers); 3) Measurement of working memory: Remembering words, Remembering letters. To assess the validity and the reliability subjects will perform the Vienna Test System, i.e., “Reaction Test” (reaction time), “Signal Detection” (sustained attention), “Corsi Block-Tapping Test” (working memory), and Perception and Attention Test (TUS), Colour Trails Test (CTT), Digit Span – subtest from The Wechsler Adult Intelligence Scale. Eighty people will be invited to a session after three months aimed to assess the consistency over time. Results: Due to ongoing research, the detailed results from 280 people will be shown at the conference separately in each age group. The results of correlation analysis with the Vienna Test System will be demonstrated as well.

Keywords: aging, attention, cognitive skills, cognitive tests, psychomotor performance, working memory

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Authors: Manoj Kumar Reddy Pulim, Lakshmi Muthukrishnan, Geetha Jayapathy, Radhika Raman

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Introduction: In the past two decades, noninvasive positive pressure ventilation (NIPPV) emerged as one of the most important advances in the management of both acute and chronic respiratory failure in children. In the acute setting, it is an alternative to intubation with a goal to preserve normal physiologic functions, decrease airway injury, and prevent respiratory tract infections. There is a need to determine the clinical profile and parameters which point towards the need for NIV in the pediatric emergency setting. Objectives: i) To study the clinical profile of children who required non invasive ventilation and invasive ventilation, ii) To study the clinical parameters common to children who required non invasive ventilation. Methods: All children between one month to 18 years, who were intubated in the pediatric emergency department and those for whom decision to commence Non Invasive Ventilation was made in Emergency Room were included in the study. Children were transferred to the Paediatric Intensive Care Unit and started on Non Invasive Ventilation as per our hospital policy and followed up in the Paediatric Intensive Care Unit. Clinical profile of all children which included age, gender, diagnosis and indication for intubation were documented. Clinical parameters such as respiratory rate, heart rate, saturation, grunting were documented. Parameters obtained were subject to statistical analysis. Observations: Airway disease (Bronchiolitis 25%, Viral induced wheeze 22%) was a common diagnosis in 32 children who required Non Invasive Ventilation. Neuromuscular disorder was the common diagnosis in 27 children (78%) who were Intubated. 17 children commenced on Non Invasive Ventilation who later needed invasive ventilation had Neuromuscular disease. High frequency nasal cannula was used in 32, and mask ventilation in 17 children. Clinical parameters common to the Non Invasive Ventilation group were age < 1 year (17), tachycardia n = 7 (22%), tachypnea n = 23 (72%) and severe respiratory distress n = 9 (28%), grunt n = 7 (22%), SPO2 (80% to 90%) n = 16. Children in the Non Invasive Ventilation + INTUBATION group were > 3 years (9), had tachycardia 7 (41%), tachypnea 9(53%) with a male predominance n = 9. In statistical comparison among 3 groups,'p' value was significant for pH, saturation, and use of Ionotrope. Conclusion: Invasive ventilation can be avoided in the paediatric Emergency Department in children with airway disease, by commencing Non Invasive Ventilation early. Intubation in the pediatric emergency department has a higher association with neuromuscular disorders.

Keywords: clinical parameters, indications, non invasive ventilation, paediatric emergency room

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