Search results for: normal tube
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 3350

Search results for: normal tube

860 Assessment of HIV/Hepatitis B Virus Co-Infection among Patients Living with HIV in Northern and Southern Region of Nigeria

Authors: Folajinmi Oluwasina, Greg Abiaziem, Moses Luke, Mobolaji Kolawole, Nancy Yibowei, Anne Taiwo

Abstract:

Background: Occurrence of HIV infection has an adverse effect on the natural causes of Hepatitis B Viral (HBV) infection, faster progression of hepatic fibrosis demonstrated in patients with co-infection. This study was carried out to determine the incidence of HBV infection among HIV-positive patients, and to retrospectively evaluate laboratory characteristics of patients with HIV/HBV co-infection. Methods: A retrospective analysis of patient files for all HIV-infected cases followed-up and treated at 52 health facilities. Among HIV-infected cases, those with HBsAg positivity and HIV/Hepatitis B co-infection were determined. Socio demographic, alcohol or substance use, ART, CD4, Viral Load levels and treatment durations were retrospectively evaluated. Results: Of the 125 HIV-infected patients evaluated retrospectively, 17 (13.6%) had HBsAg positivity. Of these 17 cases were 11(64.7%) male and 6 (35.3%) female, with a mean age of 48.7 years. No patients had a history of alcohol or substance use. The mean duration of follow up was 28 months. 9 (52.9%) patients had negative HBV DNA at presentation while 8(47%) had positive HBV DNA, with normal ALT levels in all subjects. Among the 9 cases with negative HBV DNA who had no indication for the treatment of chronic hepatitis B. In five cases, treatment was commenced since HBV DNA was elevated in conjunction with low CD4. One patient in whom treatment was not indicated based on HBV DNA and CD4 levels in conjunction with the absence of AIDS defining clinical picture was currently being followed-up without treatment. Of the patients receiving HAART therapy, the average CD4 count at presentation was 278 cells/mm3 vs. 466 cells/mm3 at the end of 12 months. In three subjects with positive HBV DNA, a decrease in HBV DNA was noted after initiation of treatment. In four patients with negative DNA who received treatment, the HBV DNA negative status was found to remain, while one patient who did not receive treatment had elevated HBV DNA and decreased CD4 levels. Conclusion: It was shown that this group of patients with HIV/HBV co-infection, HAART was found to be associated with a decrease in HBV DNA in HBV DNA positive cases, absence of transition to positivity among those with negative HBV DNA, and with increased CD4 in all subjects.

Keywords: Hepatitis B, DNA, anti retroviral therapy, co-infection

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859 Nebulized Magnesium Sulfate in Acute Moderate to Severe Asthma in Pediatric Patients

Authors: Lubna M. Zakaryia Mahmoud, Mohammed A. Dawood, Doaa A. Heiba

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A prospective double-blind placebo controlled trial carried out on 60 children known to be asthmatic who presented to the emergency department at Alexandria University of Children’s Hospital at El-Shatby with acute asthma exacerbations to assess the efficacy of adding inhaled magnesium sulfate to β-agonist, compared with β-agonist in saline, in the management of acute asthma exacerbations in children. The participants in the study were divided in two groups; Group A (study group) received inhaled salbutamol solution (0.15 ml/kg) plus isotonic magnesium sulfate 2 ml in a nebulizer chamber. Group B (control group): received nebulized salbutamol solution (0.15 ml/kg) diluted with placebo (2 ml normal saline). Both groups received inhaled solution every 20 minutes that was repeated for three doses. They were evaluated using the Pediatric Asthma Severity Score (PASS), oxygen saturation using portable pulse oximetry and peak expiratory flow rate using a portable peak expiratory flow meter at initially recorded as zero-minute assessment and every 20 minutes from the end of each nebulization (nebulization lasts 5-10 minutes) recorded as 20, 40 and 60-minute assessments. Regarding PASS, comparison showed non-significant difference with p-value 0.463, 0.472, 0.0766 at 20, 40 and 60 minutes. Regarding oxygen saturation, improvement was more significant towards group A starting from 40 min with significant p-value=0.000. At 60 min p-value=0.000. Although mean PEFR significantly improved from zero-min in both groups; however, improvement was more significant in group A with significant p-value = 0.015, 0.001, 0.001 at 20 min, 40 min and 60 min, respectively. The conclusion this study suggests is that inhaled magnesium sulfate is an efficient add on drug to standard β- agonist inhalation used in the treatment of moderate to severe asthma exacerbations.

Keywords: nebulized, magnesium sulfate, acute asthma , pediatric

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858 Association Between Disability and Obesity Status Among US Adults: Findings From 2019-2021 National Health Interview Survey (NHIS)

Authors: Chimuanya Osuji, Kido Uyamasi, Morgan Bradley

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Introduction: Obesity is a major risk factor for many chronic diseases, with higher rates occurring among certain populations. Even though disparities in obesity rates exist for those with disabilities, few studies have assessed the association between disability and obesity status. This study aims to examine the association between type of disability and obesity status among US adults during the Covid-19 pandemic (2019-2021). Methods: Data for this cross-sectional study was obtained from the 2019, 2020 and 2021 NHIS. Multinomial logistic regressions were used to assess the relationship between each type of disability and obesity status (reference= normal/underweight). Each model adjusted for demographic, health status and health-related quality of life variables. Statistical analyses were conducted using SAS version 9.4. Results: Of the 82,632 US adults who completed the NHIS in 2019, 2020, and 2021. 8.9% (n= 7,354) reported at least 1 disability-related condition. Respondents reported having a disability across vision (1.5%), hearing (1.5%), mobility (5.3%), communication (0.8%), cognition (2.4%) and self-care (1.1%) domains. After adjusting for covariates, adults with at least 1 disability-related condition were about 30% more likely to have moderate-severe obesity (AOR=1.3; 95% CI=1.11, 1.53). Mobility was the only disability category positively associated with mild obesity (AOR=1.16; 95% CI=1.01, 1.35) and moderate/severe obesity (AOR=1.6; 95% CI=1.35, 1.89). Individuals with vision disability were about 35% less likely to have mild obesity (AOR=0.66; 95% CI=0.51, 0.86) and moderate-severe obesity (AOR=0.66; 95% CI= 0.48, 0.9). Individuals with hearing disability were 28% less likely to have mild obesity (AOR=0.72; 95% CI= 0.56, 0.94). Individuals with communication disability were about 30% less likely to be overweight (AOR=0.66; 95% CI=0.47, 0.93) and 50% less likely to have mild obesity (AOR=0.45; 95% CI= 0.29, 0.71). Individuals with cognitive disability were about 25% less likely to have mild obesity and about 35% less likely to have moderate-severe obesity. Individuals with self-care disability were about 30% less likely to be overweight. Conclusion: Mobility-related disabilities are significantly associated with obesity status among adults residing in the United States. Researchers and policy makers should implement obesity intervention methods that can address the gap in obesity prevalence rates among those with and without disabilities.

Keywords: cognition, disability, mobility, obesity

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857 Impact of Social Crisis on Property Market Performance and Evolving Strategy for Improved Property Transactions in Crisis Prone Environment: A Case Study of North Eastern Nigeria

Authors: A. Yakub AbdurRaheem

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Urban violence in the form of ethnic and religious conflicts have been on the increase in many African cities in the recent years of which most of them are the result of intense and bitter competition for political power, the control of limited economic, social and environmental resources. In Nigeria, the emergence of the Boko Haram insurgency in most parts of the northeastern parts have ignited violence, bloodshed, refugee exodus and internal migration. Not only do the persistent attacks of the sect create widespread insecurity and fear, but it has also stifled normal processes of trade and investments most especially real property investment which is acclaimed to accelerate the economic cycle, thus the need to evolve strategies for an improved property market in such areas. This paper, therefore, examines the impact of this social crisis on effective and efficient utilization of real properties as a resource towards the development of the economy, using a descriptive analysis approach where particular emphasis was based on trends in residential housing values; volume of estimated property transactions and real estate investment decisions by affected individuals. Findings indicate that social crisis in the affected areas have been a clog on the wheels of property development and investment as properties worth hundreds of millions have been destroyed thereby having great impact on property values. Based on these findings, recommendations were made to include the need to strategically continue investing in property during such times, the need for Nigerian government to establish an active conflict monitoring and management unit for the prompt response, encourage community and neighborhood policing to ameliorate security challenges in Nigeria.

Keywords: social crisis, economy, resources, property market

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856 Partial Triphallia: The First Case Report of External and Internal Penile Triplication in a Cadaver

Authors: Madeleine Gadd, Rose How, Edward Mathews, John Buchanan, Vicky Cottrell, Andre Coetzee, Karuna Katti

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Introduction: Triphallia, a congenital anomaly describing the presence of three distinct penile shafts, has been reported only once in the literature. This case report describes the serendipitous discovery of the first reported human case of partial orthotopic triphallia during cadaveric dissection. Case Summary: Despite the normal appearance of external genitalia on examination, the dissection of a 78-year-old male revealed a remarkable anatomical variation: two small supernumerary penises situated in a transverse orientation postero inferiorly to the primary penis. The main and the larger supernumerary penile shafts displayed their own corpora cavernosa and glans penis, sharing a single urethra, which coursed through the secondary penis prior to its passage through the primary penis. The smallest of the supernumerary penises was similar in dimension to the secondary penis, at 3.7cm long and 1.2cm wide (compared to the secondary penis at 3.8cm long and 1.3cm wide). However, it lacked a urethra and a typical arrangement of the corpora cavernosa and spongiosum, making this a case of partial triphallia rather than true triphallia. Conclusion: This case report provides a comprehensive anatomical description of partial triphallia in a cadaver, shedding light on the morphology, embryology, and clinical implications of this anomaly. This case report underscores the importance of meticulous anatomical dissections, particularly since, without dissection, this anatomical variation would have remained undiscovered. Although we can only speculate the functional implications of this condition, understanding such anatomical variations contributes to both knowledge of human anatomy and clinical management, should the condition be encountered in living individuals.

Keywords: triphallia, diphallia, congenital abnormalities, genitourinary abnormalities, urology

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855 Evaluating the Capability of the Flux-Limiter Schemes in Capturing the Turbulence Structures in a Fully Developed Channel Flow

Authors: Mohamed Elghorab, Vendra C. Madhav Rao, Jennifer X. Wen

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Turbulence modelling is still evolving, and efforts are on to improve and develop numerical methods to simulate the real turbulence structures by using the empirical and experimental information. The monotonically integrated large eddy simulation (MILES) is an attractive approach for modelling turbulence in high Re flows, which is based on the solving of the unfiltered flow equations with no explicit sub-grid scale (SGS) model. In the current work, this approach has been used, and the action of the SGS model has been included implicitly by intrinsic nonlinear high-frequency filters built into the convection discretization schemes. The MILES solver is developed using the opensource CFD OpenFOAM libraries. The role of flux limiters schemes namely, Gamma, superBee, van-Albada and van-Leer, is studied in predicting turbulent statistical quantities for a fully developed channel flow with a friction Reynolds number, ReT = 180, and compared the numerical predictions with the well-established Direct Numerical Simulation (DNS) results for studying the wall generated turbulence. It is inferred from the numerical predictions that Gamma, van-Leer and van-Albada limiters produced more diffusion and overpredicted the velocity profiles, while superBee scheme reproduced velocity profiles and turbulence statistical quantities in good agreement with the reference DNS data in the streamwise direction although it deviated slightly in the spanwise and normal to the wall directions. The simulation results are further discussed in terms of the turbulence intensities and Reynolds stresses averaged in time and space to draw conclusion on the flux limiter schemes performance in OpenFOAM context.

Keywords: flux limiters, implicit SGS, MILES, OpenFOAM, turbulence statistics

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854 Entrepreneur Competencies: An Exploratory Study Applied to Educational Social Enterprise in South East Asia

Authors: D. Songpol, K. Taweesak, T. Sookyuen

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A social enterprise is an organization that operates commercial business as a source of income with the aim of addressing social and environmental issues. Though it is clear that this kind of organization will benefit society and environment but in practice, it is found that most of social enterprises’ goals cannot be achieved. The most success factors of social enterprises usually rely on individual characteristics of entrepreneurs, especially in educational business. This study aims to find out the magnitude of influence from the components of entrepreneur competencies to social enterprises in education. There are developmental models of research demonstrating that knowledge, skills and attributes affect the success of social enterprises in term of sustainability, social opportunities and innovation leadership. The 5-scale questionnaire was used to collect data from the social entrepreneurs in education who operates in the South East Asian region of 135 samples and then processed by the methods of structural equation models. The results show that the competency of entrepreneurs in attributes has the greatest impact on the success of social enterprises while the skills and knowledge have respectively impact on the social enterprises’ success as well. The reason why attributes of entrepreneurs have the greatest impact on social enterprise success is because, social enterprise is an organization that does not motivate or provide attractive financial incentives to the entrepreneur. Entrepreneurs, who succeed in developing their organizations, therefore need attribute factor higher than normal entrepreneurs, especially those in education sector that have somewhat few human resources to operate their businesses. More importantly, attribute’s traits such as entrepreneurial passion, self-efficacy, entrepreneurial identity and, innovativeness and perseverance will significantly affect the ideology and tolerance of the entrepreneurs once facing the problem in doing business. In conclusion, the education social enterprise would be successful depending on the performance of the entrepreneurs which derives from higher attributes competency.

Keywords: education, entrepreneur competencies, social enterprise, South East Asia

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853 A Self-Study of the Facilitation of Science Teachers’ Action Research

Authors: Jawaher A. Alsultan, Allen Feldman

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With the rapid switch to remote learning due to the COVID-19 pandemic, science teachers were suddenly required to teach their classes online. This breakneck shift to eLearning raised the question of how teacher educators could support science teachers who wanted to use reform-based methods of instruction while using virtual technologies. In this retrospective self-study, we, two science teacher educators, examined our practice as we worked with science teachers to implement inquiry, discussion, and argumentation [IDA] through eLearning. Ten high school science teachers from a large school district in the southeastern US participated virtually in the COVID-19 Community of Practice [COVID-19 CoP]. The CoP met six times from the end of April through May 2020 via Zoom. Its structure was based on a model of action research called enhanced normal practice [ENP], which includes exchanging stories, trying out ideas, and systematic inquiry. Data sources included teacher educators' meeting notes and reflective conversations, audio recordings of the CoP meetings, teachers' products, and post-interviews of the teachers. Findings included a new understanding of the role of existing relationships, shared goals, and similarities in the participants' situations, which helped build trust in the CoP, and the effects of our paying attention to the science teachers’ needs led to a well-functioning CoP. In addition, we became aware of the gaps in our knowledge of how the teachers already used apps in their practice, which they then shared with all of us about how they could be used for online teaching using IDA. We also identified the need to pay attention to feelings about tensions between the teachers and us around the expectations for final products and the project's primary goals. We found that if we are to establish relationships between us as facilitators and teachers that are honest, fair, and kind, we must express those feelings within the collective, dialogical processes that can lead to learning by all members of the CoP, whether virtual or face-to-face.

Keywords: community of practice, facilitators, self-study, action research

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852 Adsorption of Atmospheric Gases Using Atomic Clusters

Authors: Vidula Shevade, B. J. Nagare, Sajeev Chacko

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First principles simulation, meaning density functional theory (DFT) calculations with plane waves and pseudopotential, has become a prized technique in condensed matter theory. Nanoparticles (NP) have been known to possess good catalytic activities, especially for molecules such as CO, O₂, etc. Among the metal NPs, Aluminium based NPs are also widely known for their catalytic properties. Aluminium metal is a lightweight, excellent electrical, and thermal abundant chemical element in the earth’s crust. Aluminium NPs, when added to solid rocket fuel, help improve the combustion speed and considerably increase combustion heat and combustion stability. Adding aluminium NPs into normal Al/Al₂O₃ powder improves the sintering processes of the ceramics, with high heat transfer performance, increased density, and enhanced thermal conductivity of the sinter. We used VASP and Gaussian 0₃ package to compute the geometries, electronic structure, and bonding properties of Al₁₂Ni as well as its interaction with O₂ and CO molecules. Several MD simulations were carried out using VASP at various temperatures from which hundreds of structures were optimized, leading to 24 unique structures. These structures were then further optimized through a Gaussian package. The lowest energy structure of Al₁₂Ni has been reported to be a singlet. However, through our extensive search, we found a triplet state to be lower in energy. In our structure, the Ni atom is found to be on the surface, which gives the non-zero magnetic moment. Incidentally, O2 and CO molecules are also triplet in nature, due to which the Al₁₂-Ni cluster is likely to facilitate the oxidation process of the CO molecule. Our results show that the most favourable site for the CO molecule is the Ni atom and that for the O₂ molecule is the Al atom that is nearest to the Ni atom. Al₁₂Ni-O₂ and Al₁₂-Ni-CO structures we extracted using VMD. Al₁₂Ni nanocluster, due to in triplet electronic structure configuration, indicates it to be a potential candidate as a catalyst for oxidation of CO molecules.

Keywords: catalyst, gaussian, nanoparticles, oxidation

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851 Response of Grower Turkeys to Diets Containing Moringa oleifera Leaf Meal in a Tropical Environment

Authors: Augustine O. Ani, Ifeyinwa E. Ezemagu, Eunice A. Akuru

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A seven-week study was conducted to evaluate the response of grower turkeys to varying dietary levels of Moringa oleifera leaf meal (MOLM) in a humid tropical environment. A total of 90 twelve weeks old male and female grower turkeys were randomly divided into five groups of 18 birds each in a completely randomized design (CRD) and assigned to five caloric (2.57-2.60 Mcal/kg ME) and isonitrogenous (19.95% crude protein) diets containing five levels (0, 15, 20, 25 and 30%) of MOLM, respectively. Each treatment was replicated three times with 6 birds per replicate housed in a deep litter pen of fresh wood shavings measuring 1.50m x 1.50m. Feed and water were provided to the birds' ad libitum. Parameters measured were: final live weight (FLW) daily weight gain (DWG), daily feed intake (DFI), feed conversion ratio (FCR), protein efficiency ratio (PER), packed cell volume (PCV), haemoglobin concentration (Hb), red blood cell (RBC) count, white blood cell (WBC) count, mean cell volume (MCV), mean cell haemoglobin (MCH) and mean cell haemoglobin concentration (MCHC), feed cost / kg weight gain and apparent nutrient retention. Results showed that grower turkeys fed 20% MOLM diet had significantly (p < 0.05) higher FLW and DWG values (4410.30 g and 34.49 g, respectively) and higher DM and NFE retention values (67.28 and 58.12%, respectively) than turkeys fed other MOLM diets. Feed cost per kg gain decreased significantly (p < 0.05) with increasing levels of MOLM in the diets. The PCV, Hb, WBC, MCV, MCH and MCHC values of grower turkeys fed 20% MOLM diet were significantly (p < 0.05) higher than those of grower turkeys fed other diets. It was concluded that a diet containing 20% MOLM is adequate for the normal growth of grower turkeys in the tropics.

Keywords: Diets, grower turkeys, Moringa oleifera leaf meal, response, tropical environment

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850 Lung Cancer Detection and Multi Level Classification Using Discrete Wavelet Transform Approach

Authors: V. Veeraprathap, G. S. Harish, G. Narendra Kumar

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Uncontrolled growth of abnormal cells in the lung in the form of tumor can be either benign (non-cancerous) or malignant (cancerous). Patients with Lung Cancer (LC) have an average of five years life span expectancy provided diagnosis, detection and prediction, which reduces many treatment options to risk of invasive surgery increasing survival rate. Computed Tomography (CT), Positron Emission Tomography (PET), and Magnetic Resonance Imaging (MRI) for earlier detection of cancer are common. Gaussian filter along with median filter used for smoothing and noise removal, Histogram Equalization (HE) for image enhancement gives the best results without inviting further opinions. Lung cavities are extracted and the background portion other than two lung cavities is completely removed with right and left lungs segmented separately. Region properties measurements area, perimeter, diameter, centroid and eccentricity measured for the tumor segmented image, while texture is characterized by Gray-Level Co-occurrence Matrix (GLCM) functions, feature extraction provides Region of Interest (ROI) given as input to classifier. Two levels of classifications, K-Nearest Neighbor (KNN) is used for determining patient condition as normal or abnormal, while Artificial Neural Networks (ANN) is used for identifying the cancer stage is employed. Discrete Wavelet Transform (DWT) algorithm is used for the main feature extraction leading to best efficiency. The developed technology finds encouraging results for real time information and on line detection for future research.

Keywords: artificial neural networks, ANN, discrete wavelet transform, DWT, gray-level co-occurrence matrix, GLCM, k-nearest neighbor, KNN, region of interest, ROI

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849 Ground Track Assessment Using Electrical Resistivity Tomography Application

Authors: Noryani Natasha Yahaya, Anas Ibrahim, Juraidah Ahmad, Azura Ahmad, Mohd Ikmal Fazlan Rosli, Zailan Ramli, Muhd Sidek Muhd Norhasri

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The subgrade formation is an important element of the railway structure which holds overall track stability. Conventional track maintenance involves many substructure component replacements, as well as track re-ballasting on a regular basis is partially contributed to the embankment's long-term settlement problem. For subgrade long-term stability analysis, the geophysical method is commonly being used to diagnose those hidden sources/mechanisms of track deterioration problems that the normal visual method is unable to detect. Electrical resistivity tomography (ERT) is one of the applicable geophysical tools that are helpful in railway subgrade inspection/track monitoring due to its flexibility and reliability of the analysis. The ERT was conducted at KM 23.0 of Pinang Tunggal track to investigate the subgrade of railway track through the characterization/mapping on track formation profiling which was directly generated using 2D analysis of Res2dinv software. The profiles will allow examination of the presence and spatial extent of a significant subgrade layer and screening of any poor contact of soil boundary. Based on the finding, there is a mix/interpretation/intermixing of an interlayer between the sub-ballast and the sand. Although the embankment track considered here is at no immediate risk of settlement effect or any failure, the regular monitoring of track’s location will allow early correction maintenance if necessary. The developed data of track formation clearly shows the similarity of the side view with the assessed track. The data visualization in the 2D section of the track embankment agreed well with the initial assumption based on the main element structure general side view.

Keywords: ground track, assessment, resistivity, geophysical railway, method

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848 Impact of Sovereign Debt Risk and Corrective Austerity Measures on Private Sector Borrowing Cost in Euro Zone

Authors: Syed Noaman Shah

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The current paper evaluates the effect of external public debt risk on the borrowing cost of private non-financial firms in euro zone. Further, the study also treats the impact of austerity measures on syndicated-loan spreads of private firm followed by euro area member states to revive the economic growth in the region. To test these hypotheses, we follow multivariate ordinary least square estimation method to assess the effect of external public debt on the borrowing cost of private firms. By using foreign syndicated-loan issuance data of non-financial private firms from 2005 to 2011, we attempt to gauge how the private financing cost varies with high levels of sovereign external debt prevalent in the euro zone. Our results suggest significant effect of external public debt on the borrowing cost of private firm. In particular, an increase in external public debt by one standard deviation from its sample mean raises syndicated-loan spread by 89 bps. Furthermore, weak creditor rights protection prevalent in member states deepens this effect. However, we do not find any significant effect of domestic public debt on the private sector borrowing cost. In addition, the results show significant effect of austerity measures on private financing cost, both in normal and in crisis period in the euro zone. In particular, one standard deviation change in fiscal consolidation conditional mean reduces the syndicated-loan spread by 22 bps. In turn, it indicates strong presence of credibility channel due to austerity measures in euro area region.

Keywords: corporate debt, fiscal consolidation, sovereign debt, syndicated-loan spread

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847 Eosinopenia: Marker for Early Diagnosis of Enteric Fever

Authors: Swati Kapoor, Rajeev Upreti, Monica Mahajan, Abhaya Indrayan, Dinesh Srivastava

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Enteric Fever is caused by gram negative bacilli Salmonella typhi and paratyphi. It is associated with high morbidity and mortality worldwide. Timely initiation of treatment is a crucial step for prevention of any complications. Cultures of body fluids are diagnostic, but not always conclusive or practically feasible in most centers. Moreover, the results of cultures delay the treatment initiation. Serological tests lack diagnostic value. The blood counts can offer a promising option in diagnosis. A retrospective study to find out the relevance of leucopenia and eosinopenia was conducted on 203 culture proven enteric fever patients and 159 culture proven non-enteric fever patients in a tertiary care hospital in New Delhi. The patient details were retrieved from the electronic medical records section of the hospital. Absolute eosinopenia was considered as absolute eosinophil count (AEC) of less than 40/mm³ (normal level: 40-400/mm³) using LH-750 Beckman Coulter Automated machine. Leucopoenia was defined as total leucocyte count (TLC) of less than 4 X 10⁹/l. Blood cultures were done using BacT/ALERT FA plus automated blood culture system before first antibiotic dose was given. Case and control groups were compared using Pearson Chi square test. It was observed that absolute eosinophil count (AEC) of 0-19/mm³ was a significant finding (p < 0.001) in enteric fever patients, whereas leucopenia was not a significant finding (p=0.096). Using Receiving Operating Characteristic (ROC) curves, it was observed that patients with both AEC < 14/mm³ and TCL < 8 x 10⁹/l had 95.6% chance of being diagnosed as enteric fever and only 4.4% chance of being diagnosed as non-enteric fever. This result was highly significant with p < 0.001. This is a very useful association of AEC and TLC found in enteric fever patients of this study which can be used for the early initiation of treatment in clinically suspected enteric fever patients.

Keywords: absolute eosinopenia, absolute eosinophil count, enteric fever, leucopenia, total leucocyte count

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846 A Modular Reactor for Thermochemical Energy Storage Examination of Ettringite-Based Materials

Authors: B. Chen, F. Kuznik, M. Horgnies, K. Johannes, V. Morin, E. Gengembre

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More attention on renewable energy has been done after the achievement of Paris Agreement against climate change. Solar-based technology is supposed to be one of the most promising green energy technologies for residential buildings since its widely thermal usage for hot water and heating. However, the seasonal mismatch between its production and consumption makes buildings need an energy storage system to improve the efficiency of renewable energy use. Indeed, there exist already different kinds of energy storage systems using sensible or latent heat. With the consideration of energy dissipation during storage and low energy density for above two methods, thermochemical energy storage is then recommended. Recently, ettringite (3CaO∙Al₂O₃∙3CaSO₄∙32H₂O) based materials have been reported as potential thermochemical storage materials because of high energy density (~500 kWh/m³), low material cost (700 €/m³) and low storage temperature (~60-70°C), compared to reported salt hydrates like SrBr₂·6H₂O (42 k€/m³, ~80°C), LaCl₃·7H₂O (38 k€/m³, ~100°C) and MgSO₄·7H₂O (5 k€/m³, ~150°C). Therefore, they have the possibility to be largely used in building sector with being coupled to normal solar panel systems. On the other side, the lack in terms of extensive examination leads to poor knowledge on their thermal properties and limit maturity of this technology. The aim of this work is to develop a modular reactor adapting to thermal characterizations of ettringite-based material particles of different sizes. The filled materials in the reactor can be self-compacted vertically to ensure hot air or humid air goes through homogenously. Additionally, quick assembly and modification of reactor, like LEGO™ plastic blocks, make it suitable to distinct thermochemical energy storage material samples with different weights (from some grams to several kilograms). In our case, quantity of stored and released energy, best work conditions and even chemical durability of ettringite-based materials have been investigated.

Keywords: dehydration, ettringite, hydration, modular reactor, thermochemical energy storage

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845 Seroprevalence Study of Cystic Echinococcosis and Its Associated Risk Factors in Fars Province, Southern Iran

Authors: Mahmoud Reza Tahamtan, Mohammad Saleh Bahreini

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Background and Purpose: Cystic echinococcosis, caused by the larval stage of Echinococcus granulosus, is a common parasitic infection of humans and is endemic in many parts of the world, including Iran. So that, one percent of those admitted to surgery departments are hydatid cyst patients, and using the ELISA method, the infection rate has been reported in different regions of Iran from 1.2% to 21.4%. Therefore, the aim of this study was to investigate the seroepidemiology of human hydatid cysts in Fars province, southern Iran, by ELISA method. Methods: In this cross-sectional study, 600 serum samples of persons who were referred to the laboratory of Nemazi Hospital in Shiraz for normal tests were examined for the presence of specific Anti-IgG antibodies to hydatid cysts by ELISA method. During the sampling, a structured questionnaire was used to obtain social data of individuals with determinants of risk factors for Cystic echinococcosis. Finally, the results of the ELISA test, along with demographic information completed by individuals, were analyzed using SPSS software. Results: The average age of the subjects in this study was 40.01 ± 9.166. The prevalence of hydatidosis was reported as 5.66% (34/600). The disease was more in the age group of 21-30, people living in villages, working in rural areas, and people with a history of other parasitic diseases. Statistically, a significant difference was observed between the prevalence of the disease and two risk factors, contact with dogs (OR= 0.042; 95%CI: 0.014-0.12; P= 0.001) and washing vegetables with water (OR= 0.08; 95%CI: 0.011-0.56; P= 0.012). Conclusion: The present study showed that hydatid cyst disease has a significant prevalence in this area. Also, based on the results, contact with dogs and not properly washing vegetables are two important factors of disease transmission.

Keywords: Echinococcus granulosus, Cystic echinococcosis, hydatid cyst, Fars province

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844 Redirection of Cytokine Production Patterns by Dydrogesterone, an Orally-Administered Progestogen

Authors: Raj Raghupathy

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Recurrent Spontaneous Miscarriage (RSM) is a common form of pregnancy loss, 50% of which are due to ‘unexplained’ causes. Evidence exists to suggest that RSM may be caused by immunologic factors such as cytokines which are critical molecules of the immune system, with an impressive array of capabilities. An association appears to exist between Th2-type reactivity (mediated by Th2 or anti-inflammatory cytokines) and normal, successful pregnancy, and between unexplained RSM and Th1 cytokine dominance. If pro-inflammatory cytokines are indeed associated with pregnancy loss, the suppression of these cytokines, and thus the ‘redirection’ of maternal reactivity, may help prevent cytokine-mediated pregnancy loss. The objective of this study was to explore the possibility of modulating cytokine production using Dydrogesterone (Duphaston®), an orally-administered progestogen. Peripheral blood mononuclear cells from 34 women with a history of at least 3 unexplained recurrent miscarriages were stimulated in vitro with a mitogen (to elicit cytokine production) in the presence and absence of dydrogesterone. Levels of selected pro- and anti-inflammatory cytokines produced by peripheral blood mononuclear cells were measured after exposure to these progestogens. Dydrogesterone down-regulates the production of pro-inflammatory cytokines and up-regulates the production of anti-inflammatory cytokines. The ratios of Th2 to Th1 cytokines are markedly elevated in the presence of dydrogesterone, indicating a shift from potentially harmful maternal Th1 reactivity to a more pregnancy-conducive Th2 profile. We used a progesterone receptor antagonist to show that this cytokine-modulating effect of dydrogesterone is mediated via the progesterone receptor. Dydrogesterone also induces the production of the Progesterone-Induced Blocking Factor (PIBF); lymphocytes exposed to PIBF produce higher levels of Th2 cytokines, affecting a Th1 → Th2 cytokine shift which could be favourable to the success of pregnancy. We conclude that modulation of maternal cytokine production profiles is possible with dydrogesterone which has the merits that it can be administered orally and that it is safe.

Keywords: cytokines, dydrogesterone, progesterone, recurrent spontaneous miscarriage

Procedia PDF Downloads 269
843 The Axonal Connectivity of Motor and Premotor Areas as Revealed through Fiber Dissections: Shedding Light on the Structural Correlates of Complex Motor Behavior

Authors: Spyridon Komaitis, Christos Koutsarnakis, Evangelos Drosos, Aristotelis Kalyvas

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This study opts to investigate the intrinsic architecture, morphology, and spatial relationship of the subcortical pathways implicated in the connectivity of the motor/premotor cortex and SMA/pre-SMA complex. Twenty normal, adult, formalin-fixed cerebral hemispheres were explored through the fiber micro-dissection technique. Lateral to medial and medial to lateral dissections focused on the area of interest were performed in a tandem manner and under the surgical microscope. We traced the subcortical architecture, spatial relationships, and axonal connectivity of four major pathways: a) the dorsal component of the SLF (SLF-I) was found to reside in the medial aspect of the hemisphere and seen to connect the precuneus with the SMA and pre-SMA complex, b) the frontal longitudinal system (FLS) was consistently encountered as the natural anterior continuation of the SLF-II and SLF-III and connected the premotor and prefrontal cortices c) the fronto-caudate tract (FCT), a fan-shaped tract, was documented to participate in connectivity of the prefrontal and premotor cortices to the head and body of the caudate nucleus and d) the cortico-tegmental tract(CTT) was invariably recorded to subserve the connectivity of the tegmental area with the fronto-parietal cortex. No hemispheric asymmetries were recorded for any of the implicated pathways. Sub-segmentation systems were also proposed for each of the aforementioned tracts. The structural connectivity and functional specialization of motor and premotor areas in the human brain remain vague to this day as most of the available evidence derives either from animal or tractographic studies. By using the fiber-microdissection technique as our main method of investigation, we provide sound structural evidence on the delicate anatomy of the related white matter pathways.

Keywords: neuroanatomy, premotor, motor, connectivity

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842 Analysis of Magnetic Anomaly Data for Identification Structure in Subsurface of Geothermal Manifestation at Candi Umbul Area, Magelang, Central Java Province, Indonesia

Authors: N. A. Kharisa, I. Wulandari, R. Narendratama, M. I. Faisal, K. Kirana, R. Zipora, I. Arfiansah, I. Suyanto

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Acquisition of geophysical survey with magnetic method has been done in manifestation of geothermalat Candi Umbul, Grabag, Magelang, Central Java Province on 10-12 May 2013. This objective research is interpretation to interpret structural geology that control geothermal system in CandiUmbul area. The research has been finished with area size 1,5 km x 2 km and measurement space of 150 m. And each point of line space survey is 150 m using PPM Geometrics model G-856. Data processing was started with IGRF and diurnal variation correction to get total magnetic field anomaly. Then, advance processing was done until reduction to pole, upward continuation, and residual anomaly. That results become next interpretation in qualitative step. It is known that the biggest object position causes low anomaly located in central of area survey that comes from hot spring manifestation and demagnetization zone that indicates the existence of heat source activity. Then, modeling the anomaly map was used for quantitative interpretation step. The result of modeling is rock layers and geological structure model that can inform about the geothermal system. And further information from quantitative interpretations can be interpreted about lithology susceptibility. And lithology susceptibilities are andesiteas heat source has susceptibility value of (k= 0.00014 emu), basaltic as alteration rock (k= 0.0016 emu), volcanic breccia as reservoir rock (k= 0.0026 emu), andesite porfirtic as cap rock (k= 0.004 emu), lava andesite (k= 0.003 emu), and alluvium (k= 0.0007 emu). The hot spring manifestation is controlled by the normal fault which becomes a weak zone, easily passed by hot water which comes from the geothermal reservoir.

Keywords: geological structure, geothermal system, magnetic, susceptibility

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841 Advocating for and Implementing the Use of Advance Top Bar (ATB) for a More Than 100% Increase in Honey Yield in Top Bar Hives Owing to Honey Harvesting Without Comb Destruction

Authors: Perry Ayi Mankattah

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Introduction: Africa, which should lead the world in honey production, is importing three times the honey it produces even though it has a healthy, industrious and large population of bees. This is due to the mechanism of honey harvesting that destroys the combs and thereby reducing honey production and rate of harvesting. For Africa to take its place in the world of honey production, Africa should adopt a method that enables a higher rate of honey harvesting. The Advance Top Bar is, therefore, a simplified framework that provides that answer. It can be made of wood, plastic and metal that can be fabricated by tin/metal smiths, wielders and carpenters at the village level without any very sophisticated machines. Material and Methods: ATB is a top bar-like hollow framework of dimension 3.2*48 cm that can be made of wood, plastic and metal. It is made up of three parts of a constant hollow top bar, a variable grooved bottom bar with both bars being joined through synchronized holes (that align both the top and bottom bars ) by either metal or plastic rods of length 22cm and diameter of 5 mm with rounded balls at both ends It could be used with foundation combs or without and also other accessories to have about ten (10) function which includes commercial propolis harvesting queen rearing etc. The variable bottom bar length depends on the width of the hive, as most African beehives are somehow not standardized. Results: Foundation combs are placed within the Advance Top Bar for the bees to form their combs over its mesh to prevent comb breakage during honey harvesting. Similarly, honeycombs on top bars will produce natural foundation combs when also placed in the Advance top bar system just as they are re-used in the Langstroth Frames. Discussions and Conclusions: Any modification that will promote non-comb destruction during honey harvesting in Top bars shall cause Africa to increase honey production by over 100% as beekeepers adopt the mechanism. Honey-laden combs from the current normal top bars could be placed in the Advance Top Bar to harvest without comb destruction; hence the same system could be used as a transition to the adoption of the Advance Top Bar with less cost.

Keywords: honey, harvest, increase, production

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840 Hybridization of Manually Extracted and Convolutional Features for Classification of Chest X-Ray of COVID-19

Authors: M. Bilal Ishfaq, Adnan N. Qureshi

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COVID-19 is the most infectious disease these days, it was first reported in Wuhan, the capital city of Hubei in China then it spread rapidly throughout the whole world. Later on 11 March 2020, the World Health Organisation (WHO) declared it a pandemic. Since COVID-19 is highly contagious, it has affected approximately 219M people worldwide and caused 4.55M deaths. It has brought the importance of accurate diagnosis of respiratory diseases such as pneumonia and COVID-19 to the forefront. In this paper, we propose a hybrid approach for the automated detection of COVID-19 using medical imaging. We have presented the hybridization of manually extracted and convolutional features. Our approach combines Haralick texture features and convolutional features extracted from chest X-rays and CT scans. We also employ a minimum redundancy maximum relevance (MRMR) feature selection algorithm to reduce computational complexity and enhance classification performance. The proposed model is evaluated on four publicly available datasets, including Chest X-ray Pneumonia, COVID-19 Pneumonia, COVID-19 CTMaster, and VinBig data. The results demonstrate high accuracy and effectiveness, with 0.9925 on the Chest X-ray pneumonia dataset, 0.9895 on the COVID-19, Pneumonia and Normal Chest X-ray dataset, 0.9806 on the Covid CTMaster dataset, and 0.9398 on the VinBig dataset. We further evaluate the effectiveness of the proposed model using ROC curves, where the AUC for the best-performing model reaches 0.96. Our proposed model provides a promising tool for the early detection and accurate diagnosis of COVID-19, which can assist healthcare professionals in making informed treatment decisions and improving patient outcomes. The results of the proposed model are quite plausible and the system can be deployed in a clinical or research setting to assist in the diagnosis of COVID-19.

Keywords: COVID-19, feature engineering, artificial neural networks, radiology images

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839 An Investigation of the Effects of Gripping Systems in Geosynthetic Shear Testing

Authors: Charles Sikwanda

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The use of geosynthetic materials in geotechnical engineering projects has rapidly increased over the past several years. These materials have resulted in improved performance and cost reduction of geotechnical structures as compared to the use of conventional materials. However, working with geosynthetics requires knowledge of interface parameters for design. These parameters are typically determined by the large direct shear device in accordance with ASTM-D5321 and ASTM-D6243 standards. Although these laboratory tests are standardized, the quality of the results can be largely affected by several factors that include; the shearing rate, applied normal stress, gripping mechanism, and type of the geosynthetic specimens tested. Amongst these factors, poor surface gripping of a specimen is the major source of the discrepancy. If the specimen is inadequately secured to the shearing blocks, it experiences progressive failure and shear strength that deviates from the true field performance of the tested material. This leads to inaccurate, unsafe, and cost ineffective designs of projects. Currently, the ASTM-D5321 and ASTM-D6243 standards do not provide a standardized gripping system for geosynthetic shear strength testing. Over the years, researchers have come up with different gripping systems that can be used such as; glue, metal textured surface, sandblasting, and sandpaper. However, these gripping systems are regularly not adequate to sufficiently secure the tested specimens to the shearing device. This has led to large variability in test results and difficulties in results interpretation. Therefore, this study was aimed at determining the effects of gripping systems in geosynthetic interface shear strength testing using a 300 x 300 mm direct shear box. The results of the research will contribute to easy data interpretation and increase result accuracy and reproducibility.

Keywords: geosynthetics, shear strength parameters, gripping systems, gripping

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838 Engineering Thermal-Hydraulic Simulator Based on Complex Simulation Suite “Virtual Unit of Nuclear Power Plant”

Authors: Evgeny Obraztsov, Ilya Kremnev, Vitaly Sokolov, Maksim Gavrilov, Evgeny Tretyakov, Vladimir Kukhtevich, Vladimir Bezlepkin

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Over the last decade, a specific set of connected software tools and calculation codes has been gradually developed. It allows simulating I&C systems, thermal-hydraulic, neutron-physical and electrical processes in elements and systems at the Unit of NPP (initially with WWER (pressurized water reactor)). In 2012 it was called a complex simulation suite “Virtual Unit of NPP” (or CSS “VEB” for short). Proper application of this complex tool should result in a complex coupled mathematical computational model. And for a specific design of NPP, it is called the Virtual Power Unit (or VPU for short). VPU can be used for comprehensive modelling of a power unit operation, checking operator's functions on a virtual main control room, and modelling complicated scenarios for normal modes and accidents. In addition, CSS “VEB” contains a combination of thermal hydraulic codes: the best-estimate (two-liquid) calculation codes KORSAR and CORTES and a homogenous calculation code TPP. So to analyze a specific technological system one can build thermal-hydraulic simulation models with different detalization levels up to a nodalization scheme with real geometry. And the result at some points is similar to the notion “engineering/testing simulator” described by the European utility requirements (EUR) for LWR nuclear power plants. The paper is dedicated to description of the tools mentioned above and an example of the application of the engineering thermal-hydraulic simulator in analysis of the boron acid concentration in the primary coolant (changed by the make-up and boron control system).

Keywords: best-estimate code, complex simulation suite, engineering simulator, power plant, thermal hydraulic, VEB, virtual power unit

Procedia PDF Downloads 362
837 Crosslinked PVA/Bentonite Clay Nanocomposite Membranes: An Effective Membrane for the Separation of Azeotropic Composition of Isopropanol and Water

Authors: Soney C. George, Thomasukutty Jose, Sabu Thomas

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Membrane based separation is the most important energy –efficient separation processes. There are wide ranges of membrane based separation process such as Micro-filtration, ultra filtration, reverse osmosis, electro-dialysis etc. Among these pervaporation is one of the most promising techniques. The promising technique is in the sense that it needs an ease of process design, low energy consumption, environmentally clean, economically cost effective and easily separate azeotropic composition without losing any components, unlike distillation in a short period of time. In the present work, we developed a new bentonite clay reinforced cross-linked PVA nano-composite membranes by solution casting method. The membranes were used for the pervaporation separation of azeotropic composition of isopropanol and water mixtures. The azeotropic composition of water and isopropanol is difficult to separate and we can’t get a better separation by normal separation processes. But the better separation was achieved here using cross-linked PVA/Clay nano-composite membranes. The 2wt% bentonite clay reinforced 5vol% GA cross-linked nano-composite membranes showed better separation efficiency. The selectivity of the cross-linked membranes increases 65% upon filler loading. The water permeance is showed tremendous enhancement upon filler loading. The permeance value changes from 4100 to 8200, due to the incorporation hydrophilic bentonite clay to the cross-linked PVA membranes. The clay reinforced membranes shows better thermal stability upon filler loading was confirmed from TGA and DSC analysis. The dispersion of nanoclay in the polymeric matrix was clearly evident from the TEM analysis. The better dispersed membranes showed better separation performance. Thus the developed cross-linked PVA/Clay membranes can be effectively used for the separation of azeotropic composition of water and isopropanol.

Keywords: poly(vinyl alcohol), membrane, gluraldehyde, permeance

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836 Hesperidin through Acting on Proliferating Cell Nuclear Antigen and Follicle Stimulating Hormone Receptor Expression Decreased Ovarian Toxicity Induced by Malathion

Authors: Mahnaz Zarein, Hamed Shoorei

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Background: Malathion is one of the most toxic agents widely used in agriculture throughout the world. This agent has adverse effects on the functions of multiple organs such as the reproductive system in both male and female genders. On the one hand, daily use of antioxidant supplementations such as hesperidin is capable to neutralize the deleterious impacts of malathion. Therefore, in this experimental study, the protective effects of hesperidin against ovarian toxicity induced by malathion were investigated. Material & Methods: Balb/c adult mice (n=32) were randomly divided into 4 groups including 1) the control group, treated with normal saline, 2) the Mal group, treated with 30mg/kg malathion, daily for 1 month, 3) Mal + Hes group, treated with 20 mg/kg malathion and 20 mg/kg hesperidin, daily for 1 month, and 5) Hes group, treated with 20 mg/kg hesperidin. At the end of the experimental period, mice were anesthetized and their drops of blood were collected to the assessment of some hormones such as LH, FSH, E2, and P4. Also, the right ovaries were used to H&E staining, and the left ovaries were used for IHC staining (PCNA and FSHR). Results: Histopathological assessments showed that the number of follicles, i.e. primordial, primary, and secondary, significantly decreased, while the atretic follicle counts remarkably increased compared to the control group (p<0.05). Hormonal levels revealed that the production of all mentioned hormones decreased in the Mal group in comparison with the control group (p<0.05). The expression of PCNA, as a proliferative marker, and FHSR, as a marker showing maturation, decreased when mice received malathion compared to the control group (p<0.05). Interestingly, treatment with hesperidin significantly neutralized the adverse effects of malathion on all mentioned parameters. Conclusion: Daily use of antioxidant supplementations such as hesperidin could alleviate the ovarian toxicity induced by malathion.

Keywords: malathion, ovary, antioxidant hesperidin, FSHR PCNA, ovary

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835 Evaluation of the Level of Knowledge about Probiotics amongst Community Pharmacy Staff in Jordan

Authors: Feras Darwish Elhajji, Alberto Berardi, Manal Ayyash, Iman Basheti

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The concept of the use of probiotics for humans now has been known for decades however, their intake by the Jordanian population seems to be less common when compared to population in the developed countries. Community pharmacy is the main supplier of probiotics, however, after conducting an extensive literature review, not any published research article could be found talking about the role, knowledge, and practice of the pharmacists in the area of probiotics. The main aim of this study was to evaluate the level of knowledge about probiotics and their dispensing practice in community pharmacies in Jordan. Community pharmacy staff (pharmacists and technicians) in Amman and north of Jordan were randomly selected to complete an anonymous questionnaire that had been pre-tested and validated. Ethical approval was obtained from the university ethics committee. The questionnaire included the following sections: demographics, knowledge and perceptions about probiotics, and role of the pharmacist Pharmacists and technicians were visited and interviewed in 281 community pharmacies. Asking about probiotics, 90.4% of them said that they know what probiotics are, although only 29.5% agreed that pharmacy staff in Jordan have good knowledge about probiotics, and 88.3% agreed that pharmacy staff in Jordan need more training and knowledge about probiotics. Variables that were significantly related to knowledge about probiotics were being a pharmacist (ρ= 0.012), area of the community pharmacy (ρ= 0.019), and female staff (ρ= 0.031) after conducting logistic regression statistical analysis. More than two-thirds of the participants thought that probiotics are classified as dietary supplements by Jordan Food and Drug Administration (JFDA). Of those who knew probiotics, the majority of them – 76.8% and 91.7% – agreed that probiotics are effective and safe, respectively. Believing in efficacy of the probiotics was significantly associated with answering their use to be with or after antibiotic administration and to increase normal flora gut population (ρ= 0.007). Efficacy was also significantly associated with recommending probiotics to consumers by the pharmacist (ρ< 0.001) and by the doctor (ρ= 0.041). At the same time, the concept of safety was mainly associated with their use for flatulence and gases (ρ= 0.048). Level of knowledge about probiotics and their uses, efficacy and safety amongst community pharmacy staff in Jordan is found to be good. However, this level can be raised in the future, especially knowledge about uses of probiotics.

Keywords: community pharmacy, Jordan, prebiotics, probiotics

Procedia PDF Downloads 355
834 Behavior of Common Philippine-Made Concrete Hollow Block Structures Subjected to Seismic Load Using Rigid Body Spring-Discrete Element Method

Authors: Arwin Malabanan, Carl Chester Ragudo, Jerome Tadiosa, John Dee Mangoba, Eric Augustus Tingatinga, Romeo Eliezer Longalong

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Concrete hollow blocks (CHB) are the most commonly used masonry block for walls in residential houses, school buildings and public buildings in the Philippines. During the recent 2013 Bohol earthquake (Mw 7.2), it has been proven that CHB walls are very vulnerable to severe external action like strong ground motion. In this paper, a numerical model of CHB structures is proposed, and seismic behavior of CHB houses is presented. In modeling, the Rigid Body Spring-Discrete Element method (RBS-DEM)) is used wherein masonry blocks are discretized into rigid elements and connected by nonlinear springs at preselected contact points. The shear and normal stiffness of springs are derived from the material properties of CHB unit incorporating the grout and mortar fillings through the volumetric transformation of the dimension using material ratio. Numerical models of reinforced and unreinforced walls are first subjected to linearly-increasing in plane loading to observe the different failure mechanisms. These wall models are then assembled to form typical model masonry houses and then subjected to the El Centro and Pacoima earthquake records. Numerical simulations show that the elastic, failure and collapse behavior of the model houses agree well with shaking table tests results. The effectiveness of the method in replicating failure patterns will serve as a basis for the improvement of the design and provides a good basis of strengthening the structure.

Keywords: concrete hollow blocks, discrete element method, earthquake, rigid body spring model

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833 Virulence Factors and Drug Resistance of Enterococci Species Isolated from the Intensive Care Units of Assiut University Hospitals, Egypt

Authors: Nahla Elsherbiny, Ahmed Ahmed, Hamada Mohammed, Mohamed Ali

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Background: The enterococci may be considered as opportunistic agents particularly in immunocompromised patients. It is one of the top three pathogens causing many healthcare associated infections (HAIs). Resistance to several commonly used antimicrobial agents is a remarkable characteristic of most species which may carry various genes contributing to virulence. Objectives: to determine the prevalence of enterococci species in different intensive care units (ICUs) causing health care-associated infections (HAIs), intestinal carriage and environmental contamination. Also, to study the antimicrobial susceptibility pattern of the isolates with special reference to vancomycin resistance. In addition to phenotypic and genotypic detection of gelatinase, cytolysin and biofilm formation among isolates. Patients and Methods: This study was carried out in the infection control laboratory at Assiut University Hospitals over a period of one year. Clinical samples were collected from 285 patients with various (HAIs) acquired after admission to different ICUs. Rectal swabs were taken from 14 cases for detection of enterococci carriage. In addition, 1377 environmental samples were collected from the surroundings of the patients. Identification was done by conventional bacteriological methods and confirmed by analytical profile index (API). Antimicrobial sensitivity testing was performed by Kirby Bauer disc diffusion method and detection of vancomycin resistance was done by agar screen method. For the isolates, phenotypic detection of cytolysin, gelatinase production and detection of biofilm by tube method, Congo red method and microtiter plate. We performed polymerase chain reaction (PCR) for detection of some virulence genes (gelE, cylA, vanA, vanB and esp). Results: Enterococci caused 10.5% of the HAIs. Respiratory tract infection was the predominant type (86.7%). The commonest species were E.gallinarum (36.7%), E.casseliflavus (30%), E.faecalis (30%), and E.durans (3.4 %). Vancomycin resistance was detected in a total of 40% (12/30) of those isolates. The risk factors associated with acquiring vancomycin resistant enterococci (VRE) were immune suppression (P= 0.031) and artificial feeding (P= 0.008). For the rectal swabs, enterococci species were detected in 71.4% of samples with the predominance of E. casseliflavus (50%). Most of the isolates were vancomycin resistant (70%). Out of a total 1377 environmental samples, 577 (42%) samples were contaminated with different microorganisms. Enterococci were detected in 1.7% (10/577) of total contaminated samples, 50% of which were vancomycin resistant. All isolates were resistant to penicillin, ampicillin, oxacillin, ciprofloxacin, amikacin, erythromycin, clindamycin and trimethoprim-sulfamethaxazole. For the remaining antibiotics, variable percentages of resistance were reported. Cytolysin and gelatinase were detected phenotypically in 16% and 48 % of the isolates respectively. The microtiter plate method showed the highest percentages of detection of biofilm among all isolated species (100%). The studied virulence genes gelE, esp, vanA and vanB were detected in 62%, 12%, 2% and 12% respectively, while cylA gene was not detected in any isolates. Conclusions: A significant percentage of enterococci was isolated from patients and environments in the ICUs. Many virulence factors were detected phenotypically and genotypically among isolates. The high percentage of resistance, coupled with the risk of cross transmission to other patients make enterococci infections a significant infection control issue in hospitals.

Keywords: antimicrobial resistance, enterococci, ICUs, virulence factors

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832 Impact of Maternal Nutrition on Newborn Anthropometry and Hemoglobin

Authors: Vinay Mishra, Meena Malkani

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Objectives: To study the effect of physical maternal nutritional markers (viz. weight, height, gestational weight gain, BMI) and third-trimester haemoglobin concentration on anthropometry and cord blood haemoglobin of their newborn. Methods: Study area: Post-natal ward of a tertiary care hospital in an urban area. Study population: All post-partum women and their newborns. Sample size: 100. Maternal and neonatal data and anthropometric measurements were recorded in semi-structured case proforma. Data analysis: The data obtained was analysed using SPSS 20 software.The comparison between the groups was done using One-Way Analysis of Variance for two groups. For more than two groups comparisons further posthoc analysis was done using Tukey test. Pearson correlation coefficient was used for correlating the variables. A P value less than 0.05 was considered significant. Results: 1. Out of the 100 studied mothers, 52% were anaemic. 2. Cord blood haemoglobin values decreased significantly with the order of birth. 3. Cord blood haemoglobin of normal-weight newborns is significantly higher as compared to that of LBW newborns. 4. Cord blood haemoglobin has strong statistical significance with maternal anaemia. 5. Pre-pregnancy weight and gestational weight gain significantly influence the neonates anthropometry. Conclusions: 1. Birth order has a prominent inverse effect on the cord blood haemoglobin. 2. Majority of the expectant mothers are anaemic and give birth to LBW babies with reduced anthropometric markers. 3. Pre-pregnancy weight, height and gestational weight gain has a very significant impact on the neonatal anthropometry. 4. Thus, maternal nutrition during gestation and during the crucial periods of growth in the pre-child bearing age group has a very significant impact on foetal development.

Keywords: maternal nutrition, anthropometry, cord blood hemoglobin, newborn

Procedia PDF Downloads 377
831 Development of a Humanized Anti-CEA Antibody for the Near Infrared Optical Imaging of Cancer

Authors: Paul J Yazaki, Michael Bouvet, John Shively

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Surgery for solid gastrointestinal (GI) cancers such as pancreatic, colorectal, and gastric adenocarcinoma remains the mainstay of curative therapy. Complete resection of the primary tumor with negative margins (R0 resection), its draining lymph nodes, and distant metastases offers the optimal surgical benefit. Real-time fluorescence guided surgery (FGS) promises to improve GI cancer outcomes and is rapidly advancing with tumor-specific antibody conjugated fluorophores that can be imaged using near infrared (NIR) technology. Carcinoembryonic Antigen (CEA) is a non-internalizing tumor antigen validated as a surface tumor marker expressed in >95% of colorectal, 80% of gastric, and 60% of pancreatic adenocarcinomas. Our humanized anti-CEA hT84.66-M5A (M5A) monoclonal antibody (mAb)was conjugated with the NHS-IRDye800CW fluorophore and shown it can rapidly and effectively NIRoptical imageorthotopically implanted human colon and pancreatic cancer in mouse models. A limitation observed is that these NIR-800 dye conjugated mAbs have a rapid clearance from the blood, leading to a narrow timeframe for FGS and requiring high doses for effective optical imaging. We developed a novel antibody-fluorophore conjugate by incorporating a PEGylated sidearm linker to shield or mask the IR800 dye’s hydrophobicity which effectively extended the agent’s blood circulation half-life leading to increased tumor sensitivity and lowered normal hepatic uptake. We hypothesized that our unique anti-CEA linked to the fluorophore, IR800 by PEGylated sidewinder, M5A-SW-IR800 will become the next generation optical imaging agent, safe, effective, and widely applicable for intraoperative image guided surgery in CEA expressing GI cancers.

Keywords: optical imaging, anti-CEA, cancer, fluorescence-guided surgery

Procedia PDF Downloads 132