Search results for: surgical site infection

Authors: Jyh-Ping Chen, Yu-Tin Lai

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Wound healing is a complicated process involving overlapping hemostasis, inflammation, proliferation, and maturation phases. Ideal wound dressings can replace native skin functions in full thickness skin wounds through faster healing rate and also by reducing scar formation. Poly(lactic-co-glycolic acid) (PLGA) is an U.S. FDA approved biodegradable polymer to be used as ideal wound dressing material. Several in vitro and in vivo studies have demonstrated the effectiveness of curcumin in decreasing the release of inflammatory cytokines, inhibiting enzymes associated with inflammations, and scavenging free radicals that are the major cause of inflammation during wound healing. Heparin has binding affinities to various growth factors. With the unique and beneficial features offered by those molecules toward the complex process of wound healing, we postulate a composite wound dressing constructed from PLGA, curcumin and heparin would be a good candidate to accelerate scarless wound healing. In this work, we use electrospinning to prepare curcumin-loaded aligned PLGA nanofibrous membranes (PC NFMs). PC NFMs were further subject to oxygen plasma modification and surfaced-grafted with heparin through carbodiimide-mediated covalent bond formation to prepare curcumin-loaded PLGA-g-heparin (PCH) NFMs. The nanofibrous membranes could act as three-dimensional scaffolds to attract fibroblast migration, reduce inflammation, and increase wound-healing related growth factors concentrations at wound sites. From scanning electron microscopy analysis, the nanofibers in each NFM are with diameters ranging from 456 to 479 nm and with alignment angles within  0.5°. The NFMs show high tensile strength and good water absorptivity and provide suitable pore size for nutrients/wastes transport. Exposure of human dermal fibroblasts to the extraction medium of PC or PCH NFM showed significant protective effects against hydrogen peroxide than PLGA NFM. In vitro wound healing assays also showed that the extraction medium of PCH NFM showed significantly better migration ability toward fibroblasts than PC NFM, which is further better than PLGA NFM. The in vivo healing efficiency of the NFMs was further evaluated by a full thickness excisional wound healing diabetic rat model. After 14 days, PCH NFMs exhibits 86% wound closure rate, which is significantly different from other groups (79% for PC and 73% for PLGA NFM). Real-time PCR analysis indicated PC and PCH NFMs down regulated anti-oxidative enzymes like glutathione peroxidase (GPx) and superoxide dismutase (SOD), which are well-known transcription factors involved in cellular inflammatory responses to stimuli. From histology, the wound area treated with PCH NFMs showed more vascular lumen formation from immunohistochemistry of α-smooth muscle actin. The wound site also had more collagen type III (65.8%) expression and less collagen type I (3.5%) expression, indicating scar-less wound healing. From Western blot analysis, the PCH NFM showed good affinity toward growth factors from increased concentration of transforming growth factor-β (TGF-β) and fibroblast growth factor-2 (FGF-2) at the wound site to accelerate wound healing. From the results, we suggest PCH NFM as a promising candidate for wound dressing applications.

Keywords: Curcumin, heparin, nanofibrous membrane, poly(lactic-co-glycolic acid) (PLGA), wound dressing

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Authors: Javed Y. Uppal

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In this paper, a case study of a 13 storied multi storied main headquarters building of the Lahore Development Authority Lahore Pakistan has been presented, the 9th floor of which caught fire due to short circuiting and the flare spread through air-conditioning ducts to top three floors, and the building remained under fire for 15 hours before it was quenched. Some columns at the upper 3 floors started crumbling down, which were immediately propped. A visual inspection of site was first carried out, followed by onsite material tests and lab tests for residual strengths, which led to the decision of removal of the top 3 floors in a planned sequence of diamond cutting of middle strips, column strips, and shear walls, in panels and their lifting up by overhead cranes. The waffle slabs were stitched and jacketed with low viscosity polymer layer. The damaged bars were supplemented. The cracked columns were jacketed as well. The validity of rehabilitation procedure was established by load deflection behavior tests and long term performance observation over a period of 5 years. The paper concludes that the procedures adopted could be recommended for such events.

Keywords: fire damage, shotcrete, waffle slabs, delamination, drying cracking, jacketing

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Authors: Yun-Tsuen Chen, Shih-Ting Huang, Pi-Fen Cheng, Yu-Ting Su, Joffrey Hsu, Hui-Zhu Chen

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Acute intestinal obstruction is one of the differentials of acute abdomen and requires timely alleviation of intestinal distention and abdominal pain to avoid perforation, intra-abdominal infection, and peritonitis. Investigation to identify the cause of obstruction will direct treatment planning and allow for more effective management. In this study, we present a 71-year-old female presenting with symptoms of acute intestinal obstruction for five days. After extensive history taking, physical exam, medical imaging, and pathology, the patient was diagnosed with colon cancer with lung metastasis and acute intestinal obstruction. The patient was placed on nil per os status with intravenous fluid support, intravenous antibiotics, and a decompression nasogastric tube was placed. The patient received decompression with colostomy creation surgery. After assessing the patient’s clinical condition and tumor staging, a multidisciplinary healthcare team created an individualized treatment plan, which included plans to prepare the patient for home self-care and maintain good mental health with regular monitoring in the clinic setting. This case demonstrates the importance of early diagnosis, effective treatment, and a multidisciplinary approach to the management of acute intestinal obstruction secondary to colon cancer.

Keywords: acute intestinal obstruction, colostomy surgery, metastatic colon cancer, multidisciplinary healthcare team

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Authors: Nutthawadee Jampanil, Kattareeya Kumthip, Niwat Maneekarn, Pattara Khamrin

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Rotavirus A is one of the leading causes of acute gastroenteritis in children younger than five years of age, especially in low-income countries in Africa and South Asia. Two live-attenuated oral rotavirus vaccines, Rotarix and RotaTeq, have been introduced into routine immunization programs in many countries and have proven highly effective in reducing the burden of rotavirus-associated morbidity and mortality. In Thailand, Rotarix and RotaTeq vaccines have been included in the national childhood immunization program since 2020. The objectives of this research are to conduct a molecular epidemiological study and to characterize rotavirus genotypes circulating in pediatric patients with acute diarrhea in Chiang Mai, Thailand, from 2020-2022 after the implementation of rotavirus vaccines. Out of 858 stool specimens, 26 (3.0%) were positive for rotavirus A. G3P[8] (23.0%) was detected as the most predominant genotype, followed by G1P[8] (19.2%), G8P[8] (19.2%), G9P[8] (15.3%), G2P[4] (7.7%), G1P[6] (3.9%), G9P[4] (3.9%), and G8P[X] (3.9%). In addition, the uncommon rotavirus strain G3P[23] (3.9%) was also detected in this study, and this G3P[23] strain displayed a genetic background similar to the porcine rotavirus. In conclusion, there was a dramatic change in the prevalence of rotavirus A infection and the diversity of rotavirus A genotypes in pediatric patients in Chiang Mai, Northern Thailand, in the rotavirus post-vaccination period. The finding obtained from this research contributes to a better understanding of rotavirus epidemiology after rotavirus vaccine introduction. Furthermore, the identification of unusual G and P genotype combination strains provides significant evidence for the potential interspecies transmission between human and animal rotaviruses.

Keywords: rotavirus, infectious disease, gastroenteritis, Thailand

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Authors: Laila Khawaja

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In recent years, an increasing emphasis has been placed on measuring program implementation, in part because of the great variability in how complex interventions are delivered in real-life settings. There is an increased awareness that while conducting process evaluations, one should aim to identify and understand the complexities of intervention if they are to be used for future intervention development or the strategies needed to implement the same intervention in a different setting. Complex interventions are public health interventions that are not drugs or surgical procedures but have many potential active aspects of intervention. In this paper, process evaluations are aligned with MRC guidelines to identify contextual factors related to outcomes to assess the quality of implementation. This paper briefly discusses the perceptions of research team on the implementation of the intervention of ‘Engaging Adolescents in Changing Behaviour’ (EACH-B), a school-based complex intervention study aiming to improve diet and physical activity among adolescents aged 12-13 years. Through qualitative interviews and focus groups with 10 staff members, we aimed to understand their experiences and reflections on implementing the EACH-B trial delivered in 49 Schools around Hampshire, England. Data were uploaded into NVivo, and analysis was conducted using thematic analysis. The investigation revealed two overarching themes: (a) how the communication patterns with teachers were impacted during the delivery of implementation and (b) what were the team’s strategies to keep logistics aligned with the research process that impacted the overall implementation of the trial. The paper informs adaptation strategies used by the research team to establish and maintain effective communication with the teachers as well as the thoughtfulness of the team’s logistic strategy for the successful delivery of the trial.

Keywords: complex interventions, process evaluation, adaptation strategies, randomised controlled trial

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Authors: F. Bosca, F. Foglietta, F. Turci, E. Calcio Gaudino, S. Mana, F. Dosio, R. Canaparo, L. Serpe, A. Barge

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In recent years, medical science has improved chemotherapy, radiation therapy and adjuvant therapy and has developed newer targeted therapies as well as refining surgical techniques for removing cancer. However, the chances of surviving the disease depend greatly on the type and location of the cancer and the extent of the disease at the start of treatment. Moreover, mainstream forms of cancer treatment have side effects which range from the unpleasant to the fatal. Therefore, the continuation of progress in anti-cancer therapy may depend on placing emphasis on other existing but less thoroughly investigated therapeutic approaches such as Sonodynamic Therapy (SDT). SDT is based on the local activation of a so called 'sonosensitizer', a molecule able to be excited by ultrasound, the radical production as a consequence of its relaxation processes and cell death due to different mechanisms induced by radical production. The present work deals with synthesis, characterization and preliminary in vitro test of Single Walled Carbon Nanotubes (SWCNT) decorated with porphyrins and biological vectors. The SWCNT’s surface was modified exploiting 1, 3-dipolar cycloaddition or Dies Alder reactions. For this purpose, different porphyrins scaffolds were ad-hoc synthesized using also non-conventional techniques. To increase cellular specificity of porphyrin-conjugated SWCNTs and to improve their ability to be suspended in aqueous solution, the modified nano-tubes were grafted with suitable glutamine or hyaluronic acid derivatives. These nano-sized sonosensitizers were characterized by several methodologies and tested in vitro on different cancer cell lines.

Keywords: sonodynamic therapy, porphyrins synthesis and modification, SWNCT grafting, hyaluronic acid, anti-cancer treatment

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Authors: Nguyen Dang Duc, Nguyen Phuong Sinh, Lam Nguyen Hong Anh

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Superior mesenteric artery (SMA) syndrome is a rare cause of high-section intestinal obstruction. SMA syndrome is characterized by compression of the third segment of the duodenum due to the narrowing of the distance between the superior mesenteric artery and the abdominal aorta. The main clinical signs of SMA syndrome are high intestinal obstruction, such as postprandial vomiting, epigastric pain, early feeling of abdominal fullness, and indigestion. Abdominal computed tomography plays an important role in diagnosis. There are two main methods of treating SMA syndrome that are conservative and surgical treatment. We report a clinical case of an 18-year-old male patient admitted to the hospital because of a Bungarus snake bit in the second hour, to the twelfth day of treatment, the patient developed diarrhea that lasted until the twenty-fourth day of treatment. On the twenty-fifth day of treatment, the patient lost 16 kilograms (from 56 down to 40). The patient had symptoms of vomiting after eating, indigestion, and epigastric pain. On abdominal computed tomography, the angle created by the superior mesenteric artery and the abdominal aorta was 17 degrees, the distance between the two arteries was 3.8 millimeters, light dilation and stagnation of the D1 and D2 segment of the duodenum with gas and watery level inside segment D3 and D4 of the duodenum and this segment was constricted. This patient was diagnosed with superior mesenteric artery syndrome with the Bungarus snake bites. Currently, the patient was treated with feeding through a jejunal tube each other intravenous nutrition. Finally, The patient was discharged and returned to his house on the forty-fifth day of treatment. We reported this clinical case to introduce clinical and paraclinical signs, diagnose, and methods treated for patient having SMA syndrome.

Keywords: superior mesenteric artery syndrome, Bungarus snake bites, loss weight

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Authors: Inikpi Ameh, Grace Kia, A. K. B. Sackey, Joy Atawodi, Richard Whittington

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Ranaviruses are belonging to the viral Family Iridoviridae, are a group of globally emerging pathogens recognized as major viral pathogens of cold-blooded vertebrates. They cause systemic infection in fishes, amphibians, and reptiles. Ranaviruses have been associated with numerous disease outbreaks in natural and cultured populations of fish, amphibians, and reptiles. To investigate the presence of the ranavirus in fish and edible frogs sourced from dams and ponds in Zaria, Kaduna State, Nigeria. A total of 425 frogs (Rana spp.) and fishes (n=215 and n=200, respectively) were randomly collected based on consent and availability. Liver, kidney, and spleen tissue samples from each animal were pooled and homogenized. The samples were screened for ranavirus using the Indirect Enzyme linked Immunosorbent assay (ELISA). An overall prevalence of 46.1% (196/425) was obtained from the study. Frogs had a prevalence of 51.2% (110/215) while fish had 43% (86/200). This is the first study on ranavirus in fish and edible frogs in Nigeria. This study has established that edible frogs (Rana spp) and fishes sold in Zaria, Nigeria were infected with ranavirus which may have great economic importance to the nation’s aquaculture. In view of occasional massive economic losses observed in fishery industry due to deaths of unknown origin, this preliminary investigation is useful in directing veterinarians, policy makers and researchers on need to survey for ranavirus and also enlighten the relevant stakeholders on its prevention and control in Nigeria.

Keywords: fish, frogs, Nigeria, Ranavirus

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Authors: Tarek Abdel Azim Ahmed, Eman Sarhan Shaker

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This research aims to explore how well the extended model of internet commerce adoption (eMICA) model is often used to determine the extent of internet commerce adoption in the travel agencies sector in both Egypt and Kingdom of Saudi Arabia (KSA). The web content analysis method was used to analyze the level of adoption of Egyptian travel agencies and Saudi travel agencies according to data immensely available on their websites. Therefore, each site was categorized according to the phases and levels proposed. In order to achieve this, 120 websites were evaluated by the two authors over a three-month period, from August to October 2020, and then categorized according to the phases and levels of (eMICA). The results show that there are deficiencies in the application of the eMICA model by both KSA and Egyptian travel agencies, generally, updating their websites, the absence of quality certification, offering secure online payment, virtual tours, and videos using Flash animation. In general, the Egyptian companies slightly outperformed the KSA ones in applying eMICA model.

Keywords: e-commerce, internet marketing, eMICA, travel agencies, websites

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Authors: A. Zecchin, E. Vallicella, I. Alberi, A. Dalle Carbonare, A. Festi, F. Galeone, S. Garzon, R. Raffaelli, P. Pomini, M. Franchi

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Introduction: Severe endometriosis is a multiorgan disease, that involves bowel in 31% of cases. Disabling symptoms and deep infiltration can lead to bowel obstruction: surgical bowel treatment may be needed. In these cases, colorectal segment resection is usually performed by inferior mesenteric artery ligature, as radically as for oncological surgery. This study was made on surgery based on intestinal vascular axis’ preservation. It was assessed postoperative complications risks (mainly rate of dehiscence of intestinal anastomoses), and results were compared with the ones found in literature about classical colorectal resection. Materials and methods: This was a retrospective study based on 62 patients with deep infiltrating endometriosis of the bowel, which undergo segmental resection with intestinal vascular axis preservation, between 2013 and 2016. It was assessed complications related to the intervention both during hospitalization and 30-60 days after resection. Particular attention was paid to the presence of anastomotic dehiscence. 52 patients were finally telephonically interviewed in order to investigate the presence or absence of intestinal constipation. Results and Conclusion: Segmental intestinal resection performed in this study ensured a more conservative vascular approach, with lower rate of anastomotic dehiscence (1.6%) compared to classical literature data (10.0% to 11.4% ). No complications were observed regarding spontaneous recovery of intestinal motility and bladder emptying. Constipation in some patients, even after years of intervention, is not assessable in the absence of a preoperative constipation state assessment.

Keywords: anastomotic dehiscence, deep infiltrating endometriosis, colorectal resection, vascular axis preservation

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Authors: Waziri B. I., Elkhashab M. M.

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Background: One of the most serious consequences of spinal cord injury (SCI) is progressive deterioration of renal function mostly as a result of urine stasis and ascending infection of the paralyzed bladder. This necessitates for investigation of early changes in serum urea and creatinine and associated sex related differences in response to SCI. Methods: A total of 24 adult albino rats weighing above 150g were divided equally into two groups, a control and experimental group (n = 12) each containing an equal number of male and female rats. The experimental group animals were paralyzed by complete transection of spinal cord below T4 level after deep anesthesia with ketamine 75mg/kg. Blood samples were collected from both groups five days post SCI for analysis. Mean values of serum urea (mmol/L) and creatinine (µmol/L) for both groups were compared. P < 0.05 was considered as significant. Results: The results showed significantly higher levels (P < 0.05) of serum urea and creatinine in the male SCI models with mean values of 92.12 ± 0.98 and 2573 ± 70.97 respectively compared with their controls where the mean values for serum urea and creatinine were 6.31 ± 1.48 and 476. 95 ± 4.67 respectively. In the female SCI models, serum urea 13.11 ± 0.81 and creatinine 519.88 ± 31.13 were not significantly different from that of female controls with serum urea and creatinine levels of 11.71 ± 1.43 and 493.69 ± 17.10 respectively (P > 0.05). Conclusion: Spinal cord injury caused a significant increase in serum Urea and Creatinine levels in the male models compared to the females. This indicated that males might have higher risk of renal dysfunction following SCI.

Keywords: albino rats, creatinine, spinal cord injury (SCI), urea

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Authors: Fatma Kürüm Varolgüneş, Fatih Canan

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Mardin is one of the unique cities in Turkey with its rich cultural and historical heritage. Mardin’s traditional dwellings have been affected both by natural data such as climate and topography and by cultural data like lifestyle and belief. However, in the new settlements, housing is formed with modern approaches and unsuitable forms clashing with Mardin’s culture and environment. While the city is expanding, traditional textures are ignored. Thus, traditional settlements are losing their identity and are vanishing because of the rapid change and transformation. The main aim of this paper is to determine the physical and social data needed to define the characteristic features of Mardin’s old and new settlements. In this context, based on social and cultural data, old and new settlement formations of Mardin have been investigated from various aspects. During this research, the following methods have been utilized: observations, interviews, public surveys, literature review, as well as site examination via maps, photographs and questionnaire methodology. In conclusion, this paper focuses on how changes in the physical forms of cities affect the typology and the identity of cities, as in the case of Mardin.

Keywords: urban and local identity, historical city center, traditional settlements, Mardin

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Authors: Masoud Gholam Ale Mohammad, Mojtaba Hafezi Birgani

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An experimental study of saturated pool boiling on a single artificial nucleation site without and with the application of an electric field on the boiling surface has been conducted. N-pentane is boiling on a copper surface and is recorded with a high speed camera providing high quality pictures and movies. The accuracy of the visualization allowed establishing an experimental bubble growth law from a large number of experiments. This law shows that the evaporation rate is decreasing during the bubble growth, and underlines the importance of liquid motion induced by the preceding bubble. Bubble rise is therefore studied: once detached, bubbles accelerate vertically until reaching a maximum velocity in good agreement with a correlation from literature. The bubbles then turn to another direction. The effect of applying an electric field on the boiling surface in finally studied. In addition to changes in the bubble shape, changes are also shown in the liquid plume and the convective structures above the surface. Lower maximum rising velocities were measured in the presence of electric fields, especially with a negative polarity.

Keywords: single and double bubbles, electric field, boiling, rising

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Authors: Shadi Motamedighazvini, Roohollah Taherkhani, Mahdi Mahdikhani, Najme Hashempour

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Nowadays, green building rating systems are an inevitable necessity for managing environmental considerations to achieve green buildings. The aim of this paper is to deliver a detailed recognition of what has been the focus of green building policymakers around the world; It is important to conduct this study in a way that can provide a context for researchers who intend to establish or upgrade existing rating systems. In this paper, fifteen rating systems including four worldwide well-known plus eleven local rating systems which have been selected based on the answers to the questionnaires were examined. Their similarities and differences in mandatory and prerequisite clauses, highest and lowest scores for each criterion, the most frequent criteria, and most frequent sub-criteria are determined. The research findings indicated that although the criteria of energy, water, indoor quality (except Homestar), site and materials (except GRIHA) were common core criteria for all rating systems, their sub-criteria were different. This research, as a roadmap, eliminates the lack of a comprehensive reference that encompasses the key criteria of different rating systems. It shows the local systems need to be revised to be more comprehensive and adaptable to their own country’s conditions such as climate.

Keywords: environmental assessment, green buildings, green building criteria, green building rating systems, sustainability, rating tools

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Authors: Ashley Barnes

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This paper will consider the ways in which varied notions of Space played a central role in a 12-week drama project with patients in a Medium Secure Hospital in the UK. In the project, the patients devised and performed a series of sketches, inspired by Science Fiction films, which echoed their own experience of alienation. During the project, the familiar and rigorously regulated Activity Room became a site of imagination, adventure and laughter; transforming the atmosphere of the hospital and allowing the patients to be transported to another space entirely. A space that was as much in their heads as in the physical domain. It will be argued that, although work created in an institution such as a Medium Secure Hospital is infused with hegemonic associations and meanings, the starting point for such work should be to seek an empty space in which the participants can allow their imaginations to be released. This work sits within a range of contexts and will be consciously interdisciplinary. It will draw from Human Geography and Criminology, as well as Performance and Applied Theatre Literature. It is hoped that this paper will build upon the literature that relates to the very particular environment of Secure Hospitals and to provide a starting point for further practical exploration.

Keywords: criminal justice, mental health, science fiction films, space and place

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Authors: K. C. Surekha

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The natural habitat forms the setting for every urban development. The tangible and intangible characteristics of the site contributed to the sustenance of various urban dimensions of early civilizations. However, as the towns were continuously evolving and developing, the attitude towards the natural habitat changed. The after effects of this self-centered attitude resulted in various natural and manmade catastrophes. At the same time the social habitat, cities and new towns were increasingly over-populated; and will become even more numerous and crowded in the future. The coexistence of natural and urban components is necessary for a sustainable future and preserving the region’s unique features. Therefore, there is an urgent need to rethink actively on alternative development paradigms to achieve sustenance of all living forms on the planet in a more sustainable way. The main aim of this paper is to understand bioregionalism as an alternative development paradigm, its theory, concepts as well as the key aspects of bioregional planning. The paper will try to understand the concept of bioregionalism theoretically and take case studies. The critical interpretation of theory and analysis of case studies will be used to form a set of design parameters which can be physically implemented from an urban design and planning standpoint.

Keywords: bioregion, bioregionalism, holistic, sustainable

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Authors: John Angelo Labuguen, Sarah Joy Salvio

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Despite the low prevalence rate of Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS) in the Philippines, the country is one of the seven countries in the world and the only country in Southeast Asia which reported an increasing trend in the number of people infected with HIV. Furthermore, people getting infected with HIV are becoming younger every year. Eighty-five percent (7,103) of the total number of youth (15-24 years old) with HIV were recorded in the past five years. The rising rates of HIV infection suggest the need to understand HIV knowledge, attitudes, and sexual behaviors among the youth in the Philippines. The University of the Philippines (UP), having a population that represents all regions of the country, can be reflective of the current situation of the Filipino youth in the issue of HIV/AIDS. This paper attempted to: (1) assess the level of knowledge on HIV/AIDS; (2) describe the attitude towards people living with HIV/AIDS; (3) identify socio-demographic and sexual behaviors associated with the level of HIV/AIDS knowledge; and (4) determine how knowledge on HIV/AIDS is related with attitude towards people living with HIV/AIDS among tertiary students of the UP Diliman. Self-administered survey was used to collect data from 308 randomly selected respondents. Data was encoded using CS Pro 6.2 and it was exported to SPSS v23 for further analysis. Findings of the study revealed that comprehensive correct knowledge on HIV/AIDS is associated with a somewhat accepting attitude towards PLWHA. Sociodemographic and sexual behavior characteristics do not contribute to the association between level of knowledge about HIV/AIDS and attitude towards PLWHA.

Keywords: attitude towards people living with HIV/AIDS, comprehensive HIV/AIDS knowledge, Philippines, university students

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Authors: Pegah Ebrahimi, Farshad Oveissi, Iman Manavi-Tehrani, Sina Naficy, David F. Fletcher, Fariba Dehghani, David S. Winlaw

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Despite advances in modern surgery, congenital heart disease remains a medical challenge and a major cause of infant mortality. Cardiovascular prostheses are routinely used in surgical procedures to address congenital malformations, for example establishing a pathway from the right ventricle to the pulmonary arteries in pulmonary valvar atresia. Current off-the-shelf options including human and adult products have limited biocompatibility and durability, and their fixed size necessitates multiple subsequent operations to upsize the conduit to match with patients’ growth over their lifetime. Non-physiological blood flow is another major problem, reducing the longevity of these prostheses. These limitations call for better designs that take into account the hemodynamical and anatomical characteristics of different patients. We have integrated tissue engineering techniques with modern medical imaging and image processing tools along with mathematical modeling to optimize the design of cardiovascular grafts in a patient-specific manner. Computational Fluid Dynamics (CFD) analysis is done according to models constructed from each individual patient’s data. This allows for improved geometrical design and achieving better hemodynamic performance. Tissue engineering strives to provide a material that grows with the patient and mimic the durability and elasticity of the native tissue. Simulations also give insight on the performance of the tissues produced in our lab and reduce the need for costly and time-consuming methods of evaluation of the grafts. We are also developing a methodology for the fabrication of the optimized designs.

Keywords: computational fluid dynamics, cardiovascular grafts, design optimization, tissue engineering

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Authors: Benedetta Isella, Aleksander Drinic, Alissa Heim, Phillip Czichowski, Lisa Lauts, Hans Leemhuis

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Introduction: Membranes for guided bone regeneration are essential to perform a barrier function between the soft and the regenerating bone tissue. Bioabsorbable membranes are desirable in this field as they do not require a secondary surgery for removal, decreasing patient surgical risk. Collagen was the first bioabsorbable alternative introduced on the market, but its degradation time may be too fast to guarantee bone regeneration, and optimisation is needed. Silk fibroin, being biocompatible, slowly bioabsorbable, and processable into different scaffold types, could be a promising alternative. Objectives: The objective is to compare the general performance of a silk fibroin membrane for guided bone regeneration to current collagen alternatives developing suitable standardized tests for the mechanical and morphological characterization. Methods: Silk fibroin and collagen-based membranes were compared from the morphological and chemical perspective, with techniques such as SEM imaging and from the mechanical point of view with techniques such as tensile and suture retention strength (SRS) tests. Results: Silk fibroin revealed a high degree of reproducibility in surface density. The SRS of silk fibroin (0.76 ± 0.04 N), although lower than collagen, was still comparable to native tissues such as the internal mammary artery (0.56 N), and the same can be extended to general mechanical behaviour in tensile tests. The SRS could be increased by an increase in thickness. Conclusion: Silk fibroin is a promising material in the field of guided bone regeneration, covering the interesting position of not being considered a product containing cells or tissues of animal origin from the regulatory perspective and having longer degradation times with respect to collagen.

Keywords: guided bone regeneration, mechanical characterization, membrane, silk fibroin

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Authors: Dong-Ho Kim, Zheng-Xun Jin, Yong-Woon Cha, Su-Sang Lim, Sang-Won Han, Chang-Taek Hyun

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As construction is a labor-intensive industry, it is important to identify and manage labor quantities for accurate progress management of the construction project. However, the progress management that focuses on construction cost calculated based on materials rather than labor quantities has led to a difference in the implementation of cost and progress of the actual construction. In addition, since it is not easy to predict accurate labor quantities in the estimation of labor quantity-based progress rate, there have been limited researches into the progress rate estimation based on labor quantity. Accordingly, this study proposed a process for labor quantity-based progress rate estimation using a standard of estimate to predict accurate progress rate of the construction project in Republic Korea. It is expected that the utilization of the proposed process will help to identify the progress rate closer to that of the actual site management and adjust the workforce in each construction type, thereby contributing to improving construction efficiency.

Keywords: labor based, labor cost, progress management, progress rate, progress payment

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Authors: Moyahabo Molefe

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The persistence of HIV/AIDS infection rates in SA has not only been a subject of academic debate but a mediated narrative that has dominated SA’s post-apartheid film space over the last two decades. SA’s colonial geo-spatial architecture still influences migrant labour patterns, which the Oscar-nominated (2003) SA film ‘Yesterday’ has erstwhile reflected upon, yet continues to account for the spread of HIV/AIDS in SA society. Accordingly, men who had left their homes in the rural areas to work in the mines in the cities become infected with HIV/AIDS, only to return home to infect their wives or partners in the rural areas. This paper analyses, through Social Semiotic theory, how SA geo-spatial arrangement had raptured family structures with both men and women taking new residences in the urban areas where they work away from their homes. By using Social semiotic theory, this paper seeks to understand how images and discourses have been deployed in the film ‘Yesterday’ to demonstrate how HIV/AIDS is embedded in the socio-cultural, economic and political architect of SA society. The study uses qualitative approach and content/text/visual semiotic analysis to decipher meanings from array of imagery and discourses/dialogues that are used to mythologise the relationship between the spread of HIV/AIDS and SA migrant labour patterns. The findings of the study are significant to propose a conceptual framework that can be used to mitigate the spread of HIV/AIDS among SA populace, against the backdrop of changing migrant labour patterns and other related factors

Keywords: colonialism, decoloniality, HIV/AIDS, labour migration patterns, social semiotics

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Authors: Nirav J. Patel, Kalpesh K. Dudani

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Partial discharge (PD) is the dissipation of energy caused by localized breakdown of insulation. Power transformers are one of the most important components in the electrical energy network. Insulation degradation of transformer is frequently linked to PD. This is why PD detection is used in power system to monitor the health of high voltage transformer. If such problem are not detected and repaired, the strength and frequency of PD may increase and eventually lead to the catastrophic failure of the transformer. This can further cause external equipment damage, fires and loss of revenue due to an unscheduled outage. Hence, reliable online PD detection is a critical need for power companies to improve personnel safety and decrease the probability of loss of service. The PD phenomenon is manifested in a variety of physically observable signals including Ultra High Frequency (UHF) radiation and Acoustic Disturbances, Electrical pulses. Acoustic method is based on sensing the radiated acoustic emission from discharge sites in the insulation. Propagated wave from the PD fault site are captured sensor are consequently pre-amplified, filtered, recorded and analyze.

Keywords: acoustic, partial discharge, perfectly matched layer, sensor

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Authors: Nigar Sultanova

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Facial morphology is a constant topic of concern for clinicians. When anthropometric methods were introduced into clinical practice to quantify changes in the craniofacial framework, features distinguishing various ethnic group were discovered. Normative data of facial measurements are indispensable to precise determination of the degree of deviations from normal. Establish the reference range of facial proportions in Azerbaijan population by anthropometric measurements of craniofacial complex. The study group consisted of 350 healthy young subjects, 175 males and 175 females, 18 to 25 years of age, from 7 different regions of Azerbaijan. The anthropometric examination was performed according to L.Farkas's method with our modification. In order to determine the morphologic characteristics of seven regions of the craniofacial complex 42 anthropometric measurements were selected. The anthropometric examination. Included the usage of 33 anthropometric landmarks. The 80 indices of the facial proportions, suggested by Farkas and Munro, were calculated: head -10, face - 23, nose - 23, lips - 9, orbits - 11, ears - 4. The date base of the North American white population was used as a reference group. Anthropometric measurements of facial proportions in Azerbaijan population revealed a significant difference between mеn and womеn, according to sexual dimorphism. In comparison with North American whites, considerable differences of facial proportions were observed in the head, face, orbits, labio-oral, nose and ear region. However, in women of the Azerbaijani population, 29 out of 80 proportion indices were similar to the proportions of NAW women. In the men of the Azerbaijani population, 27 out of 80 proportion indices did not reveal a statistically significant difference from the proportions of NAW men. Estimation of the reference range of facial proportions in Azerbaijan population migth be helpful to formulate surgical plan in treatment of congenital or post-traumatic facial deformities successfully.

Keywords: facial morphology, anthropometry, indices of proportion, measurement

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Authors: Taleb L., Benarbia M., Boutira F. M., Allam H., Boukerche A.

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Introduction and purpose of the study: Meningiomas are the most common non-glial intracranial tumors in adults, accounting for approximately 30% of all central nervous system tumors. The aim of our study is to determine the epidemiological, clinical, therapeutic, and evolutionary characteristics of a cohort of patients with intracranial meningioma treated with radiotherapy at the Emir Abdelkader Cancer Center in Oran. Material and methods: This is a retrospective study of 44 patients during the period from 2014 to 2020. The overall survival and relapse-free survival curves were calculated using the Kaplan-Meier method. Results and statistical analysis: The median age of the patients was 49 years [21-76 years] with a clear female predominance (sex ratio=2.4). The average diagnostic delay was seven months [2 to 24 months], the circumstances of the discovery of which were dominated by headaches in 54.5% of cases (n=24), visual disturbances in 40.9% (n=18), and motor disorders in 15.9% (n=7). The seat of the tumor was essentially at the level of the base of the skull in 52.3% of patients (n=23), including 29.5% (n=13) at the level of the cavernous sinus, 27.3% (n=12) at the parasagittal level and 20.5% (n=9) at the convexity. The diagnosis was confirmed surgically in 36 patients (81.8%) whose anatomopathological study returned in favor of grades I, II, and III in respectively 40.9%, 29.5%, and 11.4% of the cases. Radiotherapy was indicated postoperatively in 45.5% of patients (n=20), exclusive in 27.3% (n=12) and after tumor recurrence in 27.3% of cases (n=18). The irradiation doses delivered were as follows: 50 Gy (20.5%), 54 Gy (65.9%), and 60 Gy (13.6%). With a median follow-up of 69 months, the probabilities of relapse-free survival and overall survival at three years are 93.2% and 95.4%, respectively, whereas they are 71.2% and 80.7% at five years. Conclusion: Meningiomas are common primary brain tumors. Most often benign but can also progress aggressively. Their treatment is essentially surgical, but radiotherapy retains its place in specific situations, allowing good tumor control and overall survival.

Keywords: diagnosis, meningioma, surgery, radiotherapy, survival

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Authors: Alebachew Halefom, Navsal Kumar, Arunava Poddar

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The purpose of this work is to specify the parameter values, the base flow index (BFI), and to rank the methods that should be used for base flow separation. Three different digital graphical approaches are chosen and used in this study for the purpose of comparison. The daily time series discharge data were collected from the site for a period of 30 years (1986 up to 2015) and were used to evaluate the algorithms. In order to separate the base flow and the surface runoff, daily recorded streamflow (m³/s) data were used to calibrate procedures and get parameter values for the basin. Additionally, the performance of the model was assessed by the use of the standard error (SE), the coefficient of determination (R²), and the flow duration curve (FDC) and baseflow indexes. The findings indicate that, in general, each strategy can be used worldwide to differentiate base flow; however, the Sliding Interval Method (SIM) performs significantly better than the other two techniques in this basin. The average base flow index was calculated to be 0.72 using the local minimum method, 0.76 using the fixed interval method, and 0.78 using the sliding interval method, respectively.

Keywords: baseflow index, digital graphical methods, streamflow, Emba Madre Watershed

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Authors: Asanka U. K. Godamunne

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Road traffic accidents (RTA) are a leading cause of death globally as well as in Sri Lanka and results in a large proportion of disability especially among young people. Ninety-percent of world’s road traffic deaths occur in low- and middle-income countries. The gross disparities in injury outcomes relate to immediate post-crash and hospital management. Emergency management, methods of patient transportation following road traffic accidents and safety measures are important factors to reduce mortality and morbidity. Studies in this area are limited in Sri Lanka. The main objective of this research was to assess the emergency management and proper method of transportation of road traffic accident victims. This offers the best way to explore the ways to reduce the mortality and morbidity and raise the public awareness. This study was conducted as a descriptive cross-sectional study. All the consecutive road traffic accident victims admitted to surgical wards at District General Hospital, Matale, Sri Lanka, over a period of three months were included in the study. Data from 387 victims were analyzed. The majority were in the 20-30 year age group. Seventy six percent of the patients were males. Motorcycles and trishaws were most affected. First-aid was given to only 2% of patients and it was given by non-medical persons. A significant proportion of patients (75%) were transported to the hospital by trishaws and only 1% transported by ambulance. About 86% of the patients were seated while transport and 14% were flat. Limbs and head were the most affected areas of the body. As per this study, immediate post-crash management and patient transportation were not satisfactory. There is a need to strengthen certain road safety laws and make sure people follow them.

Keywords: emergency management, patient transportation, road traffic accident victims, Sri Lanka

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Authors: Mohammed A. Alhoot, Rathika A/P Nagarajan

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Climate change and variability are affecting human health and diseases direct or indirectly through many mechanisms. Change in rain pattern, an increase of temperature and humidity are showing an increased trend in Malaysia. This will affect the biological, physical and chemical component of water through different pathways and will enhance the risk of waterborne diseases. Besides, the warm temperature and humid climate provide very suitable conditions for the growth of pathogenic bacteria. This study is intended to highlight the relationship between the climate changes and the incidence food and water associated infections. Incidences of food and water associated infection and climate data were collected from Malaysian Ministry of health and Malaysian Metrological Department respectively. Maximum and minimum temperature showed high correlation with incidence of typhoid, hepatitis A, dysentery, food poisoning (P value <0.05 significant with 2 tailed / 0.5<[r]). Heavy rainfall does not associated with any outbreaks. Climate change brings out new challenges in controlling food and water associated infections. Adaptation strategies should involve all key stakeholders with a strong regional cooperation to prevent and deal with cross-boundary health crises. Moreover, the role of health care personnel at local, state and national levels is important to ensure the success of these programmes. As has been shown herein, climate variability is an important element influencing the food and water associated epidemiology in Malaysia. The results of this study are crucial to implementing climate changes as a factor to reduce any future outbreaks.

Keywords: climate change, typhoid, hepatitis A, dysentery, food poisoning

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Authors: Shahzad Karim Bhatti

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Background: Ozone is a combination of oxygen and can be used in treatment of low back pain due to herniated disc. It is a minimally invasive procedure using biochemical properties of ozone resulting in reduced volume of disc and inflammation resulting in significant pain relief. Aim: The purpose of this study was to evaluate the effectiveness of ozone therapy in combination with peri-ganglionic injection of local anesthetic and corticosteroid. Material and Methods: This retrospective study was done at the Interventional Radiology Department of Mayo Hospital, Lahore. A total of 49000 patients were included from January 2008 to March 2022. All the patients presented with clinical signs and symptoms of lumber disc herniation, which was confirmed by a MRI scan of the lumbar sacral spine. The pain reduction was calculated using modified MacNab method. All the patients underwent percutaneous injection of ozone at a concentration of 27 micrograms/ml to lumber disc under fluoroscopic guidance with combination of local anesthetic and corticosteroid in peri-ganglionic space. Results were evaluated by two expert observers who were blinded to patient treatment. Results A satisfactory therapeutic outcome was obtained. 55% of the patients showed complete recovery with resolution of symptoms. 20% of the patients complained of occasional episodic pain with no limitation of occupational activity. 15% of cases showed insufficient improvement. 5% of cases had insufficient improvement and went for surgery. 10% of cases never turned up after the first visit. Conclusion Intradiscal ozone for the treatment of herniated discs has revolutionized percutaneous approach to nerve root compression making it safer, economical and easier to repeat without any side effects than treatments currently used in Pakistan.

Keywords: pain, prolapse, Ozone, backpain

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Authors: Adrian Hang Yue Siu, Matthew Holyland, Sharon Carey, Daniel Steffens, Nabila Ansari, Cherry E. Koh

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Introduction: Peritoneal malignancies are challenging cancers to manage. While cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS and HIPEC) may offer a cure, it’s considered radical and morbid. Pre-emptive identification of deconditioned patients for optimization may mitigate the risks of surgery. However, the difficulty lies in the scarcity of validated predictive tools to identify high-risk patients. In recent times, there has been growing interest in sarcopenia, which can occur as a result of malnutrition and malignancies. Therefore, the purpose of this study was to assess the utility of sarcopenia in predicting post-operative outcomes. Methods: A single quaternary-center retrospective study of CRS and HIPEC patients between 2017-2020 was conducted to determine the association between pre-operative sarcopenia and post-operative outcomes. Lumbar CT images were analyzed using Slice-o-matic® to measure sarcopenia. Results : Cohort (n=94) analysis found that 40% had sarcopenia, with a majority being female (53.2%) and a mean age of 55 years. Sarcopenia was statistically associated with decreased weight compared to non-sarcopenia patients, 72.7kg vs. 82.2kg (p=0.014) and shorter overall survival, 1.4 years vs. 2.1 years (p=0.032). Post-operatively, patients with sarcopenia experienced more post-operative complications (p=0.001). Conclusion: Complex procedures often require optimization to prevent complications and improve survival. While patient biomarkers – BMI and weight – are used for optimization, this research advocates for the identification of sarcopenia status for pre-operative planning. Sarcopenia may be an indicator of advanced disease requiring further treatment and is an emerging area of research. Larger studies are required to confirm these findings and to assess the reversibility of sarcopenia after surgery.

Keywords: sarcopaenia, cytoreductive surgery, hyperthermic intraperitoneal chemotherapy, surgical oncology

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Authors: John Scanlon, Antony Raymond, Randeep Aujla, Peter D’Alessandro, Satyen Gohil

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Background: The incidence of significant acute chondral injuries with patella dislocation is around 10-15%. It is accepted that chondral procedures should only be performed in the presence of joint stability Methods:Patients were identified from surgeon/hospital logs. Patient demographics, lesion size and location, surgical procedure, patient reported outcome measures, post-operative MR imaging, and complications were recorded. PROMs and patient satisfaction was obtained. Results:20 knees (18 patients) were included. Mean age was 18.6 years (range; 11-39), and the mean follow-up was 16.6 months (range; 2-70). The defect locations were the lateral femoral condyle (9/20; 45%), patella (9/20; 45%), medial femoral condyle (1/20; 5%) and the trochlea (1/20; 5%). The mean defect size was 2.6cm2. Twelve knees were treated with cartilage fixation, 5 with microfracture, and 3 with OATS. At follow up, the overall mean Lysholm score was 77.4 (± 17.1), with no chondral regenerative procedure being statistically superior. There was no difference in Lysholm scores between those patients having acute medial patellofemoral ligament reconstruction versus medial soft tissue plication (p=0.59). Five (25%) knees required re-operation (one arthroscopic arthrolysis; one patella chondroplasty; two removal of loose bodies; one implant adjustment). Overall, 90% responded as being satisfied with surgery. Conclusion: Our aggressive pathway to identify and treat acute cartilage defects with early operative intervention and patella stabilisation has shown high rates of satisfaction and Lysholm scores. The full range of chondral restoration options should be considered by surgeons managing these patients.

Keywords: patella dislocation, chondral restoration, knee, patella stabilisation

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