Search results for: triple negative breast cancer
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 6995

Search results for: triple negative breast cancer

4415 Economics of Conflict: Core Economic Dimensions of the Georgian-South Ossetian Context

Authors: V. Charaia

Abstract:

This article presents SWOT analysis for Georgian - South Ossetian conflict. The research analyzes socio-economic aspects and considers future prospects for all sides including neighbor countries and regions. Also it includes the possibilities of positive intervention of neighbor countries to solve the conflict or to mitigate its negative results. The main question of the article is: What will it take to award Georgians and South Ossetians with a peace dividend?

Keywords: conflict economics, investments, trade, remittances

Procedia PDF Downloads 235
4414 Views of Middle-Aged Women in Malaysia towards Menopause: A Qualitative Study

Authors: Halimatus Sakdiah Minhat, Hamizah Sulaiman

Abstract:

Introduction: Old age is commonly link with menopause among women. The main purpose of this study is to explore the views of middle-aged women and its association with menopause. Methods: Qualitative interviews in the form of focus group discussions (FGD) were conducted among women aged between 35 and 59 years old living in urban localities in two different states in Malaysia. Selection of respondents were conducted using the maximum variation sampling, focussing on five age categories which are between 35 to 39, 40 to 44, 45 to 49, 50 to 54 and 55 to 59 years old. Each FGD involved 5 to 7 respondents and lasted for 1 to 2 hours each. The content of the interviews were recorded, transcribed verbatim after each interview before the next focus group discussion is conducted. Field notes of reflexive observations were recorded by the rapporteur. Individual transcripts were analysed using standard methods of qualitative thematic analysis. The material was read through twice and later coded. The codes were further collapsed into several key themes related to perceptions towards menopause among the respondents. Results: A total number of 36 middle-aged women were consented for the interviews. The contents of the interviews revealed that younger women tend to associate menopause with being old, which were dominated by the younger aged categories of less than 50 years old. Majority of the respondents linked menopause with end of woman’s reproductive capacity or inability to give birth, lethargic or endless feeling of tiredness and insomnia, emotional instability or having more sensitive feelings and also the beginning of many health problems such as osteoarthritis which they perceived very synonyms with being old. Conclusion: The findings of this study indirectly reflect the negative views towards menopause among the middle-aged women in Malaysia. Being residents in the urban areas equipped with advanced technology and health information, do not exclude them from having negative views about menopause. However, this is a qualitative study which only focussing on age ranges, regardless of their socioeconomic and demographic background, which make further studies on related issues are necessaries. The fact that it was a qualitative interview, the findings could not be generalised and only specific to the targeted population.

Keywords: Menopause, Middle-aged women, old, Malaysia

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4413 Attitudes of the Indigenous People from Providencia, Amazon towards the Bora Language

Authors: Angela Maria Sarmiento

Abstract:

Since the end of the 19th century, the Bora people struggled to survive two stages of colonial domination, which resulted in situations of forced contact with the Western world. Their inclusion in global designs altered the configuration of their local spaces and social practices; thus the Bora language was affected and prone to transformation. This descriptive, interpretive study, within the indigenous and minoritized groups’ research field, aimed at analysing the linguistic attitudes as well as the contextual situation of the Bora language in Providencia, an ancestral territory and a speech community contained in the midst of the Colombian Amazon rainforest. Through the inquiry of their sociolinguistic practices, this study also considered the effects of the course of events derived from the rubber exploitation in the late 19th century, and the arrival of the Capuchin’s mission in the early 20th century. The methodology used in this study had an ethnographic approach, which allowed the researcher to study the social phenomena from the perspective of the participants. Fieldwork, diary, field notes, and semi-structured interviews were conducted and then triangulated with participant observations. The findings of this study suggest that there is a transition from current individual bilingualism towards Spanish monolingualism; this is enhanced by the absence of a functional distribution of the three varieties (Bora, Huitoto, and Spanish). Also, the positive attitudes towards the Spanish language are based on its functionality while positive attitudes towards the Bora language mostly refer to pride and identity. Negative attitudes are only directed towards the Bora language. In the search for the roots of these negative attitudes, appeared the traumatic experiences of the rubber exploitation and the indigenous experiences at the capuchin’s boarding school. Finally, the situation of the Bora language can be configured as a social fact strongly connected to previous years of colonial dominations and to the current and continuous incursion of new global-colonial designs.

Keywords: Bora language, language contact, linguistic attitudes, speech communities

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4412 Microfabrication of Three-Dimensional SU-8 Structures Using Positive SPR Photoresist as a Sacrificial Layer for Integration of Microfluidic Components on Biosensors

Authors: Su Yin Chiam, Qing Xin Zhang, Jaehoon Chung

Abstract:

Complementary metal-oxide-semiconductor (CMOS) integrated circuits (ICs) have obtained increased attention in the biosensor community because CMOS technology provides cost-effective and high-performance signal processing at a mass-production level. In order to supply biological samples and reagents effectively to the sensing elements, there are increasing demands for seamless integration of microfluidic components on the fabricated CMOS wafers by post-processing. Although the PDMS microfluidic channels replicated from separately prepared silicon mold can be typically aligned and bonded onto the CMOS wafers, it remains challenging owing the inherently limited aligning accuracy ( > ± 10 μm) between the two layers. Here we present a new post-processing method to create three-dimensional microfluidic components using two different polarities of photoresists, an epoxy-based negative SU-8 photoresist and positive SPR220-7 photoresist. The positive photoresist serves as a sacrificial layer and the negative photoresist was utilized as a structural material to generate three-dimensional structures. Because both photoresists are patterned using a standard photolithography technology, the dimensions of the structures can be effectively controlled as well as the alignment accuracy, moreover, is dramatically improved (< ± 2 μm) and appropriately can be adopted as an alternative post-processing method. To validate the proposed processing method, we applied this technique to build cell-trapping structures. The SU8 photoresist was mainly used to generate structures and the SPR photoresist was used as a sacrificial layer to generate sub-channel in the SU8, allowing fluid to pass through. The sub-channel generated by etching the sacrificial layer works as a cell-capturing site. The well-controlled dimensions enabled single-cell capturing on each site and high-accuracy alignment made cells trapped exactly on the sensing units of CMOS biosensors.

Keywords: SU-8, microfluidic, MEMS, microfabrication

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4411 Temperature Effect on Changing of Electrical Impedance and Permittivity of Ouargla (Algeria) Dunes Sand at Different Frequencies

Authors: Naamane Remita, Mohammed laïd Mechri, Nouredine Zekri, Smaïl Chihi

Abstract:

The goal of this study is the estimation real and imaginary components of both electrical impedance and permittivity z', z'' and ε', ε'' respectively, in Ouargla dunes sand at different temperatures and different frequencies, with alternating current (AC) equal to 1 volt, using the impedance spectroscopy (IS). This method is simple and non-destructive. the results can frequently be correlated with a number of physical properties, dielectric properties and the impacts of the composition on the electrical conductivity of solids. The experimental results revealed that the real part of impedance is higher at higher temperature in the lower frequency region and gradually decreases with increasing frequency. As for the high frequencies, all the values of the real part of the impedance were positive. But at low frequency the values of the imaginary part were positive at all temperatures except for 1200 degrees which were negative. As for the medium frequencies, the reactance values were negative at temperatures 25, 400, 200 and 600 degrees, and then became positive at the rest of the temperatures. At high frequencies of the order of MHz, the values of the imaginary part of the electrical impedance were in contrast to what we recorded for the middle frequencies. The results showed that the electrical permittivity decreases with increasing frequency, at low frequency we recorded permittivity values of 10+ 11, and at medium frequencies it was 10+ 07, while at high frequencies it was 10+ 02. The values of the real part of the electrical permittivity were taken large values at the temperatures of 200 and 600 degrees Celsius and at the lowest frequency, while the smallest value for the permittivity was recorded at the temperature of 400 degrees Celsius at the highest frequency. The results showed that there are large values of the imaginary part of the electrical permittivity at the lowest frequency and then it starts decreasing as the latter increases (the higher the frequency the lower the values of the imaginary part of the electrical permittivity). The character of electrical impedance variation indicated an opportunity to realize the polarization of Ouargla dunes sand and acquaintance if this compound consumes or produces energy. It’s also possible to know the satisfactory of equivalent electric circuit, whether it’s miles induction or capacitance.

Keywords: electrical impedance, electrical permittivity, temperature, impedance spectroscopy, dunes sand ouargla

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4410 Beam Coding with Orthogonal Complementary Golay Codes for Signal to Noise Ratio Improvement in Ultrasound Mammography

Authors: Y. Kumru, K. Enhos, H. Köymen

Abstract:

In this paper, we report the experimental results on using complementary Golay coded signals at 7.5 MHz to detect breast microcalcifications of 50 µm size. Simulations using complementary Golay coded signals show perfect consistence with the experimental results, confirming the improved signal to noise ratio for complementary Golay coded signals. For improving the success on detecting the microcalcifications, orthogonal complementary Golay sequences having cross-correlation for minimum interference are used as coded signals and compared to tone burst pulse of equal energy in terms of resolution under weak signal conditions. The measurements are conducted using an experimental ultrasound research scanner, Digital Phased Array System (DiPhAS) having 256 channels, a phased array transducer with 7.5 MHz center frequency and the results obtained through experiments are validated by Field-II simulation software. In addition, to investigate the superiority of coded signals in terms of resolution, multipurpose tissue equivalent phantom containing series of monofilament nylon targets, 240 µm in diameter, and cyst-like objects with attenuation of 0.5 dB/[MHz x cm] is used in the experiments. We obtained ultrasound images of monofilament nylon targets for the evaluation of resolution. Simulation and experimental results show that it is possible to differentiate closely positioned small targets with increased success by using coded excitation in very weak signal conditions.

Keywords: coded excitation, complementary golay codes, DiPhAS, medical ultrasound

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4409 Effect of Gender on Carcass Parameters in Japanese Quail

Authors: M. Bolacali

Abstract:

This study was conducted to determine the effects of and sex on the carcass characteristics in Japanese quails. A total of 320 (160 for each sex groups) one-day-old quail chicks were randomly allocated to the sex groups, each containing 160 chicks according to a completely randomized design. Each gender was then divided into five replicate groups of 32 chicks. According to sex groups, the chicks of all replicate groups were housed in cages. The normality of distribution for all data was tested with the Shapiro-Wilk test at 95% confidence interval. A P value of ≤ 0.05 was interpreted as different. The statistical analysis for normal distribution data of the dietary groups was carried out with the general linear model procedure of SPSS software. The results are expressed as mean ± standard deviation of five replications. Duncan’s multiple range test was used for multiple comparisons in important groups. Data points bearing different letters are significantly different P ≤ 0.05. For the distribution of data that was different from normal, Kruskal Wallis H-Test was applied as a nonparametric test, and the results were expressed as median, minimum and maximum values. Pairwise comparisons of groups were made when Kruskal Wallis H-Test was significant. The study period lasted 42 days. Hot carcass, cold carcass, heart, and leg percentages in male quails was higher than female quails (P < 0.05), but liver, and breast percentages in female quails was higher than male quails (P > 0.05). The highest slaughter and carcass weight values were determined in the female quails in the cage. As a conclusion, it may be recommended to quail meat producers, who would like to obtain higher carcass weight to make more economic profit, to raise female quails in cage.

Keywords: carcass yield, chick, gender, management

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4408 Assessment of the Risks of Environmental Factors on the Health of Kazakhstan Cities in Promoting the Sustainable Development Goals

Authors: Rassima Salimbayeva, Kaliash Stamkulova, Gulparshyn Satbayeva

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In order to adapt projects to promote Sustainable Development Goal 11. «Ensuring openness, security, resilience and environmental sustainability of cities and human settlements», presented in the UN Concept, it is necessary to assess the environmental sustainability of cities. From the analysis of the problems of sustainable development of cities in Kazakhstan, it can be seen that the industrial past created a typical range of problems -transport, housing, environment, and, importantly, image. Currently, the issue of air pollution in cities whose economies are dominated by one industry or company should be studied in more detail at the level of projects. In this research, using ecological, economic, and social indicators of five single-industry towns of the Karaganda region of Kazakhstan, an assessment of the risks of the negative impact of environmental factors on the health of the population was carried out, including by paying special attention to air quality. In order to investigate the relationship between the structure of industry, environmental pressure, and environmental sustainability of resource-oriented cities, an analysis of the main components was carried out to measure the structure of industry, environmental stress, and environmental sustainability of single-industry towns. It has been established that in resource-based cities, economic growth mainly depends on the development of one main industry, which primarily depends on local natural resources. Empirical results show that the regional structure of industry has a significant negative impact on the environmental sustainability of cities, in particular on the health of the population living in them. The paper complements the study of the theory of urban sustainability and clarifies the relationship between industrial structure and environmental pressure on health safety and environmental sustainability of cities and towns, which is crucial for further promoting the "green" development of single-industry towns based on natural resources.

Keywords: public health risks, urban sustainability, suspended solids, single-industry towns, atmospheric air, environmental pollution

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4407 Systematic Exploration and Modulation of Nano-Bio Interactions

Authors: Bing Yan

Abstract:

Nanomaterials are widely used in various industrial sectors, biomedicine, and more than 1300 consumer products. Although there is still no standard safety regulation, their potential toxicity is a major concern worldwide. We discovered that nanoparticles target and enter human cells1, perturb cellular signaling pathways2, affect various cell functions3, and cause malfunctions in animals4,5. Because the majority of atoms in nanoparticles are on the surface, chemistry modification on their surface may change their biological properties significantly. We modified nanoparticle surface using nano-combinatorial chemistry library approach6. Novel nanoparticles were discovered to exhibit significantly reduced toxicity6,7, enhance cancer targeting ability8, or re-program cellular signaling machineries7. Using computational chemistry, quantitative nanostructure-activity relationship (QNAR) is established and predictive models have been built to predict biocompatible nanoparticles.

Keywords: nanoparticle, nanotoxicity, nano-bio, nano-combinatorial chemistry, nanoparticle library

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4406 Bone Mineral Density in Long-Living Patients with Coronary Artery Disease

Authors: Svetlana V. Topolyanskaya, Tatyana A. Eliseeva, Olga N. Vakulenko, Leonid I. Dvoretski

Abstract:

Introduction: Limited data are available on osteoporosis in centenarians. Therefore, we evaluated bone mineral density in long-living patients with coronary artery disease (CAD). Methods: 202 patients hospitalized with CAD were enrolled in this cross-sectional study. The patients' age ranged from 90 to 101 years. The majority of study participants (64.4%) were women. The main exclusion criteria were any disease or medication that can lead to secondary osteoporosis. Bone mineral density (BMD) was measured by dual-energy X-ray absorptiometry. Results: Normal lumbar spine BMD was observed in 40.9%, osteoporosis – in 26.9%, osteopenia – in 32.2% of patients. Normal proximal femur BMD values were observed in 21.3%, osteoporosis – in 39.9%, and osteopenia – in 38.8% of patients. Normal femoral neck BMD was registered only in 10.4% of patients, osteoporosis was observed in 60.4%, osteopenia in 29.2%. Significant positive correlation was found between all BMD values and body mass index of patients (p < 0.001). Positive correlation was registered between BMD values and serum uric acid (p=0.0005). The likelihood of normal BMD values with hyperuricemia increased 3.8 times, compared to patients with normal uric acid, who often have osteoporosis (Odds Ratio=3.84; p = 0.009). Positive correlation was registered between all BMD values and body mass index (p < 0.001). Positive correlation between triglycerides levels and T-score (p=0.02), but negative correlation between BMD and HDL-cholesterol (p=0.02) were revealed. Negative correlation between frailty severity and BMD values (p=0.01) was found. Positive correlation between BMD values and functional abilities of patients assessed using Barthel index (r=0,44; p=0,000002) and IADL scale (r=0,36; p=0,00008) was registered. Fractures in history were observed in 27.6% of patients. Conclusions: The study results indicate some features of BMD in long-livers. In the study group, significant relationships were found between bone mineral density on the one hand, and patients' functional abilities on the other. It is advisable to further study the state of bone tissue in long-livers involving a large sample of patients.

Keywords: osteoporosis, bone mineral density, centenarians, coronary artery disease

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4405 Effect of Spirulina Supplementation on Growth Performance and Body Conformation of Two Omani Goat Breeds

Authors: Fahad Al Yahyaey, Ihab Shaat, Russell Bush

Abstract:

This study was conducted at the Livestock Research Centre, Ministry of Agriculture and Fisheries, Oman, on two local goat breeds (Jabbali and Sahrawi) due to their importance to Omani livestock production and food security. The Jabbali is characterized by increased growth rates and a higher twinning rate, while the Sahrawi has increased milk production. The aim of the study was to investigate the effect of Spirulina supplementation on live weight (BWT), average daily gain (ADG), and body conformation measurements; chest girth (CG), wither height (WH), body length (BL), and body condition score (BCS). Thirty-six males (approximately nine-months-old and 16.44 ± 0.33 kg average of initial body weight) were used across an eleven-week study from November–February 2019-2020. Each breed was divided into three groups (n = 6/group) and fed one of three rations: (1) concentrate mixture (Control) with crude protein 14% and energy 11.97% MJ/kg DM; (2) the same concentrate feed with the addition of 2 gm /capita daily Spirulina platensis (Treatment 1) and (3) the same concentrate feed with the addition of 4 gm /capita daily Spirulina platensis (Treatment 2). Analysis of weekly data collections for all traits indicated a significant effect of feeding Spirulina on all the studied traits except WH and BL. Analysis of variance for fixed effects in this study (damage and kid birth type i.e., single, twin or triple) were not significant for all studied traits. However, the breed effect was highly significant (P < 0.001) on BWT, ADG, BCS, and CG traits. On the other hand, when the analysis was done for the treatment effect within breeds for ADG, the Sahrawi breed had a significant effect (P < 0.05) at 56.52, 85.51, and 85.50 g/day for control, treatment 1 and treatment 2, respectively. This is a 51% difference between the control and treatment 1 (2 gm /capita). Whereas for the Jabbali breed, the treatment effect was not significant for ADG (P =0.55), and the actual ADG was 104.59, 118.84, and 114.25 g/day for control, treatment 1, and treatment 2, respectively, providing a 14% difference between the control group and the treated group (4 gm /capita). These findings indicate using Spirulina supplementation in Omani goat diets is recommended at 2 gm per capita as there was no benefit in feeding at 4 gm per capita for either breed. Farmers feeding Spirulina supplementation to kids after weaning at six-months could increase their herd performance and growth rate and facilitate buck selection at an earlier age.

Keywords: body conformation, goats, live weight, spirulina

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4404 A Niche Sustainable Tourism Product: Stakeholder Perceptions on Sustainable Conference Tourism in Cyprus

Authors: Xenia I. Loizidou, Anthi Gavriel, Demetra Petsa

Abstract:

The tourism industry is a significant contributor to Cyprus's Gross Domestic Product. However, as the main tourism product is 'sun and sea', the industry is significantly unsustainable, with the majority of tourists (approx. 90%) concentrated in coastal areas over a short period of time, causing negative environmental, social, and economic impacts. The newly established Cypriot Deputy Ministry of Tourism aims to diversify the Cypriot tourism industry by focusing on the development of niche tourism products that will elongate the touristic season and divert visitors to inland mountainous and rural areas. In this respect, conference and event tourism is an ideal product for development. The current paper presents the results of fieldwork carried out between January and March 2020 in Cyprus, with key stakeholders within the conference and event tourism sector. The work consisted of a survey and semi-structured interviews to determine the current level of sustainability within the conference tourism sector, the main barriers to the sector's development, as well as key stakeholder insights and suggestions for measures to improve the sector's sustainability. The results suggest that there is a general lack of understanding of the negative economic, environmental and social impacts associated with the organization of conventional conferences and events, compared to the positive impacts of sustainable conferences/events. There also seems to be a lack of awareness of actions that can be taken to make the conference and event sector more sustainable. Incentives, marketing, branding, and training are identified as some of the effective means to improve the sustainability of the Cypriot conference and event sector, as is the development of country-wide sustainability policy and a review and enforcement of national waste management legislation. The research outputs will be utilized for the development of targeted toolkits, training, and awareness-raising activities that will drive Cyprus towards becoming an international sustainable tourism destination.

Keywords: conference, event, sustainability, tourism

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4403 U-Net Based Multi-Output Network for Lung Disease Segmentation and Classification Using Chest X-Ray Dataset

Authors: Jaiden X. Schraut

Abstract:

Medical Imaging Segmentation of Chest X-rays is used for the purpose of identification and differentiation of lung cancer, pneumonia, COVID-19, and similar respiratory diseases. Widespread application of computer-supported perception methods into the diagnostic pipeline has been demonstrated to increase prognostic accuracy and aid doctors in efficiently treating patients. Modern models attempt the task of segmentation and classification separately and improve diagnostic efficiency; however, to further enhance this process, this paper proposes a multi-output network that follows a U-Net architecture for image segmentation output and features an additional CNN module for auxiliary classification output. The proposed model achieves a final Jaccard Index of .9634 for image segmentation and a final accuracy of .9600 for classification on the COVID-19 radiography database.

Keywords: chest X-ray, deep learning, image segmentation, image classification

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4402 Transarterial Chemoembolization (TACE) in Hepatocellular Carcinoma (HCC)

Authors: Ilirian Laçi, Alketa Spahiu

Abstract:

Modality of treatment in hepatocellular carcinoma (HCC) patients depends on the stage of the disease. The Barcelona Clinic Liver Cancer Classification (BCLC) is the preferred staging system. There are many patients initially present with intermediate-stage disease. For these patients, transarterial chemoembolization (TACE) is the treatment of choice. The differences in individual factors that are not captured by the BCLC framework, such as the tumor growth pattern, degree of hypervascularity, and vascular supply, complicate further evaluation of these patients. Because of these differences, not all patients benefit equally from TACE. Several tools have been devised to aid the decision-making process, which have shown promising initial results but have failed external evaluation and have not been translated to the clinic aspects. Criteria for treatment decisions in daily clinical practice are needed in all stages of the disease.

Keywords: hepatocellular carcinoma, transarterial chemoembolization, TACE, liver

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4401 Apoptotic Induction Ability of Harmalol and Its Binding: Biochemical and Biophysical Perspectives

Authors: Kakali Bhadra

Abstract:

Harmalol administration caused remarkable reduction in proliferation of HepG2 cells with GI50 of 14.2 mM, without showing much cytotoxicity in embryonic liver cell line, WRL-68. Data from circular dichroism and differential scanning calorimetric analysis of harmalol-CT DNA complex shows conformational changes with prominent CD perturbation and stabilization of CT DNA by 8 oC. Binding constant and stoichiometry was also calculated using the above biophysical techniques. Further, dose dependent apoptotic induction ability of harmalol was studied in HepG2 cells using different biochemical assays. Generation of ROS, DNA damage, changes in cellular external and ultramorphology, alteration of membrane, formation of comet tail, decreased mitochondrial membrane potential and a significant increase in Sub Go/G1 population made the cancer cell, HepG2, prone to apoptosis. Up regulation of p53 and caspase 3 further indicated the apoptotic role of harmalol.

Keywords: apoptosis, beta carboline alkaloid, comet assay, cytotoxicity, ROS

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4400 Total Arterial Coronary Revascularization with Aorto-Bifemoral Bipopliteal Bypass: A Case Report

Authors: Nuruddin Mohammod Zahangir, Syed Tanvir Ahmady, Firoz Ahmed, Mainul Kabir, Tamjid Mohammad Najmus Sakib Khan, Nazmul Hossain, Niaz Ahmed, Madhava Janardhan Naik

Abstract:

The management of combined Coronary Artery Disease and Peripheral Vascular Disease is a challenge and brings with it numerous clinical dilemmas.The 56 year old gentleman presented to our department with significant triple vessel disease with occluded lower end of aorta just before bifurcation and bilateral superficial femoral arteries. Operation was done on 11.03.14. The The Left Internal Mammary Artery (LIMA) and the Right Internal Mammary Artery (RIMA) were harvested in skeletonized manner. The free RIMA was then anastomosed with LIMA to make LIMA-RIMA Y. Cardio Pulmonary Bypass was then established and coronary artery bypass grafts performed. LIMA was anastomosed to the Left Anterior Descending artery. RIMA was anastomosed to Posterior Descending Artery, 1st and 2nd Obtuse Marginal arteries in a sequential manner. Abdomen was opened by midline incision. The infrarenal aorta exposed and was found to be severely diseased. A Vascular Clamp was applied infrarenally, aortotomy done and limited endarterectomy performed. An end-to-side anastomosis was done with upper end of PTFE synthetic Y-graft (14/7 mm) to the infarenal Aorta and the Clamp released. Good flow noted in both limbs of the graft. Patient was then slowly weaned off from Cardio Pulmonary Bypass without difficulty. The distal two limbs of the Y graft were passed to the groin through retroperitoneal tunnels and anastomosed end-to-side with the common femoral arteries. Saphenous vein was interposed between common femoral and popliteal arteries bilaterally through subfascial tunnels in both thigh. On 12th postoperative day he was discharged from hospital in good general condition. Follow up after 3 months of operation the patient is doing good and free of chest pain and claudication pain.

Keywords: total arterial, coronary revascularization, aorto-bifemoral bypass, bifemoro-bipopliteal bypass

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4399 Antibacterial and Cytotoxicity Activity of Cinchona Alkaloids

Authors: Alma Ramić, Mirjana Skočibušić, Renata Odžak, Tomica Hrenar, Ines Primožič

Abstract:

In an attempt to identify a new class of antimicrobial agents, the antimicrobial potential of Cinchona alkaloid derivatives was evaluated. The bark of the Cinchona trees is the source of a variety of alkaloids, among which the best known are quinine, quinidine, cinchonine and cinchonidine. They are very useful as organocatalysts in stereoselective synthesis. On the other hand, quinine is traditionally used in the treatment of malaria. Furthermore, Cinchona alkaloids possess various analgesic, anti-inflammatory and anti–arrhythmic properties as well. In this work we present the synthesis of twenty quaternary derivatives of pseudo−enantiomeric Cinchona alkaloid derivatives to evaluate their antibacterial activity. Quaternization of quinuclidine moiety was carried out with groups diverse in their size. The structures of compounds were systematically modified to obtain drug-like properties with proper physical and chemical properties and avoiding toxophore. All compounds were prepared in good yields and were characterized by standard analytical spectroscopy methods (1D and 2D NMR, IR, MS). The antibacterial activities of all compounds were evaluated against series of recent clinical isolates of antibiotic susceptible Gram-positive and resistant Gram-negative pathogens by determining their zone of inhibition and minimum inhibitory concentrations. All compounds showed good to strong broad-spectrum activity, equivalent or better in comparison with standard antibiotics used. Furthermore, seven compounds exhibited significant antibacterial efficiency against Gram-negative isolates. To visualize the results, principal component analysis was used as an additional classification tool. Cytotoxicity of compounds with different cell lines in human cell culture was determined. Based on these results, substituted quaternary Cinchona scaffold can be considered as promising new class of antimicrobials and further investigations should be performed. Supported by Croatian Science Foundation, Project No 3775 ADESIRE.

Keywords: antibacterial efficiency, cinchona alkaloids, cytotoxicity, pseudo‐enantiomers

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4398 Dynamic Externalities and Regional Productivity Growth: Evidence from Manufacturing Industries of India and China

Authors: Veerpal Kaur

Abstract:

The present paper aims at investigating the role of dynamic externalities of agglomeration in the regional productivity growth of manufacturing sector in India and China. Taking 2-digit level manufacturing sector data of states and provinces of India and China respectively for the period of 1998-99 to 2011-12, this paper examines the effect of dynamic externalities namely – Marshall-Arrow-Romer (MAR) specialization externalities, Jacobs’s diversity externalities, and Porter’s competition externalities on regional total factor productivity growth (TFPG) of manufacturing sector in both economies. Regressions have been carried on pooled data for all 2-digit manufacturing industries for India and China separately. The estimation of Panel has been based on a fixed effect by sector model. The results of econometric exercise show that labour-intensive industries in Indian regional manufacturing benefit from diversity externalities and capital intensive industries gain more from specialization in terms of TFPG. In China, diversity externalities and competition externalities hold better prospectus for regional TFPG in both labour intensive and capital intensive industries. But if we look at results for coastal and non-coastal region separately, specialization tends to assert a positive effect on TFPG in coastal regions whereas it has a negative effect on TFPG of coastal regions. Competition externalities put a negative effect on TFPG of non-coastal regions whereas it has a positive effect on TFPG of coastal regions. Diversity externalities made a positive contribution to TFPG in both coastal and non-coastal regions. So the results of the study postulate that the importance of dynamic externalities should not be examined by pooling all industries and all regions together. This could hold differential implications for region specific and industry-specific policy formulation. Other important variables explaining regional level TFPG in both India and China have been the availability of infrastructure, level of competitiveness, foreign direct investment, exports and geographical location of the region (especially in China).

Keywords: China, dynamic externalities, India, manufacturing, productivity

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4397 Identification of the Antimicrobial Effect of Liquorice Extracts on Gram-Positive Bacteria: Determination of Minimum Inhibitory Concentration and Mechanism of Action Using a luxABCDE Reporter Strain

Authors: Madiha El Awamie, Catherine Rees

Abstract:

Natural preservatives have been used as alternatives to traditional chemical preservatives; however, a limited number have been commercially developed and many remain to be investigated as sources of safer and effective antimicrobials. In this study, we have been investigating the antimicrobial activity of an extract of Glycyrrhiza glabra (liquorice) that was provided as a waste material from the production of liquorice flavourings for the food industry, and to investigate if this retained the expected antimicrobial activity so it could be used as a natural preservative. Antibacterial activity of liquorice extract was screened for evidence of growth inhibition against eight species of Gram-negative and Gram-positive bacteria, including Listeria monocytogenes, Listeria innocua, Staphylococcus aureus, Enterococcus faecalis and Bacillus subtilis. The Gram-negative bacteria tested include Pseudomonas aeruginosa, Escherichia coli and Salmonella typhimurium but none of these were affected by the extract. In contrast, for all of the Gram-positive bacteria tested, growth was inhibited as monitored using optical density. However parallel studies using viable count indicated that the cells were not killed meaning that the extract was bacteriostatic rather than bacteriocidal. The Minimum Inhibitory Concentration [MIC] and Minimum Bactericidal Concentration [MBC] of the extract was also determined and a concentration of 50 µg ml-1 was found to have a strong bacteriostatic effect on Gram-positive bacteria. Microscopic analysis indicated that there were changes in cell shape suggesting the cell wall was affected. In addition, the use of a reporter strain of Listeria transformed with the bioluminescence genes luxABCDE indicated that cell energy levels were reduced when treated with either 12.5 or 50 µg ml-1 of the extract, with the reduction in light output being proportional to the concentration of the extract used. Together these results suggest that the extract is inhibiting the growth of Gram-positive bacteria only by damaging the cell wall and/or membrane.

Keywords: antibacterial activity, bioluminescence, Glycyrrhiza glabra, natural preservative

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4396 Nonstationary Modeling of Extreme Precipitation in the Wei River Basin, China

Authors: Yiyuan Tao

Abstract:

Under the impact of global warming together with the intensification of human activities, the hydrological regimes may be altered, and the traditional stationary assumption was no longer satisfied. However, most of the current design standards of water infrastructures were still based on the hypothesis of stationarity, which may inevitably result in severe biases. Many critical impacts of climate on ecosystems, society, and the economy are controlled by extreme events rather than mean values. Therefore, it is of great significance to identify the non-stationarity of precipitation extremes and model the precipitation extremes in a nonstationary framework. The Wei River Basin (WRB), located in a continental monsoon climate zone in China, is selected as a case study in this study. Six extreme precipitation indices were employed to investigate the changing patterns and stationarity of precipitation extremes in the WRB. To identify if precipitation extremes are stationary, the Mann-Kendall trend test and the Pettitt test, which is used to examine the occurrence of abrupt changes are adopted in this study. Extreme precipitation indices series are fitted with non-stationary distributions that selected from six widely used distribution functions: Gumbel, lognormal, Weibull, gamma, generalized gamma and exponential distributions by means of the time-varying moments model generalized additive models for location, scale and shape (GAMLSS), where the distribution parameters are defined as a function of time. The results indicate that: (1) the trends were not significant for the whole WRB, but significant positive/negative trends were still observed in some stations, abrupt changes for consecutive wet days (CWD) mainly occurred in 1985, and the assumption of stationarity is invalid for some stations; (2) for these nonstationary extreme precipitation indices series with significant positive/negative trends, the GAMLSS models are able to capture well the temporal variations of the indices, and perform better than the stationary model. Finally, the differences between the quantiles of nonstationary and stationary models are analyzed, which highlight the importance of nonstationary modeling of precipitation extremes in the WRB.

Keywords: extreme precipitation, GAMLSSS, non-stationary, Wei River Basin

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4395 Walking the Tightrope: Balancing Project Governance, Complexity, and Servant Leadership for Megaproject Success

Authors: Muhammad Shoaib Iqbal, Shih Ping Ho

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Megaprojects are large-scale, complex ventures with significant financial investments, numerous stakeholders, and extended timelines, requiring meticulous management for successful completion. This study explores the interplay between project governance, project complexity, and servant leadership and their combined effects on project success, specifically within the context of Pakistani megaprojects. The primary objectives are to examine the direct impact of project governance on project success, understand the negative influence of project complexity, assess the positive role of servant leadership, explore the moderating effect of servant leadership on the relationship between governance and success, and investigate how servant leadership mitigates the adverse effects of complexity. Using a quantitative approach, survey data were collected from project managers and team members involved in Pakistani megaprojects. Using a Comprehensive empirical model, 257 Valid responses were analyzed. Multiple regression analysis tested the hypothesized relationships and interaction effects using PLS-SEM. Findings reveal that project governance significantly enhances project success, emphasizing the need for robust governance structures. Conversely, project complexity negatively impacts success, highlighting the challenges of managing complex projects. Servant leadership significantly boosts project success by prioritizing team support and empowerment. Although the interaction between governance and servant leadership is not significant, suggesting no significant change in project success, servant leadership significantly mitigates the negative effects of project complexity, enhancing team resilience and adaptability. These results underscore the necessity for a balanced approach integrating strong governance with flexible, supportive leadership. The study offers valuable insights for practitioners, recommending adaptive governance frameworks and promoting servant leadership to improve the management and success rates of megaprojects. This research contributes to the broader understanding of effective project management practices in complex environments.

Keywords: project governance, project complexity, servant leadership, project success, megaprojects, Pakistan

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4394 An Investigation into Why Very Few Small Start-Ups Business Survive for Longer Than Three Years: An Explanatory Study in the Context of Saudi Arabia

Authors: Motaz Alsolaim

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Nowadays, the challenges of running a start-up can be very complex and are perhaps more difficult than at any other time in the past. Changes in technology, manufacturing innovation, and product development, combined with intense competition and market regulations are factors that have put pressure on classic ways of managing firms, thereby forcing change. As a result, the rate of closure, exit or discontinuation of start-ups and young businesses is very high. Despite the essential role of small firms in an economy, they still tend to face obstacles that exert a negative influence on their performance and rate of survival. In fact, it is not easy to determine with any certainty the reasons why small firms fail. For this reason, failure itself is not clearly defined, and its exact causes are hard to diagnose. In this current study, therefore, the barriers to survival will be covered more broadly, especially personal/entrepreneurial, enterprise and environmental factors with regard to various possible reasons for this failure, in order to determine the best solutions and make appropriate recommendations. Methodology: It could be argued that mixed methods might help to improve entrepreneurship research addressing challenges emphasis in previous studies and to achieve the triangulation. Calls for the combined use of quantitative and qualitative research were also made in the entrepreneurship field since entrepreneurship is a multi-faceted area of research. Therefore, explanatory sequential mixed method was used, using questionnaire online survey for entrepreneurs, followed by semi-structure interview. Collecting over 750 surveys and accepting 296 valid surveys, after that 13 interviews from government official seniors, businessmen successful entrepreneurs, and non-successful entrepreneurs. Findings: The first phase findings ( quantitative) shows the obstacles to survive; starting from the personal/ entrepreneurial factors such as; past work experience, lack of skills and interest, are positive factors, while; gender, age and education level of the owner are negative factors. Internal factors such as lack of marketing research and weak business planning are positive. The environmental factors; in economic perspectives; difficulty to find labors, in socio-cultural perspectives; Social restriction and traditions found to be a negative factors. In other hand, from the political perspective; cost of compliance and insufficient government plans found to be a positive factors for small business failure. From infrastructure perspective; lack of skills labor, high level of bureaucracy and lack of information are positive factors. Conclusion: This paper serves to enrich the understanding of failure factors in MENA region more precisely in SA, by minimizing the probability of failure in small-micro entrepreneurial start-up in SA, in the light of the Saudi government’s Vision 2030 plan.

Keywords: small business barriers, start-up business, entrepreneurship, Saudi Arabia

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4393 Impact of COVID-19 on Radiology Training in Australia and New Zealand

Authors: Preet Gill, Danus Ravindran

Abstract:

These The COVID-19 pandemic resulted in widespread implications for medical specialist training programs worldwide, including radiology. The objective of this study was to investigate the impact of COVID-19 on the Australian and New Zealand radiology trainee experience and well-being, as well as to compare the Australasian experience with that reported by other countries. An anonymised electronic online questionnaire was disseminated to all training members of the Royal Australian and New Zealand College of Radiologists who were radiology trainees during the 2020 – 2022 clinical years. Trainees were questioned about their experience from the beginning of the COVID-19 pandemic in Australasia (March 2020) to the time of survey completion. Participation was voluntary. Questions assessed the impact of the pandemic across multiple domains, including workload (inpatient/outpatient & individual modality volume), teaching, supervision, external learning opportunities, redeployment and trainee wellbeing. Survey responses were collated and compared with other peer reviewed publications. Answer options were primarily in categorical format (nominal and ordinal subtypes, as appropriate). An opportunity to provide free text answers to a minority of questions was provided. While our results mirror that of other countries, which demonstrated reduced case exposure and increased remote teaching and supervision, responses showed variation in the methods utilised by training sites during the height of the pandemic. A significant number of trainees were affected by examination cancellations/postponements and had subspecialty training rotations postponed. The majority of trainees felt that the pandemic had a negative effect on their training. In conclusion, the COVID-19 pandemic has had a significant impact on radiology trainees across Australia and New Zealand. The present study has highlighted the extent of these effects, with most aspects of training impacted. Opportunities exist to utilise this information to create robust workplace strategies to mitigate these negative effects should the need arise in the future.

Keywords: COVID-19, radiology, training, pandemic

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4392 Clinical and Analytical Performance of Glial Fibrillary Acidic Protein and Ubiquitin C-Terminal Hydrolase L1 Biomarkers for Traumatic Brain Injury in the Alinity Traumatic Brain Injury Test

Authors: Raj Chandran, Saul Datwyler, Jaime Marino, Daniel West, Karla Grasso, Adam Buss, Hina Syed, Zina Al Sahouri, Jennifer Yen, Krista Caudle, Beth McQuiston

Abstract:

The Alinity i TBI test is Therapeutic Goods Administration (TGA) registered and is a panel of in vitro diagnostic chemiluminescent microparticle immunoassays for the measurement of glial fibrillary acidic protein (GFAP) and ubiquitin C-terminal hydrolase L1 (UCH-L1) in plasma and serum. The Alinity i TBI performance was evaluated in a multi-center pivotal study to demonstrate the capability to assist in determining the need for a CT scan of the head in adult subjects (age 18+) presenting with suspected mild TBI (traumatic brain injury) with a Glasgow Coma Scale score of 13 to 15. TBI has been recognized as an important cause of death and disability and is a growing public health problem. An estimated 69 million people globally experience a TBI annually1. Blood-based biomarkers such as glial fibrillary acidic protein (GFAP) and ubiquitin C-terminal hydrolase L1 (UCH-L1) have shown utility to predict acute traumatic intracranial injury on head CT scans after TBI. A pivotal study using prospectively collected archived (frozen) plasma specimens was conducted to establish the clinical performance of the TBI test on the Alinity i system. The specimens were originally collected in a prospective, multi-center clinical study. Testing of the specimens was performed at three clinical sites in the United States. Performance characteristics such as detection limits, imprecision, linearity, measuring interval, expected values, and interferences were established following Clinical and Laboratory Standards Institute (CLSI) guidance. Of the 1899 mild TBI subjects, 120 had positive head CT scan results; 116 of the 120 specimens had a positive TBI interpretation (Sensitivity 96.7%; 95% CI: 91.7%, 98.7%). Of the 1779 subjects with negative CT scan results, 713 had a negative TBI interpretation (Specificity 40.1%; 95% CI: 37.8, 42.4). The negative predictive value (NPV) of the test was 99.4% (713/717, 95% CI: 98.6%, 99.8%). The analytical measuring interval (AMI) extends from the limit of quantitation (LoQ) to the upper LoQ and is determined by the range that demonstrates acceptable performance for linearity, imprecision, and bias. The AMI is 6.1 to 42,000 pg/mL for GFAP and 26.3 to 25,000 pg/mL for UCH-L1. Overall, within-laboratory imprecision (20 day) ranged from 3.7 to 5.9% CV for GFAP and 3.0 to 6.0% CV for UCH-L1, when including lot and instrument variances. The Alinity i TBI clinical performance results demonstrated high sensitivity and high NPV, supporting the utility to assist in determining the need for a head CT scan in subjects presenting to the emergency department with suspected mild TBI. The GFAP and UCH-L1 assays show robust analytical performance across a broad concentration range of GFAP and UCH-L1 and may serve as a valuable tool to help evaluate TBI patients across the spectrum of mild to severe injury.

Keywords: biomarker, diagnostic, neurology, TBI

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4391 Correlation Between HIV/AIDS Stage With Oral Health, Dentition, and Periodontal Status

Authors: Eriselda Simoni, Leonard Simoni, Endri Paparisto, Laureta Flaga, Silvana Bara, Edit Xhajanka, Arjan Harxhi

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Background: Some pathologies are encountered more often in HIV/ AIDS, such as those with bacterial, fungal, viral, and neoplastic causes, but what has been more noticeable in recent years is the increased and more aggressive manifestation of periodontal disease and oral caries. Our purpose is to investigate the correlation between the HIV/AIDS stage and CD4 level with oral health, dentition, and periodontal status. Materials and Methods: We conducted a prospective observational study that included 35 patients newly diagnosed with HIV/AIDS and underwent an oral examination at the University Dental Clinic in Tirana, Albania, in the period April - July 2024. This study evaluated the basic demographic, laboratory characteristics, oral hygiene, and the presence of oral lesions. The dentition status was assessed with the values DT (decay teeth), FT (filled teeth), and MT (missing teeth) presented as DMFT. The periodontal status was evaluated through a periodontal probe measuring CPI (community periodontal index) and LOA (loss of attachment) as recommended by the WHO Oral Health Assessment Form 2013. The Pearson Correlation Coefficient (r) was used to evaluate the relationship between levels of CD4+ and DMF, CD4+ and CPI, and CD4+ and LOA. The P value ≤ 0.05 was considered statistically significant. Results: 80% of patients included were males with a mean age of 35.8 years. 8.6% of patients were categorized as HIV stage I, 28.6% as stage II, and 62.8% as HIV stage III/AIDS. The mean level value of CD4+ was 266.2 cells/mm3 and the rapport CD4+/ WBC (White Blood Cells) was 15.7%. Most patients (57.2%) used toothbrushes less than 1 time a day. An important negative correlation was found between CD4+ and dentition and periodontal status. A lower level of CD4+ was correlated with a higher DMFT, CPI, and LOA, respectively coefficient (r) for CD4/DMFT = -0.52, p =0.01, (r) for CD4/CPI= - 0.38, p=0.024 and (r) for CD4/LOA= - 0.37, p=0.029. Conclusions: In our study, it was documented that patients with HIV/AIDS had worse oral health, an important negative correlation between CD4+ and dentition and periodontal status. A lower level of CD4+ was correlated with a worse dentition status (higher DMFT), and poor periodontal health (higher CPI and LOA). The monitoring and treatment of oral pathologies can be important in early HIV/AIDS diagnoses and treatment.

Keywords: HIV/AIDS, oral health, dentition, periodontal

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4390 Identification of Lipo-Alkaloids and Fatty Acids in Aconitum carmichaelii Using Liquid Chromatography–Mass Spectrometry and Gas Chromatography–Mass Spectrometry

Authors: Ying Liang, Na Li

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Lipo-alkaloid is a kind of C19-norditerpenoid alkaloids existed in Aconitum species, which usually contains an aconitane skeleton and one or two fatty acid residues. The structures are very similar to that of diester-type alkaloids, which are considered as the main bioactive components in Aconitum carmichaelii. They have anti-inflammatory, anti-nociceptive, and anti-proliferative activities. So far, more than 200 lipo-alkaloids were reported from plants, semisynthesis, and biotransformations. In our research, by the combination of ultra-high performance liquid chromatography-quadruple-time of flight mass spectrometry (UHPLC-Q-TOF-MS) and an in-house database, 148 lipo-alkaloids were identified from A. carmichaelii, including 93 potential new compounds and 38 compounds with oxygenated fatty acid moieties. To our knowledge, this is the first time of the reporting of the oxygenated fatty acids as the side chains in naturally-occurring lipo-alkaloids. Considering the fatty acid residues in lipo-alkaloids should come from the free acids in the plant, the fatty acids and their relationship with lipo-alkaloids were further investigated by GC-MS and LC-MS. Among 17 fatty acids identified by GC-MS, 12 were detected as the side chains of lipo-alkaloids, which accounted for about 1/3 of total lipo-alkaloids, while these fatty acid residues were less than 1/4 of total fatty acid residues. And, total of 37 fatty acids were determined by UHPCL-Q-TOF-MS, including 18 oxidized fatty acids firstly identified from A. carmichaelii. These fatty acids were observed as the side chains of lipo-alkaloids. In addition, although over 140 lipo-alkaloids were identified, six lipo-alkaloids, 8-O-linoleoyl-14-benzoylmesaconine (1), 8-O-linoleoyl-14-benzoylaconine (2), 8-O-palmitoyl-14-benzoylmesaconine (3), 8-O-oleoyl-14-benzoylmesaconine (4), 8-O-pal-benzoylaconine (5), and 8-O-ole-Benzoylaconine (6), were found to be the main components, which accounted for over 90% content of total lipo-alkaloids. Therefore, using these six components as standards, a UHPLC-Triple Quadrupole-MS (UHPLC-QQQ-MS) approach was established to investigate the influence of processing on the contents of lipo-alkaloids. Although it was commonly supposed that the contents of lipo-alkaloids increased after processing, our research showed that no significant change was observed before and after processing. Using the same methods, the lipo-alkaloids in the lateral roots of A. carmichaelii and the roots of A. kusnezoffii were determined and quantified. The contents of lipo-alkaloids in A. kusnezoffii were close to that of the parent roots of A. carmichaelii, while the lateral roots had less lipo-alkaloids than the parent roots. This work was supported by Macao Science and Technology Development Fund (086/2013/A3 and 003/2016/A1).

Keywords: Aconitum carmichaelii, fatty acids, GC-MS, LC-MS, lipo-alkaloids

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4389 Analysing a Practical Teamwork Assessment for Distance Education Students at an Australian University

Authors: Celeste Lawson

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Learning to embrace and value teamwork assessment at a university level is critical for students, as graduates enter a real-world working environment where teamwork is likely to occur virtually. Student disdain for teamwork exercises is an area often overlooked or disregarded by academics. This research explored the implementation of an online teamwork assessment approach at a regional Australian university with a significant cohort of Distance Education students. Students had disliked teamwork for three reasons: it was not relevant to their study, the grading was unfair amongst team members, and managing the task was challenging in a virtual environment. Teamwork assessment was modified so that the task was an authentic task that could occur in real-world practice; team selection was based on the task topic rather than randomly; grading was based on the individual’s contribution to the task, and students were provided virtual team management skills as part of a the assessment. In this way, management of the team became an output of the task itself. Data was gathered over three years from student satisfaction surveys, failure rates, attrition figures, and unsolicited student comments. In one unit where this approach was adopted (Advanced Public Relations), student satisfaction increased from 3.6 (out of 5) in 2012 to 4.6 in 2016, with positive comments made about the teamwork approach. The attrition rate for another unit (Public Relations and the Media) reduced from 20.7% in 2012 to 2.2% in 2015. In 2012, criticism of teamwork assessment made up 50% of negative student feedback in Public Relations and the Media. By 2015, following the successful implementation of the teamwork assessment approach, only 12.5% of negative comments on the student satisfaction survey were critical of teamwork, while 33% of positive comments related to a positive teamwork experience. In 2016, students explicitly nominated teamwork as the best part of this unit. The approach is transferable to other disciplines and was adopted by other academics within the institution with similar results.

Keywords: assessment, distance education, teamwork, virtual

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4388 Evaluation of Coagulation Efficiency of Protein Extracts from Lupinus Albus L., Moringa Stenopetala Cufod., Trigonella Foenum-Graecum L. And Vicia Faba L. For Water Purification

Authors: Neway Adele, Adey Feleke

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Access to clean drinking water is a basic human right. However, an estimated 1.2 billion people across the world consume unclean water daily. Interest has been growing in natural coagulants as the health and environmental concerns of conventional chemical coagulants are rising. Natural coagulants have the potential to serve as alternative water treatment agents. In this study, Lupinus albus, Moringa stenopetala, Trigonella foenum-graecum and Vicia faba protein extracts were evaluated as natural coagulants for water treatment. The protein extracts were purified from crude extracts using a protein purifier, and protein concentrations were determined by the spectrophotometric method. Small-volume coagulation efficiency tests were conducted on raw water taken from the Legedadi water treatment plant. These were done using a completely randomized design (CRD) experiment with settling times of 0 min (initial time), 90 min, 180 min and 270 min and protein extract doses of 5 mg/L, 10 mg/L, 15 mg/L and 20 mg/L. Raw water as negative control and polyelectrolyte as positive control were also included. The optical density (OD) values were measured for all the samples. At 270 min and 20 mg/L, the coagulation efficiency percentages for Lupinus albus, Moringa stenopetala, Trigonella foenum-graecum and Vicia faba protein extracts were 71%, 89%, 12% and 67% in the water sample collected in April 2019 respectively. Similarly, Lupinus albus, Moringa stenopetala and Vicia faba achieved 17%, 92% and 12% at 270 min settling times and 5 mg/L, 20 mg/L and 10 mg/L concentration in the water sample collected from August 2019, respectively. Negative control (raw water) and polyelectrolyte (positive control) were also 6 − 10% and 89 − 94% at 270 min settling time in April and August 2019, respectively. Among the four protein extracts, Moringa stenopetala showed the highest coagulation efficiency, similar to polyelectrolyte. This study concluded that Moringa stenopetala protein extract could be used as a natural coagulant for water purification in both sampling times.

Keywords: coagulation efficiency, extraction, natural coagulant, protein extract

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4387 Healthy, Breast Fed Bangladeshi Children Can Regulate Their Food Consumption in Each Meal and Feeding Duration When Offered with Varied Energy Density and Feeding Frequency of Complementary Foods

Authors: M. Munirul Islam, Makhduma Khatun M., Janet M. Peerson, Tahmeed Ahmed, M. Abid Hossain Mollah, Kathryn G. Dewey, Kenneth H. Brown

Abstract:

Information is required on the effects of dietary energy density (ED) and feeding frequency (FF) of complementary foods (CF) on food consumption during individual meals and time expended in child feeding. We evaluated the effects of varied ED and FF of CFs on food intake and time required for child feeding during individual meals. During 9 separate, randomly ordered dietary periods lasting 3-6 days each, we measured self-determined intakes of porridges by 18 healthy, breastfed children 8-11 mo old who were fed coded porridges with energy densities of 0.5, 1.0 or 1.5 kcal/g, during 3, 4, or 5 meals/d. CF intake was measured by weighing the feeding bowl before and after every meal. Children consumed greater amounts of CFs per meal when they received diets with lower ED (p = 0.044) and fewer meals per day (p < 0.001). Food intake was less during the first meal of the day than the other meals. Greater time was expended per meal when fewer meals were offered. Time expended per meal did not vary by ED, but the children ate the lower ED diets faster (p = 0.019). Food intake velocity was also greater when more meals were offered per day (p = 0.005). These results provide further evidence of young children’s ability to regulate their energy intakes, even during infancy; and they convey information on factors that affect the amount of time that caregivers must devote to child feeding.

Keywords: complementary foods, energy density, feeding frequency, young children

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4386 Follicular Thyroid Carcinoma in a Developing Country: A Retrospective Study of 10 Years

Authors: Abdul Aziz, Muhammad Qamar Masood, Saadia Sattar, Saira Fatima, Najmul Islam

Abstract:

Introduction: The most common endocrine tumor is thyroid cancer. Follicular Thyroid Carcinoma (FTC) accounts for 5%–10% of all thyroid cancers. Patients with FTC frequently present with more advanced stage diseases and a higher occurrence of distant metastases because of the propensity of vascular invasion. FTC is mainly treated with surgery, while radioactive iodine therapy is the main adjuvant therapy as per ATA guidelines. In many developing countries, surgical facilities and radioactive iodine are in short supply; therefore, understanding follicular thyroid cancer trends may help developing countries plan and use resources more effectively. Methodology: It was a retrospective observational study of FTC patients of age 18 years and above conducted at Aga Khan University Hospital, Karachi, from 1st January 2010 to 31st December 2019. Results: There were 404 patients with thyroid carcinoma, out of which forty (10.1%) were FTC. 50% of the patients were in the 41-60 years age group, and the female to male ratio was 1.5: 1. Twenty-four patients (60%) presented with complain of neck swelling followed by metastasis (20%) and compressive symptoms (20%). The most common site of metastasis was bone (87.5%), followed by lung (12.5%). The pre-operative thyroglobulin level was done in six out of eight metastatic patients (75%) in which it was elevated. This emphasizes the importance of checking thyroglobulin level in unusual presentation (bone pain, fractures) of a patient having neck swelling also to help in establishing the primary source of tumor. There was no complete documentation of ultrasound features of the thyroid gland in all the patients, which is an important investigation done in the initial evaluation of thyroid nodule. On FNAC, 50% (20 patients) had Bethesda category III-IV nodules, while 10% ( 4 patients ) had Bethesda category II. In sixteen patients, FNAC was not done as they presented with compressive symptoms or metastasis. Fifty percent had a total thyroidectomy and 50% had subtotal followed by completion thyroidectomy, plus ten patients had lymph node dissection, out of which seven had histopathological lymph node involvement. On histopathology, twenty-three patients (57.5%) had minimally invasive, while seventeen (42.5%) had widely invasive follicular thyroid carcinoma. The capsular invasion was present in thirty-three patients (82.5%); one patient had no capsular invasion, but there was a vascular invasion. Six patients' histopathology had no record of capsular invasion. In contrast, the lymphovascular invasion was present in twenty-six patients (65%). In this study, 65 % of the patients had clinical stage 1 disease, while 25% had stage 2 and 10% had clinical stage 4. Seventeen patients (42.5%) had received RAI 30-100 mCi, while ten patients (25%) received more than 100 mCi. Conclusion: FTC demographic and clinicopathological presentation are the same in Pakistan as compared to other countries. Surgery followed by RAI is the mainstay of treatment. Thus understanding the trend of FTC and proper planning and utilization of the resources will help the developing countries in effectively treating the FTC.

Keywords: thyroid carcinoma, follicular thyroid carcinoma, clinicopathological features, developing countries

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