Search results for: mean survival time
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 18498

Search results for: mean survival time

18258 Time-Interval between Rectal Cancer Surgery and Reintervention for Anastomotic Leakage and the Effects of a Defunctioning Stoma: A Dutch Population-Based Study

Authors: Anne-Loes K. Warps, Rob A. E. M. Tollenaar, Pieter J. Tanis, Jan Willem T. Dekker

Abstract:

Anastomotic leakage after colorectal cancer surgery remains a severe complication. Early diagnosis and treatment are essential to prevent further adverse outcomes. In the literature, it has been suggested that earlier reintervention is associated with better survival, but anastomotic leakage can occur with a highly variable time interval to index surgery. This study aims to evaluate the time-interval between rectal cancer resection with primary anastomosis creation and reoperation, in relation to short-term outcomes, stratified for the use of a defunctioning stoma. Methods: Data of all primary rectal cancer patients that underwent elective resection with primary anastomosis during 2013-2019 were extracted from the Dutch ColoRectal Audit. Analyses were stratified for defunctioning stoma. Anastomotic leakage was defined as a defect of the intestinal wall or abscess at the site of the colorectal anastomosis for which a reintervention was required within 30 days. Primary outcomes were new stoma construction, mortality, ICU admission, prolonged hospital stay and readmission. The association between time to reoperation and outcome was evaluated in three ways: Per 2 days, before versus on or after postoperative day 5 and during primary versus readmission. Results: In total 10,772 rectal cancer patients underwent resection with primary anastomosis. A defunctioning stoma was made in 46.6% of patients. These patients had a lower anastomotic leakage rate (8.2% vs. 11.6%, p < 0.001) and less often underwent a reoperation (45.3% vs. 88.7%, p < 0.001). Early reoperations (< 5 days) had the highest complication and mortality rate. Thereafter the distribution of adverse outcomes was more spread over the 30-day postoperative period for patients with a defunctioning stoma. Median time-interval from primary resection to reoperation for defunctioning stoma patients was 7 days (IQR 4-14) versus 5 days (IQR 3-13 days) for no-defunctioning stoma patients. The mortality rate after primary resection and reoperation were comparable (resp. for defunctioning vs. no-defunctioning stoma 1.0% vs. 0.7%, P=0.106 and 5.0% vs. 2.3%, P=0.107). Conclusion: This study demonstrated that early reinterventions after anastomotic leakage are associated with worse outcomes (i.e. mortality). Maybe the combination of a physiological dip in the cellular immune response and release of cytokines following surgery, as well as a release of endotoxins caused by the bacteremia originating from the leakage, leads to a more profound sepsis. Another explanation might be that early leaks are not contained to the pelvis, leading to a more profound sepsis requiring early reoperations. Leakage with or without defunctioning stoma resulted in a different type of reinterventions and time-interval between surgery and reoperation.

Keywords: rectal cancer surgery, defunctioning stoma, anastomotic leakage, time-interval to reoperation

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18257 Evaluation of Reliability Indices Using Monte Carlo Simulation Accounting Time to Switch

Authors: Sajjad Asefi, Hossein Afrakhte

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This paper presents the evaluation of reliability indices of an electrical distribution system using Monte Carlo simulation technique accounting Time To Switch (TTS) for each section. In this paper, the distribution system has been assumed by accounting random repair time omission. For simplicity, we have assumed the reliability analysis to be based on exponential law. Each segment has a specified rate of failure (λ) and repair time (r) which will give us the mean up time and mean down time of each section in distribution system. After calculating the modified mean up time (MUT) in years, mean down time (MDT) in hours and unavailability (U) in h/year, TTS have been added to the time which the system is not available, i.e. MDT. In this paper, we have assumed the TTS to be a random variable with Log-Normal distribution.

Keywords: distribution system, Monte Carlo simulation, reliability, repair time, time to switch (TTS)

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18256 Decreased Tricarboxylic Acid (TCA) Cycle Staphylococcus aureus Increases Survival to Innate Immunity

Authors: Trenten Theis, Trevor Daubert, Kennedy Kluthe, Austin Nuxoll

Abstract:

Staphylococcus aureus is a gram-positive bacterium responsible for an estimated 23,000 deaths in the United States and 25,000 deaths in the European Union annually. Recurring S. aureus bacteremia is associated with biofilm-mediated infections and can occur in 5 - 20% of cases, even with the use of antibiotics. Despite these infections being caused by drug-susceptible pathogens, they are surprisingly difficult to eradicate. One potential explanation for this is the presence of persister cells—a dormant type of cell that shows a high tolerance to antibiotic treatment. Recent studies have shown a connection between low intracellular ATP and persister cell formation. Specifically, this decrease in ATP, and therefore increase in persister cell formation, is due to an interrupted tricarboxylic acid (TCA) cycle. However, S. aureus persister cells’ role in pathogenesis remains unclear. Initial studies have shown that a fumC (TCA cycle gene) knockout survives challenge from aspects of the innate immune system better than wild-type S. aureus. Specifically, challenges from two antimicrobial peptides--LL-37 and hBD-3—show a log increase in survival of the fumC::N∑ strain compared to wild type S. aureus after 18 hours. Furthermore, preliminary studies show that the fumC knockout has a log more survival within a macrophage. These data lead us to hypothesize that the fumC knockout is better suited to other aspects of the innate immune system compared to wild-type S. aureus. To further investigate the mechanism for increased survival of fumC::N∑ within a macrophage, we tested bacterial growth in the presence of reactive oxygen species (ROS), reactive nitrogen species (RNS), and a low pH. Preliminary results suggest that the fumC knockout has increased growth compared to wild-type S. aureus in the presence of all three antimicrobial factors; however, no difference was observed in any single factor alone. To investigate survival within a host, a nine-day biofilm-associated catheter infection was performed on 6–8-week-old male and female C57Bl/6 mice. Although both sexes struggled to clear the infection, female mice were trending toward more frequently clearing the HG003 wild-type infection compared to the fumC::N∑ infection. One possible reason for the inability to reduce the bacterial burden is that biofilms are largely composed of persister cells. To test this hypothesis further, flow cytometry in conjunction with a persister cell marker was used to measure persister cells within a biofilm. Cap5A (a known persister cell marker) expression was found to be increased in a maturing biofilm, with the lowest levels of expression seen in immature biofilms and the highest expression exhibited by the 48-hour biofilm. Additionally, bacterial cells in a biofilm state closely resemble persister cells and exhibit reduced membrane potential compared to cells in planktonic culture, further suggesting biofilms are largely made up of persister cells. These data may provide an explanation as to why infections caused by antibiotic-susceptible strains remain difficult to treat.

Keywords: antibiotic tolerance, Staphylococcus aureus, host-pathogen interactions, microbial pathogenesis

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18255 Safety and Efficacy of Recombinant Clostridium botulinum Types B Vaccine Candidate

Authors: Mi-Hye Hwang, Young Min Son, Kichan Lee, Bang-Hun Hyun, Byeong Yeal Jung

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Botulism is a paralytic disease of human beings and animals caused by neurotoxin produced by Clostridium botulinum. The neurotoxins are genetically distinguished into 8 types, A to H. Ingestion of performed toxin, usually types B, C, and D, have been shown to produce diseases in most cases of cattle botulism. Vaccination is the best measure to prevent cattle botulism. However, the commercially available toxoid-based vaccines are difficult and hazardous to produce. We produced recombinant protein using gene of heavy chain domain of botulinum toxin B of which binds to cellular receptor of neuron cells and used as immunogen. In this study, we evaluated the safety and efficacy of botulism vaccine composed of recombinant types B. Safety test was done by National Regulation for Veterinary Biologicals. For efficacy test, female ICR mice (5 weeks old) were subcutaneously injected, intraperitoneally challenged, and examined the survival rates compared with vaccination and non-vaccination group. Mouse survival rate of recombinant types B vaccine was above 80%, while one of non-vaccination group was 0%. A vaccine composed of recombinant types B was safe and efficacious in mouse. Our results suggest that recombinant heavy chain receptor binding domain can be used as an effective vaccine candidate for type B botulism.

Keywords: botulism, livestock, vaccine, recombinant protein, toxin

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18254 The Impact of Tax Policies on Small Business Growth in Developing Countries: A Case Study of Montserrado Mount County, Republic of Liberia

Authors: Lemuel David

Abstract:

This study aims to investigate The Impact of Tax Policies on Small Business Growth in Developing Countries: A Case Study of Montserrado Mount County, Republic of Liberia. Businesses in Liberia are crucial for job creation and the economic empowerment of its citizens, especially in Grand Cape Mount County where they provide 95% of all jobs and support local capital formation. However, many businesses face challenges that lead to premature closure, including tax-related issues such as multiple taxations and high tax burdens. This research aims to examine the effects of various taxation on business survival in Grand Cape Mount County. The study employed a survey research design with a population of 50 and a sample size of 74. Data was collected using a self-administered questionnaire and analyzed quantitatively with simple percentages, and the research hypotheses were tested with ANOVA. The study findings revealed that multiple taxations hurts business survival, and the relationship between business size and its ability to pay taxes is significant. Therefore, the study recommends that the government of Liberia should create uniform tax policies that support business development in Grand Cape Mount County, and consider the size of businesses when formulating tax policies.

Keywords: multiple taxations, businesses, mortality, growth

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18253 Association of the Time in Targeted Blood Glucose Range of 3.9–10 Mmol/L with the Mortality of Critically Ill Patients with or without Diabetes

Authors: Guo Yu, Haoming Ma, Peiru Zhou

Abstract:

BACKGROUND: In addition to hyperglycemia, hypoglycemia, and glycemic variability, a decrease in the time in the targeted blood glucose range (TIR) may be associated with an increased risk of death for critically ill patients. However, the relationship between the TIR and mortality may be influenced by the presence of diabetes and glycemic variability. METHODS: A total of 998 diabetic and non-diabetic patients with severe diseases in the ICU were selected for this retrospective analysis. The TIR is defined as the percentage of time spent in the target blood glucose range of 3.9–10.0 mmol/L within 24 hours. The relationship between TIR and in-hospital in diabetic and non-diabetic patients was analyzed. The effect of glycemic variability was also analyzed. RESULTS: The binary logistic regression model showed that there was a significant association between the TIR as a continuous variable and the in-hospital death of severely ill non-diabetic patients (OR=0.991, P=0.015). As a classification variable, TIR≥70% was significantly associated with in-hospital death (OR=0.581, P=0.003). Specifically, TIR≥70% was a protective factor for the in-hospital death of severely ill non-diabetic patients. The TIR of severely ill diabetic patients was not significantly associated with in-hospital death; however, glycemic variability was significantly and independently associated with in-hospital death (OR=1.042, P=0.027). Binary logistic regression analysis of comprehensive indices showed that for non-diabetic patients, the C3 index (low TIR & high CV) was a risk factor for increased mortality (OR=1.642, P<0.001). In addition, for diabetic patients, the C3 index was an independent risk factor for death (OR=1.994, P=0.008), and the C4 index (low TIR & low CV) was independently associated with increased survival. CONCLUSIONS: The TIR of non-diabetic patients during ICU hospitalization was associated with in-hospital death even after adjusting for disease severity and glycemic variability. There was no significant association between the TIR and mortality of diabetic patients. However, for both diabetic and non-diabetic critically ill patients, the combined effect of high TIR and low CV was significantly associated with ICU mortality. Diabetic patients seem to have higher blood glucose fluctuations and can tolerate a large TIR range. Both diabetic and non-diabetic critically ill patients should maintain blood glucose levels within the target range to reduce mortality.

Keywords: severe disease, diabetes, blood glucose control, time in targeted blood glucose range, glycemic variability, mortality

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18252 Shiva's Dance: Crisis, Local Institutions, and Private Firms

Authors: João Pereira Dos Santos

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The uneven spatial distribution of start-ups and their respective survival may reflect comparative advantages resulting from the local institutional background. For the first time, we explore this idea using Data Envelopment Analysis (DEA) to assess relative efficiency of Portuguese municipalities in this specific context. We depart from the related literature where expenditure is perceived as a desirable input by choosing a measure of fiscal responsibility and infrastructural variables in the first stage. Comparing results for 2006 and 2010, we find that mean performance decreased substantially with 1) the effects of the Global Financial Crisis; 2) as municipal population increases and 3) as financial independence decreases. A second stage is then computed employing a double-bootstrap procedure to evaluate how the regional context outside the control of local authorities (e.g. demographic characteristics and political preferences) impacts on efficiency.

Keywords: entrepreneurship, political economy, public finance, accountability, crisis, efficiency, Portuguese municipalities

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18251 An Evaluation of Rational Approach to Management by Objectives in Construction Contracting Organisation

Authors: Zakir H. Shaik, Punam L. Vartak

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Management By Objectives (MBO) is a management technique in which objectives of an organisation are conveyed to the employees to establish the individual goals. These objectives and goals are then monitored and assessed jointly by management and the employee time to time. This tool can be used for planning, monitoring as well as for performance appraisal. The success of an organisation is largely dependent on its’s Vision. Thus, it is of paramount importance to achieve the realm of vision through a mission which is well crafted within the organisation to address the objectives. The success of the mission depends upon how realistic and action oriented philosophical approach, an organisation caters to; and how the individual goals are set to track and meet the objectives. Thus, focused and passionate efforts of the team, assigned for the mission, are an absolute obligation for achieving the vision of any organisation. Any construction site is generally a controlled disorder having huge investments, resources and logistics involved. The Construction progression is time-consuming with many isolated as well as interconnected activities. Traditional MBO approach can be unsuccessful if planning and control is non-realistic and inflexible. Moreover, the Construction Industry is far behind understanding these concepts. It is important to address the employee engagement in defining and creating awareness to achieve the targets. Besides, current economic environment and competitive world demands refined management tools to achieve profit, growth and survival of the business. Therefore, the necessity of rational MBO becomes vital part towards the success of an organisation. This paper details about the philosophical assumptions to develop the grounded theory in lieu of achieving objectives through RATIONAL MBO approach in Construction Contracting Organisations. The goals and objectives of the Construction Contracting Organisations can be achieved efficiently by adopting this RATIONAL MBO approach, as those are based on realistic, logical and balanced assumptions.

Keywords: growth, leadership, management by objectives, Management By Objectives (MBO), profit, rational

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18250 Temporal Axis in Japanese: The Paradox of a Metaphorical Orientation in Time

Authors: Tomoko Usui

Abstract:

In the field of linguistics, it has been said that concepts associated with space and motion systematically contribute structure to the temporal concept. This is the conceptual metaphor theory. conceptual metaphors typically employ a more abstract concept (time) as their target and a more concrete or physical concept as their source (space). This paper will examine two major temporal conceptual metaphors: Ego-centered Moving Time Metaphor and Time-RP Metaphor. Moving time generally receives a front-back orientation, however, Japanese shows a different orientation given to time. By means of Ego perspective, this paper will illustrate the paradox of a metaphorical orientation in time.

Keywords: Ego-centered Moving Time Metaphor, Japanese saki, temporal metaphors, Time RP Metaphor

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18249 Immunologically Non-Treated Vascular Xenografts in Long-Term Survival Animals

Authors: W. G. Kim, J. M. Chang, W. S. Kim

Abstract:

Immunologically non-treated and acellularized porcine xenografts were implanted as an arterial graft in goats and comparatively analyzed for the explanted grafts with gross observation, as well as light microscopy and immunohistochemistry, following the predetermined periods. For immunologically non-treated xenografts, bilateral porcine carotid arteries were harvested, and after short-term freezing at -70°C, were implanted into goats. The preparation of acellularized xenograft vessels has been performed with Nacl-SDS solution and stored at the freezer until use. The goats were randomly assigned for three periods of observation (3, 6, and 12 months after implantation), four animals were observed at each of these times. Periodic ultrasonographic examinations were performed during observation period. Following the predetermined periods, the explanted grafts were analyzed. Among 12 animals, one goat died prematurely, and a total of 22 grafts were evaluated. Gross observations revealed non-thrombotic patent smooth lumens. Microscopic examinations of the explanted grafts showed satisfactory cellular reconstruction up to the 12-month observation period. The proportions of CD3 positive T lymphocytes among inflammatory cells infiltrations were very low. In conclusion, these findings, as a whole, suggest that porcine vessel xenografts can be clinically acceptably implanted in the goats as a form of small-diameter vascular graft, regardless of the acellularized xenograft or immunologically non-treated xenograft.

Keywords: xenograft, arterial graft, long-term survival animals, immunology

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18248 Migration, Food Security, Rapid Urbanization and Population Rise in Nigeria: A Wake-Up Call to Policy-Makers

Authors: A. E. Obayelu, S. O. Olubiyo

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Food is different from other commodities because everybody needs food for survival. This has led to a shift in focus to food security in the global policy arena. However, there is paucity of studies on the interactions between food security, migration, urbanization and population rise. This paper therefore look at the linkages between migration and food security in the context of rapid urbanization and population rise of Nigeria. The study obtained data and information from both secondary sources and primary method through the voice of some selected Nigerians through telephone interview. The findings revealed that, the primary factor for the rapid urbanization in Nigeria is migration; most foods are still produced by peasant farmers who are scattered all over the rural areas and not multinational companies who produce on large scale. The country is still characterized with inadequate infrastructural facilities and services to cater for growing population. There are no protective policies enforced by the Nigeria government. In most cases, the migrants are left entirely on mercy of what they can find to due for survival. The most common coping mechanisms by migrants from rural to urban areas are changing food intake in terms of quantity, quality, diversity and frequency and prioritizing children. Policies that address urban food security need to consider the complex relationship between rapid population rise and migration and appropriate transformations that will be able to manage urbanization. With increasing rate of urbanization, the focus of food security should no longer be that of rural only

Keywords: agricultural commercialization, agricultural transformation, food security, urban, urbanization

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18247 Effect of Different Feed Composition on the Growth Performance in Early Weaned Piglets

Authors: Obuzor Eze Obuzor, Ekpoke Okurube Sliver

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The study was carried out at Debee farms at Ahoada West Local Government area, Rivers State, Nigeria. To evaluate the impact of two different cost-effective available feed composition on growth performance of weaned piglets. Thirty weaned uncontrolled cross bred (Large white x pietrain) piglets of average initial weight of 3.04 Kg weaned at 30days were assigned to three dietary treatments, comprising three replicates of 10 weaned piglets each, piglets were kept at 7 °C in different pens with dimensions of 4.50 × 4.50 m. The design of the experiment was completely randomized design, data from the study were subjected to one-way analysis of variance (ANOVA) and significant means were separated using Duncan's Multiple Range Test using Statistical Analysis System (SAS) software for windows (2 0 0 3), statistical significance was assessed at P < 0.05 (95% confidence interval) while survival rate was calculated using simple percentage. A standard diet was prepared to meet the nutrient requirements of weaned piglets at (20.8% crude protein). The three diets were fed to the animals in concrete feeding trough, control diet (C) had soybean meal while first treatment had spent grain (T1) and the second treatment had wheat offal (T2) respectively. The experiment was partitioned into four weeks periods (days 1-7, 8-14, 15-21 and 22-28). Feed and water were given unrestrictedly throughout the period of the experiment. The feed intake and weights of the pigs were recorded on weekly basis. Feed conversion ratio and daily weight gain were calculated and the study lasted for four weeks. There was no significant (P>0.05) effect of diet on survival rate, final body weight, average daily weight gain, daily feed intake and feed conversion ratio. The overall performance showed that treatment one (T1) had survival rate (93%), improved daily weight gain (36.21 g), average daily feed intake (120.14 g) and had the best feed conversion ratio (0.29) similar high mean value with the control while treatment two (T2) had lowest and negative response to all parameters. It could be concluded that feed formulated with spent grain is cheaper than control (soybean meal) and also improved the growth performance of weaned piglets.

Keywords: piglets, weaning, feed conversions ratio, daily weight gain

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18246 Evaluation of Radio Protective Potential of Indian Bamboo Leaves

Authors: Mansi Patel, Priti Mehta

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Background: Ionizing radiations have detrimental effects on humans, and the growing technological encroachment has increased human exposure to it enormously. So, the safety issues have emphasized researchers to develop radioprotector from natural resources having minimal toxicity. A substance having anti-inflammatory, antioxidant, and immunomodulatory activity can be a potential candidate for radioprotection. One such plant with immense potential i.e. Bamboo was selected for the present study. Purpose: The study aims to evaluate the potential of Indian bamboo leaves for protection against the clastogenic effect of gamma radiation. Methods: The protective effect of bamboo leaf extract against gamma radiation-induced genetic damage in human peripheral blood lymphocytes (HPBLs) was evaluated in vitro using Cytokinesis blocked micronuclei assay (CBMN). The blood samples were pretreated with varying concentration of extract 30 min before the radiation exposure (4Gy & 6Gy). The reduction in the frequency of micronuclei was observed for the irradiated and control groups. The effect of various concentration of bamboo leaf extract (400,600,800 mg/kg) on the development of radiation induced sickness and altered mortality in mice exposed to 8 Gy of whole-body gamma radiation was studied. The developed symptoms were clinically scored by multiple endpoints for 30 days. Results: Treatment of HPBLs with varying concentration of extract before exposure to a different dose of γ- radiation resulted in significant (P < 0.0001) decline of radiation induced micronuclei. It showed dose dependent and concentration driven activity. The maximum protection ~ 70% was achieved at nine µg/ml concentration. Extract treated whole body irradiated mice showed 50%, 83.3% and 100% survival for 400, 600, and 800mg/kg with 1.05, 0.43 and 0 clinical score respectively when compared to Irradiated mice having 6.03 clinical score and 0% survival. Conclusion: Our findings indicate bamboo leaf extract reduced the radiation induced cytogenetic damage. It has also increased the survival ratio and reduced the radiation induced sickness and mortality when exposed to a lethal dose of gamma radiation.

Keywords: bamboo leaf extract, Cytokinesis blocked micronuclei (CBMN) assay, ionizing radiation, radio protector

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18245 Maintenance of Non-Crop Plants Reduces Insect Pest Population in Tropical Chili Pepper Agroecosystems

Authors: Madelaine Venzon, Dany S. S. L. Amaral, André L. Perez, Natália S. Diaz, Juliana A. Martinez Chiguachi, Maira C. M. Fonseca, James D. Harwood, Angelo Pallini

Abstract:

Integrating strategies of sustainable crop production and promoting the provisioning of ecological services on farms and within rural landscapes is a challenge for today’s agriculture. Habitat management, through increasing vegetational diversity, enhances heterogeneity in agroecosystems and has the potential to improve the recruitment of natural enemies of pests, which promotes biological control services. In tropical agroecosystems, however, there is a paucity of information pertaining to the resources provided by associated plants and their interactions with natural enemies. The maintenance of non-crop plants integrated into and/or surrounding crop fields provides the farmer with a low-investment option to enhance biological control. We carried out field experiments in chili pepper agroecosystems with small stakeholders located in the Zona da Mata, State of Minas Gerais, Brazil, from 2011 to 2015 where we assessed: (a) whether non-crop plants within and around chili pepper fields affect the diversity and abundance of aphidophagous species; (b) whether there are direct interactions between non-crop plants and aphidophagous arthropods; and (c) the importance of non-crop plant resources for survival of Coccinellidae and Chrysopidae species. Aphidophagous arthropods were dominated by Coccinellidae, Neuroptera, Syrphidae, Anthocoridae and Araneae. These natural enemies were readily observed preying on aphids, feeding on flowers or extrafloral nectaries and using plant structures for oviposition and/or protection. Aphid populations were lower on chili pepper fields associated with non-crop plants that on chili pepper monocultures. Survival of larvae and adults of different species of Coccinellidae and Chrysopidae on non-crop resources varied according to the plant species. This research provides evidence that non-crop plants in chili pepper agroecosystems can affect aphid abundance and their natural enemy abundance and survival. It is also highlighting the need for further research to fully characterize the structure and function of plant resources in these and other tropical agroecosystems. Financial support: CNPq, FAPEMIG and CAPES (Brazil).

Keywords: Conservation biological control, aphididae, Coccinellidae, Chrysopidae, plant diversification

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18244 Effect of Renin Angiotensin Pathway Inhibition on the Efficacy of Anti-programmed Cell Death (PD-1/L-1) Inhibitors in Advanced Non-small Cell Lung Cancer Patients- Comparison of Single Hospital Retrospective Assessment to the Published Literature

Authors: Esther Friedlander, Philip Friedlander

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The use of immunotherapy that inhibits programmed death-1 (PD-1) or its ligand PD-L1 confers survival benefits in patients with non-small cell lung cancer (NSCLC). However, approximately 45% of patients experience primary treatment resistance, necessitating the development of strategies to improve efficacy. While the renin-angiotensin system (RAS) has systemic hemodynamic effects, tissue-specific regulation exists along with modulation of immune activity in part through regulation of myeloid cell activity, leading to the hypothesis that RAS inhibition may improve anti-PD-1/L-1 efficacy. A retrospective analysis was conducted that included 173 advanced solid tumor cancer patients treated at Valley Hospital, a community Hospital in New Jersey, USA, who were treated with a PD-1/L-1 inhibitor in a defined time period showing a statistically significant relationship between RAS pathway inhibition (RASi through concomitant treatment with an ACE inhibitor or angiotensin receptor blocker) and positive efficacy to the immunotherapy that was independent of age, gender and cancer type. Subset analysis revealed strong numerical benefit for efficacy in both patients with squamous and nonsquamous NSCLC as determined by documented clinician assessment of efficacy and by duration of therapy. A PUBMED literature search was now conducted to identify studies assessing the effect of RAS pathway inhibition on anti-PD-1/L1 efficacy in advanced solid tumor patients and compare these findings to those seen in the Valley Hospital retrospective study with a focus on NSCLC specifically. A total of 11 articles were identified assessing the effects of RAS pathway inhibition on the efficacy of checkpoint inhibitor immunotherapy in advanced cancer patients. Of the 11 studies, 10 assessed the effect on survival of RASi in the context of treatment with anti-PD-1/PD-L1, while one assessed the effect on CTLA-4 inhibition. Eight of the studies included patients with NSCLC, while the remaining 2 were specific to genitourinary malignancies. Of the 8 studies, two were specific to NSCLC patients, with the remaining 6 studies including a range of cancer types, of which NSCLC was one. Of these 6 studies, only 2 reported specific survival data for the NSCLC subpopulation. Patient characteristics, multivariate analysis data and efficacy data seen in the 2 NSLCLC specific studies and in the 2 basket studies, which provided data on the NSCLC subpopulation, were compared to that seen in the Valley Hospital retrospective study supporting a broader effect of RASi on anti-PD-1/L1 efficacy in advanced NSLCLC with the majority of studies showing statistically significant benefit or strong statistical trends but with one study demonstrating worsened outcomes. This comparison of studies extends published findings to the community hospital setting and supports prospective assessment through randomized clinical trials of efficacy in NSCLC patients with pharmacodynamic components to determine the effect on immune cell activity in tumors and on the composition of the tumor microenvironment.

Keywords: immunotherapy, cancer, angiotensin, efficacy, PD-1, lung cancer, NSCLC

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18243 Application of Change Detection Techniques in Monitoring Environmental Phenomena: A Review

Authors: T. Garba, Y. Y. Babanyara, T. O. Quddus, A. K. Mukatari

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Human activities make environmental parameters in order to keep on changing globally. While some changes are necessary and beneficial to flora and fauna, others have serious consequences threatening the survival of their natural habitat if these changes are not properly monitored and mitigated. In-situ assessments are characterized by many challenges due to the absence of time series data and sometimes areas to be observed or monitored are inaccessible. Satellites Remote Sensing provide us with the digital images of same geographic areas within a pre-defined interval. This makes it possible to monitor and detect changes of environmental phenomena. This paper, therefore, reviewed the commonly use changes detection techniques globally such as image differencing, image rationing, image regression, vegetation index difference, change vector analysis, principal components analysis, multidate classification, post-classification comparison, and visual interpretation. The paper concludes by suggesting the use of more than one technique.

Keywords: environmental phenomena, change detection, monitor, techniques

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18242 Controlling Images and Survival Strategies for Muslim Women in Pakistan

Authors: Ayesha Murtza

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Controlling images develop misinformed behaviors about impoverished Muslim Pakistani women that add to the oppression these Pakistani women endure their whole lives. Meanwhile, patriarchal and stereotypical societies provide an ideological justification for gender, class, and racial oppression, especially for women. Cojoining the concepts of controlling images by Patricia Hill Collins (1990) and binary thinking by Barbara Christian (1987), this paper discusses the ways in which various controlling images of urban and rural women are being presented in Pakistani dramas. These images reinforce an interlocking system of oppression for women in Pakistan. This paper further explores how these controlling images of intersecting components like class, gender, religion, ethnicity, physical appearance, color, and caste normalize hegemonic gendered oppression in society and how men have the same attitude towards women of their family whether they belong to the rural or urban class since they are the product of the same society. It further sheds light on how these matrixes of domination are an inevitable part of Pakistani women’s everyday lives and how these women reinforce survival strategies for coping with all these forms of oppression. By employing the feminist interactional framework, this paper elucidates the role of masculinity, femininity, feminist activism, and traditional knowledge against a monolithic image of Pakistani women. By highlighting these, this paper complicates the role of descriptive and visual images, religion, women’s rights, and the stereotypical role of women in Pakistani dramas.

Keywords: controlling images, oppression, women, Pakistan

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18241 Protein Stabilized Foam Structures as Protective Carrier Systems during Microwave Drying of Probiotics

Authors: Jannika Dombrowski, Sabine Ambros, Ulrich Kulozik

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Due to the increasing popularity of healthy products, probiotics are still of rising importance in food manufacturing. With the aim to amplify the field of probiotic application to non-chilled products, the cultures have to be preserved by drying. Microwave drying has proved to be a suitable technique to achieve relatively high survival rates, resulting from drying at gentle temperatures, among others. However, diffusion limitation due to compaction of cell suspension during drying can prolong drying times as well as deteriorate product properties (grindability, rehydration performance). Therefore, we aimed to embed probiotics in an aerated matrix of whey proteins (surfactants) and di-/polysaccharides (foam stabilization, probiotic protection) during drying. As a result of the manifold increased inner surface of the cell suspension, drying performance was enhanced significantly as compared to non-foamed suspensions. This work comprises investigations on suitable foam matrices, being stable under vacuum (variation of protein concentration, type and concentration of di-/polysaccharide) as well as development of an applicable microwave drying process in terms of microwave power, chamber pressure and maximum product temperatures. Performed analyses included foam characteristics (overrun, drainage, firmness, bubble sizes), and properties of the dried cultures (survival, activity). In addition, efficiency of the drying process was evaluated.

Keywords: foam structure, microwave drying, polysaccharides, probiotics

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18240 Suppression of Immunostimulatory Function of Dendritic Cells and Prolongation of Skin Allograft Survival by Dryocrassin

Authors: Hsin-Lien Lin, Ju-Hui Fu

Abstract:

Dendritic cells (DCs) are the major professional antigen-presenting cells for the development of optimal T-cell immunity. DCs can be used as pharmacological targets to screen novel biological modifiers for the treatment of harmful immune responses, such as transplantation rejection. Dryopteris crassirhizoma Nakai (Aspiadaceae) is used for traditional herbal medicine in the region of East Asia. The root of this fern plant has been listed for treating inflammatory diseases. Dryocrassin is the tetrameric phlorophenone component derived from Dryopteris. Here, we tested the immunomodulatory potential of dryocrassin on lipopolysaccharide (LPS)-stimulated activation of mouse bone marrow-derived DCs in vitro and in skin allograft transplantation in vivo. Results demonstrated that dryocrassin reduced the secretion of tumor necrosis factor-α, interleukin-6, and interleukin-12p70 by LPS-stimulated DCs. The expression of LPS-induced major histocompatibility complex class II, CD40, and CD86 on DCs was also blocked by dryocrassin. Moreover, LPS-stimulated DC-elicited allogeneic T-cell proliferation was lessened by dryocrassin. In addition, dryocrassin inhibited LPS-induced activation of IϰB kinase, JNK/p38 mitogen-activated protein kinase, as well as the translocation of NF-ϰB. Treatment with dryocrassin obviously diminished 2,4-dinitro-1-fluorobenzene- induced delayed-type hypersensitivity and prolonged skin allograft survival. Dryocrassin may be one of the potent immunosuppressive agents for transplant rejection through the destruction of DC maturation and function.

Keywords: dryocrassin, dendritic cells, immunosuppression, skin allograft

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18239 The Molecular Biology Behind the Spread of Breast Cancer Inflammatory Breast Cancer: Symptoms and Genetic Factors

Authors: Fakhrosadat Sajjadian

Abstract:

In the USA, about 5% of women diagnosed with breast cancer annually are affected by Inflammatory Breast Cancer (IBC), which is a highly aggressive type of Locally Advanced Breast Cancer (LABC). It is a type of LABC that is clinically and pathologically different, known for its rapid growth, invasiveness, and ability to promote the growth of blood vessels. Almost all women are found to have lymph nodes affected upon diagnosis, while around 36% show obvious distant metastases. Even with the latest improvements in multimodality therapies, the outlook for patients with IBC remains bleak, as the average disease-free survival time is less than 2.5 years. Recent research on the genetic factors responsible for the IBC phenotype has resulted in the discovery of genes that play a role in the advancement of this illness. The development of primary human cell lines and animal models has assisted in this research. These advancements offer new possibilities for future actions in identifying and treating IBC.

Keywords: breast cancer, inflammation, diagnosis, IBC, LABC

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18238 Effect of Falcaria vulgaris in Wound Healing and Immune Response of Common Carp (Cyprinus carpio)

Authors: N. Choobkar, M. Rezaeimanesh, A. M. Emami Rad, M. Ghaeni, H. Norouzi, S. Pahlavani, M. S. Tamasoki, E. Nezafatian

Abstract:

Antibiotics are used to increase the immune and wound healing in many animals . But due to the residual effects of a drug , researchers sought to replace them with natural materials such as Plant extracts. Falcaria vulgaris is the most attractive sources of the new drugs. Falcaria vulgaris (locally named Ghazzyaghi/Poghazeh) is a member of Umbelliferae family which grows near farmlands and is consumed as a vegetable in some regions of Iran. In the West of the country, in the wound healing and irregularities in the digestive system is also used. There were no scientific reports available in literature in support of the traditional claims of F. vulgaris in fish. The present study is therefore an attempt to assess the efficacy of this indigenous herb for its healing effect in common carp (Cyprinus carpio). Falcaria vulgaris at concentrations of 0, 2 and 10 % with Lophag foods used on wound healing of common carp and immune response, and weight grow and survival during periods of 21 days with feeding 2 times per day on the basis of body weight. The results showed that, compared with the control group, using of concentration 10 % F. vulgaris have significant effect on wound healing and stimulates the immune system by increasing white blood cells (WBC) and weight grow and survival of carp. The herb can used in wound healing, increased resistance to disease and weight grow in fish and the beneficial effects of this combination goes back to man.

Keywords: common carp, falcaria vulgaris, immune response, wound healing

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18237 The Design of a Phase I/II Trial of Neoadjuvant RT with Interdigitated Multiple Fractions of Lattice RT for Large High-grade Soft-Tissue Sarcoma

Authors: Georges F. Hatoum, Thomas H. Temple, Silvio Garcia, Xiaodong Wu

Abstract:

Soft Tissue Sarcomas (STS) represent a diverse group of malignancies with heterogeneous clinical and pathological features. The treatment of extremity STS aims to achieve optimal local tumor control, improved survival, and preservation of limb function. The National Comprehensive Cancer Network guidelines, based on the cumulated clinical data, recommend radiation therapy (RT) in conjunction with limb-sparing surgery for large, high-grade STS measuring greater than 5 cm in size. Such treatment strategy can offer a cure for patients. However, when recurrence occurs (in nearly half of patients), the prognosis is poor, with a median survival of 12 to 15 months and with only palliative treatment options available. The spatially-fractionated-radiotherapy (SFRT), with a long history of treating bulky tumors as a non-mainstream technique, has gained new attention in recent years due to its unconventional therapeutic effects, such as bystander/abscopal effects. Combining single fraction of GRID, the original form of SFRT, with conventional RT was shown to have marginally increased the rate of pathological necrosis, which has been recognized to have a positive correlation to overall survival. In an effort to consistently increase the pathological necrosis rate over 90%, multiple fractions of Lattice RT (LRT), a newer form of 3D SFRT, interdigitated with the standard RT as neoadjuvant therapy was conducted in a preliminary clinical setting. With favorable results of over 95% of necrosis rate in a small cohort of patients, a Phase I/II clinical study was proposed to exam the safety and feasibility of this new strategy. Herein the design of the clinical study is presented. In this single-arm, two-stage phase I/II clinical trial, the primary objectives are >80% of the patients achieving >90% tumor necrosis and to evaluation the toxicity; the secondary objectives are to evaluate the local control, disease free survival and overall survival (OS), as well as the correlation between clinical response and the relevant biomarkers. The study plans to accrue patients over a span of two years. All patient will be treated with the new neoadjuvant RT regimen, in which one of every five fractions of conventional RT is replaced by a LRT fraction with vertices receiving dose ≥10Gy while keeping the tumor periphery at or close to 2 Gy per fraction. Surgical removal of the tumor is planned to occur 6 to 8 weeks following the completion of radiation therapy. The study will employ a Pocock-style early stopping boundary to ensure patient safety. The patients will be followed and monitored for a period of five years. Despite much effort, the rarity of the disease has resulted in limited novel therapeutic breakthroughs. Although a higher rate of treatment-induced tumor necrosis has been associated with improved OS, with the current techniques, only 20% of patients with large, high-grade tumors achieve a tumor necrosis rate exceeding 50%. If this new neoadjuvant strategy is proven effective, an appreciable improvement in clinical outcome without added toxicity can be anticipated. Due to the rarity of the disease, it is hoped that such study could be orchestrated in a multi-institutional setting.

Keywords: lattice RT, necrosis, SFRT, soft tissue sarcoma

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18236 Impact of Some Experimental Procedures on Behavioral Patterns and Physiological Traits of Rats

Authors: Amira, A. Goma, U. E. Mahrous

Abstract:

Welfare may be considered to be a subjective experience; it has a biological function that is related to the fitness and survival of the animal accordingly, researches have suggested that welfare is compromised when the animal's evolutionary fitness is reduced. This study was carried out to explain the effect of some managerial stressors as handling and restraint on behavioral patterns and biochemical parameters of rats. A total of 24 (12 males and 12 females) Sprague-Dawley rats (12 months and 150-180g) were allotted into 3 groups, handled group (4 male and 4 female), restrained group (4 male and 4 female) and control group (4 males and 4 females). The obtained results revealed that time spent feeding, drinking frequency, movement and cage exploration increased significantly in handled rats than other groups, while lying time and licking increased significantly in restrained rats than handled and controls. Moreover, social behavior decreased in both stressed groups than control. Triglycerides were significantly increased in handled rats than other groups, while total lipid, total protein and globulin significantly increased in both treated groups than control. Corticosterone increased in restrained and handled rats than control ones. Moreover, there was an increment in packed cell volume significantly in restrained rats than others. These deducted that if we want to study the effect of stress on animal welfare it is necessary to study the effect of such stressors on animal’s behavior and physiological responses.

Keywords: handling, restraint, welfare, rat, behavior, physiology

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18235 Unification of Indonesia Time Zones Encourages People to Be on Time for Facing ASEAN Economic Community

Authors: Hasrullah Hasrullah

Abstract:

Since December 2015, the ASEAN Economic Community (AEC) is officially declared in the 27th Summit Conference of ASEAN and Indonesia is one of country are listed in the ASEAN members. Per January 1st, 2016 the ASEAN Economic Community (AEC) came into effect. However, its implementation in Indonesia is still weighing the pros and cons because Indonesia is considered too late to prepare for the ASEAN Economic Community (AEC). In other words, rubber time of Indonesian people has been occurring in the AEC. This paper reviews how Indonesia language influences people’s attitude to be rubber time culture and how time zones of Indonesia influence people’s attitude through media on television to be rubber time culture. The author addresses this research question empirically by collecting data from various sources of data those are relevant and compare among the unification of Indonesia time zones. The result demonstrates that unification of Indonesia time zones to be Standard Indonesia Time is a solution to encourage people to be ready on time for facing ASEAN Economic Community (AEC).

Keywords: unification time zones, Indonesia Language, Rubber Time, AEC

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18234 A Simple Fluid Dynamic Model for Slippery Pulse Pattern in Traditional Chinese Pulse Diagnosis

Authors: Yifang Gong

Abstract:

Pulse diagnosis is one of the most important diagnosis methods in traditional Chinese medicine. It is also the trickiest method to learn. It is known as that it can only to be sensed not explained. This becomes a serious threat to the survival of this diagnostic method. However, there are a large amount of experiences accumulated during the several thousand years of practice of Chinese doctors. A pulse pattern called 'Slippery pulse' is one of the indications of pregnancy. A simple fluid dynamic model is proposed to simulate the effects of the existence of a placenta. The placenta is modeled as an extra plenum in an extremely simplified fluid network model. It is found that because of the existence of the extra plenum, indeed the pulse pattern shows a secondary peak in one pulse period. As for the author’s knowledge, this work is the first time to show the link between Pulse diagnoses and basic physical principle. Key parameters which might affect the pattern are also investigated.

Keywords: Chinese medicine, flow network, pregnancy, pulse

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18233 A Cosmic Time Dilation Model for the Week of Creation

Authors: Kwok W. Cheung

Abstract:

A scientific interpretation of creation reconciling the beliefs of six literal days of creation and a 13.7-billion-year-old universe currently perceived by most modern cosmologists is proposed. We hypothesize that the reference timeframe of God’s creation is associated with some cosmic time different from the earth's time. We show that the scale factor of earth time to cosmic time can be determined by the solution of the Friedmann equations. Based on this scale factor and some basic assumptions, we derive a Cosmic Time Dilation model that harmonizes the literal meaning of creation days and scientific discoveries with remarkable accuracy.

Keywords: cosmological expansion, time dilation, creation, genesis, relativity, Big Bang, biblical hermeneutics

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18232 Oncogenic Functions of Long Non-Coding RNA XIST in Human Nasopharyngeal Carcinoma by Targeting MiR-34a-5p

Authors: Cheng-Cao Sun, Shu-Jun Li, De-Jia Li

Abstract:

Long non-coding RNA (lncRNA) X inactivate-specific transcript (XIST) has been verified as an oncogenic gene in several human malignant tumors, and its dysregulation was closed associated with tumor initiation, development and progression. Nevertheless, whether the aberrant expression of XIST in human nasopharyngeal carcinoma (NPC) is corrected with malignancy, metastasis or prognosis has not been elaborated. Here, we discovered that XIST was up-regulated in NPC tissues and higher expression of XIST contributed to a markedly poorer survival time. In addition, multivariate analysis demonstrated XIST was an independent risk factor for prognosis. XIST over-expression enhanced, while XIST silencing hampered the cell growth in NPC. Additionally, mechanistic analysis revealed that XIST up-regulated the expression of miR-34a-5p targeted gene E2F3 through acting as a competitive ‘sponge’ of miR-34a-5p. Taking all into account, we concluded that XIST functioned as an oncogene in NPC through up-regulating E2F3 in part through ‘spongeing’ miR-34a-5p.

Keywords: X inactivate-specific transcript; hsa-miRNA-34a-5p, miR-34a-5p; E2F3, nasopharyngeal carcinoma, tumorigenesis

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18231 Patient Outcomes Following Out-of-Hospital Cardiac Arrest

Authors: Scott Ashby, Emily Granger, Mark Connellan

Abstract:

Background: In-hospital management of Out-of-Hospital Cardiac Arrest (OHCA) is complex as the aetiologies are varied. Acute coronary angiography has been shown to improve outcomes for patients with coronary occlusion as the cause; however, these patients are difficult to identify. ECG results may help identify these patients, but the accuracy of this diagnostic test is under debate, and requires further investigation. Methods: Arrest and hospital management information was collated retrospectively for OHCA patients who presented to a single clinical site between 2009 and 2013. Angiography results were then collected and checked for significance with survival to discharge. The presence of a severe lesion (>70%) was then compared to categorised ECG findings, and the accuracy of the test was calculated. Results: 104 patients were included in this study, 44 survived to discharge, 52 died and 8 were transferred to other clinical sites. Angiography appears to significantly correlate with survival to discharge. ECG showed 54.8% sensitivity for detecting the presence of a severe lesion within the group that received angiography. A combined criterion including any ECG pathology showed 100% sensitivity and negative predictive value, however, a low specificity and positive predictive value. Conclusion: In the cohort investigated, ST elevation on ECG is not a sensitive enough screening test to be used to determine whether OHCA patients have coronary stenosis as the likely cause of their arrest, and more investigation into whether screening with a combined ECG criterion, or whether all patients should receive angiography routinely following OHCA is needed.

Keywords: out of hospital cardiac arrest, coronary angiography, resuscitation, emergency medicine

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18230 Preoperative 3D Planning and Reconstruction of Mandibular Defects for Patients with Oral Cavity Tumors

Authors: Janis Zarins, Kristaps Blums, Oskars Radzins, Renars Deksnis, Atis Svare, Santa Salaka

Abstract:

Wide tumor resection remains the first choice method for tumors of the oral cavity. Nevertheless, remained tissue defect impacts patients functional and aesthetical outcome, which could be improved using microvascular tissue transfers. Mandibular reconstruction is challenging due to the complexity of composite tissue defects and occlusal relationships for normal eating, chewing, and pain free jaw motions. Individual 3-D virtual planning would provide better symmetry and functional outcome. The main goal of preoperative planning is to develop a customized surgical approach with patient specific cutting guides of the mandible, osteotomy guides of the fibula, pre-bended osteosynthesis plates to perform more precise reconstruction, to decrease the surgery time and reach the best outcome. Our study is based on the analysis of 32 patients operated on between 2019 to 2021. All patients underwent mandible reconstruction with vascularized fibula flaps. Patients characteristics, surgery profile, survival, functional outcome, and quality of life was evaluated. Preoperative planning provided a significant decrease of surgery time and the best arrangement of bone closely similar as before the surgery. In cases of bone asymmetry, deformity and malposition, a new mandible was created using 3D planning to restore the appearance of lower jaw anatomy and functionality.

Keywords: mandibular, 3D planning, cutting guides, fibula flap, reconstruction

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18229 Time to Pancreatic Surgery after Preoperative Biliary Drainage in Periampullary Cancers: A Systematic Review and Meta‑Analysis

Authors: Maatouk Mohamed, Nouira Mariem, Hamdi Kbir Gh, Mahjoubi M. F., Ben Moussa M.

Abstract:

Background and aim: Preoperative biliary drainage (PBD) has been introduced to lower bilirubin levels and to control the negative effects of obstructive jaundice in patients with malignant obstructive jaundice undergoing pancreaticoduodenectomy (PD). The optimal time interval between PBD and PD is still not clear. Delaying surgery by 4 to 6 weeks is the commonly accepted practice. However, delayed PD has been shown to decrease the rate of resection and adversely affect the tumor grading and prognosis. Thus, the purpose of our systematic review and meta-analysis was to evaluate the optimal period for PBD prior to PD: short or prolonged in terms of postoperative morbidity and survival outcomes. Methods: Trials were searched in PubMed, Science Direct, Google Scholar, and Cochrane Library until November 2022. Studies using PBD in patients with malignant obstructive jaundice that compared short duration group (SDG) (surgery performed within 3-4 weeks) with prolonged duration group (PDG) (at least 3-4 weeks after PBD) were included in this study. The risk of bias was assessed using the Rob v2 and Robins-I tools. The priori protocol was published in PROSPERO (ID: CRD42022381405). Results: Seven studies comprising 1625 patients (SDG 870, PDG 882) were included. All studies were non-randomized, and only one was prospective. No significant differences were observed between the SDG and PDG in mortality (OR= 0.59; 95% CI [0.30, 1.17], p=0.13), major morbidity (Chi² = 30.28, p <0.00001; I² = 87%), pancreatic fistula (Chi² = 6.61, p = 0.25); I² = 24%), post pancreatectomy haemorrhage (OR= 1.16; 95% CI [0.67, 2.01], p=0.59), positive drainage culture (OR= 0.36; 95% CI [0.10, 1.32], p=0.12), septic complications (OR= 0.78; 95% CI [0.23, 2.72], p=0.70), wound infection (OR= 0.08, p=0.07), operative time (MD= 0.21; p=0.21). Conclusion: Early surgery within 3 or 4 weeks after biliary drainage is both safe and effective. Thus, it is reasonable to suggest early surgery following PBD for patients having resectable periampullary cancers.

Keywords: preoperative biliary drainage, pancreatic cancer, pancreatic surgery, complication

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