Search results for: breast conservation therapy

Authors: Reetika Sharma, Lalit Tejwani, Himanshu Shekhar, Arun Singhvi

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Purpose: Advanced Glaucoma with Failed trab is not an uncommon sight in glaucoma clinic, and such cases usually tend to present with high intraocular pressure (IOP) and advanced cupping, or even glaucomatous atrophy stage. Re-surgery is needed for such cases, and wound modulation poses a major challenge in these cases. We share our experience in this case series with the use of Ologen (collagen matrix implant) along with MMC 0.04% used in surgery. The purpose of the study was to evaluate the efficacy and outcome of collagen matrix implant in re-trabeculectomy in advanced glaucoma cases. Methodology: Eleven eyes of 11 patients (one eye of one patient) underwent re-trabeculectomy surgery with MMC and Ologen. Ologen implant was used in sub scleral and subconjunctival space, as a spacer and wound modulator. In five cases, triple modulation with implant soaked in anti-VEGF was used. Results: All patients had cupping more than 0.9, and one case was GOA. All cases were on maximal medication at presentation and majority were on systemic anti-glaucoma therapy also. Post-surgery, follow-up ranged from 13 – 34 months, and all cases had a follow longer than the gap between previous surgery (which was failed) and re-trab. One case needed AC reformation and one needling was done. Phaco was done at same sitting in four cases. All cases had their IOP lowered post surgery, and vision was maintained in all, however one case was considered as failed re-surgery case. Topical medication was needed in seven cases post-surgery also. Conclusion: Ologen as adjuvant should be considered in all re-trab cases and all high risk and advanced cases, and triple modulation can be next step in these cases. Aggressive IOP control and non- reluctance to continue topical medications post second surgery should be considered in such cases, to give them best possible vision.

Keywords: failed trabeculectomy, ologen, trabeculectomy, advanced glaucoma

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Authors: Nebiyou Masebo

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The severities of land degradation in southern Ethiopia has been increasing due to high population density, replacement of an age-old agroforestry (AF) based agricultural system with monocropping. The consequences of these activities combined with climate change have been impaired soil biota, soil organic carbon (SOC), soil glomalin, soil aggregation and aggregate stability. The AF systems could curb these problems due it is an ecologically and economically sustainable. This study was aimed to determine the effect of agroforestry practices (AFPs) on soil glomalin, soil aggregate stability (SAS), and aggregate association with SOC. Soil samples (from two depth level: 0-30 & 30-60 cm) and woody species were collected from homegarden based agroforestry practice (HAFP), cropland based agroforestry practice (ClAFP), woodlot based agroforestry practice (WlAFP) and trees on soil and water conservation based agroforestry practice (TSWAFP) using systematic sampling. In this study, both easily extractable glomalin related soil protein (EEGRSP) and total glomalin related soil protein (TGRSP) were significantly (p<0.05) higher in HAFP compared to others, with decreasing order HAFP>WlAFP>TSWAFP>ClAFP at upper surface but in subsurface in decreasing order: WlAFP>HAFP>TSWAFP>ClAFP. On the other hand, the macroaggregate fraction of AFPs ranged from 22.64-36.51% where the lowest was in ClAFP, while the highest was in HAFP, moreover, the order for subsurface was also the same but SAS decreased with the increasing of soil depths. The micro-aggregate fraction ranged from 15.9–24.56%, where the lowest was in HAFP, but the highest was in ClAFP. Besides, the association of OC with both macro-and micro-aggregates was greatest in HAFP and followed by WlAFP. The findings also showed that both glomalin and SAS were significantly high with woody species diversity and richness. Thus, AFP with good management practice can play role on maintenance of biodiversity, glomalin content and other soil quality parameters with future implications for a stable ecosystem.

Keywords: agroforestry, soil aggregate stability, glomalin, aggregate-associated carbon, HAFP, ClAFP, WlAFP, TSWAFP.

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Authors: Shagufta Tazin Shathy, Mohammad Imam Hasan Reza

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Fragmentation due to urbanization and agricultural expansion has become the main reason for destruction of forest area and loss of biodiversity particularly in the developing world. At present, the world is experiencing the largest wave of urban growth in human history, and it is estimated that this influx will be mainly taking place in developing world. Therefore, study on urban fragmentation is vital for a sustainable urban development. Landscape fragmentation is one of the most important conservation issues in the last few decades. Habitat fragmentation due to landscape alteration has caused habitat isolation, destruction in ecosystem pattern and processes. Thus, this research analyses the spatial and temporal extent of urban fragmentation using landscape indices in the Kuala Lumpur (KL) – the capital and most populous city in Malaysia. The objective of this study is to examine the urban fragmentation index in KL city. Fragmentation metrics used in the study are: a) Urban landscape ratio (the ratio of urban landscape area and build up area), b) Infill (development that occurred within urbanized open space), and c) Extension (development of exterior open space). After analyzing all three metrics, these are calculated for the combined urban fragmentation index (UFI). In this combined index, all three metrics are given an equal weight. Land cover/ land use maps of the year 1996 and 2005 have been developed from the Landsat TM 30 m resolution satellite image. The year 1996 is taken as a reference year to analyze the changes. The UFI calculated for the year of 1996 and2005 found that the KL city has undergone rapid landscape changes destructing forest ecosystem adversely. Increasing UFI for the year of 1996 compared to 2005 indicates that the developmental activities have been occupying open spaces and fragmenting natural lands and forest. This index can be implemented in other unplanned and rapidly urbanizing Asian cities for example Dhaka and Delhi to calculate the urban fragmentation rate. The findings from the study will help the stakeholders and urban planners for a sustainable urban management planning in this region.

Keywords: GIS, index, sustainable urban management, urbanization

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Authors: Ririn Marinasari, S. Pi

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Hampal (Hampala macrolepidota) is one of Citarum river indigenous fishes that still find in Jatiluhur dam. IUCN at 2013 said that hampal listed on redlist species category, this species was rare in Jatiluhur dam. This species more and more decreasing because change of habitats characteristic such as water quality and fishing effort. This study aims to determine and identify the influence of fishing effort and the quality of water on the productivity of fish resources hampal (Hampala macrolepidota) in Jatiluhur. The study was conducted from October to November 2013. Zones of research include lacustrine zone, transition and Riverin. Hampal fish productivity value computed by Hampal’s CPUE values. The results showed that fish MSY hampal obtained from surplus production model of Schaefer is equal to 0.2045 tons / quarterly. In the years 2011-2012 have occurred over fishing in 2013 while still under fishing. Total catches have exceeded the MSY during the year 2011 and the third quarterly of 2012 tons of fish that exceed 0.2045 hampal. The rate of utilization of fish resources hampal is equal to 80% of MSY or equal to the allowable catch (Total Allowable Catch) for fish in Jatiluhur hampal based Schaefer surplus production theory. Fishing effort, water quality parameters such as DO, turbidity and negatively correlated sulfide as H2S, while the temperature and pH positively correlated to productivity or unit catches fish hampal efforts in quarterly time series in the period 2011-2013. Shows that the higher fishing effort, DO, turbidity and sulfide in H2S and diminishing the temperature and pH of the productivity decreases. Variables that affect the productivity of fishing hampal only H2S only factor beta coefficient -0.834 which indicates a negative effect. It can be caused by H2S levels are toxic and have already exceeded the quality standard, while for other water quality parameters are still below the maximum standards allowed in the waters. Result of the study can be a reference of fishing regulation for hampal conservation in Jatiluhur dam.

Keywords: effort, hampal, productivity, water quality

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Authors: Christiena Van Der Bank, Marjone Van Der Bank, Ronelle Prinsloo

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The constitutional right to a healthy environment and the constitutional duty imposed on the state actively to protect the environment fulfill the specific duties to prevent pollution and ecological degradation and to promote conservation. The aim of this paper is to draw attention to the relationship between child rights and the environment. The focus is to analyse government’s responses as mandated with section 24 of the Bill of Rights for ensuring the right to a clean and healthy environment. The principle of sustainability of the environment encompasses the notion of equity and the harm to the environment affects the present as well as future generations. Section 24 obliges the state to ensure that the legacy of future generations is protected, an obligation that has been said to be part of the common law. The environment is an elusive and wide concept that can mean different things to different people depending on the context in which it is used for example clean drinking water or safe food. An extensive interpretation of the term environment would include almost everything that may positively or negatively influence the quality of human life. The analysis will include assessing policy measures, legislation, budgetary measures and other measures taken by the government in order to progressively meet its constitutional obligation. The opportunity of the child to grow up in a healthy and safe environment is extremely unjustly distributed. Without a realignment of political, legal and economic conditions this situation will not fundamentally change. South Africa as a developing country that needs to meet the demand of social transformation and economic growth whilst at the same time expediting its ability to compete in global markets, the country will inevitably embark on developmental programmes as a measure for sustainable development. The courts would have to inquire into the reasonableness of those measures. Environmental threats to children’s rights must be identified, taking into account children’s specific needs and vulnerabilities, their dependence and marginalisation. Obligations of states and violations of rights must be made more visible to the general public.

Keywords: environment, children rights, pollution, healthy, violation

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Authors: Priyanka Yadav, Rajkumar Ghosh, Alok Saini

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Human civilization cannot exist and thrive in the absence of adequate water. As a result, even in smart cities, water plays an important role in human existence. The key causes of this catastrophic water scarcity crisis are lifestyle changes, over-exploitation of groundwater, water over usage, rapid urbanization, and uncontrolled population growth. Furthermore, salty water seeps into deeper aquifers, causing land subsidence. The purpose of this study on artificial groundwater recharge is to address the water shortage in Gomti Nagar, Lucknow. Submersibles are the most common methods of collecting freshwater from groundwater in Gomti Nagar neighbourhood of Lucknow. Gomti Nagar area has a groundwater depletion rate of 1968 m3/day/km2 and is categorized as Zone-A (very high levels) based on the existing groundwater abstraction pattern - A to D. Harvesting rainwater using roof top rainwater harvesting systems (RTRWHs) is an effective method for reducing aquifer depletion in a sustainable water management system. Rainwater collecting using roof top rainwater harvesting systems (RTRWHs) is an effective method for reducing aquifer depletion in a sustainable water conservation system. Due to a water imbalance of 24519 ML/yr, the Gomti Nagar region is facing severe groundwater depletion. According to the Lucknow Development Authority (LDA), the impact of installed RTRWHs (plot area 300 sq. m.) is 0.04 percent of rainfall collected through RTRWHs in Gomti Nagar region of Lucknow. When RTRWHs are deployed in all buildings, their influence will be greater. Bye-laws in India have mandated the installation of RTRWHs on plots greater than 300 sq.m. A better India without any water problem is a pipe dream that may be realized by installing residential and commercial rooftop rainwater collecting systems in every structure. According to the current study, RTRWHs should be used as an alternate source of water to bridge the gap between groundwater recharge and extraction in smart city viz. Gomti Nagar, Lucknow, India.

Keywords: groundwater recharge, RTRWHs, harvested rainwater, rainfall, water extraction

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Authors: Soudeh Tabashi, Mohammadreza Moshari, Parisa Sezari

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Introduction: Postoperative analgesia in Orthotopic Liver Transplantation (OLT) surgery is challenging for anesthesiologists. Although OLT is one of the most extensive abdominal operations, it seems that patients don’t suffer from severe post operative pain. On the other hands drug metabolism is unpredictable due to unknown graft function. The aim of this study was to compare intraoperative infusion of remifentanil versus fentanyl in postoperative opioid demand in patients with OLT and evaluating the complications in two groups. Method: In this double-blind clinical trial 34 patients who had OLT were included. They divided randomly in two groups of Remifentanil (R) and Fentanyl (F). Patients in group R and F received infusion of Remifentanil 0.3-1 µg/Kg/min and Fentanyl 0.3-1 µg/Kg/min during maintenance of anesthesia. Post operative pain were measured in 6, 12, 18, 24 hours and second and third days after surgery with Numeric Rate Scale (NRS). Patients had received intravenous acetaminophen as rescue therapy with NRS of 3 or more. In addition to demographic information, post operative opioid consumption were recorded as the primary outcome. Intraoperative blood transfusion, intraoperative inotropic drugs consumption, weaning time and intensive care unit stay were also evaluated. Results: Total dose of acetaminophen consumption in first 3 days after surgery did not have significant difference between two groups (Pvalue=0.716). intraoperative inotrope consumption, blood transfusion and post operative weaning time and ICU stay were also similar in both groups. Conclusion: This study demonstrates that intraoperative infusion of remifentanil in OLT have the same effect on post operative pain management as fentanyl. Despite the complications of operation were not increased by remifentanil.

Keywords: liver transplantation, postoperative pain, remifentanil, fentanyl

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Authors: Yiqi Sun, Zhiyuan Zhang, Chenkun Ma

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Regeneration of outmoded urban forms and restorative environments are now recognized as major assets towards achieving sustainable development. Shanghai, like many Chinese cities, is now shifting from an agitated industrial past to more livable development schemes. Therefore, a sustainable approach to Shanghai development consists in turning industrial heritage into places with high potential for improving citizen’s daily life as regard to the three pillars of sustainability, namely: environment, economy, and society. As such, this study focuses on the Corniche in Xuhui West Bund district; a former industrial area converted into recreational public spaces in Xuhui West Bund. This area was the birthplace of the aviation industry of China, and many of the industrial features were preserved. Unused areas have been transformed into exhibition halls and green spaces, integrating some of the original industrial, architectural forms. Our case study investigates the effects of this approach associating urban regeneration with restorative design, as well as its impact on the surrounding neighborhood. Information extracted from visitors’ answers to a questionnaire survey; on-site systematic observation, counts, and measurements allowed us to assess the sustainability of this intervention in terms of accessibility, functionality, cultural and restorative qualities. In general, we found that cycling is not highly encouraged by the current design and level of connectivity, while visitors widely acknowledge the enhancement of cultural heritage resulting from the intervention. Moreover, recreational and restorative areas were found to have a very positive effect on local communities. Indeed, such an approach can provide valuable insights on how future interventions in Chinese major cities could take full advantage of existing assets in creating a more environmental, more livable, and culturally richer city.

Keywords: architectural heritage conservation, cultural urban identity, sustainability assessment, restorative environment, urban regeneration

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Authors: Basit Aftab, Zhichao Wang, Feng Zhongke

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Land Use and Land Cover Change (LULCC) is a critical environmental issue that has significant effects on biodiversity, ecosystem services, and climate change. This study examines the spatiotemporal dynamics of land use and land cover (LULC) across a three-decade period (1992–2022) in a district area. The goal is to support sustainable land management and urban planning by utilizing the combination of remote sensing, GIS data, and observations from Landsat satellites 5 and 8 to provide precise predictions of the trajectory of urban sprawl. In order to forecast the LULCC patterns, this study suggests a hybrid strategy that combines the Random Forest method with Multilayer Perceptron (MLP) and Markov Chain analysis. To predict the dynamics of LULC change for the year 2035, a hybrid technique based on multilayer Perceptron and Markov Chain Model Analysis (MLP-MCA) was employed. The area of developed land has increased significantly, while the amount of bare land, vegetation, and forest cover have all decreased. This is because the principal land types have changed due to population growth and economic expansion. The study also discovered that between 1998 and 2023, the built-up area increased by 468 km² as a result of the replacement of natural resources. It is estimated that 25.04% of the study area's urbanization will be increased by 2035. The performance of the model was confirmed with an overall accuracy of 90% and a kappa coefficient of around 0.89. It is important to use advanced predictive models to guide sustainable urban development strategies. It provides valuable insights for policymakers, land managers, and researchers to support sustainable land use planning, conservation efforts, and climate change mitigation strategies.

Keywords: land use land cover, Markov chain model, multi-layer perceptron, random forest, sustainable land, remote sensing.

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Authors: Emmanuel Benjamin, Matthias Blum

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Purpose – We address smallholder farmers’ restricted possibilities to adopt sustainable technologies which have direct and indirect benefits. Smallholders often face little asset endowment due to small farm size und insecure property rights, therefore experiencing constraints in adopting agricultural innovation. A program involving payments for ecosystem services (PES) benefits poor smallholder farmers in developing countries in many ways and has been suggested as a means of easing smallholder farmers’ financial constraints. PES may also provide additional mainstay which can eventually result in more favorable credit contract terms due to the availability of collateral substitute. Results of this study may help to understand the barriers, motives and incentives for smallholders’ participation in PES and help in designing a strategy to foster participation in beneficial programs. Design/methodology/approach – This paper uses a random utility model and a logistic regression approach to investigate factors that influence agroforestry adoption. We investigate non-monetary factors, such as information spillover, that influence the decision to adopt such conservation strategies. We collected original data from non-government-run agroforestry mitigation programs with PES that have been implemented in the Mount Kenya region. Preliminary Findings – We find that spread of information, existing networks and peer involvement in such programs drive participation. Conversely, participation by smallholders does not seem to be influenced by education, land or asset endowment. Contrary to some existing literature, we found weak evidence for a positive correlation between the adoption of agroforestry with PES and age of smallholder, e.g., one increases with the other, in the Mount Kenyan region. Research implications – Poverty alleviation policies for developing countries should target social capital to increase the adoption rate of modern technologies amongst smallholders.

Keywords: agriculture innovation, agroforestry adoption, smallholders, payment for ecosystem services, Sub-Saharan Africa

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Authors: Simon Shibru, Karen Vancampenhout, Jozef Deckers, Herwig Leirs

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We investigated the population size of the endemic and endangered Swayne’s Hartebeest (Alcelaphus buselaphus swaynei) in Nech Sar National Park from 2012 to 2014 and document the major threats why the species is on the verge of local extinction. The park was once known for its abundant density of Swayne’s Hartebeest. We used direct total count methods for a census. We administered semi-structured interviews and open-ended questionnaires with senior scouts who are the member of the local communities. Historical records were obtained to evaluate the population trends of the animals since 1974. The density of the animal decreased from 65 in 1974 to 1 individual per 100 km2 in 2014 with a decline of 98.5% in the past 40 years. The respondents agreed that the conservation status of the park was in its worst condition ever now with only 2 Swayne’s Hartebeest left, with a rapid decline from 4 individuals in 2012 and 12 individuals in 2009. Mainly hunting and habitat loss, but also the unsuitable season of reproduction and shortage of forage as minor factors were identified as threats for a local extinction of the Swayne’s Hartebeests. On the other hand, predation, fire, disease, and ticks were not considered a cause for the declining trend. Hunting happens mostly out of some kind of revenge since the local community thought that they were pushed out from the land because of the presence of Swayne's Hartebeest in the area. Respondents agreed that the revenge action of the local communities was in response to their unwillingness to be displaced from the park in 1982/3. This conflict situation is resulting from the exclusionary wildlife management policy of the country. We conclude that the human interventions in general and illegal hunting, in particular, pushed the Swayne’s Hartebeest to a point of local extinction. Therefore, we recommend inclusive wildlife management approach for continuing existence of the park together with its natural resources so that sustainable use of the resources is in place.

Keywords: hunting, habitat destruction, local extinction, Nech Sar National Park, Swayne’s Hartebeest

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Authors: Christolyn Raj, Lewis Levitz

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Introduction: Two cases of late presentation ( > five years ) of bilateral pseudophakic macula edema related to oral tyrosine kinase inhibitors are described. These cases are the first of their type in the published literature. A review of ocular inflammatory complications of tyrosine kinase inhibitors in the current literature is explored. Case Presentations(s): Case 1 is an 83-year-old female who has been stable on Ibrutinib (Imbruvica ®) for chronic lymphocytic leukemia (CLL). She presented with bilateral blurred vision from severe cystoid macula edema seven years following routine cataract surgery. She was treated with intravitreal steroids with complete resolution without relapse. Case 2 is a 76-year-old female who was on therapy for polycythemia vera with Ruxolitinib (Jakafi®). She presented with bilateral blurred vision from mild cystoid macula edema six years following routine cataract surgery. She responded well to topical steroids without relapse. In both cases, oral tyrosine kinase inhibitor agents were presumed to be the underlying cause and were ceased. Over the last five years, there have been increasing reports in the literature of the inflammatory effects of tyrosine kinase inhibitors on the retina, uvea and optic nerve. Conclusion: Late presentation of pseudophakic macula edema following routine cataract surgery is rare. Such presentations should prompt investigation of the chronic use of systemic medications, especially oral kinase inhibitors. Patients who must remain on these agents require ongoing ophthalmologic assessment in view of their long-term inflammatory side effects.

Keywords: macula edema, oral kinase inhibitors, retinal toxicity, pseudo-phakia

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Authors: Wanderson Goncalves e Goncalves, José Alberto Silva de Sá

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Human actions are a threat to the balance and conservation of the Amazon forest. Therefore the environmental monitoring services play an important role as the preservation and maintenance of this environment. This study classified forest types using data from a forest inventory provided by the 'Florestal e da Biodiversidade do Estado do Pará' (IDEFLOR-BIO), located between the municipalities of Santarém, Juruti and Aveiro, in the state of Pará, Brazil, covering an area approximately of 600,000 hectares, Bands 3, 4 and 5 of the TM-Landsat satellite image, and Self - Organizing Maps. The information from the satellite images was extracted using QGIS software 2.8.1 Wien and was used as a database for training the neural network. The midpoints of each sample of forest inventory have been linked to images. Later the Digital Numbers of the pixels have been extracted, composing the database that fed the training process and testing of the classifier. The neural network was trained to classify two forest types: Rain Forest of Lowland Emerging Canopy (Dbe) and Rain Forest of Lowland Emerging Canopy plus Open with palm trees (Dbe + Abp) in the Mamuru Arapiuns glebes of Pará State, and the number of examples in the training data set was 400, 200 examples for each class (Dbe and Dbe + Abp), and the size of the test data set was 100, with 50 examples for each class (Dbe and Dbe + Abp). Therefore, total mass of data consisted of 500 examples. The classifier was compiled in Orange Data Mining 2.7 Software and was evaluated in terms of the confusion matrix indicators. The results of the classifier were considered satisfactory, and being obtained values of the global accuracy equal to 89% and Kappa coefficient equal to 78% and F1 score equal to 0,88. It evaluated also the efficiency of the classifier by the ROC plot (receiver operating characteristics), obtaining results close to ideal ratings, showing it to be a very good classifier, and demonstrating the potential of this methodology to provide ecosystem services, particularly in anthropogenic areas in the Amazon.

Keywords: artificial neural network, computational intelligence, pattern recognition, unsupervised learning

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Authors: Adeaga Ibiyemi Iyabo, Adeaga Oyetunde Adeoye

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Interestingly, mechanical drying methods has played a major role in the commercialization of agricultural and agricultural allied sectors. In the overall, drying enhances the favorable storability and preservation of agricultural produce which in turn promotes its producibility, marketability, salability, and profitability. Recent researches have shown that solar drying is easier, affordable, controllable, and of course, cleaner and purer than other means of drying methods. It is, therefore, needful to persistently appraise solar dryers with a view to improving on the existing advantages. In this paper, mathematical equations were formulated for solar dryer using mass conservation law, material balance law and least cost savings method. Computer codes were written in Visual Basic.Net. The developed computer software, which considered Ibadan, a strategic south-western geographical location in Nigeria, was used to investigate the relationship between variable orientation angle of flat plate collector on solar energy trapped, derived monthly heat load, available energy supplied by solar and fraction supplied by solar energy when 50000 Kg/Month of produce was dried over a year. At variable collector tilt angle of 10°.13°,15°,18°, 20°, the derived monthly heat load, available energy supplied by solar were 1211224.63MJ, 102121.34MJ, 0.111; 3299274.63MJ, 10121.34MJ, 0.132; 5999364.706MJ, 171222.859MJ, 0.286; 4211224.63MJ, 132121.34MJ, 0.121; 2200224.63MJ, 112121.34MJ, 0.104, respectively .These results showed that if optimum collector angle is not reached, those factors needed for efficient and cost reduction drying will be difficult to attain. Therefore, this software has revealed that off - optimum collector angle in commercial solar drying does not worth it, hence the importance of the software in decision making as to the optimum collector angle of orientation.

Keywords: energy, ibadan, heat - load, visual-basic.net

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Authors: Ipsita Biswas, Arnab Sarkar, Ashikur Rahaman, Gopeswar Mukherjee, Subhrangsu Chatterjee, Shamee Bhattacharjee, Deba Prasad Mandal

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One of the major reasons for the high mortality rate of lung cancer is the substantial delays in disease detection at late metastatic stages. It is of utmost importance to understand the detailed molecular signaling and detect the molecular markers that can be used for the early diagnosis of cancer. Several studies explored the emerging roles of long noncoding RNAs (lncRNAs) in various cancers as well as lung cancer. A long non-coding RNA LINC00273 was recently discovered to promote cancer cell migration and invasion, and its positive correlation with the pathological stages of metastasis may prove it to be a potential target for inhibiting cancer cell metastasis. Comparing real-time expression of LINC00273 in various human clinical cancer tissue samples with normal tissue samples revealed significantly higher expression in cancer tissues. This long intergenic noncoding RNA was found to be highly expressed in human liver tumor-initiating cells, human gastric adenocarcinoma AGS cell line, as well as human non-small cell lung cancer A549 cell line. SiRNA and shRNA-induced knockdown of LINC00273 in both in vitro and in vivo nude mice significantly subsided AGS and A549 cancer cell migration and invasion. LINC00273 knockdown also reduced TGF-β induced SNAIL, SLUG, VIMENTIN, ZEB1 expression, and metastasis in A549 cells. Plenty of reports have suggested the role of microRNAs of the miR200 family in reversing epithelial to mesenchymal transition (EMT) by inhibiting ZEB transcription factors. In this study, hsa-miR-200a-3p was predicted via IntaRNA-Freiburg RNA tools to be a potential target of LINC00273 with a negative free binding energy of −8.793 kcal/mol, and this interaction was verified as a confirmed target of LINC00273 by RNA pulldown, real-time PCR and luciferase assay. Mechanistically, LINC00273 accelerated TGF-β induced EMT by sponging hsa-miR-200a-3p which in turn liberated ZEB1 and promoted prometastatic functions in A549 cells in vitro as verified by real-time PCR and western blotting. The similar expression patterns of these EMT regulatory pathway molecules, viz. LINC00273, hsa-miR-200a-3p, ZEB1 and TGF-β, were also detected in various clinical samples like breast cancer tissues, oral cancer tissues, lung cancer tissues, etc. Overall, this LINC00273 mediated EMT regulatory signaling can serve as a potential therapeutic target for the prevention of lung cancer metastasis.

Keywords: epithelial to mesenchymal transition, long noncoding RNA, microRNA, non-small-cell lung carcinoma

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Authors: Fan Wei, Tang Yipeng

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The outbreak of COVID-19 in early 2020 has been raging around the world, which has severely affected people's work and life. In today's post-pandemic era, although the pandemic has been effectively controlled, people still need to maintain social distancing at all times to prevent the further spread of the virus. Based on this, social distancing in the context of the pandemic has aroused widespread attention from scholars. At present, most studies exploring the influencing factors of social distancing are studying the negative impact of social distancing on the physical and mental state of special groups from the inter-individual level, and their more focus on the forced complete social distancing during the severe period of the pandemic. Few studies have focused on the impact of social distancing on working groups in the post-pandemic era from the within-individual level. In order to explore this problem, this paper constructs a cross-level moderating model based on resource conservation theory from the perspective of psychological resources. A total of 81 subjects were recruited to fill in the three-stage questionnaires each day for 10 working days, and 661valid questionnaires were finally obtained. Through the empirical tests, the following conclusions were finally obtained: (1) At the within-individual level, daily social distancing is positively correlated with the second day’s recovery, and the individual’s low sociability regulates the relationship between social distancing and recovery. The indirect effect of daily social distancing through recovery has positive relationship employees’ work engagement and work-goal progress only when the individual has low sociability. For individuals with high sociability, none of these paths are significant. (2) At the within-individual level, there is a significant relationship between individual's recovery and work engagement and work-goal progress, indicating that the recovery of resources can produce positive work outcomes. According to the results, this study believes that in the post-pandemic era, social distancing can not only effectively prevent and control the pandemic but also have positive impacts. Employees can use the time and energy originally saved for social activities through social distancing to invest in things that can provide resources and help them recover.

Keywords: social distancing, recovery, work engagement, work goal progress, sociability

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Authors: Gloria Pinilla, Jose Manuel Baena, Patricia Gálvez-Martín, Juan Antonio Marchad

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Cartilage is a dense connective tissue with limited self-repair properties. Currently, the therapeutic use of autologous or allogenic chondrocytes makes up an alternative therapy to the pharmacological treatment. The design of a bioprinted 3D cartilage with chondrocytes and biodegradable biomaterials offers a new therapeutic alternative able of bridging the limitations of current therapies in the field. We have developed an enhanced printing processes-Injection Volume Filling (IVF) to increase the viability and survival of the cells when working with high-temperature thermoplastics without the limitation of the scaffold geometry in contact with cells. We have demonstrated the viability of the printing process using chondrocytes for cartilage regeneration. This development will accelerate the clinical uptake of the technology and overcomes the current limitation when using thermoplastics as scaffolds. An alginate-based hydrogel combined with human chondrocytes (isolated from osteoarthritis patients) was formulated as bioink-A and the polylactic acid as bioink-B. The bioprinting process was carried out with the REGEMAT V1 bioprinter (Regemat 3D, Granada-Spain) through a IVF. The printing capacity of the bioprinting plus the viability and cell proliferation of bioprinted chondrociytes was evaluated after five weeks by confocal microscopy and Alamar Blue Assay (Biorad). Results showed that the IVF process does not decrease the cell viability of the chondrocytes during the printing process as the cells do not have contact with the thermoplastic at elevated temperatures. The viability and cellular proliferation of the bioprinted artificial 3D cartilage increased after 5 weeks. In conclusion, this study demonstrates the potential use of Regemat V1 for 3D bioprinting of cartilage and the viability of bioprinted chondrocytes in the scaffolds for application in regenerative medicine.

Keywords: cartilage regeneration, bioprinting, bioink, scaffold, chondrocyte

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Authors: Jaci Mastrandrea

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Background: The National Comprehensive Cancer Network (NCCN) recommends that healthcare institutions have established processes for integrating palliative care (PC) into cancer treatment and that all cancer patients be screened for PC needs upon initial diagnosis as well as throughout the entire continuum of care (National Comprehensive Cancer Network, 2021). Early PC screening is directly correlated with improved patient outcomes. The Sky Lakes Cancer Treatment Center (SLCTC) is an institution that has access to PC services yet does not have protocols in place for identifying patients with palliative needs or a standardized referral process. The aim of this quality improvement project is to improve early access to PC services by establishing a standardized screening and referral process for outpatient oncology patients. Method: The sample population included all adult patients with an oncology diagnosis who presented to the SLCTC for treatment during the project timeline from March 15th, 2022, to April 29th, 2022. The “Palliative and Supportive Needs Assessment'' (PSNA) screening tool was developed from validated and evidence-based PC referral criteria. The tool was initially implemented using paper forms and later was integrated into the Epic-Beacon EHR system. Patients were screened by registered nurses on the SLCTC treatment team. Nurses responsible for screening patients received an educational inservice prior to implementation. Patients with a PSNA score of three or higher were considered to be a positive screen. Scores of five or higher triggered a PC referral order in the patient’s EHR for the oncologist to review and approve. All patients with a positive screen received an educational handout on the topic of PC, and the EHR was flagged for follow-up. Results: Prior to implementation of the PSCNA screening tool, the SLCTC had zero referrals to PC in the past year, excluding referrals to hospice. Data was collected from the first 100 patient screenings completed within the eight-week data collection period. Seventy-three percent of patients met criteria for PC referral with a score greater than or equal to three. Of those patients who met referral criteria, 53.4% (39 patients) were referred for a palliative and supportive care consultation. Patients that were not referred to PC upon meeting the criteria were flagged in the EHR for re-screening within one to three months. Patients with lung cancer, chronic hematologic malignancies, breast cancer, and gastrointestinal malignancy most frequently met criteria for PC referral and scored highest overall on the scale of 0-12. Conclusion: The implementation of a standardized PC screening tool at the SLCTC significantly increased awareness of PC needs among cancer patients in the outpatient setting. Additionally, data derived from this quality improvement project supports the national recommendation for PC to be an integral component of cancer treatment across the entire continuum of care.

Keywords: oncology, palliative care, symptom management, symptom screening, ambulatory oncology, cancer, supportive care

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Authors: Harini Chakkera

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Background: Inpatient hyperglycemia is an established independent risk factor among several patient cohorts with hospital readmission. This has not been studied after kidney transplantation. Nearly one-third of patients who have undergone a kidney transplant reportedly experience 30-day readmission. Methods: Data on first-time solitary kidney transplantations were retrieved between September 2015 to December 2018. Information was linked to the electronic health record to determine a diagnosis of diabetes mellitus and extract glucometeric and insulin therapy data. Univariate logistic regression analysis and the XGBoost algorithm were used to predict 30-day readmission. We report the average performance of the models on the testing set on five bootstrapped partitions of the data to ensure statistical significance. Results: The cohort included 1036 patients who received kidney transplantation, and 224 (22%) experienced 30-day readmission. The machine learning algorithm was able to predict 30-day readmission with an average AUC of 77.3% (95% CI 75.30-79.3%). We observed statistically significant differences in the presence of pretransplant diabetes, inpatient-hyperglycemia, inpatient-hypoglycemia, and minimum and maximum glucose values among those with higher 30-day readmission rates. The XGBoost model identified the index admission length of stay, presence of hyper- and hypoglycemia and recipient and donor BMI values as the most predictive risk factors of 30-day readmission. Additionally, significant variations in the therapeutic management of blood glucose by providers were observed. Conclusions: Suboptimal glucose metrics during hospitalization after kidney transplantation is associated with an increased risk for 30-day hospital readmission. Optimizing the hospital blood glucose management, a modifiable factor, after kidney transplantation may reduce the risk of 30-day readmission.

Keywords: kidney, transplant, diabetes, insulin

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Authors: Pampita Chakraborty, Sukumar Mukherjee

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The study was done to determine the microbiological profile and changing pattern of the pathogens causing UTI in the ICU patients. All the patients admitted to the ICU with urinary catheter insertion for more than 48hours were included in the study. Urine samples were collected in a sterile container with aseptic precaution using disposable syringe and was processed as per standards. Antimicrobial susceptibility test was done by Disc Diffusion method as per CLSI guidelines. A total of 100 urine samples were collected from ICU patients, out of which 30% showed significant bacterial growth and 7% showed growth of candida spp. Prevalence of UTI was more in female (73%) than male (27.%). Gram-negative bacilli 26(86.67%) were more common in our study followed by gram-positive cocci 4(13.33%). The most common uropathogens isolated were Escherichia coli 14 (46.67%), followed by Klebsiella spp 7(23.33%), Staphylococcus aureus 4(13.33%), Acinetobacter spp 3(10%), Enterococcus faecalis 1(3.33%) and Pseudomonas aeruginosa 1(3.33%). Most of the Gram-negative bacilli were sensitive to amikacin (80%) and nitrofurantoin (80%), where as all gram-positive organisms were sensitive to Vancomycin. A large number ESBL producers were also observed in this study. The study finding showed that E.coli is the predominant pathogen and has increasing resistance pattern to the commonly used antibiotics. The study proposes that the adherence to antibiotic policy is the key ingredients for successful outcome in ICU patients and also emphasizes that repeated evaluation of microbial characteristics and continuous surveillance of resistant bacteria is required for selection of appropriate antibiotic therapy.

Keywords: antimicrobial sensitivity, intensive care unit, nosocomial infection, urinary tract infection

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Authors: Stephen Daniel Iduh, Evans Chidi Egwin, Oluwatosin Kudirat Shittu

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The process for the development of reliable and eco-friendly metallic Nanoparticles is an important step in the field of Nanotechnology for biomedical application. To achieve this, use of natural sources like biological systems becomes essential. In the present work, extracellular biosynthesis of gold Nanoparticles using aqueous leave and stembark extracts of K. senegalensis has been attempted. The gold Nanoparticles produced were characterized using High Resolution scanning electron microscopy, Ultra Violet–Visible spectroscopy, zeta-sizer Nano, Energy-Dispersive X-ray (EDAX) Spectroscopy and Fourier Transmission Infrared (FTIR) Spectroscopy. The cytotoxicity of the synthesized gold nanoparticles on MCF-7 cell line was evaluated using MTT assay. The result showed a rapid development of Nano size and shaped particles within 5 minutes of reaction with Surface Plasmon Resonance at 520 and 525nm respectively. An average particle size of 20-90nm was confirmed. The amount of the extracts determines the core size of the AuNPs. The core size of the AuNPs decreases as the amount of extract increases and it causes the shift of Surface Plasmon Resonance band. The FTIR confirms the presence of biomolecules serving as reducing and capping agents on the synthesised gold nanoparticles. The MTT assay shows a significant effect of gold nanoparticles which is concentration dependent. This environment-friendly method of biological gold Nanoparticle synthesis has the potential and can be directly applied in cancer therapy.

Keywords: biosynthesis, gold nanoparticles, characterization, calotropis procera, cytotoxicity

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Authors: Rakesh Mishra

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India’s Demography has always amazed the world because of its unprecedented outcomes in the presence of multifaceted socioeconomic and geographical characteristics. Being the first one to implement family panning in 1952, it occupies 2nd largest population of the world, with some of its state like Uttar Pradesh contributing 5th largest population to the world population surpassing Brazil. Being the one with higher in number it is more prone to the demographic disparity persisting into its territories brought upon by the inequalities in availability, accessibility and attainability of socioeconomic and various other resources. Fifth goal of Millennium Development Goal emphasis to improve maternal and child health across the world as Children’s development is very important for the overall development of society and the best way to develop national human resources is to take care of children. The target is to reduce the infant deaths by three quarters between 1990 and 2015. Child health status depends on the care and delivery by trained personnel, particularly through institutional facilities which is further associated with the status of the mother. However, delivery in institutional facilities and delivery by skilled personnel are rising slowly in India. The main objective of the present study is to measure the child health status on based on the educational and occupational background of the women in India. Study indicates that women education plays a very crucial role in deciding the health of the new born care and access to family planning, but the women autonomy indicates to have mixed results in different states of India. It is observed that rural women are 1.61 times more likely to exclusive breastfed their children compared to urban women. With respect to Hindu category, women belonging to other religious community were 21 percent less likely to exclusive breastfed their child. Taking scheduled caste as reference category, the odds of exclusive breastfeeding is found to be decreasing in comparison to other castes, and it is found to be significant among general category. Women of high education status have higher odds of using family planning methods in most of the southern states of India. By and large, girls and boys are about equally undernourished. Under nutrition is generally lower for first births than for subsequent births and consistently increases with increasing birth order for all measures of nutritional status. It is to be noted that at age 12-23 months, when many children are being weaned from breast milk, 30 percent of children are severely stunted and around 21 percent are severely underweight. So, this paper presents the evidence on the patterns of prevailing child health status in India and its states with reference to the mother socioeconomics and biological characteristics and examines trends in these, and discusses plausible explanations.

Keywords: immunization, exclusive breastfeeding, under five mortality, binary logistic regression, ordinal regression and life table

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Authors: R. N. Pateriya, T. K. Bhattacharya

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In India, rice-wheat cropping system occupies the major area and contributes about 40% of the country’s total food grain production. It is necessary that production of rice and wheat must keep pace with growing population. However, various factors such as degradation in natural resources, shift in cropping pattern, energy constraints etc. are causing reduction in the productivity of these crops. Seedbed for rice after wheat is difficult to prepare due to presence of straw and stubbles, and require excessive tillage operations to bring optimum tilth. In addition, delayed sowing and transplanting of rice is mainly due to poor crop residue management, multiplicity of tillage operations and non-availability of the power source. With increasing concern for fuel conservation and energy management, farmers might wish to estimate the best cultivation system for more productivity. The widest spread method of tilling land is ploughing with mould board plough. However, with the mould board plough upper layer of soil is neither always loosened at the desired extent nor proper mixing of different layers are achieved. Therefore, additional operations carried out to improve tilth. The farmers are becoming increasingly aware of the need for minimum tillage by minimizing the use of machines. Soil management can be achieved by using the combined active-passive tillage machines. A study was therefore, undertaken in wheat-harvested field to study the impact of conventional and modified tillage practices on paddy crop cultivation. Tillage treatments with tractor as a power source were selected during the experiment. The selected level of tillage treatments of tractor machinery management were (T1:- Direct Sowing of Rice), (T2:- 2 to 3 harrowing and no Puddling with manual transplanting), (T3:- 2 to 3 harrowing and Puddling with paddy harrow with manual transplanting), (T4:- 2 to 3 harrowing and Puddling with Rotavator with manual transplanting). The maximum output was obtained with treatment T1 (7.85 t/ha)) followed by T4 (6.4 t/ha), T3 (6.25 t/ha) and T2 (6.0 t/ha)) respectively.

Keywords: crop residues, cropping system, minimum tillage, yield

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Authors: Mumtaz Ali Baloch

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This article aims at to review the policies and gaps including the socioeconomic and institutional factors that affected the enrollment of disabled children and caused drop-outs. It provides insights to scrutinize the gaps in policies, socioeconomic, and institutional factors with the specific concern in enrollment and drop out of disabled children in Pakistan, and Balochistan in particular. The findings of this study revealed that the old-age centralized policies and a number of socio-economic and institutional factors seemed to have significantly affected the enrollment and quality education in the case of physically disabled children. There were only a few schools functional in entire Balochistan. For example, an entire province (Balochistan) there are only two schools for disabled children, established in Quetta city. In the other 31 districts, an estimated population of 300,000 people of each district there were no schools for the disabled children. The findings of this study revealed that there is a great distinction between the policy and practice in the case of physically disabled children in Quetta, Balochistan. Consequently, such children seemed to have been out of schools. Dropout after the class eighth grade is almost 100%, as there are no high schools available for physically/disabled children, in Balochistan. The concerned organizations and authorities need to develop and ratify specific policies, provide required) facilities to the schools including sufficient budget, streamline the academic planning, and an effective monitoring and evaluation system. Only awareness and motivation could not help in improving the enrollment rate and decreasing the dropout in the case of physically disabled children. There is an urgent need to provide the required facilities to the schools. Almost all students needed assistive equipment, effective physical therapy as well as regular medical facilities. Such measures can improve the enrolment and rehabilitation of children.

Keywords: education policy, practices, physically disabled children, challenges, Balochistan, Pakistan

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Authors: Aastha Chaudhry

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This continuous structuring of the ego through the developmental ages, starting with the body, has been understood through various perspectives from the object-relations world. Klein, Ogden, Winnicott to name a few, have been masters at helping mark a trajectory for the self to come to fruition. However, what constitutes those states, those relational structures, the dynamics of transference and the concept of inner objects has been more or less left unexplored in the psychoanalytic developmental theory. In this paper, through the help of a case study, Ogden’s ideas of an autistic contagious position and Kleinian theory of object relations is proposed to visualize a lens that helps to understand the relationship of the autistic self and body and allows us to take a look at object relations through countertransference. With the help of case vignettes, an understanding of experience is seen as dominated in the autistic contagious position with the help of defensive structuring that is not only self-fulfilling and sensorial oriented, but is also a pre symbolic mode of relating to the other. The aim of this clinical, experiential study is to better understand the self-body and the self-other relationships, or the absence thereof, in the autistic world and states. The goal of the study was to find such a relationship between play, body, structuring of experience and an autistic self in these individuals through that. Aim being that psychotherapy is brought to fore in the world of autism. The method was case study with one on one intervention, that was psychodynamically informed and play therapy based. Some of the findings after a year of work with these individuals were that: in the absence of a shared vocabulary, communication in two contrasting individuals happens primarily through the assistance of the body. Somatic countertransference, for instance, is how one can be with someone in a therapeutic relationship – and with autistic adolescents it is a further complicated relationship. With a mind somewhere in infanthood, and body experiencing adulthood, it becomes a challenge for the therapist to meet the client where they are. With pre-verbal states, play becomes such a potential space where two individuals could meet – a safe ground for forces to be contained. Play, then, becomes a mode of communication with such a population.

Keywords: autism, psychoanalytic, play, self

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Authors: Shervin Rashidinia, Sara Shahmoradi, Seyyed Shahin Eftekhari, Mohsen Talebizadeh, Mohammad Saleh Sadeghi

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Background: Beta-thalassemia Major (BTM) is a kind of hereditary hemolytic anemia which depended on regular monthly blood transfusion. However, iron deposition into the organs leads to multi-organ damage. The present study is the first study which aimed to evaluate the average of five-years serum ferritin level and compared by the prevalence of short stature and hypocalcemia. Materials/Methods: A cross-sectional retrospective study which a total of 140 patients with beta-thalassemia who were referred to Qom Thalassemia Clinic between February 2011 and July 2016 were enrolled to be reviewed. The exclusion criteria were consisting of incomplete medical records, diagnosis less than 2-years-ago and the blood transfusion less than every 4 weeks. The data including age, gender, weight, height, age of initial blood transfusion, age of initial chelation therapy, ferritin, and calcium were collected and analysis by SPSS version 24. Results: A total of 140 patients were enrolled. Of them, 75 (53.4%) were female. The mean age of the patients was 13.4±4.6 years.The mean age of initial diagnosis was 20.2±7.4 months. Hypocalcemia and short stature were occurred in 41 (29.3%) and 37 (26.4%) patients, respectively. The mean five-years serum ferritin level was significantly higher in the patients with short stature and hypocalcemia (P<0.0001). However, rise in serum ferritin level significantly increases the risk of short-stature and hypocalcemia (1.0004- and 1.0029 fold, respectively). Conclusion: We demonstrated that prevalence of short stature and hypocalcemia were significantly higher in the BTM.However, ferritin significantly increases the risk of short stature and hypocalcemia.

Keywords: beta-thalassemia, ferritin, growth retardation, hypocalcemia

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Authors: Azza H. El-Medany, Hanan H. Hagar, Omnia A. Nayel, Jamila H. El-Medany

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In search for drugs that can target cancer cell micro-environment in as much as being able to halt malignant cellular transformation, the natural dietary phytochemical curcumin was currently assessed in DMH-induced colorectal cancer rat model. The study enrolled 50 animals divided into a control group (n=10) and DMH-induced colorectal cancer control group (n=20) (20mg/kg-body weight for 28 weeks) versus curcumin-treated group (n=20) (160 mg/kg suspension daily oral for further 8 weeks). Treatment by curcumin succeeded to significantly decrease the percent of ACF and tended to normalize back the histological changes retrieved in adenomatous and stromal cells induced by DMH. The drug also significantly elevated GSH and significantly reduced most of the accompanying biochemical elevations (namely MDA, TNF-α, TGF-β and COX2) observed in colonic carcinomatous tissue, induced by DMH, thus succeeding to revert that of MDA, COX2 and TGF-β back to near normal as justified by being non-significantly altered as compared to normal controls. The only exception was PAF that was insignificantly altered by the drug. When taken together, it could be concluded that curcumin possess the potentiality to halt some of the orchestrated cross-talk between cancerous transformation and its micro-environmental niche that contributes to cancer initiation, progression and metastasis in this experimental cancer colon model. Envisioning these merits to a drug with already known safety preferentiality, awaits final results of current ongoing clinical trials, before curcumin can be added to the new therapeutic armamentarium of anticancer therapy.

Keywords: curcumin, dimethyl hydralazine, aberrant crypt foci, malondialdehyde, reduced glutathione, cyclooxygenase-2, tumour necrosis factor-alpha, transforming growth factor-beta, platelet activating factor

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Authors: Bharat Sapkota

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Nepal is the one of the victim country of climate change. Decreasing snow line, sometimes higher and sometime non-rain fall are common phenomena in hill area. Natural flood disaster and drought is also common every year in certain place of the country. So this paper analyze the effect of climate and natural water sources for sustainability of water sanitation and hygiene of Tanahun district. It is one of the Rural Water Supply and Sanitation Project Western Nepal Phase-II (RWSSP-WN Phase-II) project district out of 14 project districts of western and mid-western Nepal. RWSSP-WN II is a bilateral development cooperation of governments of Nepal and Finland. Big investment is still going on in water sanitation and hygiene sector but sustainability is still a challenge throughout the country. So RWSSP-WN has started the strengthen of the capacity of local Governments to deliver services in water supply, sanitation and hygiene and its sustainability through the implementation of cross cutting approach of climate change and disaster risk reduction. The study shows that the average yield in 685 natural point sources were around 0.045 l/s in 2014 but it was twice as high in 2004 i.e. 0.09 l/s. The maximum measured yield in 2014 was 1.87 l/s, whereas, the maximum yield was 3 l/s in 2004. Likewise, spring source mean and maximum yield measured in 2014 were 0.16 l/s and 3.33 l/s respectively, whereas, mean and maximum yields in 2004 were 0.204 l/s and 3 l/s respectively. Small streams average yield measured in 2014 was 0.32 l/s with the maximum of around 4.99 l/s. In 2004, mean and maximum yields of streams were 0.485 l/s and 5 l/s respectively. The overall climate between years 2002 to 2013 and measured yield data between 2004 and 2014 shows climate as one of the causes of water source decline. The temperature is rising with pace of 0.041°C per year and rainfall is decreased by 16.8 mm/year. The Khosla’s empirical formula shows decrease of 1.7 cm/year in runoff. At present sustainability of water, sanitation and hygiene is more challenge due to sources decreasing in the district. Sanitation and hygiene total behavior change and watershed conservation as well as design and implementation of recharge pound construction are the way forward of sustainability of water, sanitation and hygiene.

Keywords: water sanitation, hygiene, sustainability, climate change

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Authors: Martin Mensinger, Marjolaine Pfaffinger, Matthias Haslbeck

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The maintenance and expansion of the railway network represents a central task for transport planning in the future. In addition to the ultimate limit states, the aspects of resource conservation and sustainability are increasingly more necessary to include in the basic engineering. Therefore, as part of the AiF research project, ‘Integrated assessment of steel and composite railway bridges in accordance with sustainability criteria’, the entire lifecycle of engineering structures is involved in planning and evaluation, offering a way to optimize the design of steel bridges. In order to reduce the life cycle costs and increase the profitability of steel structures, it is particularly necessary to consider the demands on hanger connections resulting from fatigue. In order for accurate analysis, a number simulations were conducted as part of the research project on a finite element model of a reference bridge, which gives an indication of the internal forces of the individual structural components of a tied arch bridge, depending on the stress incurred by various types of trains. The calculations were carried out on a detailed FE-model, which allows an extraordinarily accurate modeling of the stiffness of all parts of the constructions as it is made up surface elements. The results point to a large impact of the formation of details on fatigue-related changes in stress, on the one hand, and on the other, they could depict construction-specific specifics over the course of adding stress. Comparative calculations with varied axle-stress distribution also provide information about the sensitivity of the results compared to the imposition of stress and axel distribution on the stress-resultant development. The calculated diagrams help to achieve an optimized hanger connection design through improved durability, which helps to reduce the maintenance costs of rail networks and to give practical application notes for the formation of details.

Keywords: fatigue, influence line, life cycle, tied arch bridge

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Authors: Santosh Kumar Yadav, Shobha Keswani, Nishat Quddus, Sohrab Ahmad Khan, Zuheb Ahmad Shiddiqui, Varsha Chorsiya

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Introduction: Early onset diabetes is more aggressive than the late onset diabetes. Diabetic individual has a greater spectrum of life period to suffer from its damage, complications, and long-term disability. This study aimed at assessing knee joint muscle performance under various durations of diabetes. Method and Materials: A total of 30 diabetic subjects (18 male and 12 females) without diabetic neuropathy were included for the study. They were divided into three groups with 5 years, 10 years and 15 years of duration of disease each. Muscle performance was evaluated through strength and flexibility. Peak torque for quadriceps muscle was measured using isokinetic dynamometer. Flexibility for quadriceps and hamstring muscles were measured through Ducan’s Elys test and 90/90 test. Results: The result showed significant difference in muscle strength (p<0.05), flexibility (p≤0.05) between groups. Discussion: Optimal muscle strength and flexibility are vital for musculoskeletal health and functional independence. Conclusion: The reduced muscle performance and functional impairment in nonneuropathic diabetic patients suggest that other mechanism besides neuropathy that contribute to altered biomechanics. These findings of this study project early management of these altered parameters through disease-specific physical therapy and assessment-based intervention. Clinical Relevance: Managing disability is more costly than managing disease. Prompt and timely identification and management strategy can dramatically reduce the cost of care for diabetic patients.

Keywords: muscle flexibility, muscle performance, muscle torque, type 2 diabetes

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