Search results for: cerebral hypoxia
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 275

Search results for: cerebral hypoxia

275 Thermoelectric Blanket for Aiding the Treatment of Cerebral Hypoxia and Other Related Conditions

Authors: Sarayu Vanga, Jorge Galeano-Cabral, Kaya Wei

Abstract:

Cerebral hypoxia refers to a condition in which there is a decrease in oxygen supply to the brain. Patients suffering from this condition experience a decrease in their body temperature. While there isn't any cure to treat cerebral hypoxia as of date, certain procedures are utilized to help aid in the treatment of the condition. Regulating the body temperature is an example of one of those procedures. Hypoxia is well known to reduce the body temperature of mammals, although the neural origins of this response remain uncertain. In order to speed recovery from this condition, it is necessary to maintain a stable body temperature. In this study, we present an approach to regulating body temperature for patients who suffer from cerebral hypoxia or other similar conditions. After a thorough literature study, we propose the use of thermoelectric blankets, which are temperature-controlled thermal blankets based on thermoelectric devices. These blankets are capable of heating up and cooling down the patient to stabilize body temperature. This feature is possible through the reversible effect that thermoelectric devices offer while behaving as a thermal sensor, and it is an effective way to stabilize temperature. Thermoelectricity is the direct conversion of thermal to electrical energy and vice versa. This effect is now known as the Seebeck effect, and it is characterized by the Seebeck coefficient. In such a configuration, the device has cooling and heating sides with temperatures that can be interchanged by simply switching the direction of the current input in the system. This design integrates various aspects, including a humidifier, ventilation machine, IV-administered medication, air conditioning, circulation device, and a body temperature regulation system. The proposed design includes thermocouples that will trigger the blanket to increase or decrease a set temperature through a medical temperature sensor. Additionally, the proposed design allows an efficient way to control fluctuations in body temperature while being cost-friendly, with an expected cost of 150 dollars. We are currently working on developing a prototype of the design to collect thermal and electrical data under different conditions and also intend to perform an optimization analysis to improve the design even further. While this proposal was developed for treating cerebral hypoxia, it can also aid in the treatment of other related conditions, as fluctuations in body temperature appear to be a common symptom that patients have for many illnesses.

Keywords: body temperature regulation, cerebral hypoxia, thermoelectric, blanket design

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274 Effects of Hypoxic Duration at Different Growth Stages on Yield Potential of Waxy Corn (Zea mays L.)

Authors: S. Boonlertnirun, R. Suvannasara, K. Boonlertnirun

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Hypoxia has negative effects on growth and crop yield, its severity is so varied depending on crop growth stages, duration of hypoxia and crop species. The objective was to evaluate the sensitive growth stage and the duration of hypoxia negatively affecting growth and yield of waxy corn. Pot experiment was conducted using a split plot in randomized complete block with 3 growth stages: V3 (3-4 true leaves), V7 (7-8 true leaves), and R1 (silking stage), and three hypoxic durations: 6, 9, and 12 days, in an open–ended outdoor greenhouse during January to March 2013. The results revealed that different growth stages had significantly (p < 0.5) different responses to hypoxia, seeing that the sensitive growth stage affecting plant height, yield and yield components was mostly detected in V7 growth stage whereas leaf greenness and days to silking were sensitive to hypoxia at R1 growth stage. Different hypoxic durations significantly affected the yield and yield components, hypoxic duration of twelve days showed the most negative effect greater than the others. In this present study, it can be concluded that waxy corn plants were waterlogged at V7 growth stage for twelve days had the most negative effect on yield and yield components.

Keywords: hypoxia duration, waxy corn, growth stage, Zea mays L.

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273 Prevalence of Cerebral Microbleeds in Apparently Healthy, Elderly Population: A Meta-Analysis

Authors: Vidishaa Jali, Amit Sinha, Kameshwar Prasad

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Background and Objective: Cerebral microbleeds are frequently found in healthy elderly individuals. We performed a meta- analysis to determine the prevalence of cerebral microbleeds in apparently healthy, elderly population and to determine the effect of age, smoking and hypertension on the occurrence of cerebral microbleeds. Methods: Relevant literature was searched using electronic databases such as MEDLINE, EMBASE, PubMed, Cochrane database, Google scholar to identify studies on the prevalence of cerebral microbleeds in general elderly population till March 2016. STATA version 13 software was used for analysis. Fixed effect model was used if heterogeneity was less than 50%. Otherwise, random effect model was used. Meta- regression analysis was performed to check any effect of important variables such as age, smoking, hypertension. Selection Criteria: We included cross-sectional studies performed in apparently healthy elderly population, who had age more than 50 years. Results: The pooled proportion of cerebral microbleeds in healthy population is 12% (95% CI, 0.11 to 0.13). No significant effect of age was found on the prevalence of cerebral microbleeds (p= 0.99). A linear relationship between increase in hypertension and the prevalence of cerebral microbleeds was found, however, this linear relationship was not statistically significant (p=0.16). Similarly, A linear relationship between increase in smoking and the prevalence of cerebral microbleeds was found, however, this linear relationship was also not statistically significant (p=0.21). Conclusion: Presence of cerebral microbleeds is evident in apparently healthy, elderly population, in more than 10% of individuals.

Keywords: apparently healthy, elderly, prevalence, cerebral microbleeds

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272 In Vitro Effect of Cobalt(II) Chloride (CoCl₂)-Induced Hypoxia on Cytokine Production by Human Breast Cancer Cells

Authors: Radoslav Stojchevski, Leonid Poretsky, Dimiter Avtanski

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Proinflammatory cytokines play an important role in cancer initiation and progression by mediating the intracellular communication between the cancer cells and tumor microenvironment. Increased tumor growth causing reduced oxygen concentration and oxygen pressure commonly result in hypoxia. Mechanistically, hypoxia is characterized by stabilization and nuclear translocation of hypoxia-inducible factor 1 alpha (HIF-1α) followed by propagation of molecular pathway cascade involving multiple downstream targets. Cobalt(II) chloride (CoCl₂) is commonly used to mimic hypoxia in experimental conditions since it directly induces the expression of HIF-1α. The aim of the present study was to investigate the in vitro effects and the molecular mechanisms by which hypoxia regulates the cytokine secretory profile of breast cancer cells. As a model for this study, we used several breast cancer cell lines bearing various molecular characteristics and metastatic potential (MDA-MB-231 (clauding low, ER-/PR-/HER²⁻), MCF-7 (luminal A, ER⁺/PR⁺/HER²⁻), and BT-474 (liminal B, ER⁺/PR⁺/HER²⁺)). We demonstrated that breast cancer cells secrete numerous cytokines and cytokine ligands, including interleukins, chemokines, and growth factors. Treatment with CoCl₂significantly modulated the breast cancer cells' cytokine expression in a concentration- and time-dependent manner. These effects were mediated via activation of several signaling pathways (JNK/SAPK1, NF-κB, STAT5A/B, and Erk/MAPK1/2). Taken together, the present data define some of the molecular mechanisms by which hypoxia affects the breast cancer cells' cytokine secretory profile, thus contributing to the development of novel therapies for metastatic breast cancer.

Keywords: breast cancer, cytokines, cobalt(II) chloride (CoCl₂), hypoxia

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271 The Effect of Post Spinal Hypotension on Cerebral Oxygenation Using Near-Infrared Spectroscopy and Neonatal Outcomes in Full Term Parturient Undergoing Lower Segment Caesarean Section: A Prospective Observational Study

Authors: Shailendra Kumar, Lokesh Kashyap, Puneet Khanna, Nishant Patel, Rakesh Kumar, Arshad Ayub, Kelika Prakash, Yudhyavir Singh, Krithikabrindha V.

Abstract:

Introduction: Spinal anesthesia is considered a standard anesthesia technique for caesarean delivery. The incidence of spinal hypotension during caesarean delivery is 70 -80%. Spinal hypotension may cause cerebral hypoperfusion in the mother, but physiologically cerebral autoregulatory mechanisms accordingly prevent cerebral hypoxia. Cerebral blood flow remains constant in the 50-150 mmHg of Cerebral Perfusion Pressure (CPP) range. Near-infrared spectroscopy (NIRS) is a non-invasive technology that is used to detect Cerebral Desaturation Events (CDEs) immediately compared to other conventional intraoperative monitoring techniques. Objective: The primary aim of the study is to correlate the change in cerebral oxygen saturation using NIRS with respect to a fall in mean blood pressure after spinal anaesthesia and to find out the effects of spinal hypotension on neonatal APGAR score, neonatal acid-base variations, and presence of Postoperative Delirium (POD). Methodology: NIRS sensors were attached to the forehead of all the patients, and their baseline readings of cerebral oxygenation on the right and left frontal regions and mean blood pressure were noted. Subarachnoid block was given with hyperbaric 0.5% bupivacaine plus fentanyl, the dose being determined by the individual anaesthesiologist. Co-loading of IV crystalloid solutions was given to the patient. Blood pressure reading and cerebral saturation were recorded every 1 minute till 30min. Hypotension was a fall in MAP less than 20% of the baseline values. Patients going for hypotension were treated with an IV Bolus of phenylephrine/ephedrine. Umbilical cord blood samples were taken for blood gas analysis, and neonatal APGAR was noted by a neonatologist. Study design: A prospective observational study conducted in a population of Thirty ASA 2 and 3 parturients scheduled for lower segment caesarean section (LSCS). Results: Mean fall in regional cerebral saturation is 28.48 ± 14.7% with respect to the mean fall in blood pressure 38.92 ± 8.44 mm Hg. The correlation coefficient between fall in saturation and fall in mean blood pressure is 0.057, and p-value {0.7} after subarachnoid block. A fall in regional cerebral saturation occurred 2±1 min before a fall in mean blood pressure. Twenty-nine out of thirty patients required vasopressors during hypotension. The first dose of vasopressor requirement is needed at 6.02±2 min after the block. The mean APGAR score was 7.86 and 9.74 at 1 and 5 min of birth, respectively, and the mean umbilical arterial pH of 7.3±0.1. According to DRS-98 (Delirium Rating Scale), the mean delirium rating score on postoperative day 1 and day 2 were 0.1 and 0.7, respectively. Discussion: There was a fall in regional cerebral oxygen saturation, which started before with respect to a significant fall in mean blood pressure readings but was statistically not significant. Maximal fall in blood pressure requiring vasopressors occurs within 10 min of SAB. Neonatal APGAR scores and acid-base variations were in the normal range with maternal hypotension, and there was no incidence of postoperative delirium in patients with post-spinal hypotension.

Keywords: cerebral oxygenation, LSCS, NIRS, spinal hypotension

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270 Cerebral Toxoplasmosis: A Histopathological Diagnosis

Authors: Prateek Rastogi, Jenash Acharya

Abstract:

Histopathology examination has been a boon to forensic experts all around the world since its implication in autopsy cases. Whenever a case of sudden death is encountered, forensic experts clandestinely focus on cardiovascular, respiratory, gastrointestinal or cranio-cerebral causes. After ruling out poisoning or trauma, they are left with the only option available, histopathology examination. Besides preserving thoracic and abdominal organs, brain tissues are very less frequently subjected for the analysis. Based on provisional diagnosis documented on hospital treatment record files, one hemisphere of grossly unremarkable cerebrum was confirmatively diagnosed by histopathology examination to be a case of cerebral toxoplasmosis.

Keywords: cerebral toxoplasmosis, sudden death, health information, histopathology

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269 Anesthetic Considerations for Carotid Endarterectomy: Prospective Study Based on Clinical Trials

Authors: Ahmed Yousef A. Al Sultan

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Introduction: The aim of this review is based on clinical research that studies the changes in middle cerebral artery velocity using Transcranial Doppler (TCD) and cerebral oxygen saturation using cerebral oximetry in patients undergoing carotid endarterectomy (CEA) surgery under local anesthesia (LA). Patients with or without neurological symptoms during the surgery are taking a role in this study using triplet method of cerebral oximetry, transcranial doppler and awake test in detecting any cerebral ischemic symptoms. Methods: about one hundred patients took part during their CEA surgeries under local anesthesia, using triple assessment mentioned method, Patients requiring general anesthesia be excluded from analysis. All data were recorded at eight surgery stages separately to serve this study. Results: In total regional cerebral oxygen saturation (rSO2), middle cerebral artery (MCA) velocity, and pulsatility index were significantly decreased during carotid artery clamping step in CEA procedures on the targeted carotid side. With most observed changes in MCA velocity during the study. Discussion: Cerebral oxygen saturation and middle cerebral artery velocity were significantly decreased during clamping step of the procedures on the targeted side. The team with neurological symptoms during the procedures showed higher changes of rSO2 and MCA velocity than the team without neurological symptoms. Cerebral rSO2 and MCA velocity significantly increased directly after de-clamping of the internal carotid artery on the affected side.

Keywords: awake testing, carotid endarterectomy, cerebral oximetry, Tanscranial Doppler

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268 Underrepresentation of Right Middle Cerebral Infarct: A Statistical Parametric Mapping

Authors: Wi-Sun Ryu, Eun-Kee Bae

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Prior studies have shown that patients with right hemispheric stroke are likely to seek medical service compared with those with left hemispheric stroke. However, the underlying mechanism for this phenomenon is unknown. In the present study, we generated lesion probability maps in a patient with right and left middle cerebral artery infarct and statistically compared. We found that precentral gyrus-Brodmann area 44, a language area in the left hemisphere - involvement was significantly higher in patients with left hemispheric stroke. This finding suggests that a language dysfunction was more noticeable, thereby taking more patients to hospitals.

Keywords: cerebral infarct, brain MRI, statistical parametric mapping, middle cerebral infarct

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267 Review of the Anatomy of the Middle Cerebral Artery and Its Anomalies

Authors: Karen Cilliers, Benedict John Page

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The middle cerebral artery (MCA) is the most complex cerebral artery although few anomalies are found compared to the other cerebral arteries. The branches of the MCA cover a large part of each hemisphere, therefore it is exposed in various operations. Although the segments of the MCA are similarly described by most authors, there is some disagreement on the branching pattern of the MCA. The aim of this study was to review the available literature on the anatomy and variations of the MCA, and to compare this to a pilot study. For the pilot study, 20 hemispheres were perfused with coloured silicone and the MCA was dissected. According to the literature, the two most common branching configurations are the bifurcating and trifurcating patterns. In the pilot study, bifurcation was observed in 19 hemispheres, and in one hemisphere there was no branching (monofurcation). No trifurcation was observed. The most commonly duplicated branch was the anterior parietal artery in 30%, and most commonly absent was the common temporal artery in 65% and the temporal polar artery in 40%. Very few studies describe the origins of the branches of the MCA, therefore a detailed description is given. Middle cerebral artery variations that are occasionally reported in the literature include fenestration, and a duplicated or accessory MCA, although no variations were observed in the pilot study. Aneurysms can frequently be observed at the branching of cerebral vessels, therefore a thorough knowledge of the vascular anatomy is vital. Furthermore, knowledge of possible variations is important since variations can have serious clinical implications.

Keywords: anatomy, anomaly, description, middle cerebral artery, origin, variation

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266 Hypoxia Tolerance, Longevity and Cancer-Resistance in the Mole Rat Spalax – a Liver Transcriptomics Approach

Authors: Hanno Schmidt, Assaf Malik, Anne Bicker, Gesa Poetzsch, Aaron Avivi, Imad Shams, Thomas Hankeln

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The blind subterranean mole rat Spalax shows a remarkable tolerance to hypoxia, cancer-resistance and longevity. Unravelling the genomic basis of these adaptations will be important for biomedical applications. RNA-Seq gene expression data were obtained from normoxic and hypoxic Spalax and rat liver tissue. Hypoxic Spalax broadly downregulates genes from major liver function pathways. This energy-saving response is likely a crucial adaptation to low oxygen levels. In contrast, the hypoxiasensitive rat shows massive upregulation of energy metabolism genes. Candidate genes with plausible connections to the mole rat’s phenotype, such as important key genes related to hypoxia-tolerance, DNA damage repair, tumourigenesis and ageing, are substantially higher expressed in Spalax than in rat. Comparative liver transcriptomics highlights the importance of molecular adaptations at the gene regulatory level in Spalax and pinpoints a variety of starting points for subsequent functional studies.

Keywords: cancer, hypoxia, longevity, transcriptomics

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265 Shielding Engineered Islets with Mesenchymal Stem Cells Enhance Survival under Hypoxia by Inhibiting p38 MAPK

Authors: Bhawna Chandravanshi, Ramesh Bhonde

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In the present study, we focused on the improvisation of islet survival in hypoxia. The Islet-like cell aggregates (ICAs) derived from Wharton's jelly mesenchymal stem cells (WJ-MSC) were cultured with and without WJ-MSC for 48h in hypoxia and normoxia and tested for their direct trophic effect on β cell survival. The WJ MSCs themselves secreted insulin upon glucose challenge and expressed the pancreatic markers at both transcription and translational level (C-peptide, Insulin, Glucagon and Glut 2). Direct contact of MSCs with ICAs facilitate the highest viability under hypoxia as evidenced by fluorescein diacetate/propidium iodide and 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. The cytokine analysis of the co-cultured ICAs revealed amplification of anti-inflammatory cytokine-like TGFβ and TNFα accompanied by depletion of pro-inflammatory cytokines. The increment in VEGF and PDGFa was also seen showing their ability to vascularize upon transplantation. This was further accompanied by reduction in total reactive oxygen species, nitric oxide, and super oxide ions and down-regulation of Caspase3, Caspase8, p53 and up regulation of Bcl2 confirming prevention of apoptosis in ICAs. There was a significant reduction in the expression of p38 protein in the presence of MSCs making the ICAs responsive to glucose. Taken together our data demonstrate for the first time that the WJ-MSC expressed pancreatic markers and their supplementation protected engineered islets against hypoxia, oxidative stress, and inflammatory cytokines by inhibiting p38 MAPK protein.

Keywords: hypoxia, islet-like cell aggregates, inflammatory cytokines, oxidative stress

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264 Of Love and Isolation: Narratives of Siblings of Children with Cerebral Palsy in Sri Lanka

Authors: Shyamani Hettiarachchi

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Aim: Siblings of children with cerebral palsy are often in the periphery of discussions; their views not always taken into account. The aim of this study was to uncover the narratives of young siblings of children with cerebral palsy in Sri Lanka. Methods: Semi-structured interviews and artwork were gathered from 10 children who have siblings diagnosed with cerebral palsy. The data was analyzed using the key principles of Framework Analysis to determine the key themes within the narratives. Results: The key themes to emerge were complex and nuanced. These included themes of love and feeling of protectiveness; jealousy and uncertainly; guilt and hope. Conclusions: The results highlight the need to take document the views of siblings who are often on the margins of the family and of family decisions and discussions. It also supports the need to offer safe spaces and opportunities for siblings of children with disabilities to express their feelings and to receive support where required.

Keywords: disability, grandmothers, mothers, narratives, women

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263 Speech Disorders as Predictors of Social Participation of Children with Cerebral Palsy in the Primary Schools of the Czech Republic

Authors: Marija Zulić, Vanda Hájková, Nina Brkić–Jovanović, Srećko Potić, Sanja Tomić

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The name cerebral palsy comes from the word cerebrum, which means the brain and the word palsy, which means seizure, and essentially refers to the movement disorder. In the clinical picture of cerebral palsy, basic neuromotor disorders are associated with other various disorders: behavioural, intellectual, speech, sensory, epileptic seizures, and bone and joint deformities. Motor speech disorders are among the most common difficulties present in people with cerebral palsy. Social participation represents an interaction between an individual and their social environment. Quality of social participation of the students with cerebral palsy at school is an important indicator of their successful participation in adulthood. One of the most important skills for the undisturbed social participation is ability of good communication. The aim of the study was to determine relation between social participation of students with cerebral palsy and presence of their speech impairment in primary schools in the Czech Republic. The study was performed in the Czech Republic in mainstream schools and schools established for the pupils with special education needs. We analysed 75 children with cerebral palsy aged between six and twelve years attending up to sixth grade by using the first and the third part of the school function assessment questionnaire as the main instrument. The other instrument we used in the research is the Gross motor function classification system–five–level classification system, which measures degree of motor functions of children and youth with cerebral palsy. Funding for this study was provided by the Grant Agency of Charles University in Prague.

Keywords: cerebral palsy, social participation, speech disorders, The Czech Republic, the school function assessment

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262 Cerebral Pulsatility Mediates the Link Between Physical Activity and Executive Functions in Older Adults with Cardiovascular Risk Factors: A Longitudinal NIRS Study

Authors: Hanieh Mohammadi, Sarah Fraser, Anil Nigam, Frederic Lesage, Louis Bherer

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A chronically higher cerebral pulsatility is thought to damage cerebral microcirculation, leading to cognitive decline in older adults. Although it is widely known that regular physical activity is linked to improvement in some cognitive domains, including executive functions, the mediating role of cerebral pulsatility on this link remains to be elucidated. This study assessed the impact of 6 months of regular physical activity upon changes in an optical index of cerebral pulsatility and the role of physical activity for the improvement of executive functions. 27 older adults (aged 57-79, 66.7% women) with cardiovascular risk factors (CVRF) were enrolled in the study. The participants completed the behavioral Stroop test, which was extracted from the Delis-Kaplan executive functions system battery at baseline (T0) and after 6 months (T6) of physical activity. Near-infrared spectroscopy (NIRS) was applied for an innovative approach to indexing cerebral pulsatility in the brain microcirculation at T0 and T6. The participants were at standing rest while a NIRS device recorded hemodynamics data from frontal and motor cortex subregions at T0 and T6. The cerebral pulsatility index of interest was cerebral pulse amplitude, which was extracted from the pulsatile component of NIRS data. Our data indicated that 6 months of physical activity was associated with a reduction in the response time for the executive functions, including inhibition (T0: 56.33± 18.2 to T6: 53.33± 15.7,p= 0.038)and Switching(T0: 63.05± 5.68 to T6: 57.96 ±7.19,p< 0.001) conditions of the Stroop test. Also, physical activity was associated with a reduction in cerebral pulse amplitude (T0: 0.62± 0.05 to T6: 0.55± 0.08, p < 0.001). Notably, cerebral pulse amplitude was a significant mediator of the link between physical activity and response to the Stroop test for both inhibition (β=0.33 (0.61,0.23),p< 0.05)and switching (β=0.42 (0.69,0.11),p <0.01) conditions. This study suggests that regular physical activity may support cognitive functions through the improvement of cerebral pulsatility in older adults with CVRF.

Keywords: near-infrared spectroscopy, cerebral pulsatility, physical activity, cardiovascular risk factors, executive functions

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261 Melatonin Suppresses the Brain Injury after Cerebral Ischemia/Reperfusion in Hyperglycemic Rats

Authors: Dalia O. Saleha, Gehad A. Abdel Jaleela, Sally W. Al-Awdana

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Diabetes mellitus (DM) is known to exacerbate cerebral ischemic injury. The present study aimed to investigate the anti-oxidant and anti-inflammatory effects of oral supplementation of melatonin (MLN) on cerebral injury caused by middle cerebral artery occlusion and reperfusion (MCAO/Re) in streptozotocin (STZ)-induced hyperglycemic rats. Hyperglycemia was induced by a single injection of STZ (55mg/kg; i.p.), six weeks later the cerebral injury was induced by MCAO/Re. Twenty-four hours after the MCAO/Re the MLN (10 mg/kg) was injected for 14 consecutive days. Results of the present study revealed that MCAO/Re in STZ-induced hyperglycemia in rats causes an increase in the oxidative stress biomarkers; it increased brain lipid peroxidation (measured as malondialdehyde; MDA) and brain level of nitric oxide (NO). Moreover, MCAO/Reproduces a prominent increase in the brain inflammatory markers viz. interleukin-6 (IL-6), interleukin-1β (IL-1β) and tumor necrosis nuclear factor-alpha (TNF-α). Oral treatment of MCAO/Re in STZ-induced hyperglycemic rats with MLN (10 mg/kg) for two weeks restored the brain levels of MDA, GSH, NO, IL-6, IL-1β and the TNF-α. MLN succeeded to suppress the exacerbation of damage in the brain of hyperglycemic rats. These results suggest that daily intake of MLN attenuates the exacerbation of cerebral ischemic injury in a diabetic state, which may be attributed to anti-oxidant and anti-inflammatory effects in the brain.

Keywords: melatonin, brain injury, cerebral ischemia/reperfusion, hyperglycemia, rats

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260 Automated Classification of Hypoxia from Fetal Heart Rate Using Advanced Data Models of Intrapartum Cardiotocography

Authors: Malarvizhi Selvaraj, Paul Fergus, Andy Shaw

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Uterine contractions produced during labour have the potential to damage the foetus by diminishing the maternal blood flow to the placenta. In order to observe this phenomenon labour and delivery are routinely monitored using cardiotocography monitors. An obstetrician usually makes the diagnosis of foetus hypoxia by interpreting cardiotocography recordings. However, cardiotocography capture and interpretation is time-consuming and subjective, often lead to misclassification that causes damage to the foetus and unnecessary caesarean section. Both of these have a high impact on the foetus and the cost to the national healthcare services. Automatic detection of foetal heart rate may be an objective solution to help to reduce unnecessary medical interventions, as reported in several studies. This paper aim is to provide a system for better identification and interpretation of abnormalities of the fetal heart rate using RStudio. An open dataset of 552 Intrapartum recordings has been filtered with 0.034 Hz filters in an attempt to remove noise while keeping as much of the discriminative data as possible. Features were chosen following an extensive literature review, which concluded with FIGO features such as acceleration, deceleration, mean, variance and standard derivation. The five features were extracted from 552 recordings. Using these features, recordings will be classified either normal or abnormal. If the recording is abnormal, it has got more chances of hypoxia.

Keywords: cardiotocography, foetus, intrapartum, hypoxia

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259 Predictors of Social Participation of Children with Cerebral Palsy in Primary Schools in Czech Republic

Authors: Marija Zulić, Vanda Hájková, Nina Brkić-Jovanović, Linda Rathousová, Sanja Tomić

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Cerebral palsy is primarily reflected in the disorder of the development of movement and posture, which may be accompanied by sensory disturbances, disturbances of perception, cognition and communication, behavioural disorders and epilepsy. According to current inclusive attitudes towards people with disabilities implies that full social participation of children with cerebral palsy means inclusion in all activities in family, peer, school and leisure environments in the same scope and to the same extent as is the case with the children of proper development and without physical difficulties. Due to the fact that it has been established that the quality of children's participation in primary school is directly related to their social inclusion in future life, the aim of the paper is to identify predictors of social participation, respectively, and in particular, factors that could to improve the quality of social participation of children with cerebral palsy, in the primary school environment in Czech Republic. The study includes children with cerebral palsy (n = 75) in the Czech Republic, aged between six and 12 years who attend mainstream or special primary schools to the sixth grade. The main instrument used was the first and third part of the School function assessment questionnaire. It will also take into account the type of damage assessed according to a scale the Gross motor function classification system, five–level classification system for cerebral palsy. The research results will provide detailed insight into the degree of social participation of children with cerebral palsy and the factors that would be a potential cause of their levels of participation, in regular and special primary schools, in different socioeconomic environments in Czech Republic.

Keywords: cerebral palsy, Czech republic, social participation, the school function assessment

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258 Coping Life with Female Autistic and Cerebral Palsy Teenagers: Stress Developed by Parental Care in Ghana

Authors: Edwina Owusu Panin, Derrick Antwi

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Autism and cerebral palsy are fraternal twins in the world of communication and social interaction challenges. Caring for autistic and cerebral palsied female teenagers in Ghana can be difficult and stressful for parents. We highlight the findings of dealing with stress, where female teenagers are more daunting than male teenagers, related to the demand for a lot of attention linked to the puberty transition. This brief examines the challenges that parents face in caring for teenagers with autism and cerebral palsy in Ghana and the stress that can develop from parental care. The article also highlights the importance of identifying and addressing mental health and self-care issues in parents of disabled female teenagers, as these issues can significantly affect the well-being of both parents and their children. Parents of teenagers with disabilities often face a variety of challenges, including managing their children's care and medical needs, navigating the educational system, and addressing social and emotional needs. These challenges can be even more disheartening in Ghana, where resources and support for families of children with disabilities are limited. In a nutshell, the challenges of caring for female teenagers with autism and cerebral palsy can be significant in Ghana. The article outlines methods that parents in Ghana can take to manage their stress and provide a brighter future for their female teenagers. Parents are better able to cope with the challenges of parenting and provide the best care possible for their female teenagers with disabilities.

Keywords: autism, cerebral palsy, female teenagers, parental care

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257 Association of Hypoxia-Inducible Factor-1α in Patients with Chronic Obstructive Pulmonary Diseases

Authors: Kriti Upadhyay, Ashraf Ali, Puja Sohal, Randeep Guleria

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Background: In Chronic Obstructive Pulmonary diseases (COPD) pathogenesis oxidative stress plays an important role. Hypoxia-Inducible factor (HIF-1α) is a dimeric protein complex which Functions as a master transcriptional regulator of the adaptive response to hypoxiaand is a risk factor that increases when oxidative stress triggers. The role ofHIF-1αin COPD due to smoking is lacking. Aim: This study aims to evaluate the role of HIF-1α in smoker COPD patients comparing its association with diseases severity. Method: In this cross-sectional study, we recruited 87 subjects, 57 were smokers with COPD,15 were smokers without COPD and other 15 were non-smoker healthy controls. The mean age was 54.6± 9.32 (cases 57.08±8.15; controls 50.0± 9.8). There were 62%smokers, 25% non-smokers,7% tobacco chewers and 6% ex-smokers. Enzyme-linked immune sorbent assay (ELISA) method was used for analyzing serum samples wherein HIF-1α was analyzed by Sandwich-ELISA. Results: In smoker COPD patients, a significantly higher HIF-1α level showed positive association with hypoxia, smoking status and severity of disease (p=0.03). The mean value of HIF-1α was not significantly different in smokers without COPD and healthy controls. Conclusion: It is found that HIF-1α level was increased in smoker COPD, but not in smokers without COPD. This suggests that development of COPD drive the HIF-1α pathway and it correlates with the severity of diseases.

Keywords: COPD, chronic obstructive pulmonary diseases, smokers, nonsmokers, hypoxia

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256 Effect of Hypoxia on the Antimicrobial Activity of Corvina Drum (Cilus Gilberti) Epidermal Mucus

Authors: Belinda Vega, Claudio Alvarez, Héctor Flores, Marcia Oliva, Katherine Alveal, Teresa Toro, María José Tapia, Fanny Guzmán

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With the increase in global temperatures and the decrease of oxygen (O2) concentration in the oceans, fish cultures are exposed to frequent fluctuations in dissolved O2 (DO) concentration that can cause chronic stress in the animals, altering the normal functioning of their immune system and making them vulnerable to infections, consequently increasing morbidity and mortality in the farms with economic losses. The mucosal organs (skin -and mucus-, gills, gut, and nasal mucosa) are the first line of defense of the fish against pathogens. Therefore, the objective of this study is to evaluate the effect of hypoxia on the antimicrobial activity of epidermal mucus from corvina drum (Cilus Gilberti), a native marine species with the potential for the diversification of aquaculture in Chile. To achieve this, the epidermal mucus of juveniles (~220g) kept under normoxia (7 mg/L DO) and hypoxia (2 mg/L DO) environmental conditions was collected after 6 weeks, as well as after 6 days of intraperitoneal inoculation with lipopolysaccharide from Vibrio anguillarum to induce an immune response in the fish. Total protein extracts of the mucus were used for bactericidal activity and lysozyme and peroxidase activity assays. Although the mucus from both experimental groups showed inhibitory effects on the bacterial growth of Vibrio anguillarum and Vibrio ordalli, this effect was more long-lasting in the normoxia group. We also observed a notable reduction in the presence of lysozyme in the mucus from fish exposed to hypoxia, with no differences in peroxidase content. Future proteomic studies of corvina mucus associated with the environmental conditions studied in this work will allow the isolation and identification of peptides with antimicrobial activity, those responsible for the results obtained. This will help establish strategies aimed at minimizing the impacts of hypoxia on the defense responses of corvina drum against potential pathogens. Funding: FONDECYT 3200440 and FONDECYT 1210056

Keywords: Cilus gilberti, mucus, antimicrobial activity, HYPOXIA

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255 Insufficiency of Cardioprotection at Adaptation to Chronic Hypoxia and at Remote Postconditioning in Young and Aged Rats with Metabolic Syndrome, the Role of Metabolic Disorders or Opioid Signaling

Authors: Natalia V. Naryzhnaya, Alexandr V. Mukhomedzyanov, Ivan A. Derkachev, Boris K. Kurbatov, Leonid N. Maslov

Abstract:

Background: Techniques of adaptation to hypoxia and remote postconditioning (RPost) have great prospects for use in the clinic. However, recent studies have shown low efficacy of remote postconditioning in patients with AMI. We hypothesize that the reasons for this inefficiency may be metabolic disorders, which are very common, especially in patients with cardiovascular disease, and age of patients. The purpose of the study was to reveal the effectiveness of adaptation to chronic hypoxia and RPost. To determine the possible relationship between the decrease in the effectiveness of projective impacts and disorders of carbohydrate and lipid metabolism. Design: The study was carried out on Wistar rats 60 day old. MetS was induced by high-carbohydrate, high-fat diet (HСHFD). Modeling MS led to the formation of obesity, hypertension, impaired lipid and carbohydrate metabolism, hyperleptinemia, and moderate stress. Groups with adaptation to chronic hypoxia were subjected to hypoxia for 21 days at 12% O2 and 0.3% CO2 after complete of HСHFD. All animals were subjected to 45 min coronary occlusion and 120 min reperfusion. Groups with RPost, immediately after the end of ischemia, tourniquets were applied to the hind limbs in the area of the hip joint (3 times in the mode of 5 min ischemia, 5 min reperfusion). Results: RPost led to a twofold reduction of infarct size in rats with intact metabolism (р < 0.0001), while in rats with MetS, a decrease in infarct size during RPost was 25 % (p = 0.00003). A direct correlation was found between of infarct size during RPost and the serum leptin level of rats with MetC (r = 0.85). The presented data suggested that a decrease in the efficiency of remote postconditioning in rats with diet-induced metabolic syndrome depends on serum leptin. Chronic hypoxia resulted in a 38% reduced in infarct size in metabolically intact rats. The decrease of cardioprotection was observed in rats with chronic hypoxia and MetS. Infarct size showed a direct correlation with impaired glucose tolerance (AUC, glucose tolerance test, r = 0.034) and serum triglyceride levels (r = 0.39). Our study showed the dependence of cardioprotection in rats with metabolic syndrome during chronic hypoxia and DPost on opioids in the blood serum and myocardium, protein kinase C and NO synthase activity. Conclusion: The results obtained showed that the infarct-limiting efficiency of adaptation to hypoxia and remote postconditioning is reduced or completely absent in animals with metabolic syndrome. The increase in the infarction, in this case, directly depends on the disturbances in carbohydrate. lipid metabolism and opioids signaling. Funding: Investigation of effectiveness of chronic hypoxia at the metabolic syndrome was carried out within the support of Russian Science Foundation Grant 22-15-00048. Studies of the mechanisms of arterial hypertension in induced metabolic syndrome were carried out within the framework of the state assignment (122020300042-4). The work was performed using the Center for Collective Use "Medical Genomics".

Keywords: chronic hypoxia, opioids, remote postconditioning, metabolic syndrome

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254 Altered Proteostasis Contributes to Skeletal Muscle Atrophy during Chronic Hypobaric Hypoxia: An Insight into Signaling Mechanisms

Authors: Akanksha Agrawal, Richa Rathor, Geetha Suryakumar

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Muscle represents about ¾ of the body mass, and a healthy muscular system is required for human performance. A healthy muscular system is dynamically balanced via the catabolic and anabolic process. High altitude associated hypoxia altered this redox balance via producing reactive oxygen and nitrogen species that ultimately modulates protein structure and function, hence, disrupts proteostasis or protein homeostasis. The mechanism by which proteostasis is clinched includes regulated protein translation, protein folding, and protein degradation machinery. Perturbation in any of these mechanisms could increase proteome imbalance in the cellular processes. Altered proteostasis in skeletal muscle is likely to be responsible for contributing muscular atrophy in response to hypoxia. Therefore, we planned to elucidate the mechanism involving altered proteostasis leading to skeletal muscle atrophy under chronic hypobaric hypoxia. Material and Methods-Male Sprague Dawley rats weighing about 200-220 were divided into five groups - Control (Normoxic animals), 1d, 3d, 7d and 14d hypobaric hypoxia exposed animals. The animals were exposed to simulated hypoxia equivalent to 282 torr pressure (equivalent to an altitude of 7620m, 8% oxygen) at 25°C. On completion of chronic hypobaric hypoxia (CHH) exposure, rats were sacrificed, muscle was excised and biochemical, histopathological and protein synthesis signaling were studied. Results-A number of changes were observed with the CHH exposure time period. ROS was increased significantly on 07 and 14 days which were attributed to protein oxidation via damaging muscle protein structure by oxidation of amino acids moiety. The oxidative damage to the protein further enhanced the various protein degradation pathways. Calcium activated cysteine proteases and other intracellular proteases participate in protein turnover in muscles. Therefore, we analysed calpain and 20S proteosome activity which were noticeably increased at CHH exposure as compared to control group representing enhanced muscle protein catabolism. Since inflammatory markers (myokines) affect protein synthesis and triggers degradation machinery. So, we determined inflammatory pathway regulated under hypoxic environment. Other striking finding of the study was upregulation of Akt/PKB translational machinery that was increased on CHH exposure. Akt, p-Akt, p70 S6kinase, and GSK- 3β expression were upregulated till 7d of CHH exposure. Apoptosis related markers, caspase-3, caspase-9 and annexin V was also increased on CHH exposure. Conclusion: The present study provides evidence of disrupted proteostasis under chronic hypobaric hypoxia. A profound loss of muscle mass is accompanied by the muscle damage leading to apoptosis and cell death under CHH. These cellular stress response pathways may play a pivotal role in hypobaric hypoxia induced skeletal muscle atrophy. Further research in these signaling pathways will lead to development of therapeutic interventions for amelioration of hypoxia induced muscle atrophy.

Keywords: Akt/PKB translational machinery, chronic hypobaric hypoxia, muscle atrophy, protein degradation

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253 Infused Mesenchymal Stem Cells Ameliorate Organs Morphology in Cerebral Malaria Infection

Authors: Reva Sharan Thakur, Mrinalini Tiwari, Jyoti das

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Cerebral malaria-associated over expression of pro-inflammatory cytokines and chemokines ultimately results in the up-regulation of adhesion molecules in the brain endothelium leading to sequestration of mature parasitized RBCs in the brain. The high-parasitic load subsequently results in increased mortality or development of neurological symptoms within a week of infection. Studies in the human and experimental cerebral malaria have implicated the breakdown of the integrity of blood-brain barrier during the lethal course of infection, cerebral dysfunction, and fatal organ pathologies that result in multi-organ failure. In the present study, using Plasmodium berghei Anka as a mouse model and in vitro conditions, we have investigated the effect of MSCs to attenuate cerebral malaria pathogenesis by diminishing the effect of inflammation altered organ morphology, reduced parasitemia, and increased survival of the mice. MSCs are also validated for their role in preventing BBB dysfunction and reducing malarial toxins. It was observed that administration of MSCs significantly reduced parasitemia and increased survival in Pb A infected mice. It was further demonstrated that MSCs play a significant role in reversing neurological complexities associated with cerebral malaria. Infusion of MSCs in infected mice decreased hemozoin deposition; oedema, and haemorrhagic lesions in vascular organs. MSCs administration also preserved the integrity of the blood-brain barrier and reduced neural inflammation. Taken together, our results demonstrate the potential of MSCs as an emerging anti-malarial candidate.

Keywords: cerebral malaria, mesenchymal stem cells, erythropoesis, cell death

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252 Computational Fluid Dynamics Study of the Effects of Mechanical Forces in Cerebral Aneurysms

Authors: Hashem Al Argha

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Cerebral Aneurysms are the ballooning and defect that occurs in the arteries of the brain. This ballooning might enlarge in size due to mechanical forces and could lead to rupture and death. Computational Fluid Dynamics has been used in the recent years in creating a link between engineering sciences and medical sciences. In this paper, the effects of mechanical forces on cerebral aneurysms will be studied. Results of this study show that mechanical forces could lead to rupture of the aneurysm and could lead to death. High mechanical forces including stresses up to 1.7 MPa could pop aneurysms and lead to a brain hemorrhage.

Keywords: computational fluid dynamics, numerical, aneurysm, mechanical forces

Procedia PDF Downloads 223
251 Social Support and Quality of Life of Youth Suffering from Cerebral Palsy Temporarily Orphaned Due to Emigration of a Parent

Authors: A. Gagat-Matuła

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The article is concerned in the issue of social support and quality of life of youth suffering from cerebral palsy, who are temporarily orphaned due to the emigration of a parent. Migration causes multi-aspect consequences in various spheres of life. They are particularly severe for the functioning of families. Temporal parting of parents and children, especially the disabled, is a difficult situation. In this case, the family structure is changed, as well as the quality of life of its members. Children can handle migration parting in a better or worse way; these can be divided into properly functioning and manifesting behaviour disorders. In conditions of the progressing phenomenon of labour migration of Poles and a wide spectrum of consequences for the whole social life, it is essential to undertake actions aimed at support of migrants and their families. This article focuses mainly on social support and quality of families members, of which, are the labour migrants perceived by youth suffering from cerebral palsy. The quantitative method was used in this study. In the study, the Satisfaction with Life Scale (SWLS) by Diener, was used. The analysed group consisted of 50 persons (37 girls and 13 boys), aged 16 years to 18 years, whose parents are labour migrants. The results indicate that the quality of life and social support for youth suffering from cerebral palsy who are temporarily orphaned is at a low and average level.

Keywords: social support, quality of life, migration, cerebral palsy

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250 Construction of a Dynamic Model of Cerebral Blood Circulation for Future Integrated Control of Brain State

Authors: Tomohiko Utsuki

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Currently, brain resuscitation becomes increasingly important due to revising various clinical guidelines pertinent to emergency care. In brain resuscitation, the control of brain temperature (BT), intracranial pressure (ICP), and cerebral blood flow (CBF) is required for stabilizing physiological state of brain, and is described as the essential treatment points in many guidelines of disorder and/or disease such as brain injury, stroke, and encephalopathy. Thus, an integrated control system of BT, ICP, and CBF will greatly contribute to alleviating the burden on medical staff and improving treatment effect in brain resuscitation. In order to develop such a control system, models related to BT, ICP, and CBF are required for control simulation, because trial and error experiments using patients are not ethically allowed. A static model of cerebral blood circulation from intracranial arteries and vertebral artery to jugular veins has already constructed and verified. However, it is impossible to represent the pooling of blood in blood vessels, which is one cause of cerebral hypertension in this model. And, it is also impossible to represent the pulsing motion of blood vessels caused by blood pressure change which can have an affect on the change of cerebral tissue pressure. Thus, a dynamic model of cerebral blood circulation is constructed in consideration of the elasticity of the blood vessel and the inertia of the blood vessel wall. The constructed dynamic model was numerically analyzed using the normal data, in which each arterial blood flow in cerebral blood circulation, the distribution of blood pressure in the Circle of Willis, and the change of blood pressure along blood flow were calculated for verifying against physiological knowledge. As the result, because each calculated numerical value falling within the generally known normal range, this model has no problem in representing at least the normal physiological state of the brain. It is the next task to verify the accuracy of the present model in the case of disease or disorder. Currently, the construction of a migration model of extracellular fluid and a model of heat transfer in cerebral tissue are in progress for making them parts of an integrated model of brain physiological state, which is necessary for developing an future integrated control system of BT, ICP and CBF. The present model is applicable to constructing the integrated model representing at least the normal condition of brain physiological state by uniting with such models.

Keywords: dynamic model, cerebral blood circulation, brain resuscitation, automatic control

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249 Theory of Mind and Its Brain Distribution in Patients with Temporal Lobe Epilepsy

Authors: Wei-Han Wang, Hsiang-Yu Yu, Mau-Sun Hua

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Theory of Mind (ToM) refers to the ability to infer another’s mental state. With appropriate ToM, one can behave well in social interactions. A growing body of evidence has demonstrated that patients with temporal lobe epilepsy (TLE) may have damaged ToM due to impact on regions of the underlying neural network of ToM. However, the question of whether there is cerebral laterality for ToM functions remains open. This study aimed to examine whether there is cerebral lateralization for ToM abilities in TLE patients. Sixty-seven adult TLE patients and 30 matched healthy controls (HC) were recruited. Patients were classified into right (RTLE), left (LTLE), and bilateral (BTLE) TLE groups on the basis of a consensus panel review of their seizure semiology, EEG findings, and brain imaging results. All participants completed an intellectual test and four tasks measuring basic and advanced ToM. The results showed that, on all ToM tasks; (1)each patient group performed worse than HC; (2)there were no significant differences between LTLE and RTLE groups; (3)the BTLE group performed the worst. It appears that the neural network responsible for ToM is distributed evenly between the cerebral hemispheres.

Keywords: cerebral lateralization, social cognition, temporal lobe epilepsy, theory of mind

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248 Effects of External and Internal Focus of Attention in Motor Learning of Children with Cerebral Palsy

Authors: Morteza Pourazar, Fatemeh Mirakhori, Fazlolah Bagherzadeh, Rasool Hemayattalab

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The purpose of study was to examine the effects of external and internal focus of attention in the motor learning of children with cerebral palsy. The study involved 30 boys (7 to 12 years old) with CP type 1 who practiced throwing beanbags. The participants were randomly assigned to the internal focus, external focus, and control groups, and performed six blocks of 10-trial with attentional focus reminders during a practice phase and no reminders during retention and transfer tests. Analysis of variance (ANOVA) with repeated measures on the last factor was used. The results show that significant main effects were found for time and group. However, the interaction of time and group was not significant. Retention scores were significantly higher for the external focus group. The external focus group performed better than other groups; however, the internal focus and control groups’ performance did not differ. The study concluded that motor skills in Spastic Hemiparetic Cerebral Palsy (SHCP) children could be enhanced by external attention.

Keywords: cerebral palsy, external attention, internal attention, throwing task

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247 Microdosimetry in Biological Cells: A Monte Carlo Method

Authors: Hamidreza Jabal Ameli, Anahita Movahedi

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Purpose: In radionuclide therapy, radioactive atoms are coupled to monoclonal antibodies (mAbs) for treating cancer tumor while limiting radiation to healthy tissues. We know that tumoral and normal tissues are not equally sensitive to radiation. In fact, biological effects such as cellular repair processes or the presence of less radiosensitive cells such as hypoxic cells should be taken account. For this reason, in this paper, we want to calculate biological effect dose (BED) inside tumoral area and healthy cells around tumors. Methods: In this study, deposited doses of a radionuclide, gold-198, inside cells lattice and surrounding healthy tissues were calculated with Monte Carlo method. The elemental compositions and density of malignant and healthy tissues were obtained from ICRU Report 44. For reaching to real condition of oxygen effects, the necrosis and hypoxia area inside tumors has been assessed. Results: With regard to linear-quadratic expression which was defined in Monte Carlo, results showed that a large amount of BED is deposited in the well-oxygenated part of the hypoxia area compared to necrosis area. Moreover, there is a significant difference between the curves of absorbed dose with BED and without BED.

Keywords: biological dose, monte carlo, hypoxia, radionuclide therapy

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246 Cerebrovascular Modeling: A Vessel Network Approach for Fluid Distribution

Authors: Karla E. Sanchez-Cazares, Kim H. Parker, Jennifer H. Tweedy

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The purpose of this work is to develop a simple compartmental model of cerebral fluid balance including blood and cerebrospinal-fluid (CSF). At the first level the cerebral arteries and veins are modelled as bifurcating trees with constant scaling factors between generations which are connected through a homogeneous microcirculation. The arteries and veins are assumed to be non-rigid and the cross-sectional area, resistance and mean pressure in each generation are determined as a function of blood volume flow rate. From the mean pressure and further assumptions about the variation of wall permeability, the transmural fluid flux can be calculated. The results suggest the next level of modelling where the cerebral vasculature is divided into three compartments; the large arteries, the small arteries, the capillaries and the veins with effective compliances and permeabilities derived from the detailed vascular model. These vascular compartments are then linked to other compartments describing the different CSF spaces, the cerebral ventricles and the subarachnoid space. This compartmental model is used to calculate the distribution of fluid in the cranium. Known volumes and flows for normal conditions are used to determine reasonable parameters for the model, which can then be used to help understand pathological behaviour and suggest clinical interventions.

Keywords: cerebrovascular, compartmental model, CSF model, vascular network

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