Search results for: date of minimum durability

Authors: Aussara Panya, Nunghathai Sawasdee, Mutita Junking, Chatchawan Srisawat, Kiattawee Choowongkomon, Pa-Thai Yenchitsomanus

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Dengue virus (DENV) infection is a global public health problem with approximately 100 million infected cases a year. Presently, there is no approved vaccine or effective drug available; therefore, the development of anti-DENV drug is urgently needed. The clinical reports revealing the positive association between the disease severity and viral titer has been reported previously suggesting that the anti-DENV drug therapy can possibly ameliorate the disease severity. Although several anti-DENV agents showed inhibitory activities against DENV infection, to date none of them accomplishes clinical use in the patients. The surface envelope (E) protein of DENV is critical for the viral entry step, which includes attachment and membrane fusion; thus, the blocking of envelope protein is an attractive strategy for anti-DENV drug development. To search the safe anti-DENV agent, this study aimed to search for novel peptide inhibitors to counter DENV infection through the targeting of E protein using a structure-based in silico design. Two selected strategies has been used including to identify the peptide inhibitor which interfere the membrane fusion process whereby the hydrophobic pocket on the E protein was the target, the destabilization of virion structure organization through the disruption of the interaction between the envelope and membrane proteins, respectively. The molecular docking technique has been used in the first strategy to search for the peptide inhibitors that specifically bind to the hydrophobic pocket. The second strategy, the peptide inhibitor has been designed to mimic the ectodomain portion of membrane protein to disrupt the protein-protein interaction. The designed peptides were tested for the effects on cell viability to measure the toxic to peptide to the cells and their inhibitory assay to inhibit the DENV infection in Vero cells. Furthermore, their antiviral effects on viral replication, intracellular protein level and viral production have been observed by using the qPCR, cell-based flavivirus immunodetection and immunofluorescence assay. None of tested peptides showed the significant effect on cell viability. The small peptide inhibitors achieved from molecular docking, Glu-Phe (EF), effectively inhibited DENV infection in cell culture system. Its most potential effect was observed for DENV2 with a half maximal inhibition concentration (IC50) of 96 μM, but it partially inhibited other serotypes. Treatment of EF at 200 µM on infected cells also significantly reduced the viral genome and protein to 83.47% and 84.15%, respectively, corresponding to the reduction of infected cell numbers. An additional approach was carried out by using peptide mimicking membrane (M) protein, namely MLH40. Treatment of MLH40 caused the reduction of foci formation in four individual DENV serotype (DENV1-4) with IC50 of 24-31 μM. Further characterization suggested that the MLH40 specifically blocked viral attachment to host membrane, and treatment with 100 μM could diminish 80% of viral attachment. In summary, targeting the hydrophobic pocket and M-binding site on the E protein by using the peptide inhibitors could inhibit DENV infection. The results provide proof of-concept for the development of antiviral therapeutic peptide inhibitors to counter DENV infection through the use of a structure-based design targeting conserved viral protein.

Keywords: dengue virus, dengue virus infection, drug design, peptide inhibitor

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Authors: Nor Azian Binti Aziz, Muhammad Afiq Bin Tambichik, Zamri Bin Hashim

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The rapid development of the construction industry has contributed to increased construction waste, with concrete waste being among the most abundant. This waste is generated from ready-mix batching plants after the concrete cube testing process is completed and disposed of in landfills, leading to increased solid waste management costs. This study aims to evaluate the engineering characteristics of foamed concrete with waste mixtures construction and agricultural waste to determine the usability of recycled materials in the construction of non-load-bearing walls. This study involves the collection of construction wastes, such as recycled aggregates (RCA) obtained from the remains of finished concrete cubes, which are then tested in the laboratory. Additionally, agricultural waste, such as rice husk ash, is mixed into foamed concrete interlock blocks to enhance their strength. The optimal density of foamed concrete for this study was determined by mixing mortar and foam-backed agents to achieve the minimum targeted compressive strength required for non-load-bearing walls. The tests conducted in this study involved two phases. In Phase 1, elemental analysis using an X-ray fluorescence spectrometer (XRF) was conducted on the materials used in the production of interlock blocks such as sand, recycled aggregate/recycled concrete aggregate (RCA), and husk ash paddy/rice husk ash (RHA), Phase 2 involved physical and thermal tests, such as compressive strength test, heat conductivity test, and fire resistance test, on foamed concrete mixtures. The results showed that foamed concrete can produce lightweight interlock blocks. X-ray fluorescence spectrometry plays a crucial role in the characterization, quality control, and optimization of foamed concrete mixes containing construction and agriculture waste. The unique composition mixer of foamed concrete and the resulting chemical and physical properties, as well as the nature of replacement (either as cement or fine aggregate replacement), the waste contributes differently to the performance of foamed concrete. Interlocking blocks made from foamed concrete can be advantageous due to their reduced weight, which makes them easier to handle and transport compared to traditional concrete blocks. Additionally, foamed concrete typically offers good thermal and acoustic insulation properties, making it suitable for a variety of building projects. Using foamed concrete to produce lightweight interlock blocks could contribute to more efficient and sustainable construction practices. Additionally, RCA derived from concrete cube waste can serve as a substitute for sand in producing lightweight interlock blocks.

Keywords: construction waste, recycled aggregates (RCA), sustainable concrete, structure material

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Authors: D. Serero, L. Couton, J. D. Parisse, R. Leroy

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In urban planning, an increasing number of cities require wind analysis to verify comfort of public spaces and around buildings. These studies are made using computer fluid dynamic simulation (CFD). However, this technique is often based on wind information taken from meteorological stations located at several kilometers of the spot of analysis. The approximated input data on project surroundings produces unprecise results for this type of analysis. They can only be used to get general behavior of wind in a zone but not to evaluate precise wind speed. This paper presents another approach to this problem, based on collecting wind data and generating an urban wind cartography using connected ultrasound anemometers. They are wireless devices that send immediate data on wind to a remote server. Assembled in array, these devices generate geo-localized data on wind such as speed, temperature, pressure and allow us to compare wind behavior on a specific site or building. These Netatmo-type anemometers communicate by wifi with central equipment, which shares data acquired by a wide variety of devices such as wind speed, indoor and outdoor temperature, rainfall, and sunshine. Beside its precision, this method extracts geo-localized data on any type of site that can be feedback looped in the architectural design of a building or a public place. Furthermore, this method allows a precise calibration of a virtual wind tunnel using numerical aeraulic simulations (like STAR CCM + software) and then to develop the complete volumetric model of wind behavior over a roof area or an entire city block. The paper showcases connected ultrasonic anemometers, which were implanted for an 18 months survey on four study sites in the Grand Paris region. This case study focuses on Paris as an urban environment with multiple historical layers whose diversity of typology and buildings allows considering different ways of capturing wind energy. The objective of this approach is to categorize the different types of wind in urban areas. This, particularly the identification of the minimum and maximum wind spectrum, helps define the choice and performance of wind energy capturing devices that could be implanted there. The localization on the roof of a building, the type of wind, the altimetry of the device in relation to the levels of the roofs, the potential nuisances generated. The method allows identifying the characteristics of wind turbines in order to maximize their performance in an urban site with turbulent wind.

Keywords: computer fluid dynamic simulation in urban environment, wind energy harvesting devices, net-zero energy building, urban wind behavior simulation, advanced building skin design methodology

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Authors: Victoria Crynes

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The question of England’s role in Britain is increasingly relevant due to the ongoing rise in citizens identifying as English. Furthermore, the Brexit Referendum was predominantly supported by constituents identifying as English. Few politicians appear to comprehend how Englishness is politically manifested. Politics and the media have depicted English identity as a negative and extremist problem - an inaccurate representation that ignores the breadth of English identifying citizens. This environment prompts the question, 'How are British Politicians Addressing the Modern English Identity Question?' Parliamentary debates, political blogs, and interviews are synthesized to establish a more coherent understanding of the current political attitudes towards English identity, the perceived nature of English identity, and the political manifestation of English representation and governance. Analyzed parliamentary debates addressed the democratic structure of English governance through topics such as English votes for English laws, devolution, and the union. The blogs examined include party-based, multi-author style blogs, and independently authored blogs by politicians, which provide a dynamic and up-to-date representation of party and politician viewpoints. Lastly, fourteen semi-structured interviews of British politicians provide a nuanced perspective on how politicians conceptualize Englishness. Interviewee selection was based on three criteria: (i) Members of Parliament (MP) known for discussing English identity politics, (ii) MPs of strongly English identifying constituencies, (iii) MPs with minimal English identity affiliation. Analysis of parliamentary debates reveals the discussion of English representation has gained little momentum. Many politicians fail to comprehend who the English are, why they desire greater representation and believe that increased recognition of the English would disrupt the unity of the UK. These debates highlight the disconnect of parliament from the disenfranchised English towns. A failure to recognize the legitimacy of English identity politics generates an inability for solution-focused debates to occur. Political blogs demonstrate cross-party recognition of growing English disenfranchisement. The dissatisfaction with British politics derives from multiple factors, including economic decline, shifting community structures, and the delay of Brexit. The left-behind communities have seen little response from Westminster, which is often contrasted to the devolved and louder voices of the other UK nations. Many blogs recognize the need for a political response to the English and lament the lack of party-level initiatives. In comparison, interviews depict an array of local-level initiatives reconnecting MPs to community members. Local efforts include town trips to Westminster, multi-cultural cooking classes, and English language courses. These efforts begin to rebuild positive, local narratives, promote engagement across community sectors, and acknowledge the English voices. These interviewees called for large-scale, political action. Meanwhile, several interviewees denied the saliency of English identity. For them, the term held only extremist narratives. The multi-level analysis reveals continued uncertainty on Englishness within British politics, contrasted with increased recognition of its saliency by politicians. It is paramount that politicians increase discussions on English identity politics to avoid increased alienation of English citizens and to rebuild trust in the abilities of Westminster.

Keywords: British politics, contemporary identity politics and its impacts, English identity, English nationalism, identity politics

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Authors: E. O. Egieyeh, N. Butler, R. Coetzee, M. Van Huyssteen, A. Bheekie

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Background: High rate of maternal and child mortality is a global concern. Nationally, it constitutes one of South Africa’s quadruple burdens of diseases. Pharmacists have a crucial role in maternal and child health care delivery and as such should be equipped with adequate knowledge and skill required to contribute to maternal and child well-being. The International Pharmaceutical Federation statement of policy (2013) outlines pharmacist-led interventions in accordance with the World Health Organisation’s interventions in maternal, new-born and child health care. The South African Pharmacy Council’s guideline on Good Pharmacy Practice (2010) also stipulates the minimum standards required to participate in reproductive, maternal and child care. Pharmacy schools are obliged to train pharmacy students to meet priority health needs of the population so that graduates are ‘fit for purpose’. The purpose of the study is to evaluate the knowledge and skill of final year pharmacy students at a university in South Africa to determine their preparedness to contribute effectively to maternal and child health care. Method: A quantitative, descriptive, non-randomized baseline study was conducted among the final year students at the School of Pharmacy. Data was collected using a questionnaire designed in sections to assess knowledge of contraception, maternal and child health directed at the primary care level and framed within the scope of practice required of an entry-level generalist pharmacist. Participants’ skill in infant growth assessment was assessed in a section of the questionnaire in a written format. Participants ticked the topics they had been exposed to on a curriculum content assessment tool which was not graded. A pilot study examined the clarity and suitability of question items, and duration to complete the questionnaire. A score of 50% in each section of the questionnaire indicated a pass. The questionnaire was delivered in campus lecture venue. Results: Of the 102 students in final year, 53 (52%) students consented to participate in the study. Only 13.2% of participants scored above 50% in each section. Forty five (85%) participants scored above 50% in the contraception section while 40 (75%) scored less than 50% in the skills assessment. Less than half (45.3%) of the participants had a total score above 50%. Being a parent or working part-time as pharmacist assistance did not have any influence on the performance of the participants. Evaluation of participants’ curriculum content exposure showed differences in exposure to the various topics. Exposure to contraception teaching received the most recognition. Conclusion: Maternal and child health curriculum content should be reviewed at the university to enhance the knowledge and skill of pharmacy graduates.

Keywords: final year pharmacy students, knowledge and skill, maternal and child health, South Africa

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Authors: Betül Gelengül Eki̇mci̇, Semra Günay Aktaş

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Festive, habitual activities celebrated on the specified date by a local community, are conducive to recognition of the region. The main function of festive events is to help gathering people via an annual celebration to create an atmosphere of understanding and the opportunity to participate in the joy of life. At the same time, festive events may serve as special occasions on which immigrants return home to celebrate with their family and community, reaffirming their identity and link to the community’s traditions. Festivals also support the local economy by bringing in different visitors to the region. The tradition of “Beet Brewing-Molasses Production,” which is held in İdrisyayla Village is an intangible cultural heritage with customs, traditions, and rituals carrying impacts of cuisine culture of Rumelian immigrants in the Ottoman. After the harvest of the beet plant in the autumn season of the year, Beet Brewing Molasses syrup is made by traditional production methods with co-op of the local community. Festive occurring brewing paste made process provided transmission of knowledge and experience to the young generations. Making molasses, which is a laborious process, is accompanied by folk games such as "sayacı," which is vital element of the festive performed in İdrisyayla. Performance provides enjoyable time and supporting motivation. Like other forms of intangible cultural heritage, “Beet Brewing-Molasses Festive in İdrasyayla is threatened by rapid urbanisation, young generation migration, industrialisation and environmental change. The festive events are threatened with gradual disappearance due to changes communities undergo in modern societies because it depends on the broad participation of practitioners. Ensuring the continuity of festive events often requires the mobilization of large numbers of individuals and the social, political and legal institutions and mechanisms of society. In 2015, Intangible cultural heritage research project with the title of "İdrisyayla Molasses Process" managed by the Eskişehir Governorship, City Directorate of Culture and Tourism and Anadolu University, project members took part in the festival organization to promote sustainability, making it visible, to encourage the broadest public participation possible, to ensure public awareness on the cultural importance. To preserve the originality of and encourage participation in the festive İdrisyayla, local associations, researchers and institutions created foundation and supports festive events, such as "sayacı" folk game, which is vital element of the festive performed in İdrisyayla. Practitioners find new opportunity to market İdrisyayla Molasses production. Publicity program through the press and exhibition made it possible to stress the cultural importance of the festive in İdrisyayla Village. The research reported here used a survey analysis to evaluate an affect of the festive after the spirit of the 2015 Festive in İdrisyayla Village. Particular attention was paid to the importance of the cultural aspects of the festival. Based on a survey of more than a hundred festival attendees, several recommendations are made to festival planners. Results indicate that the variety of festive activities and products offered for sale very important to attendees. The local participants care product sales rather than cultural heritage.

Keywords: agritourism, cultural tourism, festival, sustainable cultural heritage

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Authors: Bander Alzahrani, Mohammed Alreshoodi

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Information-centric networking (ICN) using architectures such as the Publish-Subscribe Internet Technology (PURSUIT) has been proposed as a new networking model that aims at replacing the current used end-centric networking model of the Internet. This emerged model focuses on what is being exchanged rather than which network entities are exchanging information, which gives the control plane functions such as routing and host location the ability to be specified according to the content items. The forwarding plane of the PURSUIT ICN architecture uses a simple and light mechanism based on Bloom filter technologies to forward the packets. Although this forwarding scheme solve many problems of the today’s Internet such as the growth of the routing table and the scalability issues, it is vulnerable to brute force attacks which are starting point to distributed- denial-of-service (DDoS) attacks. In this work, we design and analyze a novel source-routing and information delivery technique that keeps the simplicity of using Bloom filter-based forwarding while being able to deter different attacks such as denial of service attacks at the ingress of the network. To achieve this, special forwarding nodes called Edge-FW are directly attached to end user nodes and used to perform a security test for malicious injected random packets at the ingress of the path to prevent any possible attack brute force attacks at early stage. In this technique, a core entity of the PURSUIT ICN architecture called topology manager, that is responsible for finding shortest path and creating a forwarding identifiers (FId), uses a cryptographically secure hash function to create a 64-bit hash, h, over the formed FId for authentication purpose to be included in the packet. Our proposal restricts the attacker from injecting packets carrying random FIds with a high amount of filling factor ρ, by optimizing and reducing the maximum allowed filling factor ρm in the network. We optimize the FId to the minimum possible filling factor where ρ ≤ ρm, while it supports longer delivery trees, so the network scalability is not affected by the chosen ρm. With this scheme, the filling factor of any legitimate FId never exceeds the ρm while the filling factor of illegitimate FIds cannot exceed the chosen small value of ρm. Therefore, injecting a packet containing an FId with a large value of filling factor, to achieve higher attack probability, is not possible anymore. The preliminary analysis of this proposal indicates that with the designed scheme, the forwarding function can detect and prevent malicious activities such DDoS attacks at early stage and with very high probability.

Keywords: forwarding identifier, filling factor, information centric network, topology manager

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Authors: Ivo Zution Goncalves, Christopher M. U. Neale, Hiran Medeiros, Everardo Mantovani, Natalia Souza

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Multispectral and thermal infrared imagery from satellite sensors coupled with climate and soil datasets were used to estimate evapotranspiration and biomass in center pivots planted to maize in Brazil during the 2016 season. The hybrid remote sensing based model named Spatial EvapoTranspiration Modelling Interface (SETMI) was applied using multispectral and thermal infrared imagery from the Landsat Thematic Mapper instrument. Field data collected by the IRRIGER center pivot management company included daily weather information such as maximum and minimum temperature, precipitation, relative humidity for estimating reference evapotranspiration. In addition, soil water content data were obtained every 0.20 m in the soil profile down to 0.60 m depth throughout the season. Early season soil samples were used to obtain water-holding capacity, wilting point, saturated hydraulic conductivity, initial volumetric soil water content, layer thickness, and saturated volumetric water content. Crop canopy development parameters and irrigation application depths were also inputs of the model. The modeling approach is based on the reflectance-based crop coefficient approach contained within the SETMI hybrid ET model using relationships developed in Nebraska. The model was applied to several fields located in Minas Gerais State in Brazil with approximate latitude: -16.630434 and longitude: -47.192876. The model provides estimates of real crop evapotranspiration (ET), crop irrigation requirements and all soil water balance outputs, including biomass estimation using multi-temporal satellite image inputs. An interpolation scheme based on the growing degree-day concept was used to model the periods between satellite inputs, filling the gaps between image dates and obtaining daily data. Actual and accumulated ET, accumulated cold temperature and water stress and crop water requirements estimated by the model were compared with data measured at the experimental fields. Results indicate that the SETMI modeling approach using data assimilation, showed reliable daily ET and crop water requirements for maize, interpolated between remote sensing observations, confirming the applicability of the SETMI model using new relationships developed in Nebraska for estimating mainly ET and water requirements in Brazil under tropical conditions.

Keywords: basal crop coefficient, irrigation, remote sensing, SETMI

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Authors: Ainura Tursunalieva, Irene Hudson

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Continuous improvement of both the quality and safety of health care is an important goal in Australia and internationally. The intensive care unit (ICU) receives patients with a wide variety of and severity of illnesses. Accurately identifying patients at risk of developing complications or dying is crucial to increasing healthcare efficiency. Thus, it is essential for clinicians and researchers to have a robust framework capable of evaluating the risk profile of a patient. ICU scoring systems provide such a framework. The Acute Physiology and Chronic Health Evaluation III and the Simplified Acute Physiology Score II are ICU scoring systems frequently used for assessing the severity of acute illness. These scoring systems collect multiple risk factors for each patient including physiological measurements then render the assessment outcomes of individual risk factors into a single numerical value. A higher score is related to a more severe patient condition. Furthermore, the Mortality Probability Model II uses logistic regression based on independent risk factors to predict a patient’s probability of mortality. An important overlooked limitation of SAPS II and MPM II is that they do not, to date, include interaction terms between a patient’s vital signs. This is a prominent oversight as it is likely there is an interplay among vital signs. The co-existence of certain conditions may pose a greater health risk than when these conditions exist independently. One barrier to including such interaction terms in predictive models is the dimensionality issue as it becomes difficult to use variable selection. We propose an innovative scoring system which takes into account a dependence structure among patient’s vital signs, such as systolic and diastolic blood pressures, heart rate, pulse interval, and peripheral oxygen saturation. Copulas will capture the dependence among normally distributed and skewed variables as some of the vital sign distributions are skewed. The estimated dependence parameter will then be incorporated into the traditional scoring systems to adjust the points allocated for the individual vital sign measurements. The same dependence parameter will also be used to create an alternative copula-based model for predicting a patient’s probability of mortality. The new copula-based approach will accommodate not only a patient’s trajectories of vital signs but also the joint dependence probabilities among the vital signs. We hypothesise that this approach will produce more stable assessments and lead to more time efficient and accurate predictions. We will use two data sets: (1) 250 ICU patients admitted once to the Chui Regional Hospital (Kyrgyzstan) and (2) 37 ICU patients’ agitation-sedation profiles collected by the Hunter Medical Research Institute (Australia). Both the traditional scoring approach and our copula-based approach will be evaluated using the Brier score to indicate overall model performance, the concordance (or c) statistic to indicate the discriminative ability (or area under the receiver operating characteristic (ROC) curve), and goodness-of-fit statistics for calibration. We will also report discrimination and calibration values and establish visualization of the copulas and high dimensional regions of risk interrelating two or three vital signs in so-called higher dimensional ROCs.

Keywords: copula, intensive unit scoring system, ROC curves, vital sign dependence

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Authors: Peregrine James Dalziel, Philip Vu Tran

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Objective / Introduction: Demand for radiology services from Emergency Departments (ED) continues to increase with greater demands placed on radiology staff providing reports for the management of complex cases. Queuing theory indicates that wide variability of process time with the random nature of request arrival increases the probability of significant queues. This can lead to delays in the time-to-availability of radiology reports (TTA-RR) and potentially impaired ED patient flow. In addition, greater “cognitive workload” of greater volume may lead to reduced productivity and increased errors. We sought to quantify the potential ED flow improvements obtainable from increased radiology providers serving 3 public hospitals in Melbourne Australia. We sought to assess the potential productivity gains, quality improvement and the cost-effectiveness of increased labor inputs. Methods & Materials: The Western Health Medical Imaging Department moved from single resident coverage on weekend days 8:30 am-10:30 pm to a limited period of 2 resident coverage 1 pm-6 pm on both weekend days. The TTA-RR for weekend CT scans was calculated from the PACs database for the 8 month period symmetrically around the date of staffing change. A multivariate linear regression model was developed to isolate the improvement in TTA-RR, between the two 4-months periods. Daily and hourly scan volume at the time of each CT scan was calculated to assess the impact of varying department workload. To assess any improvement in report quality/errors a random sample of 200 studies was assessed to compare the average number of clinically significant over-read addendums to reports between the 2 periods. Cost-effectiveness was assessed by comparing the marginal cost of additional staffing against a conservative estimate of the economic benefit of improved ED patient throughput using the Australian national insurance rebate for private ED attendance as a revenue proxy. Results: The primary resident on call and the type of scan accounted for most of the explained variability in time to report availability (R2=0.29). Increasing daily volume and hourly volume was associated with increased TTA-RR (1.5m (p<0.01) and 4.8m (p<0.01) respectively per additional scan ordered within each time frame. Reports were available 25.9 minutes sooner on average in the 4 months post-implementation of double coverage (p<0.01) with additional 23.6 minutes improvement when 2 residents were on-site concomitantly (p<0.01). The aggregate average improvement in TTA-RR was 24.8 hours per weekend day This represents the increased decision-making time available to ED physicians and potential improvement in ED bed utilisation. 5% of reports from the intervention period contained clinically significant addendums vs 7% in the single resident period but this was not statistically significant (p=0.7). The marginal cost was less than the anticipated economic benefit based assuming a 50% capture of improved TTA-RR inpatient disposition and using the lowest available national insurance rebate as a proxy for economic benefit. Conclusion: TTA-RR improved significantly during the period of increased staff availability, both during the specific period of increased staffing and throughout the day. Increased labor utilisation is cost-effective compared with the potential improved productivity for ED cases requiring CT imaging.

Keywords: workflow, quality, administration, CT, staffing

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Authors: Patrícia Severino, Luciana Nalone, Daniele Martins, Marco Chaud, Classius Ferreira, Cristiane Bani, Ricardo Albuquerque

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Hydrogels produced with polymers have been used in the development of dressings for wound treatment and tissue revitalization. Our study on polymer nanocomposites containing silver nanoparticles shows antimicrobial activity and applications in wound healing. The effects are linked with the slow oxidation and Ag⁺ liberation to the biological environment. Furthermore, bacterial cell membrane penetration and metabolic disruption through cell cycle disarrangement also contribute to microbial cell death. The silver antimicrobial activity has been known for many years, and previous reports show that low silver concentrations are safe for human use. This work aims to develop a hydrogel using natural polymers (sodium alginate and gelatin) combined with silver nanoparticles for wound healing and with antimicrobial properties in cutaneous lesions. The hydrogel development utilized different sodium alginate and gelatin proportions (20:80, 50:50 and 80:20). The silver nanoparticles incorporation was evaluated at the concentrations of 1.0, 2.0 and 4.0 mM. The physico-chemical properties of the formulation were evaluated using ultraviolet-visible (UV-Vis) absorption spectroscopy, Fourier transform infrared (FTIR) spectroscopy, differential scanning calorimetry (DSC), and thermogravimetric (TG) analysis. The morphological characterization was made using transmission electron microscopy (TEM). Human fibroblast (L2929) viability assay was performed with a minimum inhibitory concentration (MIC) assessment as well as an in vivo cicatrizant test. The results suggested that sodium alginate and gelatin in the (80:20) proportion with 4 mM of AgNO₃ in the (UV-Vis) exhibited a better hydrogel formulation. The nanoparticle absorption spectra of this analysis showed a maximum band around 430 - 450 nm, which suggests a spheroidal form. The TG curve exhibited two weight loss events. DSC indicated one endothermic peak at 230-250 °C, due to sample fusion. The polymers acted as stabilizers of a nanoparticle, defining their size and shape. Human fibroblast viability assay L929 gave 105 % cell viability with a negative control, while gelatin presented 96% viability, alginate: gelatin (80:20) 96.66 %, and alginate 100.33 % viability. The sodium alginate:gelatin (80:20) exhibited significant antimicrobial activity, with minimal bacterial growth at a ratio of 1.06 mg.mL⁻¹ in Pseudomonas aeruginosa and 0.53 mg.mL⁻¹ in Staphylococcus aureus. The in vivo results showed a significant reduction in wound surface area. On the seventh day, the hydrogel-nanoparticle formulation reduced the total area of injury by 81.14 %, while control reached a 45.66 % reduction. The results suggest that silver-hydrogel nanoformulation exhibits potential for wound dressing therapeutics.

Keywords: nanocomposite, wound healing, hydrogel, silver nanoparticle

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Authors: Margareth S. Zanchetta, Kateryna Metersky, Valerie Tan, Charissa Cordon, Stephanie Lucchese, Yana Siganevich, Prasha Sivasundaram, Truong Binh Nguyen, Imran Qureshi

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Due to a new area of practice, Canadian nurses possess knowledge gaps regarding the use of cannabis-based therapies by clients/patients. Education related to medical cannabis (MC) and recreational cannabis (RC) is required to promote nurses’ competency and confidence in supporting clients/patients using MC/RC toward the improvement of health outcomes. A team composed of nursing researchers and undergraduate/graduate students implemented a national survey to explore this theme with the population of undergraduate, graduate (MN and NP), and Post-Diploma (RN Bridging) nursing students enrolled in Canadian Universities Nursing Programs. Upon Research Ethics Board approval, survey recruitment was supported by major nursing stakeholders. The research questions were : (a) Which are the most preferred sources of information on MC/RC for nursing students? (b) Which are the factors and preferred learning modalities that could increase interest in learning about MC/RC, and (c) What are the future career plans among nursing students, and how would they consider the prospective use of cannabis in their practice? The survey was available from Sept. 2022 to Feb. 2023, hosted by a remote platform. An original questionnaire (English-French) was composed of 18 multiple choice questions and 2 open-ended questions. Sociodemographic information and closed-ended responses were compiled as descriptive statistics, while narrative accounts will be analysed through thematic analysis. Respondents (n=153) were from 7 Canadian provinces, national (99%) and international students (1%); the majority of respondents (61%) were in the age range of 21-30 years old. Results indicated that respondents perceive a gap in the undergraduate curriculum on the topics of MC/RC (91%) and that their learning needs include regulations (90%), data on effectiveness (88%), dosing best practices (86%), contraindications (83%), and clinical and medical indications (76%). Respondents reported motivation to learn more about MC/RC through online lectures/videos (65%), e-learning modules or online interactive training (61%), workshops (51%), webinars (36%), and social media (35%). Their primary career-related motivations regarding MC/RC knowledge include enhancing nursing practice (76%), learning about this growing scope of practice (61%), keeping up-to-date responding to scientific curiosity (59%), learning about evidence-based practice (59%), and utilizing alternative forms of medical treatment (37%). Respondents indicated that the integration of topics on cannabis in any course in the undergraduate and/or graduate curriculum would increase their desire to learn about MC/RC as equally as exposure within a clinical setting (75%). The emerging trend in the set of narrative responses (n=130) suggests that respondents believe educational MC/RC content should be integrated into core nursing courses. Respondents also urged educators to be well-informed about evidence-based practice related to MC/RC and to reflect upon stigma and biases surrounding its use. Future knowledge dissemination and translation activities include scholarly products and presentations to stimulate discussion amongst nursing faculty and students, as well as nurses in clinical settings. The goal is to mobilise talents and build collaboration for the development of a socially responsive curriculum on MC/RC competency to address the education-related expectations of all these social actors.

Keywords: Canada, medical cannabis, nursing education, nursing graduate student, nursing undergraduate student, online survey, recreational cannabis

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Authors: Andrea Hernandez Hurtado

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Research on social networks (SNs) -- the interactions individuals share with others has shed important light in helping to explain differential use of variable linguistic forms, both in L1s and L2s. Nevertheless, the acquisition of nonstandard L2 Spanish in the Region of Murcia, Spain, and how learners interact with other speakers while sojourning there have received little attention. Murcian Spanish (MuSp) was widely influenced by Panocho, a divergent evolution of Hispanic Latin, and differs from the more standard Peninsular Spanish (StSp) in phonology, morphology, and lexicon. For instance, speakers from this area will most likely palatalize diminutive endings, producing animalico [̩a.ni.ma.ˈli.ko] instead of animalito [̩a.ni.ma.ˈli.to] ‘little animal’. Because L1 speakers of the area produce and prefer salient regional lexicon and morphology (particularly the palatalized diminutive -ico) in their speech, the current research focuses on how international residents in the Region of Murcia use Spanish: (1) whether or not they acquire (perceptively and/or productively) any of the salient regional features of MuSp, and (2) how their SNs explain such acquisition. This study triangulates across three tasks -recognition, production, and preference- addressing both lexicon and morphology, with each task specifically created for the investigation of MuSp features. Among other variables, the effects of L1, residence, and identity are considered. As an ongoing dissertation research, data are currently being gathered through an online questionnaire. So far, 7 participants from multiple nationalities have completed the survey, although a minimum of 25 are expected to be included in the coming months. Preliminary results revealed that MuSp lexicon and morphology were successfully recognized by participants (p<.001). In terms of regional lexicon production (10.0%) and preference (47.5%), although participants showed higher percentages of StSp, results showed that international residents become aware of stigmatized lexicon and may incorporate it into their language use. Similarly, palatalized diminutives (production 14.2%, preference 19.0%) were present in their responses. The Social Network Analysis provided information about participants’ relationships with their interactants, as well as among them. Results indicated that, generally, when residents were more immersed in the culture (i.e., had more Murcian alters) they produced and preferred more regional features. This project contributes to the knowledge of language variation acquisition in L2 speakers, focusing on a stigmatized Spanish dialect and exploring how stigmatized varieties may affect L2 development. Results will show how L2 Spanish speakers’ language is affected by their stay in Murcia. This, in turn, will shed light on the role of SNs in language acquisition, the acquisition of understudied and marginalized varieties, and the role of immersion on language acquisition. As the first systematic account on the acquisition of L2 Spanish lexicon and morphology in the Region of Murcia, it lays important groundwork for further research on the connection between SNs and the acquisition of regional variants, applicable to Murcia and beyond.

Keywords: international residents, L2 Spanish, lexicon, morphology, nonstandard language acquisition, social networks

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Authors: Andrew D. Henshaw, James M. Austin

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Introduction: Human trafficking is an increasingly serious transnational criminal enterprise and social security issue. Despite ongoing efforts to mitigate the phenomenon and a significant expansion of security scrutiny over past decades, it is not receding. This is true for many nations in Southeast Asia, widely recognized as the global hub for trafficked persons, including men, women, and children. Clearly, human trafficking is difficult to address because there are numerous drivers, causes, and motivators for it to persist, such as non-military and non-traditional security challenges, i.e., climate change, global warming displacement, and natural disasters. These make displaced persons and refugees particularly vulnerable. The issue is so large conservative estimates put a dollar value at around $150 billion-plus per year (Niethammer, 2020) spanning sexual slavery and exploitation, forced labor, construction, mining and in conflict roles, and forced marriages of girls and women. Coupled with corruption throughout military, police, and civil authorities around the world, and the active hands of powerful transnational criminal organizations, it is likely that such figures are grossly underestimated as human trafficking is misreported, under-detected, and deliberately obfuscated to protect those profiting from it. For example, the 2022 UN report on human trafficking shows a 56% reduction in convictions in that year alone (UNODC, 2022). Our Approach: To better understand this, our research utilizes a bespoke methodology. Applying a JAM (Juxtaposition Assessment Matrix), which we previously developed to detect flows of dark money around the globe (Henshaw, A & Austin, J, 2021), we now focus on the human trafficking paradigm. Indeed, utilizing a JAM methodology has identified key indicators of human trafficking not previously explored in depth. Being a set of structured analytical techniques that provide panoramic interpretations of the subject matter, this iteration of the JAM further incorporates behavioral and driver indicators, including the employment of Open-Source Artificial Intelligence (OS-AI) across multiple collection points. The extracted behavioral data was then applied to identify non-traditional indicators as they contribute to human trafficking. Furthermore, as the JAM OS-AI analyses data from the inverted position, i.e., the viewpoint of the traffickers, it examines the behavioral and physical traits required to succeed. This transposed examination of the requirements of success delivers potential leverage points for exploitation in the fight against human trafficking in a new and novel way. Findings: Our approach identified new innovative datasets that have previously been overlooked or, at best, undervalued. For example, the JAM OS-AI approach identified critical 'dark agent' lynchpins within human trafficking that are difficult to detect and harder to connect to actors and agents within a network. Our preliminary data suggests this is in part due to the fact that ‘dark agents’ in extant research have been difficult to detect and potentially much harder to directly connect to the actors and organizations in human trafficking networks. Our research demonstrates that using new investigative techniques such as OS-AI-aided JAM introduces a powerful toolset to increase understanding of human trafficking and transnational crime and illuminate networks that, to date, avoid global law enforcement scrutiny.

Keywords: human trafficking, open-source intelligence, transnational crime, human security, international human rights, intelligence analysis, JAM OS-AI, Dark Money

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Authors: Ildiko Fekete-Kertesz, Jade Chaker, Sylvain Berthelot, Viktoria Feigl, Monika Molnar, Lidia Favier

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There has been growing concern about emerging micropollutants in recent years, because of the possible environmental and health risk posed by these substances, which are released into the environment as a consequence of anthropogenic activities. Among them pharmaceuticals are currently not considered under water quality regulations; however, their potential effect on the environment have become more frequent in recent years. Due to the fact that these compounds can be detected in natural water matrices, it can be concluded, that the currently applied water treatment processes are not efficient enough for their effective elimination. To date, advanced oxidation processes (AOPs) are considered as highly competitive water treatment technologies for the removal of those organic micropollutants not treatable by conventional techniques due to their high chemical stability and/or low biodegradability. AOPs such as (photo)chemical oxidation and heterogeneous photocatalysis have proven their potential in degrading harmful organic compounds from aqueous matrices. However, some of these technologies generate reaction by-products, which can even be more toxic to aquatic organisms than the parent compounds. Thus, target compound removal does not necessarily result in the removal of toxicity. Therefore, to evaluate process efficiency the determination of the toxicity and ecotoxicity of the reaction intermediates is crucial to estimate the environmental risk of such techniques. In this context, the present study investigates the effectiveness of TiO2 assisted photodegradation for the removal of emerging water contaminants. Two drugs named losartan (used in high blood pressure medication) and levetiracetam (used to treat epilepsy) were considered in this work. The photocatalytic reactions were carried out with a commercial catalyst usually employed in photocatalysis. Moreover, the toxicity of the by-products generated during the process was assessed with various ecotoxicological methods applying aquatic test organisms from different trophic levels. A series of experiments were performed to evaluate the toxicity of untreated and treated solutions applying the Aliivibrio fischeri bioluminescence inhibition test, the Tetrahymena pyriformis proliferation inhibition test, the Daphnia magna lethality and immobilization tests and the Lemna minor growth inhibition test. The applied ecotoxicological methodology indicated sensitively the toxic effects of the treated and untreated water samples, hence the applied test battery is suitable for the ecotoxicological characterization of TiO2 based photocatalytic water treatment technologies and the indication of the formation of toxic by-products from the parent chemical compounds. Obtained results clearly showed that the TiO2 assisted photodegradation was more efficient in the elimination of losartan than levetiracetam. It was also observed that the treated levetiracetam solutions had more severe effect on the applied test organisms. A possible explanation would be the production of levetiracetam by-products, which are more toxic than the parent compound. The increased toxicity and the risk of formation of toxic metabolites represent one possible limitation to the implementation of photocatalytic treatment using TiO2 for the removal of losartan and levetiracetam. Our results proved that, the battery of ecotoxicity tests used in this work can be a promising investigation tool for the environmental risk assessment of photocatalytic processes.

Keywords: aquatic micropollutants, ecotoxicology, nano titanium dioxide, photocatalysis, water treatment

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Authors: Nashwa Elyamany

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In visual cultures, namely that of the United States, media representations are such influential and pervasive reflections of societal norms and expectations to the extent that they impact the manner in which both genders view themselves. Health and fitness magazines fall within the realm of visual culture. Since the main goal of communication is to ensure proper dissemination of information in order for the target audience to grasp the intended messages, it becomes imperative that magazine publishers, editors, advertisers and image producers use different modes of communication within their reach to convey messages to their readers and viewers. A rapid waxing flow of multimodality floods popular discourse, particularly health and fitness magazine cover pages. The use of well-crafted cover lines and visual images is imbued with agendas, consumerist ideologies and properties capable of effectively conveying implicit and explicit meaning to potential readers and viewers. In essence, the primary goal of this thesis is to interrogate the multi-semiotic operations and manifestations of hegemonic masculinity and femininity in male and female body culture, particularly on the cover pages of the twin American magazines Men's Health and Women's Health using corpora that spanned from 2011 to the mid of 2016. The researcher explores the semiotic resources that contribute to shaping and legitimizing a new form of postmodern, consumerist, gendered discourse that positions the reader-viewer ideologically. Methodologically, the researcher carries out analysis on the macro and micro levels. On the macro level, the researcher takes on a critical stance to illuminate the ideological nature of the multimodal ensemble of the cover pages, and, on the micro level, seeks to put forward new theoretical and methodological routes through which the semiotic choices well invested on the media texts can be more objectively scrutinized. On the macro level, a 'themes' analysis is initially conducted to isolate the overarching themes that dominate the fitness discourse on the cover pages under study. It is argued that variation in terms of frequencies of such themes is indicative, broadly speaking, of which facets of hegemonic masculinity and femininity are infused in the fitness discourse on the cover pages. On the micro level, this research work encompasses three sub-levels of analysis. The researcher follows an SF-MMDA approach, drawing on a trio of analytical frameworks: Halliday's SFG for the verbal analysis; Kress & van Leeuween's VG for the visual analysis; and CMT in relation to Sperber & Wilson's RT for the pragma-cognitive analysis of multimodal metaphors and metonymies. The data is presented in terms of detailed descriptions in conjunction with frequency tables, ANOVA with alpha=0.05 and MANOVA in the multiple phases of analysis. Insights and findings from this multi-faceted, social-semiotic analysis are interpreted in light of Cultivation Theory, Self-objectification Theory and the literature to date. Implications for future research include the implementation of a multi-dimensional approach whereby linguistic and visual analytical models are deployed with special regards to cultural variation.

Keywords: gender, hegemony, magazine cover page, multimodal discourse analysis, multimodal metaphor, multimodal metonymy, systemic functional grammar, visual grammar

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Authors: D. N. Kambrekar, S. B. Jagginavar, J. Aruna

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Grape stem borer, Celosterna scrabrator is an important production constraint in grapes in India. Hitherto this pest was a severe menace only on the aged and unmanaged fields but during the recent past it has also started damaging the newly established fields. In India, since Karnataka, Andra Pradesh, Tamil Nadu and Maharashtra are the major grape production states, the incidence of stem borer is also restricted and severe in these states. The grubs of the beetle bore in to the main stem and even the branches, which affect the translocation of nutrients to the areal parts of the plant. Since, the grubs bore inside the stem, the chewed material along with its excreta is discharged outside the holes and the frass is found on the ground just below the bored holes. The portion of vines above the damaged part has a sticky appearance. The leaves become pale yellow which looks like a deficiency of micronutrients. The leaves ultimately dry and drop down. The status of the incidence of the grape stem borer in different grape growing districts of Northern Karnataka was carried out during three years. In each taluka five locations were surveyed for the incidence of grape stem borer. Further, the experiment on management of stem borer was carried out in the grape gardens of Vijayapur districts under farmers field during three years. Stem borer infested plants that show live holes were selected per treatments and it was replicated three times. Live and dead holes observed during pre-treatment were closely monitored and only plants with live holes were selected and tagged. Different doses of chlorantraniliprole 0.4% GR were incorporated into the soil around the vine basins near root zone surrounded to trunk region by removing soils up to 5-10 cm with a peripheral distance of 1 to 1.5 feet from the main trunk where feeder roots are present. Irrigation was followed after application of insecticide for proper incorporation of the test chemical. The results indicated that there was sever to moderate incidence of the stem borer in all the grape growing districts of northern Karnataka. Maximum incidence was recorded in Belagavi (11 holes per vine) and minimum was in Gadag district (8.5 holes per vine). The investigations carried out to study the efficacy of chlorantraniliprole on grape stem borer for successive three years under farmers field indicated that chlorantraniliprole @ 15g/vine applied just near the active root zone of the plant followed by irrigation has successfully managed the pest. The insecticide has translocated to all the parts of the plants and thereby stopped the activity of the pest which has resulted in to better growth of the plant and higher berry yield compared to other treatments under investigation. Thus, chlorantraniliprole 0.4 GR @ 15g/vine can be effective means in managing the stem borer.

Keywords: chlorantraniliprole, grape stem borer, Celosterna scrabrator, management

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Authors: Mohammad Moridzadeh, Gholamreza Mesri

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The effectiveness of lime treatment of soils has been commonly evaluated in terms of improved workability and increased undrained unconfined compressive strength in connection to road and airfield construction. The most common method of strength measurement has been the unconfined compression test. However, if the objective of lime treatment is to improve long-term stability of first-time or reactivated landslides in stiff clays and shales, permanent changes in the size and shape of clay particles must be realized to increase drained frictional resistance. Lime-soil interactions that may produce less platy and larger soil particles begin and continue with time under the highly alkaline pH environment. In this research, pH measurements are used to monitor chemical environment and progress of reactions. Atterberg limits are measured to identify changes in particle size and shape indirectly. Also, fully softened and residual strength measurements are used to examine an improvement in frictional resistance due to lime-soil interactions. The main variables are soil plasticity and mineralogy, lime content, water content, and curing period. Lime effect on frictional resistance is examined using samples of clays with different mineralogy and characteristics which may react with lime to various extents. Drained direct shear tests on reconstituted lime-treated clay specimens with various properties have been performed to measure fully softened shear strength. To measure residual shear strength, drained multiple reversal direct shear tests on precut specimens were conducted. This way, soil particles are oriented along the direction of shearing to the maximum possible extent and provide minimum frictional resistance. This is applicable to reactivated and part of first-time landslides. The Brenna clay, which is the highly plastic lacustrine clay of Lake Agassiz causing slope instability along the banks of the Red River, is one of the soil samples used in this study. The Brenna Formation characterized as a uniform, soft to firm, dark grey, glaciolacustrine clay with little or no visible stratification, is full of slickensided surfaces. The major source of sediment for the Brenna Formation was the highly plastic montmorillonitic Pierre Shale bedrock. The other soil used in this study is one of the main sources of slope instability in Harris County Flood Control District (HCFCD), i.e. the Beaumont clay. The shear strengths of untreated and treated clays were obtained under various normal pressures to evaluate the shear envelope nonlinearity.

Keywords: Brenna clay, friction resistance, lime treatment, residual

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Authors: Kakali Roy, Sahana P. Raju, Subhra Dhar, Sandipan Dhar

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Introduction: Xeroderma pigmentosa (XP) is a rare inherited (autosomal recessive) disease resulting from impairment in DNA repair that involves recognition and repair of ultraviolet radiation (UVR) induced DNA damage in the nucleotide excision repair pathway. Which results in increased photosensitivity, UVR induced damage to skin and eye, increased susceptibility of skin and ocular cancer, and progressive neurodegeneration in some patients. XP is present worldwide, with higher incidence in areas having frequent consanguinity. Being extremely rare, there is limited literature on XP and associated complications. Here, the clinico-pathological experience (spectrum of clinical presentation, histopathological findings of malignant skin lesions, and progression) of managing 8 cases of XP is presented. Methodology: A retrospective study was conducted in a pediatric tertiary care hospital in eastern India during a ten-year period from 2013 to 2022. A clinical diagnosis was made based on severe sun burn or premature photo-aging and/or onset of cutaneous malignancies at early age (1st decade) in background of consanguinity and autosomal recessive inheritance pattern in family. Results: The mean age of presentation was 1.2 years (range of 7month-3years), while three children presented during their infancy. Male to female ratio was 5:3, and all were born of consanguineous marriage. They presented with dermatological manifestations (100%) followed by ophthalmic (75%) and/or neurological symptoms (25%). Patients had normal skin at birth but soon developed extreme sensitivity to UVR in the form of exaggerated sun tanning, burning, and blistering on minimal sun exposure, followed by abnormal skin pigmentation like freckles and lentiginosis. Subsequently, over time there was progressive xerosis, atrophy, wrinkling, and poikiloderma. Six patients had varied degree of ocular involvement, while three of them had severe manifestation, including madarosis, tylosis, ectropion, Lagopthalmos, Pthysis bulbi, clouding and scarring of the cornea with complete or partial loss of vision, and ophthalmic malignancies. 50% (n=4) cases had skin and ocular pre-malignant (actinic keratosis) and malignant lesions, including melanoma and non melanoma skin cancer (NMSC) like squamous cell carcinoma (SCC) and basal cell carcinoma (BCC) in their early childhood. One patient had simultaneous occurrence of multiple malignancies together (SCC, BCC, and melanoma). Subnormal intelligence was noticed as neurological feature, and none had sensory neural hearing loss, microcephaly, neuroregression, or neurdeficit. All the patients had been being managed by a multidisciplinary team of pediatricians, dermatologists, ophthalmologists, neurologists and psychiatrists. Conclusion: Although till date there is no complete cure for XP and the disease is ultimately fatal. But increased awareness, early diagnosis followed by persistent vigorous protection from UVR, and regular screening for early detection of malignancies along with psychological support can drastically improve patients’ quality of life and life expectancy. Further research is required on formulating optimal management of XP, specifically the role and possibilities of gene therapy in XP.

Keywords: childhood malignancies, dermato-pathological findings, eastern India, Xeroderma pigmentosa

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Authors: Iman Janghorban Esfahani

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Due to the increased use of irrigation in agriculture, the importance and need for highly reliable water pumping systems have significantly increased. The pumping of the groundwater is essential to provide water for both drip and furrow irrigation to increase the agricultural yield, especially in arid regions that suffer from scarcities of surface water. The most common irrigation pumping systems (IPS) consume conventional energies through the use of electric motors and generators or connecting to the electricity grid. Due to the shortage and transportation difficulties of fossil fuels, and unreliable access to the electricity grid, especially in the rural areas, and the adverse environmental impacts of fossil fuel usage, such as greenhouse gas (GHG) emissions, the need for renewable energy sources such as photovoltaic systems (PVS) as an alternative way of powering irrigation pumping systems is urgent. Integration of the photovoltaic systems with irrigation pumping systems as the Photovoltaic Powered-Irrigation Pumping System (PVP-IPS) can avoid fossil fuel dependency and the subsequent greenhouse gas emissions, as well as ultimately lower energy costs and improve efficiency, which made PVP-IPS systems as an environmentally and economically efficient solution for agriculture irrigation in every region. The greatest problem faced by integration of PVP with IPS systems is matching the intermittence of the energy supply with the dynamic water demand. The best solution to overcome the intermittence is to incorporate a storage system into the PVP-IPS to provide water-on-demand as a highly reliable stand-alone irrigation pumping system. The water storage tank (WST) is the most common storage device for PVP-IPS systems. In the integrated PVP-IPS with a water storage tank (PVP-IPS-WST), a water storage tank stores the water pumped by the IPS in excess of the water demand and then delivers it when demands are high. The Freshwater pinch analysis (FWaPA) as an alternative to mathematical modeling was used by other researchers for retrofitting the off-grid battery less photovoltaic-powered reverse osmosis system. However, the Freshwater pinch analysis has not been used to integrate the photovoltaic systems with irrigation pumping system with water storage tanks. In this study, FWaPA graphical and numerical tools were used for retrofitting an existing PVP-IPS system located in Salahadin, Republic of Iraq. The plant includes a 5 kW submersible water pump and 7.5 kW solar PV system. The Freshwater Composite Curve as the graphical tool and Freashwater Storage Cascade Table as the numerical tool were constructed to determine the minimum required outsourced water during operation, optimal amount of delivered electricity to the water pump, and optimal size of the water storage tank for one-year operation data. The results of implementing the FWaPA on the case study show that the PVP-IPS system with a WST as the reliable system can reduce outsourced water by 95.41% compare to the PVP-IPS system without storage tank.

Keywords: irrigation, photovoltaic, pinch analysis, pumping, solar energy

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Authors: Sofia Papadimitriou

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INTRODUCTION: The differential diagnosis between acute viral and bacterial infections is an important cost-effectiveness parameter at the stage of the treatment process in order to achieve the maximum benefits in therapeutic intervention by combining the minimum cost to ensure the proper use of antibiotics.The discovery of sensitive and robust molecular diagnostic tests in response to the role of the host in infections has enhanced the accurate diagnosis and differentiation of infections. METHOD: The study used a sample of six independent blood samples (total=756) which are associated with human proteins-proteins, each of which at the transcription stage expresses a different response in the host network between viral and bacterial infections.Τhe individual blood samples are subjected to a sequence of computer filters that identify a gene panel corresponding to an autonomous diagnostic score. The data set and the correspondence of the gene panel to the diagnostic patents a new Bangalore -Viral Bacterial (BL-VB). FINDING: We use a biomarker based on the blood of 10 genes(Panel-VB) that are an important prognostic value for the detection of viruses from bacterial infections with a weighted average AUROC of 0.97(95% CL:0.96-0.99) in eleven independent samples (sets n=898). We discovered a base with a patient score (VB 10 ) according to the table, which is a significant diagnostic value with a weighted average of AUROC 0.94(95% CL: 0.91-0.98) in 2996 patient samples from 56 public sets of data from 19 different countries. We also studied VB 10 in a new cohort of South India (BL-VB,n=56) and found 97% accuracy in confirmed cases of viral and bacterial infections. We found that VB 10 (a)accurately identifies the type of infection even in unspecified cases negative to the culture (b) shows its clinical condition recovery and (c) applies to all age groups, covering a wide range of acute bacterial and viral infectious, including non-specific pathogens. We applied our VB 10 rating to publicly available COVID 19 data and found that our rating diagnosed viral infection in patient samples. RESULTS: Τhe results of the study showed the diagnostic power of the biomarker VB 10 as a diagnostic test for the accurate diagnosis of acute infections in recovery conditions. We look forward to helping you make clinical decisions about prescribing antibiotics and integrating them into your policies management of antibiotic stewardship efforts. CONCLUSIONS: Overall, we are developing a new property of the RNA-based biomarker and a new blood test to differentiate between viral and bacterial infections to assist a physician in designing the optimal treatment regimen to contribute to the proper use of antibiotics and reduce the burden on antimicrobial resistance, AMR.

Keywords: acute infections, antimicrobial resistance, biomarker, blood transcriptome, systems biology, classifier diagnostic score

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Authors: CA Kishore S. Peshori

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Introduction: India, a country with vast diversity and huge population is going to have largest young population by 2020. Higher education has and will always be the basic requirement for making a developing nation to a developed nation. To improve any system it needs to be bench-marked. There have been various tools for bench-marking the systems. Education is delivered in India by universities which are mainly funded by government. This universities for delivering the education sets up colleges which are again funded mainly by government. Recently however there has also been autonomy given to universities and colleges. Moreover foreign universities are waiting to enter Indian boundaries. With a large number of universities and colleges it has become more and more necessary to measure this institutes for bench-marking. There have been various tools for measuring the institute. In India college assessments have been made compulsory by UGC. Naac has been offically recognised as the accrediation criteria. The Naac criteria has been based on seven criterias namely: 1. Curricular assessments, 2. Teaching learning and evaluation, 3. Research Consultancy and Extension, 4. Infrastructure and learning resources, 5. Student support and progression, 6. Governance leadership and management, 7. Innovation and best practices. The Naac tries to bench mark the institution for identification, sustainability, dissemination and adaption of best practices. It grades the institution according to this seven criteria and the funding of institution is based on these grades. Many of the colleges are struggling to get best of grades but they have not come across a systematic tool to achieve the results. Balanced Scorecard developed by Kaplan has been a successful tool for corporates to develop best of practices so as to increase their financial performance and also retain and increase their customers so as to grow the organization to next level.It is time to test this tool for an educational institute. Methodology: The paper tries to develop a prototype for college based on the secondary data. Once a prototype is developed the researcher based on questionnaire will try to test this tool for successful implementation. The success of this research will depend on its implementation of BSC on an institute and its grading improved due to this successful implementation. Limitation of time is a major constraint in this research as Naac cycle takes minimum 4 years for accreditation and reaccreditation the methodology will limit itself to secondary data and questionnaire to be circulated to colleges along with the prototype model of BSC. Conclusion: BSC is a successful tool for enhancing growth of an organization. Educational institutes are no exception to these. BSC will only have to be realigned to suit the Naac criteria. Once this prototype is developed the success will be tested only on its implementation but this research paper will be the first step towards developing this tool and will also initiate the success by developing a questionnaire and getting and evaluating the responses for moving to the next level of actual implementation

Keywords: balanced scorecard, bench marking, Naac, UGC

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Authors: Richa Sharma, Uma Nahar, Sadhna Sharma, Indu Verma

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Counteracting the deadly pathogen Mycobacterium tuberculosis (M. tb) effectively is still a global challenge. Scrutinizing alternative weapons like antimicrobial peptides to strengthen existing tuberculosis artillery is urgently required. Considering the antimycobacterial potential of Human Beta Defensin 1 (HBD-1) along with isoniazid, the present study was designed to explore the ability of HBD-1 to act against active and dormant M. tb. HBD-1 was screened in silico using antimicrobial peptide prediction servers to identify its short antimicrobial motif. The activity of both HBD-1 and its selected motif (Pep B) was determined at different concentrations against actively growing M. tb in vitro and ex vivo in monocyte derived macrophages (MDMs). Log phase M. tb was grown along with HBD-1 and Pep B for 7 days. M. tb infected MDMs were treated with HBD-1 and Pep B for 72 hours. Thereafter, colony forming unit (CFU) enumeration was performed to determine activity of both peptides against actively growing in vitro and intracellular M. tb. The dormant M. tb models were prepared by following two approaches and treated with different concentrations of HBD-1 and Pep B. Firstly, 20-22 days old M. tbH37Rv was grown in potassium deficient Sauton media for 35 days. The presence of dormant bacilli was confirmed by Nile red staining. Dormant bacilli were further treated with rifampicin, isoniazid, HBD-1 and its motif for 7 days. The effect of both peptides on latent bacilli was assessed by colony forming units (CFU) and most probable number (MPN) enumeration. Secondly, human PBMC granuloma model was prepared by infecting PBMCs seeded on collagen matrix with M. tb(MOI 0.1) for 10 days. Histopathology was done to confirm granuloma formation. The granuloma thus formed was incubated for 72 hours with rifampicin, HBD-1 and Pep B individually. Difference in bacillary load was determined by CFU enumeration. The minimum inhibitory concentrations of HBD-1 and Pep B restricting growth of mycobacteria in vitro were 2μg/ml and 20μg/ml respectively. The intracellular mycobacterial load was reduced significantly by HBD-1 and Pep B at 1μg/ml and 5μg/ml respectively. Nile red positive bacterial population, high MPN/ low CFU count and tolerance to isoniazid, confirmed the formation of potassium deficienybaseddormancy model. HBD-1 (8μg/ml) showed 96% and 99% killing and Pep B (40μg/ml) lowered dormant bacillary load by 68.89% and 92.49% based on CFU and MPN enumeration respectively. Further, H&E stained aggregates of macrophages and lymphocytes, acid fast bacilli surrounded by cellular aggregates and rifampicin resistance, indicated the formation of human granuloma dormancy model. HBD-1 (8μg/ml) led to 81.3% reduction in CFU whereas its motif Pep B (40μg/ml) showed only 54.66% decrease in bacterial load inside granuloma. Thus, the present study indicated that HBD-1 and its motif are effective antimicrobial players against both actively growing and dormant M. tb. They should be further explored to tap their potential to design a powerful weapon for combating tuberculosis.

Keywords: antimicrobial peptides, dormant, human beta defensin 1, tuberculosis

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Authors: Kumaran Letchmanan, Shou-Cang Shen, Wai Kiong Ng

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Postoperative implant-associated infections in soft tissues and bones remain a serious complication in orthopaedic surgery, which leads to impaired healing, re-implantation, prolong hospital stay and increase cost. Drug-loaded implants with sustained release of antibiotics at the local site are current research interest to reduce the risk of post-operative infections and osteomyelitis, thus, minimize the need for follow-up care and increase patient comfort. However, the improved drug release of the drug-loaded bone cements is usually accompanied by a loss in mechanical strength, which is critical for weight-bearing bone cement. Recently, more attempts have been undertaken to develop techniques to enhance the antibiotic elution as well as preserve the mechanical properties of the bone cements. The present study investigates the potential influence of addition of mesoporous silica nanoparticles (MSN) on the in vitro drug release kinetics of gentamicin (GTMC), along with the mechanical properties of bone cements. Simplex P was formulated with MSN and loaded with GTMC by direct impregnation. Meanwhile, Simplex P with water soluble poragen (xylitol) and high loading of GTMC as well as commercial bone cement CMW Smartset GHV were used as controls. MSN-formulated bone cements are able to increase the drug release of GTMC by 3-fold with a cumulative release of more than 46% as compared with other control groups. Furthermore, a sustained release could be achieved for two months. The loaded nano-sized MSN with uniform pore channels significantly build up an effective nano-network path in the bone cement facilitates the diffusion and extended release of GTMC. Compared with formulations using xylitol and high GTMC loading, incorporation of MSN shows no detrimental effect on biomechanical properties of the bone cements as no significant changes in the mechanical properties as compared with original bone cement. After drug release for two months, the bending modulus of MSN-formulated bone cements is 4.49 ± 0.75 GPa and the compression strength is 92.7 ± 2.1 MPa (similar to the compression strength of Simplex-P: 93.0 ± 1.2 MPa). The unaffected mechanical properties of MSN-formulated bone cements was due to the unchanged microstructures of bone cement, whereby more than 98% of MSN remains in the matrix and supports the bone cement structures. In contrast, the large portions of extra voids can be observed for the formulations using xylitol and high drug loading after the drug release study, thus caused compressive strength below the ASTM F541 and ISO 5833 minimum of 70 MPa. These results demonstrate the potential applicability of MSN-functionalized poly(methyl methacrylate)-based bone cement as a highly efficient, sustained and local drug delivery system with good mechanical properties.

Keywords: antibiotics, biomechanical properties, bone cement, sustained release

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Authors: Uchenna Nkiruka Umeononihu, Adenike Kuku, Oludele Odekanyin, Olubunmi Babalola, Femi Agboola, Rapheal Okonji

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In this study, a lectin from the bulb of Dioscorea bulbifera was purified, characterised, and its acute and sub-acute toxicity was investigated with a view to evaluate its toxic effects in mice. The protein from the bulb was extracted by homogenising 50 g of the bulb in 500 ml of phosphate buffered saline (0.025 M) of pH 7.2, stirred for 3 hr, and centrifuged at the speed of 3000 rpm. Blood group and sugar specificity assays of the crude extract were determined. The lectin was purified in a two-step procedure- gel filtration on Sephadex G-75 and affinity chromatography on Sepharose 4-B arabinose. The degree of purity of the purified lectin was ascertained by SDS-polyacrylamide gel electrophoresis. Detection of covalently bound carbohydrate was carried out with Periodic Acid-Schiffs (PAS) reagent staining technique. Effects of temperature, pH, and EDTA on the lectin were carried out using standard methods. This was followed by acute toxicity studies via oral and subcutaneous routes using mice. The animals were monitored for mortality and signs of toxicity. The sub-acute toxicity studies were carried out using rats. Different concentrations of the lectin were administered twice daily for 5 days via the subcutaneous route. The animals were sacrificed on the sixth day; blood samples and liver tissues were collected. Biochemical assays (determination of total protein, direct bilirubin, Alanine aminotransferase (ALT), Aspartate aminotransferase (AST), catalase (CAT), and superoxide dismutase (SOD)) were carried out on the serum and liver homogenates. The collected organs (heart, liver, kidney, and spleen) were subjected to histopathological analysis. The results showed that lectin from the bulbs of Dioscorea bulbifera agglutinated non-specifically the erythrocytes of the human ABO system as well as rabbit erythrocytes. The haemagglutinating activity was strongly inhibited by arabinose and dulcitol with minimum inhibitory concentrations of 0.781 and 6.25, respectively. The lectin was purified to homogeneity with native and subunit molecular weights of 56,273 and 29,373 Daltons, respectively. The lectin was thermostable up to 30 0C and lost 25 %, 33.3 %, and 100 % of its heamagglutinating activity at 40°C, 50°C, and 60°C, respectively. The lectin was maximally active at pH 4 and 5 but lost its total activity at pH eight, while EDTA (10 mM) had no effect on its haemagglutinating activity. PAS reagent staining showed that the lectin was not a glycoprotein. The sub-acute studies on rats showed elevated levels of ALT, AST, serum bilirubin, total protein in serum and liver homogenates suggesting damage to liver and spleen. The study concluded that the aerial bulb of D. bulbifera lectin was non-specific in its heamagglutinating activity and dimeric in its structure. The lectin shared some physicochemical characteristics with lectins from other Dioscorecea species and was moderately toxic to the liver and spleen of treated animals.

Keywords: Dioscorea bulbifera, heamagglutinin, lectin, toxicity

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Authors: Krishan Lal, Anish Dua

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Gobind Sagar Reservoir has been created in Himachal Pradesh, India (31° 25´ N and 76 ° 25´E) by damming River Sutlej at village Bhakra in 1963. The average water spread area of this reservoir is 10,000 hectares. Fishermen have organized themselves in the form of co-operative societies. 26 fisheries co-operative societies were working in Gobind Sagar Reservoir up till 2012. June and July months were observed as closed season, no fishing was done during this period. Proper record maintaining of fish catch was done at different levels by the state fisheries department. Different measures like minimum harvestable size, mesh size regulation and prohibition of illegal fishing etc. were taken for fish conservation. Fishermen were actively involved in the management. Gill nets were used for catching fishes from this reservoir. State fisheries department is realizing 15% royalty of the sold fish. Data used in this paper is about the fish catch during 2006-2012 and were obtained from the state fisheries department, Himachal Pradesh. Catla catla, Labeo rohita, Cirrhinus mrigala, Sperata seenghala, Cyprinus carpio, Tor putitora, Hypophthalmichthys molitrix, Labeo calbasu, Labeo dero and Ctenopharyngodon idella etc., were the fish species exploited for commercial purposes. Total number of individuals of all species caught was 3141236 weighing 5637108.9 kg during 2006-2012. H. molitrix was introduced accidently in this reservoir and was making a good share of fish catch in this reservoir. The annual catch of this species was varying between 161279.6 kg, caught in 2011 and 788030.8 kg caught in 2009. Total numbers of individuals of C. idella caught were 8966 weighing 64320.2 kg. The catch of Cyprinus carpio was varying between 144826.1 kg caught in 2006 and 214480.1 kg caught in 2010. Total catch of Tor putitora was 180263.2 kg during 2006-2012. Total catch of L. dero, S. seenghala and Catla catla remained 100637.4 kg, 75297.8 kg and 561802.9 kg, respectively, during 2006-2012. Maximum fish catch was observed during the months of August (after observing Closed Season). Maximum catch of exotic carps was from Bhakra area of the reservoir which has fewer fluctuations in water levels. The reservoir has been divided into eight beats for administrative purpose, to avoid conflicts between operating fisheries co-operative societies for area of operation. Fish catch was more by co-operative societies operating in the area of reservoir having fewer fluctuations in water level and catch was less by co-operative societies operating in the area of more fluctuations in water level. Species-wise fish catch by different co-operative societies from their allotted area was studied. This reservoir is one of most scientifically managed reservoirs.

Keywords: co-operative societies, fish catch, fish species, reservoir

Procedia PDF Downloads 169

Authors: Norsuhana Omar, Amilia Aminuddina Zaiton Zakaria, Raifana Rosa Mohamad Sattar, Kalaivani Chellappan, Mohd Alauddin Mohd Ali, Norizam Salamt, Zanariyah Asmawi, Norliza Saari, Aini Farzana Zulkefli, Nor Anita Megat Mohd. Nordin

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Inflammation plays an important role in the pathogenesis of vascular dysfunction leading to arterial stiffness. Pulse wave velocity (PWV) and augmentation index (AS), as tools for the assessment of vascular damages are widely used and have been shown to predict cardiovascular disease (CVD). C-reactive protein (CRP) is a marker of inflammation. Several studies noted that regular exercise is associated with reduced arterial stiffness. The lack of exercise among Malaysians and the increasing CVD morbidity and mortality among young men are of concern. In Malaysia data on the workplace exercise intervention is scarce. A programme was designed to enable subjects to increase their level of walking as part of their daily work routine and self-monitored by using pedometers. The aim of this study to evaluate the reducing of inflammation by measuring CRP and improvement arterial stiffness measured by carotid femoral PWV (PWVCF) and AI. A total of 70 young men (20 - 40 years) who were sedentary, achieving less than 5,000 steps/day in casual walking with 2 or more cardiovascular risk factors were recruited in Institute of Vocational Skills for Youth (IKBN Hulu Langat). Subjects were randomly assigned to a control (CG) (n=34; no change in walking) and pedometer group (PG) (n=36; minimum target: 8,000 steps/day). The CRP was measured by using immunological method while PWVCF and AI were measured using Vicorder. All parameters were measured at baseline and after 12 weeks. Data for analysis was conducted using Statistical Package of Social Sciences Version 22 (SPSS Inc., Chicago, IL, USA). At post intervention, the CG step counts were similar (4983 ± 366vs 5697 ± 407steps/day). The PG increased step count from 4996 ± 805 to 10,128 ±511 steps/day (P<0.001). The PG showed significant improvement in anthropometric variables and lipid (time and group effect p<0.001). For vascular assessment, the PG showed significantly decreased for time and effect (p<0.001) for PWV (7.21± 0.83 to 6.42 ± 0.89) m/s; AI (11.88± 6.25 to 8.83 ± 3.7) % and CRP (pre= 2.28 ± 3.09, post=1.08± 1.37mg/L). However, no changes were seen in CG. As a conclusion, a pedometer-based walking programme may be an effective strategy for promoting increased daily physical activity which reduces cardiovascular risk markers and thus improve cardiovascular health in terms of inflammation and arterial stiffness. The community intervention for health maintenance has potential to adopt walking as an exercise and adopting vascular fitness index as the performance measuring tools.

Keywords: arterial stiffness, exercise, inflammation, pedometer

Procedia PDF Downloads 328

Authors: Priyanka Mondal, Santosh K. Sarkar

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The present study investigated the spatiotemporal distribution and ecological risk assessment of trace elements of surface sediments (top 0 - 5 cm; grain size ≤ 0.63 µm) in relevance to sediment quality characteristics along the Ganges River Estuary, India. Sediment samples were collected during ebb tide from intertidal regions covering seven sampling sites of diverse environmental stresses. The elements were analyzed with the help of ICPAES. This positive, mixohaline, macro-tidal estuary has global significance contributing ecological and economic services. Presence of fine-clayey particle (47.03%) enhances the adsorption as well as transportation of trace elements. There is a remarkable inter-metallic variation (mg kg-1 dry weight) in the distribution pattern in the following manner: Al (31801± 15943) > Fe (23337± 7584) > Mn (461±147) > S(381±235) > Zn(54 ±18) > V(43 ±14) > Cr(39 ±15) > As (34±15) > Cu(27 ±11) > Ni (24 ±9) > Se (17 ±8) > Co(11 ±3) > Mo(10 ± 2) > Hg(0.02 ±0.01). An overall trend of enrichment of majority of trace elements was very much pronounced at the site Lot 8, ~ 35km upstream of the estuarine mouth. In contrast, the minimum concentration was recorded at site Gangasagar, mouth of the estuary, with high energy profile. The prevalent variations in trace element distribution are being liable for a set of cumulative factors such as hydrodynamic conditions, sediment dispersion pattern and textural variations as well as non-homogenous input of contaminants from point and non-point sources. In order to gain insight into the trace elements distribution, accumulation, and their pollution status, geoaccumulation index (Igeo) and enrichment factor (EF) were used. The Igeo indicated that surface sediments were moderately polluted with As (0.60) and Mo (1.30) and strongly contaminated with Se (4.0). The EF indicated severe pollution of Se (53.82) and significant pollution of As (4.05) and Mo (6.0) and indicated the influx of As, Mo and Se in sediments from anthropogenic sources (such as industrial and municipal sewage, atmospheric deposition, agricultural run-off, etc.). The significant role of the megacity Calcutta in relevance to the untreated sewage discharge, atmospheric inputs and other anthropogenic activities is worthwhile to mention. The ecological risk for different trace elements was evaluated using sediment quality guidelines, effects range low (ERL), and effect range median (ERM). The concentration of As, Cu and Ni at 100%, 43% and 86% of the sampling sites has exceeded the ERL value while none of the element concentration exceeded ERM. The potential ecological risk index values revealed that As at 14.3% of the sampling sites would pose relatively moderate risk to benthic organisms. The effective role of finer clay particles for trace element distribution was revealed by multivariate analysis. The authors strongly recommend regular monitoring emphasizing on accurate appraisal of the potential risk of trace elements for effective and sustainable management of this estuarine environment.

Keywords: pollution assessment, sediment contamination, sediment quality, trace elements

Procedia PDF Downloads 237

Authors: Faidon Kyriakou, William Dempster, David Nash

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Abdominal Aortic Aneurysm (AAA) is a major life-threatening pathology for which modern approaches reduce the need for open surgery through the use of stenting. The success of stenting though is sometimes jeopardized by the final position of the stent graft inside the human artery which may result in migration, endoleaks or blood flow occlusion. Herein, a finite element (FE) model of the commercial medical device AnacondaTM (Vascutek, Terumo) has been developed and validated in order to create a numerical tool able to provide useful clinical insight before the surgical procedure takes place. The AnacondaTM device consists of a series of NiTi rings sewn onto woven polyester fabric, a structure that despite its column stiffness is flexible enough to be used in very tortuous geometries. For the purposes of this study, a FE model of the device was built in Abaqus® (version 6.13-2) with the combination of beam, shell and surface elements; the choice of these building blocks was made to keep the computational cost to a minimum. The validation of the numerical model was performed by comparing the deployed position of a full stent graft device inside a constructed AAA with a duplicate set-up in Abaqus®. Specifically, an AAA geometry was built in CAD software and included regions of both high and low tortuosity. Subsequently, the CAD model was 3D printed into a transparent aneurysm, and a stent was deployed in the lab following the steps of the clinical procedure. Images on the frontal and sagittal planes of the experiment allowed the comparison with the results of the numerical model. By overlapping the experimental and computational images, the mean and maximum distances between the rings of the two models were measured in the longitudinal, and the transverse direction and, a 5mm upper bound was set as a limit commonly used by clinicians when working with simulations. The two models showed very good agreement of their spatial positioning, especially in the less tortuous regions. As a result, and despite the inherent uncertainties of a surgical procedure, the FE model allows confidence that the final position of the stent graft, when deployed in vivo, can also be predicted with significant accuracy. Moreover, the numerical model run in just a few hours, an encouraging result for applications in the clinical routine. In conclusion, the efficient modelling of a complicated structure which combines thin scaffolding and fabric has been demonstrated to be feasible. Furthermore, the prediction capabilities of the location of each stent ring, as well as the global shape of the graft, has been shown. This can allow surgeons to better plan their procedures and medical device manufacturers to optimize their designs. The current model can further be used as a starting point for patient specific CFD analysis.

Keywords: AAA, efficiency, finite element analysis, stent deployment

Procedia PDF Downloads 167

Authors: Ankita Baidya, Vanishri Ganakumar, Ranveer S. Jadon, Piyush Ranjan, Rita Sood

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Septic embolism can have varied presentations and clinical considerations. Infected central venous catheters are commonly associated with septic emboli but peripheral vascular catheters are rarely implicated. We describe a rare case of septic pulmonary emboli related to infected peripheral venous cannulation caused by an unusual etiological agent. A young male presented with complaints of fever, productive cough, sudden onset shortness of breath and cellulitis in both the upper limbs. He was recently hospitalised for dengue fever and administered intravenous fluids through peripheral venous line. The patient was febrile, tachypneic and in respiratory distress, there were multiple pus filled bullae in left hand alongwith swelling and erythema involving right forearm that started at the site of cannulation. Chest examination showed active accessory muscles of respiration, stony dull percussion at the base of right lung and decreased breath sounds at right infrascapular, infraaxillary and mammary area. Other system examination was within normal limits. Chest X-ray revealed bilateral multiple patchy heterogenous peripheral opacities and infiltrates with right-sided pleural effusion. Contrast-enhanced computed tomography (CECT) chest showed feeding vessel sign confirming the diagnosis as septic emboli. Venous Doppler and 2D-echocardiogarm were normal. Laboratory findings showed marked leucocytosis (22000/mm3). Pus aspirate, blood sample, and sputum sample were sent for microbiological testing. The patient was started empirically on ceftriaxone, vancomycin, and clindamycin. The Pus culture and sputum culture showed Klebsiella pneumoniae sensitive to cefoperazone-sulbactum, piperacillin-tazobactum, meropenem and amikacin. The antibiotics were modified accordingly to antimicrobial sensitivity profile to Cefoperazone-sulbactum. Bronchoalveolar lavage (BAL) was done and sent for microbiological investigations. BAL culture showed Klebsiella pneumoniae with same antimicrobial resistance profile. On day 6 of starting cefoperazone-sulbactum, he became afebrile. The skin lesions improved significantly. He was administered 2 weeks of cefoperazone–sulbactum and discharged on oral faropenem for 4 weeks. At the time of discharge, TLC was 11200/mm3 with marked radiological resolution of infection and healed skin lesions. He was kept in regular follow up. Chest X-ray and skin lesions showed complete resolution after 8 weeks. Till date, only couple of case reports of septic emboli through peripheral intravenous line have been reported in English literature. This case highlights that a simple procedure of peripheral intravenous cannulation can lead to catastrophic complication of septic pulmonary emboli and widespread cellulitis if not done with proper care and precautions. Also, the usual pathogens in such clinical settings are gram positive bacteria, but with the history of recent hospitalization, empirical therapy should also cover drug resistant gram negative microorganisms. It also emphasise the importance of appropriate healthcare practices to be taken care during all procedures.

Keywords: antibiotics, cannula, Klebsiella pneumoniae, septic emboli

Procedia PDF Downloads 135