Search results for: law no. 19 of 2019

Authors: Chahrazed Salhi, Ayoub Zeroual, Yasmina Hamitouche

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Soil water erosion poses a significant threat to the watersheds in Algeria today. The degradation of storage capacity in large dams over the past two decades, primarily due to erosion, necessitates a comprehensive understanding of the factors that contribute to soil erosion. The Isser watershed, located in the Northwestern region of Algeria, faces additional challenges such as recurrent droughts and the presence of delicate marl and clay outcrops, which amplify its susceptibility to water erosion. This study aims to employ advanced techniques such as Geographic Information Systems (GIS) and Remote Sensing (RS), in conjunction with the Canonical Correlation Analysis (CCA) method and Soil Water Assessment Tool (SWAT) model, to predict specific erosion patterns and analyze the key factors influencing erosion in the Isser basin. To accomplish this, an array of data sources including rainfall, climatic, hydrometric, land use, soil, digital elevation, and satellite data were utilized. The application of the SWAT model to the Isser basin yielded an average annual soil loss of approximately 16 t/ha/year. Particularly high erosion rates, exceeding 12 T/ha/year, were observed in the central and southern parts of the basin, encompassing 41% of the total basin area. Through Canonical Correlation Analysis, it was determined that vegetation cover and topography exerted the most substantial influence on erosion. Consequently, the study identified significant and spatially heterogeneous erosion throughout the study area. The impact of land topography on soil loss was found to be directly proportional, while vegetation cover exhibited an inverse proportional relationship. Modeling specific erosion for the Ladrat dam sub-basin estimated a rate of around 39 T/ha/year, thus accounting for the recorded capacity loss of 17.80% compared to the bathymetric survey conducted in 2019. The findings of this research provide valuable decision-support tools for soil conservation managers, empowering them to make informed decisions regarding soil conservation measures.

Keywords: Isser watershed, RS, CCA, SWAT, vegetation cover, topography

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Authors: Canga Mimoza, Irene Malagnino, Giulia Malagnino, Vito Malagnino

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Aim: This study aims at evaluating the impact of total dust (LGS) and mineral dust (PM10), in the cardio vascular and respiratory systems. Also proving that these air polluters are the cause of several diseases, such as bronchopneumonia, pneumonia, bronchitis, angina pectoris and cardiac insufficiency. Material and Method: The study is concentrated in the cities of Fier and Vlora. This is a clinic-epidemiological study conducted during the time period 2014-2019. Some of the data of LGS and PM10 were obtained from the database of the Institute of Public Health. The formula to measure the mean value of LGS and PM10 is ∆X=X (mean)-Xᵢ. Results: Based on the calculations made, we noticed that: The mean value of LGS in the city of Fieri was 227,33, while the mean value of LGS in the city of Vlora was 177,4. Whereas, the mean value of PM10 in the city of Fieri was 105.5 and the mean value of PM10 in the city of Vlore was 77.5. According to, our statistics the values of LGS were 1.2 times higher in Fier than in Vlora and the PM10 values were 1.36 times higher in Fier than in Vlora. Based on the data, in the city of Fier, the incidence of the bronchopneumonia was 56.53 sick patients/1000 inhabitants, but in Vlora, it was 22 sick patients/1000 inhabitants, so the number of the sick patients was 2.5 times higher in the city of Fieri compared with Vlora city, (P=0.001). The number of the patients with bronchitis, in the city of Fier, was 18 patients/1000 inhabitants, whereas, in Vlora, it was 9 patients/1000 inhabitants, (P=0.005). Based on the data, 8 patients/1000 inhabitants in the city of Fier, suffered from the pneumonia disease, while in Vlora city, were 4 patients/1000 inhabitants, (P=0.005). Another disease taken in consideration was angina pectoris. This study can claim that in the city of Fier, 9.5 patients/1000 inhabitants suffered from this disease, while in Vlora city, were only 4 patients /1000 inhabitants, (P=0.001). Findings of the present study proved that 3.7 patients/1000 inhabitants in the city of Fieri, had cardiac insufficiency, whereas in the city of Vlora, were 1.8 patients/1000 inhabitants, (P=0.05). Conclusions: LGS and PM10 have an influential impact on the cardio vascular and respiratory system; that’s why their levels should be kept under control. The pollution levels are 1.2 and 1.4 times higher in Fier than in Vlora; also the incidences of the diseases are 2 times higher in Fier than in Vlora. Recommendations: In order to prevent the cardio vascular and respiratory diseases, we should avoid places where pollution is higher than the norm. This can be achieved by frequenting places where the air pollution is lower, such as parks, gardens, top floors, etc.

Keywords: impact of total dust, LGS, mineral dust, PM 10, cardio vascular pathologies, respiratory disease

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Authors: Mark Morgan, Christine Li, Shuangyu Xu, Jenny McCarty

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The National Wild and Scenic Rivers System was created by the U.S. Congress in 1968 (Public Law 90-542; 16 U.S.C. 1271 et seq.) to preserve outstanding natural, cultural, and recreational values of some U.S. rivers in a free-flowing condition for the enjoyment of present and future generations. This Act is notable for safeguarding the special character of these rivers while supporting management action that encourages public participation for co-creating river protection goals and strategies. This is not an easy task. To meet the challenges of modern ecosystem management, federal resource agencies must address many legal, environmental, economic, political, and social issues. The U.S. Forest Service manages a 44-mile section of the Eleven Point National Scenic River (EPR) in southern Missouri, mainly for outdoor recreation purposes. About half of the acreage is in private lands, while the remainder flows through the Mark Twain National Forest. Private land along the river is managed by scenic easements to ensure protection of scenic values and natural resources, without public access. A portion of the EPR lies adjacent to a 16,500-acre tract known as the Irish Wilderness. The spring-fed river has steep bluffs, deep pools, clear water, and a slow current, making it an ideal setting for outdoor enthusiasts. A 10-month visitor study was conducted at five access points along the EPR during 2019 so the US Forest Service could update their river management plan. A mail-back survey was administered to 560 on-site visitors, yielding a response rate of 53%. Although different types of visitors use the EPR, boating and fishing were the predominant forms of outdoor recreation. Some river use was from locals, but other visitors came from farther away. Formulating unbiased policies for outdoor recreation is difficult because managers must assign relative values to recreational activities and travel distance. Because policymaking is a subjective process, management decisions can affect user groups in different ways (i.e., boaters vs. fishers; proximate vs. distal visitors), as seen through a GIS analysis.

Keywords: activity selection, forest recreation, policy, travel distance

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Authors: Olumuyiwa Olusola Falowo

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One of the objectives of the Millennium Development Goals is to have sustainable access to safe drinking water and basic sanitation. In line with this objective, an assessment of groundwater quality was carried out in Odigbo Local Government Area of Ondo State in November – February, 2019 to assess the drinking, domestic and irrigation uses of the water. Samples from 30 randomly selected ground water sources; 16 shallow wells and 14 from boreholes and analyzed using American Public Health Association method for the examination of water and wastewater. Water quality index calculation, and diagrams such as Piper diagram, Gibbs diagram and Wilcox diagram have been used to assess the groundwater in conjunction with irrigation indices such as % sodium, sodium absorption ratio, permeability index, magnesium ratio, Kelly ratio, and electrical conductivity. In addition statistical Principal component analysis were used to determine the homogeneity and source(s) influencing the chemistry of the groundwater. The results show that all the parameters are within the permissible limit of World Health Organization. The physico-chemical analysis of groundwater samples indicates that the dominant major cations are in decreasing order of Na+, Ca2+, Mg2+, K+ and the dominant anions are HCO-3, Cl-, SO-24, NO-3. The values of water quality index varies suggest a Good water (WQI of 50-75) accounts for 70% of the study area. The dominant groundwater facies revealed in this study are the non-carbonate alkali (primary salinity) exceeds 50% (zone 7); and transition zone with no one cation-anion pair exceeds 50% (zone 9), while evaporation; rock–water interaction, and precipitation; and silicate weathering process are the dominant processes in the hydrogeochemical evolution of the groundwater. The study indicates that waters were found within the permissible limits of irrigation indices adopted, and plot on excellent category on Wilcox plot. In conclusion, the water in the study area are good/suitable for drinking, domestic and irrigation purposes with low equivalent salinity concentrate and moderate electrical conductivity.

Keywords: equivalent salinity concentration, groundwater quality, hydrochemical facies, principal component analysis, water-rock interaction

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Authors: Philip Friedlander, John Rutledge, Jason Suh

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Inhibition of programmed death-1 (PD-1) or its ligand PD-L1 confers therapeutic efficacy in a wide range of solid tumor malignancies. Primary or acquired resistance can develop through activation of immunosuppressive immune cells such as tumor-associated macrophages. The renin angiotensin system (RAS) systemically regulates fluid and sodium hemodynamics, but components are expressed on and regulate the activity of immune cells, particularly of myeloid lineage. We hypothesized that inhibition of RAS would improve the efficacy of PD-1/PD-L-1 treatment. A retrospective analysis was performed through a chart review of patients with solid metastatic malignancies treated with a PD-1/PD-L1 inhibitor between 1/2013 and 6/2019 at Valley Hospital, a community hospital in New Jersey, USA. Efficacy was determined by medical oncologist documentation of clinical benefit in visit notes and by the duration of time on immunotherapy treatment. The primary endpoint was the determination of efficacy differences in patients treated with an inhibitor of RAS ( ace inhibitor, ACEi, or angiotensin blocker, ARB) compared to patients not treated with these inhibitors. To control for broader antihypertensive effects, efficacy as a function of treatment with beta blockers was assessed. 173 patients treated with PD-1/PD-L-1 inhibitors were identified of whom 52 were also treated with an ACEi or ARB. Chi-square testing revealed a statistically significant relationship between being on an ACEi or ARB and efficacy to PD-1/PD-L-1 therapy (p=0.001). No statistically significant relationship was seen between patients taking or not taking beta blocker antihypertensives (p= 0.33). Kaplan-Meier analysis showed statistically significant improvement in the duration of therapy favoring patients concomitantly treated with ACEi or ARB compared to patients not exposed to antihypertensives and to those treated with beta blockers. Logistic regression analysis revealed that age, gender, and cancer type did not have significant effects on the odds of experiencing clinical benefit (p=0.74, p=0.75, and p=0.81, respectively). We conclude that retrospective analysis of the treatment of patients with solid metastatic tumors with anti-PD-1/PD-L1 in a community setting demonstrates greater clinical benefit in the context of concomitant ACEi or ARB inhibition, irrespective of gender or age. This data supports the development of prospective assessment through randomized clinical trials.

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

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Authors: Richard Okyere Boadu, Judith Obiri-Yeboah, Kwame Adu Okyere Boadu, Nathan Kumasenu Mensah, Grace Amoh-Agyei

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Routine health information system (RHIS) quality assurance has become an important issue, not only because of its significance in promoting a high standard of patient care but also because of its impact on government budgets for the maintenance of health services. A routine health information system comprises healthcare data collection, compilation, storage, analysis, report generation, and dissemination on a routine basis in various healthcare settings. The data from RHIS give a representation of health status, health services, and health resources. The sources of RHIS data are normally individual health records, records of services delivered, and records of health resources. Using reliable information from routine health information systems is fundamental in the healthcare delivery system. Quality assurance practices are measures that are put in place to ensure the health data that are collected meet required quality standards. Routine health information system quality assurance practices ensure that data that are generated from the system are fit for use. This study considered quality assurance practices in the RHIS processes. Methods: A cross-sectional study was conducted in eight health facilities in Tarkwa Sub-Municipal Health Service in the western region of Ghana. The study involved routine quality assurance practices among the 90 health staff and management selected from facilities in Tarkwa Sub-Municipal who collected or used data routinely from 24th December 2019 to 20th January 2020. Results: Generally, Tarkwa Sub-Municipal health service appears to practice quality assurance during data collection, compilation, storage, analysis and dissemination. The results show some achievement in quality control performance in report dissemination (77.6%), data analysis (68.0%), data compilation (67.4%), report compilation (66.3%), data storage (66.3%) and collection (61.1%). Conclusions: Even though the Tarkwa Sub-Municipal Health Directorate engages in some control measures to ensure data quality, there is a need to strengthen the process to achieve the targeted percentage of performance (90.0%). There was a significant shortfall in quality assurance practices performance, especially during data collection, with respect to the expected performance.

Keywords: quality assurance practices, assessment of routine health information system quality, routine health information system, data quality

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Authors: Jianzhou Ni, Hua Fan

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It has been determined that supervisor support has a major influence on postgraduate students' academic emotions and is considered a method of successfully anticipating postgraduates' good psychological well-being levels. As a result, by assessing the mediating influence upon academic emotions for contemporary postgraduates in China, this study investigated the tight reciprocal relationship between psychological empowerment and positive mental well-being among postgraduates. To that end, a help enables a theoretical analysis of role clarity, academic emotion, and positive psychological health was developed, and its validity and reliability were demonstrated for the first time using the normalized postgrad relationship with supervisor scale, academic emotion scale, and positive mental scale, as well as questionnaire data from Chinese postgraduate students. This study used the cross-lagged (ARCL) panel model data to longitudinally measure 798 valid data from two survey questions polls taken in 2019 (T1) and 2021 (T2) to investigate the link between supervisor support and positive graduate student mental well-being in a bidirectional relationship of influence. The study discovered that mentor assistance could have a considerable beneficial impact on graduate students' academic emotions and, as a result, indirectly help learners attain positive mental health development. This verifies the theoretical premise that academic emotions partially mediate the effect of mentor support on positive mental health development and argues for the coexistence of the two. The outcomes of this study can help researchers gain a better knowledge of the dynamic interplay among three different research variables: supervisor support, academic emotions, and positive mental health, as well as fill gaps in previous research. In this regard, the study indicated that mentor assistance directly stimulates students' academic drive and assists graduate students in developing good academic emotions, which contributes to the development of positive mental health. However, given the restricted measurement time in this study's cross-lagged panel data and the potential effect of moderating effects other than academic mood on graduate students' good mental health, the results of this study need to be more fully understood and validated.

Keywords: supervisor support, academic emotions, positive mental health, interaction effects, longitudinal cross-lagged measurements

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Authors: Nino G. Vepkhvadze, Tea Enukidze

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Every year the number of countries around the world face the risk of the spread of infectious diseases that bring significant ecological and social-economic damage. Hence, the importance of food product safety is emphasized that is the issue of interest for many countries. To solve them, it’s necessary to conduct preventive measures against the diseases, have accurate diagnostic results, leadership, and management. The Peste des petits ruminants (PPR) disease is caused by a morbillivirus closely related to the rinderpest virus. PPR is a transboundary disease as it emerges and evolves, considered as one of the top most damaging animal diseases. The disease imposed a serious threat to sheep-breeding when the farms of sheep, goats are significantly growing within the country. In January 2016, PPR was detected in Georgia. Up to present the origin of the virus, the age relationship of affected ruminants and the distribution of PPRV in Georgia remains unclear. Due to the nature of PPR, and breeding practices in the country, reemerging of the disease in Georgia is highly likely. The purpose of the studies is to provide laboratories with efficient tools allowing the early detection of PPR emergence and re-emergences. This study is being accomplished under the Biological Threat Reduction Program project with the support of the Defense Threat Reduction Agency (DTRA). The purpose of the studies is to investigate the samples and identify areas at high risk of the disease. Georgia has a high density of small ruminant herds bred as free-ranging, close to international borders. Kakheti region, Eastern Georgia, will be considered as area of high priority for PPR surveillance. For this reason, in 2019, in Kakheti region investigated n=484 sheep and goat serum and blood samples from the same animals, utilized serology and molecular biology methods. All samples were negative by RT-PCR, and n=6 sheep samples were seropositive by ELISA-Ab. Future efforts will be concentrated in areas where the risk of PPR might be high such as international bordering regions of Georgia. For diagnostics, it is important to integrate the PPRV knowledge with epidemiological data. Based on these diagnostics, the relevant agencies will be able to control the disease surveillance.

Keywords: animal disease, especially dangerous pathogen, laboratory diagnostics, virus

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Authors: Mikailzade Parvin, Gurbanova Jamila, Alizade Samaya, Hasanova Afat

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It is known that in March 2020, the World Health Organization (WHO) declared a global pandemic of the 2019 coronovirus disease COVID-19, caused by the severe acute respiratory syndrome coronovirus (SARS-CoV-2). In this period, ensuring the safety of pregnancy and childbirth has become one of the necessary issues. The measures taken in this direction naturally consisted of strengthening and improving preventive measures among pregnant women. It should be noted that the lethality of SARS-CoV-2 infection among women reached 25%. The relevance of studying the effect of COVID-19 on reproductive health in women is due to its wide spread worldwide, severe clinical course, and the occurrence of numerous complications or lethality. It is of urgent importance to study the impact of the mentioned coronavirus infection on the health of pregnant women and the serious complications caused by it.Taking these into account, 230 pregnant women infected with the COVID-19 virus infection were registered. The average age of the pregnant women included in the study was: 29.24±6.0. The diagnosis of corona virus infection was made on the basis of polymerase chain reaction (PCR), serological tests (IgG, IgM). In 57.4% of cases, bilateral pneumonia was recorded in pregnant women and confirmed on the basis of radiological (RH) examination. RH examination revealed pneumonia with infiltrate in the lungs. Among clinical symptoms in pregnant women infected with COVID-19 virus infection: in 86 (37.4%) cases, symptoms such as high fever (t-39.0oC), shortness of breath, fatigue, and hypoxia were noted in pregnant women. A decrease in SpO2 to a minimal level was recorded. Laboratory-instrumental examinations were carried out. The obtained results showed: the average limit of D-dimer was 0.8±0.5; prothrombin time 13.2±1.1 seconds; INR 0.98±0.08, prothrombin index 104.3±19.5%, EHS - 34.8±13.6 mm/s. It should be noted that respiratory distress syndrome (RDS), premature birth, malformed and extremely malformed newborns, asphyxia or hypoxia have been reported in infants born to pregnant women infected with the coronavirus disease.Thus, from the obtained indicators, it is known that pregnant women infected with the virus have a high risk of serious illness and death for both themselves and their babies. It has been proven that the majority of babies born to SARS-CoV-2 positive mothers have a negative impact on their health.

Keywords: Covid 19, reproductive health, preqnancy, premature birth

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Authors: Mazoun Nasser Rashid Al Kharusi, Nada Al Siyabi

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Objectives: The main aim of this study is to Find the rate of susceptibility of ESBL E. coli causing UTI to oral antibiotics. Secondary objectives: Prevalence of ESBL E. coli from community urine samples, identify the best empirical oral antibiotics with the least resistance rate for UTI and identify alternative oral antibiotics for testing and utilization. Methods: This study is a retrospective descriptive study of the last three years in five major hospitals in Oman (Khowla Hospital, AN’Nahdha Hospital, Rustaq Hospital, Nizwa Hospital, and Ibri Hospital) equipped with a microbiologist. Inclusion criteria include all eligible outpatient urine culture isolates, excluding isolates from admitted patients with hospital-acquired urinary tract infections. Data was collected through the MOH database. The MOH hospitals are using different types of testing, automated methods like Vitek2 and manual methods. Vitek2 machine uses the principle of the fluorogenic method for organism identification and a turbidimetric method for susceptibility testing. The manual method is done by double disc diffusion for identifying ESBL and the disc diffusion method is for antibiotic susceptibility. All laboratories follow the clinical laboratory science institute (CLSI) guidelines. Analysis was done by SPSS statistical package. Results: Total urine cultures were (23048). E. coli grew in (11637) 49.6% of the urine, whereas (2199) 18.8% of those were confirmed as ESBL. As expected, the resistance rate to amoxicillin and cefuroxime is 100%. Moreover, the susceptibility of those ESBL-producing E. coli to nitrofurantoin, trimethoprim+sulfamethoxazole, ciprofloxacin and amoxicillin-clavulanate is progressing over the years; however, still low. ESBL E. coli was predominating in the female gender and those aged 66-74 years old throughout all the years. Other oral antibiotic options need to be explored and tested so that we add to the pool of oral antibiotics for ESBL E. coli causing UTI in the community. Conclusion: High rate of ESBL E. coli in urine from the community. The high resistance rates to oral antibiotics highlight the need for alternative treatment options for UTIs caused by these bacteria. Further research is needed to identify new and effective treatments for UTIs caused by ESBL-E. Coli.

Keywords: UTI, ESBL, oral antibiotics, E. coli, susceptibility

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Authors: Maria L. G. Lourenço, Keylla H. N. P. Pereira, Viviane Y. Hibaru, Fabiana F. Souza, João C. P. Ferreira, Simone B. Chiacchio, Luiz H. A. Machado

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Orphaned is a risk factor for mortality in newborns since it is a condition with total or partial absence of maternal care that is essential for neonatal survival, including nursing (nutrition, the transference of passive immunity and hydration), warmth, urination, and defecation stimuli, and protection. The most common causes of mortality in orphans are related to lack of assistance, handling mistakes and infections. This study aims to describe the orphans rates in neonatal puppies, the main causes, and the mortality rates. The study included 735 neonates admitted to the Sao Paulo State University (UNESP) Veterinary Hospital, Botucatu, Sao Paulo, Brazil, between January 2018 and November 2019. The orphans rate was 43.4% (319/735) of all neonates included, and the main causes for orphaned were related to maternal agalactia/hypogalactia (23.5%, 75/319); numerous litter (15.7%, 50/319), toxic milk syndrome due to maternal mastitis (14.4%, 46/319), absence of suction/weak neonate (12.2%, 39/319), maternal disease (9.4%, 30/319), cleft palate/lip (6.3%, 20/319), maternal death (5.9%, 19/319), prematurity (5.3%, 17/319), rejection/failure in maternal instinct (3.8%, 12/319) and abandonment by the owner/separation of mother and neonate (3.5%, 11/319). The main consequences of orphaned observed in the admitted neonates were hypoglycemia, hypothermia, dehydration, aspiration pneumonia, wasting syndrome, failure in the transference of passive immunity, infections and sepsis, which happened due to failure of identifying the problem early, lack of adequate assistance, negligence and handling mistakes by the owner. The total neonatal mortality rate was 8% (59/735) and the neonatal mortality rate among orphans was 18.5% (59/319). The orphaned and mortality rates were considered high, but even higher rates may be observed in locations without adequate neonatal assistance and owner orientation. The survival of these patients is related to constant monitoring of the litter, early diagnosis and assistance, and the implementation of effective handling for orphans. Understanding the correct handling for neonates and instructing the owners regarding proper handling are essential to minimize the consequences of orphaned and the mortality rates.

Keywords: orphans, neonatal care, puppies, newborn dogs

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Authors: Alisha M. Ebrahim, Bijoy K. Menon, Eddy Lang, Shelagh B. Coutts, Katie Lin

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Introduction: Frontline emergency physicians require clear and evidence-based approaches to guide neuroimaging investigations for patients presenting with suspected acute stroke or transient ischemic attack (TIA). Various forms of computed tomography (CT) are currently available for initial investigation, including non-contrast CT (NCCT), CT angiography head and neck (CTA), and CT perfusion (CTP). However, there is uncertainty around optimal imaging choice for cost-effectiveness, particularly for minor or resolved neurological symptoms. In addition to the cost of CTA and CTP testing, there is also a concern for increased incidental findings, which may contribute to the burden of overdiagnosis. Methods: In this cross-sectional observational study, analysis was conducted on 586 anonymized triage and diagnostic imaging (DI) reports for neuroimaging orders completed on patients presenting to adult emergency departments (EDs) with a suspected stroke or TIA from January-December 2019. The primary outcome of interest is the diagnostic yield of NCCT+CTA compared to NCCT alone for patients presenting to urban academic EDs with Canadian Emergency Department Information System (CEDIS) complaints of “symptoms of stroke” (specifically acute stroke and TIA indications). DI reports were coded into 4 pre-specified categories (endorsed by a panel of stroke experts): no abnormalities, clinically significant findings (requiring immediate or follow-up clinical action), incidental findings (not meeting prespecified criteria for clinical significance), and both significant and incidental findings. Standard descriptive statistics were performed. A two-sided p-value <0.05 was considered significant. Results: 75% of patients received NCCT+CTA imaging, 21% received NCCT alone, and 4% received NCCT+CTA+CTP. The diagnostic yield of NCCT+CTA imaging for prespecified clinically significant findings was 24%, compared to only 9% in those who received NCCT alone. The proportion of incidental findings was 30% in the NCCT only group and 32% in the NCCT+CTA group. CTP did not significantly increase the yield of significant or incidental findings. Conclusion: In this cohort of patients presenting with suspected stroke or TIA, an NCCT+CTA neuroimaging strategy had a higher diagnostic yield for clinically significant findings than NCCT alone without significantly increasing the number of incidental findings identified.

Keywords: stroke, diagnostic yield, neuroimaging, emergency department, CT

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Authors: Shian Guan, Marie Bourdin, Isabelle Trenque, Younes Messaddeq, Thierry Cardinal, Nicolas Penin, Issam Mjejri, Aline Rougier, Etienne Duguet, Stephane Mornet, Manuel Gaudon

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At the interface of the studies performed by 3 Ph.D. students: Shian Guan (2017-2020), Marie Bourdin (2016-2019) and Isabelle Trenque (2012-2015), a single synthesis route: polyol-mediated process, was used with success for the preparation of different inorganic oxides. Both of these inorganic oxides were elaborated for their potential application as smart optical compounds. This synthesis route has allowed us to develop nanoparticles of zinc oxide, vanadium oxide or tungsten oxide. This route is with easy implementation, inexpensive and with large-scale production potentialities and leads to materials of high purity. The obtaining by this route of nanometric particles, however perfectly crystalline, has notably led to the possibility of doping these matrix materials with high doping ion concentrations (high solubility limits). Thus, Al3+ or Ga3+ doped-ZnO powder, with high doping rate in comparison with the literature, exhibits remarkable infrared absorption properties thanks to their high free carrier density. Note also that due to the narrow particle size distribution of the as-prepared nanometric doped-ZnO powder, the original correlation between crystallite size and unit-cell parameters have been established. Also, depending on the annealing atmosphere use to treat vanadium precursors, VO2, V2O3 or V2O5 oxides with thermochromic or electrochromic properties can be obtained without any impurity, despite the versatility of the oxidation state of vanadium. This is of more particular interest on vanadium dioxide, a relatively difficult-to-prepare oxide, whose first-order metal-insulator phase transition is widely explored in the literature for its thermochromic behavior (in smart windows with optimal thermal insulation). Finally, the reducing nature of the polyol solvents ensures the production of oxygen-deficient tungsten oxide, thus conferring to the nano-powders exotic colorimetric properties, as well as optimized photochromic and electrochromic behaviors.

Keywords: inorganic oxides, electrochromic, photochromic, thermochromic

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Authors: Ju Peng Poh, Jun Yu Charles Lee, Jonathan Chew Hoe Khoo

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The emergence of digital twin technology, a digital replica of physical world, has improved the real-time access to data from sensors about the performance of buildings. This digital transformation has opened up many opportunities to improve the management of the building by using the data collected to help monitor consumption patterns and energy leakages. One example is the integration of predictive models for anomaly detection. In this paper, we use the GAM (Generalised Additive Model) for the anomaly detection of Air Handling Units (AHU) power consumption pattern. There is ample research work on the use of GAM for the prediction of power consumption at the office building and nation-wide level. However, there is limited illustration of its anomaly detection capabilities, prescriptive analytics case study, and its integration with the latest development of digital twin technology. In this paper, we applied the general GAM modelling framework on the historical data of the AHU power consumption and cooling load of the building between Jan 2018 to Aug 2019 from an education campus in Singapore to train prediction models that, in turn, yield predicted values and ranges. The historical data are seamlessly extracted from the digital twin for modelling purposes. We enhanced the utility of the GAM model by using it to power a real-time anomaly detection system based on the forward predicted ranges. The magnitude of deviation from the upper and lower bounds of the uncertainty intervals is used to inform and identify anomalous data points, all based on historical data, without explicit intervention from domain experts. Notwithstanding, the domain expert fits in through an optional feedback loop through which iterative data cleansing is performed. After an anomalously high or low level of power consumption detected, a set of rule-based conditions are evaluated in real-time to help determine the next course of action for the facilities manager. The performance of GAM is then compared with other approaches to evaluate its effectiveness. Lastly, we discuss the successfully deployment of this approach for the detection of anomalous power consumption pattern and illustrated with real-world use cases.

Keywords: anomaly detection, digital twin, generalised additive model, GAM, power consumption, supervised learning

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Authors: Toshiki Ito, Takahiro Yamane, Yuki Adachi, Yoshiko Kato, Eiji Tsuda, Kousaku Nagasaka, Keigo Yoshida, Yoshiko Kawasaki, Naoki Aizawa, Kyouhei Nishi, Tetsuko Kato

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The epidemic of the coronavirus (COVID-19), first reported in Wuhan at the end of 2019, has drastically changed our daily lives. Under these circumstances, counseling, which provides psychological support to people, was also greatly affected. The structure of counseling, which had generally been implicitly common practice to be conducted in person, was greatly shaken. The author wondered how counseling can be conducted in situations where it is impossible to meet face-to-face. This is where telepsychological support (online counseling) came into use. The authors found that there were the following problems in telepsychological support: (1) anxiety about whether the communication is appropriate, (2) difficulty in understanding the client's situation and condition, (3) inability to perceive what was normally perceived in person, (4) difficulty in adjusting to severely ill clients, (5) difficulty in dealing with emergency situations, etc. In this study, we interviewed psychologists who had been accustomed to telepsychological support for more than two years after the Corona disaster began to clarify how they had or had not overcome the problems of telepsychological support identified in the above studies. We also aim to consider the unique possibilities of how telepsychological support, a new technique of psychological support, can be implemented to provide more effective and meaningful support in society after the end of the Corona disaster (post-Corona society). Thirteen psychologists who are currently providing telepsychological support in the Corona Disaster will be interviewed, and semi-structured interviews will be conducted for one hour per person. In order to empirically examine how the problems in telepsychological support had been overcome or not through the interview survey, the authors asked (1) how they overcame their anxiety about whether they were able to communicate appropriately, (2) how they devised ways to overcome it, (3) how they overcame the difficulty in adapting to heavy clients in terms of the level of the disease, (4) how they overcame the difficulty in dealing with emergency situations. The interviews were analyzed using Thematic Analysis, a qualitative analysis method commonly used in qualitative research overseas. The authors found that some devices and perspectives were newly discovered as a result of two years of practice of telepsychological support and that psychologists in this study considered face-to-face interviews and telepsychological support to be separate and were flexible enough to use them when available and to move to face-to-face interviews when not appropriate.

Keywords: telepsychology, COVID-19, Corona, psychologist

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Authors: Yori Gidron, Maartje Mol, Norbert Foudraine, Frits Van Osch, Joop Van Den Bergh, Moshe Farchi, Maud Straus

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Background: The worldwide pandemic of severe acute respiratory syndrome coronavirus 2 (SARS-COV2), which began in 2019, also known as Covid-19, has infected over 136 million people and tragically took the lives of over 2.9 million people worldwide. Many of the complications and deaths are predicted by the inflammatory “cytokine storm.” One way to progress in the prevention of death is by finding a predictive and protective factor that inhibits inflammation, on the one hand, and which also increases anti-viral immunity on the other hand. The vagal nerve does precisely both actions. This study examined whether vagal nerve activity, indexed by heart-rate variability (HRV), predicts survival in patients with Covid-19. Method: We performed a pseudo-prospective study, where we retroactively obtained ECGs of 271 Covid-19 patients arriving at a large regional hospital in The Netherlands. HRV was indexed by the standard deviation of the intervals between normal heartbeats (SDNN). We examined patients’ survival at 3 weeks and took into account multiple confounders and known prognostic factors (e.g., age, heart disease, diabetes, hypertension). Results: Patients’ mean age was 68 (range: 25-95) and nearly 22% of the patients had died by 3 weeks. Their mean SDNN (17.47msec) was far below the norm (50msec). Importantly, relatively higher HRV significantly predicted a higher chance of survival, after statistically controlling for patients’ age, cardiac diseases, hypertension and diabetes (relative risk, H.R, and 95% confidence interval (95%CI): H.R = 0.49, 95%CI: 0.26 – 0.95, p < 0.05). However, since HRV declines rapidly with age and since age is a profound predictor in Covid-19, we split the sample by median age (40). Subsequently, we found that higher HRV significantly predicted greater survival in patients older than 70 (H.R = 0.35, 95%CI: 0.16 – 0.78, p = 0.01), but HRV did not predict survival in patients below age 70 years (H.R = 1.11, 95%CI: 0.37 – 3.28, p > 0.05). Conclusions: To the best of our knowledge, this is the first study showing that higher vagal nerve activity, as indexed by HRV, is an independent predictor of higher chances for survival in Covid-19. The results are in line with the protective role of the vagal nerve in diseases and extend this to a severe infectious illness. Studies should replicate these findings and then test in controlled trials whether activating the vagus nerve may prevent mortality in Covid-19.

Keywords: Covid-19, heart-rate Variability, prognosis, survival, vagal nerve

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Authors: Magdalena Barbara Kaziuk

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Introduction: In December 2019, the first case of an acute infectious disease of the respiratory system caused by the SARS-CoV-2 virus was recorded in Wuhan in Central China. On March 11, 2020, the World Health Organization restrictions, among others, in the travel industry. Aim: The aim of the study was the assessment of the preparedness of European cultural institutions and catering establishments within the sanitary and epidemiological dimension during the COVID-19 pandemic by Polish tourists and their sense of safety in selected destinations. Material and methods: The study involved 300 Polish tourists (125 females, 175 males, age 46.5+/-12.9 years) who traveled during the COVID-19 pandemic to Southern European countries. 5 most popular travel destinations were selected: Italy, Austria, Greece, Croatia, and Mediterranean islands. The tourists assessed cultural institutions and catering establishments with the use of a proprietary questionnaire which concerned the preparedness regarding the sanitary and epidemiological requirements and the tourists' sense of safety. The number of respondents was deliberate - 60 persons per each country. Results: The more stringent sanitary regimes, the higher the sense of safety in the study group of females aged 45-50 (p<0.005), while the more stringent sanitary and epidemiological issues are implemented, the shorter the stay (p<0.001). Less stringent restrictions resulted in increased sense of freedom and mental rest in the group of studied males (p<0.005). Conclusions: The respondents' opinions revealed that the highest level of safety with regard to sanitary and epidemiological requirements (masks covering mouth and nose worn by both personnel and society, the necessity to present the COVID passport, the possibility to disinfect hands) was observed in Austria and Italy, while shorter length of the stay in these countries resulted from high prices, particularly in catering establishments. According to the respondents, less stringent restrictions, among others lack of the necessity to own the COVID passport, were linked to Croatia and Mediterranean islands. The sense of safety was satisfying, while the sense of freedom and mental rest was high. declared a string of COVID-19 cases a pandemic. Most countries implemented numerous sanitary and epidemiological

Keywords: sanitary and epidemiological regimes, tourist facilities, COVID-19 pandemic, sense of safety

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Authors: S. Jigna, K. Nanda Kumar, T. Anna

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Being a major contributor to the Indian economy and a critical facilitator for the country’s digital India vision, the Indian telecommunications industry is also a major source of employment for the country. Since the last few years, the Indian telecommunication service providers (TSPs), however, are facing business challenges related to increasing competition, losses, debts, and decreasing revenue. The strategic use of digital technologies for a successful digital transformation has the potential to equip organizations to meet these business challenges. Despite an increased focus on digital transformation, the telecom service providers globally, including Indian TSPs, have seen limited success so far. The purpose of this research was thus to identify the factors that are critical for the digital transformation and to what extent they influence the successful digital transformation of the Indian TSPs. The literature review of more than 300 digital transformation-related articles, mostly from 2013-2019, demonstrated a lack of an empirical model consisting of factors for the successful digital transformation of the TSPs. This study theorizes a research framework grounded in multiple theories, and a research model consisting of 7 constructs that may be influencing business success during the digital transformation of the organization was proposed. The questionnaire survey of senior managers in the Indian telecommunications industry was seeking to validate the research model. Based on 294 survey responses, the validation of the Structural equation model using the statistical tool ADANCO 2.1.1 was found to be robust. Results indicate that Digital Capabilities, Digital Strategy, and Corporate Level Data Strategy in that order has a strong influence on the successful Business Performance, followed by IT Function Transformation, Digital Innovation, and Transformation Management respectively. Even though Digital Organization did not have a direct significance on Business Performance outcomes, it had a strong influence on IT Function Transformation, thus affecting the Business Performance outcomes indirectly. Amongst numerous practical and theoretical contributions of the study, the main contribution for the Indian TSPs is a validated reference for prioritizing the transformation initiatives in their strategic roadmap. Also, the main contribution to the theory is the possibility to use the research framework artifact of the present research for quantitative validation in different industries and geographies.

Keywords: corporate level data strategy, digital capabilities, digital innovation, digital strategy

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Authors: Mohammadjavad Sotoudeheian

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COVID-19, which began in December 2019, uses the angiotensin-converting enzyme 2 (ACE2) receptor to enter and spread through the cells. ACE2 mRNA is present in almost every organ, including nasopharynx, lung, as well as the brain. Ports of entry of SARS-CoV-2 into the central nervous system (CNS) may include arterial circulation, while viremia is remarkable. However, it is imperious to develop neurological symptoms evaluation CSF analysis in patients with COVID-19, but theoretically, ACE2 receptors are expressed in cerebellar cells and may be a target for SARS-CoV-2 infection in the brain. Recent evidence agrees that SARS-CoV-2 can impact the brain through direct and indirect injury. Two biomarkers for CNS injury, glial fibrillary acidic protein (GFAP) and neurofilament light chain (NFL) detected in the plasma of patients with COVID-19. NFL, an axonal protein expressed in neurons, is related to axonal neurodegeneration, and GFAP is over-expressed in CNS inflammation. GFAP cytoplasmic accumulation causes Schwan cells to misfunction, so affects myelin generation, reduces neuroskeletal support over NfLs during CNS inflammation, and leads to axonal degeneration. Interleukin-6 (IL-6), which extensively over-express due to interleukin storm during COVID-19 inflammation, regulates gene expression, as well as GFAP through STAT molecular pathway. IL-6 also impresses the phosphoinositide 3-kinase (PI3K)/STAT/smads pathway. The PI3K/ protein kinase B (Akt) pathway is the main modulator upstream of the mammalian target of rapamycin (mTOR), and alterations in this pathway are common in neurodegenerative diseases. Most neurodegenerative diseases show a disruption of autophagic function and display an abnormal increase in protein aggregation that promotes cellular death. Therefore, induction of autophagy has been recommended as a rational approach to help neurons clear abnormal protein aggregates and survive. The mTOR is a major regulator of the autophagic process and is regulated by cellular stressors. The mTORC1 pathway and mTORC2, as complementary and important elements in mTORC1 signaling, have become relevant in the regulation of the autophagic process and cellular survival through the extracellular signal-regulated kinase (ERK) pathway.

Keywords: mTORC1, COVID-19, PI3K, autophagy, neurodegeneration

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Authors: Milton Ixquiac, Erick Montenegro, Francisco Reynoso, Matthew Schmidt, Thomas Mazur, Tianyu Zhao, Hiram Gay, Geoffrey Hugo, Lauren Henke, Jeff Michael Michalski, Angel Velarde, Vicky de Falla, Franky Reyes, Osmar Hernandez, Edgar Aparicio Ruiz, Baozhou Sun

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Purpose: Radiotherapy departments in low- and middle-income countries (LMICs) like Guatemala have recently introduced intensity-modulated radiotherapy (IMRT). IMRT has become the standard of care in high-income countries (HIC) due to reduced toxicity and improved outcomes in some cancers. The purpose of this work is to show the agreement between the dosimetric results shown in the Dose Volume Histograms (DVH) to the objectives proposed in the adopted protocol. This is the initial experience with an O-ring Linac. Methods and Materials: An O-Linac Linac was installed at our clinic in Guatemala in 2019 and has been used to treat approximately 90 patients daily with IMRT. This Linac is a completely Image Guided Device since to deliver each radiotherapy session must take a Mega Voltage Cone Beam Computerized Tomography (MVCBCT). In each MVCBCT, the Linac deliver 9 UM, and they are taken into account while performing the planning. To start the standardization, the TG263 was employed in the nomenclature and adopted a hypofractionated protocol to treat ChestWall, including supraclavicular nodes achieving 40.05Gy in 15 fractions. The planning was developed using 4 semiarcs from 179-305 degrees. The planner must create optimization volumes for targets and Organs at Risk (OARs); the difficulty for the planner was the dose base due to the MVCBCT. To evaluate the planning modality, we used 30 chestwall cases. Results: The plans created manually achieve the protocol objectives. The protocol objectives are the same as the RTOG1005, and the DHV curves look clinically acceptable. Conclusions: Despite the O-ring Linac doesn´t have the capacity to obtain kv images, the cone beam CT was created using MV energy, the dose delivered by the daily image setup process still without affect the dosimetric quality of the plans, and the dose distribution is acceptable achieving the protocol objectives.

Keywords: hypofrationation, VMAT, chestwall, radiotherapy planning

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Authors: Morteza Esfandiari, Shabnam Jabari, Heather MacGrath, David Coleman

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Flood is a severe issue in different places in the world as well as the city of Fredericton, New Brunswick, Canada. The downtown area of Fredericton is close to the Saint John River, which is susceptible to flood around May every year. Recently, the frequency of flooding seems to be increased, especially after the fact that the downtown area and surrounding urban/agricultural lands got flooded in two consecutive years in 2018 and 2019. In order to have an explicit vision of flood span and damage to affected areas, it is necessary to use either flood inundation modelling or satellite data. Due to contingent availability and weather dependency of optical satellites, and limited existing data for the high cost of hydrodynamic models, it is not always feasible to rely on these sources of data to generate quality flood maps after or during the catastrophe. Height Above the Nearest Drainage (HAND), a state-of-the-art topo-hydrological index, normalizes the height of a basin based on the relative elevation along with the stream network and specifies the gravitational or the relative drainage potential of an area. HAND is a relative height difference between the stream network and each cell on a Digital Terrain Model (DTM). The stream layer is provided through a multi-step, time-consuming process which does not always result in an optimal representation of the river centerline depending on the topographic complexity of that region. HAND is used in numerous case studies with quite acceptable and sometimes unexpected results because of natural and human-made features on the surface of the earth. Some of these features might cause a disturbance in the generated model, and consequently, the model might not be able to predict the flow simulation accurately. We propose to include a previously existing stream layer generated by the province of New Brunswick and benefit from culvert maps to improve the water flow simulation and accordingly the accuracy of HAND model. By considering these parameters in our processing, we were able to increase the accuracy of the model from nearly 74% to almost 92%. The improved model can be used for generating highly accurate flood maps, which is necessary for future urban planning and flood damage estimation without any need for satellite imagery or hydrodynamic computations.

Keywords: HAND, DTM, rapid floodplain, simplified conceptual models

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Authors: Cengiz Akyildiz, Ismail Ekmekci

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In the past 15 years, many people have sought refuge and emigrated to developed countries due to the civil war in Syria, terrorism and turmoil in Iraq, Iran and Afghanistan, hunger problems in Africa and the purpose of work. Many of these people came to Turkey. By the end of the 2019, in Turkey, regular and irregular migrants, asylum seekers and foreigners under international protection are about 6 million people. The majority of these people are Syrians. Approximately 2 800 000 immigrants and refugees are in the workforce. Migrant workers in our country constitute the largest proportion among all countries in the world according to the local labor force. 2.5 million of these employees, with a high rate of about 90%, work informally and do not have legal records and valid employment contracts as a workforce; They cannot benefit from Occupational Health and Safety (OHS) services. Migrant workers generally receive less wages than local workers, working longer hours and worse conditions; they are often subjected to human rights violations, harassment, human trafficking and violence. Migrant workers face problems such as OHS practices, environmental and occupational exposures, language / cultural barriers, access to health services, and lack of documentation. Therefore, the OHS problems of these employees are becoming an increasingly problematic area. However, there is not enough research, analysis and academic studies in this field. The order of importance should be known for the radical solution of the problems, because of the problems with high severity are also at high risk. In this study, for the first time, a Search Conference was held with the participation of 45 stakeholders to reveal the OHS problems of regular and irregular migrant workers in our country. The problems arising from this workshop were compared with the problems in the literature and the problems in this field were determined and weighted for our country. Later, to determine the significance levels of these problems, AHP study, which is a Multi Criteria Decision Making Method in which 15 experts participated, was conducted and the significance levels of these problems were determined. When the data obtained are evaluated, it has been seen that the OSH risks of migrant workers arise from 58% laws and government policies, 29% from employers, 13% from personal faults of employees. An academic study has been carried out for the first time in this field regarding the OHS problems of migrant workers, and an academic study has been created to guide which of the problems should be prioritized.

Keywords: environmental conditions, migrant workers, OHS issues, workplace conditions

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Authors: Anna Rudzińska, Katarzyna Szklener, Pola Juchaniuk, Anna Rodzajweska, Katarzyna Machulska-Ciuraj, Monika Rychlik- Grabowska, Michał łOziński, Agnieszka Kolak-Bruks, SłAwomir Mańdziuk

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Introduction: Immune checkpoint inhibition (ICI) belongs to the modern forms of anti-cancer treatment. Due to the constant development and continuous research in the field of ICI, many aspects of the treatment are yet to be discovered. One of the less researched aspects of ICI treatment is the influence of the adverse effects on the treatment success rate. It is suspected that adverse events in the course of the ICI treatment indicate a better response rate and correlate with longer progression-free- survival. Methodology: The research was conducted with the usage of the documentation of the Department of Clinical Oncology and Chemotherapy. Data of the patients with a lung cancer diagnosis who were treated between 2019-2022 and received ICI treatment were analyzed. Results: Out of over 133 patients whose data was analyzed, the vast majority were diagnosed with non-small cell lung cancer. The majority of the patients did not experience adverse effects. Most adverse effects reported were classified as grade 1 or grade 2 according to CTCAE classification. Most adverse effects involved skin, thyroid and liver toxicity. Statistical significance was found for the adverse effect incidence and overall survival (OS) and progression-free survival (PFS) (p=0,0263) and for the time of toxicity onset and OS and PFS (p<0,001). The number of toxicity sites was statistically significant for prolonged PFS (p=0.0315). The highest OS was noted in the group presenting grade 1 and grade 2 adverse effects. Conclusions: Obtained results confirm the existence of the prolonged OS and PFS in the adverse-effects-charged patients, mostly in the group presenting mild to intermediate (Grade 1 and Grade 2) adverse effects and late toxicity onset. Simultaneously our results suggest a correlation between treatment response rate and the toxicity grade of the adverse effects and the time of the toxicity onset. Similar results were obtained in several similar research conducted - with the proven tendency of better survival in mild and moderate toxicity; meanwhile, other studies in the area suggested an advantage in patients with any toxicity regardless of the grade. The contradictory results strongly suggest the need for further research on this topic, with a focus on additional factors influencing the course of the treatment.

Keywords: adverse effects, immunotherapy, lung cancer, PD-1/PD-L1 inhibitors

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Authors: Rory Brown, Jessica Daniels, Babatunde Oremule, William Tsang, Sadie Khwaja

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Introduction: Dentures are common and are an intervention for both physical and psychological symptoms associated with tooth loss. However, the humble denture can cause morbidity and mortality if swallowed or aspirated. Numerous case reports document complications including hollow viscus perforation, fistula formation and airway compromise. The purpose of this review was to examine the literature documenting cases of swallowed or aspirated dentures over the past ten years to investigate factors that contribute to developing complications. Methods: A Medline literature search was performed to identify cases of denture ingestion or aspiration for over ten years. Data was collected to include patient, appliance and temporal factors that may contribute to developing complications including hollow viscus perforation, fistula formation, abscess, bowel obstruction, necrosis, hemorrhage and airway obstruction. The data was analyzed using observational and inferential statistics in the form of Chi-Squared and Pearson correlation tests. Results: Eighty-five cases of ingested or aspirated dentures were identified from 77 articles published between 1/10/2009 and 31/10/2019. Fourteen articles were excluded because they did not provide sufficient information on individual cases. Complications were documented in 37.6% of patients, and 2 cases resulted in death. There was no significant difference in complication risk based on patient age, hooked appliance, level of impaction, or radiolucency. However, symptoms of greater than 1-day duration are associated with an increased risk of complication (p=0.005). Increased time from ingestion or aspiration to removal is associated with an increased risk of complications, and the p-value remains significant up to and including day 4 (p=0.017). Conclusions: With denture use predicted to rise complications from the denture, ingestion and aspiration may become more frequent. We have demonstrated that increased symptom duration significantly increases the risk of developing complications. Additionally, we established the risk of developing complications is significantly reduced if the denture is removed with four days of aspiration or ingestion. By actively intervening early when presented with a case of swallowed or aspirated dentures, we may be able to reduce the morbidity associated with this unassuming device.

Keywords: aspiration, denture, ingestion, endoscopic foreign, body removal, foreign body impaction

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Authors: Mohamad Ammar Ayass, Natalya Griko, Victor Pashkov, Wanying Cao, Kevin Zhu, Jin Zhang, Lina Abi Mosleh

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Respiratory syndrome coronavirus 2 (SARS-CoV-2) is the causative agent for coronavirus disease 2019 (COVID-19). Early evidence pointed at the angiotensin-converting enzyme 2 (ACE-2) expressed on the epithelial cells of the lung as the main entry point of SARS-CoV-2 into the cells. The viral entry is mediated by the binding of the Receptor Binding Domain (RBD) of the spike protein that is expressed on the surface of the virus to the ACE-2 receptor. As the number of SARS-CoV-2 variants continues to increase, mutations arising in the RBD of SARS-CoV-2 may lead to the ineffectiveness of RBD targeted neutralizing antibodies. To address this limitation, the objective of this study is to develop a combination of aptamers that target different regions of the RBD, preventing the binding of the spike protein to ACE-2 receptor and subsequent viral entry and replication. A safe and innovative biomedical tool was developed to inhibit viral infection and reduce the harms of COVID-19. In the present study, DNA aptamers were developed against a recombinant trimer S protein using the Systematic Evolution of Ligands by Exponential enrichment (SELEX). Negative selection was introduced at round number 7 to select for aptamers that bind specifically to the RBD domain. A series of 9 aptamers (ADI2010, ADI2011, ADI201L, ADI203L, ADI205L, ADIR68, ADIR74, ADIR80, ADIR83) were selected and characterized with high binding affinity and specificity to the RBD of the spike protein. Aptamers (ADI25, ADI2009, ADI203L) were able to bind and pull down endogenous spike protein expressed on the surface of SARS-CoV-2 virus in COVID-19 positive patient samples and determined by liquid chromatography- tandem mass spectrometry analysis (LC-MS/MS). LC-MS/MS data confirmed that aptamers can bind to the RBD of the spike protein. Furthermore, results indicated that the combination of the 9 best aptamers inhibited the binding of the purified trimer spike protein to the ACE-2 receptor found on the surface of Vero E6 cells. In the same experiment, the combined aptamers displayed a better neutralizing effect than antibodies. The data suggests that the selected aptamers could be used in therapy to neutralize the effect of the SARS-CoV-2 virus by inhibiting the interaction between the RBD and ACE-2 receptor, preventing viral entry into target cells and therefore blocking viral replication.

Keywords: aptamer, ACE-2 receptor, binding inhibitor, COVID-19, spike protein, SARS-CoV-2, treatment

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Authors: Aaron Kim, Nydia Hernandez

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Despite the known deficits in sleep duration among adolescents and the increasing prevalence of substance use behaviors among this group, relatively little is known about how insufficient sleep is related to various substance use behaviors and the underlying mechanisms. Informed by the literature suggesting the predictive role of insufficient sleep for substance use and depressive symptoms, we hypothesized that adolescents who lack sufficient sleep during school nights would report a higher level of depressive symptoms and substance use than their counterparts with sufficient sleep. We also hypothesized that depressive symptoms would explain the association of insufficient sleep with substance use, suggesting that mental health plays an important role as a mechanism between insufficient sleep and substance use. This study used the data drawn from the 2019 Youth Risk Behavior Surveillance System Data, which includes a nationally representative sample of U.S. high school students (N=13,677, 49.4% Female, 9th-12th graders). Self-report measures of insufficient sleep (sleeping<7 h on an average school night), depressive symptoms (yes/no), any past 30-day use of cigarette (yes/no), e-cigarette (yes/no), alcohol (yes/no), and marijuana (yes/no). Among the total sample, 47.9% of students reported that they did not have sufficient sleep on school nights, indicating sleeping less than 7 hours. Regarding depressive symptoms, 36.7% of students reported feeling sad or hopeless almost every day for two weeks or more in a row during the past 12 months. Also, the percentages of students who reported one or more times of cigarette use, e-cigarette use, alcohol use, and marijuana use in the past month were 5.32%, 30.11%, 26.83%, and 21.65%, respectively. For bivariate associations among these study variables, insufficient sleep was positively associated with other variables: depressive symptoms (r=.08, p<.001), cigarette use (r=.03, p<.001), e-cigarette use (r=.04, p<.001), alcohol use (r=.07, p<.001), and marijuana use (r=.08, p<.001). After controlling for students’ characteristics (i.e., age, gender, race/ethnicity, grades), sleeping less than 7 hours on school nights (vs. sleeping more than 7 hours) was significantly associated with the past 30-day use of alcohol and marijuana, whereas cigarette and e-cigarette uses were not. That is, the students who reported having an insufficient sleep on school nights had higher odds of alcohol (Odds Ratio [OR]=1.15, 95% Confidence Interval [CI]=1.014-1.301) and marijuana use (OR=1.36, 95% CI=1.132-1.543). In a subsequent analysis including depressive symptoms together with insufficient sleep, the association of insufficient sleep with alcohol use (OR=1.13, 95% CI=1.011-1.297) and marijuana use (OR=1.33, 95% CI=1.130-1.521) were attenuated and explained by depressive symptoms. Depressive symptoms significantly increased the odds of alcohol use by 32.2% (OR=1.32, 95% CI=1.131-1.557) and marijuana use by 202.1% (OR=2.02, 95% CI=1.672-2.502). These findings together suggest that insufficient sleep may contribute to increased risks of substance uses among adolescents. The current study also shows that psychological disorders of adolescents play important roles in understanding the association between insufficient sleep and substance use, suggesting insufficient sleep is related to substance use indirectly through depressive symptoms. This study indicates the importance of sleep deprivation among adolescents and screening for insufficient sleep in preventing/intervening in substance use.

Keywords: adolescents, depressive symptoms, sleep, substance use

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Authors: Sidra Suleman, Maliha Suleman, Jinesh Shah

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Maxillary canines play a crucial role in occlusion and aesthetics. Successful management of impacted canines requires early identification and intervention to prevent complications such as resorption of adjacent teeth and cystic changes. Although removal of the deciduous canine can encourage normal eruption of its successor, this is not always successful. Some patients may require surgical exposure and bonding of a gold chain to mobilise and align the canine, which can take up to 3 years. As this procedure has various risks, patients need to be appropriately consented to. Failure of such treatment commonly occurs due to inadequate anchorage or failure of the gold chain attachment, but in some cases, this is due to ankylosis. Aim: The aim of this study was to determine the incidence of ankylosis of unerupted maxillary ectopic canines following surgical exposure and orthodontic alignment at the Maxillofacial and Orthodontic Department, Royal Stoke University Hospital (RSUH), United Kingdom. Methodology: Patients treated from January 1, 2017, to December 31, 2019, were retrospectively studied. Electronic records with post-treatment follow-up at 3-6 months and 12-15 months were extracted and analysed. Patients were excluded based on three criteria, non-compliance with orthodontic treatment post-surgery, presence of canine transposition, and external orthodontic treatment. Sample: Overall, 159 suitable patients were selected from the 171 patients identified. Surgical exposure and gold chain bonding was carried out for a total of 206 maxillary canines, with the pattern of impaction being 159 (77.2 %) palatal, 46 (22.3%) buccal, and 1 (0.49%) in line of the arch. The sample consisted of 57 (35.8%) males and 102 (64.2%) females between the age range of 10 to 32 years, with the mean age being 15 years. The procedures were carried out under general anaesthesia for all but three patients, with two cases being repeats. Closed exposure was carried out for 189 (91.7%) canines. Results: The incidence of ankylosis from this study was 0.97%. In total, two patients had upper left canine ankylosis, which was identified at their 12-15 months orthodontic follow-up. Both patients were males, one having closed exposure at age 15 and the other having open exposure at age 19. Conclusions: Although this data shows that there is a low risk of ankylosis (0.97%), it highlights the difficulty in predicting which patients may be affected, and thus, a thorough pre-treatment assessment and careful observation during treatment is necessary. Future studies involving larger cohorts are warranted to further analyse factors affecting outcomes.

Keywords: ankylosis, ectopic, maxillary canines, orthodontics

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Authors: Miguel Limbert Ramos, Joseph Amado Galvez

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Background: The nasal septal cartilage is an autologous graft that is widely used in different otolaryngologic procedures of the different subspecialties, such as in septorhinoplasty and ear rehabilitation procedures. The cartilage can be easily accessed and harvested to be utilized for such procedures. However, the dimension of the nasal septal cartilage differs, corresponding to race, gender, and age. Measurements can be done via direct measurement of harvested septal cartilage in cadavers or utilizing radiographic imaging studies giving baseline measurement of the nasal septal cartilage distinct to every race. A preliminary baseline measurement of the dimensions of Filipino nasal septal cartilage was previously established by measuring harvested nasal septal cartilage in Filipino Malay cadavers. This study intends to reinforce this baseline measurement by utilizing computed tomography (CT) scans of adult Filipinos in a tertiary government hospital in the City of Manila, Philippines, which will cover a larger sampling population. Methods: The unit of observation and analysis will be the computed tomography (CT) scans of patients ≥ 18years old who underwent cranial, facial, orbital, paranasal sinus, and temporal bone studies for the year 2019. The measurements will be done in a generated best midsagittal image (155 subjects) which is a view through the midline of the cerebrum that is simultaneously viewed with its coronal and axial views for proper orientation. The view should reveal important structures that will be used to plot the anatomic boundaries, which will be measured by a DICOM image viewing software (RadiAnt). The measured area of nasal septal cartilage will be compared by gender and age. Results: The total area of the nasal septal cartilage is larger in males compared to females, with a mean value of 6.52 cm² and 5.71 cm², respectively. The harvestable nasal septal cartilage area is also larger in males with a mean value of 3.57 cm² compared to females with only a measured mean value of 3.13 cm². The total and harvestable area of the nasal septal cartilage is largest in the 18-30 year-old age group with a mean value of 6.47 cm² and 3.60 cm² respectively and tends to decrease with the advancement of age, which can be attributed to continuous ossification changes. Conclusion: The best time to perform septorhinoplasty and other otolaryngologic procedures which utilize the nasal septal cartilage as graft material is during post-pubertal age, hence surgeries should be avoided or delayed to allow growth and maturation of the cartilage. A computed tomography scan is a cost-effective and non-invasive tool that can provide information on septal cartilage areas prior to these procedures.

Keywords: autologous graft, computed tomography, nasal septal cartilage, septorhinoplasty

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Authors: Christian Skowronski, Andrew Shanholtzer, Brent Yelton, Muayad Almahariq, Daniel J. Krauss

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Prostate cancer has the third highest incidence rate and is the second leading cause of cancer death for men in the United States. Of the diagnostic tools available for intermediate-risk prostate cancer, magnetic resonance imaging (MRI) provides superior soft tissue delineation serving as a valuable tool for both diagnosis and treatment planning. Currently, there is minimal data regarding the practical utility of MRI for evaluation of intermediate-risk prostate cancer. As such, the National Comprehensive Cancer Network’s guidelines indicate MRI as optional in intermediate-risk prostate cancer evaluation. This project aims to elucidate whether MRI affects radiation treatment decisions for intermediate-risk prostate cancer. This was a retrospective study evaluating 210 patients with intermediate-risk prostate cancer, treated with definitive radiotherapy at our institution between 2019-2020. NCCN risk stratification criteria were used to define intermediate-risk prostate cancer. Patients were divided into two groups: those with pretreatment prostate MRI, and those without pretreatment prostate MRI. We compared the use of external beam radiotherapy, brachytherapy alone, brachytherapy boost, and androgen depravation therapy between the two groups. Inverse probability of treatment weighting was used to match the two groups for age, comorbidity index, American Urologic Association symptoms index, pretreatment PSA, grade group, and percent core involvement on prostate biopsy. Wilcoxon Rank Sum and Chi-squared tests were used to compare continuous and categorical variables. Of the patients who met the study’s eligibility criteria, 133 had a prostate MRI and 77 did not. Following propensity matching, there were no differences between baseline characteristics between the two groups. There were no statistically significant differences in treatments pursued between the two groups: 42% vs 47% were treated with brachytherapy alone, 40% vs 42% were treated with external beam radiotherapy alone, 18% vs 12% were treated with external beam radiotherapy with a brachytherapy boost, and 24% vs 17% received androgen deprivation therapy in the non-MRI and MRI groups, respectively. This analysis suggests that pretreatment MRI does not significantly impact radiation therapy or androgen deprivation therapy decisions in patients with intermediate-risk prostate cancer. Obtaining a pretreatment prostate MRI should be used judiciously and pursued only to answer a specific question, for which the answer is likely to impact treatment decision. Further follow up is needed to correlate MRI findings with their impacts on specific oncologic outcomes.

Keywords: magnetic resonance imaging, prostate cancer, definitive radiotherapy, gleason score 7

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Authors: Tarek K. Jalouta, Jolietta R. Holliman, Kathryn R. Burke, Kathleen M. Bewley-Thomas

Abstract:

Background: Chronic hepatitis C virus (HCV) infection is one of the leading causes of liver cirrhosis and hepatocellular carcinoma. In the United States, HCV screening awareness, treatment, and linkage to care are under continues ascending progress. However, still millions of people are asymptomatically infected and undiagnosed yet. Through this community mission, we sought to identify the best and the newest strategies to identify those infected people to educate them, link them to care and cure them. Methods: We have identified patients that did not have a prior HCV screening in our Electronic medical record (EMR) including all our different hospital locations (South Suburban Chicago, Northern, Western and Central Indiana). Providing education to all Primary care/Gastroenterology/Infectious diseases providers and staff in the clinic to increase awareness of the HCV screening. Health-related quality of life, chronic clinical complications, and demographics data were collected for each patient. All outcomes of HCV antibody-reactive and HCV RNA–positive results were identified and statistically analyzed. Results: From July 2016 to July 2018 we screened 35,720 individuals of birth cohort in our different Franciscan’s health medical centers. Of the screened population, 986 (2.7%) individuals were HCV AB-reactive. Of those, 319 (1%) patients were HCV RNA-positive, and 264 patients were counseled and linked to providers. 34 patients initiated anti-HCV therapy with successful treatment. Conclusions: Our HCV screening augmentation project considered the largest screening program in the Midwest. Augmenting the HCV screening process through creating a Best Practice Alert (BPA) in the EMR (Epic Sys.) and point of care testing could be helpful. Although continued work is required, our team is working on increase screening through adding HCV test to CBC-Panels in Emergency Department settings, phone calls to all birth cohort individuals through Robo-Calling System aimed to reach 75,000 individuals by 2019. However, a better linkage to care and referral monitoring system to all HCV RNA positive patients is still needed, and access to therapy, especially for uninsured patients, is challenging.

Keywords: chronic hepatitis C, chronic hepatitis C treatment, chronic hepatitis C screening, chronic hepatitis C prevention, liver cancer

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