Search results for: treatment of pulmonary embolism

Authors: G. L. Devnani, Shishir Sinha

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Natural fiber reinforced polymer composite is a very attractive area among the scientific community because of their low cost, eco-friendly and sustainable in nature. Among all advantages there are few issues which need to be addressed, those issues are the poor adhesion and compatibility between two opposite nature materials that is fiber and matrix and their relatively high water absorption. Therefore, natural fiber modifications are necessary to improve their adhesion with different matrices. Excellent properties could be achieved with the surface treatment of these natural fibers ultimately leads to property up-gradation of their reinforced composites with different polymer matrices. Lot of work is going on to improve the adhesion between reinforced fiber phase and polymer matrix phase to improve the properties of composites. Researchers have suggested various methods for natural fiber treatment like silane treatment, treatment with alkali, acetylation, acrylation, maleate coupling, etc. In this study a review is done on the different methods used for the surface treatment of natural fibers and what are the advance treatment methodologies for natural fiber surface treatment for property improvement of natural fiber reinforced polymer composites.

Keywords: composites, acetylation, natural fiber, surface treatment

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Authors: Kyngäs Helvi, Patala-Pudas, Kaakinen Pirjo

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It has been reported that COPD -patients may experience much emotional distress, which can compromise positive health outcomes. The aim of this study was to explore disease-related uncertainty as reported by Chronic Obstructive Pulmonary Disease (COPD) patients. Uncertainty was defined as a lack of confidence; negative feelings; a sense of confidence; and awareness of the sources of uncertainty. Research design was a non-experimental cross-sectional survey. The data (n=141) was collected by validated questionnaire during COPD -patients’ visits or admissions to a tertiary hospital. The response rate was 62%. The data was analyzed by statistical methods. Around 70% of the participants were male with COPD diagnosed many years ago. Fifty-four percent were under 65 years and used an electronic respiratory aid apparatus (52%) (oxygen concentrator, ventilator or electronic inhalation device). Forty-one percent of the participants smoked. Disease-related uncertainty was widely reported. Seventy-three percent of the participants had uncertainty about their knowledge of the disease, the pulmonary medication and nutrition. One-quarter (25%) did not feel sure about managing COPD exacerbation. About forty percent (43%) reported that they did not have a written exacerbation decision aid indicating how to act in relation to COPD symptoms. Over half of the respondents were uncertain about self-management behavior related to health habits such as exercise and nutrition. Over a third of the participants (37%) felt uncertain about self-management skills related to giving up smoking. Support from the care providers was correlated significantly with the patients’ sense of confidence. COPD -patients who felt no confidence stated that they received significantly less support in care. Disease-related uncertainty should be considered more closely and broadly in the patient care context, and those strategies within patient education that enhance adherence should be strengthened and incorporated into standard practice.

Keywords: adherence, COPD, disease-management, uncertainty

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Authors: Evelyn Smith, Susan Simpson

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Background: Eating disorder (ED) treatment is complicated by high rates of chronicity, comorbidity, complex personality traits and client dropout. Given these complexities, Schema Therapy (ST) has been identified as a suitable treatment option. The study primarily aims to evaluate the efficacy of group ST for the treatment of EDs. The study further evaluated the effectiveness of ST in reducing schemas and improving quality of life. Method: Participant suitability was ascertained using the Eating Disorder Examination. Following this, participants attended 90-minute weekly group sessions over 25 weeks. Groups consisted of six to eight participants and were facilitated by two psychologists, at least one of who is trained in ST. Measures were completed at pre, mid and post-treatment. Measures assessed ED symptoms, cognitive schemas, schema mode presentations, quality of life, self-compassion and psychological distress. Results: As predicted, measures of ED symptoms were significantly reduced following treatment. No significant changes were observed in early maladaptive schema severity; however, reductions in schema modes were observed. Participants did not report improvements in general quality of life measures following treatment, though improvement in psychological well-being was observed. Discussion: Overall, the findings from the current study support the use of group ST for the treatment of EDs. It is expected that lengthier treatment is needed for the reduction in schema severity. Given participant dropout was considerably low, this has important treatment implications for the suitability of ST for the treatment of EDs.

Keywords: eating disorders, schema therapy, treatment, quality of life

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Authors: Diana Islam, Juan Fang, Vito Fanelli, Bing Han, Julie Khang, Jianfeng Wu, Arthur S. Slutsky, Haibo Zhang

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Introduction: MSC delivery in preclinical models of ARDS has demonstrated significant improvements in lung function and recovery from acute injury. However, the role of MSC delivery in ARDS associated pulmonary fibrosis is not well understood. Some animal studies using bleomycin, asbestos, and silica-induced pulmonary fibrosis show that MSC delivery can suppress fibrosis. While other animal studies using radiation induced pulmonary fibrosis, liver, and kidney fibrosis models show that MSC delivery can contribute to fibrosis. Hypothesis: The beneficial and deleterious effects of MSC in ARDS are modulated by the lung microenvironment at the time of MSC delivery. Methods: To induce ARDS a two-hit mouse model of Hydrochloric acid (HCl) aspiration (day 0) and mechanical ventilation (MV) (day 2) was used. HCl and injurious MV generated fibrosis within 14-28 days. 0.5x106 mouse MSCs were delivered (via both intratracheal and intravenous routes) either in the active inflammatory phase (day 2) or during the remodeling phase (day 14) of ARDS (mouse fibroblasts or PBS used as a control). Lung injury accessed using inflammation score and elastance measurement. Pulmonary fibrosis was accessed using histological score, tissue collagen level, and collagen expression. In addition alveolar epithelial (E) and mesenchymal (M) marker expression profile was also measured. All measurements were taken at day 2, 14, and 28. Results: MSC delivery 2 days after HCl exacerbated lung injury and fibrosis compared to HCl alone, while the day 14 delivery showed protective effects. However in the absence of HCl, MSC significantly reduced the injurious MV-induced fibrosis. HCl injury suppressed E markers and up-regulated M markers. MSC delivery 2 days after HCl further amplified M marker expression, indicating their role in myofibroblast proliferation/activation. While with 14-day delivery E marker up-regulation was observed indicating their role in epithelial restoration. Conclusions: Early MSC delivery can be protective of injurious MV. Late MSC delivery during repair phase may also aid in recovery. However, early MSC delivery during the exudative inflammatory phase of HCl-induced ARDS can result in pro-fibrotic profiles. It is critical to understand the interaction between MSC and the lung microenvironment before MSC-based therapies are utilized for ARDS.

Keywords: acute respiratory distress syndrome (ARDS), mesenchymal stem cells (MSC), hydrochloric acid (HCl), mechanical ventilation (MV)

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Authors: Chigbo Ikechukwu Emmanuel

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Microalgae can be used for tertiary treatment of wastewater due to their capacity to assimilate nutrients. The pH increase which is mediated by the growing algae also induces phosphorus precipitation and ammonia stripping to the air, and may in addition act disinfecting on the wastewater. Domestic wastewater is ideal for algal growth since it contains high concentrations of all necessary nutrients. The growth limiting factor is rather light, especially at higher latitudes. The most important operational factors for successful wastewater treatment with microalgae are depth, turbulence and hydraulic retention time.

Keywords: microalgae, wastewater treatment, phosphorus, nitrogen, light, operation, ponds, growth

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Authors: Shraddha Acharya, Sharad Kumar Sharma, Ratna Bhattarai, Bhagwan Maharjan, Deepak Dahal, Serpahine Kaminsa

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Background: Drug-resistant (DR) tuberculosis (TB) continues to be a threat in Nepal, with an estimated 2800 new cases every year. The treatment of DR-TB with second line TB drugs is complex and takes longer time with comparatively lower treatment success rate than drug-susceptible TB. Delay in treatment initiation for DR-TB patients might further result in unfavorable treatment outcomes and increased transmission. This study thus aims to determine median time taken to initiate second-line treatment among Rifampicin Resistant (RR) diagnosed TB patients and to assess the proportion of treatment delays among various type of DR-TB cases. Method: A retrospective cohort study was done using national routine electronic data (DRTB and TB Laboratory Patient Tracking System-DHIS2) on drug resistant tuberculosis patients between January 2020 and December 2022. The time taken for treatment initiation was computed as– days from first diagnosis as RR TB through Xpert MTB/Rif test to enrollment on second-line treatment. The treatment delay (>7 days after diagnosis) was calculated. Results: Among total RR TB cases (N=954) diagnosed via Xpert nationwide, 61.4% were enrolled under shorter-treatment regimen (STR), 33.0% under longer treatment regimen (LTR), 5.1% for Pre-extensively drug resistant TB (Pre-XDR) and 0.4% for Extensively drug resistant TB (XDR) treatment. Among these cases, it was found that the median time from diagnosis to treatment initiation was 6 days (IQR:2-15.8). The median time was 5 days (IQR:2.0-13.3) among STR, 6 days (IQR:3.0-15.0) among LTR, 30 days (IQR:5.5-66.8) among Pre-XDR and 4 days (IQR:2.5-9.0) among XDR TB cases. The overall treatment delay (>7 days after diagnosis) was observed in 42.4% of the patients, among which, cases enrolled under Pre-XDR contributed substantially to treatment delay (72.0%), followed by LTR (43.6%), STR (39.1%) and XDR (33.3%). Conclusion: Timely diagnosis and prompt treatment initiation remain fundamental focus of the National TB program. The findings of the study, however suggest gaps in timeliness of treatment initiation for the drug-resistant TB patients, which could bring adverse treatment outcomes. Moreover, there is an alarming delay in second line treatment initiation for the Pre-XDR TB patients. Therefore, this study generates evidence to identify existing gaps in treatment initiation and highlights need for formulating specific policies and intervention in creating effective linkage between the RR TB diagnosis and enrollment on second line TB treatment with intensified efforts from health providers for follow-ups and expansion of more decentralized, adequate, and accessible diagnostic and treatment services for DR-TB, especially Pre-XDR TB cases, due to the observed long treatment delays.

Keywords: drug-resistant, tuberculosis, treatment initiation, Nepal, treatment delay

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Authors: Samuel Capintero, Ole H. Petersen

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This paper examines the utilization of public-private partnerships for the building and operation of wastewater treatment plants. Our research focuses on risk allocation in this kind of projects. Our analysis builds on more than hundred wastewater treatment plants built and operated through PPP projects in Aragon (Spain). The paper illustrates the consequences of an inadequate management of construction risk and an unsuitable transfer of demand risk in wastewater treatment plants. It also shows that the involvement of many public bodies at local, regional and national level further increases the complexity of this kind of projects and make time delays more likely.

Keywords: wastewater, treatment plants, PPP, construction

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Authors: Angelis P. Barlampas

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Learning Objectives: The purpose of this study is to inform briefly the reader about the applications of AI in chest radiology. Background: Currently, there are 190 FDA-approved radiology AI applications, with 42 (22%) pertaining specifically to thoracic radiology. Imaging findings OR Procedure details Aids of AI in chest radiology1: Detects and segments pulmonary nodules. Subtracts bone to provide an unobstructed view of the underlying lung parenchyma and provides further information on nodule characteristics, such as nodule location, nodule two-dimensional size or three dimensional (3D) volume, change in nodule size over time, attenuation data (i.e., mean, minimum, and/or maximum Hounsfield units [HU]), morphological assessments, or combinations of the above. Reclassifies indeterminate pulmonary nodules into low or high risk with higher accuracy than conventional risk models. Detects pleural effusion . Differentiates tension pneumothorax from nontension pneumothorax. Detects cardiomegaly, calcification, consolidation, mediastinal widening, atelectasis, fibrosis and pneumoperitoneum. Localises automatically vertebrae segments, labels ribs and detects rib fractures. Measures the distance from the tube tip to the carina and localizes both endotracheal tubes and central vascular lines. Detects consolidation and progression of parenchymal diseases such as pulmonary fibrosis or chronic obstructive pulmonary disease (COPD).Can evaluate lobar volumes. Identifies and labels pulmonary bronchi and vasculature and quantifies air-trapping. Offers emphysema evaluation. Provides functional respiratory imaging, whereby high-resolution CT images are post-processed to quantify airflow by lung region and may be used to quantify key biomarkers such as airway resistance, air-trapping, ventilation mapping, lung and lobar volume, and blood vessel and airway volume. Assesses the lung parenchyma by way of density evaluation. Provides percentages of tissues within defined attenuation (HU) ranges besides furnishing automated lung segmentation and lung volume information. Improves image quality for noisy images with built-in denoising function. Detects emphysema, a common condition seen in patients with history of smoking and hyperdense or opacified regions, thereby aiding in the diagnosis of certain pathologies, such as COVID-19 pneumonia. It aids in cardiac segmentation and calcium detection, aorta segmentation and diameter measurements, and vertebral body segmentation and density measurements. Conclusion: The future is yet to come, but AI already is a helpful tool for the daily practice in radiology. It is assumed, that the continuing progression of the computerized systems and the improvements in software algorithms , will redder AI into the second hand of the radiologist.

Keywords: artificial intelligence, chest imaging, nodule detection, automated diagnoses

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Authors: Priscila M. Lima, Corine A. P. de Almeida, Muriele R. de Lima, Fernando J. C. Magalhães Filho

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This work characterized the preliminary treatment in WWTPs in the state of Mato Grosso Do Sul (Brazil) and analyzed aspects of operation and maintenance of solid waste retained, and was evaluated the interference of this step in treatment efficiency beyond the relationship between solid waste generation with rainfall and seasonality in the region of each WTPs. The results shown that the standard setting in the preliminary treatment consists of grid along with Sand Trap, followed by Parshall that is used in 94.12% of WWTPs analyzed, and in 5.88% of WWTPs it was added the air-lift to the Sand Trap. Was concluded that the influence of rainfall, flow and seasonality associated with the rate of waste generation in the preliminary treatment, had little relation to the operation and maintenance of the primary treatment. But in some cases, precipitation data showed increased rainfall converging with increased flow and solid waste generation.

Keywords: pretreatment, sewage, solid waste, wastewater

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Authors: C. Pearcy, C. Rees

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Cognitive behavioural therapy (CBT) and exposure and response prevention (ERP) are currently the most efficacious treatments for Obsessive-compulsive disorder (OCD). Many clients, however, remain symptomatic following treatment. As a result, refusal of treatment, withdrawal from treatment, and partial adherence to treatment are common amongst ERP. Such limitations have caused few professionals to actually engage in ERP therapy, which has warranted the exploration of alternative treatments. This study evaluated an online self-help treatment program for OCD (the OCD Doctor Online); a 4-week Metacognitive Therapy (MCT) program which has implemented strategies from Wells’ Metacognitive model of OCD. The aim of the present study was to investigate whether an online self-help treatment using MCT would reduce symptoms of OCD, reduce unhelpful metacognitions and improve quality of life. Treatment effectiveness was assessed using a case series methodology in 3 consecutively referred individuals. At post-treatment, all participants showed reductions in unhelpful metacognitive beliefs (MCQ-30) and improvements in quality of life (Q-LES-Q), which were maintained through to 4 week follow-up. Two of the three participants showed reductions in OCD symptomology (OCI-R), which were further reduced at 4-week follow-up. The present study suggests that internet-based self-help treatment may be an effective means of delivering MCT to adults with OCD.

Keywords: internet-based, metacognitive therapy, obsessive-compulsive disorder, self-help

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Authors: M. Hadji, A. Haddad, Y. Hadji

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The effects of boronizing treatment on the friction coefficient and wear behavior of 0.35 Vf TiC- Ti3 SiC2 composite were investigated. In order to modity the surface properties of Ti3SiC2, boronizing treatment was carried out through powder pack cementation in the 1150-1350 °C temperature range. After boronizing treatment, one mixture layer, composed of TiB2 and SiC, forms on the surface of Ti3SiC2. The growth of the coating is processed by inward diffusion of Boron and obeys a linear rule. The Boronizing treatment increases the hardness of Ti3SiC2 from 6 GPa to 13 GPa. In the pin-on-disc test, i twas found that the material undergoes a steady-state coefficient of friction of around 0.8 and 0.45 in case of Ti3SiC2/Al2O3 tribocouple under 7N load for the non treated and the boronized samples, respectively. The wear resistance of Ti3SiC2 underAl2O3 ball sliding has been significantly improved, which indicated that the boronizing treatment is a promising surface modification way of Ti3SiC2.

Keywords: MAX phase, wearing, friction, boronizing

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Authors: Ju Hyun Won, Seok Hong Min, Tae Kwon Ha

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Phase equilibria of AZ91D Mg alloys for nonflammable use, containing Ca and Y, were carried out by using FactSage® and FTLite database, which revealed that solid solution treatment, could be performed at temperatures from 400 to 450 °C. Solid solution treatment of AZ91D Mg alloy without Ca and Y was successfully conducted at 420 °C and supersaturated microstructure with all beta phase resolved into matrix was obtained. In the case of AZ91D Mg alloy with some Ca and Y, however, a little amount of intermetallic particles were observed after solid solution treatment. After solid solution treatment, each alloy was annealed at temperatures of 180 and 200 °C for time intervals from 1 min to 48 hrs and hardness of each condition was measured by micro-Vickers method. Peak aging conditions were deduced as at the temperature of 200 °C for 10 hrs.

Keywords: Mg alloy, AZ91D, nonflammable alloy, phase equilibrium, peak aging

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Authors: Nguyen Thi Thanh Truc, Chi-Hyeon Lee, Srinivasa Reddy Mallampati, Byeong-Kyu Lee

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This study evaluated to facilitate separation of ABS plastics from other waste plastics by froth flotation after surface hydrophilization of ABS with heat treatment. The mild heat treatment at 100oC for 60s could selectively increase the hydrophilicity of the ABS plastics surface (i.e., ABS contact angle decreased from 79o to 65.8o) among other plastics mixture. The SEM and XPS results of plastic samples sufficiently supported the increase in hydrophilic functional groups and decrease contact angle on ABS surface, after heat treatment. As a result of the froth flotation (at mixing speed 150 rpm and airflow rate 0.3 L/min) after heat treatment, about 85% of ABS was selectively separated from other heavy plastics with 100% of purity. The effect of optimum treatment condition and detailed mechanism onto separation efficiency in the froth floatation was also investigated. This research is successful in giving a simple, effective, and inexpensive method for ABS separation from waste plastics.

Keywords: ABS, hydrophilic, heat treatment, froth flotation, contact angle

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Authors: Mohd Jaish Siddiqui

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Laryngeal TB is extremely rare in the pediatric population, accounting for 1% of all cases. Here, we present a case of laryngeal TB with miliary tuberculosis and tuberculous encephalitis, presented with sore throat, hoarseness, severe cough and, acute obstruction the larynx, sputum for AFB was negative, T-SPOT was positive and X-pert was positive, bronchoscopy revealed multiple nodules and edema around the larynx, epiglottis, bilateral arytenopharyngeal folds and vocal cord. Enhanced MRI revealed multiple small nodules in bilateral cerebral hemispheres and right thalamus, however CSF was negative. We reviewed the LTB cases that were published up to 2021. A total of twenty fine cases were identified in English literature. The most common manifestation was hoarseness of voice with 80% followed by stridor 40% of cases. Pulmonary involvement was found in 36% of cases, whereas, 45% of cases had no underlying TB. We did not find any case who developed tuberculous encephalitis in the literature.

Keywords: laryngeal tb, treatment, tuberculous encephalitis, children

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Authors: P. V. Pramila , V. Mahesh

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Pulmonary Function Tests are important non-invasive diagnostic tests to assess respiratory impairments and provides quantifiable measures of lung function. Spirometry is the most frequently used measure of lung function and plays an essential role in the diagnosis and management of pulmonary diseases. However, the test requires considerable patient effort and cooperation, markedly related to the age of patients esulting in incomplete data sets. This paper presents, a nonlinear model built using Multivariate adaptive regression splines and Random forest regression model to predict the missing spirometric features. Random forest based feature selection is used to enhance both the generalization capability and the model interpretability. In the present study, flow-volume data are recorded for N= 198 subjects. The ranked order of feature importance index calculated by the random forests model shows that the spirometric features FVC, FEF 25, PEF,FEF 25-75, FEF50, and the demographic parameter height are the important descriptors. A comparison of performance assessment of both models prove that, the prediction ability of MARS with the `top two ranked features namely the FVC and FEF 25 is higher, yielding a model fit of R2= 0.96 and R2= 0.99 for normal and abnormal subjects. The Root Mean Square Error analysis of the RF model and the MARS model also shows that the latter is capable of predicting the missing values of FEV1 with a notably lower error value of 0.0191 (normal subjects) and 0.0106 (abnormal subjects). It is concluded that combining feature selection with a prediction model provides a minimum subset of predominant features to train the model, yielding better prediction performance. This analysis can assist clinicians with a intelligence support system in the medical diagnosis and improvement of clinical care.

Keywords: FEV, multivariate adaptive regression splines pulmonary function test, random forest

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Authors: Vandana Mohan, Ashwani Koul

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Aim: To evaluate the potential of Aqueous Tinospora cordifolia stem extract (Aq.Tc) and Arabinogalactan (AG) on pulmonary carcinogenesis and associated tumor markers. Background: Lung cancer is one of the most frequent malignancy with high mortality rate due to limitation of early detection resulting in low cure rates. Current research effort focuses on identifying some blood-based biomarkers like CEA, ctDNA and LDH which may have potential to detect cancer at an early stage, evaluation of therapeutic response and its recurrence. Medicinal plants and their active components have been widely investigated for their anticancer potentials. Aqueous preparation of T. Cordifolia extract is enriched in the polysaccharide fraction i.e., AG when compared with other types of extract. Moreover, reports are available of polysaccharide fraction of T. Cordifolia in in vitro lung cancer models which showed profound anti-metastatic activity against these cell lines. However, not much has been explored about its effect in in vivo lung cancer models and the underlying mechanism involved. Experimental Design: Mice were randomly segregated into six groups. Group I animals served as control. Group II animals were administered with Aq. Tc extract (200 mg/kg b.w.) p.o.on the alternate days. Group III animals were fed with AG (7.5 mg/kg b.w.) p.o. on the alternate days (thrice a week). Group IV animals were installed with Benzo(a)pyrene (50 mg/kg b.w.), i.p. twice within an interval of two weeks. Group V animals received Aq. Tc extract as in group II along with it B(a)P was installed after two weeks of Aq. Tc administration following the same protocol as for group IV. Group VI animals received AG as in group III along with it B(a)P was installed after two weeks of AG administration. Results: Administration of B(a)P to mice resulted in increased tumor incidence, multiplicity and pulmonary somatic index with concomitant increase in serum/plasma markers like CEA, ctDNA, LDH and TNF-α.Aq.Tc and AG supplementation significantly attenuated these alterations at different stages of tumorigenesis thereby showing potent anti-cancer effect in lung cancer. A pronounced decrease in serum/plasma markers were observed in animals treated with Aq.Tc as compared to those fed with AG. Also, extensive hyperproliferation of alveolar epithelium was prominent in B(a)P induced lung tumors. However, treatment of Aq.Tc and AG to lung tumor bearing mice exhibited reduced alveolar damage evident from decreased number of hyperchromatic irregular nuclei. A direct correlation between the concentration of tumor markers and the intensity of lung cancer was observed in animals bearing cancer co-treated with Aq.Tc and AG. Conclusion: These findings substantiate the chemopreventive potential of Aq.Tc and AG against lung tumorigenesis. Interestingly, Aq.Tc was found to be more effective in modulating the cancer as reflected by various observations which may be attributed to the synergism offered by various components of Aq.Tc. Further studies are in progress to understand the underlined mechanism in inhibiting lung tumorigenesis by Aq.Tc and AG.

Keywords: Arabinogalactan, Benzo(a)pyrene B(a)P, carcinoembryonic antigen (CEA), circulating tumor DNA (ctDNA), lactate dehydrogenase (LDH), Tinospora cordifolia

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Authors: Ji Chan Kim, Seok Hong Min, Tae Kwon Ha

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Effect of boron addition on the microstructure and mechanical properties of AZ91D Mg alloy was investigated in this study. Through calculation of phase equilibria, carried out by using FactSage® and FTLite database, solution treatment temperature was decided as 420 °C where supersaturated solid solution can be obtained. Solid solution treatment was conducted at 420 °C for 24 hrs followed by hot rolling at 420 °C and the total reduction was about 60%. Recrystallization heat treatment was followed at 420 °C for 6 hrs to obtain equiaxed microstructure. After recrystallization treatment, aging heat treatment was conducted at temperature of 200 °C for time intervals from 1 min to 200 hrs and hardness of each condition was measured by micro-Vickers method. Peak hardness was observed after 20 hrs. Tensile tests were also conducted on the specimens aged for various time intervals and the results were compared with hardness.

Keywords: AZ91D Mg alloy, boron, heat treatment, microstructure, mechanical properties, hardness

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Authors: Shabnam Sarwar, Franck Lacoeuille, Nadia Withofs, Roland Hustinx

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After the development of a potential surrogate of MAA, and its successful application for the diagnosis of pulmonary embolism in artificially embolized rats’ lungs, this microparticulate system were radiolabelled with gallium-68 to synthesize 68Ga-SBMP with high radiochemical purity >99%. As a prerequisite step of clinical trials, 68Ga- labelled starch based microparticles (SBMP) were analysed for their in-vivo behavior in small animals. The purpose of the presented work includes the ex-vivo biodistribution studies of 68Ga-SBMP in order to assess the activity uptake in target organs with respect to time, excretion pathways of the radiopharmaceutical, %ID/g in major organs, T/NT ratios, in-vivo stability of the radiotracer and subsequently the microparticles in the target organs. Radiolabelling of starch based microparticles was performed by incubating it with 68Ga generator eluate (430±26 MBq) at room temperature and pressure without using any harsh reaction condition. For Ex-vivo biodistribution studies healthy White Wistar rats weighing between 345-460 g were injected intravenously 68Ga-SBMP 20±8 MBq, containing about 2,00,000-6,00,000 SBMP particles in a volume of 700µL. The rats were euthanized at predefined time intervals (5min, 30min, 60min and 120min) and their organ parts were cut, washed, and put in the pre-weighed tubes and measured for radioactivity counts through automatic Gamma counter. The 68Ga-SBMP produced >99% RCP just after 10-20 min incubation through a simple and robust procedure. Biodistribution of 68Ga-SBMP showed that initially just after 5 min post injection major uptake was observed in the lungs following by blood, heart, liver, kidneys, bladder, urine, spleen, stomach, small intestine, colon, skin and skeleton, thymus and at last the smallest activity was found in brain. Radioactivity counts stayed stable in lungs with gradual decrease with the passage of time, and after 2h post injection, almost half of the activity were seen in lungs. This is a sufficient time to perform PET/CT lungs scanning in humans while activity in the liver, spleen, gut and urinary system decreased with time. The results showed that urinary system is the excretion pathways instead of hepatobiliary excretion. There was a high value of T/NT ratios which suggest fine tune images for PET/CT lung perfusion studies henceforth further pre-clinical studies and then clinical trials should be planned in order to utilize this potential lung perfusion agent.

Keywords: starch based microparticles, gallium-68, biodistribution, target organs, excretion pathways

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Authors: Bachir Chemani, Rachid Halfaoui, Madani Maalem

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The manufacturing technology of band cotton is very delicate and depends to choice of certain parameters such as torsion of warp yarn. The fabric elasticity is achieved without the use of any elastic material, chemical expansion, artificial or synthetic and it’s capable of creating pressures useful for therapeutic treatments.Before use, the band is subjected to treatments of specific preparation for obtaining certain elasticity, however, during its treatment, there are some regression parameters. The dependence of manufacturing parameters on the quality of the chemical treatment was confirmed. The aim of this work is to improve the properties of the fabric through the development of manufacturing technology appropriately. Finally for the treatment of the strip pancake 100% cotton, a treatment method is recommended.

Keywords: elastic, cotton, processing, torsion

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Authors: X. King, E. Nazarzadeh, J. Reboud, J. Cooper

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Pulmonary diseases, such as asthma, are generally treated by the inhalation of aerosols that has the advantage of reducing the off-target (e.g., toxicity) effects associated with systemic delivery in blood. Effective respiratory drug delivery requires a droplet size distribution between 1 and 5 µm. Inhalation of aerosols with wide droplet size distribution, out of this range, results in deposition of drug in not-targeted area of the respiratory tract, introducing undesired side effects on the patient. In order to solely deliver the drug in the lower branches of the lungs and release it in a targeted manner, a control mechanism to produce the aerosolized droplets is required. To regulate the drug release and to facilitate the uptake from cells, drugs are often encapsulated into protective liposomes. However, a multistep process is required for their formation, often performed at the formulation step, therefore limiting the range of available drugs or their shelf life. Using surface acoustic waves (SAWs), a pulmonary drug delivery platform was produced, which enabled the formation of defined size aerosols and the formation of liposomes in situ. SAWs are mechanical waves, propagating along the surface of a piezoelectric substrate. They were generated using an interdigital transducer on lithium niobate with an excitation frequency of 9.6 MHz at a power of 1W. Disposable silicon superstrates were etched using photolithography and dry etch processes to create an array of cylindrical through-holes with different diameters and pitches. Superstrates were coupled with the SAW substrate through water-based gel. As the SAW propagates on the superstrate, it enables nebulisation of a lipid solution deposited onto it. The cylindrical cavities restricted the formation of large drops in the aerosol, while at the same time unilamellar liposomes were created. SAW formed liposomes showed a higher monodispersity compared to the control sample, as well as displayed, a faster production rate. To test the aerosol’s size, dynamic light scattering and laser diffraction methods were used, both showing the size control of the aerosolised particles. The use of silicon superstate with cavity size of 100-200 µm, produced an aerosol with a mean droplet size within the optimum range for pulmonary drug delivery, containing the liposomes in which the medicine could be loaded. Additionally, analysis of liposomes with Cryo-TEM showed formation of vesicles with narrow size distribution between 80-100 nm and optimal morphology in order to be used for drug delivery. Encapsulation of nucleic acids in liposomes through the developed SAW platform was also investigated. In vitro delivery of siRNA and DNA Luciferase were achieved using A549 cell line, lung carcinoma from human. In conclusion, SAW pulmonary drug delivery platform was engineered, in order to combine multiple time consuming steps (formation of liposomes, drug loading, nebulisation) into a unique platform with the aim of specifically delivering the medicament in a targeted area, reducing the drug’s side effects.

Keywords: acoustics, drug delivery, liposomes, surface acoustic waves

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Authors: A. Mech

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Repetitive transcranial magnetic stimulation has proven to be a valuable treatment option for patients who have failed to respond to multiple courses of antidepressant medication. In fact, the American Psychiatric Association recommends TMS after one failed treatment course of antidepressant medication. Genetic testing has proven valuable for pharmacokinetic variables, which, if understood, could lead to more efficient dosing of psychotropic medications to improve outcomes. Pharmacodynamic testing can identify biomarkers, which, if addressed, can improve patients' outcomes in antidepressant therapy. Monotherapy treatment of major depressive disorder with methylated B vitamin treatment has been shown to be safe and effective in patients with MTHFR polymorphisms without waiting for multiple trials of failed medication treatment for depression. Such treatment has demonstrated remission rates similar to antidepressant clinical trials. Combining pharmacodynamics testing with repetitive TMS treatment with NeuroStar has shown promising potential for enhancing remission rates and durability of treatment. In this study, a retrospective chart review (ongoing) of patients who obtained repetitive TMS treatment enhanced by dietary supplementation guided by Pharmacodynamic testing, displayed a greater remission rate (90%) than patients treated with only NeuroStar TMS (62%).

Keywords: improved remission rate, major depressive disorder, pharmacodynamic testing, rTMS outcomes

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Authors: S. Moustafa El Shanawany, I. Labib Salem, F. Mohamed Magdy Badr El Dine, H. Tag El Deen Abd Allah

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Thermal injuries remain a global health problem and a common issue encountered in forensic pathology. They are a devastating cause of morbidity and mortality in children and adults especially in developing countries, causing permanent disfigurement, scarring and grievous hurt. Burns have always been a matter of legal concern in cases of suicidal burns, self-inflicted burns for false accusation and homicidal attempts. Assessment of burn injuries as well as rating permanent disabilities and disfigurement following thermal injuries for the benefit of compensation claims represents a challenging problem. This necessitates the development of reliable scoring systems to yield an expected likelihood of permanent disability or fatal outcome following burn injuries. The study was designed to identify the risk factors of mortality in acute burn patients and to evaluate the applicability of FLAMES (Fatality by Longevity, APACHE II score, Measured Extent of burn, and Sex) and BOBI (Belgian Outcome in Burn Injury) model scores in predicting the outcome. The study was conducted on 100 adult patients with acute burn injuries admitted to the Burn Unit of Alexandria Main University Hospital, Egypt from October 2014 to October 2015. Victims were examined after obtaining informed consent and the data were collected in specially designed sheets including demographic data, burn details and any associated inhalation injury. Each burn patient was assessed using both BOBI and FLAMES scoring systems. The results of the study show the mean age of patients was 35.54±12.32 years. Males outnumbered females (55% and 45%, respectively). Most patients were accidently burnt (95%), whereas suicidal burns accounted for the remaining 5%. Flame burn was recorded in 82% of cases. As well, 8% of patients sustained more than 60% of total burn surface area (TBSA) burns, 19% of patients needed mechanical ventilation, and 19% of burnt patients died either from wound sepsis, multi-organ failure or pulmonary embolism. The mean length of hospital stay was 24.91±25.08 days. The mean BOBI score was 1.07±1.27 and that of the FLAMES score was -4.76±2.92. The FLAMES score demonstrated an area under the receiver operating characteristic (ROC) curve of 0.95 which was significantly higher than that of the BOBI score (0.883). A statistically significant association was revealed between both predictive models and the outcome. The study concluded that both scoring systems were beneficial in predicting mortality in acutely burnt patients. However, the FLAMES score could be applied with a higher level of accuracy.

Keywords: BOBI, burns, FLAMES, scoring systems, outcome

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Authors: Sara Grazhdani, Alma Cili, Arben Ivanaj

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Immune Thrombocytopenic Purpura is an autoimmune disease characterized by the destruction of platelets by immune mediators, their deficient production in the red bone marrow and increased splenic sequestration, leading to the appearance of thrombocytopenia and increased risk of hemorrhage. Treatment is indicated in patients with low platelet counts (<30 x 10 9 /L) who present clinically with hemorrhagic events or are at increased risk for hemorrhage. The goal of the treatment remains (I) prevention of hemorrhagic events and deaths resulting from them, (II) reaching an adequate level of the number of platelets, (III) treatment of patients with as few toxic effects as possible. Corticosteroid therapy remains the first choice in the treatment of patients with Primary Immune Thrombocytopenic Purpura. Rituximab (Mabthera) remains the first choice in the second line in the treatment of patients with Immune Thrombocytopenic Purpura, refractory to the use of cortisones.

Keywords: ITP, rituximab, prednisolone, relapse

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Authors: Hwasuk Jung, Seoi Lee, Dongchoon Ryou, Pyungjong Yoo, Seokmo Lee

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The Nakdong River being used as drinking water sources for Pusan metropolitan city has the vulnerability of water management due to the fact that industrial areas are located in the upper Nakdong River. Most citizens of Busan think that the water quality of Nakdong River is not good, so they boil or use home filter to drink tap water, which causes unnecessary individual costs to Busan citizens. We need to diversify water intake to reduce the cost and to change the weak water source. Under this background, this study was carried out for the environmental accounting of Namgang dam water treatment system compared to Nakdong River water treatment system by using emergy analysis method to help making reasonable decision. Emergy analysis method evaluates quantitatively both natural environment and human economic activities as an equal unit of measure. The emergy transformity of Namgang dam’s water was 1.16 times larger than that of Nakdong River’s water. Namgang Dam’s water shows larger emergy transformity than that of Nakdong River’s water due to its good water quality. The emergy used in making 1 m3 tap water from Namgang dam water treatment system was 1.26 times larger than that of Nakdong River water treatment system. Namgang dam water treatment system shows larger emergy input than that of Nakdong river water treatment system due to its construction cost of new pipeline for intaking Namgang daw water. If the Won used in making 1 m3 tap water from Nakdong river water treatment system is 1, Namgang dam water treatment system used 1.66. If the Em-won used in making 1 m3 tap water from Nakdong river water treatment system is 1, Namgang dam water treatment system used 1.26. The cost-benefit ratio of Em-won was smaller than that of Won. When we use emergy analysis, which considers the benefit of a natural environment such as good water quality of Namgang dam, Namgang dam water treatment system could be a good alternative for diversifying intake source.

Keywords: emergy, emergy transformity, Em-won, water treatment system

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Authors: Belly Yordan

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Orthodontic treatment can be done by using the fix and removable orthodontic appliance. The success of treatment depends on the patient’s age, the type of malocclusion, treatment of space discrepancy, patient’s oral hygiene, operator skills, and patient cooperation. This case report was aimed to show the success of orthodontic treatment in patients with skeletal class I relationship, class I angle dental malocclusion with anterior crowding and rotation by using a removable appliance with modification. The removable appliance used is standard with removable plate components such as passive clasp (Adam’s hook clasp) accompanied with some active clasps (labial bow, some springs, etc.). A button is used as an additional tool or combined with other tools to correct tooth in rotated position. The results obtained by the success of treatments which is shown in pre and post-treatment photos, the overjet was reduced, the arch form became normal, the tooth malposition became normal, and rotation was corrected. Facial profile appearance of the patient is getting better, and the dental coordination also became better. This case report is to prove that treatment with the removable appliance is quite successful with the robust wearing of appropriate retainers.

Keywords: success rate, anterior crowding, orthodontic treatment, removable appliances

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Authors: Cherif Y., Ghariani R., Derbal S., Farhati S., Ben Dahmen F., Abdallah M.

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Introduction: Tuberculosis (TBC) is a frequent infection and is still a major public health problem in Tunisia. The aim of this work is to focus on diagnostic and therapeutic characteristics of TBC in patients referred to our internal medicine department. Patients and Methods: The study was retrospective and descriptive of a cohort of consecutive cases treated from January 2016 to December 2019, collecting patients with latent or patent TBC. Twenty-eight medical records of adults diagnosed with TBC were reviewed. Results: Twenty-eight patients, including 18 women and 10 men, were diagnosed with TBC. Their mean age is 48 years (range: 22-78 years). Five patients have a medical history of diabetes mellitus, 1 patient was followed for systemic lupus erythematosus treated with corticosteroids and immunosuppressant drugs, and another was treated with corticosteroids for Mac Duffy syndrome. The TBC is latent in 12 cases and patent in 16 cases. The most common symptoms were fever and weight loss and were found in 10 cases, a cough in 2 cases, sputum in 3 cases, lymph nodes in 4 cases, erythema nodosum in 2 cases, and neurological signs in 3 cases. Lymphopenia is noticed in 3 cases and a biological inflammatory syndrome in 18 of the cases. The purified protein derivate reaction was positive in 17 cases, anergic in 3 cases, negative in 5 cases, and not done in 3 cases. The acid-fast bacilli stain culture was strongly positive in one patient. The histopathological study was conclusive in 11 patients and showed granulomatosis with caseous necrosis. TBC was pulmonary in 7 patients, lymph node in 7 cases, peritoneal in 7 cases, digestive in 1 case, neuromeningeal in 3 cases, and thyroïd in 1 case. Seven patients had multifocal TBC. All the patients received anti-tuberculosis treatment with a mean duration of 8 months with no failure or relapse with an average follow-up time of 10.58 months. Conclusion: Diagnosis and management of TBC remain essential to avoid serious complications. The survey is necessary to ensure timely detection and treatment of infected adults to decrease its incidence. The best treatment remains preventive through vaccination and improving social and economic conditions.

Keywords: tuberculosis, infection, autoimmune disease, granulomatosis

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Authors: Christi Jackson, Chuka Onaga

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Introduction: We report a case of delayed diagnosis of extra-pulmonary INH-mono-resistant Tuberculosis (TB) in a South African patient with drug-resistant HIV. Case Presentation: A 36-year old male was initiated on 1st line (NNRTI-based) anti-retroviral therapy (ART) in September 2009 and switched to 2nd line (PI-based) ART in 2011, according to local guidelines. He was following up at the outpatient wellness unit of a public hospital, where he was diagnosed with Protease Inhibitor resistant HIV in March 2016. He had an HIV viral load (HIVVL) of 737000 copies/mL, CD4-count of 10 cells/µL and presented with complaints of productive cough, weight loss, chronic diarrhoea and a septic buttock wound. Several investigations were done on sputum, stool and pus samples but all were negative for TB. The patient was treated with antibiotics and the cough and the buttock wound improved. He was subsequently started on a 3rd-line ART regimen of Darunavir, Ritonavir, Etravirine, Raltegravir, Tenofovir and Emtricitabine in May 2016. He continued losing weight, became too weak to stand unsupported and started complaining of abdominal pain. Further investigations were done in September 2016, including a urine specimen for Line Probe Assay (LPA), which showed M. tuberculosis sensitive to Rifampicin but resistant to INH. A lymph node biopsy also showed histological confirmation of TB. Management and outcome: He was started on Rifabutin, Pyrazinamide and Ethambutol in September 2016, and Etravirine was discontinued. After 6 months on ART and 2 months on TB treatment, his HIVVL had dropped to 286 copies/mL, CD4 improved to 179 cells/µL and he showed clinical improvement. Pharmacy supply of his individualised drugs was unreliable and presented some challenges to continuity of treatment. He successfully completed his treatment in June 2017 while still maintaining virological suppression. Discussion: Several laboratory-related factors delayed the diagnosis of TB, including the unavailability of urine-lipoarabinomannan (LAM) and urine-GeneXpert (GXP) tests at this facility. Once the diagnosis was made, it presented a treatment dilemma due to the expected drug-drug interactions between his 3rd-line ART regimen and his INH-resistant TB regimen, and specialist input was required. Conclusion: TB is more difficult to diagnose in patients with severe immunosuppression, therefore additional tests like urine-LAM and urine-GXP can be helpful in expediting the diagnosis in these cases. Patients with non-standard drug regimens should always be discussed with a specialist in order to avoid potentially harmful drug-drug interactions.

Keywords: drug-resistance, HIV, line probe assay, tuberculosis

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Authors: Chan Park, Sang-Won Park, Kwi-Dug Yun, Hyun-Pil Lim

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Purpose: Plasma treatment under various conditions has been studied to increase the bonding strength and surface sterilization of dental ceramic materials. We assessed the evolution of the shear bond strength (SBS) and antimicrobial effect of nonthermal atmospheric pressure plasma (NTAPP) treatment over time. Methods: Presintered zirconia specimens were manufactured as discs (diameter: 15 mm, height: 2 mm) after final sintering. The specimens then received a 30-min treatment with argon gas (Ar², 99.999%; 10 L/min) using an NTAPP device. Five post-treatment intervals were evaluated: control (no treatment), P0 (within 1 h), P1 (24 h), P2 (48 h), and P3 (72 h). This study investigated the surface characteristics, SBS of two different resin cement (RelyXTM U200 self-adhesive resin cement, Panavia F2.0 methacryloyloxydecyl dihydrogen phosphate (MDP)-based resin cement), and Streptococcus mutans biofilm formation. Results: The SBS of RelyXTM U200 increased significantly (p < 0.05) within 2 days following plasma treatment (P0, P1, P2). For Panavia F 2.0, a significant decrease (p < 0.05) was detected only in the group that had undergone cementation immediately after plasma treatment (P0). S. mutans adhesion decreased significantly (p < 0.05) within 2 days of plasma treatment (P0, P1, P2) compared to the control group. The P0 group displayed a lower biofilm thickness than the P1 and P2 groups (p < 0.05). Conclusions: After NTAPP treatment of zirconia, the effects on bonding strength and antimicrobial growth persist for a limited duration. The effect of NTAPP treatment on bonding strength depends on the resin cement.

Keywords: NTAPP, SBS, antimicrobial effect, zirconia

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Authors: Aparna Datta, Mahabub Alam

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Animal welfare is comparatively new area of research in Bangladesh and welfare concern for animal is increasing day by day. The study was conducted to investigate the animal welfare violations during treatment at different level of hospitals in Bangladesh and India. This study was conducted between January and May, 2017. The recorded data (N=180) were categorized into eight major types of violation like - delay in starting treatment, non-specific treatment, surgery without anesthesia, use of unsterilized needle, rough and painful handling, fearful approach, multiple pricking during injection and use of blunt needle. Categorized groups were analyzed according to different hospitals like Upazila Veterinary Hospitals, Bangladesh (UVHs), SAQ-Teaching Veterinary Hospital, Bangladesh (SAQTVH) and Veterinary College and Research Institute, India (VCRI). Among all hospitals, violation during treatment more frequently occurred in UVH. Among all violations, surgery without anesthesia was only found in UVH (80%) and it was belong to considerable number of cases (80%). In the view of other major violations like - non-specific treatment was 69% in UVHs, 13% in SAQTVH and 5% in VCRI. Use of unsterilized instruments during treatment was also higher in UVHs (65%) than SAQTVH (5%) and VCRI (1%). But delay in starting treatment varied insignificantly and it was 26-42% across the different levels of hospitals. Although multiple pricking during injection was found 30% cases in UVH, but statistical variations with other level of hospitals were unnoticed (p>0.05). The findings of this study will help to take necessary steps to control violation against animal welfare during treatment. A comprehensive study considering all levels of hospitals including field treatment is also recommended to find out the welfare violations during treatment.

Keywords: animal welfare, treatment, veterinary hospitals, violations

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Authors: M. Derraz, M.Farhaoui

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In the water treatment processes, the determination of the optimal dose of the coagulant is an issue of particular concern. Coagulant dosing is correlated to raw water quality which depends on some parameters (turbidity, ph, temperature, conductivity…). The objective of this study is to provide water treatment operators with a tool that enables to predict and replace, sometimes, the manual method (jar testing) used in this plant to predict the optimum coagulant dose. The model is constructed using actual process data for a water treatment plant located in the middle of Morocco (Meknes).

Keywords: coagulation process, aluminum sulfate, model, coagulant dose

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