Search results for: Clinical Pathway

Authors: Gorazd Karer

Abstract:

When performing a diagnostic procedure or surgery in general anesthesia (GA), a proper introduction and dosing of anesthetic agents is one of the main tasks of the anesthesiologist. That being said, depth of anesthesia (DoA) also seems to be a suitable process for closed-loop control implementation. To implement such a system, one must be able to acquire the relevant signals online and in real-time, as well as stream the calculated control signal to the infusion pump. However, during a procedure, patient monitors and infusion pumps are purposely unable to connect to an external (possibly medically unapproved) device for safety reasons, thus preventing closed-loop control. This paper proposes a conceptual solution to the aforementioned problem. First, it presents some important aspects of contemporary clinical practice. Next, it introduces the closed-loop-control-system structure and the relevant information flow. Focusing on transferring the data from the patient to the computer, it presents a non-invasive image-based system for signal acquisition from a patient monitor for online depth-of-anesthesia assessment. Furthermore, it introduces a User-Datagram-Protocol-based (UDP-based) communication method that can be used for transmitting the calculated anesthetic inflow to the infusion pump. The proposed system is independent of medical-device manufacturer and is implemented in MATLAB-Simulink, which can be conveniently used for DoA control implementation. The proposed scheme has been tested in a simulated GA setting and is ready to be evaluated in an operating theatre. However, the proposed system is only a step towards a proper closed-loop control system for DoA, which could routinely be used in clinical practice.

Keywords: Closed-loop control, Depth of Anesthesia, DoA, optical signal acquisition, Patient State index, PSi, UDP communication protocol.

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Authors: Titin Andri Wihastuti, Djanggan Sargowo

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NFκB is a transcription factor regulating many function of the vessel wall. In the normal condition , NFκB is revealed diffuse cytoplasmic expressionsuggesting that the system is inactive. The presence of activation NFκB provide a potential pathway for the rapid transcriptional of a variety of genes encoding cytokines, growth factors, adhesion molecules and procoagulatory factors. It is likely to play an important role in chronic inflamatory disease involved atherosclerosis. There are many stimuli with the potential to active NFκB, including hyperlipidemia. We used 24 mice which was divided in 6 groups. The HFD given by et libitum procedure during 2, 4, and 6 months. The parameters in this study were the amount of NFKB activation ,H2O2 as ROS and VCAM-1 as a product of NFKB activation. H2O2 colorimetryc assay performed directly using Anti Rat H2O2 ELISA Kit. The NFKB and VCAM-1 detection obtained from aorta mice, measured by ELISA kit and imunohistochemistry. There was a significant difference activation of H2O2, NFKB and VCAM-1 level at induce HFD after 2, 4 and 6 months. It suggest that HFD induce ROS formation and increase the activation of NFKB as one of atherosclerosis marker that caused by hyperlipidemia as classical atheroschlerosis risk factor.

Keywords: High Fat Diet, NFKB, H2O2, atherosclerosis

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Authors: K. Afsahi, M. Soheilifar, S. H. Hosseini, O. S. Esmaeili, R. Kezemi, N. Mehrbod, N. Vahed, T. Hajiahmad, N. N. Ansari

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Background: Stroke is a disabling neurological disease. Rehabilitative therapies are important treatment methods. This clinical trial was done to compare the effects of virtual reality (VR) beside conventional rehabilitation versus conventional rehabilitation alone on the spasticity and motor function in stroke patients. Materials and methods: In this open-label randomized controlled clinical trial, 40 consecutive patients with stable first-ever ischemic stroke in the past three to 12 months that were referred to a rehabilitation clinic in Tehran, Iran in 2020 were enrolled. After signing the informed written consent form, subjects were randomly assigned by block randomization of five in each block as cases with 1:1 into two groups of 20 cases; conventional plus VR therapy group: 45-minute conventional therapy session plus 15-minute VR therapy, and conventional group: 60-minute conventional therapy session. VR rehabilitation is designed and developed with different stages. Outcomes were Modified Ashworth scale, Recovery Stage score for motor function, range of motion (ROM) of shoulder abduction/wrist extension, and patients’ satisfaction rate. Data were compared after study termination. Results: The satisfaction rate among the patients was significantly better in combination group (P = 0.003). Only wrist extension was varied between groups and was better in combination group. The variables generally had statistically significant difference (P < 0.05). Conclusion: VR plus conventional rehabilitation therapy is superior versus conventional rehabilitation alone on the wrist and elbow spasticity and motor function in patients with stroke.

Keywords: Stroke, virtual therapy, efficacy, rehabilitation.

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Authors: Rosarin Rujananon, Poonsuk Prasertsan, Amornrat Phongdara, Tanate Panrat, Jibin Sun, Sugima Rappert, An-Ping Zeng

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In this study, a synthetic pathway was created by assembling genes from Clostridium butyricum and Escherichia coli in different combinations. Among the genes were dhaB1 and dhaB2 from C. butyricum VPI1718 coding for glycerol dehydratase (GDHt) and its activator (GDHtAc), respectively, involved in the conversion of glycerol to 3-hydroxypropionaldehyde (3-HPA). The yqhD gene from E.coli BL21 was also included which codes for an NADPHdependent 1,3-propanediol oxidoreductase isoenzyme (PDORI) reducing 3-HPA to 1,3-propanediol (1,3-PD). Molecular modeling analysis indicated that the conformation of fusion protein of YQHD and DHAB1 was favorable for direct molecular channeling of the intermediate 3-HPA. According to the simulation results, the yqhD and dhaB1 gene were assembled in the upstream of dhaB2 to express a fusion protein, yielding the recombinant strain E. coliBL21 (DE3)//pET22b+::yqhD-dhaB1_dhaB2 (strain BP41Y3). Strain BP41Y3 gave 10-fold higher 1,3-PD concentration than E. coliBL21 (DE3)//pET22b+::yqhD-dhaB1_dhaB2 (strain BP31Y2) expressing the recombinant enzymes simultaneously but in a non-fusion mode. This is the first report using a gene fusion approach to enhance the biological conversion of glycerol to the value added compound 1,3- PD.

Keywords: Recombinant E.coli, 1, 3-propanediol, glycerol, fusion protein.

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Authors: Kwame B. O. Amoah

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This paper focuses on retrofitting an old existing office building to a net-zero energy building (NZEB). An existing small office building in Melbourne, Florida, was chosen as a case study to integrate state-of-the-art design strategies and energy-efficient building systems to improve building performance and reduce energy consumption. The study aimed to explore possible ways to maximize energy savings and renewable energy generation sources to cover the building's remaining energy needs necessary to achieve net-zero energy goals. A series of retrofit options were reviewed and adopted with some significant additional decision considerations. Detailed processes and considerations leading to zero energy are well documented in this study, with lessons learned adequately outlined. Based on building energy simulations, multiple design considerations were investigated, such as emerging state-of-the-art technologies, material selection, improvements to the building envelope, optimization of the HVAC, lighting systems, and occupancy loads analysis, as well as the application of renewable energy sources. The comparative analysis of simulation results was used to determine how specific techniques led to energy saving and cost reductions. The research results indicate that this small office building can meet net-zero energy use after appropriate design manipulations and renewable energy sources.

Keywords: Energy consumption, building energy analysis, energy retrofits, energy-efficiency.

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Authors: Dmitriy Yu. Korulkin, Raissa A. Muzychkina

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The Ramon preparation is received from a plant; it is destined for external treatment of inflammations in post-surgery period. The Ramon is a biogenic immune stimulator accelerating metabolism, contributing to improvement of blood indexes, having general tonic, anti-inflammatory and bactericidal effect.

Keywords: Anti-inflammatory, anthraquinones, bactericidal activity, Ramon.

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Authors: Mustafa M. Donma, Sule G. Kacmaz, Ahsen Yilmaz, Savas Guzel, Orkide Donma

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Obesity, as excessive fat accumulation in the body, is a global health problem. The prevalence of obesity and its complications increase due to easy access to high-energy food and decreased physical activity. Cardiovascular diseases (CVDs) constitute a significant part of obesity-related morbidity and mortality. Since the effects of obesity on cardiovascular system may start during childhood without clinical findings, elucidating the mechanisms of cardiovascular changes associated with childhood obesity became more important. In this study, we aimed to investigate some biochemical parameters which may be involved in obesity-related pathologic processes of CVDs. One hundred and seventy-seven children were included in the study, and they were divided into four groups based upon WHO criteria and presence of the metabolic syndrome (MetS): children with normal-BMI, obesity, morbid obesity, and MetS. High-sensitive cardiac troponin T (hs-cTnT), cardiac myosin binding protein C (cMyBP-C), trimethylamine N-oxide (TMAO), soluble tumor necrosis factor-like weak inducer (sTWEAK), chromogranin A (CgA), multimerin-2 levels, and other biochemical parameters were measured in serum samples. Anthropometric measurements and clinical findings of the children were recorded. Statistical analyses were performed. Children with normal-BMI had significantly higher CgA levels than children with obesity, morbid obesity, and MetS (p < 0.05). Cardiac MyBP-C levels of children with MetS were significantly higher than of children with normal-BMI and OB children (p < 0.05). There was no significant difference in hs-cTnT, sTWEAK, TMAO and multimerin-2 between the groups (p>0.05). These results suggested that cMyBP-C and CgA molecules may be involved in the pathogenesis of obesity-related CVDs.

Keywords: biomarker, cardiovascular diseases, children, obesity

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Authors: Mughal Yar M, Israr Ul Haq, Bushra Noman

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The stem cells have ability to differentiated themselves through mitotic cell division and various range of specialized cell types. Cellular differentiation is a way by which few specialized cell develops into more specialized.This paper studies the fundamental problem of computational schema for an artificial neural network based on chemical, physical and biological variables of state. By doing this type of study system could be model for a viable propagation of various economically important stem cells differentiation. This paper proposes various differentiation outcomes of artificial neural network into variety of potential specialized cells on implementing MATLAB version 2009. A feed-forward back propagation kind of network was created to input vector (five input elements) with single hidden layer and one output unit in output layer. The efficiency of neural network was done by the assessment of results achieved from this study with that of experimental data input and chosen target data. The propose solution for the efficiency of artificial neural network assessed by the comparatative analysis of “Mean Square Error" at zero epochs. There are different variables of data in order to test the targeted results.

Keywords: Computational shcmin, meiosis, mitosis, neuralnetwork, Stem cell SOM;

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Authors: Methawee Yuttapongtada

Abstract:

Intensifier is the linguistic term and device that is generally found in different languages in order to enhance and give additional quantity, quality or emotion to the words of each language. In fact, each language in the world has both of the similar and dissimilar intensifying device. More specially, the wide variety of intensifying device is used for Thai language and one of those is usage of the impolite word or the word that used to mean something negative as intensifier. The data collection in this study was done throughout the spoken language style by collecting from intensifiers regarded as impolite words because these words as employed in the other contexts will be held as the rude, swear words or the words with negative meaning. Then, backward study to the past was done in order to consider the historical change. Explanation of the original meaning and the contexts of words use from the past till the present time were done by use of both textual documents and dictionaries available in different periods. It was found that regarding the semantics and pragmatic aspects, subjectification also is the significant motivation that changed the impolite words to intensifiers. At last, it can explain pathway of the semantic change of these very words undoubtedly. Moreover, it is found that use tendency in the impolite word or the word that used to mean something negative will more be increased and this phenomenon is commonly found in many languages in the world and results of this research may support to the belief that human language in the world is universal and the same still reflected that human has the fundamental thought as the same to each other basically.

Keywords: Impolite word, intensifier, Thai, semantic change.

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Authors: Munir Majdalawieh, Adam Marks

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In today’s very competitive higher education industry (HEI), HEIs are faced with the primary concern of developing, deploying, and sustaining high quality academic programs. Today, the HEI has well-established accreditation systems endorsed by a country’s legislation and institutions. The accreditation system is an educational pathway focused on the criteria and processes for evaluating educational programs. Although many aspects of the accreditation process highlight both the past and the present (prove), the “program review” assessment is "forward-looking assessment" (improve) and thus transforms the process into a continuing assessment activity rather than a periodic event. The purpose of this study is to propose a conceptual measurement framework for program review to be used by HEIs to undertake a robust and targeted approach to proactively and continuously review their academic programs to evaluate its practicality and effectiveness as well as to improve the education of the students. The proposed framework consists of two main components: program review principles and the program review measurement matrix.

Keywords: Academic program, program review principles, curriculum development, accreditation, evaluation, assessment, review measurement matrix, program review process, information technologies supporting learning, learning/teaching methodologies and assessment.

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Authors: Yasuyuki Takahashi, Hayato Ishimura, Masao Miyagawa, Teruhito Mochizuki

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Quantitative measurement of myocardium perfusion is possible with single photon emission computed tomography (SPECT) using a semiconductor detector. However, accumulation of ^99mTc-tetrofosmin in the liver may make it difficult to assess that accurately in the inferior myocardium. Our idea is to reduce the high accumulation in the liver by using dynamic SPECT imaging and a technique called time subtraction. We evaluated the performance of a new SPECT system with a cadmium-zinc-telluride solid-state semi- conductor detector (Discovery NM 530c; GE Healthcare). Our system acquired list-mode raw data over 10 minutes for a typical patient. From the data, ten SPECT images were reconstructed, one for every minute of acquired data. Reconstruction with the semiconductor detector was based on an implementation of a 3-D iterative Bayesian reconstruction algorithm. We studied 20 patients with coronary artery disease (mean age 75.4 ± 12.1 years; range 42-86; 16 males and 4 females). In each subject, 259 MBq of ^99mTc-tetrofosmin was injected intravenously. We performed both a phantom and a clinical study using dynamic SPECT. An approximation to a liver-only image is obtained by reconstructing an image from the early projections during which time the liver accumulation dominates (0.5~2.5 minutes SPECT image-5~10 minutes SPECT image). The extracted liver-only image is then subtracted from a later SPECT image that shows both the liver and the myocardial uptake (5~10 minutes SPECT image-liver-only image). The time subtraction of liver was possible in both a phantom and the clinical study. The visualization of the inferior myocardium was improved. In past reports, higher accumulation in the myocardium due to the overlap of the liver is un-diagnosable. Using our time subtraction method, the image quality of the ^99mTc-tetorofosmin myocardial SPECT image is considerably improved.

Keywords: 99mTc-tetrofosmin, dynamic SPECT, time subtraction, semiconductor detector.

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Authors: Christos Bouras, Eirini Stergiou, Charitini Karakostaki, Vasileios Tzanos, Vasileios Kokkinos

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Wind power represents a major pathway to curtailing greenhouse gas emissions and thus reducing the rate of climate change. A wind turbine runs practically emission-free for 20 years, representing one of the most environmentally sustainable sources of energy. Nevertheless, environmental and biodiversity concerns can often slow down or halt the deployment of wind farms due to local public opposition. This opposition is often fuelled by poor relationships between wind energy stakeholders and civil society, which in many cases led to conflictual protests and property damage. In this context, addressing these concerns is essential in order to facilitate the proliferation of wind farms in Europe and the phase-out of fossil fuels from the energy mix. The aim of this study is to identify a number of good practices and cases to avoid increasing biodiversity protection at all stages of wind farms’ lifecycle in three participating countries, namely Greece, Latvia, and Poland. The results indicate that although available technological solutions are already being exploited worldwide, in these countries, there is still room for improvement. To address this gap, a set of policy recommendations is proposed to accomplish the wind energy targets in the near future while simultaneously mitigating the pertinent biodiversity risks.

Keywords: Biodiversity protection, environmental impact, social acceptance, wind energy.

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Authors: Isam A. Mohamed Ahmed, Jiro Arima, Tsuyoshi Ichiyanagi, Emi Sakuno, Nobuhiro Mori

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The aim of this study was to screen for microorganism that able to utilize 3-N-trimethylamino-1-propanol (homocholine) as a sole source of carbon and nitrogen. The aerobic degradation of homocholine has been found by a gram-positive Rhodococcus sp. bacterium isolated from soil. The isolate was identified as Rhodococcus sp. strain A4 based on the phenotypic features, physiologic and biochemical characteristics, and phylogenetic analysis. The cells of the isolated strain grown on both basal-TMAP and nutrient agar medium displayed elementary branching mycelia fragmented into irregular rod and coccoid elements. Comparative 16S rDNA sequencing studies indicated that the strain A4 falls into the Rhodococcus erythropolis subclade and forms a monophyletic group with the type-strains of R. opacus, and R. wratislaviensis. Metabolites analysis by capillary electrophoresis, fast atom bombardment-mass spectrometry, and gas chromatography- mass spectrometry, showed trimethylamine (TMA) as the major metabolite beside β-alanine betaine and trimethylaminopropionaldehyde. Therefore, the possible degradation pathway of trimethylamino propanol in the isolated strain is through consequence oxidation of alcohol group (-OH) to aldehyde (-CHO) and acid (-COOH), and thereafter the cleavage of β-alanine betaine C-N bonds yielded trimethylamine and alkyl chain.

Keywords: Homocholine, 3-N-trimethylamino-1-propanol, Quaternary ammonium compounds, 16S rDNA gene sequence.

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Authors: M. Tsirintani

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The article is proposing a base plan for the future Patient Care Information Systems in a changing health care environment where it is necessary to assure quality patient care services and reducing cost and where new technology trends give the opportunities to develop clinical applications and services patient focused according to new business objectives.

Keywords: Health care management, planning patient care information system.

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Authors: Ratnakar Tripathi, Rajnikant Mishra

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The PAX6, a transcription factor, is essential for the morphogenesis of the eyes, brain, pituitary and pancreatic islets. In rodents, the loss of Pax6 function leads to central nervous system defects, anophthalmia, and nasal hypoplasia. The haplo-insufficiency of Pax6 causes microphthalmia, aggression and other behavioral abnormalities. It is also required in brain patterning and neuronal plasticity. In human, heterozygous mutation of Pax6 causes loss of iris [aniridia], mental retardation and glucose intolerance. The 3- deletion in Pax6 leads to autism and aniridia. The phenotypes are variable in peneterance and expressivity. However, mechanism of function and interaction of PAX6 with other proteins during development and associated disease are not clear. It is intended to explore interactors of PAX6 to elucidated biology of PAX6 function in the tissues where it is expressed and also in the central regulatory pathway. This report describes In-silico approaches to explore interacting proteins of PAX6. The models show several possible proteins interacting with PAX6 like MITF, SIX3, SOX2, SOX3, IPO13, TRIM, and OGT. Since the Pax6 is a critical transcriptional regulator and master control gene of eye and brain development it might be interacting with other protein involved in morphogenesis [TGIF, TGF, Ras etc]. It is also presumed that matricelluar proteins [SPARC, thrombospondin-1 and osteonectin etc] are likely to interact during transport and processing of PAX6 and are somewhere its cascade. The proteins involved in cell survival and cell proliferation can also not be ignored.

Keywords: Interacting Proteins, Pax6, PIP, STRING

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Authors: Ashwin Belle, Bryce Benson, Mark Salamango, Fadi Islim, Rodney Daniels, Kevin Ward

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A reliable, real-time, and non-invasive system that can identify patients at risk for hemodynamic instability is needed to aid clinicians in their efforts to anticipate patient deterioration and initiate early interventions. The purpose of this pilot study was to explore the clinical capabilities of a real-time analytic from a single lead of an electrocardiograph to correctly distinguish between rapid response team (RRT) activations due to hemodynamic (H-RRT) and non-hemodynamic (NH-RRT) causes, as well as predict H-RRT cases with actionable lead times. The study consisted of a single center, retrospective cohort of 21 patients with RRT activations from step-down and telemetry units. Through electronic health record review and blinded to the analytic’s output, each patient was categorized by clinicians into H-RRT and NH-RRT cases. The analytic output and the categorization were compared. The prediction lead time prior to the RRT call was calculated. The analytic correctly distinguished between H-RRT and NH-RRT cases with 100% accuracy, demonstrating 100% positive and negative predictive values, and 100% sensitivity and specificity. In H-RRT cases, the analytic detected hemodynamic deterioration with a median lead time of 9.5 hours prior to the RRT call (range 14 minutes to 52 hours). The study demonstrates that an electrocardiogram (ECG) based analytic has the potential for providing clinical decision and monitoring support for caregivers to identify at risk patients within a clinically relevant timeframe allowing for increased vigilance and early interventional support to reduce the chances of continued patient deterioration.

Keywords: Critical care, early warning systems, emergency medicine, heart rate variability, hemodynamic instability, rapid response team.

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Authors: Abdelgawad, Salah El-Tahawy

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This paper aimed to establish econometrical equation models for the Nile delta region in Egypt, which will represent a basement for future predictions of Lumpy skin disease outbreaks and its pathway in relation to climate change. Data of lumpy skin disease (LSD) outbreaks were collected from the cattle farms located in the provinces representing the Nile delta region during 1 January, 2015 to December, 2015. The obtained results indicated that there was a significant association between the degree of the LSD outbreaks and the investigated climate factors (temperature, wind speed, and humidity) and the outbreaks peaked during the months of June, July, and August and gradually decreased to the lowest rate in January, February, and December. The model obtained depicted that the increment of these climate factors were associated with evidently increment on LSD outbreaks on the Nile Delta of Egypt. The model validation process was done by the root mean square error (RMSE) and means bias (MB) which compared the number of LSD outbreaks expected with the number of observed outbreaks and estimated the confidence level of the model. The value of RMSE was 1.38% and MB was 99.50% confirming that this established model described the current association between the LSD outbreaks and the change on climate factors and also can be used as a base for predicting the of LSD outbreaks depending on the climatic change on the future.

Keywords: LSD, climate factors, econometric models, Nile Delta.

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Authors: Fernanda T. Orsati, Julie Causton

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Discursive practices enacted by educators in kindergarten create a blueprint for how the educational trajectories of students with disabilities are constructed. This two-year ethnographic case study critically examines educators’ relationships with students considered to present challenging behaviors in one kindergarten classroom located in a predominantly White middle class school district in the Northeast of the United States. Focusing on the language and practices used by one special education teacher and three teaching assistants, this paper analyzes how teacher responses to students’ behaviors constructs and positions students over one year of kindergarten education. Using a critical discourse analysis it shows that educators understand students’ behaviors as deficit and needing consequences. This study highlights how educators’ responses reflect students' individual characteristics including family background, socioeconomics and ability status. This paper offers in depth analysis of two students’ stories, which evidenced that the language used by educators amplifies the social positioning of students within the classroom and creates a foundation for who they are constructed to be. Through exploring routine language and practices, this paper demonstrates that educators outlined a blueprint of kindergartners, which positioned students as learners in ways that became the ground for either a limited or a promising educational pathway for them.

Keywords: Behavior, early education, special education, critical discourse analysis.

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Authors: Abu Salim Mustafa

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Polymerase chain reaction (PCR) assays targeting genomic DNA segments have been established for the detection of Helicobacter pylori in clinical specimens. However, the data on comparative evaluations of various targets in detection of H. pylori are limited. Furthermore, the frequencies of vacA (s1 and s2) and cagA genotypes, which are suggested to be involved in the pathogenesis of H. pylori in other parts of the world, are not well studied in Kuwait. The aim of this study was to evaluate PCR assays for the detection and genotyping of H. pylori by targeting the amplification of DNA targets from four genomic segments. The genomic DNA were isolated from 72 clinical isolates of H. pylori and tested in PCR with four pairs of oligonucleotides primers, i.e. ECH-U/ECH-L, ET-5U/ET-5L, CagAF/CagAR and Vac1F/Vac1XR, which were expected to amplify targets of various sizes (471 bp, 230 bp, 183 bp and 176/203 bp, respectively) from the genomic DNA of H. pylori. The PCR-amplified DNA were analyzed by agarose gel electrophoresis. PCR products of expected size were obtained with all primer pairs by using genomic DNA isolated from H. pylori. DNA dilution experiments showed that the most sensitive PCR target was 471 bp DNA amplified by the primers ECH-U/ECH-L, followed by the targets of Vac1F/Vac1XR (176 bp/203 DNA), CagAF/CagAR (183 bp DNA) and ET-5U/ET-5L (230 bp DNA). However, when tested with undiluted genomic DNA isolated from single colonies of all isolates, the Vac1F/Vac1XR target provided the maximum positive results (71/72 (99% positives)), followed by ECH-U/ECH-L (69/72 (93% positives)), ET-5U/ET-5L (51/72 (71% positives)) and CagAF/CagAR (26/72 (46% positives)). The results of genotyping experiments showed that vacA s1 (46% positive) and vacA s2 (54% positive) genotypes were almost equally associated with VaCA+/CagA- isolates (P > 0.05), but with VacA+/CagA+ isolates, S1 genotype (92% positive) was more frequently detected than S2 genotype (8% positive) (P< 0.0001). In conclusion, among the primer pairs tested, Vac1F/Vac1XR provided the best results for detection of H. pylori. The genotyping experiments showed that vacA s1 and vacA s2 genotypes were almost equally associated with vaCA⁺/cagA^- isolates, but vacA s1 genotype had a significantly increased association with vacA⁺/cagA⁺ isolates.

Keywords: H. pylori, detection, genotyping, Kuwait.

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Authors: S. A. Nta

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Application of health risk assessment methods is important in order to comprehend the risk of human exposure to heavy metals and other dangerous pollutants. Four soil samples were collected at distances of 10, 20, 30 m and the control 100 m away from the dump site at depths of 0.3, 0.6 and 0.9 m. The collected soil samples were examined for Zn, Cu, Pb, Cd and Ni using standard methods. The health risks via the main pathways of human exposure to heavy metal were detected using relevant standard equations. Hazard quotient was calculated to determine non-carcinogenic health risk for each individual heavy metal. Life time cancer risk was calculated to determine the cumulative life cancer rating for each exposure pathway. The estimated health risk values for adults and children were generally lower than the reference dose. The calculated hazard quotient for the ingestion, inhalation and dermal contact pathways were less than unity. This means that there is no detrimental concern to the health on human exposure to heavy metals in contaminated soil. The life time cancer risk 5.4 × 10^-2 was higher than the acceptable threshold value of 1 × 10^-4 which is reflected to have significant health effects on human exposure to heavy metals in contaminated soil. Good hygienic practices are recommended to ease the potential risk to children and adult who are exposed to contaminated soils. Also, the local authorities should be made aware of such health risks for the purpose of planning the management strategy accordingly.

Keywords: Health risk assessment, pollution, heavy metals, soil.

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Authors: M. Saravanan

Abstract:

Antimicrobial resistant is becoming a major factor in virtually all hospital acquired infection may soon untreatable is a serious public health problem. These concerns have led to major research effort to discover alternative strategies for the treatment of bacterial infection. Nanobiotehnology is an upcoming and fast developing field with potential application for human welfare. An important area of nanotechnology for development of reliable and environmental friendly process for synthesis of nanoscale particles through biological systems In the present studies are reported on the use of fungal strain Aspergillus species for the extracellular synthesis of bionanoparticles from 1 mM silver nitrate (AgNO3) solution. The report would be focused on the synthesis of metallic bionanoparticles of silver using a reduction of aqueous Ag+ ion with the culture supernatants of Microorganisms. The bio-reduction of the Ag+ ions in the solution would be monitored in the aqueous component and the spectrum of the solution would measure through UV-visible spectrophotometer The bionanoscale particles were further characterized by Atomic Force Microscopy (AFM), Fourier Transform Infrared Spectroscopy (FTIR) and Thin layer chromatography. The synthesized bionanoscale particle showed a maximum absorption at 385 nm in the visible region. Atomic Force Microscopy investigation of silver bionanoparticles identified that they ranged in the size of 250 nm - 680 nm; the work analyzed the antimicrobial efficacy of the silver bionanoparticles against various multi drug resistant clinical isolates. The present Study would be emphasizing on the applicability to synthesize the metallic nanostructures and to understand the biochemical and molecular mechanism of nanoparticles formation by the cell filtrate in order to achieve better control over size and polydispersity of the nanoparticles. This would help to develop nanomedicine against various multi drug resistant human pathogens.

Keywords: Bionanoparticles, UV-visible spectroscopy, AtomicForce Microscopy, Extracellular synthesis, Multi drug resistant, antimicrobial activity, Nanomedicine

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Authors: Werner Sandmann, Verena Wolf

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Stochastic models of biological networks are well established in systems biology, where the computational treatment of such models is often focused on the solution of the so-called chemical master equation via stochastic simulation algorithms. In contrast to this, the development of storage-efficient model representations that are directly suitable for computer implementation has received significantly less attention. Instead, a model is usually described in terms of a stochastic process or a "higher-level paradigm" with graphical representation such as e.g. a stochastic Petri net. A serious problem then arises due to the exponential growth of the model-s state space which is in fact a main reason for the popularity of stochastic simulation since simulation suffers less from the state space explosion than non-simulative numerical solution techniques. In this paper we present transition class models for the representation of biological network models, a compact mathematical formalism that circumvents state space explosion. Transition class models can also serve as an interface between different higher level modeling paradigms, stochastic processes and the implementation coded in a programming language. Besides, the compact model representation provides the opportunity to apply non-simulative solution techniques thereby preserving the possible use of stochastic simulation. Illustrative examples of transition class representations are given for an enzyme-catalyzed substrate conversion and a part of the bacteriophage λ lysis/lysogeny pathway.

Keywords: Computational Modeling, Biological Networks, Stochastic Models, Markov Chains, Transition Class Models.

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Authors: Syed Dawood Md. Taimur, Md. Hasanur Rahman, Syeda Fahmida Afrin, Farzana Islam

Abstract:

The concept of myocardial injury, although first recognized from animal studies, is now recognized as a clinical phenomenon that may result in microvascular damage, no-reflow phenomenon, myocardial stunning, myocardial hibernation and ischemic preconditioning. The final consequence of this event is left ventricular (LV) systolic dysfunction leading to increased morbidity and mortality. The typical clinical case of reperfusion injury occurs in acute myocardial infarction (MI) with ST segment elevation in which an occlusion of a major epicardial coronary artery is followed by recanalization of the artery. This may occur spontaneously or by means of thrombolysis and/or by primary percutaneous coronary intervention (PCI) with efficient platelet inhibition by aspirin (acetylsalicylic acid), clopidogrel and glycoprotein IIb/IIIa inhibitors. In recent years, percutaneous coronary intervention (PCI) has become a well-established technique for the treatment of coronary artery disease. PCI improves symptoms in patients with coronary artery disease and it has been increasing safety of procedures. However, peri- and post-procedural myocardial injury, including angiographical slow coronary flow, microvascular embolization, and elevated levels of cardiac enzyme, such as creatine kinase and troponin-T and -I, has also been reported even in elective cases. Furthermore, myocardial reperfusion injury at the beginning of myocardial reperfusion, which causes tissue damage and cardiac dysfunction, may occur in cases of acute coronary syndrome. Because patients with myocardial injury is related to larger myocardial infarction and have a worse long-term prognosis than those without myocardial injury, it is important to prevent myocardial injury during and/or after PCI in patients with coronary artery disease. To date, many studies have demonstrated that adjunctive pharmacological treatment suppresses myocardial injury and increases coronary blood flow during PCI procedures. In this review, we highlight the usefulness of pharmacological treatment in combination with PCI in attenuating myocardial injury in patients with coronary artery disease.

Keywords: Coronary artery disease, Percutaneous coronary intervention, Myocardial injury, Pharmacology.

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Authors: Tony Austin, Shanghua Sun, Nathan Lea, Steve Iliffe, Dipak Kalra, David Ingram, David Patterson

Abstract:

Computer-based decision support (CDSS) systems can deliver real patient care and increase chances of long-term survival in areas of chronic disease management prone to poor control. One such CDSS, for the management of warfarin, is described in this paper and the outcomes shown. Data is derived from the running system and show a performance consistently around 20% better than the applicable guidelines.

Keywords: "Decision Support", "Anticoagulant Control"

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Authors: K. Turhan, B. Kurt, E. Uzun

Abstract:

This paper describes Clinical Document Architecture Release Two (CDA R2) standard and a client application for messaging with SAĞLIK-NET project developed by The Ministry of Health of Turkey. CDA R2 , developed by Health Level 7 (HL7) organization and approved by American National Standards Institute (ANSI) in 2004, to standardize medical information to be able to share semantically and syntactically. In this study, a client application compatible with HL7 V3 for a project named SAĞLIKNET, aimed to build a National Health Information System by Turkey. Moreover, CDA conformance of this application will also be evaluated.

Keywords: HL7 V3, CDA, Interoperability, Web Service.

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Authors: Sadaf Moeez, Madiha Khalid, Zoya Khalid, Sania Shaheen, Sumbul Khalid

Abstract:

Background: Inter-individual variation in response to metformin, which has been considered as a first line therapy for T2DM treatment is considerable. In the current study, it was aimed to investigate the impact of two genetic variants Leu125Phe (rs77474263) and Gly64Asp (rs77630697) in gene SLC47A1 on the clinical efficacy of metformin in T2DM Pakistani patients. Methods: The study included 800 T2DM patients (400 metformin responders and 400 metformin non-responders) along with 400 ethnically matched healthy individuals. The genotypes were determined by allele-specific polymerase chain reaction. In-silico analysis was done to confirm the effect of the two SNPs on the structure of genes. Association was statistically determined using SPSS software. Results: Minor allele frequency for rs77474263 and rs77630697 was 0.13 and 0.12. For SLC47A1 rs77474263 the homozygotes of one mutant allele ‘T’ (CT) of rs77474263 variant were fewer in metformin responders than metformin non-responders (29.2% vs. 35.5 %). Likewise, the efficacy was further reduced (7.2% vs. 4.0 %) in homozygotes of two copies of ‘T’ allele (TT). Remarkably, T2DM cases with two copies of allele ‘C’ (CC) had 2.11 times more probability to respond towards metformin monotherapy. For SLC47A1 rs77630697 the homozygotes of one mutant allele ‘A’ (GA) of rs77630697 variant were fewer in metformin responders than metformin non-responders (33.5% vs. 43.0 %). Likewise, the efficacy was further reduced (8.5% vs. 4.5%) in homozygotes of two copies of ‘A’ allele (AA). Remarkably, T2DM cases with two copies of allele ‘G’ (GG) had 2.41 times more probability to respond towards metformin monotherapy. In-silico analysis revealed that these two variants affect the structure and stability of their corresponding proteins. Conclusion: The present data suggest that SLC47A1 Leu125Phe (rs77474263) and Gly64Asp (rs77630697) polymorphisms were associated with the therapeutic response of metformin in T2DM patients of Pakistan.

Keywords: Diabetes, T2DM, SLC47A1, Pakistan, polymorphism.

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Authors: Pei-Chann Chang, Jui-Chien Hsieh, Jyun-Jie Lin, Feng-Ming Yeh

Abstract:

Atrial Fibrillation is the most common sustained arrhythmia encountered by clinicians. Because of the invisible waveform of atrial fibrillation in atrial activation for human, it is necessary to develop an automatic diagnosis system. 12-Lead ECG now is available in hospital and is appropriate for using Independent Component Analysis to estimate the AA period. In this research, we also adopt a second-order blind identification approach to transform the sources extracted by ICA to more precise signal and then we use frequency domain algorithm to do the classification. In experiment, we gather a significant result of clinical data.

Keywords: 12-Lead ECG, Atrial Fibrillation, Blind SourceSeparation, Kurtosis

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Authors: J. M. Counsell, Y. Khalid, M. J. Stewart

Abstract:

Achieving nearly zero carbon heating continues to be identified by UK government analysis as an important feature of any lowest cost pathway to reducing greenhouse gas emissions. Heat currently accounts for 48% of UK energy consumption and approximately one third of UK’s greenhouse gas emissions. Heat Networks are being promoted by UK investment policies as one means of supporting hybrid heat pump based solutions. To this effect the RISE (Renewable Integrated and Sustainable Electric) heating system project is investigating how an all-electric heating sourceshybrid configuration could play a key role in long-term decarbonisation of heat.  For the purposes of this study, hybrid systems are defined as systems combining the technologies of an electric driven air source heat pump, electric powered thermal storage, a thermal vessel and micro-heat network as an integrated system.  This hybrid strategy allows for the system to store up energy during periods of low electricity demand from the national grid, turning it into a dynamic supply of low cost heat which is utilized only when required. Currently a prototype of such a system is being tested in a modern house integrated with advanced controls and sensors. This paper presents the virtual performance analysis of the system and its design for a micro heat network with multiple dwelling units. The results show that the RISE system is controllable and can reduce carbon emissions whilst being competitive in running costs with a conventional gas boiler heating system.

Keywords: Gas boilers, heat pumps, hybrid heating and thermal storage, renewable integrated& sustainable electric.

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Authors: Jafar Ahmadi, Zhohreh Asiaban, Sedigheh Fabriki Ourang

Abstract:

Brassinosteroids (BRs) regulate cell elongation, vascular differentiation, senescence, and stress responses. BRs signal through the BES1/BZR1 family of transcription factors, which regulate hundreds of target genes involved in this pathway. In this research a comprehensive genome-wide analysis was carried out in BES1/BZR1 gene family in Arabidopsis thaliana, Cucumis sativus, Vitis vinifera, Glycin max and Brachypodium distachyon. Specifications of the desired sequences, dot plot and hydropathy plot were analyzed in the protein and genome sequences of five plant species. The maximum amino acid length was attributed to protein sequence Brdic3g with 374aa and the minimum amino acid length was attributed to protein sequence Gm7g with 163aa. The maximum Instability index was attributed to protein sequence AT1G19350 equal with 79.99 and the minimum Instability index was attributed to protein sequence Gm5g equal with 33.22. Aliphatic index of these protein sequences ranged from 47.82 to 78.79 in Arabidopsis thaliana, 49.91 to 57.50 in Vitis vinifera, 55.09 to 82.43 in Glycin max, 54.09 to 54.28 in Brachypodium distachyon 55.36 to 56.83 in Cucumis sativus. Overall, data obtained from our investigation contributes a better understanding of the complexity of the BES1/BZR1 gene family and provides the first step towards directing future experimental designs to perform systematic analysis of the functions of the BES1/BZR1 gene family.

Keywords: BES1/BZR1, Brassinosteroids, Phylogenetic analysis, Transcription factor.

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Authors: S.M. Abdul Khader, Md. Zubair, Raghuvir Pai. B, V.R.K. Rao, S. Ganesh Kamath

Abstract:

The recent advances in computational fluid dynamics (CFD) can be useful in observing the detailed hemodynamics in cerebral aneurysms for understanding not only their formation and rupture but also for clinical evaluation and treatment. However, important hemodynamic quantities are difficult to measure in vivo. In the present study, an approximate model of normal middle cerebral artery (MCA) along with two cases consisting broad and narrow saccular aneurysms are analyzed. The models are generated in ANSYS WORKBENCH and transient analysis is performed in ANSYS-CFX. The results obtained are compared for three cases and agree well with the available literature.

Keywords: Aneurysms, ANSYS – CFX, CFD, Pulsatile flow.

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