The effect of a novel electrical stimulation method for improving lower limb blood flow in healthy volunteers

PhDVenous thromboembolism (VTE) is a significant preventable complication that causes morbidity and mortality not only in hospitalised patients, but also in healthy individuals. Pharmacological and mechanical prophylactic methods are available. Pharmacological methods, although are effective in reducing the incidence of VTE, the bleeding risk associated with their use is a major drawback. Besides pharmacological methods, clinical practice guidelines also recommend the use of mechanical methods (NICE, 2010b). The rationale for using mechanical methods is to increase venous return and decrease the risk of venous stasis, one of the compounding factors for VTE. As with pharmacological methods, mechanical interventions are also associated with side effects. Electrical stimulation is an alternative method, which has been shown to be effective in improving blood flow (Faghri et al., 1997, Lindstrom et al., 1982, Nicolaides et al., 1972). This method however, has not gained widespread use mainly due to the elevated discomfort associated with its use at high intensities. The limited number of available electrical stimulation devices, are complex in structure and restricts mobility. Therefore, developing an alternative technique that is effective and easy to use is justifiable. It is among our intentions in the studies presented in this thesis, to investigate the effectiveness of a novel electrical stimulation technique. The studies outlined in this thesis were carried out on healthy adult volunteers, with the intention of investigating the efficacy of a custom built neuromuscular electrical stimulation device (THRIVE) in enhancing lower limb blood flow and supporting the development of a prototype to a commercial medical device (geko™ T-1). The device activates foot and calf muscle pumps of the lower leg using OnPulse™ Technology; a software that ensures safe and controlled delivery of electrical impulses. The effect of the novel device on cardiac function was initially investigated, where the electrical stimulation device was applied bilaterally for 30 minutes at two pulse width settings 400μs and 600μs on 10 healthy subjects lying supine. A significant difference in cardiac output was reported following echocardiography assessments, p ≤ 0.05. Similarly, a significant increase in skin microcirculatory velocity together with arterial peak velocity and blood volume flow was reported, p ≤ 0.05. Further investigations were then performed on 10 healthy subjects seated in an airline seat for a period of 4 hours, to explore the systemic effect of the electrical stimulation device applied for a period of 5 minutes on specific blood coagulation parameters. A series of lower limb circulatory dynamic assessments were performed at baseline and at 1, 2, 3 and 4 hours. Blood coagulation parameters and blood clotting time were measured through analysis of blood withdrawn from three anatomical sites (arm, right leg and left leg). Results obtained have shown a highly significant increase in lower limb blood perfusion, p ≤ 0.001. An enhanced fibrinolytic activity, characterised by a significant drop in tissue plasminogen antigen levels was seen. No major effects on vital signs were reported. Finally, a comparison of the effectiveness of the novel device with two leading mechanical prophylaxis devices, Huntleigh Flowtron™ Universal and Kendall SCD™ was performed on 10 healthy subjects. Each device was fitted for a period of 30 minutes followed by a 10 minute recovery phase, in a sequential manner. Colour flow Doppler ultrasound in addition to skin microcirculatory and vital Abstract Page 5 of 265 sign assessments were carried out to further assess the comparative efficacy. Results obtained demonstrate that the novel device is significantly more effective in increasing microcirculatory velocity, p ≤ 0.001 in comparison to the IPC devices investigated. Venous blood flow measurements were also significantly higher for the geko™ T-1 device compared to the IPC devices. Furthermore, a significant increase in both arterial blood velocity and volume was reported following the use of the geko™ T-1 device. The safety and tolerability to the device was also of prime concern. Results showed that the device was well tolerated throughout, as indicated by the minimal discomfort sensation perceived by the subjects using visual analogue scale (VAS) and verbal rating score (VRS) in all studies. In conclusion, the results obtained in this thesis indicate that the geko™ T-1 device investigated has a potential use in the prevention of deep vein thrombosis and other peripheral vascular disorders due to significant effects on circulatory dynamics in arterial, venous, and microcirculatory systems

Quantum Mechanical Investigations into Thermochemistry Properties and Electronic, Structural of Nanocrystals

This paper presents quantum mechanical investigations that is into electronic and thermochemistry properties of Gallium phosphide. It also investigates diamondoids and nanocrystals using the density functional theory. This is done at the generalized gradient approximation of Perdew et al basis set. This has been used to create Gaussian 09 program auxiliary by Gaussian view. In order to full investigate the ionization potential, affinity, valance bond, conduction bond, zero point energy and thermochemistry properties. The result GaP diamondoids. Electron affinity and conduction band, decreases as a function of the total number of Ga and P atoms in most of the investigated range. Ionization energies zero point and valance bands increased with the number of Ga and P atoms but there are fluctuations in tetramantane and hexamantane In fact, since the present diamondoids are built from nearly cubic cages. Thermochemistry entails calculation of frequency which also includes thermochemical analysis of actual system comprising of thermal energy correction, heat capacity and entropy

Analysis of the amount of lost fluids, some blood components and mineral salts in volleyball under hot weather conditions

The research objective was to study the amount of lost fluids, some blood components and mineral salts in volleyball players under hot weather conditions. The sample of the present study was composed of 12 volleyball players of Al-Sinaa Club (Baghdad, Iraq) in the 2022/2023 season. The variables analyzed in this study were: Heart rate before and after exercise, internal and external body temperature before and after exertion, potassium ion, sodium ion, calcium ion, and the amount of fluid lost (the player's weight) before and after the exercise. The tests were conducted at a temperature between 42-47 degrees Celsius. The maximum anaerobic exercise was performed with volleyball. The results showed that to play volleyball under hot weather conditions (42-47 degrees Celsius) significantly increased the following variables in volleyball players: heart rate, external body temperature, internal body temperature, sodium ion and calcium ion. However, potassium ion significantly decreased. Therefore, training in hot weather has positive physical repercussions. The authors recommend to train in different weather conditions

Analysis of the amount of lost fluids, some blood components and mineral salts in volleyball under hot weather conditions

The research objective was to study the amount of lost fluids, some blood components and mineral salts in volleyball players under hot weather conditions. The sample of the present study was composed of 12 volleyball players of Al-Sinaa Club (Baghdad, Iraq) in the 2022/2023 season. The variables analyzed in this study were: Heart rate before and after exercise, internal and external body temperature before and after exertion, potassium ion, sodium ion, calcium ion, and the amount of fluid lost (the player's weight) before and after the exercise. The tests were conducted at a temperature between 42-47 degrees Celsius. The maximum anaerobic exercise was performed with volleyball. The results showed that to play volleyball under hot weather conditions (42-47 degrees Celsius) significantly increased the following variables in volleyball players: heart rate, external body temperature, internal body temperature, sodium ion and calcium ion. However, potassium ion significantly decreased. Therefore, training in hot weather has positive physical repercussions. The authors recommend to train in different weather conditions

Significance of Interleukin-8 in Cystitis and Schistosomal Chronic Cystitis

One of the important mediators of early inflammatory response in cystitis and an agent for attraction of neutrophils to the inflammation site is IL-8, in addition to its role in regulation angiogenesis. This study was carried out to assess the level of IL-8 biomarker in urine of cystitis patients (schistosomal chronic cystitis and non schistosomal cystitis).             Eighty eight Iraqi individual were divided to 50 cystitis patients and 38 healthy control, of whom urine sample and bladder biopsy were collected. Diagnosis of cystitis patients carried out by cystoscopy followed by histopathological examination and was classified to schistosomal chronic cystitis and non-schistosomal cystitis. Urine IL-8 level of studied groups was measured by ELISA test.             According to the result of ELISA technique, the mean urine concentration (pg/ml) of IL-8 increased significantly in cystitis patients 224.86 pg/ml than healthy controls 51.70 pg/ml. In regard to the age of cystitis patients urine level of this marker was significantly different (P<0.05), but there was not  any  significant increase in  IL-8 urine level according to sex, while IL-8 was with significant increase in Schistosomal chronic cystitis than non-Schistosomal cystitis. Lastly urine IL-8 showed specificity in diagnosis of cystitis 91.39% and more sensitivity 96.34%.             Result of this study showed significant increase in urinary IL-8 concentration in cystitis patients, with significant correlation between IL-8 level with Schistsoma infection and age

E-learning in the Cloud Computing Environment: Features, Architecture, Challenges and Solutions

The need to constantly and consistently improve the quality and quantity of the educational system is essential. E-learning has emerged from the rapid cycle of change and the expansion of new technologies. Advances in information technology have increased network bandwidth, data access speed, and reduced data storage costs. In recent years, the implementation of cloud computing in educational settings has garnered the interest of major companies, leading to substantial investments in this area. Cloud computing improves engineering education by providing an environment that can be accessed from anywhere and allowing access to educational resources on demand. Cloud computing is a term used to describe the provision of hosting services on the Internet. It is predicted to be the next generation of information technology architecture and offers great potential to enhance productivity and reduce costs. Cloud service providers offer their processing and memory resources to users. By paying for the use of these resources, users can access them for their calculations and processing anytime and anywhere. Cloud computing provides the ability to increase productivity, save information technology resources, and enhance computing power, converting processing power into a tool with constant access capabilities. The use of cloud computing in a system that supports remote education has its own set of characteristics and requires a unique strategy. Students can access a wide variety of instructional engineering materials at any time and from any location, thanks to cloud computing. Additionally, they can share their materials with other community members. The use of cloud computing in e-learning offers several advantages, such as unlimited computing resources, high scalability, and reduced costs associated with e-learning. An improvement in the quality of teaching and learning is achieved through the use of flexible cloud computing, which offers a variety of resources for educators and students. In light of this, the current research presents cloud computing technology as a suitable and superior option for e-learning systems

The Antibacterial Effect of Phytosterols Isolated from Echinops heterophyllus in Comparison with MEBO® and Standard Antimicrobial Agents.

This study investigated the types of phytosterols that exists in the aerial and root parts of Echinops heterophyllus and explored the antibacterial effect of these phytosterols against some pathogenic bacteria in comparison with Moist Exposed Wound Ointment (MEBO®) and gentamicin.Plant was extracted and phytosterols were isolated and purified from the crude extract of Echinops heterophyllus by using chemical method. Thin Layer Chromatography (TLC) detected the presence of steroids in the aerial and roots part and gas chromatographymass spectrophotometer GC/MS analysis was used to identify some of these compounds and among them were beta-sitosterol and stigmasterol. Standard dilutions of the phytosterols isolated from Echinops heterophyllus were made from 10-100%; its antibacterial effect had been examined by seeded agar method against Staphylococcus aureus and Pseudomonas aeruginosa. The effect of these phytosetrols against Staphylococcus aureus was more potent than against Pseudomonas aeruginosa. The minimum inhibitory concentration (MIC) was seventy mg/ml and the minimum bactericidal concentration (MBC) was eighty five mg/ml. This study illustrates that sitosterol isolated from Echinops heterophyllus has a greater inhibitory effect on the test bacteria than gentamicine and closer results to MEBO®. It can be concluded in this study is a good step to show the types of phytosterols isolated from Echinops heterophyllus and the antibacterial effect of these phytosterols in vitro against Staphylococcus aureus and Pseudomonas aeruginosa

Assessing Fracture Resistance of Restored Premolars with Novel Composite Materials: An In Vitro Study

During restorative treatment, premolars restored with resin filling materials using the conventional incremental-fill technique take longer restoration time and undermine the integrity of the tooth. The aim of this study was to assess fracture resistance of premolars restored by various types of novel bulk-fill composite resin materials. Forty-eight (n = 48) freshly extracted sound maxillary first premolars were used in this in vitro study. The teeth were divided into six groups, each having 8 specimens. Group A (positive control) was allocated for the intact teeth. For specimens in Groups B to F, a large cavity (Class-II MOD) was prepared with a standardized dimension of cavity (3 mm depth on the pulpal floor, 4 mm at the gingival seat, and 3 mm cavity width). Group B represented prepared teeth without any restoration. Group C, Group D, Group E, and Group F were restored with Tetric EvoCeram® incremental-fill (conventional), Beautifil bulk-fill, Filtek posterior bulk-fill, and SonicFill 2 bulk-fill restorative materials, respectively. All samples were finished and polished with an enhanced finishing kit and stored in distilled water for a month before the fracture resistance testing. All the samples were exposed to the axial loading (the speed of crosshead was 1 mm/min) in a computer-controlled universal testing machine (LARYEE, China) via a steel bar (6 mm in diameter) and the maximum applied force in Newton was recorded as the fracture resistance. One-way analysis of variance (SPSS 21) was used to compare the fracture resistance within the groups, and Tukey’s post hoc test was used to determine the difference between the groups. The lowest value of fracture resistance was recorded for Group B, and the highest value was recorded for Group A followed by the values of Group D, Group C, Group F, and Group E. One-way ANOVA revealed a statistically significant difference between the groups (P<0.05). Nonsignificant difference was found between the premolars restored by bulk-fill and conventional composites. Among the bulk-fill restored specimens, Beautifil restorative demonstrated significantly higher fracture resistance in comparison with the other two bulk-fill restored specimen groups (SonicFill 2 and Filtek). Bulk-fill composite such as Beautifil could be an alternative option to conventional incremental-fill composite for premolar restoration

Efflux in Acinetobacter baumannii can be determined by measuring accumulation of H33342 (bis-benzamide)

10.1093/jac/dkt052Journal of Antimicrobial Chemotherapy6871594-160

Assessing disparities in medical students’ knowledge and attitude about monkeypox: a cross-sectional study of 27 countries across three continents

Background and aimsThe recent monkeypox (Mpox) outbreak confirmed by the World Health Organization (WHO) underscores the importance of evaluating the knowledge and attitude of medical students toward emerging diseases, given their potential roles as healthcare professionals and sources of public information during outbreaks. This study aimed to assess medical students’ knowledge and attitude about Mpox and to identify factors affecting their level of knowledge and attitude in low-income and high-income countries.MethodsA cross-sectional study was conducted on 11,919 medical students from 27 countries. A newly-developed validated questionnaire was used to collect data on knowledge (14 items), attitude (12 items), and baseline criteria. The relationship between a range of factors with knowledge and attitude was studied using univariate and multivariate analyses.Results46% of the study participants were males; 10.7% were in their sixth year; 54.6% knew about smallpox; 84% received the coronavirus disease 2019 (COVID-19) vaccine; and 12.5% had training on Mpox. 55.3% had good knowledge of Mpox and 51.7% had a positive attitude towards it. Medical students in their third, fifth, or sixth year high- income countries who obtained information on Mpox from friends, research articles, social media and scientific websites were positive predictors for good knowledge. Conversely, being male or coming from high-income countries showed a negative relation with good knowledge about Mpox. Additionally, a positive attitude was directly influenced by residing in urban areas, being in the fifth year of medical education, having knowledge about smallpox and a history of receiving the coronavirus disease 2019 (COVID-19) vaccine. Receiving information about Mpox from social media or scientific websites and possessing good knowledge about Mpox were also predictors of a positive attitude. On the other hand, being male, employed, or receiving a training program about Mpox were inversely predicting positive attitude about Mpox.ConclusionThere were differences in knowledge and attitude towards Mpox between medical students in low and high-income countries, emphasizing the need for incorporating epidemiology of re-emerging diseases like Mpox into the medical curriculum to improve disease prevention and control