Cost-effectiveness analysis of 3-D computerized tomography colonography versus optical colonoscopy for imaging symptomatic gastroenterology patients.

BACKGROUND: When symptomatic gastroenterology patients have an indication for colonic imaging, clinicians have a choice between optical colonoscopy (OC) and computerized tomography colonography with three-dimensional reconstruction (3-D CTC). 3-D CTC provides a minimally invasive and rapid evaluation of the entire colon, and it can be an efficient modality for diagnosing symptoms. It allows for a more targeted use of OC, which is associated with a higher risk of major adverse events and higher procedural costs. A case can be made for 3-D CTC as a primary test for colonic imaging followed if necessary by targeted therapeutic OC; however, the relative long-term costs and benefits of introducing 3-D CTC as a first-line investigation are unknown. AIM: The aim of this study was to assess the cost effectiveness of 3-D CTC versus OC for colonic imaging of symptomatic gastroenterology patients in the UK NHS. METHODS: We used a Markov model to follow a cohort of 100,000 symptomatic gastroenterology patients, aged 50 years or older, and estimate the expected lifetime outcomes, life years (LYs) and quality-adjusted life years (QALYs), and costs (£, 2010-2011) associated with 3-D CTC and OC. Sensitivity analyses were performed to assess the robustness of the base-case cost-effectiveness results to variation in input parameters and methodological assumptions. RESULTS: 3D-CTC provided a similar number of LYs (7.737 vs 7.739) and QALYs (7.013 vs 7.018) per individual compared with OC, and it was associated with substantially lower mean costs per patient (£467 vs £583), leading to a positive incremental net benefit. After accounting for the overall uncertainty, the probability of 3-D CTC being cost effective was around 60 %, at typical willingness-to-pay values of £20,000-£30,000 per QALY gained. CONCLUSION: 3-D CTC is a cost-saving and cost-effective option for colonic imaging of symptomatic gastroenterology patients compared with OC

Proximate and Mineral Composition of the Pulp of Chrysophyllum albidum Fruit

The proximate composition of Chrysophyllum albidum fruit pulp was determined. Mineral elements were determined using a tri-acid digestion method. The result of the proximate composition of the fruit pulp showed moisture content (64.00 ± 0.02%), ash (3.00 ± 0.02%), lipids (8.50 ± 0.02%), crude fibre (4.00 ± 0.02%), crude protein (0.24 ± 0.03%) and soluble carbohydrate (20.26±0.03%). The energy value of the fruit was found to be (663.12±0.60%kJ/100g) in the fruit pulp. Similarly, mineral analysis revealed potassium with (256.57± 5.77mg/100g), sodium (40.00 ± 0.00mg/100g), phosphorus (2.21 ± 0.03mg/100g), calcium (61.67±5.77mg/100g), magnesium (33.33 ± 20.21mg/100g), copper (0.94 ± 0.20mg/100g), zinc (0.26 + 0.10mg/100g), and iron (3.46+ 0.06). Others include heavy metal such as lead (0.09 ±0.08mg/100g), chromium (6.83± 6.26/100g) and cadmium was not detected. The pulp also contained appreciable amount of vitamin C (3.70 ± 0.17mg/100g). The results showed that the fruit pulp of Chrysophyllum albidum contained essential nutrients and mineral elements.Keywords: Chrysophyllum albidum, minerals, proximat

Obesity and cardiovascular disease risk factors among adult Sudanese

Subjects and methods: In this study, the effect of obesity on the development of dyslipidemia, hypertension and glucose intolerance among Sudanese adults attending weight reduction programs was investigated. According to the BMI (Body mass index), 98 overweight/obese and 60 normal weight adults were included. Anthropometric measures were taken, lipid profile and C – reactive protein (CRP) were determined using commercial kits.Results: Obesity related dyslipidemia seems to affect overweight/obese males more than females. On the other hand, overweight /obesity among females, not like males, was found to be associated with high blood pressure probably due inflammation, as determined by CRP level.Conclusion and recommendation: Obesity related dyslipidemia is more prominent among males while obesity related hypertension is a phenomenon among females probably due to release of CRP. We recommend a more detailed study of inflammatory cytokines, in relation to obesity, that mayreflect the mass and/or activity of the adipose tissue.Key words: overweight, dyslipedemia, CVD

Developing a model for the implementation of designing out waste in construction

Waste mitigation is recognised as the most effective strategy for managing construction and demolition waste. Designing out Waste (DoW) is an approach aimed at reducing waste during construction and demolition by improving project planning and design. Despite its recognition, limited research has been conducted on the factors influencing the implementation of DoW in construction. A questionnaire survey was conducted to collect data on DoW practices, barriers, and enablers from 76 construction practitioners in New South Wales, Australia. A model was developed and analysed using partial least squares structural equation modelling (PLS-SEM). The results indicate a significant relationship between DoW practices and two key barriers: Design-related Barriers and Lack of Experience and Skills. The results also show a significant relationship between Enablers and DoW. Three significant enabling variables identified in this study, which are good communication and coordination, Building Information Modelling (BIM), and utilisation of prefabrication, precast and 3D printing. However, no moderating influence of the enablers was identified in the relationship between the barriers and DoW practices. Through the developed model, this research provides insights into implementing DoW in construction by addressing multifaceted barriers and implementing interventions for effective waste reduction.fals

Partial characterization of three &#946-defensin gene transcripts in river buffalo and cattle

In this study, the tracheal tissues from Egyptian river buffalo and cattle were screened for the presence of three bovine β-defensin gene transcripts. Three primer pairs were designed on the basis of published Bos taurus sequences for partial amplification of β-defensin 4, β-defensin 10 and β-defensin 11 complementary DNA (cDNA). The amplified cDNA products of the three genes in both buffalo and cattle were sequenced. The sequences were analyzed to verify gene identity and to identify differences with the corresponding buffalo (Bubalus bubalis bubalis) and/or cattle (Bos taurus) β-defensin mRNAs published sequences in the GenBank database. β-Defensin 4 and β-defensin 10 primer pairs amplified cDNA sequences in buffalo and cattle that corresponded to those mRNAs of the two genes in GenBank database with nucleotide percentage homology of 83 and 84% for β-defensin 4, and 87 and 90% for β-defensin10, respectively. The translated protein sequences obtained for buffalo and cattle showed protein percentage similarity of 86 and 81% for β-defensin 4, and 87.5 and 87% for β-defensin 10 with the corresponding proteins of B. bubalis bubalis and/or B. taurus in GenBank database. On the other hand, cDNA sequences amplified by β-defensin 11 primer pair in both buffalo and cattle corresponded more to lingual antimicrobial peptide (LAP) mRNAs of B. bubalis bubalis and B. taurus (94 and 82% nucleotide similarity and 92 and 77% translated-protein similarity) rather than β-defensin 11 mRNA of B. taurus (68 and 66% nucleotide similarity and 74 and 65.5% translated-protein similarity).Key words: β-Defensin 4, β-defensin 10, β-defensin 11, lingual antimicrobial peptide (LAP), river buffalo, cattle

Nanomaterials for the cleaning and pH adjustment of vegetable tanned leather

Leather artifacts in historical collections and archives are often contaminated by physical changes such as soiling, which alter their appearance and readability, and by chemical changes which occur on ageing and give rise to excessive proportion of acids that promote hydrolysis of collagen, eventually leading to gelatinization and loss of mechanical properties. However, both cleaning and pH adjustment of vegetable tanned leather pose a great challenge for conservators, owing to the sensitivity of these materials to the action of solvents, especially water-based formulations and alkaline chemicals. In this study the cleaning of historical leather samples was optimized by confining an oil-in-water (o/w) nanostructured fluid in a highly retentive chemical hydrogel, which allows the controlled release of the cleaning fluid on sensitive surfaces. The chemical gel exhibits optimal viscoelasticity, which facilitates its removal after the application without leaving residues on the object. Nanoparticles of calcium hydroxide and lactate, dispersed in 2-propanol, were used to adjust the pH up to the natural value of leather, preventing too high alkalinity which causes swelling of fibers and denaturation of the collagen. The treated samples were characterized using Scanning Electron Microscopy (FE SEM), controlled environment dynamic mechanical analysis (DMA-RH), and infrared spectroscopy (ATR-FTIR). The analytical assessment validated the use of tools derived from colloid and materials science for the preservation of collagen-based artifacts

Molecular Characterization of Glucose-6-Phosphate Dehydrogenase Deficiency in a University Community in Malaysia

Purpose: To determine the prevalence of glucose-6-phosphate dehydrogenase (G6PD) deficiency among staff and students of a university community in Malaysia as well as to identify molecular genetics by determination of G6PD mutations.Methods: Cross-sectional and experimental studies were carried out on the staff and students of Advanced Medical and Dental Institute (AMDI) of Universiti Sains Malaysia (USM) from July 2009 to April 2010. Venous blood samples were collected from 87 individuals (45 males and 42 females), all of whom gave informed consent. Full blood count, reticulocyte count, screening test and quantitative determination of G6PD were performed. The deficient subjects were confirmed by standard PCR restriction enzyme. DNA samples from these subjects were analyzed for certain known G6PDmutations by digesting them with appropriate restriction enzymes.Results: Out of the 87 subjects (80 were Malay, 2 were Chinese, 1 was Indian and 4 were others). The total prevalence of G6PD deficiency among the subjects was 4.59 % (4/87), all of whom were Malay males. One of the deficient subjects had G6PD Viangchan, while the other three were G6PDMahidol (487 G>A).Conclusion: The finding of this study demonstrate that the most common mutation among AMDI staff and students is Mahidol (487G>A), followed by mutation Viangchan (871G>A).Keywords: Glucose-6-Phosphate Dehydrogenase, Mahidol, Viangchan, Haemolytic anaemi

Effect of Bone Marrow-derived Mesenchymal Stem Cells and Umbilical Cord Blood-CD34+ cells on Experimental Rat liver Fibrosis

Background and Objective: Liver disease is one of the major causes of death in many countries. Hence, the development of effective therapies for liver fibrosis is a major aim of medical research. So this study was designed to investigate the therapeutical role of mesenchymal stem cells (MSCs) and hematopoietic stem cells (HSCs) transplantation in the experimental rat liver fibrosis. Design and Method: Bone marrow-derived MSCs were isolated from femoral and tibial bones of male albino rats, then were grown and propagated in culture for 2 weeks and were characterized morphologically and by detection of CD29 by real time-PCR. Human umbilical cord blood cells were obtained after full-term caesarean delivery from healthy donors after written informed consent. Low-density mononuclear cells were separated over Ficoll- Paque (Gibco-Invitrogen, Grand Island, NY), and then CD34+ HSC was isolated using a magnetic cell sorter (MiniMACS; Miltenyi Biotec, Bergisch Gladbach, Germany). The cells were then infused intraperitoneally in rats that received CCl4 injection to induce liver fibrosis. Rats were divided into 4 groups: control, CCl4, CCl4 plus MSC, and CCl4 plus CD34+. Liver tissue was examined histopathologically for all groups. The expression of collagen I and metalloproteinase-2 genes as a marker of liver fibrosis was measured by real time RT- PCR. Results: The results of the present study showed that both MSCs and CD34+ have a significant antifibrotic effect as evidenced by the significant decrease in liver collagen gene expression as well as the decrease in MMP-2 (p < 0.05) compared to the CCl4 group

Overexpression, purification and characterization of the Aspergillus niger endoglucanase, EglA, in Pichia pastoris>/i>

Cellulases are industrially important hydrolytic enzymes applicable in the bioconversion of cellulosic biomass to simple sugars. In this work, an endoglucanase from Aspergillus niger ATCC 10574, EglA, was expressed in the methylotrophic yeast Pichia pastoris and the properties of the recombinant protein were characterized. The full length cDNA of eglA has been cloned into a pPICZαC expression vector and expressed extracellularly as a ~30 kDa recombinant protein in P. pastoris X-33. Pure EglA displayed optimum activity at 50°C and was stable between 30 and 55°C. The pH stability of this enzyme was shown to be in the range of pH 2.0 to 7.0 and optimum at pH 4.0. EglA showed the highest affinity toward β-glucan followed by carboxymethyl cellulose (CMC) with a specific activity of 63.83 and 9.47 U/mg, respectively. Very low or no detectable hydrolysis of cellobiose, laminarin, filter paper and avicel were observed. Metal ions such as Mn2+, Co2+, Zn2+, Mg2+, Ba2+, Fe2+, Ca2+ and K+ showed significant augmentation of endoglucanase activity, with manganese ions causing the highest increase in activity to about 2.7 fold when compared with the control assay, whereas Pd2+, Cu2+, SDS and EDTA showed inhibition of EglA activity.Key words: Cellulase, endoglucanase, recombinant, Aspergillus niger, Pichia pastoris