Friday, December 4, 2020

Iris Publishers- Open access Journal of Biomedical Engineering & Biotechnology | Antiviral Activity of Diterpenes From Canistrocarpus Cervicornis against Human Herpesvirus 1 and Bovine Herpesvirus 5

 


Authored by Ana Maria Viana Pinto*

Abstract

Human alphaherpesvirus 1 is an etiologic agent of infection endemic in the world transmitted by oral to oral oral-genital contact, from mothers causing neonatal herpes and complications such encephalitis or ocular disease. Bovine alphaherpesvirus 5 is an important agent of meningoencephalitis in cattle and has been identified in outbreaks of neurological disease in bovine in several Brazilian States. The aims of this work were to evaluate cytotoxic effect, antiviral properties of the diterpenes 1 and 2 isolated from Canistrocarpus cervicornis. The results of cytotoxic effects in VERO cell showed diterpene 1 more cytotoxic in MTT and Neutral red assay than diterpene 2. The low value to effective concentration required to diterpenes achieve 50% protection to Vero cell showed to diterpene 1 high selectivity index. Both compounds were not cytotoxic to MDBK cell, but they are not able to inhibit Bovine alphaherpesvirus 5 (BoHV-5RJ42/01) replication. Diterpenes 1 and 2 interacted directly with Human alphaherpesvirus 1 (KOS) and BoHV-5RJ42/01 reducing their infectivity on VERO and MDBK cells but they did not inhibit KOS and BoHV- 5RJ42/01 attachment and penetration in Vero and MDBK cells respectively.

Keywords: Canistrocarpus cervicornis; Diterpenes; Human alphaherpesvirus 1; KOS, Bovine alphaherpesvirus 5 BoHV-5; Antiviral

Introduction

Human alphaherpesvirus 1 and Bovine alphaherpesvirus 5 (BoHV-5) are members of the family Herpesviridae, subfamily Alphaherpesvirinae. Human alphaherpesvirus 1 (HHV-1) is including in genus Simplex distributed worldwide [1]. The frequency of seropositive individuals is high, ranging from 50% to over 80% [2]. The Human alphaherpesvirus 1 transmission occurs by direct contact person to person and more likely if blisters or lesions are present. Adolescents and adults frequently get exposed by skin contact but may get exposure by kissing or sexual contact [2]. HHV- 1 infection can occur at different sites of the body. Primary disease is characterized by sore throat, ulcerative and vesicular lesions, gingivostomatitis lymphadenopathy with fever and malaise. Rare, keratoconjunctivitis, encephalitis, and disseminated infections are severe complications of HHV-1 infection [2].

Bovine alphaherpesviruses 5 (BoHV-5) is belonging to the genus Varicellovirus [1], and has been associated with fatal meningoencephalitis in cattle [3] and it has been reported in Australia [4], Argentina [3] and Brazil [5,6] as etiologic agent of neurological disease. BoHV-5 affects mainly but not exclusively young animals. Furthermore, it has been identified from the respiratory [7], genital tracts [8]. BoHV-5 has been described in cryopreserved semen (8) and after experimental infection in oocytes, embryos and inside spermatozoids [9,10].

Bioactive compounds from marine seaweed have been studied to understand their biological effects and application in drugs development. Compounds from marine algae have revealed healthpromoting effects, including anti-oxidative, anti-inflammatory, antimicrobial, anti-cancer and antiviral effects [11]. Canistrocarpus cervicornis (Kutzing) De Paula and De Clerck is important and abundant seaweed of Brazilian coast [12]. From this seaweed was described the isolation of many dolastanes and secodolastanes diterpenes [13-17]. Since then a variety of biological activities of these diterpenes have been published [18-21], including activity against Human alphaherpesvirus 1 [22] and against human immunodeficiency virus 1 [23]. Our purposes in this work were to evaluate the cytotoxicity effect and antiviral activity of two diterpenes purified from crude extract from C. cervicornis and to determine the activities of these compounds on HHV-1 KOS and BoHV-5RJ42/01 replication.

Materials and Methods

Algal collection

Specimens of brown seaweed C. cervicornis (Kützing) De Paula and De Clerck were collected at Praia do Velho in Angra dos Reis, in the south of Rio de Janeiro State, Brazil (lat. 23˚01’S, long. 44˚ 00’W). Voucher specimens (HRJ 10754) were deposited in the Herbarium of the Universidade do Estado do Rio de Janeiro (UERJ). The seaweeds were washed with local sea water and separated from sediments, epiphytes, and other associated organisms.

In order to prepare crude extract air-dried seaweeds were exhaustively extracted with CH2Cl2 at room temperature. The extract was evaporated under reduced pressure, yielding a brownish residue. The crude extract was acetylated as described previously by our group [23]. The acetylated extract was subjected to silica gel chromatography (3 x 40 cm) eluted with 100% n-hexane to 100% EtOAc, in steps of 10% and 100 mL, from which 49 fractions were obtained. The fractionation was monitored by thin layer chromatography and spots of diterpenes were detected as pink-colored spots after heating the plated specimens at 100°C for 3 minutes. The fraction 9 yielded the dolastane diterpene 1. The acetylation reaction and silica gel chromatography were repeated on another aliquot of crude extract, from which 44 fractions were obtained. The fractions 26, 27, and 28 yielded the dolastane diterpene 2. The structures of the diterpenes were assigned by comparison of physical and spectroscopic data with reported values [15] (Figure 1).

Cells and virus and acyclovir

African green monkey kidney VERO-ATCCCCL81 originally obtained from ATCC and Madin-Darbin bovine kidney (MDBK) cell lineage, originally obtained from ATCC (CCL-22) were grown and maintained in Eagle’s minimum essential medium (EMEM) containing 292 μg/mL of L-glutamine, 50 μg/mL of gentamicin and supplemented with 2-5% heated inactivated certified fetal calf serum (Invitrogen). Overlay medium for plaque assay consisted of EMEM 2 x plus in agarose 2% (1:1). Human alphaherpesvirus 1 (HHV-1 KOS) stocks were prepared by infecting subconfluent monolayers of Vero cells at a multiplicity of infection of the 1 MOI. Infected cells were incubated at 37 °C under a 5% CO2 humidified atmosphere and harvested when total cytopathic effect was observed. After three freeze-thaw cycles, cell debris was removed by low-speed centrifugation (2,000 x g at 4°C for 15 min) and titers were determined by plaque assays on Vero cells (24) and expressed as plaque forming units (P.F.U per mL-1). Aliquots of HHV-1 KOS were stored at -70°C until use. Bovine alphaherpesvirus 5 (BoHV- 5RJ42/01) was isolated and characterized previously (Pinto et al. 2015). Virus stocks were propagated in MDBK cells, and the virus titer was determined by plaque assay (PA) (24). The title of the virus was expressed as plaque-forming units (PFU per mL-1). Acyclovir (ACV) used as standard compound purchase from Sigma-Aldrich. All compounds were dissolved in dimetylsulphoxide (DMSO) to obtain stock solutions of 50 mM then diluted in the culture medium without serum to obtain the desired compound’s concentration before use. The final concentration of DMSO was < 0.1%.

Cytotoxicity assay

The cytotoxic effect of seaweed diterpenes 1, 2 and acyclovir was assayed by three methodologies (3-(4,5-dimethylthiazol- 2yl)-2,5diphenyl tetrazolium bromide (MTT) (25), neutral red (NR) (26) and violet crystal ( VC) (27) in Vero and MDBK cell with some modification. Vero and MDBK cells at density of 3x103 were grown in 96 well microplates at 37 °C under a 5% CO2 humidified atmosphere. After 24 hours culture media were replaced with EMEM containing different concentrations of diterpene 1 and 2 and standard compound acyclovir (12.5, 25, 50, 100 and 200 μM) in triplicate. Vero and MDBK cell untreated were used as control. After 72 hours of incubation the supernatants were discarded, and plates separated in three groups for revelation.

the first group of the plates was added MTT (100 μL of 1 mg mL-1 in EMEM) in each well following reincubation for 3h 37 °C under a 5% CO2 humidified atmosphere. Then the medium was discarded and DMSO (100 μL) added before a further incubation for 30 min.

red 0.01% were added in all plates wells and after 3 h at 37 °C under a 5% CO2 humidified atmosphere then supernatants were discarded and cell fixed with formaldehyde [100 μL of 1 mg mL-1 in PBS (NaCl 130 mM; KCl2 mM; Na2HPO4 2H2O6 mM; K2HPO4 1 mM, pH 7.2)] and after reincubation for 15 min the formaldehyde was removed and the neutral red was extracted from cell with 100 μL of the acetic acid1% in methanol 50%.

In the third sets of the plates was added violet crystal (VC) 0.5% in acetic acid 30% (100 μL). The plates were maintained for 30 min at room temperature. Then cells were washed with water and dried at 37ºC following elution of VC by addition of methanol P.A (100 μL). Finally, optical densities of all three experiments were measured at 520 nm in microplate reader and results were expressed as the 50% cytotoxic concentration (CC50). The compound concentration required to reduce the optical density in relation to the cell control was calculated by a linear regression analysis.

Screening of antiviral activity of compounds by plaque reduction assay

An antiviral screening test was performed in Vero and MDBK cells grown in 24 well microplates were inoculated with 200 P.F.U of the HHV-1KOS and BoHV-5RJ42/01 respectively as described previously (24) with some modifications (28). After one hour for virus adsorption at 37 °C with a 5% CO2 atmosphere the inoculum was discarded for addition of the differents concentration of diterpenes 1, 2 and ACV (12.5, 25, 50 and 100 μM). The plates were reincubated for 72 h at 37 °C with a 5% CO2 atmosphere. Then cell monolayer was fixed and stained with crystal violet (1%) in formalin (10%). The antiviral concentration of compounds of 50% effectiveness (EC50) was defined as the concentration required reducing plaque number by 50% in the treated cells compared to untreated ones by the formula:

Percent of inhibition (%) = Number total of control plaques – Number total of tested plaques x 100

Number of total of control plaques

Virus inactivation of infectivity assay

In brief HHV-1KOS and BoHV-5RJ42/01 suspension containing 1x104 P.F.U mL-1 were mixed with 12.5, 25 and 50 μM of compounds and kept at room temperature (24ºC) for 1 h. Meanwhile, control of untreated virus suspension was performed in the same conditions. After that they were diluted, and residual infectivity was determined by plaque assay as described previously [24].

Inhibition of virus attachment assay in pretreated cell and unpretreated cell

Virion attachment assay was performed as described earlier [24] with some modifications [28]. Vero and MDBK cells monolayers grown in 24 well microplates were pre-chilled at 4°C for 1 h. The medium was aspirated and a set of the monolayers were inoculated with 200 P.F.U of HHV-1 KOS or BoHV-5RJ42/01 after pre-treatment with compounds (12.5 and 50 μM) for 1 h at 4ºC. Other set of monolayers previously chilled were inoculated with HHV-1 KOS or BoHV-5RJ42/01 in the presence or absence of differents concentrations of diterpene 1, diterpene 2 and ACV (12.5 and 50 μM). Next, all plates were reincubated for 3 h at 4 °C. Then cell monolayers were washed three times with MEM-E and covered with overlaid medium and reincubated. After 72 h cell monolayers were stained and the attachment-inhibition percentage was calculated as described in the item: Screening of antiviral activity by plaque reduction assay.

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Iris Publishers- Open access Journal of Biomedical Engineering & Biotechnology | Failure Criteria of Artificial Joints: A review

 


Authored by Abdelbary A*

Abstract

Tribology has a significant role in the functioning of artificial joints. The tribological aspects of total artificial replacement joints is reviewed. The basics of tribology are applied to understand the friction, wear and lubrication of natural and artificial joints. The basic wear mechanisms in artificial joint are introduced. Bearing lubrication concepts can be applied to determine the lubrication performance of artificial joints. Major failure criteria of artificial joints, retrieved from patients, are overviewed and discussed. The role of surface and subsurface cracks in polyethylene along with the effect of counterface imperfections in the wear of artificial joints are pointed out. Wear debris are the key factor related with the contacting surfaces of artificial joints which can cause adverse tissue reactions and the loosening of the prosthetic components. In this paper, generation and classification of wear debris are deliberated.

Keywords: Tribology; Artificial joint; Failure criteria; Fatigue; Wear debrisr

Introduction

Artificial joint replacement is one of the most essential arthroplasty for sever diseases of human joints. This surgical treatment involves the replacement of native articulating joints, such as the knee, hip, ankle, and shoulder with artificial components. Currently, it is assumed that there are well over one million artificial joints implanted yearly into patients world-wide [1,2]. By 2030, there may be 500, 000 total hip arthroplasty (THA) and 3 million total knee arthroplasty (TKA) cases per year [3,4]. Various biomaterial combinations include metals, ceramics, carbon and synthetic polymers are now used in biomedical applications.

In particular, polymeric materials have shown a greatest success in this field due to its excellent tribological properties. Low friction coefficient, high wear resistance, compatibility of wear debris with the body, compatibility of being sterilized by γ-irradiation, and the facility to operate efficiently for long time under no maintenance conditions are the factors that have made it a highly successful bearing material in these applications [5-8].

For several decades’ polyethylene has remained the most suitable material choice for the articulating surface in total joint replacements [9-11]. UHMWPE used as an acetabular cup where the femoral head was stainless steel, ceramic or alumina. UHMWPE was first introduced by Charnley J [12,13] as an alternative for the failed previous polytetrafluoroethylene (PTFE), because the superior wear resistance of the former. A new type of polyethylene material has been developed recently which shown excellent wear properties compared to UHMWPE. This material has been named as ultra-low wear polyethylene (ULWPE). In addition, ULWPE has excellent wear resistance, which is also easy to process [14].

Friction, wear and lubrication of artificial joints play important roles in its successful function. However, it is unpredictable due to complex tribological and biological behaviours and long-term wear [15]. Research efforts are currently addressing the evaluation of the determinants affecting the overall wear rate of the artificial joint articulating surfaces, with the aim of reducing wear rate. However, one of the main challenges is the translation of research data from in vitro to in vivo environments [16]. For example, the wear debris produced by the hip joint simulator has a larger average size and wider distribution range compared to those from the implanted artificial joint [17]. The average diameter of the wear debris from joint simulator is 7.54 μm. The average diameter of the wear debris from artificial joint is 1.33 μm (about 18% of the wear debris from joint simulator).

In order to study the failure criteria of artificial joints, a pioneer work was done by Atkinson [13] based on the investigation of a number of worn hip joints ranging in age from 1- 12 years. They observed that the wear and deformation processes of the acetabular cups seemed to be as follows:

1. Initially, a running-in period: the entire cup surface wears abrasively.

2. With increasing mobility, the upper half of the cup wears adhesively.

3. After several years’ wear, fine fatigue cracks formed on the wear area.

Many questions which need answering were recognized:

Are any of the observed wear feature likely to enhance early failure of the acetabular cup or are there other possible mechanisms?

Are the surface fatigue cracks going to be deletrious? Will they shorten the useable lifetime of the cup?

What is the effect of the cyclic loading on the failure resistance and surface cracks of the polymeric material specially in fluid lubricated media?

What is the effect of the generated wear particle size on the clinical infection?

Finally, it was reported that no conclusions could be drawn, and further researches are necessary. For more than four decades, to the best of our knowledge, hundreds of researches were established in order to find answers for those questions. The present paper is aimed to review and argue the failure criteria of artificial joints.

Tribology of Artificial Joints

Tribology has a significant role in the functioning of artificial joints. General fundamentals of tribology can be used to understand the friction, lubrication and wear of natural and artificial joints in the body [18]. Friction played a dominant role in the design of original Charnley low-friction arthroplasty [19]. Also, wear has an important role, not only from the integrity of the prosthetic component point of view, but also from that of wear debris which can cause adversely biological reactions [15]. Finally, both of friction and wear can be reduced effectively by lubrication.

Friction

In his low-friction arthroplasty, Charnley, J. introduced the significance of friction in the design of artificial joints [12]. At first, McKee-Farrar introduced metal-on-metal hips. Then, polytetrafluoroethylene (PTFE) was selected for its lowest frictional coefficient, although massive wear was subsequently found with the cups made of this material. Charnley preserved with polymer on metal combinations to maintain low frictional torques and introduced UHMWPE cups sliding on stainless steel femoral heads. This combination of materials has proved to be extremely successful giving low friction, low wear rates of the UHMWPE and smaller amounts of wear debris, which could be more readily tolerated by the body [10,11,20,21].

The following three laws of dry friction are often defined:

1. The force of friction (F) is directly proportional to the applied load (W).

2. The force of friction (F) is independent of the apparent area of contact.

3. The kinetic force of friction (F) is independent of the sliding speed (V).

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Thursday, December 3, 2020

Iris Publishers- Open access Journal of Pediatrics & Neonatal Care | Psychotherapy with Children and Adolescents with First Episode Psychosis: Limitations of the Research

 


Authored by James B McCarthy*

Abstract

Empirical studies of children and adolescents at high-risk for psychosis and those with first episode psychosis include investigations of the associated risk factors, neurobiological correlates and longitudinal trajectories and the use of pharmacological and psychosocial interventions, but few studies compare the impact of different forms of psychotherapy with each other or with multimodal treatment with both psychotherapy and psychotropic medication. There is a scarcity of trials that compare the efficacy and long-term outcome of cognitive behavioral therapy, psychodynamic psychotherapy and family therapy with these vulnerable youth even though evidence has been accumulating about their positive impact with children, adolescents and adults with many psychiatric disorders. Research on first episode psychosis in children and adolescents needs to be enhanced by studies that ascertain the benefits of cognitive behavior therapy, psychodynamic psychotherapy, and family therapy and their role in combined treatment.

Keywords: First episode psychosis; Psychotic disorders; Childhood psychosis; Psychodynamic psychotherapy; CBT; Family therapy; Antipsychotic medication

Introduction

Considerable difficulties occur in doing research with children and adolescents with severe psychiatric disorders, and studies of youth at high-risk for psychosis reveal variable outcomes. Early identification and prevention programs for children and adolescents at risk for psychosis investigate clinical characteristics, family history, and genetic, neurobiological and environmental risk factors while utilizing diverse preventative strategies. Assessments of the factors contributing to the conversion to psychosis indicate some salient predictor variables in first episode psychosis along with heterogeneous developmental trajectories with less than one third of high-risk youth developing persistent psychotic disorders [1]. However, few investigations have compared the impact of different forms of psychotherapy with each other in terms of their influence on the outcomes of children and adolescents who experience a first episode of psychosis even though studies have demonstrated that the combination of psychological and psychopharmacological interventions can have a positive effect on early-onset psychotic disorders [2]. This review aims to emphasize the need for studies that compare the impact of Cognitive Behavior therapy (CBT), psychodynamic psychotherapy and family therapy, and combinations of different forms of psychotherapy with psychopharmacological approaches in the treatment of children and youth who experience a first episode of psychosis.

Practice guidelines point to the importance of psychological therapy for individuals with a first episode of psychosis. Modestly effective results have been shown to derive from combinations of CBT and psychosocial interventions with children at risk for psychosis, but there have been few attempts to study very longterm benefits of CBT for the first episode of a psychotic disorder in childhood [3,4]. Reviews of typically cited databases, such as PubMed, PyschInfo, and Medline, note studies of the predictor variables, the diagnostic stability and the use of antipsychotic medication with first episode psychosis in children, adolescents and adults but an absence of investigations of different forms of psychotherapy with children and young adolescents who experience first episode psychosis [5-8].

The majority of children and adolescents who have brief psychotic symptoms will continue to experience later mental health problems, but most will not develop actual psychotic disorders [9]. One-year outcome studies of children and adolescents at high clinical risk who do develop non-affective psychosis indicate the predictive importance of both positive and negative symptoms and that more than half of the youth continue to be at high-risk while at least 20% develop schizophrenia [10]. The presence of psychotic symptoms is also associated with a greater severity of Major Depressive Disorder and a longer duration of episodes of illness in children and adolescents with Bipolar Disorder [11]. A study of adults with first episode psychosis revealed that for individuals who experience only one episode of psychosis the combination of prompt treatment and social and family support lowers the risk of future episode of psychosis [12]. Even among high-risk children and adolescents who have attenuated symptoms of psychosis, not all will develop a psychotic disorder [13], but there are few prospective studies or randomized trials that compare the potential long-term gains associated with different forms of psychotherapy with very high-risk children and adolescents who develop psychosis.

Case Example

X, a nine-year-old Caucasian girl with deteriorating academic functioning, no prior psychiatric history or mental health treatment and no discernable history of trauma or psychiatric illness in the family, set a fire in her apartment in which a family member was severely burned. She reported that a voice told her to set the fire because the apartment had been invaded by demons and that burning the demons would be the only way to keep her parents and siblings safe from harm.

Research on CBT with First Episode Psychosis

The findings from the influential Child and Adolescent First Episode of Psychosis Study (CAFEPS) indicate that for youth with a first episode of psychosis, aged nine to seventeen, Psychotic Disorder Not Otherwise Specified, Mood Disorder with Psychosis, and Schizophreniform Disorder are the most common diagnoses and that clinical assessments of symptom severity and negative symptoms are the most meaningful predictive outcome indicators [14]. Studies measuring the effect of CBT with individuals with first episode psychosis throughout the lifespan note either effective results when compared with treatment as usual or inconsistent findings [15]. For example, Addington et al. [4] reported no significant improvements with either the use of CBT or treatment as usual [16]. Early literature reviews of first episode psychosis studies revealed that psychosocial therapies, in general, in combination with psychopharmacology and the absence of a diagnosis of schizophrenia are associated with more positive outcomes [17]. More recent systematic reviews of preventative interventions and studies comparing the impact of psychological, psychopharmacological and combined treatments with children, adolescents and young adults with psychosis have found that antipsychotic medications have a modestly beneficial effect on psychotic symptoms and that family therapy in addition to CBT can be useful in delaying the onset of psychotic episodes, but no trials were found that compared psychotherapeutic interventions with youth under the age of eighteen [3,18].

Early investigations of the use of CBT with adults with schizophrenia who experience a first episode of psychosis often found little difference between CBT and supportive psychotherapy, but later studies placed a greater emphasis on the functional adaptations and quality of life issues that are associated with a persistent psychotic disorder [19]. Other early studies of CBT with first episode psychosis in adults showed that CBT has some efficacy in lowering psychotic symptoms and improving the individual’s quality of life but little influence on the reoccurrence of psychotic episodes [20]. Within the last ten years, the use of group CBT treatments with adults with first episode psychosis has been increasingly studied [21] with the caveat that the complexity of the clinical variables, such as comorbidity, and the limitations of the mental health care system can make it difficult to apply group CBT interventions effectively [22]. Gaynor and colleagues [22] reported that outpatient group CBT is more effective than individual CBT with relatively stable adults with first episode psychosis in reducing the presence of negative symptoms [23], while a 2018 investigation of group cohesion in cognitive behavioral group therapy with adults with first episode psychosis revealed that group participation and group cohesion are positively associated with both improved selfesteem and symptom reductions [24].

Studies of group cognitive behavioral therapy with adults with either first episode psychosis or a recent onset of psychosis also point to the value of groups in sustaining symptomatic improvements after there has been a stabilization of the psychotic symptoms [25], but as far as we know similar studies are lacking that assess the overall efficacy and long term outcome of individual or group CBT with children and young adolescents with a first episode of psychosis.

Research on Psychodynamic Psychotherapy with First Episode Psychosis

Psychodynamic psychotherapy, with its emphasis on the developmental roots of the individual’s subjective experience, the nuances of the therapeutic relationship, and scrutiny of therapistpatient mutual influences in transference-countertransference exchanges, has rarely been the subject of empirical studies with individuals who experience a first episode of psychosis. In one of the few prospective studies of psychodynamic psychotherapy with adults with a first episode of Schizophrenia Spectrum Disorder, a multisite, two year-long study was conducted that compared treatment as usual with supportive psychodynamic psychotherapy with a combination of both interventions; the combination of the two had a much stronger association with significant improvements in symptoms and global functioning [26]. Similar studies are lacking with children and young adolescents who are at very high risk for psychosis or are experiencing first episode psychosis.

Since its early origins, psychodynamic psychotherapy has been concerned with the intrapsychic sequalae of trauma as well as the relationship between difficulties in mental functioning and problems in forming and sustaining mental representations of self and others. Recent studies of psychodynamic and integrative psychotherapy approaches have examined such posttraumatic phenomena and object relations deficits as crucial aspects of psychotherapy with individuals who are suffering from early signs of psychosis or persistent psychotic disorders. Investigations of efforts to improve metacognition or metacognitive reflection ability in individuals experiencing early phases of psychosis have also been increasing in number [27,28]. Consumer oriented approaches to individual psychotherapy with people with psychotic disorders similarly emphasize the individual’s understanding and emotional experience of the illness and facilitating openness to accepting support and avenues for empowerment that can enhance social, cognitive and emotional functioning. In addition, psychodynamic approaches with their emphasis on psychological defenses and internalized relationship patterns are well suited for the exploration of adolescents’ and young adults’ concerns about identity, autonomy, intimacy and the experience of the self in the midst of struggles with psychotic illness [29]. There is a very long history of influential theoretical and clinical articles on psychoanalytic approaches to the treatment of childhood psychosis; some of the contributions are consistent with the steadily emerging literature about the relationship between trauma and psychotic symptoms [30]. However, in spite of the voluminous literature on the use of psychodynamic principles in understanding psychotic communication and attachment difficulties, a comprehensive 2017 survey of the growing empirical support for psychodynamic psychotherapy with children and adolescents found no empirical studies of the efficacy of psychodynamic psychotherapy with psychotic children and adolescents [31].

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Iris Publishers- Open access Journal of Pediatrics & Neonatal Care | Immediate Outcomes of Neonatal Transport in a Tertiary Hospital in South-West of Nigeria

 


Authored by Tongo Olukemi*

Abstract

Aim: Only a third of deliveries in Nigeria occur in health facilities and a number of sick neonates have to be referred for advanced care. We sought to assess the morbidity and mortality within 24 and 48 hours of arrival among neonates presenting at the University College Hospital, (UCH) Ibadan in relation to the prevailing neonatal transport care practices.

Methods: The pretransport and intratransport care available to 401 neonates presenting in UCH were determined and their respiratory rate, heart rate, SpO2, serum bicarbonate, temperature and blood pressure were checked on arrival. TRIPS (Transport Risk Index of Physiologic Stability) scores were determined and same parameters were reassessed 24 and 48 hours after presentation.

Results: Nineteen babies (4.7%) were brought in dead. The morbidities present on admission were hypothermia (35.1%), hypoxia (28.4%), hypoglycaemia (12.5%), apnoea (9%), acidosis (8.2%), unrecordable blood pressure (16.5%). The median TRIP score on arrival was 17 with 23% having very severe score (>30), severe 19.4%, moderate 24.6% and low 33%. Babies who received oxygen, IVF/breastmilk during transport were more in the low and moderate scores. By 48 hours of admission, 22% had died and those who did not receive IVF/breastmilk had the highest risk of dying (OR 4.67 CI 1.81,12.05).

Conclusion: Neonates presenting at the UCH had significant morbidity and mortality in the first 48 hours of presentation, which was associated with poor pre and intratransport care. It is crucial to emphasize pretransport stabilization and suitable intratransport care in the training of peripheral healthcare workers in resource limited settings in order to improve newborn outcomes.

Keywords: Outcomes; Neonatal; Transport; TRIPS; Nigeria

Abbreviations: CHILD: Child Intervention for Living Drug-Free; WHO: World Health Organization; INL: International Narcotics and Law Enforcement Affairs, US Department of States; GLMM: General Linear Mixed Model; ASSIST: Alcohol, Smoking and Substance Involvement Screening Test; ASSIST-Y: Alcohol, Smoking and Substance Involvement Screening Test-Youth

Introduction

Neonatal morbidity and mortality continue to be major public health burden in developing countries despite the availability of proven cost-effective interventions for addressing it [1]. By the end of 2015, global neonatal mortality rates (NMR) had not reduced as much as under-five mortality rates and the need for 13 nations including Nigeria to accelerate the reduction in neonatal mortality rate in order to achieve 12 per 1000 live births by 2030 in line with the SDGs has been identified [2]. The need to strengthen community and facility newborn care services to achieve this cannot be overemphasized.

It has been shown that poor pre-transport and intra-transport care is associated with early neonatal morbidity and mortality [3]. Serious neonatal morbidity such as hypothermia, hyperthermia and hypoglycaemia may result from poor transportation and inadequate care resulting in increased risk of neonatal mortality [4,5]. Furthermore, only about 36% of births take place in health facilities in Nigeria [6], which implies that many of the neonates are delivered in settings without adequate resources for newborn care and they would require immediate transportation to betterequipped facilities should they require further care. Sick neonates in developing countries including Nigeria often require to be transported from places of birth to other health facilities for better care in conditions that are often suboptimal and capable of compromising survival even if they get to such centers alive [7]. The conditions of most transported neonates on arrival at the neonatal care centers can be poor because of inadequate attention given to pre- and intra-transport stabilization. Many of the babies thus transported are cold, blue, and hypoglycemic, and as many as 75% of the babies transferred this way have been reported to have serious clinical complications [8-10]. One of the critical requirements for neonatal referral is optimal transportation from the place of delivery to neonatal care centers, as well as the clinical state of the child being transported. In many developed countries, this aspect of neonatal care is well documented and there are established guidelines as well as written polices, but there is dearth of data on neonatal transportation and its immediate outcomes in Nigeria or other sub-Saharan countries. The only available data from Nigeria was published over 40 years ago, which may not be a true reflection of the current practice [11].

The TRIPS score has been used as a tool to evaluate the effect of transport on illness severity in newborns even in some developing countries [12]. The TRIPS score is not being used in Nigeria and many other developing countries however, it would be a useful tool in such settings as it would allow health care workers assess the impact of transport practices on outcomes of these sick newborns and make necessary adjustments. Although some information is available on the clinical state of referred and inborn neonates at point of admission in Nigeria [13-15], not much is known about the effect of transportation on these morbidity in the first few hours of admission. This study was conducted during a study to evaluate neonatal transport practices in Ibadan, South West Nigeria which has been previously published [7]. It sought to determine the association between pre-transport and intra-transport care and immediate (first 48 hours) morbidity using the TRIPS score and mortality of neonates presenting to UCH a tertiary hospital in South West Nigeria.

Materials and Methods

This was a cross-sectional study of newborns presenting at the emergency unit of the University College Hospital (UCH), Ibadan from August 2012 to February 2013. Ethical approval was obtained from the University of Ibadan/University College Hospital ethics review committee. Newborns with lethal congenital anomalies such as anencephaly were excluded from the study. The UCH receives referral from other hospitals/clinics in Ibadan and neighboring villages, towns, and states. Newborns accounted for about 30% of the annual pediatric emergencies seen. The newborns were resuscitated and stabilized at the emergency unit, and subsequently transferred to neonatal wards within 48 hours of presentation.

Four hundred and one consecutive newborns out of 411 presenting to the children’s emergency room, UCH were recruited. Information on resuscitation and the care given before referral, during transport and on admission was obtained with a structured case record form. Resuscitation for this purpose was at least clearing of the airway usually by suctioning using manual suction, bulb syringe or suctioning machine and bag and mask ventilation if indicated.

On admission, detailed clinical assessment of each baby was carried out and the following parameters documented; the rectal temperature, random plasma glucose, respiratory rate, heart rate, oxygen saturation, blood pressure and serum bicarbonate. The Transport Risk Index of Physiologic Stability (TRIPS) score was calculated for each of the neonates and classified as low (0-10), moderate (11-20), severe (21-30), and very severe (>30) [16-19]. The TRIPS comprise four empirically weighted items (temperature, blood pressure, respiratory status, and response to noxious stimuli) is validated for infant transport assessment [20]. Each neonate was reassessed after 48 hours of presentation to determine the outcome in terms of normalization of above parameters and/or mortality. Mortality within 24 hours was also noted. All neonates that were brought in dead were also recruited and the pre- and intra-transport information were obtained.

The rectal temperatures were measured by the attending nurse using digital thermometers (Omron® Digital Thermometer, made in Germany). Oxygen saturation was recorded using the pulse oximeter (Massimo® Rad 5 Pulse Oximeter, made in U.S.A). The random plasma glucose was determined using the glucometer (Accu-Chek® Glucometer, made in Germany). The serum bicarbonate was also determined in the laboratory. All the above procedures were done following the written protocol in-use at the emergency unit during the study. The neonates were weighed using an infant digital weighing scale (SECA Model 354, SECA Medical Systems, made in Germany) to the nearest 10g. General examination was performed and standard protocol of care of newborns as practiced in the department was followed.

Hypothermia was defined as temperatures <36.5 °C (WHO) [20]. Hypoglycaemia was taken as blood glucose <2.2mmol/l, using American Academy of Pediatrics (AAP) recommendation [21], SpO2 values less than <90% was considered as hypoxaemia [22] and bicarbonate <16mmol/L as metabolic acidosis [23]. The expected pretransport care was as defined by STABLE, an acronym for “Sugar control, Temperature control, Airway maintenance, Blood pressure, Laboratory work, and Emotional support for the family” [24]. Emotional support could not be quantified, hence, for this study, emotional support was taken as all actions taken at the sources of referral or during transportation to ameliorate the emotional distress the caregivers were undergoing immediately the decision to refer the neonate was taken. It included empathy, counselling regarding explanation of the diagnosis and hope given to the caregivers of the patients from referring centers.

Data analysis

The main outcome (dependent) variables were the immediate morbidity on arrival in the emergency unit (core temperature, oxygen saturation, random plasma glucose, respiratory rate, heart rate, blood pressure, resuscitation requirements as well as serum bicarbonate) and whether patient survived the first 24 hours and 48 hours or not. Independent variables were pre-transport and intratransport care given to neonates such intravenous fluid, oxygen administration, incubator care, administration of drugs, methods of resuscitation and means of providing warmth. Categorical variables were compared using the Chi square test while continuous variables were compared by the student t-test. Logistic regression analysis was used to determine predictors of survival for 48 hours. Only variables found to be significantly associated with outcome (survived or died) were included in the logistic regression model. The data were entered and analyzed using SPSS 17.0 statistical software (SPSS Inc. USA). Statistical significance level was set at P = 0.05.

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Wednesday, December 2, 2020

Iris Publishers- Open access Journal of Modern Concepts in Material Science | Optimization of Process Parameters to Maximize Ultimate Tensile Strength and Hardness of Underwater Friction Stir Welded Aluminium Alloys using Fuzzy Logic

 


Authored by Ibrahim Sabry*

Abstract

This paper addresses the development of a fuzzy model for weld quality prediction. Significant underwater friction stir welding parameters affecting the weld quality are rotational speed, traverse speed, and tool shoulder diameter . Welding experiment is performed on AA 1050 aluminium pipes by central composite design to attain maximum tensile strength and hardness of the weld joint. Quality of weld measured in terms of tensile strength and hardness is predicted using fuzzy logic and the results are compared with statistical analysis. Confirmatory experimental results show that the fuzzy model can predict an adequate output with less error than statistical analysis.

Keywords: Friction stir welding; Fuzzy logic; Tensile strength; Hardness test

Introduction

A Patented in 1991 by researchers at The Welding Institute of Cambridge, England, Friction Stir Welding (FSW) is a novel solid state joining process used in applications worldwide [1]. The process, which occurs below the melting temperature of the joint material, represents a departure from traditional fusion welding

methods. In conventional FSWoP, a rotating tool is plunged into the surface of adjoining metal pipes. The rotation of the tool generates heat at the interface, resulting in local plasticization of the material due to shear stress. As the tool traverses along the joint line, the material behind the tool consolidates, forming a welded region with a width roughly corresponding to the diameter of the tool in contact with the surface [2].

In Figure 1 observation, the mechanism is clarified that the advancing and retreating sides of the weld are established relative to the direction of tool rotation. The advancing side is the weld side where the rotation of the tool is in the same direction as the traverse; the retreating side is the opposite side of the rotation of the tool and the direction of welding. Material is swept from the forward side during a weld and deposited on the retreating side. As a relatively new technology, a lot of research has devoted to the influences of process parameters on the quality of the finished joint.

There are four key process parameters which can be differ in FSW: rotation speed, traverse speed, tilt angle, and shoulder diameter. Rotation speed (N) is in units of rotations per minute (rpm) and designates the rate at which the tool rotates. Traverse speed (F) indicates the speed at which the tool traverses the material. ν is usually specified in units of inches per minute (mm/ min) [3,4].

The essential parameters influencing the two processes are typically as follows: tool rotational speed of the tool [5,6], The tool’s travel speed in the FSW process of the plates [7] while it is referred to the rotational speed of pipes in FSWoP process [8], tool pin profile [9,10], joint thickness [11]. It was evident from all these studies that the optimum levels of these parameters for optimizing the FSW of plates are not the same for the FSWoP process under the same conditions. As an example, the FSW of plates has been studied in [12] and the FSWoP in [13] under the same range of rotational speed. The effect of rotational speed for the plate on the joint’s tensile strength is entirely different from that for the pipes [14]. The Process parameters such as tool rotation speed (N) and travel speed (F) determine the strength and efficiency of the joints generated by the FSWoP process [15]. Research has been applied out in the improvement of the FSWoP process as a distinguished solid-state join the ng process ever since its invention [16]. According to the results of this paper, Al 7075-T7351 is a quench prone alloy due to faster natural aging response and enhanced mechanical properties. The natural response to aging has been assessed through the testing of transverse tensile properties and micro-hardness. Most notably, the conditions of water cooling increased the properties of tensile by about 10 percent above normal FSW. Fu RD, et al. [17] too states that tensile strength of Underwater FSW method reached 75% of base metal and the elongation is comparably better than the normal FSW joint. Moreover, the hardness and tensile strength of Underwater FSW joint were improved compared to normal FSW joint properties. Darras B, et al. [18] studied Underwater FSW for Al AA2219-T6 to clarify the enhanced value in tensile strength compared to normal FSW joint. This study also proved that the influences of water cooling is the essential cause for the underwater FSW joint to increase the strength.

Upadhyay P, et al. [19] again, focused their research on underwater FSW of Al 2219 to moreover advance the mechanical properties of the joint with varying welding temperature history. This work is able to discover that external water-cooling action in underwater FSW developed the normal FSW joint tensile value from 324 to 341 MPa. Liu H, et al. [20] conducted experimental study to different welding conditions in Underwater FSW of 6061 aluminium alloy. The experimental outcome proved that underwater joint generates less peak temperature compared to normal FSW joint [21]. The grain sizes were predicted using boundary migration model. In addition, Transmission Electron Microscopy (TEM) was used to characterize the microstructures. Kishta EE, et al. [22] conducted experimental study to Underwater FSW of AL AA2219-T6 performed an experimental analysis for improving mechanical properties in the heat-affected area (HAZ). The experimental observations during microstructural analysis uncovered that the hardness of the HAZ can be enhanced with UFSW method due to the narrowing of precipitate free zone.

Cheng, et al. [23] explain the fuzzy control of the feed rate in the final milling process. different in the cutting parameters and nonlinearities in the processes are the drawbacks in the development of suitable mathematical models. Fuzzy logic technology offers an alternative approach and models a system as a black box with variables of input and output [24,25]. The fundamental frequencies of electromagnetic radiation emitted during the FSW welds tensile failure, generated at different process parameters, were analysed using fuzzy modelling [26]. It was estimated that the fundamental frequency of weld failures from the fuzzy model was closer to the experimental results. Dewan MW, et al. [27] found that the number of the membership functions (MF) and their locations on the universe of discourse influenced the fuzzy algorithm, compared to the shape variations of MFs. Zhang Q, et al. [28] developed a systematic datadriven fuzzy modelling approach to AA5083 Aluminum alloyrelated FSW behaviour with microstructural features, mechanical properties, and overall weld quality. The extracted models have proven to be accurate, interpretable, and resilient, and can be applied to facilitate the optimal design of process parameters to achieve the desired welding properties. Hence, the FSW process parameters, rotation speed, travels speed, and shoulder diameter, effect the tensile strength and hardness underwater FSWoP joints. There is a gap between predicting tensile strength and hardness for different parameters and for various materials. This gap could be filled by developing a fuzzy logic-based model for the underwater FSWoP process. In this work, an attempt was made to develop a straightforward fuzzy model for the prediction of weld strength and hardness, within the range of the process parameters, which could provide a perfect joint through utilize underwater FSWoP.

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Iris Publishers- Open access Journal of Modern Concepts in Material Science | The Adsorption Behavior of Copper Clusters on SiO2 and TiO2 Surfaces: A Computational Study

 


Authored by Shenna M Shearin*

Abstract

In this study the various adsorption modes of binding of copper on SiO2 and TiO2 surfaces were investigated by advanced computational techniques. The central objective of this study was to develop a working model of metal-oxide surface-mediated copper clusters, since such catalytic matrixes have a wide-range of applications in the Methanol Steam Reform process. The structural models of the copper clusters ranging from n=2 to n=20 were created using the Birmingham Cluster genetic algorithm (BCGA) coupled with the Gupta potential based on the physiochemical parameters published by Cleri and Rosato [1]. Optimization of the copper clusters was performed using Density Functional Theory (DFT) with PBE XC functional of Pbe0 and LANL2DZ basis set of NWChem package. Adsorption binding of the Cu clusters on SiO2 and TiO2 surfaces were performed using periodic Density Functional Theory (DFT) and PBE XC functional of the Quantum Expresso package. to investigate the binding free energy, the most optimal mode of binding, and the key adsorption interactions of Cu atoms on SiO2 and TiO2 surfaces.

Keywords: Adsorption; Copper; Metal-oxide; Density functional theory; Methanol steam reform

Introduction

Depletion of petroleum based fossils fuels provoked the pursuit for generating alternative safe and environmentally clean fuels over the past decade. Hydrogen gas (H2) has long been regarded as a promising alternative to fossil fuels. For instance, fuel cells polymer electrolyte membrane fuel cells (PEMFC) are one of the primary sources as high efficiency energy converting devices. In such processes, producing safe storage of explosive hydrogen gas and circumventing the opportunities of leakage remains a challenging task. Compared to gaseous hydrogen gas storage, on-board hydrogen production by reforming liquid hydrogen carriers will be more promising for future commercialization. Steam reforming of alcoholic sources such as methanol, ethanol or glycerol have been investigated comprehensively for their potential to be converted to hydrogen. Methanol steam reforming (MSR) is considered one of the most favorable chemical processes for on-the-fly hydrogen production for several reasons [2,3]. (i) Methanol is in liquid-state at ambient condition; (ii) it has high H-to-C atom ratio; (iii) requirement of relatively low temperatures (200-400 °C) for activation of methanol and (iv) methanol is sulfur-free and can be easily produced from biomass. Various catalysts have been developed for MSR reactions.

In particular, copper (Cu) based catalysts have demonstrated the ability to produce gas with high hydrogen (H2) concentration and high selectivity for carbon dioxide (CO2) [2,3]. Metal oxide substrates exhibit a strong effect on the catalytic efficiency. Copper supported catalysts exhibited a higher selectivity for hydrogen and a lower selectivity for CO2 on silica (SiO2) than on a titania (TiO2) at 250 °C [2,3]. SiO2 has been used as a structural support matrix as it stabilizes copper particles and enhances the activity in Methanol Steam Reforming (MSR) reactions [2,3]. Additionally, experimen- tal studies reveal Cu-SiO2 catalysts exhibits a higher selectivity for hydrogen and a lower selectivity for carbon monoxide (CO) than that of Cu in the framework of TiO2 [2,3]. Understanding the nature of these reactions on an atomic level by experimental techniques is difficult due to the electronic effect of metal-oxide interactions. Furthermore, quantum mechanical methods are powerful tools that contribute useful information about the microscopic aspects of metal-oxide interactions [4-19]. In a study by Pacchioni and coworkers, Density Functional Theory (DFT) calculations were used to predict the interaction of isolated Cu atoms and small Cun clusters (2 ≥ n ≤ 5) on metal-oxide support which resulted due to the electrostatic interactions between the Cu metal and the support of a two-coordinated oxygen of the SiO2 [4]. It was also demonstrated that isolated Cu atoms deposited on TiO2 shows a preference to transfer their valence electron to the bridging oxygen sites of TiO2 with formation of a strong bond while the interaction with the Ti sites are weak [4].

The adsorption behavior and binding interactions of Cu clusters on SiO2 and TiO2 supports are difficult to elucidate via experimental methods. This study is useful for gaining an in-depth understanding of the adsorption behavior of small Cun clusters on SiO2 and TiO2 supports and the thermodynamic properties of cluster- oxide interactions for producing optimal yields of hydrogen in the MSR process.

Methods and Design

Construction of Cun clusters

The Birmingham Cluster Genetic Algorithm (BCGA) combined with Gupta potential [20] and DFT using XC functional of Pbe0 and LANL2DZ basis set of NWChem package were employed to construct and optimize the Cu clusters [22,20,5,6]. The inter-atomic interactions provided by the Gupta potential, a many-body potential based on the Friedel’s tight-binding model [20], was used to account for the repulsive and attractive terms. In this model, the configurational energy of a cluster is written as the summation of all atoms of attractive and repulsive energy components in equation (1);

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Iris Publishers-Open access Journal of Hydrology & Meteorology | Influence of Community Resilience to Flood Risk and Coping Strategies in Bayelsa State, Southern Nigeria

  Authored by  Nwankwoala HO *, Abstract This study is aimed at assessing the influence of community resilience to flood risk and coping str...