Search results for: glycogen storage disease
2307 Correlation between Diabetic Cataract, HBA1C and Gurakhu, a Clinical Study in Chhattisgarh State
Authors: A. Bhattacharya, Sanjay Gupta, S. H. Bodakhe
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HbA1c is form of the haemoglobin that is used to measure the average plasma glucose concentration over prolonged periods of time. It is formed in a non-enzymatic glycation pathway by hemoglobin's exposure to plasma glucose. In diabetes mellitus, higher amounts of glycated hemoglobin, indicating poorer control of blood glucose levels, have been associated with cardiovascular disease, nephropathy, and retinopathy. Guraku’s basic components are nicotine and jaggery, jaggery is made up of sugarcane so can have a diabetogenic potential which is exacerbated in presence of nicotine. This work had done with the aim to find correlation between Diabetic cataract, HbA1c and Guraku. Subjects were enrolled according to the inclusion and exclusion criteria. In this study total 75 subjects were included. In the study it was found that people consuming Guraku had a high level of HbA1c thus are more prone to the development of diabetic cataract. Male subjects are the more than female subjects. Most of the subjects belong to the lower socioeconomical class and not very educated. It could be concluded that this type of study could be useful in indentifying number of subjects suffering from diabetic cataract whose condition get worse by use of nicotine product like Guraku and preventive measure to be taken in prevention of this type of diabetic complication.Keywords: diabetic cataract, HbA1c, Guraku, diabetogenic potential
Procedia PDF Downloads 4002306 Consumers’ Perceptions of Non-Communicable Diseases and Perceived Product Value Impacts on Healthy Food Purchasing Decisions
Authors: Khatesiree Sripoothon, Usanee Sengpanich, Rattana Sittioum
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The objective of this study is to examine the factors influencing consumer purchasing decisions about healthy food. This model consists of two latent variables: Consumer Perception relating to NCDs and Consumer Perceived Product Value. The study was conducted in the northern provinces of Thailand, which are popular with tourists and have received support from the government for health tourism. A survey was used as the data collection method, and the questionnaire was applied to 385 tourists. An accidental sampling method was used to identify the sample. The statistics of frequency, percentage, mean, and structural equation model were used to analyze the data obtained. Additionally, all factors had a significant positive influence on healthy food purchasing decisions (p<0.01) and were predictive of healthy food purchasing decisions at 46.20 (R2=0.462). Also, these findings seem to underline a supposition that consumer perceptions of NCDs and perceived product value are key variables that strengthens the competitive effects of a healthy-friendly business entrepreneur. Moreover, reduce the country's public health costs for treating patients with the disease of NCDs in Thailand.Keywords: healthy food, perceived product value, perception of non-communicable diseases, purchasing decisions
Procedia PDF Downloads 1612305 Point-of-Decision Design (PODD) to Support Healthy Behaviors in the College Campuses
Authors: Michelle Eichinger, Upali Nanda
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Behavior choices during college years can establish the pattern of lifelong healthy living. Nearly 1/3rd of American college students are either overweight (25 < BMI < 30) or obese (BMI > 30). In addition, overweight/obesity contributes to depression, which is a rising epidemic among college students, affecting academic performance and college drop-out rates. Overweight and obesity result in an imbalance of energy consumption (diet) and energy expenditure (physical activity). Overweight/obesity is a significant contributor to heart disease, diabetes, stroke, physical disabilities and some cancers, which are the leading causes of death and disease in the US. There has been a significant increase in obesity and obesity-related disorders such as type 2 diabetes, hypertension, and dyslipidemia among people in their teens and 20s. Historically, the evidence-based interventions for obesity prevention focused on changing the health behavior at the individual level and aimed at increasing awareness and educating people about nutrition and physical activity. However, it became evident that the environmental context of where people live, work and learn was interdependent to healthy behavior change. As a result, a comprehensive approach was required to include altering the social and built environment to support healthy living. College campus provides opportunities to support lifestyle behavior and form a health-promoting culture based on some key point of decisions such as stairs/ elevator, walk/ bike/ car, high-caloric and fast foods/balanced and nutrient-rich foods etc. At each point of decision, design, can help/hinder the healthier choice. For example, stair well design and motivational signage support physical activity; grocery store/market proximity influence healthy eating etc. There is a need to collate the vast information that is in planning and public health domains on a range of successful point of decision prompts, and translate it into architectural guidelines that help define the edge condition for critical point of decision prompts. This research study aims to address healthy behaviors through the built environment with the questions, how can we make the healthy choice an easy choice through the design of critical point of decision prompts? Our hypothesis is that well-designed point of decision prompts in the built environment of college campuses can promote healthier choices by students, which can directly impact mental and physical health related to obesity. This presentation will introduce a combined health and architectural framework aimed to influence healthy behaviors through design applied for college campuses. The premise behind developing our concept, point-of-decision design (PODD), is healthy decision-making can be built into, or afforded by our physical environments. Using effective design intervention strategies at these 'points-of-decision' on college campuses to make the healthy decision the default decision can be instrumental in positively impacting health at the population level. With our model, we aim to advance health research by utilizing point-of-decision design to impact student health via core sectors of influences within college settings, such as campus facilities and transportation. We will demonstrate how these domains influence patterns/trends in healthy eating and active living behaviors among students. how these domains influence patterns/trends in healthy eating and active living behaviors among students.Keywords: architecture and health promotion, college campus, design strategies, health in built environment
Procedia PDF Downloads 2222304 Preliminary Results on a Study of Antimicrobial Susceptibility Testing of Bacillus anthracis Strains Isolated during Anthrax Outbreaks in Italy from 2001 to 2017
Authors: Viviana Manzulli, Luigina Serrecchia, Adelia Donatiello, Valeria Rondinone, Sabine Zange, Alina Tscherne, Antonio Parisi, Antonio Fasanella
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Anthrax is a zoonotic disease that affects a wide range of animal species (primarily ruminant herbivores), and can be transmitted to humans through consumption or handling of contaminated animal products. The etiological agent B.anthracis is able to survive in unfavorable environmental conditions by forming endospore which remain viable in the soil for many decades. Furthermore, B.anthracis is considered as one of the most feared agents to be potentially misused as a biological weapon and the importance of the disease and its treatment in humans has been underscored before the bioterrorism events in the United States in 2001. Due to the often fatal outcome of human cases, antimicrobial susceptibility testing plays especially in the management of anthrax infections an important role. In Italy, animal anthrax is endemic (predominantly found in the southern regions and on islands) and is characterized by sporadic outbreaks occurring mainly during summer. Between 2012 and 2017 single human cases of cutaneous anthrax occurred. In this study, 90 diverse strains of B.anthracis, isolated in Italy from 2001 to 2017, were screened to their susceptibility to sixteen clinically relevant antimicrobial agents by using the broth microdilution method. B.anthracis strains selected for this study belong to the strain collection stored at the Anthrax Reference Institute of Italy located inside the Istituto Zooprofilattico Sperimentale of Puglia and Basilicata. The strains were isolated at different time points and places from various matrices (human, animal and environmental). All strains are a representative of over fifty distinct MLVA 31 genotypes. The following antibiotics were used for testing: gentamicin, ceftriaxone, streptomycin, penicillin G, clindamycin, chloramphenicol, vancomycin, linezolid, cefotaxime, tetracycline, erythromycin, rifampin, amoxicillin, ciprofloxacin, doxycycline and trimethoprim. A standard concentration of each antibiotic was prepared in a specific diluent, which were then twofold serial diluted. Therefore, each wells contained: bacterial suspension of 1–5x104 CFU/mL in Mueller-Hinton Broth (MHB), the antibiotic to be tested at known concentration and resazurin, an indicator of cell growth. After incubation overnight at 37°C, the wells were screened for color changes caused by the resazurin: a change from purple to pink/colorless indicated cell growth. The lowest concentration of antibiotic that prevented growth represented the minimal inhibitory concentration (MIC). This study suggests that B.anthracis remains susceptible in vitro to many antibiotics, in addition to doxycycline (MICs ≤ 0,03 µg/ml), ciprofloxacin (MICs ≤ 0,03 µg/ml) and penicillin G (MICs ≤ 0,06 µg/ml), recommend by CDC for the treatment of human cases and for prophylactic use after exposure to the spores. In fact, the good activity of gentamicin (MICs ≤ 0,25 µg/ml), streptomycin (MICs ≤ 1 µg/ml), clindamycin (MICs ≤ 0,125 µg/ml), chloramphenicol(MICs ≤ 4 µg/ml), vancomycin (MICs ≤ 2 µg/ml), linezolid (MICs ≤ 2 µg/ml), tetracycline (MICs ≤ 0,125 µg/ml), erythromycin (MICs ≤ 0,25 µg/ml), rifampin (MICs ≤ 0,25 µg/ml), amoxicillin (MICs ≤ 0,06 µg/ml), towards all tested B.anthracis strains demonstrates an appropriate alternative choice for prophylaxis and/or treatment. All tested B.anthracis strains showed intermediate susceptibility to the cephalosporins (MICs ≥ 16 µg/ml) and resistance to trimethoprim (MICs ≥ 128 µg/ml).Keywords: Bacillus anthracis, antibiotic susceptibility, treatment, minimum inhibitory concentration
Procedia PDF Downloads 2132303 Anemia and Nutritional Status as Dominant Factor of the Event Low Birth Weight in Indonesia: A Systematic Review
Authors: Lisnawati Hutagalung
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Background: Low birth weight (LBW) is one cause of newborn death. Babies with low birth weight tend to have slower cognitive development, growth retardation, more at risk of infectious disease event at risk of death. Objective: Identifying risk factors and dominant factors that influence the incidence of LBW in Indonesia. Method: This research used some database of public health such as Google Scholar, UGM journals, UI journals and UNAND journals in 2012-2015. Data were filtered using keywords ‘Risk Factors’ AND ‘Cause LBW’ with amounts 2757 study. The filtrate obtained 5 public health research that meets the criteria. Results: Risk factors associated with LBW, among other environment factors (exposure to cigarette smoke and residence), social demographics (age and socio-economic) and maternal factors (anemia, placental abnormal, nutritional status of mothers, examinations antenatal, preeclampsia, parity, and complications in pregnancy). Anemia and nutritional status become the dominant factor affecting LBW. Conclusions: The risk factors that affect LBW, most commonly found in the maternal factors. The dominant factors are a big effect on LBW is anemia and nutritional status of the mother during pregnancy.Keywords: low birth weight, anemia, nutritional status, the dominant factor
Procedia PDF Downloads 3652302 Effects of Physical Activity on the Association of CETP Gene with HDL Cholesterol Levels in Korean Population
Authors: Jae Woong Sull, Sun Ha Jee
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High-density lipoprotein (HDL) cholesterol levels are associated with decreased risk of coronary artery disease. Several genome-wide association studies (GWAS) for HDL cholesterol levels have implicated cholesterol ester transfer protein (CETP) as possibly causal. We tested for the association between single nucleotide polymorphisms (SNPs) in CETP gene and HDL cholesterol levels in Korean population. Subjects were selected from the Korean Metabolic Syndrome Research Initiative study in the Bundang-Gu area. A total of 2,304 individuals from Bundang-Gu were recruited in 2008. Other subjects were selected from the Severance Hospital (N=4,294). SNP rs6499861 in the CETP gene was associated with mean HDL cholesterol levels (effect per allele -2.044 mg/dL, p=7.23×10-7). Subjects with the CG/GG genotype had a 1.46 -fold (range 1.24–1.72-fold) higher risk of having abnormal HDL cholesterol levels (<40 mg/dL) than subjects with the CC genotype. When analyzed by gender, the association of CETP was stronger in women than in men. When analyzed by physical activity behavior, the association with CETP was much stronger in male subjects with low physical activity (OR=1.54, 95% CI: 1.23-1.92, P=0.0001) than in male subjects with high physical activity. This study clearly demonstrates that genetic variants in CETP influence HDL cholesterol levels in Korean adults.Keywords: CETP, HDL cholesterol, physical activity, polymorphisms
Procedia PDF Downloads 2862301 Supervisory Controller with Three-State Energy Saving Mode for Induction Motor in Fluid Transportation
Authors: O. S. Ebrahim, K. O. Shawky, M. O. S. Ebrahim, P. K. Jain
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Induction Motor (IM) driving pump is the main consumer of electricity in a typical fluid transportation system (FTS). It was illustrated that changing the connection of the stator windings from delta to star at no load could achieve noticeable active and reactive energy savings. This paper proposes a supervisory hysteresis liquid-level control with three-state energy saving mode (ESM) for IM in FTS including storage tank. The IM pump drive comprises modified star/delta switch and hydromantic coupler. Three-state ESM is defined, along with the normal running, and named analog to computer ESMs as follows: Sleeping mode in which the motor runs at no load with delta stator connection, hibernate mode in which the motor runs at no load with a star connection, and motor shutdown is the third energy saver mode. A logic flow-chart is synthesized to select the motor state at no-load for best energetic cost reduction, considering the motor thermal capacity used. An artificial neural network (ANN) state estimator, based on the recurrent architecture, is constructed and learned in order to provide fault-tolerant capability for the supervisory controller. Sequential test of Wald is used for sensor fault detection. Theoretical analysis, preliminary experimental testing and, computer simulations are performed to show the effectiveness of the proposed control in terms of reliability, power quality and energy/coenergy cost reduction with the suggestion of power factor correction.Keywords: ANN, ESM, IM, star/delta switch, supervisory control, FT, reliability, power quality
Procedia PDF Downloads 1932300 Do Women with Endometriosis Have Higher Perceived Stress Levels than Healthy Women?
Authors: Jodie Hughes
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Endometriosis affects 1 in 10 individuals that were born female globally. Endometriosis incidence rates peak between 30-40 year of age, in young women and adolescents it is a rarely suspected and often ill-diagnosed. The average cost of endometriosis is €9,579 per woman. More than 75% of women have reported being absent from work due to endometriosis, with 40% of women becoming unemployed due to the disease. 46% of patients with endometriosis need to have appointments with upward of five doctors to gain a correct diagnosis. Quantitative data were collected by way of an online PSS-10 survey that included demographic questions from two sample groups of females, group 1 was females with endometriosis, group 2 were healthy women. The data were scored using Cohens scoring system, overall scores were input to SPSS. A non-parametric Mann-Whitney U test and ANOVA was used to ascertain any differences between the PSS-10 scores of the two groups. A significance level of P<0.05 was adopted. Four women were invited to take part in a semi structured interview that was recorded, transcribed and coded using interpretive phenomenological analysis (IPA) using NVivo 12. Results showed that the PSS-10 scores were significantly higher in women with endometriosis compared to healthy women with a p=<0.005. Endometriosis affects all aspects of a patient’s life, to adequately diagnose and treat the condition and improve HRQoL there needs to be better understanding of the clinical symptoms and how they impact the lives of patients.Keywords: endometriosis, HRQoL, perceived stress, women
Procedia PDF Downloads 1362299 Evaluation of Orthodontic Patients’ Dental Visits and Problems During Covid-19 Pandemic in Sari Dental School in 2021
Authors: Mobina Bagherianlemraski, Parastoo Namdar
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Background: The ongoing coronavirus disease has affected most countries. This virus has high transmission power. Due to the closure of most dental clinics, millions of orthodontic patients missed their appointments during the COVID-19 pandemic. Methods: A questionnaire was developed and sent to patients receiving orthodontic treatment at a public or private clinic. Results: A total of 200 responses were analyzed: These included 153 women (76.5%) and 47 men (23.5%). The mean and standard deviation of their age was 18.92±7.23 years, with an age range of 8 to 40 years. One hundred eighty-nine patients (94.5%) had fixed appliances, and 11 patients (5.5%) had removable appliances. Of all participants, 35% (70) missed their appointments. The highest and lowest reasons for stopping appointments were concerned about the spread of COVID-19 with 28 cases (40%) and the closure of the clinic with 15 cases (21.4%). Of the 53 patients who contacted their orthodontists, 86.8 % (46) communicated via office phone and 5.7% (3) through social media. Conclusion: This study determined that the coronavirus pandemic and quarantine have had an important impact on orthodontic treatments. The greatest concern of orthodontic patients was increasing in treatment duration. Patients who used fixed appliances reported missing dental appointments more than others. Therefore, during COVID 19 Pandemic, orthodontists should prepare patients to solve their problems linked to orthodontic appliances when possible.Keywords: orthodontic patients, coronavirus pandemic, appointments, COVID-19
Procedia PDF Downloads 1382298 Analysis of the Impacts and Challenges of Conventional Solid Waste Management in Urban Centers of Developing Countries
Authors: Haruna Abdu Usman, J. Mohammed Umar, U. M. Bashir
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Solid waste management continued to be the biggest threat to the sustainability of urban centers of developing countries. Most streets corners of these urban centers are characterized by heaps of uncollected wastes at drains, public spaces and road sides destroying the aesthetic qualities and environmental ecosystems of these cities. Also, harboring disease vectors and rodents putting the health of the populace at risk, thus posing a serious challenge to the municipalities who are in most cases responsible for the solid waste management in these cities. The typical or commonest method adapted by these agencies in dealing with the solid waste management is the conventional approach; focusing mainly on waste collection ,treatment(composting and incineration)and disposal giving little consideration to the 3RS, of waste reduce, re-used and recycled. The resultant consequence being huge budget spending in solid waste management as high as 80% but little collection rate as low as 50%. This paper attempt to analyze the impacts and effects of the conventional solid waste management practices on the stakeholders in solid waste management; the municipal authorities, the communities, formal and informal waste managers, the NGOs and CBOs and suggests appropriate measures that would lessen the effects.Keywords: conventional waste management, solid waste, waste stakeholders, developing countries
Procedia PDF Downloads 4562297 Dietetics Practice in the Scope of Disease Prevention in Community Settings: A School-Based Obesity Prevention Program
Authors: Elham Abbas Aljaaly, Nahlaa Abdulwahab Khalifa
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The active method of disease prevention is seen as the most affordable and sustainable action to deal with risks of non-communicable diseases such as obesity. This eight-week project aimed to pilot the feasibility and acceptability of a school-based programme, which is proposed to prevent and modify overweight status and possible related risk factors among student girls 'at the intermediate level' in Jeddah city. The programme was conducted through comprehensible approach targeting physical environment and school policies (nutritional/exercise/behavioural approach). The programme was designed to cultivate the personal and environmental awareness in schools for girls. This was applied by promoting healthy eating and physical activity through policies, physical education, healthier options for school canteens, and the creation of school health teams. The prevention programme was applied on 68 students (who agreed to participate) from grades 7th, 8th and 9th. A pre and post assessment questionnaire was employed on 66 students. The questionnaires were designed to obtain information on students' knowledge about health, nutrition and physical activity. Survey questions included information about nutrients, food consumption patterns, food intake and lifestyle. Physical education included training sessions for new opportunities for physical activities to be performed during school or after school hours. A running competition 'to enhance students’ performance for physical activities' was also conducted during the school visit. A visit to the school canteen was conducted to check, observe, record and assess all available food/beverage items and meals. The assessment method was a subjective method for the type of food/beverages if high in saturated fat, salt and sugar (HFSS) or non-HFSS. The school canteen administrators were encouraged to provide healthy food/beverage items and a sample healthy canteen was provided for implementation. Two healthy options were introduced to the school canteen. A follow up for students’ preferences for the introduced options and the purchasing power were assessed. Thirty-eight percent of young girls (n=26) were not participating in any form of physical activities inside or outside school. Skipping breakfast was stated by 42% (n=28) of students with no daily consumption (19%, n=13) for fruit/vegetables. Significant changes were noticed in students’ (n=66) overall responses to the pre and post questions (P value=.001). All students had participated in the conducted running competition sessions and reported satisfaction and enjoyment about the sessions. No absence was reported by the research team for attending physical education and activity sessions throughout the delivered programme. The purchasing power of the introduced healthy options of 'Salad and oatmeal' was increased to 18% in 8 weeks at the school canteen, and slightly affected the purchase for other less healthy options. The piloted programme indorsed better health and nutrition knowledge, healthy eating and lifestyle attitude, which could help young girls to obtain sustainable changes. It is expected that the outcomes of the programme will be a cornerstone for the futuristic national study that will assist policy makers and participants to build a knowledgeable health promotion scenario and make sure that school students have access to healthy foods, physical exercise and healthy lifestyle.Keywords: adolescents, diet, exercise, behaviours, overweight/obesity, prevention-intervention programme, Saudi Arabia, schoolgirls
Procedia PDF Downloads 1292296 Development and Evaluation of Novel Diagnostic Methods for Infectious Rhinotracheitis of Cattle
Authors: Wenxiao Liu, Kun Zhang, Yongqing Li
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Bovine herpesvirus 1, a member of the genus Variellovirus of the subfamily Alphaherpesvirinae, has caused severe economic cost to the bovine industry. In this study, BoHV-1 glycerol protein gD was expressed in insect cells, and the purified gD was immunized in the Balb/C mice to generate monoclonal antibodies. Based on hybridoma cell fusion techniques, 20 monoclonal antibodies against Bovine herpesvirus 1 have been obtained. Further, mAb 3F8 with neutralizing activity and gD were applied to develop a blocking enzyme-linked immunosorbent assay (Elisa) for detecting neutralizing antibodies against BoHV-1, which shows a significant correlation between the blocking Elisa and VNT. The sensitivity and specificity of the test were estimated to be 94.59% and 93.42%, respectively. Furthermore, antibody pairing tests revealed that mAb 1B6 conjugated to fluorescence microspheres was used as the capture antibody, and mAb 3F9 was used as the detectable antibody to establish the immunochromatographic assay (ICS). The ICS was conducted to detect BoHV-1 in bovine samples with high sensitivity, specificity, and good stability. Clinical sample testing revealed that the results of ICS and real-time PCR have a coincidence rate of 95.42%. Our research confirmed that the ICS is a rapid and reliable method for the diagnosis of BoHV-1. In conclusion, our results lay a solid foundation for the prevention and control of BoHV-1 infection.Keywords: bovine disease, BoHV-1, ELISA, ICS assay
Procedia PDF Downloads 742295 LiTa2PO8-based Composite Solid Polymer Electrolytes for High-Voltage Cathodes in Lithium-Metal Batteries
Authors: Kumlachew Zelalem Walle, Chun-Chen Yang
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Solid-state Lithium metal batteries (SSLMBs) that contain polymer and ceramic solid electrolytes have received considerable attention as an alternative to substitute liquid electrolytes in lithium metal batteries (LMBs) for highly safe, excellent energy storage performance and stability under elevated temperature situations. Here, a novel fast Li-ion conducting material, LiTa₂PO₈ (LTPO), was synthesized and electrochemical performance of as-prepared powder and LTPO-incorporated composite solid polymer electrolyte (LTPO-CPE) membrane were investigated. The as-prepared LTPO powder was homogeneously dispersed in polymer matrices, and a hybrid solid electrolyte membrane was synthesized via a simple solution-casting method. The room temperature total ionic conductivity (σt) of the LTPO pellet and LTPO-CPE membrane were 0.14 and 0.57 mS cm-1, respectively. A coin battery with NCM811 cathode is cycled under 1C between 2.8 to 4.5 V at room temperature, achieving a Coulombic efficiency of 99.3% with capacity retention of 74.1% after 300 cycles. Similarly, the LFP cathode also delivered an excellent performance at 0.5C with an average Coulombic efficiency of 100% without virtually capacity loss (the maximum specific capacity is at 27th: 138 mAh g−1 and 500th: 131.3 mAh g−1). These results demonstrates the feasibility of a high Li-ion conductor LTPO as a filler, and the developed polymer/ceramic hybrid electrolyte has potential to be a high-performance electrolyte for high-voltage cathodes, which may provide a fresh platform for developing more advanced solid-state electrolytes.Keywords: li-ion conductor, lithium-metal batteries, composite solid electrolytes, liTa2PO8, high-voltage cathode
Procedia PDF Downloads 662294 A Study of Influence of Freezing on Mechanical Properties of Tendon Fascicles
Authors: Martyna Ekiert, Andrzej Mlyniec
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Tendons are the biological structures, which primary function is to transfer force generated by muscles to the bones. Unfortunately, damages of tendons are also one of the most common injuries of the human musculoskeletal system. For the most severe cases of tendon rupture, such as the tear of calcaneus tendon or anterior cruciate ligament of the knee, a surgical procedure is the only possible way of full recovery. Tendons used as biological grafts are usually subjected to the process of deep freezing and subsequent thawing. This, in particular for multiple freezing/thawing cycles, may result in changes of tendon internal structure causing deterioration of mechanical properties of the tissue. Therefore, studies on the influence of freezing on tendons biomechanics, including internal water content in soft tissue, seems to be greatly needed. An experimental study of the influence of freezing on mechanical properties of the tendon was performed on fascicles samples dissected form bovine flexor tendons. The preparation procedure was performed with the presence of 0.9% saline solution in order to prevent an excessive tissue drying. All prepared samples were subjected to the different number of freezing/thawing cycles. For freezing part of the protocol we used -80°C temperature while for slow thawing we used fridge temperature (4°C) combined with equalizing temperatures in the standard state (25°C). After final thawing, the mechanical properties of each sample was examined using cyclic loading test. Our results may contribute for better understanding of negative effects of soft tissues freezing, resulting from abnormal thermal expansion of water. This also may help to determine the limit of freezing/thawing cycles disqualifying tissue for surgical purposes and thus help optimize tissues storage conditions.Keywords: freezing, soft tissue, tendon, bovine fascicles
Procedia PDF Downloads 2192293 Prevalence of Metabolic Syndrome According to Different Criteria in Population over 20 Years Old in Ahvaz
Authors: Armaghan Moravej Aleali, Hajieh Shahbazian, Seyed Mahmoud Latifi, Leila Yazdanpanah
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Objective: Metabolic syndrome or insulin resistance syndrome or syndrome X is a collection of abdominal obesity, hypertension, glucose intolerance and lipid abnormalities (elevated triglycerides, elevated LDL, and decrease the amount of HDL). That increases the incidence of diabetes and risk of cardiovascular disease. The aim of this study is to investigate the prevalence of metabolic syndrome in people over 20 years of Ahvaz according to IDF, ATPIII, Harmonized I and Harmonized II. Material & Methods: A cross-sectional study with a random cluster sampling in six health centers in Ahvaz was done. After obtaining informed consent, questionnaire for each person filled up including demographic data and examinations, including blood pressure in sitting position, weight, height, waist circumference, and waist circumference measurement. Results: From all participating 912 people, (434 (2/47%) male and 478 (2/52%) female) were evaluated. Mean age was 42/27± 14years (44/2±14/26 for male and 40/5±13/5 for female). Prevalence of metabolic syndrome was 22/8%, 28/4%, 30/9% and 16/9% according to ATPIII, IDF, Harmonized I and Harmonized II criteria respectively and increased with age in both sexes. IDF and Harmonized I had most kappa coordination (0/94). Conclusion: The results show a high prevalence of metabolic syndrome in Ahvaz. So, identification of the risk factors should be attempted to prevent metabolic syndrome.Keywords: metabolic syndrome, IDF, ATP III, prevalence
Procedia PDF Downloads 5792292 Relevance of Dosing Time for Everolimus Toxicity on Thyroid Gland and Hormones in Mice
Authors: Dilek Ozturk, Narin Ozturk, Zeliha Pala Kara, Engin Kaptan, Serap Sancar Bas, Nurten Ozsoy, Alper Okyar
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Most physiological processes oscillate in a rhythmic manner in mammals including metabolism and energy homeostasis, locomotor activity, hormone secretion, immune and endocrine system functions. Endocrine body rhythms are tightly regulated by the circadian timing system. The hypothalamic-pituitary-thyroid (HPT) axis is under circadian control at multiple levels from hypothalamus to thyroid gland. Since circadian timing system controls a variety of biological functions in mammals, circadian rhythms of biological functions may modify the drug tolerability/toxicity depending on the dosing time. Selective mTOR (mammalian target of rapamycin) inhibitor everolimus is an immunosuppressant and anticancer agent that is active against many cancers. It was also found to be active in medullary thyroid cancer. The aim of this study was to investigate the dosing time-dependent toxicity of everolimus on the thyroid gland and hormones in mice. Healthy C57BL/6J mice were synchronized with 12h:12h Light-Dark cycle (LD12:12, with Zeitgeber Time 0 – ZT0 – corresponding to Light onset). Everolimus was administered to male (5 mg/kg/day) and female mice (15 mg/kg/day) orally at ZT1-rest period- and ZT13-activity period- for 4 weeks; body weight loss, clinical signs and possible changes in serum thyroid hormone levels (TSH and free T4) were examined. Histological alterations in the thyroid gland were evaluated according to the following criteria: follicular size, colloid density and viscidity, height of the follicular epithelium and the presence of necrotic cells. The statistical significance between differences was analyzed with ANOVA. Study findings included everolimus-related diarrhea, decreased activity, decreased body weight gains, alterations in serum TSH levels, and histopathological changes in thyroid gland. Decreases in mean body weight gains were more evident in mice treated at ZT1 as compared to ZT13 (p < 0.001, for both sexes). Control tissue sections of thyroid glands exhibited well-organized histoarchitecture when compared to everolimus-treated groups. Everolimus caused histopathological alterations in thyroid glands in male (5 mg/kg, slightly) and female mice (15 mg/kg; p < 0.01 for both ZT as compared to their controls) irrespective of dosing-time. TSH levels were slightly decreased upon everolimus treatment at ZT13 in both males and females. Conversely, increases in TSH levels were observed when everolimus treated at ZT1 in both males (5 mg/kg; p < 0.05) and females (15 mg/kg; slightly). No statistically significant alterations in serum free T4 levels were observed. TSH and free T4 is clinically important thyroid hormones since a number of disease states have been linked to alterations in these hormones. Serum free T4 levels within the normal ranges in the presence of abnormal serum TSH levels in everolimus treated mice may suggest subclinical thyroid disease which may have repercussions on the cardiovascular system, as well as on other organs and systems. Our study has revealed the histological damage on thyroid gland induced by subacute everolimus administration, this effect was irrespective of dosing time. However, based on the body weight changes and clinical signs upon everolimus treatment, tolerability for the drug was best following dosing at ZT13 in both male and females. Yet, effects of everolimus on thyroid functions may deserve further studies regarding their clinical importance and chronotoxicity.Keywords: circadian rhythm, chronotoxicity, everolimus, thyroid gland, thyroid hormones
Procedia PDF Downloads 3502291 Nonlinear Analysis of Postural Sway in Multiple Sclerosis
Authors: Hua Cao, Laurent Peyrodie, Olivier Agnani, Cecile Donze
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Multiple sclerosis (MS) is a disease, which affects the central nervous system, and causes balance problem. In clinical, this disorder is usually evaluated using static posturography. Some linear or nonlinear measures, extracted from the posturographic data (i.e. center of pressure, COP) recorded during a balance test, has been used to analyze postural control of MS patients. In this study, the trend (TREND) and the sample entropy (SampEn), two nonlinear parameters were chosen to investigate their relationships with the expanded disability status scale (EDSS) score. Forty volunteers with different EDSS scores participated in our experiments with eyes open (EO) and closed (EC). TREND and two types of SampEn (SampEn1 and SampEn2) were calculated for each combined COP’s position signal. The results have shown that TREND had a weak negative correlation to EDSS while SampEn2 had a strong positive correlation to EDSS. Compared to TREND and SampEn1, SampEn2 showed a better significant correlation to EDSS and an ability to discriminate the MS patients in the EC case. In addition, the outcome of the study suggests that the multi-dimensional nonlinear analysis could provide some information about the impact of disability progression in MS on dynamics of the COP data.Keywords: balance, multiple sclerosis, nonlinear analysis, postural sway
Procedia PDF Downloads 3382290 Traditional Role of Women and Its Implication in Solid Waste Management in Bauchi Metropolis
Authors: Bogoro Audu Gani, Tobi Nzelibe Ajiji Haruna
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Women have both knowledge and expertise, whose recognition can lead to more efficient, effective, sustainable, and fair waste management operations. Studies have shown that the failure to take cognizance of the traditional role of women in the management of urban environments results in a serious loss of efficiency and productivity. However, urban managers in developing countries are yet to identify and integrate those critical roles of women into urban environmental management. This research is motivated not only due the poor solid waste management but also by the total neglect of the role of women in solid waste management in the Bauchi metropolis. Systematic random sampling technique was adopted for the selection of the samples and 4% of the study population was taken as the sample size. The major instruments used for data collection were questionnaires, interviews and direct measurement of household solid waste at source and the data is presented in tables and charts. It is found that over 95% of sweeping, cooking and food preparation are exclusively reserved for women in the study area. Women dominate the generation, storage and collection of household solid waste with 81%, 96% and 91%, respectively, within the study area. It is also discovered that segregation can be 95% effectively carried out by women that have free time. However, urban managers in the Bauchi metropolis are yet to identify the role of women with a view to integrating them into solid waste management in order to achieve a healthy and clean living environment in the Bauchi metropolis. Among other suggestions, the paper recommends that the role of women should be identified and integrated into developing policies and programs for a clean and healthy living urban environment; this will not only improve the environmental quality but would also increase the income base of the family.Keywords: women, solid waste, integration, segregation
Procedia PDF Downloads 882289 The Effect of Benson Relaxation Method on Quality of Life in Hemodialysis Patients in 2012-2013, Kermanshah, Iran
Authors: Fateme Hadadian, Behnam Khaledi Paveh, Hosein Feizi
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Background: High number of patients with end-stage renal disease worldwide, and Iran and the patients required hemodialysis, As well as symptoms and treatment process and its impact on quality of life The researcher had to take a step towards solving these problems. Methods: In randomized clinical trial in 60 hemodialysis patients admitted to hospital hemodialysis Imam Reza (AS) were studied. Using questionnaires dialysis patients' QOL, quality of life was measured in patients and controls were divided randomly into two groups. Benson's relaxation method for the experimental group and two months at home, once per day, respectively and the control group received no special action. Immediately after the end of the period with was used for evaluating the quality of life in both the experimental and control groups were survey and data using independent t-test were used for statistical analysis. Results: The general dimensions of quality of life scores before and after intervention, there was significant difference (P=0/001). But this difference was not significant after QOL (P=0/2). Between QOL scores before and after treatment between the two groups was statistically significant (P=0/02). Conclusion: Benson relaxation has the desired effect on quality of life in hemodialysis patients and can be used as a useful method to enhance the quality of life in hemodialysis patients, implementation and training will be given.Keywords: hemodialysis, quality of life, Benson muscle relaxation, biomedicine
Procedia PDF Downloads 4282288 Association of miRNA146a rs2910164 Polymorphism and Helicobacter pylori Infection in Colorectal Cancer
Authors: Zahra Solgi, Hossein Rassi
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Colorectal cancer (CRC) is a multi-step disease, and chronic gastric infection with H. pylori could play a role in one or more of the steps in this pathogenic process. Polymorphisms in several miRNAs are considered to increase the risk for the development of CRC by controlling proliferation, apoptosis and H. pylori pathogenesis. Therefore, the aim of this study was to investigate miRNA146a rs2910164 polymorphism and Helicobacter pylori infection in CRC. A total of 65 patients with CRC were divided into 2 groups: 28 patients < 50 years of age and 37 patients ≥ 50 years of age. DNA was extracted from all samples by a standard method and H. pylori cagA and miRNA146a rs2910164 genotypes were determined by PCR method. The results show that there was no significant difference in the frequency of H. pylori cagA gene between the two groups but there was a significant difference in the distribution of rs2910164 genotypes in patients < 50 years of age with the p-value of 0.05 and odds ratio equal to 2.69. On other hand, patients < 50 years of age with genotype CC of miRNA146a showed a significant difference in CRC risk. Furthermore, there was a significant correlation between rs2910164 CC genotype with Helicobacter pylori infection in patients < 50 years of age. The present study suggests that the CC genotype of miRNA146a in combination with H. pylori infection can be effective as risk factors and molecular markers for early diagnosis and treatment of CRC.Keywords: colorectal cancer, Helicobacter pylori, miRNA146a, rs2910164 polymorphism
Procedia PDF Downloads 1522287 Phenotypical and Genotypical Assessment Techniques for Identification of Some Contagious Mastitis Pathogens
Authors: Ayman El Behiry, Rasha Nabil Zahran, Reda Tarabees, Eman Marzouk, Musaad Al-Dubaib
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Mastitis is one of the most economic disease affecting dairy cows worldwide. Its classic diagnosis using bacterial culture and biochemical findings is a difficult and prolonged method. In this research, using of matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) permitted identification of different microorganisms with high accuracy and rapidity (only 24 hours for microbial growth and analysis). During the application of MALDI-TOF MS, one hundred twenty strains of Staphylococcus and Streptococcus species isolated from milk of cows affected by clinical and subclinical mastitis were identified, and the results were compared with those obtained by traditional methods as API and VITEK 2 Systems. 37 of totality 39 strains (~95%) of Staphylococcus aureus (S. aureus) were exactly detected by MALDI TOF MS and then confirmed by a nuc-based PCR technique, whereas accurate identification was observed in 100% (50 isolates) of the coagulase negative staphylococci (CNS) and Streptococcus agalactiae (31 isolates). In brief, our results demonstrated that MALDI-TOF MS is a fast and truthful technique which has the capability to replace conventional identification of several bacterial strains usually isolated in clinical laboratories of microbiology.Keywords: identification, mastitis pathogens, mass spectral, phenotypical
Procedia PDF Downloads 3332286 Investigating Ethnic Stereotypes and Perception of Anorexia Nervosa
Authors: Kaitlyn Deierlein, Janet Lydecker
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Stereotypes surrounding anorexia nervosa are that the illness is commonly perceived as a self-inflicted disorder influenced by controlling parents, vanity, and cultural pressures. According to the authors' best knowledge minimal research has examined interactions with other factors, including gender and racial stereotypes involving this disorder. A common stereotype of this disease is that it mainly only affects Caucasian women and is very rarely seen in any other ethnicity. Previous literature has failed to investigate how visual body image and ethnic stereotypes affect the mental health of different ethnic groups, how various cultures impact the type of anorexia nervosa in the patient, and the different stereotypes associated with their eating disorder. Participants completed a pre-test questionnaire with vignettes, an image exposure portion, and a post-test questionnaire, which will all be evaluated and analyzed by ANOVA t-test and SPSS. Results showed that participants picked Caucasian females as more likely to have anorexia nervosa than those of Asian, Latin American, or African American descent subjects in both picture identification and vignettes. Future research should be conducted to further the results of this study by examining differences between gender stereotypes with anorexia nervosa as well as how sexuality has a role in perception.Keywords: anorexia nervosa, ethnicity, stereotypes, eating disorders, perception
Procedia PDF Downloads 742285 Isolation of the Leptospira spp. from the Rice Farming Lands in the North of Iran by EMJH Media
Authors: S. Rostampour Yasouri, M. Ghane
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Leptospirosis is one the most important common diseases between human and live stock occurred by different species of Leptospira. This disease has been construed as the native in the northern provinces of Iran and risk of the infection with pathogenic is high. One hundred fifteen samples of water (67), soil (36) and feces of rodents (12) were collected from the rice fields of the suburbs of Tonekabon Township situated in northern part of Iran in 2012. The samples, after passage from membranous filters, were cultured in the liquid and solid EMJH medium and incubated at 30°C for 1 month. Leptospira spp. were isolated using culture technique, and the plates were studied from viewpoint of colony formation, microscopic observations and then identified by phenotyping tests. Finally, the identification of Leptospira genus was verified by PCR technique and 16S rRNA gene sequencing. Of 115 samples totally, 55 samples (47.82%) became positive by use of the culture technique which the positive cases included 47 water samples (70.14%) and 8 soil samples (22.22%), while the isolation was not accomplished from the sample of the rodents feces. Overall, according to these data, Leptospira spp. exists with high frequency in North Iran. Hence, based on foregoing evidence environments in the north of Iran are vehicles of Leptospira spp.Keywords: EMJH Medium, Leptospira, Northern of Iran, rice fields
Procedia PDF Downloads 1792284 In Vitro Study of Antioxidant Capacity of Chrysanthemum Indicum Extract
Authors: Puchita Chokcharoenying
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Polyphenols are the most abundant antioxidants found in plants, and they are highly effective at scavenging oxidative free radicals. Antioxidants are substances found in medicinal plants to help prevent heart disease, stroke, and some cancers. This study focused on evaluating the flavonoids content of Chrysanthemum Indicum and determine their antioxidant capacity by using DPPH and ABTS radical scavenging capacity assay. The total flavonoid content of C. indicumextract was determined and expressed as quercetin equivalents (QE)/g measured by an aluminiumchloride colorimetric method. The results showed that the IC50 of C. indicum extract were 83.57μg/mL ± 0.875 and52.57μg/mL ± 0.632for DPPH and ABTS, respectively. C. indicumextract exhibited antioxidant activities as a concentration dependent manner. In the DPPH assay, vitamin C was used as a positive control, whereas Trolox was used as a positive control in the ABTS assay. In summary, C. indicum extract is rich in flavonoids, which have potent antioxidant properties. Thus, C. indicum extract is a good source of antioxidants and can be developed for medicinal purposes. Nevertheless, more research on the antioxidant activity of C. indicum extract and in vivo antioxidant studies are still needed.Keywords: ABTS assay, antioxidant, chrysanthemum indicum, DPPH assay, total flavonoid content
Procedia PDF Downloads 2582283 Lumbar Tuberculous Spondylitis in a Child Treated by Posterior Osteosynthesis: Apropos of a Case
Authors: Ghoul Rachid Brahim
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Introduction: Tuberculous spondylodiscitis is an infection of the spine by Mycobacterium tuberculosis. Tuberculous spondylodiscitis still remains a topical disease in developing countries and continues to pose a public health problem in endemic countries. Materials and methods: Clinical case: This is a 12-year-old child followed in pediatrics for weight loss and progressively worsening low back pain. The neurological examination found an irritative pyramidal syndrome in both lower limbs with a severe lumbar spinal syndrome. The radiological assessment: (Rx of the spine supplemented by CT and MRI) shows L1L2 spondylodiscitis. Treatment: The child is put on anti-tuberculosis treatment, and the spine is restrained with a corset. Control MRI shows a worsening of the dorsal kyphosis with a backward movement of the posterior wall and spinal cord compression. The child is operated on via the posterior approach (the operative procedure consists of an L1 laminectomy and D11 L3 osteosynthesis). Results: Spinal cord décompression and stabilization of the spine. Conclusion: Tuberculous spondylodiscitis in children remains a rare, aggressive, and progressive condition. The prognosis depends on the diagnosis's precocity and the therapeutic management quality.Keywords: tuberculous spondylodiscitis, mycobacterium tuberculosis, laminectomy, MRI
Procedia PDF Downloads 912282 Antimicrobial Activity of the Natural Products Derived from Phyllanthus Emblica and Gracilaria Fisheri Against Staphylococcus Aureus
Authors: Woraprat Amnuaychaichana
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Several medicinal plants are well known to contain active constituents such as flavonoids and phenolic compounds with are plausible candidates for therapeutic purposes. An infectious disease caused by microbial infection is the leading cause of death. Antibiotics are typically used to eradicate these microbes, but recent evidence indicates that they are developing antibiotic-resistant effects. This study focused on antimicrobial activities of Phyllanthus emblica and Gracilaria fisheri using the agar disk diffusion method and broth microdilution to determine the minimum inhibitory concentration (MIC) value. The extracts were screened against Staphylococcus aureus. Five concentrations of plant extracts were used to determine the minimum inhibitory concentration (MIC) by 2-fold dilution of plant extract. The results indicated that G. fisheri extract gave the maximum zones of inhibition of 11.7 mm against S. aureus while P. emblica showed no effects. The MIC values of G. fisheri extract against S. aureus was 500 µg/ml. To summarise, G. fisheri extracts demonstrated high efficacy of antibacterial activity against Gram-positive S. aureus, which may pave the way for developing a formulation containing this plant. G. fisheri extract should be subjected to additional investigation in order to determine the mechanism of action of its antimicrobial activity.Keywords: antibacterial activity, Staphylococcus aureus, gracilaria fishery, Phyllanthus emblica
Procedia PDF Downloads 1882281 High-Resolution Computed Tomography Imaging Features during Pandemic 'COVID-19'
Authors: Sahar Heidary, Ramin Ghasemi Shayan
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By the development of new coronavirus (2019-nCoV) pneumonia, chest high-resolution computed tomography (HRCT) has been one of the main investigative implements. To realize timely and truthful diagnostics, defining the radiological features of the infection is of excessive value. The purpose of this impression was to consider the imaging demonstrations of early-stage coronavirus disease 2019 (COVID-19) and to run an imaging base for a primary finding of supposed cases and stratified interference. The right prophetic rate of HRCT was 85%, sensitivity was 73% for all patients. Total accuracy was 68%. There was no important change in these values for symptomatic and asymptomatic persons. These consequences were besides free of the period of X-ray from the beginning of signs or interaction. Therefore, we suggest that HRCT is a brilliant attachment for early identification of COVID-19 pneumonia in both symptomatic and asymptomatic individuals in adding to the role of predictive gauge for COVID-19 pneumonia. Patients experienced non-contrast HRCT chest checkups and images were restored in a thin 1.25 mm lung window. Images were estimated for the existence of lung scratches & a CT severity notch was allocated separately for each patient based on the number of lung lobes convoluted.Keywords: COVID-19, radiology, respiratory diseases, HRCT
Procedia PDF Downloads 1422280 Predicting Potential Protein Therapeutic Candidates from the Gut Microbiome
Authors: Prasanna Ramachandran, Kareem Graham, Helena Kiefel, Sunit Jain, Todd DeSantis
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Microbes that reside inside the mammalian GI tract, commonly referred to as the gut microbiome, have been shown to have therapeutic effects in animal models of disease. We hypothesize that specific proteins produced by these microbes are responsible for this activity and may be used directly as therapeutics. To speed up the discovery of these key proteins from the big-data metagenomics, we have applied machine learning techniques. Using amino acid sequences of known epitopes and their corresponding binding partners, protein interaction descriptors (PID) were calculated, making a positive interaction set. A negative interaction dataset was calculated using sequences of proteins known not to interact with these same binding partners. Using Random Forest and positive and negative PID, a machine learning model was trained and used to predict interacting versus non-interacting proteins. Furthermore, the continuous variable, cosine similarity in the interaction descriptors was used to rank bacterial therapeutic candidates. Laboratory binding assays were conducted to test the candidates for their potential as therapeutics. Results from binding assays reveal the accuracy of the machine learning prediction and are subsequently used to further improve the model.Keywords: protein-interactions, machine-learning, metagenomics, microbiome
Procedia PDF Downloads 3762279 Inhibition of Crystallization Lithiasis Phosphate (Struvite) by Extracts Zea mays
Authors: N. Benahmed, A. Cheriti
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Kidney stones of infectious origin, in particular, the phosphate amoniaco-magnesian hexahydrate or struvite are one of the risk factors that most often leads of renal insufficiency. Many plants species, described in pharmacopoeias of several countries is used as a remedy for urinary stones, the latter is a disease resulting from the presence of stones in the kidneys or urinary tract. Our research is based on the existing relationship between the effect of extracts of medicinal plant used for the cure of urinary tract diseases in the region of Algeria south-west on urolithiasis especially Ammonium-Magnesium Phosphate Hexahydrate (Struvite). We have selected Zea mays L. (POACEAE) for this study. On the first stage, we have studied the crystallisation of struvite 'in vitro' without inhibitors, after we have compared to crystallization with inhibitors. Most of The organic and aqueous extracts of this plant give an effect on the crystal size of struvite. It is a very significant reduction in the size of the crystals of struvite in the presence of hexane and ethanol extract (12 to 5-6 μm). We’ve observed a decrease in the size of the aggregates in the presence of all the extracts. This reduction is important for the aqueous, acetone and chloroform extract (45 to 10-16μm). Finally, a deep study was conducted on the effective extract of Zea mays L.; for determine the influence of inhibitory phytochemical compounds.Keywords: medicinal plants, struvite, urolithiasis, zea mays
Procedia PDF Downloads 4492278 Unlocking Justice: Exploring the Power and Challenges of DNA Analysis in the Criminal Justice System
Authors: Sandhra M. Pillai
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This article examines the relevance, difficulties, and potential applications of DNA analysis in the criminal justice system. A potent tool for connecting suspects to crime sites, clearing the innocent of wrongdoing, and resolving cold cases, DNA analysis has transformed forensic investigations. The scientific foundations of DNA analysis, including DNA extraction, sequencing, and statistical analysis, are covered in the article. To guarantee accurate and trustworthy findings, it also discusses the significance of quality assurance procedures, chain of custody, and DNA sample storage. DNA analysis has significantly advanced science, but it also brings up substantial moral and legal issues. To safeguard individual rights and uphold public confidence, privacy concerns, possible discrimination, and abuse of DNA information must be properly addressed. The paper also emphasises the effects of the criminal justice system on people and communities while highlighting the necessity of equity, openness, and fair access to DNA testing. The essay describes the obstacles and future directions for DNA analysis. It looks at cutting-edge technology like next-generation sequencing, which promises to make DNA analysis quicker and more affordable. To secure the appropriate and informed use of DNA evidence, it also emphasises the significance of multidisciplinary collaboration among scientists, law enforcement organisations, legal experts, and policymakers. In conclusion, DNA analysis has enormous potential for improving the course of criminal justice. We can exploit the potential of DNA technology while respecting the ideals of justice, fairness, and individual rights by navigating the ethical, legal, and societal issues and encouraging discussion and collaboration.Keywords: DNA analysis, DNA evidence, reliability, validity, legal frame, admissibility, ethical considerations, impact, future direction, challenges
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