Search results for: women with breast cancer
1396 Biosynthesis of Natural and Halogenated Plant Alkaloids in Yeast
Authors: Beata J. Lehka, Samuel A. Bradley, Frederik G. Hansson, Khem B. Adhikari, Daniela Rago, Paulina Rubaszka, Ahmad K. Haidar, Ling Chen, Lea G. Hansen, Olga Gudich, Konstantina Giannakou, Yoko Nakamura, Thomas Dugé de Bernonville, Konstantinos Koudounas, Sarah E. O’Connor, Vincent Courdavault, Jay D. Keasling, Jie Zhang, Michael K. Jensen
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Monoterpenoid indole alkaloids (MIAs) represent a large class of natural plant products with marketed pharmaceutical activities against a wide range of applications, including cancer and mental disorders. Halogenated MIAs have shown improved pharmaceutical properties; however, characterisation and synthesis of new-to-nature halogenated MIAs remain a challenge in slow-growing plants with limited genetic tractability. Here, we demonstrate a platform for de novo biosynthesis of two bioactive MIAs, serpentine and alstonine, in baker’s yeast Saccharomyces cerevisiae, reaching titers of 8.85 mg/L and 4.48 mg/L, respectively, when cultivated in fed-batch micro bioreactors. Using this MIA biosynthesis platform, we undertake a systematic exploration of the derivative space surrounding these compounds and produce halogenated MIAs. The aim of the current study is to develop a fermentation process for halogenated MIAs.Keywords: monoterpenoid indole alkaloids, Saccharomyces cerevisiae, halogenated derivatives, fermentation
Procedia PDF Downloads 2101395 Potential Activities of Human Endogenous Retroviral kDNA in Melanoma Pathogenesis and HIV-1 Infection
Authors: Jianli Dong, Fangling Xu, Gengming Huang
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Human endogenous retroviral elements (HERVs) comprise approximately 8% of the human genome. They are thought to be germline-integrated genetic remnants of retroviral infections. Although HERV sequences are highly defective, some, especially the K type (HERV-K), have been shown to be expressed and may have biological activities in the pathogenesis of cancer, chronic inflammation and autoimmune diseases. We found that HERV-K GAG and ENV proteins were strongly expressed in pleomorphic melanoma cells. We also detected a critical role of HERV-K ENV in mediating intercellular fusion and colony formation of melanoma cells. Interestingly, we found that levels of HERV-K GAG and ENV expression correlated with the activation of ERK and loss of p16INK4A in melanoma cells, and inhibition of MEK or CDK4, especially in combination, reduced HERV-K expression in melanoma cells. We also performed a reverse transcription-polymerase chain reaction (RT-PCR) assay using DNase I digestion to remove “contaminating” HERV-K genomic DNA and examined HERV-K RNA expression in plasma samples from HIV-1 infected individuals. We found a covariation between HERV-K RNA expression and CD4 cell counts in HIV-1 positive samples. Although a causal link between HERV-K activation and melanoma development, and between HERV-K activation, HIV-1 infection and CD4 cell count have yet to be determined, existing data support the further research efforts in HERV-K.Keywords: CD4 cell, HERV-K, HIV-1, melanoma
Procedia PDF Downloads 2321394 Characterizing and Developing the Clinical Grade Microbiome Assay with a Robust Bioinformatics Pipeline for Supporting Precision Medicine Driven Clinical Development
Authors: Danyi Wang, Andrew Schriefer, Dennis O'Rourke, Brajendra Kumar, Yang Liu, Fei Zhong, Juergen Scheuenpflug, Zheng Feng
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Purpose: It has been recognized that the microbiome plays critical roles in disease pathogenesis, including cancer, autoimmune disease, and multiple sclerosis. To develop a clinical-grade assay for exploring microbiome-derived clinical biomarkers across disease areas, a two-phase approach is implemented. 1) Identification of the optimal sample preparation reagents using pre-mixed bacteria and healthy donor stool samples coupled with proprietary Sigma-Aldrich® bioinformatics solution. 2) Exploratory analysis of patient samples for enabling precision medicine. Study Procedure: In phase 1 study, we first compared the 16S sequencing results of two ATCC® microbiome standards (MSA 2002 and MSA 2003) across five different extraction kits (Kit A, B, C, D & E). Both microbiome standards samples were extracted in triplicate across all extraction kits. Following isolation, DNA quantity was determined by Qubit assay. DNA quality was assessed to determine purity and to confirm extracted DNA is of high molecular weight. Bacterial 16S ribosomal ribonucleic acid (rRNA) amplicons were generated via amplification of the V3/V4 hypervariable region of the 16S rRNA. Sequencing was performed using a 2x300 bp paired-end configuration on the Illumina MiSeq. Fastq files were analyzed using the Sigma-Aldrich® Microbiome Platform. The Microbiome Platform is a cloud-based service that offers best-in-class 16S-seq and WGS analysis pipelines and databases. The Platform and its methods have been extensively benchmarked using microbiome standards generated internally by MilliporeSigma and other external providers. Data Summary: The DNA yield using the extraction kit D and E is below the limit of detection (100 pg/µl) of Qubit assay as both extraction kits are intended for samples with low bacterial counts. The pre-mixed bacterial pellets at high concentrations with an input of 2 x106 cells for MSA-2002 and 1 x106 cells from MSA-2003 were not compatible with the kits. Among the remaining 3 extraction kits, kit A produced the greatest yield whereas kit B provided the least yield (Kit-A/MSA-2002: 174.25 ± 34.98; Kit-A/MSA-2003: 179.89 ± 30.18; Kit-B/MSA-2002: 27.86 ± 9.35; Kit-B/MSA-2003: 23.14 ± 6.39; Kit-C/MSA-2002: 55.19 ± 10.18; Kit-C/MSA-2003: 35.80 ± 11.41 (Mean ± SD)). Also, kit A produced the greatest yield, whereas kit B provided the least yield. The PCoA 3D visualization of the Weighted Unifrac beta diversity shows that kits A and C cluster closely together while kit B appears as an outlier. The kit A sequencing samples cluster more closely together than both the other kits. The taxonomic profiles of kit B have lower recall when compared to the known mixture profiles indicating that kit B was inefficient at detecting some of the bacteria. Conclusion: Our data demonstrated that the DNA extraction method impacts DNA concentration, purity, and microbial communities detected by next-generation sequencing analysis. Further microbiome analysis performance comparison of using healthy stool samples is underway; also, colorectal cancer patients' samples will be acquired for further explore the clinical utilities. Collectively, our comprehensive qualification approach, including the evaluation of optimal DNA extraction conditions, the inclusion of positive controls, and the implementation of a robust qualified bioinformatics pipeline, assures accurate characterization of the microbiota in a complex matrix for deciphering the deep biology and enabling precision medicine.Keywords: 16S rRNA sequencing, analytical validation, bioinformatics pipeline, metagenomics
Procedia PDF Downloads 1701393 A Review on the Mechanism Removal of Pesticides and Heavy Metal from Agricultural Runoff in Treatment Train
Authors: N. A. Ahmad Zubairi, H. Takaijudin, K. W. Yusof
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Pesticides have been used widely over the world in agriculture to protect from pests and reduce crop losses. However, it affects the environment with toxic chemicals. Exceed of toxic constituents in the ecosystem will result in bad side effects. The hydrological cycle is related to the existence of pesticides and heavy metal which it can penetrate through varieties of sources into the soil or water bodies, especially runoff. Therefore, proper mechanisms of pesticide and heavy metal removal should be studied to improve the quality of ecosystem free or reduce from unwanted substances. This paper reviews the use of treatment train and its mechanisms to minimize pesticides and heavy metal from agricultural runoff. Organochlorine (OCL) is a common pesticide that was found in the agricultural runoff. OCL is one of the toxic chemicals that can disturb the ecosystem such as inhibiting plants' growth and harm human health by having symptoms as asthma, active cancer cell, vomit, diarrhea, etc. Thus, this unwanted contaminant gives disadvantages to the environment and needs treatment system. Hence, treatment train by bioretention system is suitable because removal efficiency achieves until 90% of pesticide removal with selected vegetated plant and additive.Keywords: pesticides, heavy metal, agricultural runoff, bioretention, mechanism removal, treatment train
Procedia PDF Downloads 1591392 Mechanistic Structural Insights into the UV Induced Apoptosis via Bcl-2 proteins
Authors: Akash Bera, Suraj Singh, Jacinta Dsouza, Ramakrishna V. Hosur, Pushpa Mishra
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Ultraviolet C (UVC) radiation induces apoptosis in mammalian cells and it is suggested that the mechanism by which this occurs is the mitochondrial pathway of apoptosis through the release of cytochrome c from the mitochondria into the cytosol. The Bcl-2 family of proteins pro-and anti-apoptotic is the regulators of the mitochondrial pathway of apoptosis. Upon UVC irradiation, the proliferation of apoptosis is enhanced through the downregulation of the anti-apoptotic protein Bcl-xl and up-regulation of Bax. Although the participation of the Bcl-2 family of proteins in apoptosis appears responsive to UVC radiation, to the author's best knowledge, it is unknown how the structure and, effectively, the function of these proteins are directly impacted by UVC exposure. In this background, we present here a structural rationale for the effect of UVC irradiation in restoring apoptosis using two of the relevant proteins, namely, Bid-FL and Bcl-xl ΔC, whose solution structures have been reported previously. Using a variety of biophysical tools such as circular dichroism, fluorescence and NMR spectroscopy, we show that following UVC irradiation, the structures of Bcl-xlΔC and Bid-FL are irreversibly altered. Bcl-xLΔC is found to be more sensitive to UV exposure than Bid-FL. From the NMR data, dramatic structural perturbations (α-helix to β-sheet) are seen to occur in the BH3 binding region, a crucial segment of Bcl-xlΔC which impacts the efficacy of its interactions with pro-apoptotic tBid. These results explain the regulation of apoptosis by UVC irradiation. Our results on irradiation dosage dependence of the structural changes have therapeutic potential for the treatment of cancer.Keywords: Bid, Bcl-xl, UVC, apoptosis
Procedia PDF Downloads 1271391 Endometrial Biopsy Curettage vs Endometrial Aspiration: Better Modality in Female Genital Tuberculosis
Authors: Rupali Bhatia, Deepthi Nair, Geetika Khanna, Seema Singhal
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Introduction: Genital tract tuberculosis is a chronic disease (caused by reactivation of organisms from systemic distribution of Mycobacterium tuberculosis) that often presents with low grade symptoms and non-specific complaints. Patients with genital tuberculosis are usually young women seeking workup and treatment for infertility. Infertility is the commonest presentation due to involvement of the fallopian tubes, endometrium and ovarian damage with poor ovarian volume and reserve. The diagnosis of genital tuberculosis is difficult because of the fact that it is a silent invader of genital tract. Since tissue cannot be obtained from fallopian tubes, the diagnosis is made by isolation of bacilli from endometrial tissue obtained by endometrial biopsy curettage and/or aspiration. Problems are associated with sampling technique as well as diagnostic modality due to lack of adequate sample volumes and the segregation of the sample for various diagnostic tests resulting in non-uniform distribution of microorganisms. Moreover, lack of an efficient sampling technique universally applicable for all specific diagnostic tests contributes to the diagnostic challenges. Endometrial sampling plays a key role in accurate diagnosis of female genital tuberculosis. It may be done by 2 methods viz. endometrial curettage and endometrial aspiration. Both endometrial curettage and aspirate have their own limitations as curettage picks up strip of the endometrium from one of the walls of the uterine cavity including tubal osteal areas whereas aspirate obtains total tissue with exfoliated cells present in the secretory fluid of the endometrial cavity. Further, sparse and uneven distribution of the bacilli remains a major factor contributing to the limitations of the techniques. The sample that is obtained by either technique is subjected to histopathological examination, AFB staining, culture and PCR. Aim: Comparison of the sampling techniques viz. endometrial biopsy curettage and endometrial aspiration using different laboratory methods of histopathology, cytology, microbiology and molecular biology. Method: In a hospital based observational study, 75 Indian females suspected of genital tuberculosis were selected on the basis of inclusion criteria. The women underwent endometrial tissue sampling using Novaks biopsy curette and Karmans cannula. One part of the specimen obtained was sent in formalin solution for histopathological testing and another part was sent in normal saline for acid fast bacilli smear, culture and polymerase chain reaction. The results so obtained were correlated using coefficient of correlation and chi square test. Result: Concordance of results showed moderate agreement between both the sampling techniques. Among HPE, AFB and PCR, maximum sensitivity was observed for PCR, though the specificity was not as high as other techniques. Conclusion: Statistically no significant difference was observed between the results obtained by the two sampling techniques. Therefore, one may use either EA or EB to obtain endometrial samples and avoid multiple sampling as both the techniques are equally efficient in diagnosing genital tuberculosis by HPE, AFB, culture or PCR.Keywords: acid fast bacilli (AFB), histopatholgy examination (HPE), polymerase chain reaction (PCR), endometrial biopsy curettage
Procedia PDF Downloads 3271390 Cultural Unconscious Believes About Couple Relationship in Married People
Authors: Saba Moghaddam
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There is an ongoing and dynamic interplay between cultural environment and individuals’ psych, an interaction that starts at birth and continues throughout life. Cultural Unconscious affects the way people choose their partners and how they shape their relationships. The aim of this study is to identify cultural unconscious beliefs that play a decisive role in the relationship between couples. The study used the method of thematic analysis, and through purposeful sampling and semi-interviews, the themes regarding cultural unconscious in 17 married people between the ages of 24 and 40 years were identified. These themes are (1) Feminization-masculinization of post-marriage roles; (2) Subordinate Women – an intergenerational belief; (3) cultural standards affecting the choice of spouse; (4) primary family beliefs about marriage. Based on these findings, traditional beliefs continue to play a decisive function and effect on people’s unconscious, and in order to achieve a couple's relationship satisfaction, identifying their roles and becoming conscious of these unconscious cultural beliefs is very important.Keywords: couple relationship, partner choice, thematic analysis, unconscious cultural believes
Procedia PDF Downloads 321389 Wetland Community and Their Livelihood Opportunities in the Face of Changing Climatic Condition in Southwest Bangladesh
Authors: Mohsina Aktar, Bishawjit Mallick
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Bangladesh faces the multidimensional manifestations of climate change e.g. flood, cyclone, sea level rise, drainage congestion, salinity, etc. This study aimed at to find out the community’s perception of the perceived impact of climate change on their wetland resource based livelihood, to analyze their present livelihood scenario and to find out required institutional setup to strengthen present livelihood scenario. Therefore, this study required both quantitative analysis like quantification of wetland resources, occupation, etc. and also exploratory information like policy and institutional reform. For quantitative information 200 questionnaire survey and in some cases observation survey and for socially shareable qualitative and quantitative issues case study and focus group discussion were conducted. In-Depth interview was conducted for socially non-shareable qualitative issues. The overall findings of this study have been presented maintaining a sequence- perception about climate change effect, livelihood scenario and required institutional support of the wetland community. Flood has been ranked where cyclone effect is comparatively less disastrous in this area. Heavy rainfall comes after the cyclone. Female members responded almost same about the ranking and effects of frequently occurred and devastating effects of climate change. People are much more aware of the impact of climate change. Training of Care in RVCC project helps to increase their knowledge level. If the level of education can be increased, people can fight against calamity and poverty with more confidence. People seem to overcome the problems of water logging and thus besides involving in Hydroponics (33.3%) as prime occupation in monsoon; they are also engaged in other business related activities. January to May is the low-income season for the farmers. But some people don’t want to change their traditional occupation and their age is above 45. The young earning member wants to utilize their lean income period by alternative occupation. People who do not have own land and performing water transportation or other types of occupation are now interested about Hydroponics. People who give their land on rent are now thinking about renting their land in monsoon as through that they can earn a sound amount rather than get nothing. What they require is just seed, training, and capital. Present marketing system faces the problem of communication. So this sector needed to be developed. Involvement of women in income earning activity is very low (5.1%), and 100% women are housewives. They became inferior due to their educational level and dominance of their husband. Only one NGO named BCAS (Bangladesh Center for Advanced Studies) has been found engage training facilities and advocacy for this purpose. Upazilla agricultural extension office like other GO remains inactive to give support the community for extension and improvement of Hydroponics agriculture. If the community gets proper support and inspiration, they can fight against crisis of low-income and climate change, with the Hydroponics cultivation system successfully.Keywords: wetland community, hydroponics, climate change adaptation, livelihood
Procedia PDF Downloads 2741388 Traditional Practices of Conserving Biodiversity: A Case Study around Jim Corbett National Park, Uttarakhand, India
Authors: Rana Parween, Rob Marchant
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With the continued loss of global biodiversity despite the application of modern conservation techniques, it has become crucial to investigate non-conventional methods. Accelerated destruction of ecosystems due to altered land use, climate change, cultural and social change, necessitates the exploration of society-biodiversity attitudes and links. While the loss of species and their extinction is a well-known and well-documented process that attracts much-needed attention from researchers, academics, government and non-governmental organizations, the loss of traditional ecological knowledge and practices is more insidious and goes unnoticed. The growing availability of 'indirect experiences' such as the internet and media are leading to a disaffection towards nature and the 'Extinction of Experience'. Exacerbated by the lack of documentation of traditional practices and skills, there is the possibility for the 'extinction' of traditional practices and skills before they are fully recognized and captured. India, as a mega-biodiverse country, is also known for its historical conservation strategies entwined in traditional beliefs. Indigenous communities hold skillsets, knowledge, and traditions that have accumulated over multiple generations and may play an important role in conserving biodiversity today. This study explores the differences in knowledge and attitudes towards conserving biodiversity, of three different stakeholder groups living around Jim Corbett National Park, based on their age, traditions, and association with the protected area. A triangulation designed multi-strategy investigation collected qualitative and quantitative data through a questionnaire survey of village elders, the general public, and forest officers. Following an inductive approach to analyzing qualitative data, the thematic content analysis was followed. All coding and analysis were completed using NVivo 11. Although the village elders and some general public had vast amounts of traditional knowledge, most of it was related to animal husbandry and the medicinal value of plants. Village elders were unfamiliar with the concept of the term ‘biodiversity’ albeit their way of life and attitudes ensured that they care for the ecosystem without having the scientific basis underpinning biodiversity conservation. Inherently, village elders were keen to conserve nature; the superimposition of governmental policies without any tangible benefit or consultation was seen as detrimental. Alienating villagers and consequently the village elders who are the reservoirs of traditional knowledge would not only be damaging to the social network of the area but would also disdain years of tried and tested techniques held by the elders. Forest officers advocated for biodiversity and conservation education for women and children. Women, across all groups, when questioned about nature conservation, showed more interest in learning and participation. Biodiversity not only has an ethical and cultural value, but also plays a role in ecosystem function and, thus, provides ecosystem services and supports livelihoods. Therefore, underpinning and using traditional knowledge and incorporating them into programs of biodiversity conservation should be explored with a sense of urgency.Keywords: biological diversity, mega-biodiverse countries, traditional ecological knowledge, society-biodiversity links
Procedia PDF Downloads 1061387 Motherhood in the Poetry of Rosario Castellanos: Other Face of Womanhood
Authors: Dovile Kuzminskaite
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Rosario Castellanos is one of the most important Mexican writers; in her poetry and essays, she demythologizes social stereotypes about womanhood that were deeply present in Mexican society of the XXth century. In her extent poetic work, Rosario Castellanos demythologizes such concepts as romance, marriage, and motherhood, showing them in a way which did not agree with the norms of the catholic based society of her times. The aim of this research is to analyze the poetry of Rosario Castellanos working on sematic and structural levels and to investigate closely how she represents motherhood, what is the role of mother and the relationship of mother and child in her poems. Also, it is of interest to observe what are the elements used in the process of creating a different concept of motherhood. In order to reflect on this subject, this research will be based on semiotics, queer studies, and the philosophy of Michel Foucault, who introduces the concept of power when reflecting on gender and society. Rosario Castellanos turned into an example of disobedience and otherness for a generation of intellectuals in Spanish speaking countries, and because of this reason, it is of great importance to understand the politic and social statements that are represented by her poetry.Keywords: motherhood, women, poetry, Mexico
Procedia PDF Downloads 1991386 The Debacle of the Social Pact: Finding a New Theoretical Framework for Egalitarian Justice
Authors: Abosede Priscilla Ipadeola
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The quest for egalitarian justice requires a suitable theoretical foundation that can address the problem of marginalization and subjugation arising from various forms of oppression, such as sexism, racism, classism, and others. Many thinkers and societies have appealed to contractarianism, a theory that has been widely regarded as a doctrine of egalitarianism by some political theorists for about five centuries. Despite its numerous criticisms, the social contract still enjoys a prominent status as a key theory for egalitarian justice. However, Pateman and Mills have contended that the contractarian approach legitimizes gender and racial inequalities by excluding and marginalizing women and people of color from the original agreement. Therefore, the social contract is incapable of generating or fostering equality. This study proposes postcontractarianism, which is a viable alternative to the social contract. Postcontractarianism argues that the basis for egalitarianism cannot be grounded on agreement but rather on understanding. Postcontractarianism draws on Jorge Nef’s idea of mutual vulnerability and Obiri (an African theory of cosmology) to argue for the imperative of social equality.Keywords: postcontractarianism, obiri, mutual vulnerability, egalitarianism, the social contract
Procedia PDF Downloads 581385 Neutron Contamination in 18 MV Medical Linear Accelerator
Authors: Onur Karaman, A. Gunes Tanir
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Photon radiation therapy used to treat cancer is one of the most important methods. However, photon beam collimator materials in Linear Accelerator (LINAC) head generally contains heavy elements is used and the interaction of bremsstrahlung photon with such heavy nuclei, the neutron can be produced inside the treatment rooms. In radiation therapy, neutron contamination contributes to the risk of secondary malignancies in patients, also physicians working in this field. Since the neutron is more dangerous than photon, it is important to determine neutron dose during radiotherapy treatment. In this study, it is aimed to analyze the effect of field size, distance from axis and depth on the amount of in-field and out-field neutron contamination for ElektaVmat accelerator with 18 MV nominal energy. The photon spectra at the distance of 75, 150, 225, 300 cm from target and on the isocenter of beam were scored for 5x5, 10x10, 20x20, 30x30 and 40x40 cm2 fields. Results demonstrated that the neutron spectra and dose are dependent on field size and distances. Beyond 225 cm of isocenter, the dependence of the neutron dose on field size is minimal. As a result, it is concluded that as the open field increases, neutron dose determined decreases. It is important to remember that when treating with high energy photons, the dose from contamination neutrons must be considered as it is much greater than the photon dose.Keywords: radiotherapy, neutron contamination, linear accelerators, photon
Procedia PDF Downloads 3481384 Developing Effective Strategies to Reduce Hiv, Aids and Sexually Transmitted Infections, Nakuru, Kenya
Authors: Brian Bacia, Esther Githaiga, Teresia Kabucho, Paul Moses Ndegwa, Lucy Gichohi
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Purpose: The aim of the study is to ensure an appropriate mix of evidence-based prevention strategies geared towards the reduction of new HIV infections and the incidence of Sexually transmitted Illnesses Background: In Nakuru County, more than 90% of all HIV-infected patients are adults and on a single-dose medication-one pill that contains a combination of several different HIV drugs. Nakuru town has been identified as the hardest hit by HIV/Aids in the County according to the latest statistics from the County Aids and STI group, with a prevalence rate of 5.7 percent attributed to the high population and an active urban center. Method: 2 key studies were carried out to provide evidence for the effectiveness of antiretroviral therapy (ART) when used optimally on preventing sexual transmission of HIV. Discussions based on an examination, assessments of successes in planning, program implementation, and ultimate impact of prevention and treatment were undertaken involving health managers, health workers, community health workers, and people living with HIV/AIDS between February -August 2021. Questionnaires were carried out by a trained duo on ethical procedures at 15 HIV treatment clinics targeting patients on ARVs and caregivers on ARV prevention and treatment of pediatric HIV infection. Findings: Levels of AIDS awareness are extremely high. Advances in HIV treatment have led to an enhanced understanding of the virus, improved care of patients, and control of the spread of drug-resistant HIV. There has been a tremendous increase in the number of people living with HIV having access to life-long antiretroviral drugs (ARV), mostly on generic medicines. Healthcare facilities providing treatment are stressed challenging the administration of the drugs, which require a clinical setting. Women find it difficult to take a daily pill which reduces the effectiveness of the medicine. ART adherence can be strengthened largely through the use of innovative digital technology. The case management approach is useful in resource-limited settings. The county has made tremendous progress in mother-to-child transmission reduction through enhanced early antenatal care (ANC) attendance and mapping of pregnant women Recommendations: Treatment reduces the risk of transmission to the child during pregnancy, labor, and delivery. Promote research of medicines through patients and community engagement. Reduce the risk of transmission through breastfeeding. Enhance testing strategies and strengthen health systems for sustainable HIV service delivery. Need exists for improved antenatal care and delivery by skilled birth attendants. Develop a comprehensive maternal reproductive health policy covering equitability, efficient and effective delivery of services. Put in place referral systems.Keywords: evidence-based prevention strategies, service delivery, human management, integrated approach
Procedia PDF Downloads 881383 Amniotic Fluid Mesenchymal Stem Cells Selected for Neural Specificity Ameliorates Chemotherapy Induced Hearing Loss and Pain Perception
Authors: Jan F. Talts, Amit Saxena, Kåre Engkilde
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Chemotherapy-induced peripheral neuropathy (CIPN) is one of the most frequent side effects caused by anti-neoplastic agents, with a prevalence from 19 % to 85 %. Clinically, CIPN is a mostly sensory neuropathy leading to pain and to motor and autonomic changes. Due to its high prevalence among cancer patients, CIPN constitutes a major problem for both cancer patients and survivors, especially because currently, there is no single effective method of preventing CIPN. Hearing loss is the most common form of sensory impairment in humans and can be caused by ototoxic chemical compounds such as chemotherapy (platinum-based antineoplastic agents).In rodents, single or repeated cisplatin injections induce peripheral neuropathy and hearing impairment mimicking human disorder, allowing studying the efficacy of new pharmacological candidates in chemotherapy-induced hearing loss and peripheral neuropathy. RNA sequencing data from full term amniotic fluid (TAF) mesenchymal stemcell (MSC) clones was used to identify neural-specific markers present on TAF-MSC. Several prospective neural markers were tested by flow cytometry on cultured TAF-MSC. One of these markers was used for cell-sorting using Tyto MACSQuant cell sorter, and the neural marker positive cell population was expanded for several passages to the final therapeutic product stage. Peripheral neuropathy and hearing loss was induced in mice by administration of cisplatin in three week-long cycles. The efficacy of neural-specific TAF-MSC in treating hearing loss and pain perception was evaluated by administration of three injections of 3 million cells/kg by intravenous route or three injections of 3 million cells/kg by intra-arterial route after each cisplatin cycle treatment. Auditory brainstem responses (ABR) are electric potentials recorded from scalp electrodes, and the first ABR wave represents the summed activity of the auditory nerve fibers contacting the inner hair cells. For ABR studies, mice were anesthetized, then earphones were placed in the left ear of each mouse, an active electrode was placed in the vertex of the skull, a reference electrode under the skin of the mastoid bone, and a ground electrode in the neck skin. The stimuli consisted of tone pips of five frequencies (2, 4, 6, 12, 16, and 24 kHz) at various sound levels (from 0 to 90 dB) ranging to cover the mouse auditory frequency range. The von Frey test was used to assess the onset and maintenance of mechanical allodynia over time. Mice were placed in clear plexiglass cages on an elevated mesh floor and tested after 30 min of habituation. Mechanical paw withdrawal threshold was examined using an electronic von Frey anesthesiometer. Cisplatin groups treated with three injections of 3 million cells/kg by intravenous route and three injections of 3 million cells/kg by intra-arterial route after each cisplatin cycle treatment presented, a significant increase of hearing acuity characterized by a decrease of ABR threshold and a decrease of neuropathic pain characterized by an increase of von Frey paw withdrawal threshold compared to controls only receiving cisplatin. This study shows that treatment with MSCselected for neural specificity presents significant positive efficacy on the chemotherapy-induced neuropathic pain and the chemotherapy-induced hearing loss.Keywords: mesenchymal stem cell, peripheral neuropathy, amniotic fluid, regenerative medicine
Procedia PDF Downloads 1661382 Improving Oxidative Stability of Encapsulated Krill and Black Cumin Oils and its Application in Functional Yogurt
Authors: Tamer El-Messery, Beraat Ozcelik
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This study aimed to produce functional yogurt supplemented with microencapsulated krill oil as a source of omega 3, which is known, to maintain the normal brain function, reduce the risk of cancer, and preventing cardiovascular disease. Krill oil was mixed with black cumin oil (1:1) in order to increase its oxidative stability. β-caroteine (10 mg/100 ml) was used as a standard antioxidant. Maltodextrin (MD) was mixed with whey protein concentrate (WPC) and gum Arabic (GA) at the ratio of 8:2:0.5 ratios and used for microencapsulation of single or mixed oils. The microcapsules were dried by freeze and spray drying in order to maximize encapsulation efficiency and minimize lipid oxidation. The feed emulsions used for particle production were characterized for stability, viscosity and particle size, zeta potential, and oxidative stability. The oxidative stability for mixed krill oil and black cumin oil was the highest. The highest encapsulation efficiency was obtained using spray drying, which also showed the highest oxidative stability. The addition of encapsulated krill and black cumin oils (1:1) powder in yogurt manufacture reduced slightly effects on the development of acidity, textural parameters, and water holding capacity of yogurt as compared to control.Keywords: Krill oil, black cumin oil, micro-encapsulation, oxidative stability, functional yogurt
Procedia PDF Downloads 1071381 Municipal-Level Gender Norms: Measurement and Effects on Women in Politics
Authors: Luisa Carrer, Lorenzo De Masi
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In this paper, we exploit the massive amount of information from Facebook to build a measure of gender attitudes in Italy at a previously impossible resolution—the municipal level. We construct our index via a machine learning method to replicate a benchmark region-level measure. Interestingly, we find that most of the variation in our Gender Norms Index (GNI) is across towns within narrowly defined geographical areas rather than across regions or provinces. In a second step, we show how this local variation in norms can be leveraged for identification purposes. In particular, we use our index to investigate whether these differences in norms carry over to the policy activity of politicians elected in the Italian Parliament. We document that females are more likely to sit in parliamentary committees focused on gender-sensitive matters, labor, and social issues, but not if they come from a relatively conservative town. These effects are robust to conditioning the legislative term and electoral district, suggesting the importance of social norms in shaping legislators’ policy activity.Keywords: gender equality, gender norms index, Facebook, machine learning, politics
Procedia PDF Downloads 791380 Ground Water Contamination by Tannery Effluents and Its Impact on Human Health in Peshawar, Pakistan
Authors: Fawad Ali, Muhammad Ateeq, Ikhtiar Khan
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Ground water, a major source of drinking water supply in Peshawar has been severely contaminated by leather tanning industry. Effluents from the tanneries contain high concentration of chromium besides several other chemical species. Release of untreated effluents from the tanning industry has severely damaged surface and ground water, agriculture soil as well as vegetables and crops. Chromium is a well-known carcinogenic and mutagenic agent. Once in the human food chain, it causes multiple problems to the exposed population including various types of cancer, skin dermatitis, and DNA damage. In order to assess the extent of chromium and other heavy metals contamination, water samples were analyzed for heavy metals using Graphite Furnace Atomic Absorption Spectrometer (GFAAS, Analyst 700, Perkin Elmer). Total concentration of chromium was above the permissible limit (0.048 mg/l) in 85% of the groundwater (drinking water) samples. The concentration of cobalt, manganese, cadmium, nickel, lead, zinc and iron was also determined in the ground water, surface water, agriculture soil, and vegetables samples from the affected area.Keywords: heavy metals, soil, groundwater, tannery effluents, food chain
Procedia PDF Downloads 3461379 Simultaneous Removal of Arsenic and Toxic Metals from Contaminated Soil: a Pilot-Scale Demonstration
Authors: Juan Francisco Morales Arteaga, Simon Gluhar, Anela Kaurin, Domen Lestan
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Contaminated soils are recognized as one of the most pressing global environmental problems. As is one of the most hazardous elements: chronic exposure to arsenic has devastating effects on health, cardiovascular diseases, cancer, and eventually death. Pb, Zn and Cd are very highly toxic metals that affect almost every organ in the body. With this in mind, new technologies for soil remediation processes are urgently needed. Calcareous artificially contaminated soil containing 231 mg kg-1 As and historically contaminated with Pb, Zn and Cd was washed with a 1:1.5 solid-liquid ratio of 90 mM EDTA, 100 mM oxalic acid, and 50 mM sodium dithionite to remove 59, 75, 29, and 53% of As, Pb, Zn, and Cd, respectively. To reduce emissions of residual EDTA and chelated metals from the remediated soil, zero valent iron (ZVI) was added (1% w/w) to the slurry of the washed soil immediately prior to rinsing. Experimental controls were conducted without the addition of ZVI after remediation. The use of ZVI reduced metal leachability and minimized toxic emissions 21 days after remediation. After this time, NH4NO3 extraction was performed to determine the mobility of toxic elements in the soil. In addition, Unified Human BioaccessibilityMethod (UBM) was performed to quantify the bioaccessibility levels of metals in stimulated human gastric and gastrointestinal phases.Keywords: soil remediation, soil science, soil washing, toxic metals removal
Procedia PDF Downloads 1751378 Serological Assay and Genotyping of Hepatitis C Virus in Infected Patients in Zanjan Province
Authors: Abdolreza Esmaeilzadeh, Maryam Erfanmanesh, Sousan Ghasemi, Farzaneh Mohammadi
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Background: Hepatitis C Virus (HCV), a public health problem, is an enveloped, single-stranded RNA virus and a member of the Hepacivirus genus of the Flaviviridae family. Liver cancer, cirrhosis, and end-stage liver are the outcomes of chronic infection with HCV. HCV isolates show significant heterogeneity in genetics around the world. Therefore, determining HCV genotypes is a vital step in determining prognosis and planning therapeutic strategies. Materials and Methods: Serum samples of 136 patients were collected and analyzed for anti-HCV antibodies using ELISA (The enzyme-linked immunosorbent assay) method. Then, positive samples were exposed to RT-PCR, which was performed under standard condition. Afterwards, they investigated for genotyping using allele-specific PCR (AS-PCR), and HCV genotype 2.0 line probe assay (LiPA). Results: Samples indicated 216 bp bands on 2% agarose gel. Analyses of the results demonstrated that the most dominant subtype was 3a with frequency of 38.26% in Zanjan Province followed by subtypes of 1b, 1a, 2, and 4 with frequencies of 25.73%, 22.05%, 5.14%, and 4.41%, respectively. The frequency of unknown HCV genotypes was 4.41%. Conclusions: According to the results, it was found that HCV high prevalent genotype in Zanjan is subtype 3a. Analysis of the results provides identification of certain HCV genotypes, and these valuable findings could affect the type and duration of the treatment.Keywords: anti-HCV antibody, Hepatitis C Virus (HCV), genotype, RT-PCR, AS-PCR
Procedia PDF Downloads 4891377 Curcumin and Methotrexate Loaded Montmollilite Clay for Sustained Oral Drug Delivery Application
Authors: Subrata Kar, Banani Kundu, Papiya Nandy, Ruma Basu, Sukhen Das
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Natural montmorilollite clay is a common ingredient in pharmaceutical products, both as excipients and active support; hence considered as suitable candidate for Drug Delivery System. In this work, cationic detergent CTAB is used to increase the interlayer spacing of Na+-Montmoriollite clay to intercalate curcumin and methotrexate. Methotrexate is a folic acid antagonist, anti-proliferative and immunosuppressive agent; while curcumin is a bioactive constituent of rhizomes of Curcuma longa, possessing remarkable chemo-preventive and anti-inflammatory properties. The resultant inorganic-organic hybrids are characterized by X-ray diffraction (XRD), Infrared spectroscopy (FTIR) and Thermo Gravimetric Analysis (TGA) to confirm successful intercalation of curcumin and Methotrexate within clay layers. Pharmaceutical investigation of the hybrids is explored by studying the drug loading (%), encapsulation efficiency and release kinetics. Finally in-vitro studies are performed using cancer cells to find the effect of released curcumin to improve the sensitivity of clay bound methotrexate to ameliorate cell death compared to their effectiveness when used without the inorganic aluminosilicate vehicle.Keywords: montmorillonite, methotrexate, curcumin, loading efficiency, release kinetics, anticancer activity
Procedia PDF Downloads 5151376 Effectiveness of Video Interventions for Perpetrators of Domestic Violence
Authors: Zeynep Turhan
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Digital tools can improve knowledge and awareness of strategies and skills for healthy and respectful intimate relationships. The website of the Healthy and Respectful Relationship Program has been developed and included five key videos about how to build healthy intimate relationships. This study examined the perspectives about informative videos by focusing on how individuals learn new information or challenge their preconceptions or attitudes regarding male privilege and women's oppression. Five individuals who received no-contact orders and attended group intervention were the sample of this study. The observation notes were the major methodology examining how participants responded to video tools. The data analysis method was the interpretative phenomenological analysis. The results showed that many participants found the tools useful in learning the types of violence and communication strategies. Nevertheless, obstacles to implementing some techniques were found in their relationships. These digital tools might enhance healthy and respectful relationships despite some limitations.Keywords: healthy relationship, digital tools, intimate partner violence, perpetrators, video interventions
Procedia PDF Downloads 951375 Supporting a Moral Growth Mindset Among College Students
Authors: Kate Allman, Heather Maranges, Elise Dykhuis
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Moral Growth Mindset (MGM) is the belief that one has the capacity to become a more moral person, as opposed to a fixed conception of one’s moral ability and capacity (Han et al., 2018). Building from Dweck’s work in incremental implicit theories of intelligence (2008), Moral Growth Mindset (Han et al., 2020) extends growth mindsets into the moral dimension. The concept of MGM has the potential to help researchers understand how both mindsets and interventions can impact character development, and it has even been shown to have connections to voluntary service engagement (Han et al., 2018). Understanding the contexts in which MGM might be cultivated could help to promote the further cultivation of character, in addition to prosocial behaviors like service engagement, which may, in turn, promote larger scale engagement in social justice-oriented thoughts, feelings, and behaviors. In particular, college may be a place to intentionally cultivate a growth mindset toward moral capacities, given the unique developmental and maturational components of the college experience, including contextual opportunity (Lapsley & Narvaez, 2006) and independence requiring the constant consideration, revision, and internalization of personal values (Lapsley & Woodbury, 2016). In a semester-long, quasi-experimental study, we examined the impact of a pedagogical approach designed to cultivate college student character development on participants’ MGM. With an intervention (n=69) and a control group (n=97; Pre-course: 27% Men; 66% Women; 68% White; 18% Asian; 2% Black; <1% Hispanic/Latino), we investigated whether college courses that intentionally incorporate character education pedagogy (Lamb, Brant, Brooks, 2021) affect a variety of psychosocial variables associated with moral thoughts, feelings, identity, and behavior (e.g. moral growth mindset, honesty, compassion, etc.). The intervention group consisted of 69 undergraduate students (Pre-course: 40% Men; 52% Women; 68% White; 10.5% Black; 7.4% Asian; 4.2% Hispanic/Latino) that voluntarily enrolled in five undergraduate courses that encouraged students to engage with key concepts and methods of character development through the application of research-based strategies and personal reflection on goals and experiences. Moral Growth Mindset was measured using the four-item Moral Growth Mindset scale (Han et al., 2020), with items such as You can improve your basic morals and character considerably on a six-point Likert scale from 1 (strongly disagree) to 6 (strongly agree). Higher scores of MGM indicate a stronger belief that one can become a more moral person with personal effort. Reliability at Time 1 was Cronbach’s ɑ= .833, and at Time 2 Cronbach’s ɑ= .772. An Analysis of Covariance (ANCOVA) was conducted to explore whether post-course MGM scores were different between the intervention and control when controlling for pre-course MGM scores. The ANCOVA indicated significant differences in MGM between groups post-course, F(1,163) = 8.073, p = .005, R² = .11, where descriptive statistics indicate that intervention scores were higher than the control group at post-course. Results indicate that intentional character development pedagogy can be leveraged to support the development of Moral Growth Mindset and related capacities in undergraduate settings.Keywords: moral personality, character education, incremental theories of personality, growth mindset
Procedia PDF Downloads 1471374 Impact of Land-Use and Climate Change on the Population Structure and Distribution Range of the Rare and Endangered Dracaena ombet and Dobera glabra in Northern Ethiopia
Authors: Emiru Birhane, Tesfay Gidey, Haftu Abrha, Abrha Brhan, Amanuel Zenebe, Girmay Gebresamuel, Florent Noulèkoun
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Dracaena ombet and Dobera glabra are two of the most rare and endangered tree species in dryland areas. Unfortunately, their sustainability is being compromised by different anthropogenic and natural factors. However, the impacts of ongoing land use and climate change on the population structure and distribution of the species are less explored. This study was carried out in the grazing lands and hillside areas of the Desa'a dry Afromontane forest, northern Ethiopia, to characterize the population structure of the species and predict the impact of climate change on their potential distributions. In each land-use type, abundance, diameter at breast height, and height of the trees were collected using 70 sampling plots distributed over seven transects spaced one km apart. The geographic coordinates of each individual tree were also recorded. The results showed that the species populations were characterized by low abundance and unstable population structure. The latter was evinced by a lack of seedlings and mature trees. The study also revealed that the total abundance and dendrometric traits of the trees were significantly different between the two land uses. The hillside areas had a denser abundance of bigger and taller trees than the grazing lands. Climate change predictions using the MaxEnt model highlighted that future temperature increases coupled with reduced precipitation would lead to significant reductions in the suitable habitats of the species in northern Ethiopia. The species' suitable habitats were predicted to decline by 48–83% for D. ombet and 35–87% for D. glabra. Hence, to sustain the species populations, different strategies should be adopted, namely the introduction of alternative livelihoods (e.g., gathering NTFP) to reduce the overexploitation of the species for subsistence income and the protection of the current habitats that will remain suitable in the future using community-based exclosures. Additionally, the preservation of the species' seeds in gene banks is crucial to ensure their long-term conservation.Keywords: grazing lands, hillside areas, land-use change, MaxEnt, range limitation, rare and endangered tree species
Procedia PDF Downloads 971373 Microdosimetry in Biological Cells: A Monte Carlo Method
Authors: Hamidreza Jabal Ameli, Anahita Movahedi
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Purpose: In radionuclide therapy, radioactive atoms are coupled to monoclonal antibodies (mAbs) for treating cancer tumor while limiting radiation to healthy tissues. We know that tumoral and normal tissues are not equally sensitive to radiation. In fact, biological effects such as cellular repair processes or the presence of less radiosensitive cells such as hypoxic cells should be taken account. For this reason, in this paper, we want to calculate biological effect dose (BED) inside tumoral area and healthy cells around tumors. Methods: In this study, deposited doses of a radionuclide, gold-198, inside cells lattice and surrounding healthy tissues were calculated with Monte Carlo method. The elemental compositions and density of malignant and healthy tissues were obtained from ICRU Report 44. For reaching to real condition of oxygen effects, the necrosis and hypoxia area inside tumors has been assessed. Results: With regard to linear-quadratic expression which was defined in Monte Carlo, results showed that a large amount of BED is deposited in the well-oxygenated part of the hypoxia area compared to necrosis area. Moreover, there is a significant difference between the curves of absorbed dose with BED and without BED.Keywords: biological dose, monte carlo, hypoxia, radionuclide therapy
Procedia PDF Downloads 4871372 The Impact of Female Education on Fertility: A Natural Experiment from Egypt
Authors: Fatma Romeh, Shiferaw Gurmu
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This paper examines the impact of female education on fertility, using the change in length of primary schooling in Egypt in 1988-89 as the source of exogenous variation in schooling. In particular, beginning in 1988, children had to attend primary school for only five years rather than six years. This change was applicable to all individuals born on or after October 1977. Using a nonparametric regression discontinuity approach, we compare education and fertility of women born just before and after October 1977. The results show that female education significantly reduces the number of children born per woman and delays the time until first birth. Applying a robust regression discontinuity approach, however, the impact of education on the number of children is no longer significant. The impact on the timing of first birth remained significant under the robust approach. Each year of female education postponed childbearing by three months, on average.Keywords: Egypt, female education, fertility, robust regression discontinuity
Procedia PDF Downloads 3381371 Barred from Each Other: Why Normative Husbands Remain Married to Incarcerated Wives
Authors: Tomer Einat, Sharon Rabinovitz, Inbal Harel-Aviram
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This study explores men’s motivation and justification to remain married to their criminal, imprisoned wives. Using semi-structured interviews and content-analysis, data were collected and analyzed from eight men who maintain stable marriage relationships with their incarcerated wives. Participants are normative men who describe incarceration as a challenge that enhances mutual responsibility and commitment. They exaggerate the extent to which their partners resemble archetypal romantic ideals. They use motivational accounts to explain the woman’s criminal conduct, which is perceived as non-relevant to her real identity. Physical separation and lack of physical intimacy are perceived as the major difficulties in maintaining their marriage relations. Length of imprisonment and marriage was found to be related to the decision whether to continue or terminate the relationships. Women-inmates’ partners experience difficulties and use coping strategies very similar to those cited by other normative spouses facing lengthy separation.Keywords: female inmates, marriage, normative spouses, romantic accounts
Procedia PDF Downloads 4611370 Towards Women Empowerment: An Examination of Gender Equity and Access to Tertiary Education in Nigeria
Authors: Funmilayo Florence Adegoke
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The study looks into the issue of gender equity among the staff and students of tertiary institutions in Osun State, Nigeria, specifically the study examined the opinion of the staff and students concerning equity of gender and also examined access to tertiary Education and related courses vis-à-vis gender. A total of 800 subjects consisting of six hundred and forty students, eighty lecturers and eighty non-teaching staff were drawn from four tertiary institutions namely a University, a Polytechnic and two Colleges of Education in the State. The main research instruments used for the study are two sets of questionnaires (one for the students and one for the staff) and records of students’ analyzed for the purpose of testing the research questions that were raised. The result showed among others that the staff and the students opined that there are generally inequalities in the attributes of the two genders. It was also found that significantly more boys enrolled in science and related courses than girls. Based on the findings, useful recommendations that would enhance the contribution of both male and female to science education and the nation as a whole were made.Keywords: gender, access, tertiary, education, Nigeria
Procedia PDF Downloads 3931369 Optimization of the Self-Recognition Direct Digital Radiology Technology by Applying the Density Detector Sensors
Authors: M. Dabirinezhad, M. Bayat Pour, A. Dabirinejad
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In 2020, the technology was introduced to solve some of the deficiencies of direct digital radiology. SDDR is an invention that is capable of capturing dental images without human intervention, and it was invented by the authors of this paper. Adjusting the radiology wave dose is a part of the dentists, radiologists, and dental nurses’ tasks during the radiology photography process. In this paper, an improvement will be added to enable SDDR to set the suitable radiology wave dose according to the density and age of the patients automatically. The separate sensors will be included in the sensors’ package to use the ultrasonic wave to detect the density of the teeth and change the wave dose. It facilitates the process of dental photography in terms of time and enhances the accuracy of choosing the correct wave dose for each patient separately. Since the radiology waves are well known to trigger off other diseases such as cancer, choosing the most suitable wave dose can be helpful to decrease the side effect of that for human health. In other words, it decreases the exposure time for the patients. On the other hand, due to saving time, less energy will be consumed, and saving energy can be beneficial to decrease the environmental impact as well.Keywords: dental direct digital imaging, environmental impacts, SDDR technology, wave dose
Procedia PDF Downloads 1941368 Stability Analysis of Tumor-Immune Fractional Order Model
Authors: Sadia Arshad, Yifa Tang, Dumitru Baleanu
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A fractional order mathematical model is proposed that incorporate CD8+ cells, natural killer cells, cytokines and tumor cells. The tumor cells growth in the absence of an immune response is modeled by logistic law as it was the simplest form for which predictions also agreed with the experimental data. Natural Killer Cells are our first line of defense. NK cells directly kill tumor cells through several mechanisms, including the release of cytoplasmic granules containing perforin and granzyme, expression of tumor necrosis factor (TNF) family members. The effect of the NK cells on the tumor cell population is expressed with the product term. Rational form is used to describe interaction between CD8+ cells and tumor cells. A number of cytokines are produced by NKs, including tumor necrosis factor TNF, IFN, and interleukin (IL-10). Source term for cytokines is modeled by Michaelis-Menten form to indicate the saturated effects of the immune response. Stability of the equilibrium points is discussed for biologically significant values of bifurcation parameters. We studied the treatment of fractional order system by investigating analytical conditions of tumor eradication. Numerical simulations are presented to illustrate the analytical results.Keywords: cancer model, fractional calculus, numerical simulations, stability analysis
Procedia PDF Downloads 3151367 Data Analytics of Electronic Medical Records Shows an Age-Related Differences in Diagnosis of Coronary Artery Disease
Authors: Maryam Panahiazar, Andrew M. Bishara, Yorick Chern, Roohallah Alizadehsani, Dexter Hadleye, Ramin E. Beygui
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Early detection plays a crucial role in enhancing the outcome for a patient with coronary artery disease (CAD). We utilized a big data analytics platform on ~23,000 patients with CAD from a total of 960,129 UCSF patients in 8 years. We traced the patients from their first encounter with a physician to diagnose and treat CAD. Characteristics such as demographic information, comorbidities, vital, lab tests, medications, and procedures are included. There are statistically significant gender-based differences in patients younger than 60 years old from the time of the first physician encounter to coronary artery bypass grafting (CABG) with a p-value=0.03. There are no significant differences between the patients between 60 and 80 years old (p-value=0.8) and older than 80 (p-value=0.4) with a 95% confidence interval. This recognition would affect significant changes in the guideline for referral of the patients for diagnostic tests expeditiously to improve the outcome by avoiding the delay in treatment.Keywords: electronic medical records, coronary artery disease, data analytics, young women
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