Search results for: early middle ages

Authors: Khrystyna Zai

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This research delves into the profound impact of Ukrainian musical traditions on the life and works of the renowned composer Sergei Prokofiev. Sergei Prokofiev's formative years in Ukraine, particularly in Sontsivka(Eastern Ukraine), allowed him to immerse himself in the local music. He encountered Ukrainian folk songs and dances, which left an indelible mark on his musical sensibilities. With a focus on the early 20th century, a period of significant cultural transformation in both Ukraine and Europe, this study examines how Prokofiev's exposure to Ukrainian folk music, its melodic motifs, and rhythmic patterns influenced his compositions. Prokofiev’s works showcase his deliberate efforts to fuse Ukrainian elements with his distinctive modernist style. This study analyzes Prokofiev's engagement with Ukrainian themes in his music, such as the "Semen Kotko”, “The Love of Three Oranges”, “On the Dnieper”, “Scythian Suite”, “Sinfonia Concertante" for cello and orchestra, "Sonata No. 9,", “Partisans in the steppes of Ukraine” (where Prokofiev uses texts in Ukrainian). The scientific work mentions his interactions and collaborations with Ukrainian musicians and cultural figures during Prokofiev’s career. Notably, his association with Ukrainian pianist Sviatoslav Richter and conductor Kirill Karabits led to interpretations of his compositions with a Ukrainian perspective. This research illuminates the nuances of cross-cultural influences in Prokofiev's oeuvre, contributing to a deeper understanding of the interplay between national identities and artistic expression during a pivotal period in history, based on the fact that the composer himself considered Ukraine to be his homeland, calling himself “steppe boy”.

Keywords: florida atlantic university, ukrainian music, ukrainian composer, sergei prokofiev

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Authors: Maria Ines Azambuja

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Graphic displays of Age-Period-Cohort (APC) mortality trends generally uses data aggregated within 5 or 10-year intervals. Technology allows one to increase the amount of processed data. Displaying occurrences by 1-year intervals is a logic first step in the direction of attaining higher quality landscapes of variations in temporal occurrences. Method: 1) Comparison of UK mortality trends plotted by 10-, 5- and 1-year intervals; 2) Comparison of UK and US mortality trends (period X age and cohort X age) displayed by 1-year intervals. Source: Mortality data (period, 1x1, males, 1933-1912) uploaded from the Human Mortality Database to Excel files, where Period X Age and Cohort X Age graphics were produced. The choice of transforming age-specific trends from calendar to birth-cohort years (cohort = period – age) (instead of using cohort 1x1 data available at the HMD resource) was taken to facilitate the comparison of age-specific trends when looking across calendar-years and birth-cohorts. Yearly live births, males, 1933 to 1912 (UK) were uploaded from the HFD. Influenza references are from the literature. Results: 1) The use of 1-year intervals unveiled previously unsuspected period, cohort and interacting period x cohort effects upon all-causes mortality. 2) The UK and US figures showed variations associated with particular calendar years (1936, 1940, 1951, 1957-68, 72) and, most surprisingly, with particular birth-cohorts (1889-90 in the US, and 1900, 1918-19, 1940-41 and 1946-47, in both countries. Also, the figures showed ups and downs in age-specific trends initiated at particular birth-cohorts (1900, 1918-19 and 1947-48) or a particular calendar-year (1968, 1972, 1977-78 in the US), variations at times restricted to just a range of ages (cohort x period interacting effects). Importantly, most of the identified “scars” (period and cohort) correlates with the record of occurrences of Influenza A epidemics since the late 19th Century. Conclusions: The use of 1-year intervals to describe APC mortality trends both increases the amount of information available, thus enhancing the opportunities for patterns’ recognition, and increases our capability of interpreting those patterns by describing trends across smaller intervals of time (period or birth-cohort). The US and the UK mortality landscapes share many but not all 'scars' and distortions suggested here to be associated with influenza epidemics. Different size-effects of wars are evident, both in mortality and in fertility. But it would also be realistic to suppose that the preponderant influenza A viruses circulating in UK and US at the beginning of the 20th Century might be different and the difference to have intergenerational long-term consequences. Compared with the live births trend (UK data), birth-cohort scars clearly depend on birth-cohort sizes relatives to neighbor ones, which, if causally associated with influenza, would result from influenza-related fetal outcomes/selection. Fetal selection could introduce continuing modifications on population patterns of immune-inflammatory phenotypes that might give rise to 'epidemic constitutions' favoring the occurrence of particular diseases. Comparative analysis of mortality landscapes may help us to straight our record of past circulation of Influenza viruses and document associations between influenza recycling and fertility changes.

Keywords: age-period-cohort trends, epidemic constitution, fertility, influenza, mortality

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Authors: Irokanulo I. Emmanuel

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The idea of ‘Oshinowoism’ is a representational school, which is a concept based on pure and rustic energy in painting. It is described as any painting that depicts the actions of significant through simple illusions. The idea is never to replicate a photographic resemblance with paint but to create an affinity between what one sees and what one artistically intends to create as a representation of that which one beholds in society as an illusion of reality, not as a reality in itself, but as subjective analysis of reality. The disciples of ‘Oshinowoism’ pursue their art from a representational point of view, creating material realities within feels of colours, forms and space, not trying to confuse the art as a substitute for reality nor reality as a substitute for art, but giving each its space and materialism to exist. The depictions of Oshinowo are the constant reminders or perhaps interpretations of those developments that emerged in contemporary African societies because of neocolonialism. This essay has three objectives. First, it examines the misconception around the development of this thought. Secondly, it contextualizes the later contemporary development of painting as art and craft in present-day Lagos, and third, it constructs the misconception and misconstruction of the concept of ‘Oshinowoism’ and offers a correct ideology of this thought with the body of Oshinowo’s work to give the existence to this philosophy. This study looks at the students of Kolade Oshinowo, especially those students who share similar elements and an affinity with the master painting skills, as a way of reconstructing and addressing the misconception in his style. The early works of Olaku, Edosa, and Lara Ige Jacks are plausible evidence of the existential essence of Oshinowo’s artistic philosophy. To this end, therefore, this study would explore the quality of their pictorial techniques and skills in painting as a way of preserving their master’s philosophy.

Keywords: Oshinowoism, colour scheme, drawing, philosophy, representations

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Authors: Jocelyn Solomons, Sheree Bekker, Ryan Groom, Wilbur Kraak

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Sports coaching is marked by inherent elements of complexity. Coaches constantly encounter ambiguity, as they are unable to have complete certainty regarding the perspectives and expectations of stakeholders. Moreover, the coaching environment is characterised by its dynamic nature and intricate micro-political dynamics which further add to the complexity that coaches must navigate. This research study offers a unique perspective on the practical manifestation of coaching effectiveness in the South African (SA) context, where the sport is in its early stages of development. With a predominant presence of male coaches training female players and players originating from diverse sporting backgrounds, including a majority of those who commence their rugby careers at the university level, this exploration, along with practical recommendations, becomes essential. It allows for a nuanced understanding of coaching practices within a rugby system that concurrently focuses on development and high performance. By integrating the views of both players and coaches, insights are gained that extend traditional assessments, enabling a comprehensive understanding of coaching effectiveness and its implications in this evolving Women’s Rugby landscape. Through semi-structured interviews, the research delves into their assessments of coaching strategies, methodologies, and outcomes, aiming to understand coaching efficacy and its impact on player development. The findings contribute to a nuanced understanding of coaching effectiveness, paving the way for evidence-based recommendations to enhance coaching development and positively impact the sport's growth and success in SA.

Keywords: women’s rugby, coaching effectiveness, coaching, rugby, coaching education

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Authors: Davendra Singh Malik

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India is one of the mega-biodiversity countries in the world and contributing about 11.72% of global fish diversity. The Yamuna river is the longest tributary of Ganga river ecosystem, providing a natural habitat for existing fish diversity of Himalayan region of Indian subcontinent. The several hydropower dams and barrages have been constructed on different locations of major rivers in Garhwal region. These dams have caused a major ecological threat to change existing fresh water ecosystems altering water flows, interrupting ecological connectivity, fragmenting habitats and native riverine fish species. Mahseer fishes (Indian carp) of the genus Tor, are large cyprinids endemic to continental Asia popularly known as ‘Game or sport fishes’ have continued to be decimated by fragmented natural habitats due to damming the water flow in riverine system and categorized as threatened fishes of India. The fresh water fish diversity as 24 fish species were recorded from Yamuna river. The present fish catch data has revealed that mahseer fishes (Tor tor and Tor putitora) were contributed about 32.5 %, 25.6 % and 18.2 % in upper, middle and lower riverine stretches of Yaumna river. The length range of mahseer (360-450mm) recorded as dominant size of catch composition. The CPUE (catch per unit effort) of mahseer fishes also indicated about a sharp decline of fish biomass, changing growth pattern, sex ratio and maturity stages of fishes. Only 12.5 – 14.8 % mahseer female brooders have showed only maturity phases in breeding months. The fecundity of mature mahseer female fish brooders ranged from 2500-4500 no. of ova during breeding months. The present status of mahseer fishery has attributed to the over exploitative nature in Yamuna river. The mahseer population is shrinking continuously in down streams of Yamuna river due to cumulative effects of various ecological stress. Mahseer conservation programme have implemented as 'in situ fish conservation' for enhancement of viable population size of mahseer species and restore the genetic loss of mahseer fish germplasm in Yamuna river of Garhwal Himalayan region.

Keywords: conservation practice, population dynamics, tor fish species, Yamuna River

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Authors: Kateryna Nykytchenko

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Modern fiction and non-fiction writers commonly use their own lexical and stylistic devices to capture a reader’s attention and bring certain thoughts and feelings to his reader. Among such devices is the appearance of one of the neologic notions – individual author’s formations: occasionalisms or nonce words. To a significant extent, the host of examples of new words occurs in chick lit genre which has experienced exponential growth in recent years. Chick Lit is a new-millennial postfeminist fiction which focuses primarily on twenty- to thirtysomething middle-class women. It brings into focus the image of 'a new woman' of the 21st century who is always fallible, funny. This paper aims to investigate different types of occasional word-formation which reflect cognitive mechanisms of conveying women’s perception of the world. Chick lit novels of Irish author Marian Keyes present genuinely innovative mixture of forms, both literary and nonliterary which is displayed in different types of occasional word-formation processes such as blending, compounding, creative respelling, etc. Crossing existing mental and linguistic boundaries, adopting herself to new and overlapping linguistic spaces, chick lit author creates new words which demonstrate the result of development and progress of language and the relationship between language, thought and new reality, ultimately resulting in hybrid word-formation (e.g. affixation or pseudoborrowing). Moreover, this article attempts to present the main characteristics of chick-lit fiction genre with the help of the Marian Keyes’s novels and their influence on occasionalisms. There has been a lack of research concerning cognitive nature of occasionalisms. The current paper intends to account for occasional word-formation as a set of interconnected cognitive mechanisms, operations and procedures meld together to create a new word. The results of the generalized analysis solidify arguments that the kind of new knowledge an occasionalism manifests is inextricably linked with cognitive procedure underlying it, which results in corresponding type of word-formation processes. In addition, the findings of the study reveal that the necessity of creating occasionalisms in postmodern fiction novels arises from the need to write in a new way keeping up with a perpetually developing world, and thus the evolution of the speaker herself and her perception of the world.

Keywords: Chick Lit, occasionalism, occasional word-formation, cognitive linguistics

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Authors: Tegene Nigussie

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Introduction: Maize is the most domesticated of all the field crops. Wild maize has not been found to date and there has been much speculation on its origin. Regardless of the validity of different theories, it is generally agreed that the center of origin of maize is Central America, primarily Mexico and the Caribbean. Maize in Africa is of a recent introduction although data suggest that it was present in Nigeria even before Columbus voyages. After being taken to Europe in 1493, maize was introduced to Africa and distributed through the continent by different routes. Maize is an important cereal crop in Ethiopia. In general, it is the primarily stable food, and rural households show a strong preference. For human food, the important constituents of grain are carbohydrates (starch and sugars), protein, fat or oil (in the embryo) and minerals. About 75 percent of the kernel is starch, a range of 60.80 percent, but low protein content (8-15). In Ethiopia, the introduction of modern farming techniques appears to be a priority. However, the adoption of modern inputs by peasant farmers is found to be very slow; for example, the adoption rate of fertilizer, an input that is relatively adopted, is very slow. The difference socio economic factors lied behind the low rate of technology adoption, including price &marketing input. Objective: The objective of this study is to determine the optimum application rate or level of different nitrogen fertilizers for the vegetative growth of maize and to identify the effect of different nitrogen rates on the growth and development of maize. Methods: The vegetative parameter (above ground) measurement from five plants randomly sampled from the middle rows of each plot. Results: The interaction of nitrogen and maize variety showed a significant at (p<0.01) effect on plant height, with the application of 60kg/ha and BH140 maize variety in combination and root length with the application of 60kg/ha of nitrogen and BH140 variety of maize. The highest mean (12.33) of the number of leaves per plant and mean (7.1) of the number of nodes per plant can be used as an alternative for better vegetative growth of maize. Conclusion: Maize is one of the most popular and cultivated crops in Ethiopia. The study was conducted to investigate the best dosage of nitrogen for vegetative growth, yield, and better quality of maize variety and to recommend a level of nitrogen rate and the best variety adaptable to the specific soil condition or area.

Keywords: parameter, chlorosis, germination, flood, sesbania, cultivar

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Authors: Natalia Moreira, Trevor Wood-Harper

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The acceptance of sustainable products by the final consumer is still one of the challenges of the industry, which constantly seeks alternative approaches to successfully be accepted in the global market. A large set of methods and approaches have been discussed and analysed throughout the literature. Considering the current need for sustainable development and the current pace of consumption, the need for a combined solution towards the development of new products became clear, forcing researchers in product development to propose alternatives to the previous standard product development models. This paper presents, through a systemic analysis of the literature on product development, eco-design and consumer involvement, a set of alternatives regarding consumer involvement towards the development of sustainable products and how these approaches could help improve the sustainable industry’s establishment in the general market. The initial findings of the research show that the understanding of the benefits of sustainable behaviour lead to a more conscious acquisition and eventually to the implementation of sustainable change in the consumer. Thus this paper is the initial approach towards the development of new sustainable products using the fashion industry as an example of practical implementation and acceptance by the consumers. By comparing the existing literature and critically analysing it this paper concluded that the consumer involvement is strategic to improve the general understanding of sustainability and its features. The use of consumers and communities has been studied since the early 90s in order to exemplify uses and to guarantee a fast comprehension. The analysis done also includes the importance of this approach for the increase of innovation and ground breaking developments, thus requiring further research and practical implementation in order to better understand the implications and limitations of this methodology.

Keywords: consumer involvement, products development, sustainability, eco-design

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Authors: Omid Gholipoor Bashiri, Ghafur Mosavi, Aliasghar Behnamghader, Seyed Mahmood Rabiee

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Objective: To determine the effect of selected bone graft on the compression properties of radial bone in rabbit. Design-Experimental in vivo study. Animals: A total of 45 adult male New Zealand white rabbits. Procedures: The rabbits were anesthetized and a one-cm-full thickness piece of radial bone was removed using oscillating saw in the all rabbit. The rabbits were divided into 5 groups on the basis of the material used to fill the bone defect: group 1: the paste of bone cement calcium phosphate; group II: the paste of calcium phosphate mixture with type I collagen; group III: tricalcium phosphate mixed with hydroxyapatite (TCP & HP) with 5% porosity; group IV: the same scaffold as group III with 10% porosity; and group V: the same scaffold as group III and IV with 20% porosity, with 9 rabbits in each group. Subsequently subdivided into 3 subgroups of 3 rabbits each. Results: There was a significant increase in compression properties of radial bone in the group II and V in 2nd and 3rd months as compared with groups I, III and IV. The mean endurable crack-strength in group II and V were slightly higher than that of normal radius (P<0.05). Conclusion and clinical relevance: Application of calcium phosphate paste with type I collagen and scaffold of tricalcium phosphate with hydroxyapatite having 20% porosity indicated to have positive effect in integral formation of qualitative callus at the site of fracture and early re-organization of callus to regain mechanical strength too.

Keywords: calcium phosphate, tricalcium phosphate, hydroxyapatite, radial bone, compressive properties, porosity, type i collagen, rabbit

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Authors: Ayse Cobanoglu

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Working memory can be defined as a workspace that holds and regulates active information in mind. This study investigates individual changes in children's working memory from kindergarten to first grade. The main purpose of the study is whether parental discipline methods and child impulsive/overactive behaviors affect children's working memory initial status and growth rate, controlling for gender, minority status, and socioeconomic status (SES). A linear growth curve model with the first four waves of the Early Childhood Longitudinal Study-Kindergarten Cohort of 2011 (ECLS-K:2011) is performed to analyze the individual growth of children's working memory longitudinally (N=3915). Results revealed that there is a significant variation among students' initial status in the kindergarten fall semester as well as the growth rate during the first two years of schooling. While minority status, SES, and children's overactive/impulsive behaviors influenced children's initial status, only SES and minority status were significantly associated with the growth rate of working memory. For parental discipline methods, such as giving a warning and ignoring the child's negative behavior, are also negatively associated with initial working memory scores. Following that, students' working memory growth rate is examined, and students with lower SES as well as minorities showed a faster growth pattern during the first two years of schooling. However, the findings of parental disciplinary methods on working memory growth rates were mixed. It can be concluded that schooling helps low-SES minority students to develop their working memory.

Keywords: growth curve modeling, impulsive/overactive behaviors, parenting, working memory

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Authors: Mohammad Fereidoonnezhad, Seán Leen, Stephen Nash, Patrick McGarry

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From the perspective of research innovation, the tidal energy industry is still in its early stages. While a very small number of turbines have progressed to utility-scale deployment, blade breakage is commonly reported due to the enormous hydrodynamic loading applied to devices. The aim of this study is the development of computer simulation technologies for the design of next-generation fibre-reinforced composite tidal turbines. This will require significant technical advances in the areas of tidal turbine testing and multi-scale computational modelling. The complex turbine blade profiles are designed to incorporate non-linear distributions of airfoil sections to optimize power output and self-starting capability while reducing power fluctuations. A number of candidate blade geometries are investigated, ranging from spiral geometries to parabolic geometries, with blades arranged in both cylindrical and spherical configurations on a vertical axis turbine. A combined blade element theory (BET-start-up model) is developed in MATLAB to perform computationally efficient parametric design optimisation for a range of turbine blade geometries. Finite element models are developed to identify optimal fibre-reinforced composite designs to increase blade strength and fatigue life. Advanced fluid-structure-interaction models are also carried out to compute blade deflections following design optimisation.

Keywords: tidal turbine, composite materials, fluid-structure-interaction, start-up capability

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Authors: Anton Andreev

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With the collapse of the Soviet Union and the collapse of a large part of the socialist regimes, left-wing parties all over the world entered the space of crisis, of problems with ideology, identity, with the definition of its goals and objectives. First of all, we can say that the communist parties actually lost their foundation. In 1992, despite the victory of left-wing forces, a Broad Front in which was the winner in the struggle against dictatorship plunged into a deep crisis, the nature of which is looking for a new platform, a new foundation, new goals. Thus, in the late 20th century, the party has revised theoretical beliefs and positions. Radical communist ideology was moderated to social reformism. Modern leftist movement in Uruguay is a movement of moderate reform. Left forces suggest going through successive changes. Changes in ideology and ideas have influenced to the understanding of foreign policy. After the collapse of the Soviet Union Broad Front has changed the direction of its diplomacy from the orientation to the Soviet state to support the USA policy. Government formed by Broad Front, supported the integration processes in the South America. Uruguay was developing the cooperation in the framework of MERCOSUR and began to create relationship with the new centers of power in world political space. Uruguay in the early 21st century is a country that starts to play important role in the international arena. Elections of 26 October 2014 should answer the question of support of internal policy of a Broad Front, as well as of the support of the diplomatic work of the "Left" governments of the country.

Keywords: Uruguay, broad front, Vazquez, international dimensions

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Authors: Penrug Pengsombut, Worawut Hamarn, Teerawuth Suwannasri, Kittiphong Songrukkiat, Kanatip Ratanachoo

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PTT Public Company Limited or simply PTT has played an important role in strengthening national energy security of the Kingdom of Thailand by transporting natural gas to customers in power, industrial and commercial sectors since 1981. PTT has been constructing and operating natural gas pipeline system of over 4,500-km network length both onshore and offshore laid through different area classifications i.e., marine, forest, agriculture, rural, urban, and city areas. During project development phase, an Environmental Impact Assessment (EIA) is conducted and submitted to the Office of Natural Resources and Environmental Policy and Planning (ONEP) for approval before project construction commencement. Knowledge and experiences gained and revealed from EIA in the past projects definitely are developed to further advance EIA study process for newly 5th Transmission Natural Gas Pipeline Project (5TP) with approximately 415 kilometers length. The preferred pipeline route is selected and justified by SMARTi map, an advance digital one-map platform with consists of multiple layers geographic and environmental information. Sensitive area impact focus (SAIF) is a practicable impact assessment methodology which appropriate for a particular long distance infrastructure project such as 5TP. An environmental modeling simulation is adopted into SAIF methodology for impact quantified in all sensitive areas whereas other area along pipeline right-of-ways is typically assessed as an impact representative. Resulting time and cost deduction is beneficial to project for early start.

Keywords: environmental impact assessment, EIA, natural gas pipeline, sensitive area impact focus, SAIF

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Authors: Elena Perepelova

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As the world approaches the 4th industrial revolution, income inequality has become one of the major societal concerns. Displacement of workers by technology becomes a reality, and in return, new skills and competencies are required. More important than ever, education needs to help individuals understand the wider world around them and make global connections. The author argues for the necessity to incorporate business, economics and finance studies as a part of primary education and offer access to business education to the general population with the primary objective to understand how the world functions. The paper offers a fresh look at existing business theory through an innovative program called 'Usefulnomics'. Realizing that the subject of Economics, Finance and Business are perceived as overwhelming for a large part of the population, the author has taken a holistic approach and created a program that simplifies the definitions of the existing concepts and shifts from the traditional breakdown into subjects and specialties to a teaching method that is based exclusively on real-life example case studies and group debates, in order to better grasp the concepts and put them into context. The paper findings are the result of a two-year project and experimental work with students from UK, USA, Malaysia, Russia, and Spain. The author conducted extensive research through on-line and in-person classes and workshops as well as in-depth interviews of primary and secondary grade students to assess their understanding of what is a business, how businesses operate and the role businesses play in their communities. The findings clearly indicate that students of all ages often understood business concepts and processes only in an intuitive way, which resulted in misconceptions and gaps in knowledge. While knowledge gaps were easier to identify and correct in primary school students, as students’ age increased, the learning process became distorted by career choices, political views, and the students’ actual (or perceived) economic status. While secondary school students recognized more concepts, their real understanding was often on par with upper primary school age students. The research has also shown that lack of correct vocabulary created a strong barrier to communication and real-life application or further learning. Based on these findings, each key business concept was practiced and put into context with small groups of students in order to design the content and format which would be well accepted and understood by the target group. As a result, the final learning program package was based on case studies from daily modern life and used a wide range of examples: from popular brands and well-known companies to basic commodities. In the final stage, the content and format were put into practice in larger classrooms. The author would like to share the key findings from the research, the resulting learning program as well as present new ideas on how the program could be further enriched and adapted so schools and organizations can deliver it.

Keywords: business, finance, economics, lifelong learning, XXI century skills

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Authors: B. Baran, S. N. Kaptanoglu, M. Ocal, Y. Kagnici, E. Esen, E. Siyez, D. M. Siyez

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Infertility is the fact that couples cannot have children despite 1 year of unprotected sexual life. Infertility can be considered as an important problem affecting not only sexual life but also social and psychological conditions of couples. Learning about information about preventable factors related to infertility during university years plays an important role in preventing a possible infertility case in older ages. The possibility to facilitate access to information with the internet has provided the opportunity to reach a broad audience in the diverse learning environments and educational environment. Moreover, the internet has become a basic resource for the 21st-century learners. Providing information about infertility over the internet will enable more people to reach in a short time. When studies conducted abroad about infertility are examined, interactive websites and online education programs come to the fore. In Turkey, while there is no comprehensive online education program for university students, it seems that existing studies are aimed to make more advertisements for doctors or hospitals. In this study, it was aimed to design and develop online infertility prevention education for university students. Mayer’s Multimedia Learning Theory made up the framework for the online learning environment in this study. The results of the needs analysis collected from the university students in Turkey who were selected with sampling to represent the audience for online learning contributed to the design phase. In this study, an infertility prevention online education environment designed as a 4-week education was developed by explaining the theoretical basis and needs analysis results. As a result; in the development of the online environment, different kind of visual aids that will increase teaching were used in the environment of online education according to Mayer’s principles of extraneous processing (coherence, signaling, spatial contiguity, temporal contiguity, redundancy, expectation principles), essential processing (segmenting, pre-training, modality principles) and generative processing (multimedia, personalization, voice principles). For example, the important points in reproductive systems’ expression were emphasized by visuals in order to draw learners’ attention, and the presentation of the information was also supported by the human voice. In addition, because of the limited knowledge of university students in the subject, the issue of female reproductive and male reproductive systems was taught before preventable factors related to infertility. Furthermore, 3D video and augmented reality application were developed in order to embody female and male reproductive systems. In conclusion, this study aims to develop an interactive Online Infertility Prevention Education in which university students can easily access reliable information and evaluate their own level of knowledge about the subject. It is believed that the study will also guide the researchers who want to develop online education in this area as it contains design-stage decisions of interactive online infertility prevention education for university students.

Keywords: infertility, multimedia learning theory, online education, reproductive health

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Authors: Ha T. T. Ly, Truc B. Truc, Hai N. Truong, Mai P. T. Nguyen, Ngoc D. Ngo, Khanh V. Tran, Hai T. Le

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Beta thalassemia is one of the most common inherited blood disorders, which is characterized by decreased or absent in beta globin expression. Patients with Beta thalassemia whose anemia is not so severe as to necessitate transfusions are said to have thalassemia intermedia. Objective: The goal of this study is prenatal diagnosis for pregnancy woman with Beta thalassemia intermedia and her husband with Beta thalassemia carrier at high risk of Beta thalassemia major in Northern of Vietnam. Material and method: The family has a 6 years-old compound heterozygous thalassemia major for CD71/72(+A) and Hbb:c. -78A>G/nt-28(A>G) male child. The father was heterozygous for CD71/72(+A) mutation which is Beta plus type and the mother was compound heterozygosity of two different variants, namely, Hbb: c. -78A>G/nt-28(A>G) and CD26(A-G) HbE. Prenatal Beta thalassemia mutation detection in fetal DNA was carried out using multiplex Amplification-refractory mutation system ARMS-PCR and confirmed by direct Sanger-sequencing Hbb gene. Prenatal diagnoses were perfomed by amniotic fluid sampling from pregnant woman in the 16-18th week of pregnancy after the genotypes of parents of the probands were identified. Result: When amniotic fluid sample was analyzed for Beta globin gene (Hbb), we found that the genotype is heterozygous for CD71/72(+A) and CD26(A-G) HbE. This genotype is different from the 1st child of this family. Conclusion: Prenatal diagnosis helps the parents to know the genotype and the thalassemia status of the fetus, so they can have early decision on their pregnancy. Genetic diagnosis provided a useful method in diagnosis for familial members in pedigree, genetic counseling and prenatal diagnosis.

Keywords: beta thalassemia intermedia, Hbb gene, pedigree, prenatal diagnosis

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Authors: Joselyne Rugema, Innocent Twagirayezu, Aimable Nkurunziza, Alice Nyirazigama, Vedaste Bagweneza, Belancilla Nikuze

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Introduction: Burn injuries among children are associated with major complications. Early health care seeking and appropriate management are crucial in saving lives and preventing complications. Objective: To assess home-based management practices and health seeking behaviors among caregivers of children admitted with burn injuries at selected hospitals in Rwanda. Methods: A cross-sectional descriptive study was conducted among caregivers of children admitted with burn injuries at three hospitals in Kigali. A semi-structured questionnaire was used to collect the data that were analyzed using SPSS version 25. Statistical software Results: Most of the children with burn injuries had median age of 36 months, and 89.9% had second-degree burns. 92.4% of burns happened at home and 63.3% were scalds. Only 18% of the caregivers seek care immediately after children’s burn injuries. About 2.5% reported not seeking any care after burn injuries and 3.8% sought care from traditional healers. 65.9% of the participants used wrong practices before seeking care such as applying honey, cooking oil and urine to the burn injuries. Transportation difficulties before consulting health facilities were the main reported faced barriers to success health care (86.1%). Conclusion: Immediate health seeking behavior was low. Wrong practices including application of harmful products to burn injuries are common in the community. There is a need for community based interventions to prevent burn injuries at home and to empower the community with appropriate actions to take after injuries.

Keywords: adolescent pregnancy, qualitative design, childbearing, teenage mothers

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Authors: Giorgia Predari, Riccardo Gulli

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The paper describes the history and the stylistic choices adopted in the construction of Palazzo Ronzani in Bologna, which was the first building to rise after the heavy demolitions carried out in the historical center of the city at the beginning of the twentieth century. In 1910, the local administration adopted a detailed plan to change the aspect of the city, as it was already happening in the main European capitals. In this context, starting from 1911, the architect and scenographer Gualtiero Pontoni designed for Alessandro Ronzani -the owner of a well-known Bolognese beer company- his Palazzo, which is listed among the first multifunctional buildings in Bologna, containing offices, commercial activities, and entertainment spaces. In an area of about 2000 m², the architect was able to propose a theatre with a capacity of 2000 seats at the basement, shops, a cafè-chantant and a restaurant on the ground floor, clubs, studios and commercial stores on the mezzanine and the first plan, and a hotel on the upper floors. The whole core of the building, at the underground levels, consisted of a reinforced concrete frame (one of the first examples of this type of construction in the city), which allowed the hall to have a free span of 11 x 12 meters, and a height of about 9 meters. Used until 2007 as a cinema, the hall has remained then in disuse for almost 10 years, but now an important functional restoration project with a strong architectural and scenographic value is taking place. It will bring the spaces back to the original geometries, in a historical and artistic condition inspired by the styles of the early Twentieth century.

Keywords: Modernissimo, Palazzo Ronzani, liberty, Bologna

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Authors: Komathy Thiagarajan, Mohd. Azizuddin Mohd. Yussof, Hasnoorina Husin, Noor Azreena Abd Aziz, Faezah Shekh Abdullah, Abdul Wahaf Abdul Wahid

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Polycystic Ovary Syndrome (PCOS) presents with a plethora of clinical features owing to the multifaceted underlying pathophysiology. This study was conducted to determine the clinical features unique to the sub fertile women attending the Sub fertility Clinic of the National Population and Family Development Board (NPFDB) so that a more holistic approach can be adopted to further enhance the pregnancy outcome in those women. This was a case-control study conducted over a span of three years (from January 2014 until December 2016), whereby women who fulfilled the Rotterdam Criteria 2004 were classified as PCOS (n=79) and women who did not fulfill the Rotterdam Criteria were classified as controls (n=88). The mean age of the women was 30.1 years and the mean duration of marriage was 3.93 years. The majority of women suffered from primary sub fertility (82.6%). The median age was lower among PCOS women (29.0 years) compared to the controls (30.0 years), p<0.05. The majority of PCOS women (43.0%) were obese (BMI > 30 kg/m2) compared to only 19.3% who were obese in the control group, p<0.05. Hypertension was present in 59.5% of PCOS women and only in 36.4% of the control group, p<0.05. There were significantly more women who presented with hirsutism in PCOS group (27.8%) as compared to the control group (5.7%), p<0.05. The findings of this study elucidate that the clinical features of significance among sub fertile women suffering from PCOS, if detected early, are amenable to lifestyle modifications and timely interventions can potentially improve the fertility outcomes in this group of women.

Keywords: clinical features, fertility, lifestyle modification, PCOS

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Authors: Joanna Kochanska, Dagmara Gornicka, Anna Burduk

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The article examines the process of implementing a new assembly line in a manufacturing enterprise of the household appliances industry area. At the initial stages of the project, a decision was made that one of its foundations should be the concept of lean management. Because of that, eliminating as many errors as possible in the first phases of its functioning was emphasized. During the start-up of the line, there were identified and documented all production losses (from serious machine failures, through any unplanned downtime, to micro-stops and quality defects). During 6 weeks (line start-up period), all errors resulting from problems in various areas were analyzed. These areas were, among the others, production, logistics, quality, and organization. The aim of the work was to analyze the occurrence of production failures during the initial phase of starting up the line and to propose a method for determining their critical level during its full functionality. There was examined the repeatability of the production losses in various areas and at different levels at such an early stage of implementation, by using the methods of statistical process control. Based on the Pareto analysis, there were identified the weakest points in order to focus improvement actions on them. The next step was to examine the effectiveness of the actions undertaken to reduce the level of recorded losses. Based on the obtained results, there was proposed a method for determining the critical failures level in the studied areas. The developed coefficient can be used as an alarm in case of imbalance of the production, which is caused by the increased failures level in production and production support processes in the period of the standardized functioning of the line.

Keywords: production failures, level of production losses, new production line implementation, assembly line, statistical process control

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Authors: Jamila Fakchich, Mostafa Jamila Lazaar Elachouri, Lakhder Fakchich, Fatna Ouali, Abd Errazzak Belkacem

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Diabetes is a chronic metabolic disease that has a significant impact on the health, quality of life, and life expectancy of patients as well as the health care system. By its nature diabetes, is a multisystem disease with wide-ranging complication that span nearly all region of the body. This epidemic problem, however, is not unique to the industrialized society, but has also hardly struck the developing countries. In Morocco, as developing country, there is an epidemic rise in diabetes, with ensuing concern about the management and control of this disease; it began a chronic burdensome disease of largely middle-aged and elderly people, with a long course and serious complications often resulting in high death-rate, the treatment of diabetes spent vast amount of resources including medicines, diets, physical training. Treatment of this disease is considered problematic due to the lack of effective and safe drugs capable of inducing sustained clinical, biochemical, and histological cure. In Moroccan society, the phytoremedies are some times the only affordable sources of healthcare, particularly for the people in remote areas. In this paper, we present a synthesis work obtained from the ethnobotanical data reported in different specialized journals. A Synthesis of four published ethnobotanical studies that have been carried out in different region of Morocco by different team seekers during the period from 1997 to 2015. Medicinal plants inventoried by different seekers in four Moroccan’s areas have been regrouped and codified, then, Factorial Analysis (FA) and Principal Components Analysis (PCA) are used to analyse the aggregated data from the four studies and plants are classified according to their frequency of use by population. Our work deals with an attempt to gather information on some traditional uses of medicinal plants from different regions of Morocco, also, it was designed to give a set of medicinal plants commonly used by Moroccan people in the treatment of diabetes; In this paper, we intended to provide a basic knowledge about plant species used by Moroccan society for treatment of diabetes. One of the most interesting aspects of this type of works is to assess the relative cultural importance of medicinal plants for specific illnesses and exploring its usefulness in the context of diabetes.

Keywords: Morocco, medicinal plants, ethnobotanical, diabetes, phytoremedies

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Authors: Jocelyn Cohen

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This paper identifies a powerful synchronicity of two traditions of life-story writing in the autobiographies of ritual abuse (RA) survivors, the Christian conversion narrative and the memoir of healing from childhood sexual trauma. Using methodologies from literary studies, history, and psychology, a close reading of three RA memoirs sheds light on a taboo and deeply suspect form of violence. Treatment of RA survivors and the unique role of psychotherapists, in particular, deserve far greater attention from multi-disciplinary scholars. Each story reflects salient characteristics of the Christian conversion narrative, a genre which originated in the US in the early 19th century with the serendipitous confluence of the simultaneous emergence of print culture and the basic structures of evangelicalism during the Second Great Awakening. The impulse of writing is thus to give testimony against the sin they witnessed and endured as young children during ritual violence perpetrated within the church. Importantly, RA is seen as an inherent if obscure aspect of Christian discourse itself, not in opposition to it, and not as an aberration. In RA's memoir, healing comes in part from the Christian narrative praxis of personal redemption, framed as prevailing in a war between good and evil. In other words, storytelling itself affects the healing, much as it does by means of each writer’s 'talking cure,' in the relationship with a psychotherapist who guides her through a repair of the life-story through the excavation of traumatic memories and their integration into the writer’s psyche. Integrating literary techniques into the psychotherapeutic relationship, therapists leverage the deep linguistic structures that clients possess as a resource to aid in their healing.

Keywords: memoir, psychotherapy, religion, trauma

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Authors: Zeinab Mirabulqasemi, Gholamali Hatam

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This article discusses the significance of mural paintings in Iranian culture, particularly within the context of religious tombs known as Imamzadehs. These tombs, dedicated to Shiite imams and other revered religious figures, serve as important religious and communal spaces. The tradition of tomb construction evolved from early Islamic practices, gradually transforming burial sites into places of worship. In the Gilan region of Iran, these tombs hold a revered status, serving as focal points for religious observances and social gatherings. The murals adorning these tombs often depict religious motifs, with a particular emphasis on events like the Day of Judgment and the martyrdom of the Imams, notably the saga of Ashura. These paintings also reflect the community's social perspectives and historical allegiances. Various architectural styles are employed in constructing these tombs, including Islamic, traditional, local, and aesthetic architecture. However, the region's climate poses challenges to the preservation of these structures and their murals. Despite these challenges, efforts are made to document and preserve these artworks to ensure their accessibility for future generations. This research also studies tomb paintings by adopting a multifaceted approach, including library research, image analysis, and field research. Finally, it examines the portrayal of significant figures such as the Shiite imams, prophets, and Imamzadehs within these murals, highlighting their thematic significance and cultural importance.

Keywords: cultural ritual, Shiite imams, mural, belief foundations, religious paintings

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Authors: Daniel M. Barry

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Since more than half a century ago, attempts have been made to culture cells and embryos outside the body (in vitro or ex vivo). This was done with different culture media and in various “incubators”. In the present study two different culture media were used: a standard TCM-199 culture medium and first trimester amniotic fluid (BAF) collected sterilely from pregnant cows after slaughter. Two different culture conditions were also investigated, the standard laboratory CO2 incubator versus culturing bovine embryos in the vagina of a goat doe. Two experiments were done: Firstly the permeability of different receptacles to CO2 gas was analyzed for possible culture in the vagina. Four-well plates and straws were used to incubate TCM-199 and BAF for a period of 120 h in the presence or absence of 5% CO2 gas. The pH values were measured and recorded every 24 h. In the second experiment pre-compacted morula stage bovine embryos were cultured in the above culture media in sealed 0.25 mL straws in a standard laboratory incubator and in the vagina of a goat doe. Evaluation was done on (1) stage of development and (2) number of blastomeres after 96 h of culture. In the first experiment it was shown that the CO2 gas diffused out of the 4-well plate as well as through the wall of the straws in the absence of CO2 gas, while in the presence of CO2 the pH of both media stabilized between 7.3 and 7.5. This meant that the semen straws were permeable to CO2 gas and could therefore be used as receptacles for culturing early stage bovine embryos. In the second experiment no statistical differences (p>0.05) were found in the number of pre-compacted bovine embryos that developed to the blastocyst stage, or the hatched blastocyst stage, neither for the culture medium used, or the method of culturing in the two incubators. Neither was there any difference (p>0.05) in the number of blastomeres that developed at the blastocyst stage between the two types of incubators. The bovine embryos tended to develop more blastomeres when cultured in BAF than when cultured in TCM-199 in both the standard laboratory incubator and when using the vagina of a goat doe as an incubator.

Keywords: alternative culture, bovine embryos, vagina, bovine amniotic fluid, incubator

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Authors: Fadwa Al Bawardi

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In March 2021, the Saudi Arabian Council of Ministers issued a decision to form a committee called the "Higher Committee for Research, Development and Innovation," a committee linked to the Council of Economic and Development Affairs, chaired by the Chairman of the Council of Economic and Development Affairs, and concerned with the development of the research, development and innovation sector in the Kingdom. In order to talk about the dimensions of this wonderful step, let us first try to answer the following questions. Is there a difference between creativity and innovation..? What are the factors of creativity in the individual. Are they mental genetic factors or are they factors that an individual acquires through learning..? The methodology included surveys that have been conducted on more than 500 individuals, males and females, between the ages of 18 till 60. And the answer is. "Creativity" is the creation of a new idea, while "Innovation" is the development of an already existing idea in a new, successful way. They are two sides of the same coin, as the "creative idea" needs to be developed and transformed into an "innovation" in order to achieve either strategic achievements at the level of countries and institutions to enhance organizational intelligence, or achievements at the level of individuals. For example, the beginning of smart phones was just a creative idea from IBM in 1994, but the actual successful innovation for the manufacture, development and marketing of these phones was through Apple later. Nor does creativity have to be hereditary. There are three basic factors for creativity: The first factor is "the presence of a challenge or an obstacle" that the individual faces and seeks thinking to find solutions to overcome, even if thinking requires a long time. The second factor is the "environment surrounding" of the individual, which includes science, training, experience gained, the ability to use techniques, as well as the ability to assess whether the idea is feasible or otherwise. To achieve this factor, the individual must be aware of own skills, strengths, hobbies, and aspects in which one can be creative, and the individual must also be self-confident and courageous enough to suggest those new ideas. The third factor is "Experience and the Ability to Accept Risk and Lack of Initial Success," and then learn from mistakes and try again tirelessly. There are some tools and techniques that help the individual to reach creative and innovative ideas, such as: Mind Maps tool, through which the available information is drawn by writing a short word for each piece of information and arranging all other relevant information through clear lines, which helps in logical thinking and correct vision. There is also a tool called "Flow Charts", which are graphics that show the sequence of data and expected results according to an ordered scenario of events and workflow steps, giving clarity to the ideas, their sequence, and what is expected of them. There are also other great tools such as the Six Hats tool, a useful tool to be applied by a group of people for effective planning and detailed logical thinking, and the Snowball tool. And all of them are tools that greatly help in organizing and arranging mental thoughts, and making the right decisions. It is also easy to learn, apply and use all those tools and techniques to reach creative and innovative solutions. The detailed figures and results of the conducted surveys are available upon request, with charts showing the %s based on gender, age groups, and job categories.

Keywords: innovation, creativity, factors, tools

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Authors: Yinglisong, Jingge Chen, Jingxuan Chen, Yan Wang, Hui Huang, Jing Zhnag, Qianqian Zhang, Zhenzhen Zhang, Ji Zhang

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Purpose: The study aims to establish a nomogram prediction model for postpartum hemorrhage (PPH) in vaginal delivery. Patients and Methods: Clinical data were retrospectively collected from vaginal delivery patients admitted to a hospital in Zhengzhou, China, from June 1, 2022 - October 31, 2022. Univariate and multivariate logistic regression were used to filter out independent risk factors. A nomogram model was established for PPH in vaginal delivery based on the risk factors coefficient. Bootstrapping was used for internal validation. To assess discrimination and calibration, receiver operator characteristics (ROC) and calibration curves were generated in the derivation and validation groups. Results: A total of 1340 cases of vaginal delivery were enrolled, with 81 (6.04%) having PPH. Logistic regression indicated that history of uterine surgery, induction of labor, duration of first labor, neonatal weight, WBC value (during the first stage of labor), and cervical lacerations were all independent risk factors of hemorrhage (P <0.05). The area-under-curve (AUC) of ROC curves of the derivation group and the validation group were 0.817 and 0.821, respectively, indicating good discrimination. Two calibration curves showed that nomogram prediction and practical results were highly consistent (P = 0.105, P = 0.113). Conclusion: The developed individualized risk prediction nomogram model can assist midwives in recognizing and diagnosing high-risk groups of PPH and initiating early warning to reduce PPH incidence.

Keywords: vaginal delivery, postpartum hemorrhage, risk factor, nomogram

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Authors: Mizuno Norihito

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This study attempts to examine Japanese views of Thailand primarily in the 1920s and 1930s through the analysis of documents published by the Office of Governor-General of Taiwan (Taiwan Sotokufu) and its affiliated organizations. Japan regarded Taiwan, under its control since 1895, as a foothold to making inroads into the South, and The governor-general office was active in investigations and intelligence gathering in Southeast Asia, as well as the southern part of the Chinese continent. Documents published by the governor-general office and its related organizations, especially those in a couple of decades following the First World War, reveal that the Japanese paid attention to the presence of the-Thai-Chinese during the time period. It would not be surprising that the desiring to penetrating into the Thai market, as well as the markets of the rest of Southeast Asia, the Japanese could not ignore the presence of the Thai-Chinese because of their local economic influences. The increased Japanese concern about the Thai-Chinese toward the end of the 1920s and throughout the 1930s was, moreover, intertwined with the increased tension between China and Japan. In other words, Thailand, as well as the rest of Southeast Asia, became another arena of Sino-Japanese confrontation. The rise of nationalism against Japan in China infected the Thai-Chinese communities and threatened Japanese economic activities in the country. However, the Japanese simultaneously found out that Thai-Chinese concert with anti-Japanese in China did not necessarily match their business interests and that the Thai government’s efforts to assimilate the Thai-Chinese into the Thais society and strategic approach to Japan in the late 1930s hampered their anti-Japanese actions.

Keywords: Japanese-Thai Relations, Sino-Japanese relations, Thai Chinese, Overseas Japanese

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Authors: Hsueh Ping Peng

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End-stage renal disease most commonly occurs in the elderly population. Elderly people are approaching the end of their lives, and when facing major life-threatening situations, apart from aggressive medical treatment, they can also choose treatment methods such as hospice care to improve their quality of life. The purpose of this study was to investigate factors associated with the awareness and willingness to sign hospice and palliative care consent forms in elderly with end-stage renal disease. This study used both quantitative, cross-sectional study designs. In the quantitative section, 110 elderly patients (aged 65 or above) with end-stage renal disease receiving conventional hemodialysis were recruited as study participants from a medical center in Taipei City. Data were collected using structured questionnaires. Study tools included basic demographic data, questionnaires on the awareness and perception of hospice and palliative care, etc. After collecting the data, data analysis was conducted using SPSS 20.0 statistical software, including descriptive statistics, chi-square test, logistic regression, and other inferential statistics. The results showed that the average age of participants was 71.6 years old, more males than females, average years of dialysis was 6.1 years and most subjects rated their self-perceived health status as fair. Results of the study are summarized as follows: Elderly people with end-stage renal disease did not have sufficient knowledge and awareness about hospice and palliative care. Influencing factors included level of education, marital status, years of dialysis and age, etc. Demographic factors influencing the signing of consent forms included gender, marital status, and age, which all showed significant impacts. Factors taken into consideration when signing consent forms included awareness of hospice care, understanding the relevant definitions of hospice care, and understanding that consent may be modified or cancelled at any time; it was predicted that people who knew more about ways to receive hospice care or more related definitions were more willing to sign the consent forms. In the qualitative study section, 10 participants who signed the consent form, five male, and 5 female, between the ages of 65-90, have completed the semi-structured interviews. Analysis of the interviews revealed six themes: (1) passing away peacefully, (2) autonomy on arrangements of life and death, (3) unwillingness to increase family and social burden, (4) friends and relatives’ experience influencing the decision to give consent, (5) sharing information to facilitate the giving of consent, (6) facing each day with ease, to reflect the experience and factors of consideration for elderly with end-stage renal disease when signing consent forms. The results of this study provides the awareness, thoughts and feelings of elderly with end-stage renal disease on signing consent forms, and serve as a future reference for the dialysis unit to enhance the promotion of hospice and palliative care and related caregiving measures, thereby improving the quality of life and care for elderly people with end-stage renal disease.

Keywords: end-stage renal disease, hemodialysis, hospice and palliative care, awareness, willingness

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Authors: Mustafa Al-Yaseen, Haider Mohammed Mahdi, Haider Ali Al–Zahid, Nazar S. Haddad

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Background: Early diagnosis of musculoskeletal infections is of vital importance to avoid devastating complications. There is no single laboratory marker which is sensitive and specific in diagnosing these infections accurately. White blood cell count, erythrocyte sedimentation rate, and C-reactive protein are not specific as they can also be elevated in conditions other than bacterial infections. Materials Culture and sensitivity is not a true gold standard due to its varied positivity rates. Serum Procalcitonin is one of the new laboratory markers for pyogenic infections. The objective of this study is to assess the value of PCT in the diagnosis of soft tissue, bone, and joint infections. Patients and Methods: Patients of all age groups (seventy-four patients) with a diagnosis of musculoskeletal infection are prospectively included in this study. All patients were subjected to White blood cell count, erythrocyte sedimentation rate, C-reactive protein, and serum Procalcitonin measurements. A healthy non infected outpatient group (twenty-two patients) taken as a control group and underwent the same evaluation steps as the study group. Results: The study group showed mean Procalcitonin levels of 1.3 ng/ml. Procalcitonin, at 0.5 ng/ml, was (42.6%) sensitive and (95.5%) specific in diagnosing of musculoskeletal infections with (positive predictive value of 87.5% and negative predictive value of 48.3%) and (positive likelihood ratio of 9.3 and negative likelihood ratio of 0.6). Conclusion: Serum Procalcitonin, at a cut – off of 0.5 ng/ml, is a specific but not sensitive marker in the diagnosis of musculoskeletal infections, and it can be used effectively to rule in the diagnosis of infection but not to rule out it.

Keywords: procalcitonin, infection, labratory markers, musculoskeletal

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Authors: Mustafa Metin Donma, Orkide Donma

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Childhood obesity is an important clinical problem because it may lead to chronic diseases during the adulthood period of the individual. Obesity is a metabolic disease associated with low-grade inflammation. The liver occurs at the center of metabolic pathways. Adropin, fibroblast growth factor-21 (FGF-21), and fetuin-A are hepatokines. Due to the immense participation of the liver in glucose metabolism, these liver-derived factors may be associated with insulin resistance (IR), which is a phenomenon discussed within the scope of obesity problems. The aim of this study is to determine the concentrations of adropin, FGF-21, and fetuin-A in childhood obesity, to point out possible differences between the obesity groups, and to investigate possible associations among these three hepatokines in obese and morbidly obese children. A total of one hundred and thirty-two children were included in the study. Two obese groups were constituted. The groups were matched in terms of mean ± SD values of ages. Body mass index values of obese and morbidly obese groups were 25.0 ± 3.5 kg/m² and 29.8 ± 5.7 kg/m², respectively. Anthropometric measurements including waist circumference, hip circumference, head circumference, and neck circumference were recorded. Informed consent forms were taken from the parents of the participants. The ethics committee of the institution approved the study protocol. Blood samples were obtained after overnight fasting. Routine biochemical tests, including glucose- and lipid-related parameters, were performed. Concentrations of the hepatokines (adropin, FGF-21, fetuin A) were determined by enzyme-linked immunosorbent assay. Insulin resistance indices such as homeostasis model assessment for IR (HOMA-IR), alanine transaminase-to aspartate transaminase ratio (ALT/AST), diagnostic obesity notation model assessment laboratory index, diagnostic obesity notation model assessment metabolic syndrome index as well as obesity indices such as diagnostic obesity notation model assessment-II index, and fat mass index were calculated using the previously derived formulas. Statistical evaluation of the study data as well as findings of the study was performed by SPSS for Windows. Statistical difference was accepted significant when p is smaller than 0.05. Statistically significant differences were found for insulin, triglyceride, high-density lipoprotein cholesterol levels of the groups. A significant increase was observed for FGF-21 concentrations in the morbidly obese group. Higher adropin and fetuin-A concentrations were observed in the same group in comparison with the values detected in the obese group (p > 0.05). There was no statistically significant difference between the ALT/AST values of the groups. In all of the remaining IR and obesity indices, significantly increased values were calculated for morbidly obese children. Significant correlations were detected between HOMA-IR and each of the hepatokines. The highest one was the association with fetuin-A (r=0.373, p=0.001). In conclusion, increased levels observed in adropin, FGF-21, and fetuin-A have shown that these hepatokines possess increasing potential going from obese to morbid obese state. Out of the correlations found with the IR index, the most affected hepatokine was fetuin-A, the parameter possibly used as the indicator of the advanced obesity stage.

Keywords: adropin, fetuin A, fibroblast growth factor-21, insulin resistance, pediatric obesity

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