Search results for: high research and development intensity industries
Commenced in January 2007
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Edition: International
Paper Count: 46796

Search results for: high research and development intensity industries

566 Food Composition Tables Used as an Instrument to Estimate the Nutrient Ingest in Ecuador

Authors: Ortiz M. Rocío, Rocha G. Karina, Domenech A. Gloria

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There are several tools to assess the nutritional status of the population. A main instrument commonly used to build those tools is the food composition tables (FCT). Despite the importance of FCT, there are many error sources and variability factors that can be presented on building those tables and can lead to an under or over estimation of ingest of nutrients of a population. This work identified different food composition tables used as an instrument to estimate the nutrient ingest in Ecuador.The collection of data for choosing FCT was made through key informants –self completed questionnaires-, supplemented with institutional web research. A questionnaire with general variables (origin, year of edition, etc) and methodological variables (method of elaboration, information of the table, etc) was passed to the identified FCT. Those variables were defined based on an extensive literature review. A descriptive analysis of content was performed. Ten printed tables and three databases were reported which were all indistinctly treated as food composition tables. We managed to get information from 69% of the references. Several informants referred to printed documents that were not accessible. In addition, searching the internet was not successful. Of the 9 final tables, n=8 are from Latin America, and, n= 5 of these were constructed by indirect method (collection of already published data) having as a main source of information a database from the United States department of agriculture USDA. One FCT was constructed by using direct method (bromatological analysis) and has its origin in Ecuador. The 100% of the tables made a clear distinction of the food and its method of cooking, 88% of FCT expressed values of nutrients per 100g of edible portion, 77% gave precise additional information about the use of the table, and 55% presented all the macro and micro nutrients on a detailed way. The more complete FCT were: INCAP (Central America), Composition of foods (Mexico). The more referred table was: Ecuadorian food composition table of 1965 (70%). The indirect method was used for most tables within this study. However, this method has the disadvantage that it generates less reliable food composition tables because foods show variations in composition. Therefore, a database cannot accurately predict the composition of any isolated sample of a food product.In conclusion, analyzing the pros and cons, and, despite being a FCT elaborated by using an indirect method, it is considered appropriate to work with the FCT of INCAP Central America, given the proximity to our country and a food items list that is very similar to ours. Also, it is imperative to have as a reference the table of composition for Ecuadorian food, which, although is not updated, was constructed using the direct method with Ecuadorian foods. Hence, both tables will be used to elaborate a questionnaire with the purpose of assessing the food consumption of the Ecuadorian population. In case of having disparate values, we will proceed by taking just the INCAP values because this is an updated table.

Keywords: Ecuadorian food composition tables, FCT elaborated by direct method, ingest of nutrients of Ecuadorians, Latin America food composition tables

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565 Environmental Threats and Great Barrier Reef: A Vulnerability Assessment of World’s Best Tropical Marine Ecosystems

Authors: Ravi Kant Anand, Nikkey Keshri

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The Great Barrier Reef of Australia is known for its beautiful landscapes and seascapes with ecological importance. This site was selected as a World Heritage site in 1981 and popularized internationally for tourism, recreational activities and fishing. But the major environmental hazards such as climate change, pollution, overfishing and shipping are making worst the site of marine ecosystem. Climate change is directly hitting on Great Barrier Reef through increasing level of sea, acidification of ocean, increasing in temperature, uneven precipitation, changes in the El Nino and increasing level of cyclones and storms. Apart from that pollution is second biggest factor which vanishing the coral reef ecosystem. Pollution including over increasement of pesticides and chemicals, eutrophication, pollution through mining, sediment runoff, loss of coastal wetland and oil spills. Coral bleaching is the biggest problem because of the environmental threatening agents. Acidification of ocean water reduced the formation of calcium carbonate skeleton. The floral ecosystem (including sea grasses and mangroves) of ocean water is the key source of food for fishes and other faunal organisms but the powerful waves, extreme temperature, destructive storms and river run- off causing the threat for them. If one natural system is under threat, it means the whole marine food web is affected from algae to whale. Poisoning of marine water through different polluting agents have been affecting the production of corals, breeding of fishes, weakening of marine health and increased in death of fishes and corals. In lieu of World Heritage site, tourism sector is directly affected and causing increasement in unemployment. Fishing sector also affected. Fluctuation in the temperature of ocean water affects the production of corals because it needs desolate place, proper sunlight and temperature up to 21 degree centigrade. But storms, El Nino, rise in temperature and sea level are induced for continuous reduction of the coral production. If we do not restrict the environmental problems of Great Barrier Reef than the best known ecological beauty with coral reefs, pelagic environments, algal meadows, coasts and estuaries, mangroves forests and sea grasses, fish species, coral gardens and the one of the best tourist spots will lost in upcoming years. My research will focus on the different environmental threats, its socio-economic impacts and different conservative measures.

Keywords: climate change, overfishing, acidification, eutrophication

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564 Human Wildlife Conflict Outside Protected Areas of Nepal: Causes, Consequences and Mitigation Strategies

Authors: Kedar Baral

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This study was carried out in Mustang, Kaski, Tanahun, Baitadi, and Jhapa districts of Nepal. The study explored the spatial and temporal pattern of HWC, socio economic factors associated with it, impacts of conflict on life / livelihood of people and survival of wildlife species, and impact of climate change and forest fire onHWC. Study also evaluated people’s attitude towards wildlife conservation and assessed relevant policies and programs. Questionnaire survey was carried out with the 250 respondents, and both socio-demographic and HWC related information werecollected. Secondary information were collected from Divisional Forest Offices and Annapurna Conservation Area Project.HWC events were grouped by season /months/sites (forest type, distances from forest, and settlement), and the coordinates of the events were exported to ArcGIS. Collected data were analyzed using descriptive statistics in Excel and R Program. A total of 1465 events were recorded in 5 districts during 2015 and 2019. Out of that, livestock killing, crop damage, human attack, and cattle shed damage events were 70 %, 12%, 11%, and 7%, respectively. Among 151 human attack cases, 23 people were killed, and 128 were injured. Elephant in Terai, common leopard and monkey in Middle Mountain, and snow leopard in high mountains were found as major problematic animals. Common leopard attacks were found more in the autumn, evening, and on human settlement area. Whereas elephant attacks were found higher in winter, day time, and on farmland. Poor people farmers were found highly victimized, and they were losing 26% of their income due to crop raiding and livestock depredation. On the other hand, people are killing many wildlife in revenge, and this number is increasing every year. Based on the people's perception, climate change is causing increased temperature and forest fire events and decreased water sources within the forest. Due to the scarcity of food and water within forests, wildlife are compelled to dwell at human settlement area, hence HWC events are increasing. Nevertheless, more than half of the respondents were found positive about conserving entire wildlife species. Forests outside PAs are under the community forestry (CF) system, which restored the forest, improved the habitat, and increased the wildlife.However, CF policies and programs were found to be more focused on forest management with least priority on wildlife conservation and HWC mitigation. Compensation / relief scheme of government for wildlife damage was found some how effective to manage HWC, but the lengthy process, being applicable to the damage of few wildlife species and highly increasing events made it necessary to revisit. Based on these facts, the study suggest to carry out awareness generation activities to the poor farmers, linking the property of people with the insurance scheme, conducting habitat management activities within CF, promoting the unpalatable crops, improvement of shed house of livestock, simplifying compensation scheme and establishing a fund at the district level and incorporating the wildlife conservation and HWCmitigation programs in CF. Finally, the study suggests to carry out rigorous researches to understand the impacts of current forest management practices on forest, biodiversity, wildlife, and HWC.

Keywords: community forest, conflict mitigation, wildlife conservation, climate change

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563 Stakeholder Engagement to Address Urban Health Systems Gaps for Migrants

Authors: A. Chandra, M. Arthur, L. Mize, A. Pomeroy-Stevens

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Background: Lower and middle-income countries (LMICs) in Asia face rapid urbanization resulting in both economic opportunities (the urban advantage) and emerging health challenges. Urban health risks are magnified in informal settlements and include infectious disease outbreaks, inadequate access to health services, and poor air quality. Over the coming years, urban spaces in Asia will face accelerating public health risks related to migration, climate change, and environmental health. These challenges are complex and require multi-sectoral and multi-stakeholder solutions. The Building Health Cities (BHC) program is funded by the United States Agency for International Development (USAID) to work with smart city initiatives in the Asia region. BHC approaches urban health challenges by addressing policies, planning, and services through a health equity lens, with a particular focus on informal settlements and migrant communities. The program works to develop data-driven decision-making, build inclusivity through stakeholder engagement, and facilitate the uptake of appropriate technology. Methodology: The BHC program has partnered with the smart city initiatives of Indore in India, Makassar in Indonesia, and Da Nang in Vietnam. Implementing partners support municipalities to improve health delivery and equity using two key approaches: political economy analysis and participatory systems mapping. Political economy analyses evaluate barriers to collective action, including corruption, security, accountability, and incentives. Systems mapping evaluates community health challenges using a cross-sectoral approach, analyzing the impact of economic, environmental, transport, security, health system, and built environment factors. The mapping exercise draws on the experience and expertise of a diverse cohort of stakeholders, including government officials, municipal service providers, and civil society organizations. Results: Systems mapping and political economy analyses identified significant barriers for health care in migrant populations. In Makassar, migrants are unable to obtain the necessary card that entitles them to subsidized health services. This finding is being used to engage with municipal governments to mitigate the barriers that limit migrant enrollment in the public social health insurance scheme. In Indore, the project identified poor drainage of storm and wastewater in migrant settlements as a cause of poor health. Unsafe and inadequate infrastructure placed residents of these settlements at risk for both waterborne diseases and injuries. The program also evaluated the capacity of urban primary health centers serving migrant communities, identifying challenges related to their hours of service and shortages of health workers. In Da Nang, the systems mapping process has only recently begun, with the formal partnership launched in December 2019. Conclusion: This paper explores lessons learned from BHC’s systems mapping, political economy analyses, and stakeholder engagement approaches. The paper shares progress related to the health of migrants in informal settlements. Case studies feature barriers identified and mitigating steps, including governance actions, taken by local stakeholders in partner cities. The paper includes an update on ongoing progress from Indore and Makassar and experience from the first six months of program implementation from Da Nang.

Keywords: informal settlements, migration, stakeholder engagement mapping, urban health

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562 A Qualitative Exploration of the Sexual and Reproductive Health Practices of Adolescent Mothers from Indigenous Populations in Ratanak Kiri Province, Cambodia

Authors: Bridget J. Kenny, Elizabeth Hoban, Jo Williams

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Adolescent pregnancy presents a significant public health challenge for Cambodia. Despite declines in the overall fertility rate, the adolescent fertility rate is increasing. Adolescent pregnancy is particularly problematic in the Northeast provinces of Ratanak Kiri and Mondul Kiri where 34 percent of girls aged between 15 and 19 have begun childbearing; this is almost three times Cambodia’s national average of 12 percent. Language, cultural and geographic barriers have restricted qualitative exploration of the sexual and reproductive health (SRH) challenges that face indigenous adolescents in Northeast Cambodia. The current study sought to address this gap by exploring the SRH practices of adolescent mothers from indigenous populations in Ratanak Kiri Province. Twenty-two adolescent mothers, aged between 15 and 19, were recruited from seven indigenous villages in Ratanak Kiri Province and asked to participate in a combined body mapping exercise and semi-structured interview. Participants were given a large piece of paper (59.4 x 84.1 cm) with the outline of a female body and asked to draw the female reproductive organs onto the ‘body map’. Participants were encouraged to explain what they had drawn with the purpose of evoking conversation about their reproductive bodies. Adolescent mothers were then invited to participate in a semi-structured interview to further expand on topics of SRH. The qualitative approach offered an excellent avenue to explore the unique SRH challenges that face indigenous adolescents in rural Cambodia. In particular, the use of visual data collection methods reduced the language and cultural barriers that have previously restricted or prevented qualitative exploration of this population group. Thematic analysis yielded six major themes: (1) understanding of the female reproductive body, (2) contraceptive knowledge, (3) contraceptive use, (4) barriers to contraceptive use, (5) sexual practices, (6) contact with healthcare facilities. Participants could name several modern contraceptive methods and knew where they could access family planning services. However, adolescent mothers explained that they gained this knowledge during antenatal care visits and consequently participants had limited SRH knowledge, including contraceptive awareness, at the time of sexual initiation. Fear of the perceived side effects of modern contraception, including infertility, provided an additional barrier to contraceptive use for indigenous adolescents. Participants did not cite cost or geographic isolation as barriers to accessing SRH services. Child marriage and early sexual initiation were also identified as important factors contributing to the high prevalence of adolescent pregnancy in this population group. The findings support the Ministry of Education, Youth and Sports' (MoEYS) recent introduction of SRH education into the primary and secondary school curriculum but suggest indigenous girls in rural Cambodia require additional sources of SRH information. Results indicate adolescent girls’ first point of contact with healthcare facilities occurs after they become pregnant. Promotion of an effective continuum of care by increasing access to healthcare services during the pre-pregnancy period is suggested as a means of providing adolescents girls with an additional avenue to acquire SRH information.

Keywords: adolescent pregnancy, contraceptive use, family planning, sexual and reproductive health

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561 Innovative Technologies Functional Methods of Dental Research

Authors: Sergey N. Ermoliev, Margarita A. Belousova, Aida D. Goncharenko

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Application of the diagnostic complex of highly informative functional methods (electromyography, reodentography, laser Doppler flowmetry, reoperiodontography, vital computer capillaroscopy, optical tissue oximetry, laser fluorescence diagnosis) allows to perform a multifactorial analysis of the dental status and to prescribe complex etiopathogenetic treatment. Introduction. It is necessary to create a complex of innovative highly informative and safe functional diagnostic methods for improvement of the quality of patient treatment by the early detection of stomatologic diseases. The purpose of the present study was to investigate the etiology and pathogenesis of functional disorders identified in the pathology of hard tissue, dental pulp, periodontal, oral mucosa and chewing function, and the creation of new approaches to the diagnosis of dental diseases. Material and methods. 172 patients were examined. Density of hard tissues of the teeth and jaw bone was studied by intraoral ultrasonic densitometry (USD). Electromyographic activity of masticatory muscles was assessed by electromyography (EMG). Functional state of dental pulp vessels assessed by reodentography (RDG) and laser Doppler flowmetry (LDF). Reoperiodontography method (RPG) studied regional blood flow in the periodontal tissues. Microcirculatory vascular periodontal studied by vital computer capillaroscopy (VCC) and laser Doppler flowmetry (LDF). The metabolic level of the mucous membrane was determined by optical tissue oximetry (OTO) and laser fluorescence diagnosis (LFD). Results and discussion. The results obtained revealed changes in mineral density of hard tissues of the teeth and jaw bone, the bioelectric activity of masticatory muscles, regional blood flow and microcirculation in the dental pulp and periodontal tissues. LDF and OTO methods estimated fluctuations of saturation level and oxygen transport in microvasculature of periodontal tissues. With LFD identified changes in the concentration of enzymes (nicotinamide, flavins, lipofuscin, porphyrins) involved in metabolic processes Conclusion. Our preliminary results confirmed feasibility and safety the of intraoral ultrasound densitometry technique in the density of bone tissue of periodontium. Conclusion. Application of the diagnostic complex of above mentioned highly informative functional methods allows to perform a multifactorial analysis of the dental status and to prescribe complex etiopathogenetic treatment.

Keywords: electromyography (EMG), reodentography (RDG), laser Doppler flowmetry (LDF), reoperiodontography method (RPG), vital computer capillaroscopy (VCC), optical tissue oximetry (OTO), laser fluorescence diagnosis (LFD)

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560 Exploring the Spatial Characteristics of Mortality Map: A Statistical Area Perspective

Authors: Jung-Hong Hong, Jing-Cen Yang, Cai-Yu Ou

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The analysis of geographic inequality heavily relies on the use of location-enabled statistical data and quantitative measures to present the spatial patterns of the selected phenomena and analyze their differences. To protect the privacy of individual instance and link to administrative units, point-based datasets are spatially aggregated to area-based statistical datasets, where only the overall status for the selected levels of spatial units is used for decision making. The partition of the spatial units thus has dominant influence on the outcomes of the analyzed results, well known as the Modifiable Areal Unit Problem (MAUP). A new spatial reference framework, the Taiwan Geographical Statistical Classification (TGSC), was recently introduced in Taiwan based on the spatial partition principles of homogeneous consideration of the number of population and households. Comparing to the outcomes of the traditional township units, TGSC provides additional levels of spatial units with finer granularity for presenting spatial phenomena and enables domain experts to select appropriate dissemination level for publishing statistical data. This paper compares the results of respectively using TGSC and township unit on the mortality data and examines the spatial characteristics of their outcomes. For the mortality data between the period of January 1st, 2008 and December 31st, 2010 of the Taitung County, the all-cause age-standardized death rate (ASDR) ranges from 571 to 1757 per 100,000 persons, whereas the 2nd dissemination area (TGSC) shows greater variation, ranged from 0 to 2222 per 100,000. The finer granularity of spatial units of TGSC clearly provides better outcomes for identifying and evaluating the geographic inequality and can be further analyzed with the statistical measures from other perspectives (e.g., population, area, environment.). The management and analysis of the statistical data referring to the TGSC in this research is strongly supported by the use of Geographic Information System (GIS) technology. An integrated workflow that consists of the tasks of the processing of death certificates, the geocoding of street address, the quality assurance of geocoded results, the automatic calculation of statistic measures, the standardized encoding of measures and the geo-visualization of statistical outcomes is developed. This paper also introduces a set of auxiliary measures from a geographic distribution perspective to further examine the hidden spatial characteristics of mortality data and justify the analyzed results. With the common statistical area framework like TGSC, the preliminary results demonstrate promising potential for developing a web-based statistical service that can effectively access domain statistical data and present the analyzed outcomes in meaningful ways to avoid wrong decision making.

Keywords: mortality map, spatial patterns, statistical area, variation

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559 Automated Computer-Vision Analysis Pipeline of Calcium Imaging Neuronal Network Activity Data

Authors: David Oluigbo, Erik Hemberg, Nathan Shwatal, Wenqi Ding, Yin Yuan, Susanna Mierau

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Introduction: Calcium imaging is an established technique in neuroscience research for detecting activity in neural networks. Bursts of action potentials in neurons lead to transient increases in intracellular calcium visualized with fluorescent indicators. Manual identification of cell bodies and their contours by experts typically takes 10-20 minutes per calcium imaging recording. Our aim, therefore, was to design an automated pipeline to facilitate and optimize calcium imaging data analysis. Our pipeline aims to accelerate cell body and contour identification and production of graphical representations reflecting changes in neuronal calcium-based fluorescence. Methods: We created a Python-based pipeline that uses OpenCV (a computer vision Python package) to accurately (1) detect neuron contours, (2) extract the mean fluorescence within the contour, and (3) identify transient changes in the fluorescence due to neuronal activity. The pipeline consisted of 3 Python scripts that could both be easily accessed through a Python Jupyter notebook. In total, we tested this pipeline on ten separate calcium imaging datasets from murine dissociate cortical cultures. We next compared our automated pipeline outputs with the outputs of manually labeled data for neuronal cell location and corresponding fluorescent times series generated by an expert neuroscientist. Results: Our results show that our automated pipeline efficiently pinpoints neuronal cell body location and neuronal contours and provides a graphical representation of neural network metrics accurately reflecting changes in neuronal calcium-based fluorescence. The pipeline detected the shape, area, and location of most neuronal cell body contours by using binary thresholding and grayscale image conversion to allow computer vision to better distinguish between cells and non-cells. Its results were also comparable to manually analyzed results but with significantly reduced result acquisition times of 2-5 minutes per recording versus 10-20 minutes per recording. Based on these findings, our next step is to precisely measure the specificity and sensitivity of the automated pipeline’s cell body and contour detection to extract more robust neural network metrics and dynamics. Conclusion: Our Python-based pipeline performed automated computer vision-based analysis of calcium image recordings from neuronal cell bodies in neuronal cell cultures. Our new goal is to improve cell body and contour detection to produce more robust, accurate neural network metrics and dynamic graphs.

Keywords: calcium imaging, computer vision, neural activity, neural networks

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558 The Effect of Disseminating Basic Knowledge on Radiation in Emergency Distance Learning of COVID-19

Authors: Satoko Yamasaki, Hiromi Kawasaki, Kotomi Yamashita, Susumu Fukita, Kei Sounai

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People are susceptible to rumors when the cause of their health problems is unknown or invisible. In order for individuals to be unaffected by rumors, they need basic knowledge and correct information. Community health nursing classes use cases where basic knowledge of radiation can be utilized on a regular basis, thereby teaching that basic knowledge is important in preventing anxiety caused by rumors. Nursing students need to learn that preventive activities are essential for public health nursing care. This is the same methodology used to reduce COVID-19 anxiety among individuals. This study verifies the learning effect concerning the basic knowledge of radiation necessary for case consultation by emergency distance learning. Sixty third-year nursing college students agreed to participate in this research. The knowledge tests conducted before and after classes were compared, with the chi-square test used for testing. There were five knowledge questions regarding distance lessons. This was considered to be 5% significant. The students’ reports which describe the results of responding to health consultations, were analyzed qualitatively and descriptively. In this case study, a person living in an area not affected by radiation was anxious about drinking water and, thus, consulted with a student. The contents of the lecture were selected the minimum amount of knowledge used for the answers of the consultant; specifically hot spots, internal exposure risk, food safety, characteristics of cesium-137, and precautions for counselors. Before taking the class, the most correctly answered question by students concerned daily behavior at risk of internal exposure (52.2%). The question with the fewest correct answers was the selection of places that are likely to be hot spots (3.4%). All responses increased significantly after taking the class (p < 0.001). The answers to the counselors, as written by the students, were 'Cesium is strongly bound to the soil, so it is difficult to transfer to water' and 'Water quality test results of tap water are posted on the city's website.' These were concrete answers obtained by using specialized knowledge. Even in emergency distance learning, the students gained basic knowledge regarding radiation and created a document to utilize said knowledge while assuming the situation concretely. It was thought that the flipped classroom method, even if conducted remotely, could maintain students' learning. It was thought that setting specific knowledge and scenes to be used would enhance the learning effect. By changing the case to concern that of the anxiety caused by infectious diseases, students may be able to effectively gain the basic knowledge to decrease the anxiety of residents due to infectious diseases.

Keywords: effect of class, emergency distance learning, nursing student, radiation

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557 The Use of Rotigotine to Improve Hemispatial Neglect in Stroke Patients at the Charing Cross Neurorehabilitation Unit

Authors: Malab Sana Balouch, Meenakshi Nayar

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Hemispatial Neglect is a common disorder primarily associated with right hemispheric stroke, in the acute phase of which it can occur up to 82% of the time. Such individuals fail to acknowledge or respond to people and objects in their left field of vision due to deficits in attention and awareness. Persistent hemispatial neglect significantly impedes post-stroke recovery, leading to longer hospital stays post-stroke, increased functional dependency, longer-term disability in ADLs and increased risk of falls. Recently, evidence has emerged for the use of dopamine agonist Rotigotine in neglect. The aim of our Quality Improvement Project (QIP) is to evaluate and better the current protocols and practice in assessment, documentation and management of neglect and rotigotine use at the Neurorehabilitation unit at Charing Cross Hospital (CNRU). In addition, it brings light to rotigotine use in the management of hemispatial neglect and paves the way for future research in the field. Our QIP was based in the CNRU. All patients admitted to the CNRU suffering from a right-sided stroke from 2nd of February 2018 to the 2nd of February 2021 were included in the project. Each patient’s multidisciplinary team report and hospital notes were searched for information, including bio-data, fulfilment of the inclusion criteria (having hemispatial neglect) and data related to rotigotine use. This includes whether or not the drug was administered, any contraindications to drug in patients that did not receive it, and any therapeutic benefits(subjective or objective improvement in neglect) in those that did receive the rotigotine. Data was simultaneously entered into excel sheet and further statistical analysis was done on SPSS 20.0. Out of 80 patients suffering from right sided strokes, 72.5% were infarcts and 27.5% were hemorrhagic strokes, with vast majority of both types of strokes were in the middle cerebral artery territory (MCA). A total of 31 (38.8%) of our patients were noted to have hemispatial neglect, with the highest number of cases being associated with MCA strokes. Almost half of our patients with MCA strokes suffered from neglect. Neglect was more common in male patients. Out of the 31 patients suffering from visuospatial neglect, only 16% actually received rotigotine and 80% of them were noted to have an objective improvement in their neglect tests and 20% revealed subjective improvement. After thoroughly going through neglect-associated documentation, the following recommendations/plans were put in place for the future. We plan to liaise with the occupational therapy team at our rehab unit to set a battery of tests that would be done on all patients presenting with neglect and recommend clear documentation of outcomes of each neglect screen under it. Also to create two proformas; one for the therapy team to aid in systematic documentation of neglect screens done prior to and after rotigotine administration and a second proforma for the medical team with clear documentation of rotigotine use, its benefits and any contraindications if not administered.

Keywords: hemispatial Neglect, right hemispheric stroke, rotigotine, neglect, dopamine agonist

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556 Role of Psychological Capital in Organizational and Personal Outcomes: An Exploratory Study of Medical Professionals in Pakistan

Authors: Shazia Almas, Jaffar Iqbal, Nazia Almas

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In most of the South Asian countries like Pakistan medical profession is one the most valued and respectful professions yet being a medical professional requires an enormous amount of responsibilities and work overload at the same time which possibly can be in contrast with family role of a doctor. Job and family are two primary spheres of a person's life no matter whatever the profession one adopts and the type of family one is running. There is a bi-directional relationship between job and family. The type and nature of work, time schedules, working shifts in medical profession are very demanding in the countries like Pakistan where number of patients is far more higher than the number of doctors available. The work life also have significant impact on family life and vice versa. Because of the sensitivity and interdependency of these relations, today’s overarching and competing demands remain dissatisfactory. The main objective of the current research is to investigate how interpersonal relationships affect work and work affects interpersonal relationships of medical professionals. In line with identifying these facts, the current study aimed to examine the predictive role of psychological capital (self-efficacy, hope, optimism, and resilience), in organizational outcome (job satisfaction) and personal outcome (family satisfaction) amongst male and medical professionals. A total of 350 participants from public and private sector hospitals of Pakistan were recruited through simple random and stratified sampling techniques, with age ranges from 26-50 years. The questionnaire including established and certified self-report measures of Psychological Capital Questionnaire, Job Satisfaction, and Family Satisfaction were adopted to collect the data. The reliability and validity of mentioned instruments were established through Cronbach’s alpha and factor analyses (exploratory and confirmatory) respectively using Structural Equation Modeling (SEM) by AMOS. The proposed hypotheses were tested using Pearson’s Correlation and Regression analyses for predicting effect whereas, t-Test was deployed to verify the difference between male and female health professionals. The results revealed that self-efficacy and optimism predicted job satisfaction while, self-efficacy, hope, and resilience predicted family satisfaction. Moreover, the results depicted significant gender differences in job satisfaction where females were higher on job satisfaction as compared to male medical professionals but no significant differences were observed in levels of family satisfaction between both genders. The study has implications for social, organizational and work policy designers. The study also paves for more researches with positive psychological approach to promote work-family harmony.

Keywords: family satisfaction, job satisfaction, medical professionals, psychological capital

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555 Branding in FMCG Sector in India: A Comparison of Indian and Multinational Companies

Authors: Pragati Sirohi, Vivek Singh Rana

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Brand is a name, term, sign, symbol or design or a combination of all these which is intended to identify the goods or services of one seller or a group of sellers and to differentiate them from those of the competitors and perception influences purchase decisions here and so building that perception is critical. The FMCG industry is a low margin business. Volumes hold the key to success in this industry. Therefore, the industry has a strong emphasis on marketing. Creating strong brands is important for FMCG companies and they devote considerable money and effort in developing brands. Brand loyalty is fickle. Companies know this and that is why they relentlessly work towards brand building. The purpose of the study is a comparison between Indian and Multinational companies with regard to FMCG sector in India. It has been hypothesized that after liberalization the Indian companies has taken up the challenge of globalization and some of these are giving a stiff competition to MNCs. There is an existence of strong brand image of MNCs compared to Indian companies. Advertisement expenditures of MNCs are proportionately higher compared to Indian counterparts. The operational area of the study is the country as a whole. Continuous time series data is available from 1996-2014 for the selected 8 companies. The selection of these companies is done on the basis of their large market share, brand equity and prominence in the market. Research methodology focuses on finding trend growth rates of market capitalization, net worth, and brand values through regression analysis by the usage of secondary data from prowess database developed by CMIE (Centre for monitoring Indian Economy). Estimation of brand values of selected FMCG companies is being attempted, which can be taken to be the excess of market capitalization over the net worth of a company. Brand value indices are calculated. Correlation between brand values and advertising expenditure is also measured to assess the effect of advertising on branding. Major results indicate that although MNCs enjoy stronger brand image but few Indian companies like ITC is the outstanding leader in terms of its market capitalization and brand values. Dabur and Tata Global Beverages Ltd are competing equally well on these values. Advertisement expenditures are the highest for HUL followed by ITC, Colgate and Dabur which shows that Indian companies are not behind in the race. Although advertisement expenditures are playing a role in brand building process there are many other factors which affect the process. Also, brand values are decreasing over the years for FMCG companies in India which show that competition is intense with aggressive price wars and brand clutter. Implications for Indian companies are that they have to consistently put in proactive and relentless efforts in their brand building process. Brands need focus and consistency. Brand longevity without innovation leads to brand respect but does not create brand value.

Keywords: brand value, FMCG, market capitalization, net worth

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554 Redeeming the Self-Settling Scores with the Nazis by the Means of Poetics

Authors: Liliane Steiner

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Beyond the testimonial act, that sheds light on the feminine experience in the Holocaust, the survivors' writing voices first and foremost the abjection of the feminine self brutally inflicted by the Nazis in the Holocaust, and in the same movement redeems the self by the means of poetics, and brings it to an existential state of being a subject. This study aims to stress the poetics of this writing in order to promote the Holocaust literature from the margins to the mainstream and to contribute to the commemoration of the Holocaust in the next generations. Methodology: The study of the survivors' redeeming of self is based on Julia Kristeva's theory of the abject: the self-throws out everything that threatens its existence and Liliane Steiner's theory of the post- abjection of hell: the belated act of vomiting the abject experiences settles cores with the author of the abject to redeem the self. The research will focus on Ruth Sender's trilogy The Cage, To Life and The Holocaust Lady as a case study. Findings: The binary mode that characterizes this writing reflects the experience of Jewish women, who were subject(s), were treated violently as object(s), debased, defeminized and, eventually turned into abject by the Nazis. In a tour de force, this writing re-enacts the postponed resistance, that vomited the abject imposed on the feminine self by the very act of narration, which denounces the real abject, the perpetrators. The post-abjection of self is acted out in constructs of abject, relating the abject experience of the Holocaust as well as the rehabilitation of the surviving self (subject). The transcription of abject surfaces in deconstructing the abject through self- characterization, and in the elusive rendering of bad memories, having recourse to literary figures. The narrative 'I' selects, obstructs, mends and tells the past events from an active standpoint, as would a subject in control of its (narrative) fate. In a compensatory movement, the narrating I tells itself by reconstructing the subject and proving time and again that I is other. Moreover, in the belated endeavor to revenge, testify and narrate the abject, the narrative I defies itself, and represents itself as a dialectical I, splitting and multiplying itself in a deconstructing way. The dialectical I is never (one) I. It voices not only the unvoiced but also and mainly the other silenced 'I's. Drawing its nature and construct from traumatic memories, the dialectical I transgresses boundaries to narrate her story, and in the same breath, the story of Jewish women doomed to silence. In this narrative feat, the dialectical I stresses its essential dialectical existence with the past, never to be (one) again. Conclusion: The pattern of I is other generates patterns of subject(s) that defy, transgress and repudiate the abject and its repercussions on the feminine I. The feminine I writes itself as a survivor that defies the abject (Nazis) and takes revenge. The paradigm of metamorphosis that accompanies the journey of the Holocaust memoirist engenders life and surviving as well as a narration that defies stagnation and death.

Keywords: abject, feminine writing, holocaust, post-abjection

Procedia PDF Downloads 85
553 Determination of the Knowledge Level of Healthcare Professional's Working at the Emergency Services in Turkey about Their Approaches to Common Forensic Cases

Authors: E. Tuğba Topçu, Ebru E. Kazan, Erhan Büken

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Emergency nurses are the first health care professional to generally observe the patients, communicate patients’ family or relatives, touch the properties of patients and contact to laboratory sample of patients. Also, they are the encounter incidents related crime, people who engage in violence or suspicious injuries frequently. So, documentation of patients’ condition came to the hospital and conservation of evidence are important in the inquiry of forensic medicine. The aim of the study was to determine the knowledge level of healthcare professional working at the emergency services regarding their approaches to common forensic cases. The study was comprised of 404 healthcare professional working (nurse, emergency medicine technician, health officer) at the emergency services of 6 state hospitals, 6 training and 6 research hospitals and 3 university hospitals in Ankara. Data was collected using questionnaire form which was developed by researches in the direction of literature. Questionnaire form is comprised of two sections. The first section includes 17 questions related demographic information about health care professional and 4 questions related Turkish laws. The second section includes 43 questions to the determination of knowledge level of health care professional’s working in the emergency department, about approaches to frequently encountered forensic cases. For the data evaluation of the study; Mann Whitney U test, Bonferroni correction Kruskal Wallis H test and Chi Square tests have been used. According to study, it’s said that there is no forensic medicine expert in the foundation by 73.4% of health care professionals. Two third (66%) of participants’ in emergency department reported daily average 7 or above forensic cases applied to the emergency department and 52.1% of participants did not evaluate incidents came to the emergency department as a forensic case. Most of the participants informed 'duty of preservation of evidence' is health care professionals duty related forensic cases. In result, we determinated that knowledge level of health care professional working in the emergency department, about approaches to frequently encountered forensic cases, is not the expected level. Because we found that most of them haven't received education about forensic nursing.Postgraduates participants, educated health professional about forensic nursing, staff who applied to sources about forensic nursing and staff who evaluated emergency department cases as forensic cases have significantly higher level of knowledge. Moreover, it’s found that forensic cases diagnosis score is the highest in health officer and university graduated. Health care professional’s deficiency in knowledge about forensic cases can cause defects in operation of the forensic process because of mistakes in collecting and conserving of evidence. It is obvious that training about the approach to forensic nursing should be arranged.

Keywords: emergency nurses, forensic case, forensic nursing, level of knowledge

Procedia PDF Downloads 265
552 How Does Paradoxical Leadership Enhance Organizational Success?

Authors: Wageeh A. Nafei

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This paper explores the role of Paradoxical Leadership (PL) in enhancing Organizational Success (OS) at private hospitals in Egypt. Based on the collected data from employees in private hospitals (doctors, nursing staff, and administrative staff). The researcher has adopted a sampling method to collect data for the study. The appropriate statistical methods, such as Alpha Correlation Coefficient (ACC), Confirmatory Factor Analysis (CFA), and Multiple Regression Analysis (MRA), are used to analyze the data and test the hypotheses. The research has reached a number of results, the most important of which are (1) there is a statistical relationship between the independent variable represented by PL and the dependent variable represented by Organizational Success (OS). The paradoxical leader encourages employees to express their opinions and builds a work environment characterized by flexibility and independence. Also, the paradoxical leader works to support specialized work teams, which leads to the creation of new ideas, on the one hand, and contributes to the achievement of outstanding performance on the other hand. (2) the mentality of the paradoxical leader is flexible and capable of absorbing all suggestions from all employees. Also, the paradoxical leader is interested in enhancing cooperation among them and provides an opportunity to transfer experience and increase knowledge-sharing. Also, the sharing of knowledge creates the necessary diversity that helps the organization to obtain rich external information and enables the organization to deal with a rapidly changing environment. (3) The PL approach helps in facing the paradoxical demands of employees. A paradoxical leader plays an important role in reducing the feeling of instability in the work environment and lack of job security, reducing negative feelings for employees, restoring balance in the work environment, improving the well-being of employees, and increasing the degree of job satisfaction of employees in the organization. The study referred to a number of recommendations, the most important of which are (1) the leaders of the organizations must listen to the views of employees and their needs and move away from the official method of control. The leader should give sufficient freedom to employees to participate in decision-making and maintain enough space among them. The treatment between the leaders and employees must be based on friendliness, (2) the need for organizational leaders to pay attention to sharing knowledge among employees through training courses. The leader should make sure that every information provided by the employee is valuable and useful, which can be used to solve a problem that may face his/her colleagues at work, (3) the need for organizational leaders to pay attention to sharing knowledge among employees through brainstorming sessions. The leader should ensure that employees obtain knowledge from their colleagues and share ideas and information among them. This is in addition to motivating employees to complete their work in a new creative way, which leads to employees’ not feeling bored of repeating the same routine procedures in the organization.

Keywords: paradoxical leadership, organizational success, human resourece, management

Procedia PDF Downloads 36
551 Influence of Spirituality on Health Outcomes and General Well-Being in Patients with End-Stage Renal Disease

Authors: Ali A Alshraifeen, Josie Evans, Kathleen Stoddart

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End-stage renal disease (ESRD) introduces physical, psychological, social, emotional and spiritual challenges into patients’ lives. Spirituality has been found to contribute to improved health outcomes, mainly in the areas of quality of life (QOL) and well-being. No studies exist to explore the influence of spirituality on the health outcomes and general well-being in patients with end-stage renal disease receiving hemodialysis (HD) treatment in Scotland. This study was conducted to explore spirituality in the daily lives of among these patients and how it may influence their QOL and general well-being. The study employed a qualitative method. Data were collected using semi-structured interviews with a sample of 21 patients. A thematic approach using Framework Analysis informed the qualitative data analysis. Participants were recruited from 11 dialysis units across four Health Boards in Scotland. The participants were regular patients attending the dialysis units three times per week. Four main themes emerged from the qualitative interviews: ‘Emotional and Psychological Turmoil’, ‘Life is Restricted’, ‘Spirituality’ and ‘Other Coping Strategies’. The findings suggest that patients’ QOL might be affected because of the physical challenges such as unremitting fatigue, disease unpredictability and being tied down to a dialysis machine, or the emotional and psychological challenges imposed by the disease into their lives such as wholesale changes, dialysis as a forced choice and having a sense of indebtedness. The findings also revealed that spirituality was an important coping strategy for the majority of participants who took part in the qualitative component (n=16). Different meanings of spirituality were identified including connection with God or Supernatural Being, connection with the self, others and nature/environment. Spirituality encouraged participants to accept their disease and offered them a sense of protection, instilled hope in them and helped them to maintain a positive attitude to carry on with their daily lives, which may have had a positive influence on their health outcomes and general well-being. The findings also revealed that humor was another coping strategy that helped to diffuse stress and anxiety for some participants and encouraged them to carry on with their lives. The findings from this study provide a significant contribution to a very limited body of work. The study contributes to our understanding of spirituality and how people receiving dialysis treatment use it to manage their daily lives. Spirituality is of particular interest due to its connection with health outcomes in patients with chronic illnesses. The link between spirituality and many chronic illnesses has gained some recognition, yet the identification of its influence on the health outcomes and well-being in patients with ESRD is still evolving. There is a need to understand patients’ experiences and examine the factors that influence their QOL and well-being to ensure that the services available are adequately tailored to them. Hence, further research is required to obtain a better understanding of the influence of spirituality on the health outcomes and general well-being of patients with ESRD.

Keywords: end-stage renal disease, general well-being, quality of life, spirituality

Procedia PDF Downloads 202
550 Xen45 Gel Implant in Open Angle Glaucoma: Efficacy, Safety and Predictors of Outcome

Authors: Fossarello Maurizio, Mattana Giorgio, Tatti Filippo.

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The most widely performed surgical procedure in Open-Angle Glaucoma (OAG) is trabeculectomy. Although this filtering procedure is extremely effective, surgical failure and postoperative complications are reported. Due to the its invasive nature and possible complications, trabeculectomy is usually reserved, in practice, for patients who are refractory to medical and laser therapy. Recently, a number of micro-invasive surgical techniques (MIGS: Micro-Invasive Glaucoma Surgery), have been introduced in clinical practice. They meet the criteria of micro-incisional approach, minimal tissue damage, short surgical time, reliable IOP reduction, extremely high safety profile and rapid post-operative recovery. Xen45 Gel Implant (Allergan, Dublin, Ireland) is one of the MIGS alternatives, and consists in a porcine gelatin tube designed to create an aqueous flow from the anterior chamber to the subconjunctival space, bypassing the resistance of the trabecular meshwork. In this study we report the results of this technique as a favorable option in the treatment of OAG for its benefits in term of efficacy and safety, either alone or in combination with cataract surgery. This is a retrospective, single-center study conducted in consecutive OAG patients, who underwent Xen45 Gel Stent implantation alone or in combination with phacoemulsification, from October 2018 to June 2019. The primary endpoint of the study was to evaluate the reduction of both IOP and number of antiglaucoma medications at 12 months. The secondary endpoint was to correlate filtering bleb morphology evaluated by means of anterior segment OCT with efficacy in IOP lowering and eventual further procedures requirement. Data were recorded on Microsoft Excel and study analysis was performed using Microsoft Excel and SPSS (IBM). Mean values with standard deviations were calculated for IOPs and number of antiglaucoma medications at all points. Kolmogorov-Smirnov test showed that IOP followed a normal distribution at all time, therefore the paired Student’s T test was used to compare baseline and postoperative mean IOP. Correlation between postoperative Day 1 IOP and Month 12 IOP was evaluated using Pearson coefficient. Thirty-six eyes of 36 patients were evaluated. As compared to baseline, mean IOP and the mean number of antiglaucoma medications significantly decreased from 27,33 ± 7,67 mmHg to 16,3 ± 2,89 mmHg (38,8% reduction) and from 2,64 ± 1,39 to 0,42 ± 0,8 (84% reduction), respectively, at 12 months after surgery (both p < 0,001). According to bleb morphology, eyes were divided in uniform group (n=8, 22,2%), subconjunctival separation group (n=5, 13,9%), microcystic multiform group (n=9, 25%) and multiple internal layer group (n=14, 38,9%). Comparing to baseline, there was no significative difference in IOP between the 4 groups at month 12 follow-up visit. Adverse events included bleb function decrease (n=14, 38,9%), hypotony (n=8, 22,2%) and choroidal detachment (n=2, 5,6%). All eyes presenting bleb flattening underwent needling and MMC injection. The higher percentage of patients that required secondary needling was in the uniform group (75%), with a significant difference between the groups (p=0,03). Xen45 gel stent, either alone or in combination with phacoemulsification, provided a significant lowering in both IOP and medical antiglaucoma treatment and an elevated safety profile.

Keywords: anterior segment OCT, bleb morphology, micro-invasive glaucoma surgery, open angle glaucoma, Xen45 gel implant

Procedia PDF Downloads 109
549 Road Systems as Environmental Barriers: An Overview of Roadways in Their Function as Fences for Wildlife Movement

Authors: Rachael Bentley, Callahan Gergen, Brodie Thiede

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Roadways have a significant impact on the environment in so far as they function as barriers to wildlife movement, both through road mortality and through resultant road avoidance. Roads have an im-mense presence worldwide, and it is predicted to increase substantially in the next thirty years. As roadways become even more common, it is important to consider their environmental impact, and to mitigate the negative effects which they have on wildlife and wildlife mobility. In a thorough analysis of several related studies, a common conclusion was that roads cause habitat fragmentation, which can lead split populations to evolve differently, for better or for worse. Though some populations adapted positively to roadways, becoming more resistant to road mortality, and more tolerant to noise and chemical contamination, many others experienced maladaptation, either due to chemical contamination in and around their environment, or because of genetic mutations from inbreeding when their population was fragmented too substantially to support a large enough group for healthy genetic exchange. Large mammals were especially susceptible to maladaptation from inbreed-ing, as they require larger areas to roam and therefore require even more space to sustain a healthy population. Regardless of whether a species evolved positively or negatively as a result of their proximity to a road, animals tended to avoid roads, making the genetic diversity from habitat fragmentation an exceedingly prevalent issue in the larger discussion of road ecology. Additionally, the consideration of solu-tions, such as overpasses and underpasses, is crucial to ensuring the long term survival of many wildlife populations. In studies addressing the effectiveness of overpasses and underpasses, it seemed as though animals adjusted well to these sorts of solutions, but strategic place-ment, as well as proper sizing, proper height, shelter from road noise, and other considerations were important in construction. When an underpass or overpass was well-built and well-shielded from human activity, animals’ usage of the structure increased significantly throughout its first five years, thus reconnecting previously divided populations. Still, these structures are costly and they are often unable to fully address certain issues such as light, noise, and contaminants from vehicles. Therefore, the need for further discussion of new, crea-tive solutions remains paramount. Roads are one of the most consistent and prominent features of today’s landscape, but their environmental impacts are largely overlooked. While roads are useful for connecting people, they divide landscapes and animal habitats. Therefore, further research and investment in possible solutions is necessary to mitigate the negative effects which roads have on wildlife mobility and to pre-vent issues from resultant habitat fragmentation.

Keywords: fences, habitat fragmentation, roadways, wildlife mobility

Procedia PDF Downloads 144
548 Flood Risk Assessment for Agricultural Production in a Tropical River Delta Considering Climate Change

Authors: Chandranath Chatterjee, Amina Khatun, Bhabagrahi Sahoo

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With the changing climate, precipitation events are intensified in the tropical river basins. Since these river basins are significantly influenced by the monsoonal rainfall pattern, critical impacts are observed on the agricultural practices in the downstream river reaches. This study analyses the crop damage and associated flood risk in terms of net benefit in the paddy-dominated tropical Indian delta of the Mahanadi River. The Mahanadi River basin lies in eastern part of the Indian sub-continent and is greatly affected by the southwest monsoon rainfall extending from the month of June to September. This river delta is highly flood-prone and has suffered from recurring high floods, especially after the 2000s. In this study, the lumped conceptual model, Nedbør Afstrømnings Model (NAM) from the suite of MIKE models, is used for rainfall-runoff modeling. The NAM model is laterally integrated with the MIKE11-Hydrodynamic (HD) model to route the runoffs up to the head of the delta region. To obtain the precipitation-derived future projected discharges at the head of the delta, nine Global Climate Models (GCMs), namely, BCC-CSM1.1(m), GFDL-CM3, GFDL-ESM2G, HadGEM2-AO, IPSL-CM5A-LR, IPSL-CM5A-MR, MIROC5, MIROC-ESM-CHEM and NorESM1-M, available in the Coupled Model Intercomparison Project-Phase 5 (CMIP5) archive are considered. These nine GCMs are previously found to best-capture the Indian Summer Monsoon rainfall. Based on the performance of the nine GCMs in reproducing the historical discharge pattern, three GCMs (HadGEM2-AO, IPSL-CM5A-MR and MIROC-ESM-CHEM) are selected. A higher Taylor Skill Score is considered as the GCM selection criteria. Thereafter, the 10-year return period design flood is estimated using L-moments based flood frequency analysis for the historical and three future projected periods (2010-2039, 2040-2069 and 2070-2099) under Representative Concentration Pathways (RCP) 4.5 and 8.5. A non-dimensional hydrograph analysis is performed to obtain the hydrographs for the historical/projected 10-year return period design floods. These hydrographs are forced into the calibrated and validated coupled 1D-2D hydrodynamic model, MIKE FLOOD, to simulate the flood inundation in the delta region. Historical and projected flood risk is defined based on the information about the flood inundation simulated by the MIKE FLOOD model and the inundation depth-damage-duration relationship of a normal rice variety cultivated in the river delta. In general, flood risk is expected to increase in all the future projected time periods as compared to the historical episode. Further, in comparison to the 2010s (2010-2039), an increased flood risk in the 2040s (2040-2069) is shown by all the three selected GCMs. However, the flood risk then declines in the 2070s as we move towards the end of the century (2070-2099). The methodology adopted herein for flood risk assessment is one of its kind and may be implemented in any world-river basin. The results obtained from this study can help in future flood preparedness by implementing suitable flood adaptation strategies.

Keywords: flood frequency analysis, flood risk, global climate models (GCMs), paddy cultivation

Procedia PDF Downloads 41
547 Genetic Diversity of Cord Blood of the National Center of Blood Transfusion, Mexico (NCBT)

Authors: J. Manuel Bello-López, Julieta Rojo-Medina

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Introduction: The transplant of Umbilical Cord Blood Units (UCBU) are a therapeutic possibility for patients with oncohaematological disorders, especially in children. In Mexico, 48.5% of oncological diseases in children 1-4 years old are leukemias; whereas in patients 5-14 and 15-24 years old, lymphomas and leukemias represent the second and third cause of death in these groups respectively. Therefore it is necessary to have more registries of UCBU in order to ensure genetic diversity in the country; the above because the search for appropriate a UCBU is increasingly difficult for patients of mixed ethnicity. Objective: To estimate the genetic diversity (polymorphisms) of Human Leucocyte Antigen (HLA) Class I (A, B) and Class II (DRB1) in UCBU cryopreserved for transplant at Cord Blood Bank of the NCBT. Material and Methods: HLA typing of 533 UCBU for transplant was performed from 2003-2012 at the Histocompatibility Laboratory from the Research Department (evaluated by Los Angeles Ca. Immunogenetics Center) of the NCBT. Class I HLA-A, HLA-B and Class II HLA-DRB1 typing was performed using medium resolution Sequence-Specific Primer (SSP). In cases of an ambiguity detected by SSP; Sequence-Specific Oligonucleotide (SSO) method was carried out. A strict analysis of populations genetic parameters were done in 5 representative UCBU populations. Results: 46.5% of UCBU were collected from Mexico City, State of Mexico (30.95%), Puebla (8.06%), Morelos (6.37%) and Veracruz (3.37%). The remaining UCBU (4.75%) are represented by other states. The identified genotypes correspond to Amerindian origins (HLA-A*02, 31; HLA-B*39, 15, 48), Caucasian (HLA-A*02, 68, 01, 30, 31; HLA-B*35, 15, 40, 44, 07 y HLA-DRB1*04, 08, 07, 15, 03, 14), Oriental (HLA-A*02, 30, 01, 31; HLA-B* 35, 39, 15, 40, 44, 07,48 y HLA-DRB1*04, 07,15, 03) and African (HLA-A*30 y HLA-DRB1*03). The genetic distances obtained by Cavalli-Sforza analysis of the five states showed significant genetic differences by comparing genetic frequencies. The shortest genetic distance exists between Mexico City and the state of Puebla (0.0039) and the largest between Veracruz and Morelos (0.0084). In order to identify significant differences between this states, the ANOVA test was performed. This demonstrates that UCBU is significantly different according to their origin (P <0.05). This is shown by the divergence between arms at the Dendogram of Neighbor-Joining. Conclusions: The NCBT provides UCBU in patients with oncohaematological disorders in all the country. There is a group of patients for which not compatible UCBU can be find due to the mixed ethnic origin. For example, the population of northern Mexico is mostly Caucasian. Most of the NCBT donors are of various ethnic origins, predominantly Amerindians and Caucasians; although some ethnic minorities like Oriental, African and pure Indian ethnics are not represented. The NCBT is, therefore, establishing agreements with different states of Mexico to promote the altruistic donation of Umbilical Cord Blood in order to enrich the genetic diversity in its files.

Keywords: cord blood, genetic diversity, human leucocyte antigen, transplant

Procedia PDF Downloads 361
546 A Study of Lapohan Traditional Pottery Making in Selakan Island, Semporna Sabah: An Initial Framework

Authors: Norhayati Ayob, Shamsu Mohamad

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This paper aims to provide an initial background of the process of making traditional ceramic pottery, focusing on the materials and the influence of culture heritage. Ceramic pottery is one of the hallmarks of Sabah’s heirloom, not only use as cooking and storage containers but also closely linked with folk cultures and heritage. The Bajau Laut ethnic community of Semporna or better known as the Sea Gypsies, mostly are boat dwellers and work as fishermen in the coast. This ethnic community is famous for their own artistic traditional heirloom, especially the traditional hand-made clay stove called Lapohan. It is found that in the daily life of Bajau Laut community, Lapohan (clay stove) is used to prepare the meal and as a food warmer while they are at the sea. Besides, Lapohan pottery conveys symbolic meaning of natural objects, which portrays the identity, and values of Bajau Laut community. It is acknowledged that the basic process of making potterywares was much the same for people all across the world, nevertheless, it is crucial to consider that different ethnic groups may have their own styles and choices of raw materials. Furthermore, it is still unknown why and how the Bajau Laut ethnic of Semporna get started making their own pottery and to survive until today by heavily depending on the raw materials available in Semporna. In addition, the emergent problem faced by the pottery maker in Sabah is the absence of young successor to continue the heirloom legacy. Therefore, this research aims to explore the traditional pottery making in Sabah, by investigating the background history of Lapohan pottery and to propose the classification of Lapohan based on design and motifs of traditional pottery that will be recognised throughout the study. It is postulated that different techniques and forms of making traditional pottery may produce different types of pottery in terms of surface decoration, shape, and size that portrays different cultures. This study will be conducted at Selakan Island, Semporna, which is the only location that still has Lapohan making. This study is also based on the chronological process of making pottery and taboos of the process of preparing the clay, forming, decoration technique, motif application and firing techniques. The relevant information for the study will be gathered from field study, including observation, in-depth interview and video recording. In-depth interviews will be conducted with several potters and the conversation and pottery making process will be recorded in order to understand the actual process of making Lapohan. The findings hope to provide several types of Lapohan based on different designs and cultures, for example, the one with flat-shape design or has round-shape on the top of clay stove will be labeled with suitable name based on their culture. In conclusion, it is hoped that this study will contribute to conservation for traditional pottery making in Sabah as well as to preserve their culture and heirloom for future generations.

Keywords: Bajau Laut, culture, Lapohan, traditional pottery

Procedia PDF Downloads 159
545 The Use of Stroke Journey Map in Improving Patients' Perceived Knowledge in Acute Stroke Unit

Authors: C. S. Chen, F. Y. Hui, B. S. Farhana, J. De Leon

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Introduction: Stroke can lead to long-term disability, affecting one’s quality of life. Providing stroke education to patient and family members is essential to optimize stroke recovery and prevent recurrent stroke. Currently, nurses conduct stroke education by handing out pamphlets and explaining their contents to patients. However, this is not always effective as nurses have varying levels of knowledge and depth of content discussed with the patient may not be consistent. With the advancement of information technology, health education is increasingly being disseminated via electronic software and studies have shown this to have benefitted patients. Hence, a multi-disciplinary team consisting of doctors, nurses and allied health professionals was formed to create the stroke journey map software to deliver consistent and concise stroke education. Research Objectives: To evaluate the effectiveness of using a stroke journey map software in improving patients’ perceived knowledge in the acute stroke unit during hospitalization. Methods: Patients admitted to the acute stroke unit were given stroke journey map software during patient education. The software consists of 31 interactive slides that are brightly coloured and 4 videos, based on input provided by the multi-disciplinary team. Participants were then assessed with pre-and-post survey questionnaires before and after viewing the software. The questionnaire consists of 10 questions with a 5-point Likert scale which sums up to a total score of 50. The inclusion criteria are patients diagnosed with ischemic stroke and are cognitively alert and oriented. This study was conducted between May 2017 to October 2017. Participation was voluntary. Results: A total of 33 participants participated in the study. The results demonstrated that the use of a stroke journey map as a stroke education medium was effective in improving patients’ perceived knowledge. A comparison of pre- and post-implementation data of stroke journey map revealed an overall mean increase in patients’ perceived knowledge from 24.06 to 40.06. The data is further broken down to evaluate patients’ perceived knowledge in 3 domains: (1) Understanding of disease process; (2) Management and treatment plans; (3) Post-discharge care. Each domain saw an increase in mean score from 10.7 to 16.2, 6.9 to 11.9 and 6.6 to 11.7 respectively. Project Impact: The implementation of stroke journey map has a positive impact in terms of (1) Increasing patient’s perceived knowledge which could contribute to greater empowerment of health; (2) Reducing need for stroke education material printouts making it environmentally friendly; (3) Decreasing time nurses spent on giving education resulting in more time to attend to patients’ needs. Conclusion: This study has demonstrated the benefit of using stroke journey map as a platform for stroke education. Overall, it has increased patients’ perceived knowledge in understanding their disease process, the management and treatment plans as well as the discharge process.

Keywords: acute stroke, education, ischemic stroke, knowledge, stroke

Procedia PDF Downloads 140
544 Light, Restorativeness and Performance in the Workplace: A Pilot Study

Authors: D. Scarpanti, M. Brondino, M. Pasini

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Background: the present study explores the role of light and restorativeness on work. According with the Attention Restoration Theory (ART) and a Model of Work Environment, the main idea is that some features of environment, i.e., lighting, influences the direct attention, and so, the performance. Restorativeness refers to the presence/absence level of all the characteristics of physical environment that help to regenerate direct attention. Specifically, lighting can affect level of fascination and attention in one hand; and in other hand promotes several biological functions via pineal gland. Different reviews on this topic show controversial results. In order to bring light on this topic, the hypotheses of this study are that lighting can affect the construct of restorativeness and, in the second time, the restorativeness can affect the performance. Method: the participants are 30 workers of a mechatronic company in the North Italy. Every subject answered to a questionnaire valuing their subjective perceptions of environment in a different way: some objective features of environment, like lighting, temperature and air quality; some subjective perceptions of this environment; finally, the participants answered about their perceived performance. The main attention is on the features of light and his components: visual comfort, general preferences and pleasantness; and the dimensions of the construct of restorativeness; fascination, coherence and being away. The construct of performance per se is conceptualized in three level: individual, team membership and organizational membership; and in three different components: proficiency, adaptability, and proactivity, for a total of 9 subcomponents. Findings: path analysis showed that some characteristics of lighting respectively affected the dimension of fascination; and, as expected, the dimension of fascination affected work performance. Conclusions: The present study is a first pilot step of a wide research. These first results can be summarized with the statement that lighting and restorativeness contribute to explain work performance variability: in details perceptions of visual comfort, satisfaction and pleasantness, and fascination respectively. Results related to fascination are particularly interesting because fascination is conceptualized as the opposite of the construct of direct attention. The main idea is, in order to regenerate attentional capacity, it’s necessary to provide a lacking of attention (fascination). The sample size did not permit to test simultaneously the role of the perceived characteristics of light to see how they differently contribute to predict fascination of the work environment. However, the results highlighted the important role that light could have in predicting restorativeness dimensions and probably with a larger sample we could find larger effects also on work performance. Furthermore, longitudinal data will contribute to better analyze the causal model along time. Applicative implications: the present pilot study highlights the relevant role of lighting and perceived restorativeness in the work environment and the importance to focus attention on light features and the restorative characteristics in the design of work environments.

Keywords: lighting, performance, restorativeness, workplace

Procedia PDF Downloads 133
543 Efficacy and Safety of Combination Therapy in Androgenetic Alopecia: Randomized Uncontrolled Evaluator, Blind Study

Authors: Shivani Dhande, Sanjiv Choudhary, Adarshlata Singh

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Introduction: Early age of onset of baldness has marked psychological impact on personality. Combination therapies have better efficacy than monotherapy in androgenetic alopecia. Although medical, surgical treatment and cosmetic aids are available for treatment of pattern baldness, medical is first preferred the line of treatment. Although only 5% topical minoxidil is USFDA approved, 10% is available in India since 2007. Efficacy of tablet finasteride is well established in male pattern baldness. 5% topical minoxidil is effective and safe in female pattern baldness. There is a role of saw palmetto in regrowth of scalp hair. With this background research was undertaken to study efficacy and safety of topical minoxidil 10% + tab. Finesteride (1mg) + dermaroller in male pattern baldness and topical minoxidil 5% + cap. Saw palmetto (320 mg) + dermaroller in female pattern baldness. Methods and Materials: It was a randomized uncontrolled evaluator blind study consisting of total 21 patients, 15 of male pattern baldness and 6 of female pattern baldness within 20-35 yrs of age were enrolled. Male patients had Hamilton grade 2-4 MPB and females had Ludwig grade 2 FPB. Male patients were treated with Tab Finesteride 1mg once daily + 10% topical Minoxidil 1ml twice daily for 6 months. Female patients were treated with Cap. Saw palmetto 320 mg once daily + 5% topical Minoxidil twice daily for 6 months. In both male & female patients dermaroller therapy was used once in 10 days for 4 sittings followed by once in 15 days for next 5 months. Blood pressure and possible side effects were monitored in every follow up visits. Pre and post treatment photographs were taken. Assessment of hair growth was done at baseline and at the end of 6 months. Patients satisfactory grading scale and Physician assessment of hair growth scale were used to assessing the results. Trichoscan was done for assessment of hair-shaft diameter and density. Pre and post treatment photographs and Trichoscan hair growth analysis (by diameter and density) was done by physician (dermatologist) not directly involved in this study (evaluator blind). Result: This combination therapy showed moderate response in female pattern alopecia and good to excellent results in male pattern alopecia at the end of 6 months. During therapy none of the patients showed side effects like hypotension, headache and loss of libido, hirsuitism. Mild irritation due to crystal deposition was noted by 3 patients. Conclusion: Effective and early treatment using combination therapy with higher percent of Minoxidil for rapid hair growth is necessary in initial period since it will boost up the self-confidence in patients leading to better treatment compliance. Subsequent maintenance of hair growth can be done with lower concentration. No significant side effects with treatment are observed in both group of patients.

Keywords: androgenetic alopecia, dermaroller, finasteride, minoxidil, saw palmetto

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542 Thinking Historiographically in the 21st Century: The Case of Spanish Musicology, a History of Music without History

Authors: Carmen Noheda

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This text provides a reflection on the way of thinking about the study of the history of music by examining the production of historiography in Spain at the turn of the century. Based on concepts developed by the historical theorist Jörn Rüsen, the article focuses on the following aspects: the theoretical artifacts that structure the interpretation of the limits of writing the history of music, the narrative patterns used to give meaning to the discourse of history, and the orientation context that functions as a source of criteria of significance for both interpretation and representation. This analysis intends to show that historical music theory is not only a means to abstractly explore the complex questions connected to the production of historical knowledge, but also a tool for obtaining concrete images about the intellectual practice of professional musicologists. Writing about the historiography of contemporary Spanish music is a task that requires both a knowledge of the history that is being written and investigated, as well as a familiarity with current theoretical trends and methodologies that allow for the recognition and definition of the different tendencies that have arisen in recent decades. With the objective of carrying out these premises, this project takes as its point of departure the 'immediate historiography' in relation to Spanish music at the beginning of the 21st century. The hesitation that Spanish musicology has shown in opening itself to new anthropological and sociological approaches, along with its rigidity in the face of the multiple shifts in dynamic forms of thinking about history, have produced a standstill whose consequences can be seen in the delayed reception of the historiographical revolutions that have emerged in the last century. Methodologically, this essay is underpinned by Rüsen’s notion of the disciplinary matrix, which is an important contribution to the understanding of historiography. Combined with his parallel conception of differing paradigms of historiography, it is useful for analyzing the present-day forms of thinking about the history of music. Following these theories, the article will in the first place address the characteristics and identification of present historiographical currents in Spanish musicology to thereby carry out an analysis based on the theories of Rüsen. Finally, it will establish some considerations for the future of musical historiography, whose atrophy has not only fostered the maintenance of an ingrained positivist tradition, but has also implied, in the case of Spain, an absence of methodological schools and an insufficient participation in international theoretical debates. An update of fundamental concepts has become necessary in order to understand that thinking historically about music demands that we remember that subjects are always linked by reciprocal interdependencies that structure and define what it is possible to create. In this sense, the fundamental aim of this research departs from the recognition that the history of music is embedded in the conditions that make it conceivable, communicable and comprehensible within a society.

Keywords: historiography, Jörn Rüssen, Spanish musicology, theory of history of music

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541 Distribution, Source Apportionment and Assessment of Pollution Level of Trace Metals in Water and Sediment of a Riverine Wetland of the Brahmaputra Valley

Authors: Kali Prasad Sarma, Sanghita Dutta

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Deepor Beel (DB), the lone Ramsar site and an important wetland of the Brahmaputra valley in the state of Assam. The local people from fourteen peripheral villages traditionally utilize the wetland for harvesting vegetables, flowers, aquatic seeds, medicinal plants, fish, molluscs, fodder for domestic cattle etc. Therefore, it is of great importance to understand the concentration and distribution of trace metals in water-sediment system of the beel in order to protect its ecological environment. DB lies between26°05′26′′N to 26°09′26′′N latitudes and 90°36′39′′E to 91°41′25′′E longitudes. Water samples from the surface layer of water up to 40cm deep and sediment samples from the top 5cm layer of surface sediments were collected. The trace metals in waters and sediments were analysed using ICP-OES. The organic Carbon was analysed using the TOC analyser. The different mineral present in the sediments were confirmed by X-ray diffraction method (XRD). SEM images were recorded for the samples using SEM, attached with energy dispersive X-ray unit, with an accelerating voltage of 20 kv. All the statistical analyses were performed using SPSS20.0 for windows. In the present research, distribution, source apportionment, temporal and spatial variability, extent of pollution and the ecological risk of eight toxic trace metals in sediments and water of DB were investigated. The average concentrations of chromium(Cr) (both the seasons), copper(Cu) and lead(Pb) (pre-monsoon) and zinc(Zn) and cadmium(Cd) (post-monsoon) in sediments were higher than the consensus based threshold concentration(TEC). The persistent exposure of toxic trace metals in sediments pose a potential threat, especially to sediment dwelling organisms. The degree of pollution in DB sediments for Pb, Cobalt (Co) Zn, Cd, Cr, Cu and arsenic (As) was assessed using Enrichment Factor (EF), Geo-accumulation index (Igeo) and Pollution Load Index (PLI). The results indicated that contamination of surface sediments in DB is dominated by Pb and Cd and to a lesser extent by Co, Fe, Cu, Cr, As and Zn. A significant positive correlation among the pairs of element Co/Fe, Zn/As in water, and Cr/Zn, Fe/As in sediments indicates similar source of origin of these metals. The effects of interaction among trace metals between water and sediments shows significant variations (F =94.02, P < 0.001), suggesting maximum mobility of trace metals in DB sediments and water. The source apportionment of the heavy metals was carried out using Principal Component Analysis (PCA). SEM-EDS detects the presence of Cd, Cu, Cr, Zn, Pb, As and Fe in the sediment sample. The average concentration of Cd, Zn, Pb and As in the bed sediments of DB are found to be higher than the crustal abundance. The EF values indicate that Cd and Pb are significantly enriched. From source apportionment studies of the eight metals using PCA revealed that Cd was anthropogenic in origin; Pb, As, Cr, and Zn had mixed sources; whereas Co, Cu and Fe were natural in origin.

Keywords: Deepor Beel, enrichment factor, principal component analysis, trace metals

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540 Accumulated Gender-Diverse Co-signing Experience, Knowledge Sharing, and Audit Quality

Authors: Anxuan Xie, Chun-Chan Yu

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Survey evidence provides support that auditors can gain professional knowledge not only from client firms but also from teammates they work with. Furthermore, given that knowledge is accumulated in nature, along with the reality that auditors today must work in an environment of increased diversity, whether the attributes of teammates will influence the effects of knowledge sharing and accumulation and ultimately influence an audit partner’s audit quality should be interesting research issues. We test whether the gender of co-signers will moderate the effect of a lead partner’s cooperative experiences on financial restatements. Furthermore, if the answer is “yes”, we further investigate the underlying reasons. We use data from Taiwan because, according to Taiwan’s law, engagement partners, who are basically two certificate public accountants from the same audit firm, are required to disclose (i.e., sign) their names in the audit report of public companies since 1983. Therefore, we can trace each engagement partner’s historic direct cooperative (co-signing) records and get large-sample data. We find that the benefits of knowledge sharing manifest primarily via co-signing audit reports with audit partners of different gender from the lead engagement partners, supporting the argument that in an audit setting, accumulated gender-diverse working relationship is positively associated with knowledge sharing, and therefore improve lead engagements’ audit quality. This study contributes to the extant literature in the following ways. First, we provide evidence that in the auditing setting, the experiences accumulated from cooperating with teammates of a different gender from the lead partner can improve audit quality. Given that most studies find evidence of negative effects of surface-level diversity on team performance, the results of this study support the prior literature that the association between diversity and knowledge sharing actually hinges on the context (e.g., organizational culture, task complexity) and “bridge” (a pre-existing commonality among team members that can smooth the process of diversity toward favorable results) among diversity team members. Second, this study also provides practical insights with respect to the audit firms’ policy of knowledge sharing and deployment of engagement partners. For example, for audit firms that appreciate the merits of knowledge sharing, the deployment of auditors of different gender within an audit team can help auditors accumulate audit-related knowledge, which will further benefit the future performance of those audit firms. Moreover, nowadays, client firms also attach importance to the diversity of their engagement partners. As their policy goals, lawmakers and regulators also continue to promote a gender-diverse working environment. The findings of this study indicate that for audit firms, gender diversity will not be just a means to cater to those groups. Third, for audit committees or other stakeholders, they can evaluate the quality of existing (or potential) lead partners by tracking their co-signing experiences, especially whether they have gender-diverse co-signing experiences.

Keywords: co-signing experiences, audit quality, knowledge sharing, gender diversity

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539 Socially Sustainable Urban Rehabilitation Projects: Case Study of Ortahisar, Trabzon

Authors: Elif Berna Var

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Cultural, physical, socio-economic, or politic changes occurred in urban areas might be resulted in the decaying period which may cause social problems. As a solution to that, urban renewal projects have been used in European countries since World War II whereas they have gained importance in Turkey after the 1980s. The first attempts were mostly related to physical or economic aspects which caused negative effects on social pattern later. Thus, social concerns have also started to include in renewal processes in developed countries. This integrative approach combining social, physical, and economic aspects promotes creating more sustainable neighbourhoods for both current and future generations. However, it is still a new subject for developing countries like Turkey. Concentrating on Trabzon-Turkey, this study highlights the importance of socially sustainable urban renewal processes especially in historical neighbourhoods where protecting the urban identity of the area is vital, as well as social structure, to create sustainable environments. Being in the historic city centre and having remarkable traditional houses, Ortahisar is an important image for Trabzon. Because of the fact that architectural and historical pattern of the area is still visible but need rehabilitations, it is preferred to use 'urban rehabilitation' as a way of urban renewal method for this study. A project is developed by the local government to create a secondary city centre and a new landmark for the city. But it is still ambiguous if this project can provide social sustainability of area which is one of the concerns of the research. In the study, it is suggested that social sustainability of an area can be achieved by several factors. In order to determine the factors affecting the social sustainability of an urban rehabilitation project, previous studies have been analysed and some common features are attempted to define. To achieve this, firstly, several analyses are conducted to find out social structure of Ortahisar. Secondly, structured interviews are implemented to 150 local people which aims to measure satisfaction level, awareness, the expectation of them, and to learn their demographical background in detail. Those data are used to define the critical factors for a more socially sustainable neighbourhood in Ortahisar. Later, the priority of those factors is asked to 50 experts and 150 local people to compare their attitudes and to find common criterias. According to the results, it can be said that social sustainability of Ortahisar neighbourhood can be improved by considering various factors like quality of urban areas, demographical factors, public participation, social cohesion and harmony, proprietorial factors, facilities of education and employment. In the end, several suggestions are made for Ortahisar case to promote more socially sustainable urban neighbourhood. As a pilot study highlighting the importance of social sustainability, it is hoped that this attempt might be the contributory effect on achieving more socially sustainable urban rehabilitation projects in Turkey.

Keywords: urban rehabilitation, social sustainability, Trabzon, Turkey

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538 Analyzing Temperature and Pressure Performance of a Natural Air-Circulation System

Authors: Emma S. Bowers

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Perturbations in global environments and temperatures have heightened the urgency of creating cost-efficient, energy-neutral building techniques. Structural responses to this thermal crisis have included designs (including those of the building standard PassivHaus) with airtightness, window placement, insulation, solar orientation, shading, and heat-exchange ventilators as potential solutions or interventions. Limitations in the predictability of the circulation of cooled air through the ambient temperature gradients throughout a structure are one of the major obstacles facing these enhanced building methods. A diverse range of air-cooling devices utilizing varying technologies is implemented around the world. Many of them worsen the problem of climate change by consuming energy. Using natural ventilation principles of air buoyancy and density to circulate fresh air throughout a building with no energy input can combat these obstacles. A unique prototype of an energy-neutral air-circulation system was constructed in order to investigate potential temperature and pressure gradients related to the stack effect (updraft of air through a building due to changes in air pressure). The stack effect principle maintains that since warmer air rises, it will leave an area of low pressure that cooler air will rush in to fill. The result is that warmer air will be expelled from the top of the building as cooler air is directed through the bottom, creating an updraft. Stack effect can be amplified by cooling the air near the bottom of a building and heating the air near the top. Using readily available, mostly recyclable or biodegradable materials, an insulated building module was constructed. A tri-part construction model was utilized: a subterranean earth-tube heat exchanger constructed of PVC pipe and placed in a horizontally oriented trench, an insulated, airtight cube aboveground to represent a building, and a solar chimney (painted black to increase heat in the out-going air). Pressure and temperature sensors were placed at four different heights within the module as well as outside, and data was collected for a period of 21 days. The air pressures and temperatures over the course of the experiment were compared and averaged. The promise of this design is that it represents a novel approach which directly addresses the obstacles of air flow and expense, using the physical principle of stack effect to draw a continuous supply of fresh air through the structure, using low-cost and readily available materials (and zero manufactured energy). This design serves as a model for novel approaches to creating temperature controlled buildings using zero energy and opens the door for future research into the effects of increasing module scale, increasing length and depth of the earth tube, and shading the building. (Model can be provided).

Keywords: air circulation, PassivHaus, stack effect, thermal gradient

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537 Targeting Matrix Metalloprotease-9 to Reduce Coronary Artery Manifestations of Kawasaki’s Disease

Authors: Mohammadjavad Sotoudeheian, Navid Farahmandian

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Kawasaki disease (KD) is the primary cause of acquired pediatric heart disease as an acute vasculitis. In children with prolonged fever, rash, and inflammation of the mucosa KD must be considered as a clinical diagnosis. There is a persuasive suggestion of immune-mediated damage as the pathophysiologic cascade of KD. For example, the invasion of cytotoxic T-cells supports a viral etiology and the inflammasome of the innate immune system is a critical component in the vasculitis formation in KD. Animal models of KD propose the cytokine profiles, such as increased IL-1 and GM-CSF, which cause vascular damage. CRP and IFN-γ elevated expression and the upregulation of IL-6, and IL-10 production are also described in previous studies. Untreated KD is a critical risk factor for coronary artery diseases and myocardial infarction. Vascular damage may encompass amplified T-cell activity. SMAD3 is an essential molecule in down-regulating T-cells and increasing expression of FoxP3. It has a critical effect in the differentiation of regulatory T-cells. The discrepancy of regulatory T-cells and pro-inflammatory Th17 has been studied in acute coronary syndrome during KD. However in the coronary artery damaged lymphocytes and IgA plasma cells are seen at the lesion locations, the major immune cells in the coronary lesions are monocytes/macrophages and neutrophils. These cells secrete TNF-α, and activates matrix metalloprotease (MMP)-9, reducing the integrity of vessels and prompting patients to arise aneurysm. MMPs can break down the components of the extracellular matrix and assist immune cell movement. IVIG as an effective form of treatment clarified the role of the immune system, which may target pathogenic antigens and regulate cytokine production. Several reports have revealed that in the coronary arteries, high expression of MMP-9 in monocyte/macrophage results in pathologic cascades. Curcumin is a potent antioxidant and anti-inflammatory molecule. Curcumin decreases the production of reactive oxygen and nitrogen species and inhibits transcription factors like AP-1 and NF-κB. Curcumin also contains the characteristics of inhibitory effects on MMPs, especially MMP-9. The upregulation of MMP-9 is an important cellular response. Curcumin treatment caused a reverse effect and down-regulates MMP-9 gene expression which may fund the anti-inflammatory effect. Curcumin inhibits MMP-9 expression via PKC and AMPK-dependent pathways in Human monocytes cells. Elevated expression and activity of MMP-9 are correlated with advanced vascular lesions. AMPK controls lipid metabolism and oxidation, and protein synthesis. AMPK is also necessary for the MMP-9 activity and THP-1 cell adhesion to endothelial cells. Curcumin was shown to inhibit the activation of AMPKα. Compound C (AMPK inhibitor) inhibits MMP-9 expression level. Therefore, through inactivating AMPKs and PKC, curcumin decreases the MMP-9 level, which results in inhibiting monocyte/macrophage differentiation. Compound C also suppress the phosphorylation of three major classes of MAP kinase signaling, suggesting that curcumin may suppress MMP-9 level by inactivation of MAPK pathways. MAPK cascades are activated to induce the expression of MMP-9. Curcumin inhibits MAPKs phosphorylation, which contributes to the down-regulation of MMP-9. This study demonstrated that the potential inhibitory properties of curcumin over MMP-9 lead to a therapeutic strategy to reduce the risk of coronary artery involvement during KD.

Keywords: MMP-9, coronary artery aneurysm, Kawasaki’s disease, curcumin, AMPK, immune system, NF-κB, MAPK

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