Search results for: challenges in higher institutions
12515 Detection of Helicobacter Pylori by PCR and ELISA Methods in Patients with Hyperlipidemia
Authors: Simin Khodabakhshi, Hossein Rassi
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Hyperlipidemia refers to any of several acquired or genetic disorders that result in a high level of lipids circulating in the blood. Helicobacter pylori infection is a contributing factor in the progression of hyperlipidemia with serum lipid changes. The aim of this study was to detect of Helicobacter pylori by PCR and serological methods in patients with hyperlipidemia. In this case-control study, 174 patients with hyperlipidemia and 174 healthy controls were studied. Also, demographics, physical and biochemical parameters were performed in all samples. The DNA extracted from blood specimens was amplified by H pylori cagA specific primers. The results show that H. pylori cagA positivity was detected in 79% of the hyperlipidemia and in 56% of the control group by ELISA test and 49% of the hyperlipidemia and in 24% of the control group by PCR test. Prevalence of H. pylori infection was significantly higher in hyperlipidemia as compared to controls. In addition, patients with hyperlipidemia had significantly higher values for triglyceride, total cholesterol, LDL-C, waist to hip ratio, body mass index, diastolic and systolic blood pressure and lower levels of HDL-C than control participants (all p < 0.0001). Our result detected the ELISA was a rapid and cost-effective detection and considering the high prevalence of cytotoxigenic H. pylori strains, cag A is suggested as a promising target for PCR and ELISA tests for detection of infection with toxigenic strains. In general, it can be concluded that molecular analysis of H. pylori cagA and clinical parameters are important in early detection of hyperlipidemia and atherosclerosis with H. pylori infection by PCR and ELISA tests.Keywords: Helicobacter pylori, hyperlipidemia, PCR, ELISA
Procedia PDF Downloads 19412514 Decoding Gender Disparities in AI: An Experimental Exploration Within the Realm of AI and Trust Building
Authors: Alexander Scott English, Yilin Ma, Xiaoying Liu
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The widespread use of artificial intelligence in everyday life has triggered a fervent discussion covering a wide range of areas. However, to date, research on the influence of gender in various segments and factors from a social science perspective is still limited. This study aims to explore whether there are gender differences in human trust in AI for its application in basic everyday life and correlates with human perceived similarity, perceived emotions (including competence and warmth), and attractiveness. We conducted a study involving 321 participants using a two-subject experimental design with a two-factor (masculinized vs. feminized voice of the AI) multiplied by a two-factor (pitch level of the AI's voice) between-subject experimental design. Four contexts were created for the study and randomly assigned. The results of the study showed significant gender differences in perceived similarity, trust, and perceived emotion of the AIs, with females rating them significantly higher than males. Trust was higher in relation to AIs presenting the same gender (e.g., human female to female AI, human male to male AI). Mediation modeling tests indicated that emotion perception and similarity played a sufficiently mediating role in trust. Notably, although trust in AIs was strongly correlated with human gender, there was no significant effect on the gender of the AI. In addition, the study discusses the effects of subjects' age, job search experience, and job type on the findings.Keywords: artificial intelligence, gender differences, human-robot trust, mediation modeling
Procedia PDF Downloads 3712513 Correlation of P53 Gene Expression With Serum Alanine Transaminase Levels and Hepatitis B Viral Load in Cirrhosis and Hepatocellular Carcinoma Patients
Authors: Umme Shahera, Saifullah Munshi, Munira Jahan, Afzalun Nessa, Shahinul Alam, Shahina Tabassum
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The development of HCC is a multi-stage process. Several extrinsic factors, such as aflatoxin, HBV, nutrition, alcohol, and trace elements are thought to initiate or/and promote the hepatocarcinogenesis. Alteration of p53 status is an important intrinsic factor in this process as p53 is essential for preventing inappropriate cell proliferation and maintaining genome integrity following genotoxic stress. This study was designed to assess the correlation of p53 gene expression with HBV-DNA and serum Alanine transaminase (ALT) in patients with cirrhosis and HCC. The study was conducted among 60 patients. The study population were divided into four groups (15 in each groups)-HBV positive cirrhosis, HBV negative cirrhosis, HBV positive HCC and HBV negative HCC. Expression of p53 gene was observed using real time PCR. P53 gene expressions in the above mentioned groups were correlated with serum ALT level and HBV viral load. p53 gene was significantly higher in HBV-positive patients with HCC than HBV-positive cirrhosis. Similarly, the expression of p53 was significantly higher in HBV-positive HCC than HBV-negative HCC patients. However, the expression of p53 was reduced in HBV-positive cirrhosis in comparison with HBV-negative cirrhosis. P53 gene expression in liver was not correlated with the serum levels of ALT in any of the study groups. HBV- DNA load also did not correlated with p53 gene expression in HBV positive HCC and HBV positive cirrhosis patients. This study shows that there was no significant change with the expression of p53 gene in any of the study groups with ALT level or viral load, though differential expression of p53 gene were observed in cirrhosis and HCC patients.Keywords: P53, ALT, HBV-DNA, liver cirrhosis, hepatocellular carcinoma
Procedia PDF Downloads 8912512 Implementation of Stop Tuberculosis Strategy in High Burden Country like India and the Role of Ni-Kshay Mitra
Authors: Upvan Chobera
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India bears the highest burden of tuberculosis globally, facing a significant incidence rate. To combat this public health challenge, the Ministry of Health and Family Welfare in India has launched an ambitious national strategic plan with the aim of achieving END TB targets by 2025. Addressing tuberculosis requires a comprehensive, multi-sectoral approach that encompasses factors such as nutritional support, living and working conditions, and improved access to diagnostics and treatment services. This study delves into the burden of tuberculosis in India, examining the government's strategic plan to combat the disease. Additionally, it explores the role of Ni-Kshay Mitra (community support) in this fight, encompassing various entities such as cooperative societies, corporations, elected representatives, individuals, institutions, non-government organizations, and political parties or individual donors. These efforts aim to enhance the response against tuberculosis, complementing the government's initiatives and catering to district-specific requirements, all coordinated with the district administration. It is important to note that the support provided under the Ni-Kshay Mitra initiative is supplementary to the free services offered by the National TB Elimination Program (NTEP) available to all patients.Keywords: end TB targets, Ni-kshay Mitra, NTEP, tuberculosis burden in India
Procedia PDF Downloads 7412511 The Difficulties Witnessed by People with Intellectual Disability in Transition to Work in Saudi Arabia
Authors: Adel S. Alanazi
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The transition of a student with a disability from school to work is the most crucial phase while moving from the stage of adolescence into early adulthood. In this process, young individuals face various difficulties and challenges in order to accomplish the next venture of life successfully. In this respect, this paper aims to examine the challenges encountered by the individuals with intellectual disabilities in transition to work in Saudi Arabia. For this purpose, this study has undertaken a qualitative research-based methodology; wherein interpretivist philosophy has been followed along with inductive approach and exploratory research design. The data for the research has been gathered with the help of semi-structured interviews, whose findings are analysed with the help of thematic analysis. Semi-structured interviews were conducted with parents of persons with intellectual disabilities, officials, supervisors and specialists of two vocational rehabilitation centres providing training to intellectually disabled students, in addition to that, directors of companies and websites in hiring those individuals. The total number of respondents for the interview was 15. The purposive sampling method was used to select the respondents for the interview. This sampling method is a non-probability sampling method which draws respondents from a known population and allows flexibility and suitability in selecting the participants for the study. The findings gathered from the interview revealed that the lack of awareness among their parents regarding the rights of their children who are intellectually disabled; the lack of adequate communication and coordination between various entities; concerns regarding their training and subsequent employment are the key difficulties experienced by the individuals with intellectual disabilities. Training in programmes such as bookbinding, carpentry, computing, agriculture, electricity and telephone exchange operations were involved as key training programmes. The findings of this study also revealed that information technology and media were playing a significant role in smoothing the transition to employment of individuals with intellectual disabilities. Furthermore, religious and cultural attitudes have been identified to be restricted for people with such disabilities in seeking advantages from job opportunities. On the basis of these findings, it can be implied that the information gathered through this study will serve to be highly beneficial for Saudi Arabian schools/ rehabilitation centres for individuals with intellectual disability to facilitate them in overcoming the problems they encounter during the transition to work.Keywords: intellectual disability, transition services, rehabilitation centre, employment
Procedia PDF Downloads 15412510 Community-Based Palliative Care for Patients with Cerebral Palsy and Developmental Disabilities
Authors: Elizabeth Grier, Meg Gemmill, Mary Martin, Leora Reiter, Herman Tang, Alexandra Donaldson, Isis Lunsky, Mia Wu
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Background: Individuals with Cerebral Palsy (CP) and/or IDD face numerous physical and mental health challenges, including difficulty accessing effective palliative care. The aim of this study is to assess the knowledge and comfort of healthcare providers in providing community-based palliative care for patients with Cerebral Palsy (CP) and severe to profound Intellectual and Developmental Disabilities (IDD). Methods: This study includes a mixed methods approach obtaining both quantitative and qualitative data. Quantitative data from palliative care practitioners was obtained through an online survey assessing comfort in symptom management, grief assessment, and goals of care discussion. This survey was distributed to physicians and allied health practitioners across Canada through the College of Family Physicians of Canada Member Interest Groups for Palliative Care and for IDD. Survey results guided the development of a semi-structured interview template, which was used to conduct a focus group on the same topic. Participants were four palliative care providers (3 physicians and one spiritual care practitioner). The focus group transcript is currently undergoing thematic analysis using NVivo 12 software. Results: 57 palliative care practitioners completed the survey. 87% of participants indicated they have provided palliative care services for persons with CP and/or IDD. Findings suggest practitioners are somewhat confident in identifying specific physical symptoms (dyspnea, pressure ulcers) but less confident in identifying physical/emotional pain, addressing grief, and prognosticating life expectancy in this population. 54% of responses indicated they had little/no training on palliating those with CP or IDD, and 45% somewhat or strongly disagree members of their profession can manage symptoms for this population. Focus group analysis is underway, and results will be available at the time of the poster presentation. Conclusion: Persons with CP and IDD are more likely to experience severe health inequities when accessing palliative care. Results of this study suggest further education is needed for palliative care professionals to address the barriers and challenges in providing palliative care to this patient population.Keywords: palliative care, symptom management, health equity, community healthcare, intellectual and developmental disabilities
Procedia PDF Downloads 13112509 The Miller Umwelt Assessment Scale: A Tool for Planning Interventions for Children on the Autism Spectrum
Authors: Sonia Mastrangelo
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The Miller Umwelt Assessment Scale is a useful tool for obtaining information about the developmental capacities of children on the autism spectrum. The assessment, made up of 19 tasks in the areas of: body organization, contact with surroundings, expressive and receptive communication, representation, and social-emotional development, has been used with much success over the past 40 years. While many assessments are difficult to administer to children on the autism spectrum, the simplicity of the MUAS reveals key strengths and challenges for both low and high functioning children on the spectrum. The results guide parents and clinicians in providing a curriculum and/or home program that moves children up the developmental ladder.Keywords: autism spectrum disorder, assessment, reading intervention, Miller method
Procedia PDF Downloads 53012508 Creating an Inclusive Classroom: Country Case Studies Analysis on Mainstream Teachers’ Teaching-Efficacy and Attitudes towards Inclusive Education in Japan and Singapore
Authors: Yei Mian Adrian Yap
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How we idealize the regular schools to be inclusive as much as possible hinges on mainstream teachers’ attitudes and teaching-efficacy towards the inclusion of students with special needs in the regular schools. This research studies the Japanese and Singaporean mainstream teachers’ attitudes and teaching-efficacy towards the inclusion of students with special needs in the regular classrooms by investigating what key variables influence their attitudes and teaching-efficacy and how they strategize to address their challenges to include their students with special needs in their regular classrooms. In order to understand the nature of teachers’ attitudes and teaching-efficacy towards the inclusive education, a mixed-method research methodology was carried out in Japan and Singapore; it involved an explanatory sequential method of employing quantitative research first before qualitative research. In the quantitative research, 189 Japanese and 183 Singaporean teachers were invited to participate in the questionnaires and out of these participants, 38 Japanese and 15 Singaporean teachers shared their views during their semi-structured interviews. Based on the empirical findings, Japanese teachers’ attitudes and teaching-efficacy were more likely to be influenced by their experiences in teaching students with special needs, knowledge about disability legislation, presence of their disabled family members and level of confidence to teach students with special needs. On the other hand, Singaporean teachers’ attitudes and teaching-efficacy were affected by gender, educational level, received trainings in special needs education, knowledge about disability legislation and level of confidence to teach students with special needs. Both country results also demonstrated that there was a positive correlation between their teaching-efficacy and attitude. Narrative findings further expanded the reasons behind these quantitative factors that shaped teachers’ attitudes and teaching-efficacy. Also it discussed the various problems faced by Japanese and Singaporean teachers and how they identified their coping strategies to circumvent their challenges in including their students with special needs in their regular classrooms. The significance of this research manifests in necessary educational reforms in both countries especially in the context of inclusive education. These findings may not be as definitive as expected but it is believed that it could provide useful information on the current situation about teachers’ concerns towards the inclusive education. In conclusion, this research could potentially make its positive contribution to the body of literature on teachers’ attitudes and teaching-efficacy in the context of Asian developed countries and these findings could posit that regular teachers’ positive attitudes and strong sense of teaching self-efficacy could directly improve the success rate of inclusion of students with special needs in the regular classrooms.Keywords: attitudes, inclusive education, special education, teaching-efficacy
Procedia PDF Downloads 33312507 Cognition in Crisis: Unravelling the Link Between COVID-19 and Cognitive-Linguistic Impairments
Authors: Celine Davis
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The novel coronavirus 2019 (COVID-19) is an infectious disease caused by the virus SARS-CoV-2, which has detrimental respiratory, cardiovascular, and neurological effects impacting over one million lives in the United States. New researches has emerged indicating long-term neurologic consequences in those who survive COVID-19 infections, including more than seven million Americans and another 27 million people worldwide. These consequences include attentional deficits, memory impairments, executive function deficits and aphasia-like symptoms which fall within the purview of speech-language pathology. The National Health Interview Survey (NHIS) is a comprehensive annual survey conducted by the National Center for Health Statistics (NCHS), a branch of the Centers for Disease Control and Prevention (CDC) in the United States. The NHIS is one of the most significant sources of health-related data in the country and has been conducted since 1957. The longitudinal nature of the study allows for analysis of trends in various variables over the years, which can be essential for understanding societal changes and making treatment recommendations. This current study will utilize NHIS data from 2020-2022 which contained interview questions specifically related to COVID-19. Adult cases of individuals between the ages of 18-50 diagnosed with COVID-19 in the United States during 2020-2022 will be identified using the National Health Interview Survey (NHIS). Multiple regression analysis of self-reported data confirming COVID-19 infection status and challenges with concentration, communication, and memory will be performed. Latent class analysis will be utilized to identify subgroups in the population to indicate whether certain demographic groups have higher susceptibility to cognitive-linguistic deficits associated with COVID-19. Completion of this study will reveal whether there is an association between confirmed COVID-19 diagnosis and heightened incidence of cognitive deficits and subsequent implications, if any, on activities of daily living. This study is distinct in its aim to utilize national survey data to explore the relationship between confirmed COVID-19 diagnosis and the prevalence of cognitive-communication deficits with a secondary focus on resulting activity limitations. To the best of the author’s knowledge, this will be the first large-scale epidemiological study investigating the associations between cognitive-linguistic deficits, COVID-19 and implications on activities of daily living in the United States population. These findings will highlight the need for targeted interventions and support services to address the cognitive-communication needs of individuals recovering from COVID-19, thereby enhancing their overall well-being and functional outcomes.Keywords: cognition, COVID-19, language, limitations, memory, NHIS
Procedia PDF Downloads 4212506 Studies of Lactose Utilization in Microalgal Isolate for Further Use in Dairy By-Product Bioconversion
Authors: Sergejs Kolesovs, Armands Vigants
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The use of dairy industry by-products and wastewater as a cheap substrate for microalgal growth is gaining recognition. However, the mechanisms of lactose utilization remain understudied, limiting the potential of successful microalgal biomass production using various dairy by-products, such as whey and permeate. The necessity for microalgae to produce a specific enzyme, β-galactosidase, requires the selection of suitable strains. This study focuses on a freshwater microalgal isolate's ability to grow on a semi-synthetic medium supplemented with lactose. After 10 days of agitated cultivation, an axenic microalgal isolate achieved significantly higher biomass production under mixotrophic growth conditions (0.86 ± 0.07 g/L, dry weight) than heterotrophic growth (0.46 ± 0.04 g/L). Moreover, mixotrophic cultivation had significantly higher biomass production compared to photoautotrophic growth (0.67 ± 0.05 g/L). The activity of β-galactosidase was detected in both supernatant and microalgal biomass under mixotrophic and heterotrophic growth conditions, showing the potential of extracellular and intracellular mechanisms of enzyme production. However, the main limiting factor in this study was the increase of pH values during the cultivation, significantly reducing the activity of the β-galactosidase enzyme after 3rd day of cultivation. It highlights the need for stricter control of growth parameters to ensure the enzyme's activity. Further research will assess the isolate's suitability for dairy by-product bioconversion and biomass composition.Keywords: microalgae, lactose, whey, permeate, beta-galactosidase, mixotrophy, heterotrophy
Procedia PDF Downloads 4812505 Developing the P1-P7 Management and Analysis Software for Thai Child Evaluation (TCE) of Food and Nutrition Status
Authors: S. Damapong, C. Kingkeow, W. Kongnoo, P. Pattapokin, S. Pruenglamphu
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As the presence of Thai children double burden malnutrition, we conducted a project to promote holistic age-appropriate nutrition for Thai children. Researchers developed P1-P7 computer software for managing and analyzing diverse types of collected data. The study objectives were: i) to use software to manage and analyze the collected data, ii) to evaluate the children nutritional status and their caretakers’ nutrition practice to create regulations for improving nutrition. Data were collected by means of questionnaires, called P1-P7. P1, P2 and P5 were for children and caretakers, and others were for institutions. The children nutritional status, height-for-age, weight-for-age, and weight-for-height standards were calculated using Thai child z-score references. Institution evaluations consisted of various standard regulations including the use of our software. The results showed that the software was used in 44 out of 118 communities (37.3%), 57 out of 240 child development centers and nurseries (23.8%), and 105 out of 152 schools (69.1%). No major problems have been reported with the software, although user efficiency can be increased further through additional training. As the result, the P1-P7 software was used to manage and analyze nutritional status, nutrition behavior, and environmental conditions, in order to conduct Thai Child Evaluation (TCE). The software was most widely used in schools. Some aspects of P1-P7’s questionnaires could be modified to increase ease of use and efficiency.Keywords: P1-P7 software, Thai child evaluation, nutritional status, malnutrition
Procedia PDF Downloads 34712504 Effects of Supplementation of Nano-Particle Zinc Oxide and Mannan-Oligosaccharide (MOS) on Growth, Feed Utilization, Fatty Acid Profile, Intestinal Morphology, and Hematology in Nile tilapia, Oreochromis niloticus (L.) fry
Authors: Tewodros Abate Alemayehu, Abebe Getahun, Akewake Geremew, Dawit Solomon Demeke, John Recha, Dawit Solomon, Gebremedihin Ambaw, Fasil Dawit Moges
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The purpose of this study was to examine the effects of supplementation of zinc oxide (ZnO) nanoparticles and Mannan-oligosaccharide (MOS) on growth performance, feed utilization, fatty acid profiles, hematology, and intestinal morphology of Chamo strain Nile tilapia Oreochromis niloticus (L.) fry reared at optimal temperature (28.62 ± 0.11 ⁰C). Nile tilapia fry (initial weight 1.45 ± 0.01g) were fed basal diet/control diet (Diet-T1), 6 g kg-¹ MOS supplemented diet (Diet-T2), 4 mg ZnO-NPs supplemented diet (Diet-T3), 4 mg ZnO-Bulk supplemented diet (Diet-T4), a combination of 6 g kg-¹ MOS and 4 mg ZnO-Bulk supplemented diet (Diet-T5) and combination of 6 g kg-¹ MOS and 4 mg ZnO-NPs supplemented diet (Diet-T6). Randomly, duplicate aquariums for each diet were assigned and hand-fed to apparent satiation three times daily (08:00, 12:00, and 16:00) for 12 weeks. Fish fed MOS, ZnO-NPs, and a combination of MOS and ZnO-Bulk supplemented diet had higher weight gain, Daily Growth Rate (DGR), and Specific Growth Rate (SGR) than fish fed the basal diet and other feeding groups, although the effect was not significant. According to the GC analysis, Nile tilapia was supplemented with 6 g kg-¹ MOS, 4 mg ZnO-NPs, or a combination of ZnO-NPs, and MOS showed the highest content of EPA, DHA, and higher ratios of PUFA/SFA than other feeding groups. Mean villi length in the proximal and middle portion of the Nile tilapia intestine was affected significantly (p<0.05) by diet. Fish fed Diet-T2 and Diet-T3 had significantly higher villi lengths in the proximal and middle portions of the intestine compared to other feeding groups. The inclusion of additives significantly improved goblet numbers at the proximal, middle, and distal portions of the intestine. Supplementation of additives had also improved some hematological parameters compared with control groups. In conclusion, dietary supplementation of additives MOS and ZnO-NPs could confer benefits on growth performance, fatty acid profiles, hematology, and intestinal morphology of Chamo strain Nile tilapia.Keywords: chamo strain nile tilapia, fatty acid profile, hematology, intestinal morphology, MOS, ZnO-Bulk, ZnO-NPs
Procedia PDF Downloads 6712503 Perovskite Nanocrystals and Quantum Dots: Advancements in Light-Harvesting Capabilities for Photovoltaic Technologies
Authors: Mehrnaz Mostafavi
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Perovskite nanocrystals and quantum dots have emerged as leaders in the field of photovoltaic technologies, demonstrating exceptional light-harvesting abilities and stability. This study investigates the substantial progress and potential of these nano-sized materials in transforming solar energy conversion. The research delves into the foundational characteristics and production methods of perovskite nanocrystals and quantum dots, elucidating their distinct optical and electronic properties that render them well-suited for photovoltaic applications. Specifically, it examines their outstanding light absorption capabilities, enabling more effective utilization of a wider solar spectrum compared to traditional silicon-based solar cells. Furthermore, this paper explores the improved durability achieved in perovskite nanocrystals and quantum dots, overcoming previous challenges related to degradation and inconsistent performance. Recent advancements in material engineering and techniques for surface passivation have significantly contributed to enhancing the long-term stability of these nanomaterials, making them more commercially feasible for solar cell usage. The study also delves into the advancements in device designs that incorporate perovskite nanocrystals and quantum dots. Innovative strategies, such as tandem solar cells and hybrid structures integrating these nanomaterials with conventional photovoltaic technologies, are discussed. These approaches highlight synergistic effects that boost efficiency and performance. Additionally, this paper addresses ongoing challenges and research endeavors aimed at further improving the efficiency, stability, and scalability of perovskite nanocrystals and quantum dots in photovoltaics. Efforts to mitigate concerns related to material degradation, toxicity, and large-scale production are actively pursued, paving the way for broader commercial application. In conclusion, this paper emphasizes the significant role played by perovskite nanocrystals and quantum dots in advancing photovoltaic technologies. Their exceptional light-harvesting capabilities, combined with increased stability, promise a bright future for next-generation solar cells, ushering in an era of highly efficient and cost-effective solar energy conversion systems.Keywords: perovskite nanocrystals, quantum dots, photovoltaic technologies, light-harvesting, solar energy conversion, stability, device designs
Procedia PDF Downloads 7812502 The Prognostic Value of Dynamic Changes of Hematological Indices in Oropharyngeal Cancer Patients Treated with Radiotherapy
Authors: Yao Song, Danni Cheng, Jianjun Ren
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Objectives: We aimed to explore the prognostic effects of absolute values and dynamic changes of common hematological indices on oropharynx squamous cell carcinoma (OPSCC) patients treated with radiation. Methods and materials: The absolute values of white blood cell (WBC), absolute neutrophil count (ANC), absolute lymphocyte count (ALC), hemoglobin (Hb), platelet (Plt), albumin (Alb), neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) at baseline (within 45 days before radiation), 1-, 3-, 6- and 12-months after the start of radiotherapy were retrospectively collected. Locally-estimated smoothing scatterplots were used to describe the smooth trajectory of each index. A mixed-effect model with a random slope was fitted to describe the changing rate and trend of indices over time. Cox proportional hazard analysis was conducted to assess the correlation between hematological indices and treatment outcomes. Results: Of the enrolled 85 OPSCC patients, inflammatory indices, such as WBC and ALC, dropped rapidly during acute treatment and gradually recovered, while NLR and PLR increased at first three months and subsequently declined within 3-12 months. Higher absolute value or increasing trend of nutritional indices (Alb and Hb) was associated with better prognosis (all p<0.05). In contrast, patients with higher absolute value or upward trend of inflammatory indices (WBC, ANC, Plt, PLR and NLR) had worse survival (all p<0.05). Conclusions: The absolute values and dynamic changes of hematological indices were valuable prognostic factors for OPSCC patients who underwent radiotherapy.Keywords: hematological indices, oropharyngeal cancer, radiotherapy, NLR, PLR
Procedia PDF Downloads 17112501 Social Entrepreneurship against Depopulation: Network Analysis within the Theoretical Framework of the Quadruple Helix
Authors: Esperanza Garcia-Uceda, Josefina L. Murillo-Luna, M. Pilar Latorre-Martinez, Marta Ferrer-Serrano
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Social entrepreneurship represents an innovation of traditional business models. During the last decade, its important role in contributing to rural and regional development has been widely recognized, due to its capacity to combat the problem of depopulation through the creation of employment. However, the success of this type of innovative business initiatives depends to a large extent on the existence of an adequate ecosystem of support resources. Based on the theoretical framework of the quadruple helix (QH), which highlights the need for collaboration between different interest groups -university, industry, government and civil society- for the development of regional innovations, in this work the network analysis is applied to study the ecosystem of resources to support social entrepreneurship in the rural area of the province of Zaragoza (Spain). It is a quantitative analysis that can be used to measure the interactions between the different actors that make up the quadruple helix, as well as the networks created between the different institutions and support organizations, through the study of the complex networks they form. The results show the importance of the involvement of local governments and the university, as key elements in the development process, but also allow identifying other issues that are susceptible to improvement.Keywords: ecosystem of support resources, network analysis, quadruple helix, social entrepreneurship
Procedia PDF Downloads 24512500 Exploring the Birth of Modern Art in Borneo, Post-War Era 1945 to 1970
Authors: Rahah Hasan, Faridah Sahari
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This paper describes the development of modern art in Borneo, particularly in Sarawak, Sabah, and Brunei, after the Second World War until the 1970s. This was the period when the British Colonial government dictated the education system, which consequentially inculcated visual art through art and craft subjects imposed on all vernacular schools in Borneo. British influence within the state governance, social, and education system designed with Western ideology created not only a westernized society and mindset but at the same time generated artistic opportunities for emerging local painters to be involved in the initiation of Modern Art in Borneo. Through the historical method and analysis of primary and secondary data, it was obvious that the existence of colonial government departments and institutions such as museums and teaching colleges, and other social organizations in Borneo at that time contributed significantly to the artistic movement. The similar structure and motivation of development in other areas of Borneo confirmed that artistic affirmation of modern art advanced homogenously. Their understanding of easel painting as well as a unique interpretation of culture once distanced from traditional art, resulting in a new visual image that transcended their ethnicity and identity through new mediums and tools. These meticulous interventions modestly visualized in each painting, as discussed in this paper, hopefully, will give a deeper understanding and appreciation of the history of modern art in Borneo.Keywords: art history, Borneo art, fine art, modern art
Procedia PDF Downloads 13612499 In vitro Comparison Study of Biologically Synthesized Cupper-Disulfiram Nanoparticles with Its Free Corresponding Complex as Therapeutic Approach for Breast and Liver Cancer
Authors: Marwa M. Abu-Serie, Marwa M. Eltarahony
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The search for reliable, effective, and safe nanoparticles (NPs) as a treatment for cancer is a pressing priority. In this study, Cu-NPs were fabricated by Streptomyces cyaneofuscatus through simultaneous bioreduction strategy of copper nitrate salt. The as-prepared Cu-NPs subjected to structural analysis; energy-dispersive X-ray spectroscopy, elemental mapping, X-ray diffraction, transmission electron microscopy, and ζ-potential. These biological synthesized Cu-NPs were mixed with disulfiram (DS), forming a nanocomplex of Cu-DS with a size of ~135 nm. The prepared nanocomplex (nanoCu-DS) exhibited higher anticancer activity than that of free complex of DS-Cu, Cu-NPs, and DS alone. This was illustrated by the lowest IC50 of nanoCu-DS (< 4 µM) against human breast and liver cancer cell lines comparing with DS-Cu, Cu-NPs, and DS (~8, 22.98-33.51 and 11.95-14.86, respectively). Moreover, flow cytometric analysis confirmed that higher apoptosis percentage range of nanoCu-DS-treated in MDA-MB 231, MCF-7, Huh-7, and HepG-2 cells (51.24-65.28%) than free complex of Cu-DS ( < 4.5%). Regarding inhibition potency of liver and breast cancer cell migration, no significant difference was recorded between free and nanocomplex. Furthermore, nanoCu-DS suppressed gene expression of β-catenine, Akt, and NF-κB and upregulated p53 expression (> 3, >15, > 5 and ≥ 3 folds, respectively) more efficiently than free complex (all ~ 1 fold) in MDA-MB 231 and Huh-7 cells. Our finding proved this prepared nano complex has a powerful anticancer activity relative to free complex, thereby offering a promising cancer treatment.Keywords: biologically prepared Cu-NPs, breast cancer cell lines, liver cancer cell lines, nanoCu- disulfiram
Procedia PDF Downloads 18112498 Human Immunodeficiency Virus (HIV) Test Predictive Modeling and Identify Determinants of HIV Testing for People with Age above Fourteen Years in Ethiopia Using Data Mining Techniques: EDHS 2011
Authors: S. Abera, T. Gidey, W. Terefe
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Introduction: Testing for HIV is the key entry point to HIV prevention, treatment, and care and support services. Hence, predictive data mining techniques can greatly benefit to analyze and discover new patterns from huge datasets like that of EDHS 2011 data. Objectives: The objective of this study is to build a predictive modeling for HIV testing and identify determinants of HIV testing for adults with age above fourteen years using data mining techniques. Methods: Cross-Industry Standard Process for Data Mining (CRISP-DM) was used to predict the model for HIV testing and explore association rules between HIV testing and the selected attributes among adult Ethiopians. Decision tree, Naïve-Bayes, logistic regression and artificial neural networks of data mining techniques were used to build the predictive models. Results: The target dataset contained 30,625 study participants; of which 16, 515 (53.9%) were women. Nearly two-fifth; 17,719 (58%), have never been tested for HIV while the rest 12,906 (42%) had been tested. Ethiopians with higher wealth index, higher educational level, belonging 20 to 29 years old, having no stigmatizing attitude towards HIV positive person, urban residents, having HIV related knowledge, information about family planning on mass media and knowing a place where to get testing for HIV showed an increased patterns with respect to HIV testing. Conclusion and Recommendation: Public health interventions should consider the identified determinants to promote people to get testing for HIV.Keywords: data mining, HIV, testing, ethiopia
Procedia PDF Downloads 48812497 Characteristics of Interaction Forces Acting on a Newly-Design Rotary Blade for Thai Walking Tractor
Authors: Sirisak Choedkiatphon, Tanya Niyamapa
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This research aimed to indeed understand the soil-rotary blade interaction of the newly-design rotary blade for Thai walking tractor. Therefore, this study was carried out to clarify the characteristics of the horizontal and the vertical forces and the moment around a rotary shaft of prototype rotary blade 15 lengthwise slice angle. It was set up and tested in laboratory soil bin at Kasetsart University under sandy loam and clay soil at soil dry bulk density and soil specific weight of 9.81 kN/m3 and 11.3% (d.b.), respectively. The tests were conducted at travel speeds of 0.069 and 0.142 m/s and rotational speeds of 150, 250 and 350 rpm. The characteristic of pushing-forward and lifting-up forces and moment around a rotor shaft were obtained by using the EOR transducer. Also, the acting point of resultant force of these soil-blade reaction forces was determined. The pushing-forward and lifting-up forces, moment around a rotor shaft and resultant force increased at higher travel speed and higher soil moisture content. In tilling stage, the acting points of resultant force located inside the circumstance of the blade locus. The results showed that the variation of magnitude and direction of pushing-forward, lifting-up and resultant forces corresponded to soil-blade interaction of the newly-design in tilling stage.Keywords: rotary blde, soil-blade interaction, walking tractor, clay, sandy loam
Procedia PDF Downloads 20412496 The Effect of Framework Structure on N2O Formation over Cu-Based Zeolites during NH3-SCR Reactions
Authors: Ghodsieh Isapour Toutizad, Aiyong Wang, Joonsoo Han, Derek Creaser, Louise Olsson, Magnus Skoglundh, Hanna HaRelind
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Nitrous oxide (N2O), which is generally formed as a byproduct of industrial chemical processes and fossil fuel combustion, has attracted considerable attention due to its destructive role in global warming and ozone layer depletion. From various developed technologies used for lean NOx reduction, the selective catalytic reduction (SCR) of NOx with ammonia is presently the most applied method. Therefore, the development of catalysts for efficient lean NOx reduction without forming N2O in the process, or only forming it to a very small extent from the exhaust gases is of crucial significance. One type of catalysts that nowadays are used for this aim are zeolite-based catalysts. It is owing to their remarkable catalytic performance under practical reaction conditions such as high thermal stability and high N2 selectivity. Among all zeolites, copper ion-exchanged zeolites, with CHA, MFI, and BEA framework structure (like SSZ-13, ZSM-5 and Beta, respectively), represent higher hydrothermal stability, high activity and N2 selectivity. This work aims at investigating the effect of the zeolite framework structure on the formation of N2O during NH3-SCR reaction conditions over three Cu-based zeolites ranging from small-pore to large-pore framework structure. In the zeolite framework, Cu exists in two cationic forms, that can catalyze the SCR reaction by activating NO to form NO+ and/or surface nitrate species. The nitrate species can thereafter react with NH3 to form another intermediate, ammonium nitrate, which seems to be one source for N2O formation at low temperatures. The results from in situ diffuse reflectance infrared Fourier transform spectroscopy (DRIFTS) indicate that during the NO oxidation step, mainly NO+ and nitrate species are formed on the surface of the catalysts. The intensity of the absorption peak attributed to NO+ species is higher for the Cu-CHA sample compared to the other two samples, indicating a higher stability of this species in small cages. Furthermore, upon the addition of NH3, through the standard SCR reaction conditions, absorption peaks assigned to N-H stretching and bending vibrations are building up. At the same time, negative peaks are evolving in the O-H stretching region, indicating blocking/replacement of surface OH-groups by NH3 and NH4+. By removing NH3 and adding NO2 to the inlet gas composition, the peaks in the N-H stretching and bending vibration regions show a decreasing trend in intensity, with the decrease being more pronounced for increasing pore size. It can probably be owing to the higher accumulation of ammonia species in the small-pore size zeolite compared to the other two samples. Furthermore, it is worth noting that the ammonia surface species are strongly bonded to the CHA zeolite structure, which makes it more difficult to react with NO2. To conclude, the framework structure of the zeolite seems to play an important role in the formation and reactivity of surface species relevant for the SCR process. Here we intend to discuss the connection between the zeolite structure, the surface species, and the formation of N2O during ammonia-SCR.Keywords: fast SCR, nitrous oxide, NOx, standard SCR, zeolites
Procedia PDF Downloads 22912495 Identification of Ice Hockey World Championship International Sports Event through Brand Personality
Authors: Eva Čáslavová, Andrej Višněvský
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This research focused on the dimensions of brand personality of the Ice Hockey World Championship sporting event. The authors compared the elements in relation to different demographic groups including gender, age, level of education and student status of the population of Prague. Moreover, the differences of opinions of respondents who had experience of visiting a sports event and those who had not were assessed. In the research, the modified brand personality scale was used. This modified scale consists of five dimensions: responsibility, activity, toughness, individuality and emotionality, none of which was previously tested. The authors had an intentional sample of 291 respondents from Prague available, ranging in age from 18 years to 75 years, with either a high school or university education. The respondents rated the characteristic features in a seven-point Likert Scale and the data was collected in November 2012. The results suggest that the Ice Hockey World Championship is most identified with these dimensions: responsibility, emotionality and activity. Men had higher mean scores (4.93) on the Likert Scale in the emotionality dimension, while women had higher mean scores (4.91) in the activity dimension. Those respondents with experience visiting an Ice Hockey World Championship match had the highest mean score (5.10) in the emotionality dimension. This research had expected to show more pronounced mean values (above six) on the Likert scale in the emotionality and activity dimensions that more strongly characterize the brand personality of the Ice Hockey World Championship, however this expectation was not confirmed.Keywords: dimensions, brand personality, ice hockey, international sports event, marketing
Procedia PDF Downloads 22912494 Challenges and Pitfalls of Nutrition Labeling Policy in Iran: A Policy Analysis
Authors: Sareh Edalati, Nasrin Omidvar, Arezoo Haghighian Roudsari, Delaram Ghodsi, Azizollaah Zargaran
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Background and aim: Improving consumer’s food choices and providing a healthy food environment by governments is one of the essential approaches to prevent non-communicable diseases and to fulfill the sustainable development goals (SDGs). The present study aimed to provide an analysis of the nutrition labeling policy as one of the main components of the healthy food environment to provide learning lessons for the country and other low and middle-income countries. Methods: Data were collected by reviewing documents and conducting semi-structured interviews with stakeholders. Respondents were selected through purposive and snowball sampling and continued until data saturation. MAXQDA software was used to manage data analysis. A deductive content analysis was used by applying the Kingdon multiple streams and the policy triangulation framework. Results: Iran is the first country in the Middle East and North Africa region, which has implemented nutrition traffic light labeling. The implementation process has gone through two phases: voluntary and mandatory. In the voluntary labeling, volunteer food manufacturers who chose to have the labels would receive an honorary logo and this helped to reduce the food-sector resistance gradually. After this phase, the traffic light labeling became mandatory. Despite these efforts, there has been poor involvement of media for public awareness and sensitization. Also, the inconsistency of nutrition traffic light colors which are based on food standard guidelines, lack of consistency between nutrition traffic light colors, the healthy/unhealthy nature of some food products such as olive oil and diet cola and the absence of a comprehensive evaluation plan were among the pitfalls and policy challenges identified. Conclusions: Strengthening the governance through improving collaboration within health and non-health sectors for implementation, more transparency of truthfulness of nutrition traffic labeling initiating with real ingredients, and applying international and local scientific evidence or any further revision of the program is recommended. Also, developing public awareness campaigns and revising school curriculums to improve students’ skills on nutrition label applications should be highly emphasized.Keywords: nutrition labeling, policy analysis, food environment, Iran
Procedia PDF Downloads 18212493 Cross-Sectoral Energy Demand Prediction for Germany with a 100% Renewable Energy Production in 2050
Authors: Ali Hashemifarzad, Jens Zum Hingst
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The structure of the world’s energy systems has changed significantly over the past years. One of the most important challenges in the 21st century in Germany (and also worldwide) is the energy transition. This transition aims to comply with the recent international climate agreements from the United Nations Climate Change Conference (COP21) to ensure sustainable energy supply with minimal use of fossil fuels. Germany aims for complete decarbonization of the energy sector by 2050 according to the federal climate protection plan. One of the stipulations of the Renewable Energy Sources Act 2017 for the expansion of energy production from renewable sources in Germany is that they cover at least 80% of the electricity requirement in 2050; The Gross end energy consumption is targeted for at least 60%. This means that by 2050, the energy supply system would have to be almost completely converted to renewable energy. An essential basis for the development of such a sustainable energy supply from 100% renewable energies is to predict the energy requirement by 2050. This study presents two scenarios for the final energy demand in Germany in 2050. In the first scenario, the targets for energy efficiency increase and demand reduction are set very ambitiously. To build a comparison basis, the second scenario provides results with less ambitious assumptions. For this purpose, first, the relevant framework conditions (following CUTEC 2016) were examined, such as the predicted population development and economic growth, which were in the past a significant driver for the increase in energy demand. Also, the potential for energy demand reduction and efficiency increase (on the demand side) was investigated. In particular, current and future technological developments in energy consumption sectors and possible options for energy substitution (namely the electrification rate in the transport sector and the building renovation rate) were included. Here, in addition to the traditional electricity sector, the areas of heat, and fuel-based consumptions in different sectors such as households, commercial, industrial and transport are taken into account, supporting the idea that for a 100% supply from renewable energies, the areas currently based on (fossil) fuels must be almost completely be electricity-based by 2050. The results show that in the very ambitious scenario a final energy demand of 1,362 TWh/a is required, which is composed of 818 TWh/a electricity, 229 TWh/a ambient heat for electric heat pumps and approx. 315 TWh/a non-electric energy (raw materials for non-electrifiable processes). In the less ambitious scenario, in which the targets are not fully achieved by 2050, the final energy demand will need a higher electricity part of almost 1,138 TWh/a (from the total: 1,682 TWh/a). It has also been estimated that 50% of the electricity revenue must be saved to compensate for fluctuations in the daily and annual flows. Due to conversion and storage losses (about 50%), this would mean that the electricity requirement for the very ambitious scenario would increase to 1,227 TWh / a.Keywords: energy demand, energy transition, German Energiewende, 100% renewable energy production
Procedia PDF Downloads 12712492 National System of Innovation in Zambia: Towards Socioeconomic Development
Authors: Ephraim Daka, Maxim Kotsemir
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The National system Innovation (NSI) have recently proliferated as a vehicle for addressing poverty and national competitiveness in the developing countries. While several governments in Sub-Saharan Africa have adopted the developed countries’ models of innovation to local conditions, the Zambian case is rather unique. This study highlights conceptual and socioeconomic challenges directed to the performances of the NSI. The paper analyses science and technology strategies with the inclusion of “innovation” and its effect towards improving socioeconomic elements. The authors reviewed STI policy and national strategy documents, followed by interviews compared to economical regional and national data sets. The NSI and its related to inter-linkages and support mechanism to socioeconomic development were explored.Keywords: national system of innovation, socioeconomics, development, Zambia
Procedia PDF Downloads 21312491 Nutritional Properties and Lipid Oxidation Assessments of Sucuks Prepared with Camel (Camelus Dromedarius) Meat and Hump
Authors: Mina Kargozari, Isabel Revilla Martin, Ángel A. Carbonell-Barrachina
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Different formulations of Turkish fermented sausages (sucuks) prepared with camel meat-hump (CH), camel meat-beef fat (CB), beef-hump (BH) and beef-beef fat (BB), were characterized. The sausages were analytically compared to determine differences in proximate composition and total cholesterol content (TCC), quality parameters such as fatty acids profile and fat quality characteristics, and lipid oxidation parameters including peroxide value, thiobarbituric acid-reactive substances (TBARS) and resulted carbonyl compounds. The PUFAs/SFAs ratio was higher in CB and BB samples than CH and BH (p<0.05). The higher calculated atherogenic and thrombogenic indexes (AI and TI) were obtained from the samples made with hump (p< 0.05) as a result of high amounts of their SFAs. The CH sausages contained high amount of total fat (p<0.05) among all samples. The CB sucuks exhibited the highest protein content and the lowest TCC and rancidity at the end of ripening (p<0.05). The TBARS results showed that beef fat samples were more susceptible to lipid oxidation. Moreover, no significant difference (p<0.05) was observed for the values of short aldehydes among the sucuk samples excepting nonanal. This study demonstrated that supplementing camel meat for the production of dry-fermented sausage resulted in high quality products with good functional and nutritional characteristics.Keywords: fermented sausages, quality properties, SPME, total cholesterol content
Procedia PDF Downloads 31712490 Assessment of Sex Differences in Serum Urea and Creatinine Level in Response to Spinal Cord Injury Using Albino Rat Models
Authors: Waziri B. I., Elkhashab M. M.
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Background: One of the most serious consequences of spinal cord injury (SCI) is progressive deterioration of renal function mostly as a result of urine stasis and ascending infection of the paralyzed bladder. This necessitates for investigation of early changes in serum urea and creatinine and associated sex related differences in response to SCI. Methods: A total of 24 adult albino rats weighing above 150g were divided equally into two groups, a control and experimental group (n = 12) each containing an equal number of male and female rats. The experimental group animals were paralyzed by complete transection of spinal cord below T4 level after deep anesthesia with ketamine 75mg/kg. Blood samples were collected from both groups five days post SCI for analysis. Mean values of serum urea (mmol/L) and creatinine (µmol/L) for both groups were compared. P < 0.05 was considered as significant. Results: The results showed significantly higher levels (P < 0.05) of serum urea and creatinine in the male SCI models with mean values of 92.12 ± 0.98 and 2573 ± 70.97 respectively compared with their controls where the mean values for serum urea and creatinine were 6.31 ± 1.48 and 476. 95 ± 4.67 respectively. In the female SCI models, serum urea 13.11 ± 0.81 and creatinine 519.88 ± 31.13 were not significantly different from that of female controls with serum urea and creatinine levels of 11.71 ± 1.43 and 493.69 ± 17.10 respectively (P > 0.05). Conclusion: Spinal cord injury caused a significant increase in serum Urea and Creatinine levels in the male models compared to the females. This indicated that males might have higher risk of renal dysfunction following SCI.Keywords: albino rats, creatinine, spinal cord injury (SCI), urea
Procedia PDF Downloads 13112489 Adaptation of Climate Change and Building Resilience for Seaports: Empirical Study on Egyptian Mediterranean Seaports
Authors: Alsnosy Balbaa, Mohamed Nabil Elnabawi, Yasmin El Meladi
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With the ever-growing concerns of climate change, Mediterranean ports, as vital economic and transport hubs face unique challenges in maintaining operations and infrastructure. This empirical study seeks to understand the current adaptations and preparedness levels of Egyptian Mediterranean ports against climate-induced disruptions. Drawing from a structured questionnaire, the research gathers insights on observed climate impacts, infrastructure adaptations, operational changes, and stakeholder engagement, aiming to shed light on the resilience of these ports in the face of a changing climate.Keywords: climate, infrastructures, port, mediterranean
Procedia PDF Downloads 5812488 Anthropomorphism in the Primate Mind-Reading Debate: A Critique of Sober's Justification Argument
Authors: Boyun Lee
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This study aims to discuss whether anthropomorphism some scientists tend to use in cross-species comparison can be justified epistemologically, especially in the primate mind-reading debate. Concretely, this study critically analyzes Elliott Sober’s argument about mind-reading hypothesis (MRH), an anthropomorphic hypothesis which states that nonhuman primates (e.g., chimpanzee) are mind-readers like humans. Although many scientists consider anthropomorphism as an error and choosing anthropomorphic hypothesis like MRH without any definite evidence invalid, Sober advocates that anthropomorphism is supported by cladistic parsimony that suggests choosing the simplest hypothesis postulating the minimum number of evolutionary changes, which can be justified epistemologically in the mind-reading debate. However, his argument has several problems. First, Reichenbach’s theorem which Sober uses in process of showing that MRH has the higher likelihood than its competing hypothesis, behavior-reading hypothesis (BRH), does not fit in the context of inferring the evolutionary relationship. Second, the phylogenetic tree Sober supports is one of the possible scenarios of MRH, and even without this problem, it is difficult to prove that the possibility nonhuman primate species and human share mind-reading ability is higher than the possibility of the other case, considering how evolution occurs. Consequently, it seems hard to justify anthropomorphism of MRH under Sober’s argument. Some scientists and philosophers say that anthropomorphism sometimes helps observe interesting phenomena or make hypotheses in comparative biology. Nonetheless, we cannot determine that it provides answers about why and how the interesting phenomena appear or which of the hypotheses is better, at least the mind-reading debate, under the current state.Keywords: anthropomorphism, cladistic parsimony, comparative biology, mind-reading debate
Procedia PDF Downloads 16512487 Impact of Organic Architecture in Building Design
Authors: Zainab Yahaya Suleiman
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Physical fitness, as one of the most important keys to a healthy wellbeing, is the basis of dynamic and creative intellectual activity. As a result, the fitness world is expanding every day. It is believed that a fitness centre is a place of healing and also the natural environment is vital to speedy recovery. The aim of this paper is to propose and designs a suitable location for a fitness centre in Batagarawa metropolis. Batagarawa city is enriched with four tertiary institutions with diverse commerce and culture but lacks the facility of a well-equipped fitness centre. The proposed fitness centre intends to be an organically sound centre that will make use of principles of organic architecture to create a new pleasant environment between man and his environments. Organic architecture is the science of designing a building within pleasant natural resources and features surrounding the environment. It is regarded as visual poetry and reinterpretation of nature’s principles; as well as embodies a settlement of person, place, and materials. Using organic architecture, the design was interlaced with the dynamic, organic and monumental features surrounding the environment. The city has inadequate/no facility that is considered organic where one can keep fit in a friendly, conducive and adequate location. Thus, the need for establishing a fitness centre to cater for this need cannot be over-emphasised. Conclusively, a fitness centre will be an added advantage to this fast growing centre of learning.Keywords: organic architecture, fitness center, environment, natural resources, natural features, building design
Procedia PDF Downloads 40412486 Predictors of Response to Interferone Therapy in Chronic Hepatitis C Virus Infection
Authors: Ali Kassem, Ehab Fawzy, Mahmoud Sef el-eslam, Fatma Salah- Eldeen, El zahraa Mohamed
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Introduction: The combination of interferon (INF) and ribavirin is the preferred treatment for chronic hepatitis C viral (HCV) infection. However, nonresponse to this therapy remains common and is associated with several factors such as HCV genotype and HCV viral load in addition to host factors such as sex, HLA type and cytokine polymorphisms. Aim of the work: The aim of this study was to determine predictors of response to (INF) therapy in chronic HCV infected patients treated with INF alpha and ribavirin combination therapy. Patients and Methods: The present study included 110 patients (62 males, 48 females) with chronic HCV infection. Their ages ranged from 20-59 years. Inclusion criteria were organized according to the protocol of the Egyptian National Committee for control of viral hepatitis. Patients included in this study were recruited to receive INF ribavirin combination therapy; 54 patients received pegylated NF α-2a (180 μg) and weight based ribavirin therapy (1000 mg if < 75 kg, 1200 mg if > 75 kg) for 48 weeks and 53 patients received pegylated INF α-2b (1.5 ug/kg/week) and weight based ribavirin therapy (800 mg if < 65 kg, 1000 mg if 65-75 kg and 1200 mg if > 75kg). One hundred and seven liver biopsies were included in the study and submitted to histopathological examination. Hematoxylin and eosin (H&E) stained sections were done to assess both the grade and the stage of chronic viral hepatitis, in addition to the degree of steatosis. Modified hepatic activity index (HAI) grading, modified Ishak staging and Metavir grading and staging systems were used. Laboratory follow up including: HCV PCR at the 12th week to assess the early virologic response (EVR) and at the 24th week were done. At the end of the course: HCV PCR was done at the end of the course and tested 6 months later to document end virologic response (ETR) and sustained virologic response (SVR) respectively. Results One hundred seven patients; 62 males (57.9 %) and 45 females (42.1%) completed the course and included in this study. The age of patients ranged from 20-59 years with a mean of 40.39±10.03 years. Six months after the end of treatment patients were categorized into two groups: Group (1): patients who achieved sustained virological response (SVR). Group (2): patients who didn't achieve sustained virological response (non SVR) including non-responders, breakthrough and relapsers. In our study, 58 (54.2%) patients showed SVR, 18 (16.8%) patients were non-responders, 15 (14%) patients showed break-through and 16 (15 %) patients were relapsers. Univariate binary regression analysis of the possible risk factors of non SVR showed that the significant factors were higher age, higher fasting insulin level, higher Metavir stage and higher grade of hepatic steatosis. Multivariate binary regression analysis showed that the only independent risk factor for non SVR was high fasting insulin level. Conclusion: Younger age, lower Metavir stage, lower steatosis grade and lower fasting insulin level are good predictors of SVR and could be used in predicting the treatment response of pegylated interferon/ribavirin therapy.Keywords: chronic HCV infection, interferon ribavirin combination therapy, predictors to antiviral therapy, treatment response
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