Search results for: clinical decision support systems

Authors: M. R. Ebrahimi, B. Mahdaviani

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Conventional electric distribution systems are radial in nature, supplied at one end through a main source. These networks generally have a simple protection system usually implemented using fuses, re-closers, and over-current relays. Recently, great attention has been paid to applying Distributed energy resources (DERs) throughout electric distribution systems. Presence of such generation in a network leads to losing coordination of protection devices. Therefore, it is desired to develop an algorithm which is capable of protecting distribution systems that include DER. On the other hand smart grid brings opportunities to the power system. Fast advancement in communication and measurement techniques accelerates the development of multi agent system (MAS). So in this paper, a new approach for the protection of distribution networks in the presence of DERs is presented base on MAS. The proposed scheme has been implemented on a sample 27-bus distribution network.

Keywords: distributed energy resource, distribution network, protection, smart grid, multi agent system

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Authors: Salim Khan

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The attainment of the carbon neutrality objective and Sustainable Development Goal 13 (SDG-13) target, which pertains to climate actions, received widespread attention in developing and emerging nations. Given the increasing pace of urbanization, technological advancements, and rapid growth, it is imperative to examine the linear and nonlinear effects of urbanization and economic growth and the linear impact of information and communication technology (ICT) on carbon emissions (CO2e). This study employs the Dynamic System GMM (DSGMM) and Panel Quantile Regression (PQR) methodologies to investigate the causal relationship between urbanization, ICT, economic growth, and their interplay on CO2e in 39 BRI countries from 2001 to 2020. The study's findings indicate that the impact of urbanization on CO2e exhibits linear and nonlinear patterns. The specific nonlinear impact of urbanization leads to a decrease in CO2e, hence facilitating the achievement of carbon neutrality and contributing to SDG-13. The study highlights the importance of ICT in achieving SDG-13 by reducing CO2e, emphasizing the need for informatization. Simultaneously, the findings support the Environmental Kuznets Curve (EKC) hypothesis and support the pollution haven theory. Finally, based on empirical findings, significant policy implications are suggested for achieving SGD 13 and carbon neutrality.

Keywords: urbanization, ICT, CO2 emission, EKC, pollution haven, BRI

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Authors: Fitih Ademe, Kibebew Kibret, Sheleme Beyene, Mezgebu Getnet, Gashaw Meteke

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Soil moisture and nutrient availability are the two key edaphic factors that affect crop yields and are directly or indirectly affected by climate variability and change. The study examined climate-induced yield level, yield variability and gap of maize during 1981-2010 main growing season in the Central Rift Valley (CRV) of Ethiopia. Pearson correlation test was employed to see the relationship between climate variables and yield. The coefficient of variation (CV) was used to analyze annual yield variability. Decision Support System for Agro-technology Transfer cropping system model (DSSAT-CSM) was used to simulate the growth and yield of maize for the study period. The result indicated that maize grain yield was strongly (P<0.01) and positively correlated with seasonal rainfall (r=0.67 at Melkassa and r = 0.69 at Ziway) in the CRV while day temperature affected grain yield negatively (r= -0.44) at Ziway (P<0.05) during the simulation period. Variations in total seasonal rainfall at Melkassa and Ziway explained 44.9 and 48.5% of the variation in yield, respectively, under optimum nutrition. Following variation in rainfall, high yield variability (CV=23.5%, Melkassa and CV=25.3%, Ziway) was observed for optimum nutrient simulation than the corresponding nutrient limited simulation (CV=16%, Melkassa and 24.1%, Ziway) in the study period. The observed farmers’ yield was 72, 52 and 43% of the researcher-managed, water-limited and potential yield of the crop, respectively, indicating a wide maize yield gap in the region. The study revealed rainfed crop production in the CRV is prone to yield variabilities due to its high dependence on seasonal rainfall and nutrient level. Moreover, the high coefficient of variation in the yield gap for the 30-year period also foretells the need for dependable water supply at both locations. Given the wide yield gap especially during lower rainfall years across the simulation periods, it signifies the requirement for a more dependable application of irrigation water and a potential shift to irrigated agriculture; hence, adopting options that can improve water availability and nutrient use efficiency would be crucial for crop production in the area.

Keywords: climate variability, crop model, water availability, yield gap, yield variability

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Authors: Ioannis Panagiotopoulos, Efstathios Kastritis, Anastasia Katinioti, Georgios Efthymiadis, Argyrios Doumas, Maria Koutelou

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Introduction: Transthyretin amyloidosis (ATTR) is a rare but serious infiltrative disease. Myocardial scintigraphy with DPD has emerged as the most effective, non-invasive, highly sensitive, and highly specific diagnostic method for cardiac ATTR amyloidosis. However, there are cases in which additional laboratory investigations reveal AL amyloidosis or other diseases despite a positive DPD scintigraphy. We describe the experience from the Onassis Cardiac Surgery Center and the monitoring center for infiltrative myocardial diseases of the cardiology clinic at AHEPA. Materials and Methods: All patients with clinical suspicion of cardiac or extracardiac amyloidosis undergo a myocardial scintigraphy scan with Tc-99m DPD. In this way, over 500 patients have been examined. Further diagnostic approach based on clinical and imaging findings includes laboratory investigation and invasive techniques (e.g., biopsy). Results: Out of 76 patients in total with positive myocardial scintigraphy Grade 2 or 3 according to the Perugini scale, 8 were proven to suffer from AL Amyloidosis during the investigation of paraproteinemia. Among these patients, 3 showed Grade 3 uptake, while the rest were graded as Grade 2, or 2 to 3. Additionally, one patient presented diffuse and unusual radiopharmaceutical uptake in soft tissues throughout the body without cardiac involvement. These findings raised suspicions, leading to the analysis of κ and λ light chains in the serum, as well as immunostaining of proteins in the serum and urine of these specific patients. The final diagnosis was AL amyloidosis. Conclusion: The value of DPD scintigraphy in the diagnosis of cardiac amyloidosis from transthyretin is undisputed. However, positive myocardial scintigraphy with DPD should not automatically lead to the diagnosis of ATTR amyloidosis. Laboratory differentiation between ATTR and AL amyloidosis is crucial, as both prognosis and therapeutic strategy are dramatically altered. Laboratory exclusion of paraproteinemia is a necessary and essential step in the diagnostic algorithm of ATTR amyloidosis for all positive myocardial scintigraphy with diphosphonate tracers since >20% of patients with Grade 3 and 2 uptake may conceal AL amyloidosis.

Keywords: AL amyloidosis, amyloidosis, ATTR, myocardial scintigraphy, Tc-99m DPD

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Authors: Abdelrahman A. Elsehsah, Nada A. El-Kordy

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The "Investing in Minds: A Financial Framework for Mental Health and Well-Being in the Workplace" project is designed to enhance employee mental health and well-being through a structured and comprehensive approach that includes program development, implementation, and evaluation. This initiative acknowledges the growing importance of mental health in workplace settings, particularly in light of rising stress levels and the prevalence of mental health issues among employees. Research indicates that mental health challenges can significantly impact workforce productivity and overall employee engagement. To effectively address these challenges, the project will commence with a detailed needs assessment aimed at identifying the specific mental health issues faced by employees across various organizational contexts. This assessment will provide critical insights into the unique challenges within different sectors, enabling the development of targeted training and support programs tailored to meet these needs. The importance of understanding the specific mental health landscape within an organization cannot be overstated, as it lays the groundwork for effective interventions. Implementation of the project will feature several key components, including the introduction of Employee Assistance Programs (EAPs), wellness initiatives, and strategies for enhancing the workplace environment to foster a supportive atmosphere for mental health. EAPs have been shown to provide valuable resources and support for employees dealing with personal and professional challenges, thereby improving their overall well-being and j7ob satisfaction. Moreover, wellness initiatives can promote healthy behaviors and resilience among employees, contributing to a more positive workplace culture. A robust communication strategy will also be integral to the project's success. By ensuring that all employees are aware of the available resources and programs, the project aims to foster a culture of openness and support regarding mental health issues. Effective communication has been highlighted as a critical factor in the successful implementation of workplace mental health initiatives. This aspect of the project will involve not only disseminating information but also creating avenues for employees to engage in discussions about mental health, thereby reducing stigma and promoting a more accepting environment. The project's impact will be rigorously evaluated using both quantitative and qualitative measures. This comprehensive evaluation framework will allow for a deeper understanding of the effectiveness of the initiatives and will provide valuable feedback for continuous improvement by establishing clear metrics for success, organizations can monitor progress and make adjustments as needed to ensure that mental health support remains relevant and effective over time. The anticipated benefits of the "Investing in Minds" project include reduced healthcare costs, improved employee retention, and enhanced organizational performance. By prioritizing mental health, organizations can create a healthier workplace culture that not only improves employee morale but also contributes to better business outcomes. Ultimately, this project seeks not only to address immediate mental health needs but also to establish a sustainable framework for ongoing mental health support within the organization, ensuring that mental well-being becomes an integral part of the workplace ethos.

Keywords: mental health, workplace well-being, employee assistance programs, evaluation framework

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Authors: Chokri Slim

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The objective of this research is attempting to respond to this question: Is there a significant difference between the regression model and statistical learning models in predicting credit risk management? A Multiple Linear Regression (MLR) model was compared with neural networks including Multi-Layer Perceptron (MLP), and a Support vector regression (SVR). The population of this study includes 50 listed Banks in Tunis Stock Exchange (TSE) market from 2000 to 2016. Firstly, we show the factors that have significant effect on the quality of loan portfolios of banks in Tunisia. Secondly, it attempts to establish that the systematic use of objective techniques and methods designed to apprehend and assess risk when considering applications for granting credit, has a positive effect on the quality of loan portfolios of banks and their future collectability. Finally, we will try to show that the bank governance has an impact on the choice of methods and techniques for analyzing and measuring the risks inherent in the banking business, including the risk of non-repayment. The results of empirical tests confirm our claims.

Keywords: credit risk management, multiple linear regression, principal components analysis, artificial neural networks, support vector machines

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Authors: Kazuki Kamada, Haruka Yamashita

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In Japan, taxi is one of the popular transportations and taxi industry is one of the big businesses. However, in recent years, there has been a difficult problem of reducing the number of taxi drivers. In the taxi business, mainly three passenger catching methods are applied. One style is "cruising" that drivers catches passengers while driving on a road. Second is "waiting" that waits passengers near by the places with many requirements for taxies such as entrances of hospitals, train stations. The third one is "dispatching" that is allocated based on the contact from the taxi company. Above all, the cruising taxi drivers need the experience and intuition for finding passengers, and it is difficult to decide "the destination for cruising". The strong recommendation system for the cruising taxies supports the new drivers to find passengers, and it can be the solution for the decreasing the number of drivers in the taxi industry. In this research, we propose a method of recommending a destination for cruising taxi drivers. On the other hand, as a machine learning technique, the embedding models that embed the high dimensional data to a low dimensional space is widely used for the data analysis, in order to represent the relationship of the meaning between the data clearly. Taxi drivers have their favorite courses based on their experiences, and the courses are different for each driver. We assume that the course of cruising taxies has meaning such as the course for finding business man passengers (go around the business area of the city of go to main stations) and course for finding traveler passengers (go around the sightseeing places or big hotels), and extract the meaning of their destinations. We analyze the cruising history data of taxis based on the embedding model and propose the recommendation system for passengers. Finally, we demonstrate the recommendation of destinations for cruising taxi drivers based on the real-world data analysis using proposing method.

Keywords: taxi industry, decision making, recommendation system, embedding model

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Authors: Zhengkun Yi

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Surface texture discrimination using artificial tactile sensors has attracted increasing attentions in the past decade as it can endow technical and robot systems with a key missing ability. However, as a major component of texture, roughness has rarely been explored. This paper presents an approach for tactile surface roughness discrimination, which includes two parts: (1) design and fabrication of a bioinspired artificial fingertip, and (2) tactile signal processing for tactile surface roughness discrimination. The bioinspired fingertip is comprised of two polydimethylsiloxane (PDMS) layers, a polymethyl methacrylate (PMMA) bar, and two perpendicular polyvinylidene difluoride (PVDF) film sensors. This artificial fingertip mimics human fingertips in three aspects: (1) Elastic properties of epidermis and dermis in human skin are replicated by the two PDMS layers with different stiffness, (2) The PMMA bar serves the role analogous to that of a bone, and (3) PVDF film sensors emulate Meissner’s corpuscles in terms of both location and response to the vibratory stimuli. Various extracted features and classification algorithms including support vector machines (SVM) and k-nearest neighbors (kNN) are examined for tactile surface roughness discrimination. Eight standard rough surfaces with roughness values (Ra) of 50 μm, 25 μm, 12.5 μm, 6.3 μm 3.2 μm, 1.6 μm, 0.8 μm, and 0.4 μm are explored. The highest classification accuracy of (82.6 ± 10.8) % can be achieved using solely one PVDF film sensor with kNN (k = 9) classifier and the standard deviation feature.

Keywords: bioinspired fingertip, classifier, feature extraction, roughness discrimination

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Authors: Jolanta Jonak, Sylvia Tolczyk

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Educational systems are tasked with preparing students for future success in academic or work environments. Schools strive to achieve this goal, but often it is challenging as conventional teaching approaches are often ineffective in increasingly diverse educational systems. In today’s ever-increasing global society, educational systems become increasingly diverse in terms of cultural and linguistic differences, learning preferences and styles, ability and disability. Through increased understanding of disabilities and improved identification processes, students having some form of disabilities tend to be identified earlier than in the past, meaning that more students with identified disabilities are being supported in our classrooms. Also, a large majority of students with disabilities are educated in general education environments. Due to cognitive makeup and life experiences, students have varying learning styles and preferences impacting how they receive and express what they are learning. Many students come from bi or multilingual households and with varying proficiencies in the English language, further impacting their learning. All these factors need to be seriously considered when developing learning opportunities for student's. Educators try to adjust their teaching practices as they discover that conventional methods are often ineffective in reaching each student’s potential. Many teachers do not have the necessary educational background or training to know how to teach students whose learning needs are more unique and may vary from the norm. This is further complicated by the fact that many classrooms lack consistent access to interventionists/coaches that are adequately trained in evidence-based approaches to meet the needs of all students, regardless of what their academic needs may be. One evidence-based way for providing successful education for all students is by incorporating cognitive approaches and strategies that tap into affective, recognition, and strategic networks in the student's brain. This can be done through Differentiated Instruction (DI). Differentiated Instruction is increasingly recognized model that is established on the basic principles of Universal Design for Learning. This form of support ensures that regardless of the students’ learning preferences and cognitive learning profiles, they have opportunities to learn through approaches that are suitable to their needs. This approach improves the educational outcomes of students with special needs and it benefits other students as it accommodates learning styles as well as the scope of unique learning needs that are evident in the typical classroom setting. Differentiated Instruction also is recognized as an evidence-based best practice in education and is highly effective when it is implemented within the tiered system of the Response to Intervention (RTI) model. Recognition of DI becomes more common; however, there is still limited understanding of the effective implementation and use of strategies that can create unique learning environments for each student within the same setting. Through employing knowledge of a variety of instructional strategies, general and special education teachers can facilitate optimal learning for all students, with and without a disability. A desired byproduct of DI is that it can eliminate inaccurate perceptions about the students’ learning abilities, unnecessary referrals for special education evaluations, and inaccurate decisions about the presence of a disability.

Keywords: differentiated instruction, universal design for learning, special education, diversity

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Authors: Nguyen J. M., Lucas G., Ruan S., Digonnet H., Antonioli D.

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Introduction: Deep Learning (DL) is a very powerful tool for analyzing image data. But for tabular data, it cannot compete with machine learning methods like XGBoost. The research question becomes: can tabular data be transformed into images that can be analyzed by simple CNNs (Convolutional Neuron Networks)? Will DL be the absolute tool for data classification? All current solutions consist in repositioning the variables in a 2x2 matrix using their correlation proximity. In doing so, it obtains an image whose pixels are the variables. We implement a technology, DeepNIC, that offers the possibility of obtaining an image for each variable, which can be analyzed by simple CNNs. Material and method: The 'ROP' (Regression OPtimized) model is a binary and atypical decision tree whose nodes are managed by a new artificial neuron, the Neurop. By positioning an artificial neuron in each node of the decision trees, it is possible to make an adjustment on a theoretically infinite number of variables at each node. From this new decision tree whose nodes are artificial neurons, we created the concept of a 'Random Forest of Perfect Trees' (RFPT), which disobeys Breiman's concepts by assembling very large numbers of small trees with no classification errors. From the results of the RFPT, we developed a family of 10 statistical information criteria, Nguyen Information Criterion (NICs), which evaluates in 3 dimensions the predictive quality of a variable: Performance, Complexity and Multiplicity of solution. A NIC is a probability that can be transformed into a grey level. The value of a NIC depends essentially on 2 super parameters used in Neurops. By varying these 2 super parameters, we obtain a 2x2 matrix of probabilities for each NIC. We can combine these 10 NICs with the functions AND, OR, and XOR. The total number of combinations is greater than 100,000. In total, we obtain for each variable an image of at least 1166x1167 pixels. The intensity of the pixels is proportional to the probability of the associated NIC. The color depends on the associated NIC. This image actually contains considerable information about the ability of the variable to make the prediction of Y, depending on the presence or absence of other variables. A basic CNNs model was trained for supervised classification. Results: The first results are impressive. Using the GSE22513 public data (Omic data set of markers of Taxane Sensitivity in Breast Cancer), DEEPNic outperformed other statistical methods, including XGBoost. We still need to generalize the comparison on several databases. Conclusion: The ability to transform any tabular variable into an image offers the possibility of merging image and tabular information in the same format. This opens up great perspectives in the analysis of metadata.

Keywords: tabular data, CNNs, NICs, DeepNICs, random forest of perfect trees, classification

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Authors: U. Schmidt, D. Dannehl, I. Schuch, J. Suhl, T. Rocksch, R. Salazar-Moreno, E. Fitz-Rodrigues, A. Rojano Aquilar, I. Lopez Cruz, G. Navas Gomez, R. A. Abraham, L. C. Irineo, N. G. Gilberto

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The integration of agricultural production systems into urban areas is a challenge for the coming decades. Because of increasing greenhouse gas emission and rising resource consumption as well as costs in animal husbandry, the dietary habits of people in the 21st century have to focus on herbal foods. Intensive plant cultivation systems in large cities and megacities require a smart coupling of information, material and energy flow with the urban infrastructure in terms of Horticulture 4.0. In recent years, many puzzle pieces have been developed for these closed processes at the Humboldt University. To compile these for an urban plant production, it has to be optimized and networked with urban infrastructure systems. In the field of heat energy production, it was shown that with closed greenhouse technology and patented heat exchange and storage technology energy can be provided for heating and domestic hot water supply in the city. Closed water circuits can be drastically reducing the water requirements of plant production in urban areas. Ion sensitive sensors and new disinfection methods can help keep circulating nutrient solutions in the system for a longer time in urban plant production greenhouses.

Keywords: semi closed, greenhouses, urban farming, solar heat collector, closed water cycles, aquaponics

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Authors: A. G. Margaryan

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Ability of adaptation of the organism is considered as an important component of health in maintaining relative dynamic constancy of the hemostasis and functioning of all organs and systems. Among the various forms of adaptation (individual, species and mental), social adaptation of the organism has a particular role. The aim of this study was to evaluate the subjective perception of social factors, social welfare and the level of adaptability of Armenian physicians. The survey involved 2,167 physicians (592 men and 1,575 women). According to the survey, most physicians (75.1%) were married. It was found that 88.6% of respondents had harmonious family relationships, 7.6% of respondents – tense relationships, and 1.0% – marginal relationships. The results showed that the average monthly salary with all premium payments amounted to 88 263.6±5.0 drams, and 16.7% of physicians heavily relied on the material support of parents or other relatives. Low material welfare was also confirmed by the analysis of the living conditions. Analysis of the results showed that the degree of subjective perception of social factors of different specialties averaged 11.3±3.1 points, which corresponds to satisfactory results (a very good result – 4.0 points). The degree of social adaptation of physicians on average makes 4.13±1.9 points, which corresponds to poor results (allowable less than 3.0 points). The distribution of the results of social adaptation severity revealed that the majority of physicians (58.6%) showed low social adaptation, average social adaptation is observed in 22.4% of the physicians and high adaptation – in only 17.4% of physicians. In conclusions, the findings of this study suggest that the degree of social adaptation of currently practicing physicians is low.

Keywords: physician's health, social adaptation, social factor, social health

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Authors: Chiara Magliacane

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This project aims to analyse the relationship between the post-conflict Northern Irish environment and youth trauma in deprived areas. Using an anthropological perspective and methodology, the study investigates the possible contribution that a socio-cultural perspective can give to the current research on the field, with a special focus on the role of transgenerational trauma. The recognition of the role that socio-economic determinants have on health is usually a challenge for social researchers. In post-conflict Northern Ireland, the overall lack of research about connections between the social context and youth trauma opens the way to the present project. Anthropological studies on social implications of mental disorders have achieved impressive results in many societies; they show how conditions of sufferance and poverty are not intrinsically given, but are the products of historical processes and events. The continuum of violence and the politics of victimhood sustains a culture of silence and fear in deprived areas; this implies the need of investigating the structural and symbolic violence that lies behind the diffusion of mental suffering. The project refers to these concepts from Medical Anthropology and looks at connections between trauma and social, political and economic structures. Accordingly, the study considers factors such as poverty, unemployment, social inequality and gender and class perspectives. At the same time, the project problematises categories such as youth and trauma. 'Trauma' is currently debated within the social sciences since the 'invention' of the Post-Traumatic Stress Disorder (PTSD) in 1980. Current critics made to its clinical conception show how trauma has been mainly analysed as a memory of the past. On the contrary, medical anthropological research focuses on wider perspectives on society and its structures; this is a new and original approach to the study of youth trauma considering that, to author’s best knowledge, there is no research of this kind regarding Northern Ireland. Methods: Qualitative interviews, participant observation. Expected Impact: Local Northern Ireland organizations, i.e. specific charities that provide mental health support. Ongoing and present connections will ensure they will hear about this research.

Keywords: health and social inequalities, Northern Ireland, structural violence, youth

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Authors: Jefferson Camacho Mejia, Jenny Paola Forero Pachon, Luis Carlos Gomez Florez

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The innumerable possibilities offered by the use of Information Technology (IT) in the development of different socio-economic activities has made a change in the social paradigm and the emergence of the so-called information and knowledge society. The Colombian government, aware of this reality, has been promoting the use of IT as part of the E-government strategy adopted in the country. However, it is well known that the use of IT implies the existence of certain threats that put the security of information in the digital environment at risk. One of the priorities of the Colombian government is to improve access to alternative justice through IT, in particular, access to Alternative Dispute Resolution (ADR): conciliation, arbitration and friendly composition; by means of which it is sought that the citizens directly resolve their differences. To this end, a trend has been identified in the use of Online Dispute Resolution (ODR) systems, which extend the benefits of ADR to the digital environment through the use of IT. This article presents a process for the analysis of information security risks associated with the incorporation of ODR systems in the context of conciliation in Colombia, based on four fundamental stages identified in the literature: (I) Identification of assets, (II) Identification of threats and vulnerabilities (III) Estimation of the impact and 4) Estimation of risk levels. The methodological design adopted for this research was the grounded theory, since it involves interactions that are applied to a specific context and from the perspective of diverse participants. As a result of this investigation, the activities to be followed are defined to carry out an analysis of information security risks, in the context of the conciliation in Colombia supported by ODR systems, thus contributing to the estimation of the risks to make possible its subsequent treatment.

Keywords: alternative dispute resolution, conciliation, information security, online dispute resolution systems, process, risk analysis

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Authors: Seyyed Masoud Seyyedoshohadaei, Borhanuddin Mohd Ali

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To support group mobility, the NEMO Basic Support Protocol has been standardized as an extension of Mobile IP that enables an entire network to change its point of attachment to the Internet. Using NEMO in IEEE 802.16e (WiMax) networks causes latency in handover procedure and affects seamless communication of real-time applications. To decrease handover latency and service disruption time, an integrated scheme named Optimized Fast NEMO (OFNEMO) was introduced by authors of this paper. In OFNEMO a pre-establish multi tunnels concept, cross function optimization and cross layer design are used. In this paper, an analytical model is developed to evaluate total cost consisting of signaling and packet delivery costs of the OFNEMO compared with RFC3963. Results show that OFNEMO increases probability of predictive mode compared with RFC3963 due to smaller handover latency. Even though OFNEMO needs extra signalling to pre-establish multi tunnel, it has less total cost thanks to its optimized algorithm. OFNEMO can minimize handover latency for supporting real time application in moving networks.

Keywords: fast mobile IPv6, handover latency, IEEE802.16e, network mobility

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Authors: Abu Salim Mustafa

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Polymerase chain reaction (PCR) assays targeting genomic DNA segments have been established for the detection of Helicobacter pylori in clinical specimens. However, the data on comparative evaluations of various targets in detection of H. pylori are limited. Furthermore, the frequencies of vacA (s1 and s2) and cagA genotypes, which are suggested to be involved in the pathogenesis of H. pylori in other parts of the world, are not well studied in Kuwait. The aim of this study was to evaluate PCR assays for the detection and genotyping of H. pylori by targeting the amplification of DNA targets from four genomic segments. The genomic DNA were isolated from 72 clinical isolates of H. pylori and tested in PCR with four pairs of oligonucleotides primers, i.e. ECH-U/ECH-L, ET-5U/ET-5L, CagAF/CagAR and Vac1F/Vac1XR, which were expected to amplify targets of various sizes (471 bp, 230 bp, 183 bp and 176/203 bp, respectively) from the genomic DNA of H. pylori. The PCR-amplified DNA were analyzed by agarose gel electrophoresis. PCR products of expected size were obtained with all primer pairs by using genomic DNA isolated from H. pylori. DNA dilution experiments showed that the most sensitive PCR target was 471 bp DNA amplified by the primers ECH-U/ECH-L, followed by the targets of Vac1F/Vac1XR (176 bp/203 DNA), CagAF/CagAR (183 bp DNA) and ET-5U/ET-5L (230 bp DNA). However, when tested with undiluted genomic DNA isolated from single colonies of all isolates, the Vac1F/Vac1XR target provided the maximum positive results (71/72 (99% positives)), followed by ECH-U/ECH-L (69/72 (93% positives)), ET-5U/ET-5L (51/72 (71% positives)) and CagAF/CagAR (26/72 (46% positives)). The results of genotyping experiments showed that vacA s1 (46% positive) and vacA s2 (54% positive) genotypes were almost equally associated with VaCA+/CagA- isolates (P > 0.05), but with VacA+/CagA+ isolates, S1 genotype (92% positive) was more frequently detected than S2 genotype (8% positive) (P< 0.0001). In conclusion, among the primer pairs tested, Vac1F/Vac1XR provided the best results for detection of H. pylori. The genotyping experiments showed that vacA s1 and vacA s2 genotypes were almost equally associated with vaCA⁺/cagA^- isolates, but vacA s1 genotype had a significantly increased association with vacA⁺/cagA⁺ isolates.

Keywords: H. pylori, PCR, detection, genotyping

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Authors: Alie Wube Dametew, Frank Ebinger

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This study investigated the roles of technological innovation on basic metal industries and then developed technological innovation framework for enhancing sustainable competitive advantage in the basic metal industries. The previous research work indicates that technological innovation has critical impact in promoting local industries to improve their performance and achieve sustainable competitive environments. The filed observation, questioner and expert interview result from basic metal industries indicate that the technological capability of local industries to invention, adoption, modification, improving and use a given innovative technology is very poor. As the result, this poor technological innovation was occurred due to improper innovation and technology transfer framework, non-collaborative operating environment between foreign and local industries, very weak national technology policies, problems research and innovation centers, the common miss points on basic metal industry innovation systems were investigated in this study. One of the conclusions of the article is that, through using the developed technological innovation framework in this study, basic metal industries improve innovation process and support an innovative culture for sector capabilities and achieve sustainable competitive advantage.

Keywords: technological innovation, competitive advantage, sustainable, basic metal industry, conceptual model, sustainability, supply chain integration

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Authors: Pilly Joseph Kagosi

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The study aims at assessing challenges observed during the implementation of participatory irrigation management (PIM) approach for food security in semi-arid areas of Tanzania. Data were collected through questionnaire, PRA tools, key informants discussion, Focus Group Discussion (FGD), participant observation, and literature review. Data collected from the questionnaire was analysed using SPSS while PRA data was analysed with the help of local communities during PRA exercise. Data from other methods were analysed using content analysis. The study revealed that PIM approach has a contribution in improved food security at household level due to the involvement of communities in water management activities and decision making which enhanced the availability of water for irrigation and increased crop production. However, there were challenges observed during the implementation of the approach including; minimum participation of beneficiaries in decision-making during planning and designing stages, meaning inadequate devolution of power among scheme owners. Inadequate and lack of transparency on income expenditure in Water Utilization Associations’ (WUAs), water conflict among WUAs members, conflict between farmers and livestock keepers and conflict between WUAs leaders and village government regarding training opportunities and status; WUAs rules and regulation are not legally recognized by the National court and few farmers involved in planting trees around water sources. However, it was realized that some of the mentioned challenges were rectified by farmers themselves facilitated by government officials. The study recommends that the identified challenges need to be rectified for farmers to realize impotence of PIM approach as it was realized by other Asian countries.

Keywords: challenges, participatory approach, irrigation management, food security, semi arid areas

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Authors: Ilona Buchem, Carolin Gellner

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Over the last few years, the call for the support of senior learners in the development of their digital literacy has become prevalent, mainly due to the progression towards ageing societies paired with advances in digitalisation in all spheres of life, including e-health and electronic patient record (EPA). While major research efforts in supporting senior learners in developing digital literacy have been invested so far in e-learning focusing on knowledge acquisition and cognitive tasks, little research exists in learning models which target virtual mentoring and coaching with the help of pedagogical agents and address the social dimensions of learning. Research from studies with students in the context of formal education has already provided methods for designing intelligent virtual agents in support of personalised learning. However, this research has mostly focused on cognitive skills and has not yet been applied to the context of mentoring/coaching of senior learners, who have different characteristics and learn in different contexts. In this paper, we describe how insights from previous research can be used to develop an intelligent virtual learning coach (agent) for senior learners with a focus on building the social relationship between the agent and the learner and the key task of the agent to socialize learners to the larger context of digital literacy with a focus on electronic health records. Following current approaches to mentoring and coaching, the agent is designed not to enhance and monitor the cognitive performance of the learner but to serve as a trusted friend and advisor, whose role is to provide one-to-one guidance and support sharing of experiences among learners (peers). Based on literature review and synopsis of research on virtual agents and current coaching/mentoring models under consideration of the specific characteristics and requirements of senior learners, we describe the design framework which was applied to design an intelligent virtual learning coach as part of the e-learning system for digital literacy of senior learners in the ePA-Coach project founded by the German Ministry of Education and Research. This paper also presents the results from the evaluation study, which compared the use of the first prototype of the virtual learning coach designed according to the design framework with a voice narration in a multimedia learning environment with senior learners. The focus of the study was to validate the agent design in the context of the persona effect (Lester et al., 1997). Since the persona effect is related to the hypothesis that animated agents are perceived as more socially engaging, the study evaluated possible impacts of agent coaching in comparison with voice coaching on motivation, engagement, experience, and digital literacy.

Keywords: virtual learning coach, virtual mentor, pedagogical agent, senior learners, digital literacy, electronic health records

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Authors: Bindu I. Somarajan, Viney Gupta, Gagandeep Kaur Walia, Jasbir Kaur, Sunil Kumar, Shikha Gupta, Abadh K. Chaurasia, Dinesh Gupa, Abhinav Kaushik, Aditi Mehta, Vipin Gupta, Arundhati Sharma

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Background: Juvenile onset primary open angle glaucoma (JOAG), affects individuals under the age of 40 years. Studies on a few families of JOAG, that led to the discovery of the Myocilin gene, reported the disease to have an autosomal dominant pattern of inheritance. However, sporadic forms of JOAG been seen to be more common in some populations. Most pathological homozygous mutations in the CYP1B1 gene associated with JOAG have been seen among sporadic cases. Given the higher prevalence of sporadic JOAG cases in our population, we aimed to look for common mutations E229K and R368H, the two most common variants in the CYP1B1 gene associated with glaucoma. Objective: To determine the frequency and evaluate genotype phenotype correlation of CYP1B1 E229K and R368H mutations in a cohort of 120 sporadic Juvenile open angle glaucoma patients.Methods: Unrelated JOAG patients whose first degree relatives had been examined and found to be unaffected were included in the study. The patients and their parents were screened for E229K and R368H mutations. The phenotypic characteristics were compared between probands with and with out these mutations by SPSS v16. Results: Out of 120 JOAG patients included in the study, the E229K mutation was seen in 9 probands (7.5%) and R368H in 7 (5.8%). The average age of onset of the disease (p=0.3) and the highest untreated IOP (p=0.4) among those carrying mutations was not significantly different from those who did not have these mutations. The proportion of probands with angle dysgenesis among those with E229K and R368H mutations was 70% (11 out of 16) in comparison to 65% (67 out of 104) of those who did not harbour these mutations (p=0.56). Similarly the probands with moderate to high myopia among those with E229K and R368H mutations was 20% (3 out of 16) in comparison to 18% (18 out of 104) of those who did not harbour these mutations(p=0.59). Conclusion: The frequency of E229K and R368H mutations of the CYP1B1 gene is low even among sporadic JOAG patients. Moreover there is no clinical correlation between the presence of these mutations and disease severity

Keywords: CYP1B1, gene, IOP, JOAG, mutation

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Authors: Yuliya Markava

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The laser in situ keratomileusis (LASIK) is widely common surgical procedure, which has become an alternative for patients who are not satisfied with the performance of other correction methods. A high level of patient satisfaction functional outcomes after refractive surgery confirms the high reliability and safety of LASIK and provides a significant improvement in the quality of life and social adaptation. Purpose: To perform clinical analysis of the results of correction made to the excimer laser system SCHWIND AMARIS 500E in patients with different types of refractive anomalies. Materials and Methods: This was a retrospective analysis of 1581 operations (812 patients): 413 males (50.86%) and 399 females (49.14%) at the age from 18 to 47 years with different types of ametropia. All operations were performed on excimer laser SCHWIND AMARIS 500E in the LASIK procedure. Formation of the corneal flap was made by mechanical microkeratome SCHWIND. Results: Analyzing the structure of refractive anomalies: The largest number of interventions accounted for myopia: 1505 eyes (95.2%), of which about a low myopia: 706 eyes (44.7%), moderate myopia: 562 eyes (35.5 %), high myopia: eyes 217 (13.7%) and supermyopia: 20 eyes (1.3%). Hyperopia was 0.7% (11 eyes), mixed astigmatism: 4.1% (65 eyes). The efficiency was 80% (in patients with supermyopia) to 91.6% and 95.4% (in groups with myopia low and moderate, respectively). Uncorrected visual acuity average values before and after laser operation was in groups: a low myopia 0.18 (up 0.05 to 0.31) and 0.80 (up 0.60 to 1.0); moderate myopia 0.08 (up 0.03 to 0.13) and 0.87 ( up 0.74 to 1.0); high myopia 0.05 (up 0.02 to 0.08) and 0.83 (up 0.66 to 1.0); supermyopia 0.03 (up 0.02 to 0.04) and 0.59 ( up 0.34 to 0.84); hyperopia 0.27 (up 0.16 to 0.38) and 0.57 (up 0.27 to 0.87); mixed astigmatism of 0.35 (up 0.19 to 0.51) and 0.69 (up 0.44 to 0.94). In all cases, after LASIK indicators uncorrected visual acuity significantly increased. Reoperation was 4.43%. Significance: Clinical results of refractive surgery at the excimer laser system SCHWIND AMARIS 500E in different ametropia correction is characterized by high efficiency.

Keywords: effectiveness of laser correction, LASIK, refractive anomalies, surgical treatment

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Authors: John Acord, Ankita Batla, Kiran Khepar, Maude Schmidt, Charlotte Allen, Russ Bradford

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Objectives: Despite the availability oftreatment options, Parkinson’s disease (PD) continues to impact heavily on a patient’s quality of life (QoL), as many symptoms that bother the patient remain unexplored and untreated in clinical settings. The aims of this research were to understand the burden of PDsymptoms from a patient perspective, particularly those which are the most persistent and debilitating, and to determine if current treatments and treatment algorithms adequately focus on their resolution. Methods: A13-question, online, patient-reported survey was created based on the MDS-Unified Parkinson’s Disease Rating Scale (MDS-UPDRS)and symptoms listed on Parkinson’s Disease Patient Advocacy Groups websites, and then validated by 10 Parkinson’s patients. In the survey, patients were asked to choose both their most common and their most bothersome symptoms, whether they had received treatment for those and, if so, had it been effective in resolving those symptoms. Results: The most bothersome symptoms reported by the 111 participants who completed the survey were sleep problems (61%), feeling tired (56%), slowness of movements (54%), and pain in some parts of the body (49%). However, while 86% of patients reported receiving dopamine or dopamine like drugs to treat their PD, far fewer reported receiving targeted therapies for additional symptoms. For example, of the patients who reported having sleep problems, only 33% received some form of treatment for this symptom. This was also true for feeling tired (30% received treatment for this symptom), slowness of movements (62% received treatment for this symptom), and pain in some parts of the body (61% received treatment for this symptom). Additionally, 65% of patients reported that the symptoms they experienced were not adequately controlled by the treatments they received, and 9% reported that their current treatments had no effect on their symptoms whatsoever. Conclusion: The survey outcomes highlight that the majority of patients involved in the study received treatment focused on their disease, however, symptom-based treatments were less well represented. Consequently, patient-reported symptoms such as sleep problems and feeling tired tended to receive more fragmented intervention than ‘classical’ PD symptoms, such as slowness of movement, even though they were reported as being amongst the most bothersome symptoms for patients. This research highlights the need to explore symptom burden from the patient’s perspective and offer Customised treatment/support for both motor and non-motor symptoms maximize patients’ quality of life.

Keywords: survey, patient reported symptom burden, unmet needs, parkinson's disease

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Authors: Shahid Noor, Kazim Najjad, Muhammad Nasir, Irshad Bhutto, Abdul Samad Memon, Khurram Anwar, Tehseen Riaz, Mian Muhammad Hanif, Nauman A. Mallik, Saeed Ahmed, Israr Ahmed, Ali Yasir

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Background: Musculoskeletal pain is the most common complaint presented to the health practitioner. It is well known that untreated or under-treated pain can have a significant negative impact on an individual’s quality of life (QoL). Objectives: This study was conducted across 10 sites in six (6) major cities of Pakistan to evaluate the tolerability, safety, and the clinical response of Nuberol Forte® (Paracetamol 650 mg + Orphenadrine 50 mg) to musculoskeletal pain in routine Pakistani practice and its impact on improving the patient’s QoL. Design & Methods: This NFORT-EFFECT observational, prospective multicenter study was conducted in compliance with Good Clinical Practice guidelines and local regulatory requirements. The study sponsor was "The Searle Company Limited, Pakistan. To maintain the GCP compliances, the sponsor assigned the CRO for the site and data management. Ethical approval was obtained from an independent ethics committee. The IEC reviewed the progress of the study. Written informed consent was obtained from the study participants, and their confidentiality was maintained throughout the study. A total of 399 patients with known prescreened musculoskeletal conditions and pain who attended the study sites were recruited, as per the inclusion/exclusion criteria (clinicaltrials.gov ID# NCT04765787). The recruited patients were then prescribed Paracetamol (650 mg) and Orphenadrine (50 mg) combination (Nuberol Forte®) for 7 to 14 days as per the investigator's discretion based on the pain intensity. After the initial screening (visit 1), a follow-up visit was conducted after 1-2 weeks of the treatment (visit 2). Study Endpoints: The primary objective was to assess the pain management response of Nuberol Forte treatment and the overall safety of the drug. The Visual Analogue Scale (VAS) scale was used to measure pain severity. Secondary to pain, the patients' health-related quality of life (HRQoL) was also assessed using the Muscle, Joint Measure (MJM) scale. The safety was monitored on the first dose by the patients. These assessments were done on each study visit. Results: Out of 399 enrolled patients, 49.4% were males, and 50.6% were females with a mean age of 47.24 ± 14.20 years. Most patients were presented with Knee Osteoarthritis (OA), i.e., 148(38%), followed by backache 70(18.2%). A significant reduction in the mean pain score was observed after the treatment with the combination of Paracetamol and Orphenadrine (p<0.05). Furthermore, an overall improvement in the patient’s QoL was also observed. During the study, only ten patients reported mild adverse events (AEs). Conclusion: The combination of Paracetamol and Orphenadrine (Nuberol Forte®) exhibited effective pain management among patients with musculoskeletal conditions and also improved their QoL.

Keywords: musculoskeletal pain, orphenadrine/paracetamol combination, pain management, quality of life, Pakistani population

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Authors: LaShawnda N. Fields, Valandra

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As part of a larger study, this particular line of inquiry focuses on experiences of tokenism and invisible labor expected of Black women within social work education. Black women faculty members and doctoral students participated in semi-formal, in-depth interviews. All participants were identified as members of schools of social work within Carnegie-designated R-1 institutions. Several participants believed that their race independently and the intersection of their race and gender was often misrepresented by their institution as an indication of a diverse and equitable environment. These women believed they were often solicited to participate in visual materials and make public appearances to benefit the school while feeling invisible. Most of the Black women interviewed, whether faculty members or doctoral students, were the sole Black person or one of very few Black women at these schools of social work. Similarly, the Black doctoral students spoke of being “paraded around” as a prized show horse while enduring a toxic culture that lacks inclusion. These women expressed frustration and disappointment as their images and scholarship were featured on websites and within marketing materials, not the pride and joy such exposure should elicit. These experiences of tokenism were taking place while the women constantly received messages of not being good enough or not a good fit at their institution. Invisible labor refers to work that is not compensated nor formally recognized. This labor is primarily committee work and student support. Representation of Black women faculty members is limited at these research-intensive schools of social work resulting in these women being sought out by students across disciplines. Similarly, the Black women doctoral students are informally recruited as peer mentors to support those students rising in the ranks behind them. Though this work is rooted in retention efforts, it is never identified as such. All participants identified committee work related to their identities as another way they find themselves engaged in work that often goes unrecognized and underappreciated. Committee work is usually tied to identity work, such as diversity, equity, and inclusion though it rarely translates to action and improvements. This qualitative study provides insight into the lived experiences of an at-risk and under-represented demographic. Institutions can better understand how they can support this demographic. These Black women scholars have been invited into these institutions but have not historically been granted full access. These women have survived unsavory conditions through sheer determination and support found mostly outside their schools of social work. Utilizing this data as a springboard for informed and action-oriented strategic planning would allow institutions to create inclusive and equity cultures that result in Black women thriving versus simply surviving.

Keywords: education, equity, invisible labor, tokenism, intersectionality

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Authors: Gueidi Afef, Gharsellaoui Hamza, Ben Ahmed Samir

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This paper deals with the secret of the continual progression data that new data management solutions have been emerged: The NoSQL databases. They crossed several areas like personalization, profile management, big data in real-time, content management, catalog, view of customers, mobile applications, internet of things, digital communication and fraud detection. Nowadays, these database management systems are increasing. These systems store data very well and with the trend of big data, a new challenge’s store demands new structures and methods for managing enterprise data. The new intelligent machine in the e-learning sector, thrives on more data, so smart machines can learn more and faster. The robotics are our use case to focus on our test. The implementation of NoSQL for Robotics wrestle all the data they acquire into usable form because with the ordinary type of robotics; we are facing very big limits to manage and find the exact information in real-time. Our original proposed approach was demonstrated by experimental studies and running example used as a use case.

Keywords: NoSQL databases, database management systems, robotics, big data

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Authors: Fleura Shkëmbi, Valbona Treska

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In elementary school, we discover that a metaphor is a decorative linguistic device just for poets. But now that we know, it's also a crucial tactic that individuals employ to understand the universe, from fundamental ideas like time and causation to the most pressing societal challenges today. Metaphor is the use of language to refer to something other than what it was originally intended for or what it "literally" means in order to suggest a similarity or establish a connection between the two. People do not identify metaphors as relevant in their decisions, according to a study on metaphor and its effect on decision-making; instead, they refer to more "substantive" (typically numerical) facts as the basis for their problem-solving decision. Every day, metaphors saturate our lives via language, cognition, and action. They argue that our conceptions shape our views and interactions with others and that concepts define our reality. Metaphor is thus a highly helpful tool for both describing our experiences to others and forming notions for ourselves. In therapeutic contexts, their shared goal appears to be twofold. The cognitivist approach to metaphor regards it as one of the fundamental foundations of human communication. The benefits and disadvantages of utilizing the metaphor differ depending on the target domain that the metaphor portrays. The challenge of creating messages and surroundings that affect customers' notions of abstract ideas in a variety of industries, including health, hospitality, romance, and money, has been studied for decades in marketing and consumer psychology. The aim of this study is to examine, through a systematic literature review, the role of the metaphor in communication and in advertising. This study offers a selected analysis of this literature, concentrating on research on customer attitudes and product appraisal. The analysis of the data identifies potential research questions. With theoretical and applied implications for marketing, design, and persuasion, this study sheds light on how, when, and for whom metaphoric communications are powerful.

Keywords: metaphor, communication, advertising, cognition, action

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Authors: Eric Fang, Robert Chen, Ghim Song Chia, Bien Soo Tan

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Objective and Rationale: Training of radiology residents hinges on practical, on-the-job training in all facets and modalities of diagnostic radiology. Although residency is structured to be comprehensive, clinical exposure depends on the case mix available locally and during the posting period. To supplement clinical training, there are several e-learning resources available to allow for greater exposure to radiological cases. The objective of this study was to survey residents and faculty on the usefulness of these e-learning resources. Methods: E-learning resources were shortlisted with input from radiology residents, Google search and online discussion groups, and screened by their purported focus. Twelve e-learning resources were found to meet the criteria. Both radiology residents and experienced radiology faculty were then surveyed electronically. The e-survey asked for ratings on breadth, depth, testing capability and user-friendliness for each resource, as well as for rankings for the top 3 resources. Statistical analysis was performed using SAS 9.4. Results: Seventeen residents and fifteen faculties completed an e-survey. Mean response rate was 54% ± 8% (Range: 14- 96%). Ratings and rankings were statistically identical between residents and faculty. On a 5-point rating scale, breadth was 3.68 ± 0.18, depth was 3.95 ± 0.14, testing capability was 2.64 ± 0.16 and user-friendliness was 3.39 ± 0.13. Top-ranked resources were STATdx (first), Radiopaedia (second) and Radiology Assistant (third). 9% of responders singled out R-ITI as potentially good but ‘prohibitively costly’. Statistically significant predictive factors for higher rankings are familiarity with the resource (p = 0.001) and user-friendliness (p = 0.006). Conclusion: A good e-learning system will complement on-the-job training with a broad case base, deep discussion and quality trainee evaluation. Based on our study on twelve e-learning resources, no single program fulfilled all requirements. The perception and use of radiology e-learning resources depended more on familiarity and user-friendliness than on content differences and testing capability.

Keywords: e-learning, medicine, radiology, survey

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Authors: Chuanju Cheng

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In Taiwan, the system of indigenous reserved land was established in 1928 during the Japanese rule. The purpose of setting up indigenous reserved land is to support the livelihood of tribal peoples who live in the mountainous area. Since 1945, the KMT government has kept the indigenous reserved land; in principle, only indigenous people can use indigenous reserved land. However, the government also makes some exceptions for non-indigenous peoples to use the land. Furthermore, since 1966, an indigenous individual can have ownership (fee simple) over the land he/she uses. Recent studies showed that there are many problems regarding the indigenous reserved lands, such as indigenous peoples have been losing ownership of their land (both legally and illegally), mismatched data of the true owner and the nominal owner, overutilization of the reserved land and so on. Using a Truku tribe in Hualien County as an example, this paper tries to find out how many people still own indigenous reserved land, do land owners constantly utilize their lands, and if so, whether or not (and by what extent) the indigenous reserved land support the livelihood of tribal peoples? After ten months of working data-collecting, we’ve successfully collected 327 questionnaires (70% of total households); preliminary research results show that less than 5% of indigenous reserved land in and around that specific Truku tribe is owned by tribal people. And most of the landowners do not utilize indigenous reserved land. It seems that the indigenous reserved land system does not meet its legislative goals and needs to be redesigned.

Keywords: indigenous people, truku nation, taiwan, indigenous reserved land, poverty, economic development

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Authors: B. S. Akhmetov, P. T.Kharitonov, L. Sh. Balgabayeva, O. V. Kisseleva, T. S. Kartbayev

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This article analyzes the applicability of known renewable energy technical means as mobile power sources under the field and extreme conditions. The requirements are determined for the parameters of mobile micro-HPP. The application prospectively of the mobile micro-HPP with intelligent control systems is proved for this purpose. Variants of low-speed electric generators for micro HPP are given. Variants of designs for mobile micro HPP are presented with the direct (gearless) transfer of torque from the hydraulic drive to the rotor of the electric generator. Variant of the hydraulic drive for micro HPP is described workable at low water flows. A general structure of the micro HPP intelligent system control is offered that implements the principle of maximum energy efficiency. The legitimacy of construction and application of mobile micro HPP is proved as electrical power sources for life safety of people under the field and extreme conditions.

Keywords: mobile micro-hydro powerplants, information management systems, hydraulic drive, computer science

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Authors: Seema Ahlawat, Parul Saxena, Malik Zainul Abdin

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Malaria is a major health problem in many developing countries. The parasite responsible for the vast majority of fatal malaria infections is Plasmodium falciparum. Unfortunately, most Plasmodium strains including P. falciparum have become resistant to most of the antimalarials including chloroquine, mefloquine, etc. To combat this problem, WHO has recommended the use of artemisinin and its derivatives in artemisinin based combination therapy (ACT). Due to its current use in artemisinin based-combination therapy (ACT), its global demand is increasing continuously. But, the relatively low yield of artemisinin in A. annua L. plants and unavailability of economically viable synthetic protocols are the major bottlenecks for its commercial production and clinical use. Chemical synthesis of artemisinin is also very complex and uneconomical. The hairy root system, using the Agrobacterium rhizogenes LBA 9402 strain to enhance the production of artemisinin in A. annua L., is developed in our laboratory. The transgenic nature of hairy root lines and the copy number of trans gene (rol B) were confirmed using PCR and Southern Blot analyses, respectively. The effect of different concentrations of Piriformospora indica on artemisinin production in hairy root cultures were evaluated. 3% P. indica has resulted 1.97 times increase in artemisinin production in comparison to control cultures. The effects of P. indica on artemisinin production was positively correlated with regulatory genes of MVA, MEP and artemisinin biosynthetic pathways, viz. hmgr, ads, cyp71av1, aldh1, dxs, dxr and dbr2 in hairy root cultures of A. annua L. Mass scale cultivation of A. annua L. hairy roots by plant tissue culture technology may be an alternative route for production of artemisinin. A comprehensive investigation of the hairy root system of A. annua L. would help in developing a viable process for the production of artemisinin. The efficiency of the scaling up systems still needs optimization before industrial exploitation becomes viable.

Keywords: A. annua L., artemisinin, hairy root cultures, malaria

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