Search results for: demographic change
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 8319

Search results for: demographic change

3279 Structural Alteration of MoS₂ by Incorporating Fe, Co Composite for an Enhanced Oxygen Evolution Reaction

Authors: Krishnamoorthy Sathiyan, Shanti Gopal Patra, Ronen Bar-Ziv, Tomer Zidki

Abstract:

Developing efficient non-noble metal catalysts that are cheap and durable for oxygen evolution reaction (OER) is a great challenge. Moreover, altering the electronic structure of the catalyst and structural engineering of the materials provide a new direction for enhancing the OER. Herein, we have successfully synthesized Fe and Co incorporated MoS₂ catalysts, which show improved catalytic activity for OER when compared with MoS₂, Fe-MoS₂, and Co-MoS₂. It was found that at an optimal ratio of Fe and Co, the electronic and structural modification of MoS₂ occurs, which leads to change in orientation and thereby enhances the active catalytic sites on the edges, which are more exposed for OER. The nanocomposites have been well characterized by X-ray diffraction (XRD), scanning electron microscope (SEM), and energy dispersive X-ray analysis (EDX), Elemental Mapping, transmission electron microscope (TEM), and high-resolution transmission electron microscope (HR-TEM) analysis. Among all, a particular ratio of FeCo-MoS₂ exhibits a much smaller onset with better catalytic current density. The remarkable catalytic activity is mainly attributed to the synergistic effect from the Fe and Co. Most importantly, our work provides an essential insight in altering the electronic structure of MoS₂ based materials by incorporating promoters such as Co and Fe in an optimal amount, which enhances OER activity.

Keywords: electrocatalysts, molybdenum disulfide, oxygen evolution reaction, transition metals

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3278 Application of Discrete-Event Simulation in Health Technology Assessment: A Cost-Effectiveness Analysis of Alzheimer’s Disease Treatment Using Real-World Evidence in Thailand

Authors: Khachen Kongpakwattana, Nathorn Chaiyakunapruk

Abstract:

Background: Decision-analytic models for Alzheimer’s disease (AD) have been advanced to discrete-event simulation (DES), in which individual-level modelling of disease progression across continuous severity spectra and incorporation of key parameters such as treatment persistence into the model become feasible. This study aimed to apply the DES to perform a cost-effectiveness analysis of treatment for AD in Thailand. Methods: A dataset of Thai patients with AD, representing unique demographic and clinical characteristics, was bootstrapped to generate a baseline cohort of patients. Each patient was cloned and assigned to donepezil, galantamine, rivastigmine, memantine or no treatment. Throughout the simulation period, the model randomly assigned each patient to discrete events including hospital visits, treatment discontinuation and death. Correlated changes in cognitive and behavioral status over time were developed using patient-level data. Treatment effects were obtained from the most recent network meta-analysis. Treatment persistence, mortality and predictive equations for functional status, costs (Thai baht (THB) in 2017) and quality-adjusted life year (QALY) were derived from country-specific real-world data. The time horizon was 10 years, with a discount rate of 3% per annum. Cost-effectiveness was evaluated based on the willingness-to-pay (WTP) threshold of 160,000 THB/QALY gained (4,994 US$/QALY gained) in Thailand. Results: Under a societal perspective, only was the prescription of donepezil to AD patients with all disease-severity levels found to be cost-effective. Compared to untreated patients, although the patients receiving donepezil incurred a discounted additional costs of 2,161 THB, they experienced a discounted gain in QALY of 0.021, resulting in an incremental cost-effectiveness ratio (ICER) of 138,524 THB/QALY (4,062 US$/QALY). Besides, providing early treatment with donepezil to mild AD patients further reduced the ICER to 61,652 THB/QALY (1,808 US$/QALY). However, the dominance of donepezil appeared to wane when delayed treatment was given to a subgroup of moderate and severe AD patients [ICER: 284,388 THB/QALY (8,340 US$/QALY)]. Introduction of a treatment stopping rule when the Mini-Mental State Exam (MMSE) score goes below 10 to a mild AD cohort did not deteriorate the cost-effectiveness of donepezil at the current treatment persistence level. On the other hand, none of the AD medications was cost-effective when being considered under a healthcare perspective. Conclusions: The DES greatly enhances real-world representativeness of decision-analytic models for AD. Under a societal perspective, treatment with donepezil improves patient’s quality of life and is considered cost-effective when used to treat AD patients with all disease-severity levels in Thailand. The optimal treatment benefits are observed when donepezil is prescribed since the early course of AD. With healthcare budget constraints in Thailand, the implementation of donepezil coverage may be most likely possible when being considered starting with mild AD patients, along with the stopping rule introduced.

Keywords: Alzheimer's disease, cost-effectiveness analysis, discrete event simulation, health technology assessment

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3277 Effect of Testing Device Calibration on Liquid Limit Assessment

Authors: M. O. Bayram, H. B. Gencdal, N. O. Fercan, B. Basbug

Abstract:

Liquid limit, which is used as a measure of soil strength, can be detected by Casagrande and fall-cone testing methods. The two methods majorly diverge from each other in terms of operator dependency. The Casagrande method that is applied according to ASTM D4318-17 standards may give misleading results, especially if the calibration process is not performed well. To reveal the effect of calibration for drop height and amount of soil paste placement in the Casagrande cup, a series of tests were carried out by multipoint method as it is specified in the ASTM standards. The tests include the combination of 6 mm, 8 mm, 10 mm, and 12 mm drop heights and under-filled, half-filled, and full-filled Casagrande cups by kaolinite samples. It was observed that during successive tests, the drop height of the cup deteriorated; hence the device was recalibrated before and after each test to provide the accuracy of the results. Besides, the tests by under-filled and full-filled samples for higher drop heights revealed lower liquid limit values than the lower drop heights revealed. For the half-filled samples, it was clearly seen that the liquid limit values didn’t change at all as the drop height increased, and this explains the function of standard specifications.

Keywords: calibration, casagrande cup method, drop height, kaolinite, liquid limit, placing form

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3276 Impact Factor Analysis for Spatially Varying Aerosol Optical Depth in Wuhan Agglomeration

Authors: Wenting Zhang, Shishi Liu, Peihong Fu

Abstract:

As an indicator of air quality and directly related to concentration of ground PM2.5, the spatial-temporal variation and impact factor analysis of Aerosol Optical Depth (AOD) have been a hot spot in air pollution. This paper concerns the non-stationarity and the autocorrelation (with Moran’s I index of 0.75) of the AOD in Wuhan agglomeration (WHA), in central China, uses the geographically weighted regression (GRW) to identify the spatial relationship of AOD and its impact factors. The 3 km AOD product of Moderate Resolution Imaging Spectrometer (MODIS) is used in this study. Beyond the economic-social factor, land use density factors, vegetable cover, and elevation, the landscape metric is also considered as one factor. The results suggest that the GWR model is capable of dealing with spatial varying relationship, with R square, corrected Akaike Information Criterion (AICc) and standard residual better than that of ordinary least square (OLS) model. The results of GWR suggest that the urban developing, forest, landscape metric, and elevation are the major driving factors of AOD. Generally, the higher AOD trends to located in the place with higher urban developing, less forest, and flat area.

Keywords: aerosol optical depth, geographically weighted regression, land use change, Wuhan agglomeration

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3275 Service Life Modelling of Concrete Deterioration Due to Biogenic Sulphuric Acid (BSA) Attack-State-of-an-Art-Review

Authors: Ankur Bansal, Shashank Bishnoi

Abstract:

Degradation of Sewage pipes, sewage pumping station and Sewage treatment plants(STP) is of major concern due to difficulty in their maintenance and the high cost of replacement. Most of these systems undergo degradation due to Biogenic sulphuric acid (BSA) attack. Since most of Waste water treatment system are underground, detection of this deterioration remains hidden. This paper presents a literature review, outlining the mechanism of this attack focusing on critical parameters of BSA attack, along with available models and software to predict the deterioration due to this attack. This paper critically examines the various steps and equation in various Models of BSA degradation, detail on assumptions and working of different softwares are also highlighted in this paper. The paper also focuses on the service life design technique available through various codes and method to integrate the servile life design with BSA degradation on concrete. In the end, various methods enhancing the resistance of concrete against Biogenic sulphuric acid attack are highlighted. It may be concluded that the effective modelling for degradation phenomena may bring positive economical and environmental impacts. With current computing capabilities integrated degradation models combining the various durability aspects can bring positive change for sustainable society.

Keywords: concrete degradation, modelling, service life, sulphuric acid attack

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3274 Pharmacokinetic Assessment of Antimicrobial Treatment of Acute Exacerbations of Chronic Obstructive Pulmonary Disease in Hospitalized Patients Colonized with Pseudomonas aeruginosa

Authors: Juliette Begin, Juliano Colapelle, Andrea Taratanu, Daniel Thirion, Amelie Marsot, Bryan A. Ross

Abstract:

Chronic obstructive pulmonary disease (COPD), a leading cause of death globally, is characterized by chronic airflow obstruction and acute exacerbations (AECOPDs) that are often triggered by respiratory infections. Pseudomonas aeruginosa (P. aeruginosa), a potentially serious bacterial cause of AECOPDs, is treated with targeted anti-pseudomonal antibiotics. These select few antimicrobials are often used as first-line therapy in patients who are clinically unwell and/or in those suspected of P. aeruginosa-related infection prior to confirmation, potentially contributing to antimicrobial resistance. The present study evaluates prescribing practices in patients with a confirmed sputum history of P. aeruginosa admitted for AECOPD at the McGill University Health Centre (MUHC) and treated with anti-pseudomonal antibiotics. Serum antibiotic concentrations were measured from the same-day peak, trough, and mid-dose blood sampling intervals after reaching steady-state (on or after day 3) and were quantified using ultra-high-performance liquid chromatography (UHPLC). Demographic, clinical, and treatment outcomes were extracted from patient medical charts. Treatment failure was defined by respiratory-related death or mechanical ventilation after ≥3 days of antibiotics; antibiotic therapy extended beyond 2 weeks or a new antibiotic regimen started; or urgent care readmission within 30 days for AECOPD. To date, 9 of 30 planned participants have completed testing: seven received ciprofloxacin, one received meropenem, and one received piperacillin-tazobactam. Due to serum sample batching requirements, the serum ciprofloxacin concentration results for the first 2/8 participants are presented at the time of writing. The first participant had serum levels of 5.45mg/L (T₀), 4.74mg/L (T₅₀), and 4.49mg/L (T₁₀₀), while the second had serum levels of 5mg/L (T₀), 2.6mg/L (T₅₀), and 2.51mg/L (T₁₀₀). Pharmacokinetic parameters Cmax (5.18±0.43mg/L), T₁/₂ (23.56±18.94hours), and AUC (181.9±155.95mg*h/l) were higher than reported monograph values and met target AUC-to-MIC ratio of >125. The patients treated with meropenem and with piperacillin-tazobactam experienced treatment failure. Preliminary results suggest that standard ciprofloxacin dosing in patients experiencing an AECOPD and colonized with P. aeruginosa appears to achieve effective serum concentrations. Final cohort results will inform the pharmacokinetic appropriateness and clinical sufficiency of current AECOPD antimicrobial strategies in P. aeruginosa-colonized patients. This study will guide clinicians in determining the appropriate dosing for AECOPD treatment to achieve therapeutic levels, optimizing outcomes, and minimizing adverse effects. It could also highlight the value of routine antibiotic level monitoring in patients with treatment failure to ensure optimal serum concentrations.

Keywords: acute exacerbation, antimicrobial resistance, chronic obstructive pulmonary disease, pharmacokinetics/pharmacodynamics, Pseudomonas aeruginosa

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3273 Kinetics of Acetaminophen Based Oscillatory Chemical Reaction with and without Ferroin as Catalyst: An Inorganic Prototype Model for Paracetamol-Ethanol Syndrome

Authors: Nadeem Bashir, Ghulam Mustafa Peerzada

Abstract:

The present study pertains to the nonlinear behavior of acetaminophen based uncatalyzed Belousov-Zhabotinsky (BZ) oscillator and its dynamics in the presence of Ferroin as the catalyst. The role of free metal ions as catalysts was examined and the results compared with corresponding complexed catalysts. Free metal ions were found to be sluggish with respect to the evolution of the oscillatory regime as compared to complexed ones. Effect of change of the ligand moiety of the catalyst complex on the oscillatory parameters was monitored. Since ethanol potentiates the hepatotoxicity caused by acetaminophen in-vivo, it is thought to understand this interaction by virtue of causing perturbation of the acetaminophen based oscillator with different concentrations of the ethanol with and without ferroin as the catalyst. Another dimension to the ethanol effect was added by perturbation of the system with ethanol at different stages of the reaction so as to get an idea whether it is acetaminophen or some reactive intermediate generated in the reaction system which reacts with ethanol. Further, the ferroin-catalyzed oscillator is taken as a prototype inorganic model of the acetaminophen-ethanol syndrome, as ferroin and HOBr were inorganic replacements to Cyt P450 and NADPH in the alcohol metabolism.

Keywords: Belousov-Zhabotinsky reaction, ferroin, Paracetamol-Ethanol syndrome, kinetics

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3272 Experimental Study on Post-Fire Mechanical Properties of S235 Steel

Authors: Mahyar Maali, Merve Sagiroglu, Mahmut Kilic, Abdulkadir Cuneyt Aydin

Abstract:

In order to evaluate the residual strength of S235 (St37) steel structures after the fire, an experimental program was undertaken to investigate the post-fire mechanical properties. Tensile coupons taken from S235 sheets were exposed to varying temperatures as 200°C, 400°C, 600°C, and 800 °C. The samples were then allowed to cool down to ambient temperature before they were tested to failure. To obtain the mechanical properties of steels; tensile tests are performed, and the post-fire stress-strain curves are evaluated. The microstructures of the heat-treated specimens were examined by Scanning Electron Microscope (SEM). It is seen that morphology and size of the precipitates in the specimens change, as the heat increases. The modulus of elasticity decreases, and deformation increases with temperature. Energy dissipation decreases due to lower stress according to the stress-strain curves of the specimens. Especially, the mechanical properties were decreased compared with the pre-fire ones. As a result of the post-fire and pre-fire behavior of S235, a set of equations is evaluated to predict the mechanical properties after the fire. These types of equations may allow the structural and/or fire engineers to predict accurately the post-fire behavior of the buildings constructed with S235 type steel.

Keywords: post-fire behavior, stress-strain curves, experimental study, S235 steel

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3271 Young Women in Residential Care: The Interplay between Dominant Narratives and Personal Stories

Authors: M. A. Marlow, R. Sørly, H. K. Kaatrakoski

Abstract:

Social work practice produces and circulates dominant narratives of young women in residential care. These stories are characterised by negative descriptions and hopelessness while dismissing the capabilities of narrative practice. This paper gives an account of how young women with histories in residential care can resist the dominant narratives. The analysis is based on a study of five young women aged 17 to 26 years old with different backgrounds and experiences with Norwegian residential care. The meaning of the context is analysed based on two interviews that were completed and one that was cancelled in the field. The contextual narrative analysis was oriented around the understanding of stories as performances and provided insight into a possible future storytelling practice in social work. The first author’s field notes are included as part of the data material in the analysis and provide a picture of important knowledge development related to stories and the value of being able to tell one’s own experiences. Faced with the dominant narratives that define young women with negative experiences with residential care, we provide a more contextualised understanding of storytelling as a possibility for positive change. To allow young women to create new stories from their lives, we, as both social workers and researchers, must be aware of what kinds of stories we relate to our own practices.

Keywords: context analysis, narrative research, rejection, residential care, social work practice

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3270 Comparative Study on Effectiveness and Safety of Oral Antidiabetic Medications in Patients with Type 2 Diabetes Mellitus in a Tertiary Care Hospital of Bangalore, South India - A Prospective Cohort Study

Authors: Shobha Rani R. Hiremath, Keerthana R., Madhuvan H. S.

Abstract:

BACKGROUND: Type 2 Diabetes is a chronic health condition where the body cannot effectively use the insulin it produces, leading to elevated blood sugar levels It is often associated with lifestyle factors and insulin resistance. Globally, diabetes is on the rise, with urban areas like Bangalore seeing a surge due to lifestyle changes, stress, and dietary habits. To manage diabetes effectively, over 50 medications are available, each serving to regulate blood sugar through different mechanisms. This reflects the complex and individualized nature of diabetes treatment. Given the increase in medications for Type 2 diabetes mellitus, it is important to evaluate their effectiveness and safety so that clinicians can make informed choices while treating their patients. OBJECTIVES: To evaluate the effectiveness of various anti-diabetic medications used in the hospital in Type 2 diabetes patients by monitoring their HbA1c levels. To assess the safety of these medications by monitoring Adverse drug reactions if any. METHODOLOGY Design : Prospective Cohort study, Study period: 8 months, Sample Size: 100 patients, Inclusion Criteria: Patients above 18 years of both genders who were diagnosed with T2DM and who were prescribed oral hypoglycaemic agents. Exclusion Criteria: Diabetic patients with hepatic/renal failure, patients prescribed with insulin /not prescribed with OHAs and patients who were terminally ill, pregnant and lactating patients. Source of Data: Prescriptions, lab reports, ECG reports. Data collection forms were used to collect data which consisted of patient demographic details, drugs prescribed, laboratory investigations such as HbA1C, FBS, PPBS , ECG and any ADRs experienced. Data was collected at baseline, 3 months, and 6 months. It was statistically analyzed using SPSS (version 26) software. RESULTS: Greater number of patients (46%) were in the age group of greater than 61 years. 43 patients had no co-morbidities whereas 51 patients had Hypertension as the co morbidity. Basically 5 Drug combinations were prescribed as follows. Combination 1: Tablet Metformin HCL + Glimepiride (500, 2 mg) : 1-0-1, Combination 2: Tablet Sitagliptin + Metformin HCL (50, 500 mg) : 1-0-1, Combination 3: Tablet Vildagliptin + Metformin HCL (50, 500 mg): 1-0-1, Combination 4: Tablet Voglibose+ Glimepiride+ Metformin HCL (0.2 ,2 ,500mg): : 1-0-1, Combination 5: Tablet Voglibose+ Glimepiride+ Metformin HCL (0.2, 2 ,500mg): : 1-0-1 and T. Sitagliptin +Metformin HCL (50, 500 mg): 0-1-0. Combination 5 (Voglibose, Glimepiride, Metformin, Sitagliptin) was most effective in reducing HbA1c levels, showing a significant decrease (-0.00682, p = 0.001), followed by Combinations 4 and 3. However, Combination 5 also had the highest incidence of gastrointestinal side effects (72.7%) and ECG abnormalities (27.3%). Combination 1 (Metformin + Glimepiride) had the highest occurrence of hypoglycemia due to Glimepiride's insulin-stimulating effects. Weight loss was most notable in Combination 5, affecting 36.36% of patients. CONCLUSION: The enhanced effectiveness of Combinations 3, 4, and 5 suggests that a multi-drug approach that incorporates different mechanisms of action is more effective in managing HbA1c levels in patients with diabetes. Adverse effect profiles should be considered for personalized treatment strategies.

Keywords: type 2 diabetes, safety, oral anti diabetic medications, effectiveness

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3269 Gum Arabic-Coated Magnetic Nanoparticles for Methylene Blue Removal

Authors: Eman Alzahrani

Abstract:

Magnetic nanoparticles (MNPs) were fabricated using the chemical co-precipitation method followed by coating the surface of magnetic Fe3O4 nanoparticles with gum arabic (GA). The fabricated magnetic nanoparticles were characterised using transmission electron microscopy (TEM) which showed that the Fe3O4 nanoparticles and GA-MNPs nanoparticles had a mean diameter of 33 nm, and 38 nm, respectively. Scanning electron microscopy (SEM) images showed that the MNPs modified with GA had homogeneous structure and agglomerated. The energy dispersive X-ray spectroscopy (EDAX) spectrum showed strong peaks of Fe and O. X-ray diffraction patterns (XRD) indicated that the naked magnetic nanoparticles were pure Fe3O4 with a spinel structure and the covering of GA did not result in a phase change. The covering of GA on the magnetic nanoparticles was also studied by BET analysis, and Fourier transform infrared spectroscopy. Moreover, the present study reports a fast and simple method for removal and recovery of methylene blue dye (MB) from aqueous solutions by using the synthesised magnetic nanoparticles modified with gum arabic as adsorbent. The experimental results show that the adsorption process attains equilibrium within five minutes. The data fit the Langmuir isotherm equation and the maximum adsorption capacities were 8.77 mg mg-1 and 14.3 mg mg-1 for MNPs and GA-MNPs, respectively. The results indicated that the homemade magnetic nanoparticles were quite efficient for removing MB and will be a promising adsorbent for the removal of harmful dyes from waste-water.

Keywords: Fe3O4 magnetic nanoparticles, gum arabic, co-precipitation, adsorption dye, methylene blue, adsorption isotherm

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3268 Research on Road Openness in the Old Urban Residential District Based on Space Syntax: A Case Study on Kunming within the First Loop Road

Authors: Haoyang Liang, Dandong Ge

Abstract:

With the rapid development of Chinese cities, traffic congestion has become more and more serious. At the same time, there are many closed old residential area in Chinese cities, which seriously affect the connectivity of urban roads and reduce the density of urban road networks. After reopening the restricted old residential area, the internal roads in the original residential area were transformed into urban roads, which was of great help to alleviate traffic congestion. This paper uses the spatial syntactic theory to analyze the urban road network and compares the roads with the integration and connectivity degree to evaluate whether the opening of the roads in the residential areas can improve the urban traffic. Based on the road network system within the first loop road in Kunming, the Space Syntax evaluation model is established for status analysis. And comparative analysis method will be used to compare the change of the model before and after the road openness of the old urban residential district within the first-ring road in Kunming. Then it will pick out the areas which indicate a significant difference for the small dimensions model analysis. According to the analyzed results and traffic situation, the evaluation of road openness in the old urban residential district will be proposed to improve the urban residential districts.

Keywords: Space Syntax, Kunming, urban renovation, traffic jam

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3267 Point-Mutation in a Rationally Engineered Esterase Inverts its Enantioselectivity

Authors: Yasser Gaber, Mohamed Ismail, Serena Bisagni, Mohamad Takwa, Rajni Hatti-Kaul

Abstract:

Enzymes are safe and selective catalysts. They skillfully catalyze chemical reactions; however, the native form is not usually suitable for industrial applications. Enzymes are therefore engineered by several techniques to meet the required catalytic task. Clopidogrel is recorded among the five best selling pharmaceutical in 2010 under the brand name Plavix. The commonly used route for production of the drug on an industrial scale is the synthesis of the racemic mixture followed by diastereomeric resolution to obtain the pure S isomer. The process consumes a lot of solvents and chemicals. We have evaluated a biocatalytic cleaner approach for asymmetric hydrolysis of racemic clopidogrel. Initial screening of a selected number of hydrolases showed only one enzyme EST to exhibit activity and selectivity towards the desired stereoisomer. As the crude EST is a mixture of several isoenzymes, a homology model of EST-1 was used in molecular dynamic simulations to study the interaction of the enzyme with R and S isomers of clopidogrel. Analysis of the geometric hindrances of the tetrahedral intermediates revealed a potential site for mutagenesis in order to improve the activity and the selectivity. Single point mutation showed dramatic increase in activity and inversion of the enantioselectivity (400 fold change in E value).

Keywords: biocatalysis, biotechnology, enzyme, protein engineering, molecular modeling

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3266 Surface Enhanced Raman Substrate Detection on the Structure of γ-Aminobutyric Acid(GABA) Connected with Modified Gold-Chitosan Nanoparticles by Mercaptopropionic Acid (MPA)

Authors: Bingjie Wang, Su-Yeon Kwon, Ik-Joong Kang

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A Surface-enhanced Raman Scattering (SERS) as the principle for enhancing Raman scattering by molecules adsorbed on rough metal surfaces or by nanostructures is used to detect the concentration change of γ-Aminobutyric Acid (GABA). As for the gold-chitosan nanoshell, it is made by using chitosan nanoparticles crosslinking with sodium tripolyphosphate(TPP) for the first step to form the chitosan nanoparticles, which would be covered with the gold sequentially. The size of the fabricated product was around 100nm. Based on the method that the sulfur end of the MPA linked to gold can form the very strong S–Au bond, and the carboxyl group, the other end of the MPA, can easily absorb the GABA. GABA is the mainly inhibitory neurotransmitter in the mammalian central nervous system in the human body. It plays such significant role in reducing neuronal excitability throughout the nervous system. When the system formed, it generated SERS, which made a clear difference in the intensity of Raman scattering within the range of GABA concentration. So it is obtained from the experiment that the calibration curve according to the GABA concentration relevant with the SERS scattering. In this study, DLS, SEM, FT-IR, UV, SERS were used to analyze the products to obtain the conclusion.

Keywords: chitosan-gold nanoshell, mercaptopropionic acid, γ-aminobutyric acid, surface-enhanced Raman scattering

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3265 Green Synthesis and Characterization of Zinc and Ferrous Nanoparticles for Their Potent Therapeutic Approach

Authors: Mukesh Saran, Ashima Bagaria

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Green nanotechnology is the most researched field in the current scenario. Herein we study the synthesis of Zinc and Ferrous nanoparticles using Moringa oleifera leaf extracts. Our protocol using established protocols heat treatment of plant extracts along with the solution of copper sulphate in the ratio of 1:1. The leaf extracts of Moringa oleifera were prepared in deionized water. Copper sulfate solution (1mM) was added to this, and the change in color of the solution was observed indicating the formation of Cu nanoparticles. The as biosynthesized Cu nanoparticles were characterized with the help of Scanning Electron Microscopy (SEM), and Fourier Transforms Infrared Spectroscopy (FTIR). It was observed that the leaf extracts of Moringa oleifera can reduce copper ions into copper nanoparticles within 8 to 10 min of reaction time. The method thus can be used for rapid and eco-friendly biosynthesis of stable copper nanoparticles. Further, we checked their antimicrobial and antioxidant potential, and it was observed that maximum antioxidant activity was observed for the particles prepared using the heating method. The maximum antibacterial activity was observed in Streptomyces grisveus particles and in Triochoderma Reesei for the maximum antifungal activity. At present, we are engaged in studying the anti-inflammatory activities of these as prepared nanoparticles.

Keywords: green synthesis, antibacterial, antioxidant, antifungal, anti-inflammatory

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3264 Cross-Sectional Associations between Deprivation Status and Physical Activity, Dietary Behaviours, Health-Related Variables, and Health-Related Quality of Life among Children Aged 9-11 Years

Authors: Maria Cardova

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Aim and objectives: The purpose of this studywas to explore to what extent the deprivation statusinfluenced children’s physical activity, dietary behaviour, and health outcomes such as weight status. Background: The United Kingdom’s childhood obesity rates are currently ranked among the highest in Europe. North West England deals with highest rates of childhood obesity. Data from the UK Millennium Cohort Study suggested a deprivation gradient to childhood obesity in England, with obesity rates being the highest in the most deprived areas. Traditionally, it has been individual conception of health, but the contemporary stance is that health behaviours affecting obesity are influenced by a broad range of factors operating at multiple levels. According to socio-ecological model of health behaviour, differences in obesity rates and health outcomes are likely explained by differences in lifestyle behaviours including physical activity and diet behaviours. However, higher rates of obesity among deprived children are not due to physical inactivity, in fact, most socially disadvantaged children are the most physically active. Poor diet including high consumption of fast food and sugar-sweetened beverages and low consumption of fruit and vegetables was found to be the most prevalent among adolescents living in poverty. Methods: This study adopted quantitative approach. It consisted of combination of basic demographic data, anthropometry, and questionnaires. Children (N = 165, mean age = 10.04 years; 53.33% female; 46.66% male) completed survey packs during school day including KIDSCREEN, Youth Activity Profile, Beverage and Snack Questionnaire, and Child Body Image Scale questionnaires as well as had anthropometric measurements taken including Body mass index, waist circumference, weight, and height. Children’s deprivation status was based on the English Indices of Multiple Deprivation scores of the school they attended. Results: Children from more deprived areas had higher weight status, waist circumference. Deprivation status had also effect on some dimensions of the KIDSCREEN questionnaire, such as that those from more deprived areas felt less socially accepted and bullied by their peers, had worse feelings about themselves such as body image, and more difficulty with school and learning. Children from more deprived areas reported higher rates of physical activity and also differences in snack and fruit and vegetable intake than their more affluent peers. Conclusion: Results demonstrated that, children living in the most-deprived areas appear to be at greater risk of unfavourable health-related variables and behaviours and are exposed to home and neighbourhood environments that are less conducive to health-promoting behaviours compared to their peers from less deprived areas. These findings indicate that children living in highly deprived areas represent an important group for future interventions designed to promote health-behaviours that would impact on the quality of life of the child and other health variables such as weight status.

Keywords: children, dietary behaviour, health, obesity, physical Activity, weight Status

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3263 Interior Outdoors of Tomorrow: A Study on the Rising Influence of the 'Interior' Vocabulary in the Design of Outdoor Spaces and the Fading Role of the Architectural Discourse

Authors: Massimo Imparato

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The study aims to identify the background of the contemporary trends in the design of commercial outdoors, and the reasons for the radical change in the traditional relationship between architecture and interior design, where the latter is taking over the construction of the visual narrative framing the users’ experience, which was ruled in the past by the architectural discourse. The design of commercial interiors, in fact, influences the way in which their outdoor spaces are organized and used more than ever before, and reflects the multi-faceted changes in the consumers’ behaviors and their interaction with the built environment. The study starts with the analysis of the evolution of sheltered outdoor spaces to achieve a broader understanding of the shift of meaning of subjects such as private and public domains, and to consider the varied ways of interaction/integration between the building and its exterior space. The study identifies the major social, physical and cultural aspects influencing the design of contemporary commercial outdoor spaces, suggests a new framework for their understanding and draws the methodological guidelines for the development of a structured approach to the design of commercial outdoors. The purpose of the paper is to stress the influence of the design of interiors into the public realm, to indicate new directions in this field of research, and to provide new methodological tools for interior design professionals.

Keywords: interior design, landscape design, visual narrative, outdoor design

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3262 Impact of the COVID-19 Pandemic and Social Isolation on the Clients’ Experiences in Counselling and their Access to Services: Perspectives of Violence Against Women Program Staff - A Qualitative Study

Authors: Habiba Nahzat, Karen Crow, Lisa Manuel, Maria Huijbregts

Abstract:

Background and Rationale: The World Health Organization (WHO) declared COVID-19 a pandemic on March 11, 2020. Shortly after, the Ontario provincial and Toronto municipal governments also released multiple directives that led to the mass closure of businesses both in the public and private sectors. Recent research has identified connections between Intimate Partner Violence (IPV) and COVID-19 related stressors - especially because of lockdown and social isolation measures. Psychological impacts of lengthy seclusion coupled with disconnection from extended family and diminished support services can take a toll on families at risk and may increase mental health issues and the prevalence of IPV. Research Question: Thus, the purpose of the study was to understand the perspective of the Violence Against Women (VAW) program staff on the impact of the COVID-19 pandemic; we especially wanted to understand staff views of restrictions on clients’ counseling experiences and the ability to access services in general. The study also aimed to examine VAW program staff experiences regarding remote work and explore how the pandemic restriction measures affected the ability of their program operations to support their clients and each other. Method: A cross-sectional, descriptive qualitative study was conducted with a purposive sample of 9 VAW program staff – eight VAW counselors and one VAW manager. Prior to data collection, program staff collaborated in the development of the study purpose, interview questions and methodology. Ethics approval was obtained from the sponsoring organization’s Research Ethics Board. In-depth individual interviews were conducted with study participants using a semi-structured interview questionnaire. Brief demographic information was also collected prior to the interview. Descriptive statistics were used to analyze quantitative data and qualitative data was analyzed by thematic content analysis. Results: Findings from this study indicate that the COVID-19 pandemic restrictions had an adverse impact on clients seeking VAW services based on VAW staff perspectives. Program staff reported a perceived increase in abuse among women, especially in emotional and financial abuse and experiences of isolation and trauma. Findings further highlight the challenges women experienced when trying to access services in general as well as counseling and legal services. This was perceived to be more prominent among newcomers and marginalized women. The study also revealed client and staff challenges when participating in virtual counseling, their innovations and clients’ creativity in accessing needed counseling and how staff over time adapted to providing virtual support during the pandemic. Conclusion and Next Steps: This study builds upon existing evidence on the impact of COVID-19 restrictions on VAW and may inform future research to better understand the association between the COVID-19 pandemic restrictions and VAW on a broader scale and to inform and support possible short-term and long-term changes in the client experience and counselling practice.

Keywords: COVID-19, pandemic, virtual, violence against women (VAW)

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3261 Large-Eddy Simulations for Flow Control

Authors: Reda Mankbadi

Abstract:

There are several technologically-important flow situations in which there is a need to control the outcome of the fluid flow. This could include flow separation, drag, noise, as well as particulate separations, to list only a few. One possible approach is the passive control, in which the design geometry is changed. An alternative approach is the Active Flow Control (AFC) technology in which an actuator is imbedded in the flow field to change the outcome. Examples of AFC are pulsed jets, synthetic jets, plasma actuators, heating and cooling, Etc. In this work will present an overview of the development of this field. Some examples will include: Airfoil Noise Suppression: LES is used to simulate the effect of the synthetic jet actuator on controlling the far field sound of a transitional airfoil. The results show considerable suppression of the noise if the synthetic jet is operated at frequencies. Mixing Enhancement and suppression: Results will be presented to show that imposing acoustic excitations at the nozzle exit can lead to enhancement or reduction of the jet plume mixing. In a vertical takeoff of Aircraft or in Space Launch, we will present results on the effects of water injection on reducing noise, and on protect the structure and pay load from fatigue damage. Other applications will include airfoil-gust interaction and propulsion systems optimizations.

Keywords: aerodynamics, simulations, aeroacoustics, active flow control (AFC), Large-Eddy Simulations (LES)

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3260 Transparency within the Hierarchy of the Catholic Church in the Treatment of Clergy Sexual Abuse Cases

Authors: Brang Mai Lazing

Abstract:

The central argument of this paper proposes that while democracy cannot guarantee transparency, authentic transparency within the hierarchy of the Church can be pursued as a means of dealing with cases of clergy sexual abuse. Amid the recent global scandal of clergy sexual abuse cases, a previous study has argued that a democratic rule should be applied to the administration of the Church so that, while a democratic Church could be compelled to exercise greater transparency when handling such cases, the Church might thereby regain credibility. Using the methodology of literature analysis, this paper explores the necessity for hierarchy and finds that democracy cannot be a guarantee for transparency. Further, through a dialogue between the theological insights of Benedict XVI and Edward Schillebeeckx, this paper argues that transparency practices are possible within the hierarchy of the Catholic Church in dealing with clergy sexual abuse cases. Finally, three implications of transparency in dealing with clergy sexual abuse cases are proposed, viz.: (a) that the harm which is ultimately done to the sacred faith of believers and to the sacred origin of the hierarchy through clergy sexual abuse cases should be given greater emphasis, (b) that the removal of unnecessary layers within the Church hierarchy or replacement with layers empowered with the authority to effect change might help implement accountability and transparency practices, and (c) that any changes made to enhance transparency should be made in terms of ‘adaptability’.

Keywords: Benedict XVI, clergy sexual abuses, democracy, Edward Schillebeeckx, hierarchy, transparency

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3259 The Symbiotic Relation of Mythical Stories in Transforming Human Lives

Authors: Gayatri Kanwar

Abstract:

The purpose of this research paper is to explore the power of myth in changing human lives; it establishes patterns in the human psyche, affects the way of thinking, as myths unveil various subjects, ideas, and challenges. Through mythological stories one comes to understand the images behind the emotions and feelings, they influence him as it changes his thought patterns, their therapeutic sets the individual on the path of healing and transforms human lives. Every civilization in the olden times had a vast source of myths which they lived by. They were not ordinary stories of everyday life, but exemplary cases narrated through oral traditions in a sacred manner revealed the 'way to live life'. The mythical stories have a spiritual touch which brought him to the acceptance of suffering or finding a solution to his life problems. In modern times, the significance of the age old myth has lost their touch. Each one of us bears countless stories inside ourselves of our own lives and all its happenings. Therefore, each being is a natural narrator. Everybody tells stories about their lives; hence, one tends to know oneself as well as seeks understanding of others through them. When one remembers their stories they speak in narratives. As stated by Jung, these narratives grow into a personal mythology one lives by. Nonetheless, there are times when one becomes stuck in their own stories or myths. Hence, mythology can change one’s perception and can open pathways to other ways of discovering, feeling and experiencing one’s lives.

Keywords: Power of Myths, Significance of myths in modern times, Transforming human lives, Benefits to Society

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3258 Mapping Stress in Submerged Aquatic Vegetation Using Multispectral Imagery and Structure from Motion Photogrammetry

Authors: Amritha Nair, Fleur Visser, Ian Maddock, Jonas Schoelynck

Abstract:

Inland waters such as streams sustain a rich variety of species and are essentially hotspots for biodiversity. Submerged aquatic vegetation, also known as SAV, forms an important part of ecologically healthy river systems. Direct and indirect human influences, such as climate change are putting stress on aquatic plant communities, ranging from the invasion of non-native species and grazing, to changes in the river flow conditions and temperature. There is a need to monitor SAV, because they are in a state of deterioration and their disappearance will greatly impact river ecosystems. Like terrestrial plants, SAV can show visible signs of stress. However, the techniques used to map terrestrial vegetation from its spectral reflectance, are not easily transferable to a submerged environment. Optical remote sensing techniques are employed to detect the stress from remotely sensed images through multispectral imagery and Structure from Motion photogrammetry. The effect of the overlying water column in the form of refraction, attenuation of visible and near infrared bands in water, as well as highly moving targets, are NIR) key challenges that arise when remotely mapping SAV. This study looks into the possibility of mapping the changes in spectral signatures from SAV and their response to certain stresses.

Keywords: submerged aquatic vegetation, structure from motion, photogrammetry, multispectral, spectroscopy

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3257 Experimental Research on the Elastic Modulus of Bones at the Lamellar Level under Fatigue Loading

Authors: Xianjia Meng, Chuanyong Qu

Abstract:

Compact bone produces fatigue damage under the inevitable physiological load. The accumulation of fatigue damage can change the bone’s micro-structure at different scales and cause the catastrophic failure eventually. However, most tests were limited to the macroscopic modulus of bone and there is a need to assess the microscopic modulus during fatigue progress. In this paper, nano-identation was used to investigate the bone specimen subjected to four point bending. The microscopic modulus of the same area were measured at different degrees of damage including fracture. So microscopic damage can be divided into three stages: first, the modulus decreased rapidly and then They fell slowly, before fracture the decline became fast again. After fracture, the average modulus decreased by 20%. The results of inner and outer planes explained the influence of compressive and tensile loads on modulus. Both the compressive and tensile moduli decreased with the accumulation of damage. They reached the minimum at ending and increased after fracture. The modulus evolution under different strains were revealed by the side. They all fell slowly and then fast with the accumulation of damage. The fractured results indicated that the elastic modulus decreased obviously at the high strain while decreased less at the low strain. During the fatigue progress, there was a significant difference in modulus at low degree of damage. However, the dispersed modulus tended to be similar at high degree of damage, but they became different again after the failure.

Keywords: fatigue damage, fracture, microscopic modulus, bone, nano-identation

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3256 The Impact of Technology on Architecture and Graphic Designs

Authors: Feby Zaki Raouf Fawzy

Abstract:

Nowadays, design and architecture are being affected and undergoing change with the rapid advancements in technology, economics, politics, society, and culture. Architecture has been transforming with the latest developments after the inclusion of computers in design. Integration of design into the computational environment has revolutionized architecture and unique perspectives in architecture have been gained. The history of architecture shows the various technological developments and changes in which architecture has transformed with time. Therefore, the analysis of integration between technology and the history of the architectural process makes it possible to build a consensus on the idea of how architecture is to proceed. In this study, each period that occurs with the integration of technology into architecture is addressed within the historical process. At the same time, changes in architecture via technology are identified as important milestones and predictions with regards to the future of architecture have been determined. Developments and changes in technology and the use of technology in architecture within years are analyzed in charts and graphs comparatively. The historical process of architecture and its transformation via technology is supported by a detailed literature review, and they are consolidated with the examination of focal points of 20th-century architecture under the titles parametric design, genetic architecture, simulation, and biomimicry. It is concluded that with the historical research between past and present, the developments in architecture cannot keep up with the advancements in technology, and recent developments in technology overshadow architecture; even technology decides the direction of architecture. As a result, a scenario is presented with regard to the reach of technology in the future of architecture and the role of the architect.

Keywords: design and development the information technology architecture, enterprise architecture, enterprise architecture design result, TOGAF architecture development method (ADM)

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3255 A Novel Exploration/Exploitation Policy Accelerating Learning In Both Stationary And Non Stationary Environment Navigation Tasks

Authors: Wiem Zemzem, Moncef Tagina

Abstract:

In this work, we are addressing the problem of an autonomous mobile robot navigating in a large, unknown and dynamic environment using reinforcement learning abilities. This problem is principally related to the exploration/exploitation dilemma, especially the need to find a solution letting the robot detect the environmental change and also learn in order to adapt to the new environmental form without ignoring knowledge already acquired. Firstly, a new action selection strategy, called ε-greedy-MPA (the ε-greedy policy favoring the most promising actions) is proposed. Unlike existing exploration/exploitation policies (EEPs) such as ε-greedy and Boltzmann, the new EEP doesn’t only rely on the information of the actual state but also uses those of the eventual next states. Secondly, as the environment is large, an exploration favoring least recently visited states is added to the proposed EEP in order to accelerate learning. Finally, various simulations with ball-catching problem have been conducted to evaluate the ε-greedy-MPA policy. The results of simulated experiments show that combining this policy with the Qlearning method is more effective and efficient compared with the ε-greedy policy in stationary environments and the utility-based reinforcement learning approach in non stationary environments.

Keywords: autonomous mobile robot, exploration/ exploitation policy, large, dynamic environment, reinforcement learning

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3254 Gymnastics Under Special Surveillance. The Impact of Western Sanctions on Russian Sport

Authors: Aleksandra Majewska

Abstract:

The article analyses the impact of Western sanctions on Russian rhythmic gymnastics since the outbreak of war in Ukraine. The chronological presentation of events shows how international political tensions and economic sanctions have affected the organisation of competitions, training and the careers of athletes. The article outlines the key moments and decisions that have changed the landscape of Russian sport, including the decision to change the citizenship made by some gymnasts in order to continue competing in international competitions. Russia strongly opposes participation in competitions without its flag and anthem while maintaining the view that Russian gymnasts are crucial to the prestige of rhythmic gymnastics in the world. In response to the sanctions, Russia created its own rules for rhythmic gymnastics, according to which they now compete domestically. Furthermore, this sport in Russia is strongly linked to politics, which further emphasises its importance in the national and international context. The information collected derives from numerous interviews with Russian athletes, coaches and other people, which are available only in the Russian language. The findings highlight the significant difficulties Russian athletes have faced due to their isolation in the international arena and the adaptive strategies adopted by Russia in the face of these challenges. The article makes an important contribution to understanding the consequences of global politics on the world of sport and the fate of individual athletes.

Keywords: sport, gymnastics, war in Ukraine, sanctions

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3253 Migrant and Population Health, Two Sides of a Coin: A Descriptive Study

Authors: A. Sottomayor, M. Perez Duque, M. C. Henriques

Abstract:

Introduction: Migration is not a new phenomenon; nomads often traveled, seeking better living conditions, including food and water. The increase of migrations affects all countries, rising health-related challenges. In Portugal, we have had migrant movements in the last decades, pairing with economic behavior. Irregular immigrants are detained in Santo António detention center from Portuguese Immigration and Borders Service (USHA-SEF) in Porto until court decision for a maximum of 60 days. It is the only long stay officially designated detention center for immigrants in Portugal. Immigrant health is important for public health (PH). It affects and is affected by the community. The XXVII Portuguese Government considered immigrant integration, including access to health, health promotion, protection and reduction of inequities a political priority. Many curative, psychological and legal services are provided for detainees, but until 2015, no structured health promotion or prevention actions were being held at USHA-SEF. That year, Porto Occidental PH Local Unit started to provide vaccination and health literacy on this theme for detainees and SEF workers. Our activities include a vaccine lecture, a medical consultation with vaccine prescription and administration, along with documented proof of vaccination. All vaccines are volunteer and free of charge. This action reduces the risk of importation and transmission of diseases, contributing to world eradication and elimination programs. We aimed to characterize the demography of irregular immigrant detained at UHSA-SEF and describe our activity. Methods: All data was provided by Porto Occidental Public Health Unit. All paper registers of vaccination were uploaded to MicrosoftExcel®. We included all registers and collected demographic variables, nationality, vaccination date, category, and administered vaccines. Descriptive analysis was performed using MicrosoftExcel®. Results: From 2015 to 2018, we delivered care to 256 individuals (179 immigrants; 77 workers). Considering immigrants, 72% were male, and 8 (16%) women were pregnant. 85% were between 20-54 years (ᵡ=30,8y; 2-71y), and 11 didn’t report any age. Migrants came from 48 countries, and India had the highest number (9%). MMR and Tetanus vaccines had > 90% vaccination rate and Poliomyelitis, hepatitis B and flu vaccines had around 85% vaccination rates. We had a consistent number of refusals. Conclusion: Our irregular migrant population comes from many different countries, which increases the risk of disease importation. Pregnant women are present as a particular subset of irregular migrants, and vaccination protects them and the baby. Vaccination of migrant is valuable for them and for the countries in which they pass. It contributes to universal health coverage, for eradication programmes and accomplishment of the Sustainable Development Goals. Peer influence may present as a determinant of refusals so we must consistently educate migrants before vaccination. More studies would be valuable, particularly on the migrant trajectory, duration of stay, destiny after court decision and health impact.

Keywords: migrants, public health, universal health coverage, vaccination

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3252 A New Intelligent, Dynamic and Real Time Management System of Sewerage

Authors: R. Tlili Yaakoubi, H.Nakouri, O. Blanpain, S. Lallahem

Abstract:

The current tools for real time management of sewer systems are based on two software tools: the software of weather forecast and the software of hydraulic simulation. The use of the first ones is an important cause of imprecision and uncertainty, the use of the second requires temporal important steps of decision because of their need in times of calculation. This way of proceeding fact that the obtained results are generally different from those waited. The major idea of this project is to change the basic paradigm by approaching the problem by the "automatic" face rather than by that "hydrology". The objective is to make possible the realization of a large number of simulations at very short times (a few seconds) allowing to take place weather forecasts by using directly the real time meditative pluviometric data. The aim is to reach a system where the decision-making is realized from reliable data and where the correction of the error is permanent. A first model of control laws was realized and tested with different return-period rainfalls. The gains obtained in rejecting volume vary from 19 to 100 %. The development of a new algorithm was then used to optimize calculation time and thus to overcome the subsequent combinatorial problem in our first approach. Finally, this new algorithm was tested with 16- year-rainfall series. The obtained gains are 40 % of total volume rejected to the natural environment and of 65 % in the number of discharges.

Keywords: automation, optimization, paradigm, RTC

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3251 Spatio-Temporal Data Mining with Association Rules for Lake Van

Authors: Tolga Aydin, M. Fatih Alaeddinoğlu

Abstract:

People, throughout the history, have made estimates and inferences about the future by using their past experiences. Developing information technologies and the improvements in the database management systems make it possible to extract useful information from knowledge in hand for the strategic decisions. Therefore, different methods have been developed. Data mining by association rules learning is one of such methods. Apriori algorithm, one of the well-known association rules learning algorithms, is not commonly used in spatio-temporal data sets. However, it is possible to embed time and space features into the data sets and make Apriori algorithm a suitable data mining technique for learning spatio-temporal association rules. Lake Van, the largest lake of Turkey, is a closed basin. This feature causes the volume of the lake to increase or decrease as a result of change in water amount it holds. In this study, evaporation, humidity, lake altitude, amount of rainfall and temperature parameters recorded in Lake Van region throughout the years are used by the Apriori algorithm and a spatio-temporal data mining application is developed to identify overflows and newly-formed soil regions (underflows) occurring in the coastal parts of Lake Van. Identifying possible reasons of overflows and underflows may be used to alert the experts to take precautions and make the necessary investments.

Keywords: apriori algorithm, association rules, data mining, spatio-temporal data

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3250 The Role of Serum Fructosamine as a Monitoring Tool in Gestational Diabetes Mellitus Treatment in Vietnam

Authors: Truong H. Le, Ngoc M. To, Quang N. Tran, Luu T. Cao, Chi V. Le

Abstract:

Introduction: In Vietnam, the current monitoring and treatment for ordinary diabetic patient mostly based on glucose monitoring with HbA1c test for every three months (recommended goal is HbA1c < 6.5%~7%). For diabetes in pregnant women or Gestational diabetes mellitus (GDM), glycemic control until the time of delivery is extremly important because it could reduce significantly medical implications for both the mother and the child. Besides, GDM requires continuos glucose monitoring at least every two weeks and therefore an alternative marker of glycemia for short-term control is considering a potential tool for the healthcare providers. There are published studies have indicated that the glycosylated serum protein is a better indicator than glycosylated hemoglobin in GDM monitoring. Based on the actual practice in Vietnam, this study was designed to evaluate the role of serum fructosamine as a monitoring tool in GDM treament and its correlations with fasting blood glucose (G0), 2-hour postprandial glucose (G2) and glycosylated hemoglobin (HbA1c). Methods: A cohort study on pregnant women diagnosed with GDM by the 75-gram oralglucose tolerance test was conducted at Endocrinology Department, Cho Ray hospital, Vietnam from June 2014 to March 2015. Cho Ray hospital is the final destination for GDM patient in the southern of Vietnam, the study population has many sources from other pronvinces and therefore researchers belive that this demographic characteristic can help to provide the study result as a reflection for the whole area. In this study, diabetic patients received a continuos glucose monitoring method which consists of bi-weekly on-site visit every 2 weeks with glycosylated serum protein test, fasting blood glucose test and 2-hour postprandial glucose test; HbA1c test for every 3 months; and nutritious consultance for daily diet program. The subjects still received routine treatment at the hospital, with tight follow-up from their healthcare providers. Researchers recorded bi-weekly health conditions, serum fructosamine level and delivery outcome from the pregnant women, using Stata 13 programme for the analysis. Results: A total of 500 pregnant women was enrolled and follow-up in this study. Serum fructosamine level was found to have a light correlation with G0 ( r=0.3458, p < 0.001) and HbA1c ( r=0.3544, p < 0.001), and moderately correlated with G2 ( r=0.4379, p < 0.001). During study timeline, the delivery outcome of 287 women were recorded with the average age of 38.5 ± 1.5 weeks, 9% of them have macrosomia, 2.8% have premature birth before week 35th and 9.8% have premature birth before week 37th; 64.8% of cesarean section and none of them have perinatal or neonatal mortality. The study provides a reference interval of serum fructosamine for GDM patient was 112.9 ± 20.7 μmol/dL. Conclusion: The present results suggests that serum fructosamine is as effective as HbA1c as a reflection of blood glucose control in GDM patient, with a positive result in delivery outcome (0% perinatal or neonatal mortality). The reference value of serum fructosamine measurement provided a potential monitoring utility in GDM treatment for hospitals in Vietnam. Healthcare providers in Cho Ray hospital is considering to conduct more studies to test this reference as a target value in their GDM treatment and monitoring.

Keywords: gestational diabetes mellitus, monitoring tool, serum fructosamine, Vietnam

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