Search results for: Hayatabad Medical Complex
Commenced in January 2007
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Edition: International
Paper Count: 8494

Search results for: Hayatabad Medical Complex

3244 Dynamical Analysis of the Fractional-Order Mathematical Model of Hashimoto’s Thyroiditis

Authors: Neelam Singha

Abstract:

The present work intends to analyze the system dynamics of Hashimoto’s thyroiditis with the assistance of fractional calculus. Hashimoto’s thyroiditis or chronic lymphocytic thyroiditis is an autoimmune disorder in which the immune system attacks the thyroid gland, which gradually results in interrupting the normal thyroid operation. Consequently, the feedback control of the system gets disrupted due to thyroid follicle cell lysis. And, the patient perceives life-threatening clinical conditions like goiter, hyperactivity, euthyroidism, hyperthyroidism, etc. In this work, we aim to obtain the approximate solution to the posed fractional-order problem describing Hashimoto’s thyroiditis. We employ the Adomian decomposition method to solve the system of fractional-order differential equations, and the solutions obtained shall be useful to provide information about the effect of medical care. The numerical technique is executed in an organized manner to furnish the associated details of the progression of the disease and to visualize it graphically with suitable plots.

Keywords: adomian decomposition method, fractional derivatives, Hashimoto's thyroiditis, mathematical modeling

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3243 FracXpert: Ensemble Machine Learning Approach for Localization and Classification of Bone Fractures in Cricket Athletes

Authors: Madushani Rodrigo, Banuka Athuraliya

Abstract:

In today's world of medical diagnosis and prediction, machine learning stands out as a strong tool, transforming old ways of caring for health. This study analyzes the use of machine learning in the specialized domain of sports medicine, with a focus on the timely and accurate detection of bone fractures in cricket athletes. Failure to identify bone fractures in real time can result in malunion or non-union conditions. To ensure proper treatment and enhance the bone healing process, accurately identifying fracture locations and types is necessary. When interpreting X-ray images, it relies on the expertise and experience of medical professionals in the identification process. Sometimes, radiographic images are of low quality, leading to potential issues. Therefore, it is necessary to have a proper approach to accurately localize and classify fractures in real time. The research has revealed that the optimal approach needs to address the stated problem and employ appropriate radiographic image processing techniques and object detection algorithms. These algorithms should effectively localize and accurately classify all types of fractures with high precision and in a timely manner. In order to overcome the challenges of misidentifying fractures, a distinct model for fracture localization and classification has been implemented. The research also incorporates radiographic image enhancement and preprocessing techniques to overcome the limitations posed by low-quality images. A classification ensemble model has been implemented using ResNet18 and VGG16. In parallel, a fracture segmentation model has been implemented using the enhanced U-Net architecture. Combining the results of these two implemented models, the FracXpert system can accurately localize exact fracture locations along with fracture types from the available 12 different types of fracture patterns, which include avulsion, comminuted, compressed, dislocation, greenstick, hairline, impacted, intraarticular, longitudinal, oblique, pathological, and spiral. This system will generate a confidence score level indicating the degree of confidence in the predicted result. Using ResNet18 and VGG16 architectures, the implemented fracture segmentation model, based on the U-Net architecture, achieved a high accuracy level of 99.94%, demonstrating its precision in identifying fracture locations. Simultaneously, the classification ensemble model achieved an accuracy of 81.0%, showcasing its ability to categorize various fracture patterns, which is instrumental in the fracture treatment process. In conclusion, FracXpert has become a promising ML application in sports medicine, demonstrating its potential to revolutionize fracture detection processes. By leveraging the power of ML algorithms, this study contributes to the advancement of diagnostic capabilities in cricket athlete healthcare, ensuring timely and accurate identification of bone fractures for the best treatment outcomes.

Keywords: multiclass classification, object detection, ResNet18, U-Net, VGG16

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3242 In-Situ Sludge Minimization Using Integrated Moving Bed Biofilm Reactor for Industrial Wastewater Treatment

Authors: Vijay Sodhi, Charanjit Singh, Neelam Sodhi, Puneet P. S. Cheema, Reena Sharma, Mithilesh K. Jha

Abstract:

The management and secure disposal of the biosludge generated from widely commercialized conventional activated sludge (CAS) treatments become a potential environmental issue. Thus, a sustainable technological upgradation to the CAS for sludge yield minimization has recently been gained serious attention of the scientific community. A number of recently reported studies effectively addressed the remedial technological advancements that in monopoly limited to the municipal wastewater. Moreover, the critical review of the literature signifies side-stream sludge minimization as a complex task to maintain. In this work, therefore, a hybrid moving bed biofilm reactor (MBBR) configuration (named as AMOMOX process) for in-situ minimization of the excess biosludge generated from high organic strength tannery wastewater has been demonstrated. The AMOMOX collectively stands for anoxic MBBR (as AM), aerobic MBBR (OM) and an oxic CAS (OX). The AMOMOX configuration involved a combined arrangement of an anoxic MBBR and oxic MBBR coupled with the aerobic CAS. The AMOMOX system was run in parallel with an identical CAS reactor. Both system configurations were fed with same influent to judge the real-time operational changes. For the AMOMOX process, the strict maintenance of operational strategies resulted about 95% removal of NH4-N and SCOD from tannery wastewater. Here, the nourishment of filamentous microbiota and purposeful promotion of cell-lysis effectively sustained sludge yield (Yobs) lowering upto 0.51 kgVSS/kgCOD. As a result, the volatile sludge scarcity apparent in the AMOMOX system succeeded upto 47% reduction of the excess biosludge. The corroborated was further supported by FE-SEM imaging and thermogravimetric analysis. However, the detection of microbial strains habitat underlying extended SRT (23-26 days) of the AMOMOX system would be the matter of further research.

Keywords: tannery wastewater, moving bed biofilm reactor, sludhe yield, sludge minimization, solids retention time

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3241 Animations for Teaching Food Chemistry: A Design Approach for Linking Chemistry Theory to Everyday Food

Authors: Paulomi (Polly) Burey, Zoe Lynch

Abstract:

In STEM education, students often have difficulty linking static images and words from textbooks or online resources, to the underlying mechanisms of the topic of study. This can often dissuade some students from pursuing study in the physical and chemical sciences. A growing movement in current day students demonstrates that the YouTube generation feel they learn best from video or dynamic, interactive learning tools, and will seek these out as alternatives to their textbooks and the classroom learning environment. Chemistry, and in particular visualization of molecular structures in everyday materials, can prove difficult to comprehend without significant interaction with the teacher of the content and concepts, beyond the timeframe of a typical class. This can cause a learning hurdle for distance education students, and so it is necessary to provide strong electronic tools and resources to aid their learning. As one of the electronic resources, an animation design approach to link everyday materials to their underlying chemistry would be beneficial for student learning, with the focus here being on food. These animations were designed and storyboarded with a scaling approach and commence with a focus on the food material itself and its component parts. This is followed by animated transitions to its underlying microstructure and identifying features, and finally showing the molecules responsible for these microstructural features. The animation ends with a reverse transition back through the molecular structure, microstructure, all the way back to the original food material, and also animates some reactions that may occur during food processing to demonstrate the purpose of the underlying chemistry and how it affects the food we eat. Using this cyclical approach of linking students’ existing knowledge of food to help guide them to understanding more complex knowledge, and then reinforcing their learning by linking back to their prior knowledge again, enhances student understanding. Food is also an ideal material system for students to interact with, in a hands-on manner to further reinforce their learning. These animations were launched this year in a 2nd year University Food Chemistry course with improved learning outcomes for the cohort.

Keywords: chemistry, food science, future pedagogy, STEM Education

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3240 Analyzing Industry-University Collaboration Using Complex Networks and Game Theory

Authors: Elnaz Kanani-Kuchesfehani, Andrea Schiffauerova

Abstract:

Due to the novelty of the nanotechnology science, its highly knowledge intensive content, and its invaluable application in almost all technological fields, the close interaction between university and industry is essential. A possible gap between academic strengths to generate good nanotechnology ideas and industrial capacity to receive them can thus have far-reaching consequences. In order to be able to enhance the collaboration between the two parties, a better understanding of knowledge transfer within the university-industry relationship is needed. The objective of this research is to investigate the research collaboration between academia and industry in Canadian nanotechnology and to propose the best cooperative strategy to maximize the quality of the produced knowledge. First, a network of all Canadian academic and industrial nanotechnology inventors is constructed using the patent data from the USPTO (United States Patent and Trademark Office), and it is analyzed with social network analysis software. The actual level of university-industry collaboration in Canadian nanotechnology is determined and the significance of each group of actors in the network (academic vs. industrial inventors) is assessed. Second, a novel methodology is proposed, in which the network of nanotechnology inventors is assessed from a game theoretic perspective. It involves studying a cooperative game with n players each having at most n-1 decisions to choose from. The equilibrium leads to a strategy for all the players to choose their co-worker in the next period in order to maximize the correlated payoff of the game. The payoffs of the game represent the quality of the produced knowledge based on the citations of the patents. The best suggestion for the next collaborative relationship is provided for each actor from a game theoretic point of view in order to maximize the quality of the produced knowledge. One of the major contributions of this work is the novel approach which combines game theory and social network analysis for the case of large networks. This approach can serve as a powerful tool in the analysis of the strategic interactions of the network actors within the innovation systems and other large scale networks.

Keywords: cooperative strategy, game theory, industry-university collaboration, knowledge production, social network analysis

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3239 Being Young in Times of Change: Transformative Aspects of Migration across Generations in South Wollo, Ethiopia

Authors: Adamnesh A. Bogale, Dorte Thorsen

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This paper aims to learn how children/siblings left behind due to parental migration experience care and the effects of the separation. It also aims to unpack the experiences of youth migrants in rural Ethiopia. It focuses specifically on how children and youth are affected in order to highlight in which areas intervention can enhance or inadvertently undermine the development impact of migration on young people. Based on a qualitative study in South Wollo, Ethiopia, which was undertaken in three stages in 2017-19 and involved 34 households and a number of key informants, the analysis offers insights into how migration contributes to household sustainability and, in the process, alters intergenerational relationships and dynamics. Contemporary migration in Ethiopia is complex and highly gendered. For young women, the migration corridor from Ethiopia to the Middle East is the most important, whereas young men mostly engage in local migration or travel to South Africa or Sudan. Arguing that children and youths’ experience of migration must be understood in the context of the moral, affective, and material economies, the paper distinguishes between young people’s experiences of migration as children of migrants, as siblings of a migrant, and as migrants. The material shows that children and youths demonstrate different experiences in parental migration depending on age, care arrangement, and the ability to communicate with an absent mother. Migration has a different implication for younger siblings depending on their gender. The division of work and future responsibilities post marriage combine to disadvantage female siblings while male siblings are either unaffected or reaped the benefits of investments made with remittances. Finally, migration is a mechanism to change generational power relationships. As remitters, young migrants yield better recognition in the family, though not always to the degree that they can control the use of remittances. The power to make decisions is not tied only to material resources and the household; migration facilitates social change that opens space for young women to have more influence over their own lives.

Keywords: migration, youth, Ethiopia, generations

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3238 Epigenetic Modifying Potential of Dietary Spices: Link to Cure Complex Diseases

Authors: Jeena Gupta

Abstract:

In the today’s world of pharmaceutical products, one should not forget the healing properties of inexpensive food materials especially spices. They are known to possess hidden pharmaceutical ingredients, imparting them the qualities of being anti-microbial, anti-oxidant, anti-inflammatory and anti-carcinogenic. Further aberrant epigenetic regulatory mechanisms like DNA methylation, histone modifications or altered microRNA expression patterns, which regulates gene expression without changing DNA sequence, contribute significantly in the development of various diseases. Changing lifestyles and diets exert their effect by influencing these epigenetic mechanisms which are thus the target of dietary phytochemicals. Bioactive components of plants have been in use since ages but their potential to reverse epigenetic alterations and prevention against diseases is yet to be explored. Spices being rich repositories of many bioactive constituents are responsible for providing them unique aroma and taste. Some spices like curcuma and garlic have been well evaluated for their epigenetic regulatory potential, but for others, it is largely unknown. We have evaluated the biological activity of phyto-active components of Fennel, Cardamom and Fenugreek by in silico molecular modeling, in vitro and in vivo studies. Ligand-based similarity studies were conducted to identify structurally similar compounds to understand their biological phenomenon. The database searching has been done by using Fenchone from fennel, Sabinene from cardamom and protodioscin from fenugreek as a query molecule in the different small molecule databases. Moreover, the results of the database searching exhibited that these compounds are having potential binding with the different targets found in the Protein Data Bank. Further in addition to being epigenetic modifiers, in vitro study had demonstrated the antimicrobial, antifungal, antioxidant and cytotoxicity protective effects of Fenchone, Sabinene and Protodioscin. To best of our knowledge, such type of studies facilitate the target fishing as well as making the roadmap in drug design and discovery process for identification of novel therapeutics.

Keywords: epigenetics, spices, phytochemicals, fenchone

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3237 Improving the Uniformity of Electrostatic Meter’s Spatial Sensitivity

Authors: Mohamed Abdalla, Ruixue Cheng, Jianyong Zhang

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In pneumatic conveying, the solids are mixed with air or gas. In industries such as coal fired power stations, blast furnaces for iron making, cement and flour processing, the mass flow rate of solids needs to be monitored or controlled. However the current gas-solids two-phase flow measurement techniques are not as accurate as the flow meters available for the single phase flow. One of the problems that the multi-phase flow meters to face is that the flow profiles vary with measurement locations and conditions of pipe routing, bends, elbows and other restriction devices in conveying system as well as conveying velocity and concentration. To measure solids flow rate or concentration with non-even distribution of solids in gas, a uniform spatial sensitivity is required for a multi-phase flow meter. However, there are not many meters inherently have such property. The circular electrostatic meter is a popular choice for gas-solids flow measurement with its high sensitivity to flow, robust construction, low cost for installation and non-intrusive nature. However such meters have the inherent non-uniform spatial sensitivity. This paper first analyses the spatial sensitivity of circular electrostatic meter in general and then by combining the effect of the sensitivity to a single particle and the sensing volume for a given electrode geometry, the paper reveals first time how a circular electrostatic meter responds to a roping flow stream, which is much more complex than what is believed at present. The paper will provide the recent research findings on spatial sensitivity investigation at the University of Tees side based on Finite element analysis using Ansys Fluent software, including time and frequency domain characteristics and the effect of electrode geometry. The simulation results will be compared tothe experimental results obtained on a large scale (14” diameter) rig. The purpose of this research is paving a way to achieve a uniform spatial sensitivity for the circular electrostatic sensor by mean of compensation so as to improve overall accuracy of gas-solids flow measurement.

Keywords: spatial sensitivity, electrostatic sensor, pneumatic conveying, Ansys Fluent software

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3236 Variation in Maternal Mortality in Sidama National Regional State, Southern Ethiopia: A Population Based Cross Sectional Household Survey

Authors: Aschenaki Zerihun Kea, Bernt Lindtjorn, Achamyelesh Gebretsadik, Sven Gudmund Hinderaker

Abstract:

Introduction: Maternal mortality studies conducted at the national level do not provide the information needed for planning and monitoring health programs at lower administrative levels. The aim of this study was to measure maternal mortality, identify risk factors and district-level variations in Sidama National Regional State, southern Ethiopia. Methods: A cross sectional population-based survey was carried out in households where women reported pregnancy and birth outcomes in the past five years. The study was conducted in the Sidama National Regional State, southern Ethiopia, from July 2019 to May 2020. Multi-stage cluster sampling technique was employed. The outcome variable of the study was maternal mortality. Complex sample logistic regression analysis was applied to assess variables independently associated with maternal mortality. Results: We registered 10602 live births (LB) and 48 maternal deaths, yielding an overall maternal mortality ratio (MMR) of 419; 95% CI: 260-577 per 100,000 LB. Aroresa district had the highest MMR with 1142 (95% CI: 693-1591) per 100,000 LB. Leading causes of death were haemorrhage 21 (41%) and eclampsia 10 (27%). Thirty (59%) mothers died during labour, or within 24 hours after delivery, 25 (47%) died at home and 17 (38%) at a health facility. Mothers who did not have formal education had a higher risk of maternal death (AOR: 4.4; 95% CI: 1.7 – 11.0). The risk of maternal death was higher in districts with a low midwife-to-population ratio (AOR: 2.9; 95% CI: 1.0-8.9). Conclusion: The high maternal mortality with district-level variations in Sidama Region highlights the importance of improving obstetric care and employing targeted interventions in areas with high mortality rates. Due attention should be given to improving access to female education. Additional midwives have to be trained and deployed to improve maternal health services and consequently save the lives of mothers.

Keywords: maternal mortality variation, maternal death, Sidama, Ethiopia

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3235 Maternity Care Model during Natural Disaster or Humanitarian Emegerncy Setting in Rural Pakistan

Authors: Humaira Maheen, Elizabeth Hoban, Catherine Bennette

Abstract:

Background: Globally, role of Community Health Workers (CHW) as front line disaster health work force is underutilized. Developing countries which are at risk of natural disasters or humanitarian emergencies should lay down effective strategies especially to ensure adequate access to maternity care during crisis situation by using CHW as they are local, trained, and most of them possess a good relationship with the community. The Minimum Initial Service Package (MISP) is a set of universal guidelines that addresses women’s reproductive health needs during the first phase of an emergency. According to the MISP, pregnant women should have access to a skilled birth attendant and adequate transportation arrangements so they can access a maternity care facility. Pakistan is one of the few countries which has been severely affected by a number of natural disaster as well as humanitarian emergencies in last decade. Pakistan has a young and structured National Disaster Management System in place, where District Authorities play a vital role in disaster management. The District Health Department develops the contingency health plan for an emergency situation and implements it under the existing district health human resources (health workers and medical staff at the health facility) and infrastructure (health care facilities). Methods: A mixed methods study was conducted in rural villages of Sindh adjacent to the river Indus, and included in-depth interviews with 15 women who gave birth during the floods, structured interviews with 668 women who were pregnant during 2010-2014, and in-depth interviews with 25 community health workers (CHW) and 30 key informants. Results: Women said that giving birth in the relief camps during the floods was one of the most challenging times of their life. The district health department didn’t make transportation arrangement for labouring women from relief camp to the nearest health care facility. As a result 91.2% women gave birth in temporary shelters with the help of a traditional birth attendant (Dai) with no clean physical space available to birth. Of the 332 women who were pregnant at the time of the floods, 26 had adverse birth outcomes; 10 had miscarriages, 14 had stillbirths and there were four neonatal deaths. Conclusion: The district health department was not able to provide access to adequate maternity care during according to the international standard during the floods in 2011. We propose a model where CHWs will be used as frontline maternity care providers during any emergency or disaster situations in Pakistan. A separate "birthing station" should be mandatory in all district relief camps, managed by CHWs. Community midwives (CMW) would and the Lady Health Workers (LHW) would provide antenatal and postnatal care alongside, vaccination for pregnant women, neonates and children under five. There must be an ambulance facility for emergency obstetric cases and all district health facilities should have at least two medical staff identified and trained for emergency obstetric management. The District Health Department must provide clean birthing kits and regular and emergency contraceptives in the relief camps. Methods: A mixed methods study was conducted in rural villages of Sindh adjacent to the river Indus, and included in-depth interviews with 15 women who gave birth during the floods, structured interviews with 668 women who were pregnant during 2010-2014, and in-depth interviews with 25 community health workers (CHW) and 30 key informants. Results: Women said that giving birth in the relief camps during the floods was one of the most challenging times of their life. Nearly 91.2% women gave birth in temporary shelters with the help of a traditional birth attendant (Dai) with no clean physical space available to birth, and the health camp was mostly accessed by men and always overcrowded. There was no obstetric trained medical staff in the health camps or transportation provided to take women with complications to the nearest health facility. The rate of adverse outcome following disaster was 22.2% (95% CI: 8.62% – 42.2%) amongst 27 women who did not evacuate as compare to 7.91% (95% CI: 5.03% – 11.8%) among 278 women who lived in relief camp study participants. There were 27 women who evacuated on pre-flood warning and had 0% rate of adverse outcome. Conclusion: We propose a model where CHWs will be used as frontline maternity care providers during any emergency or disaster situations in Pakistan. A separate "birthing station" should be mandatory in all district relief camps, managed by CHWs. Community midwives (CMW) would and the Lady Health Workers (LHW) would provide antenatal and postnatal care alongside, vaccination for pregnant women, neonates and children under five. There must be an ambulance facility for emergency obstetric cases and all district health facilities should have at least two medical staff identified and trained for emergency obstetric management. The District Health Department must provide clean birthing kits and regular and emergency contraceptives in the relief camps.

Keywords: natural disaster, maternity care model, rural, Pakistan, community health workers

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3234 Design and Development of Bioactive a-Hydroxy Carboxylate Group Modified MnFe₂O₄ Nanoparticle: Comparative Fluorescence Study, Magnetism and DNA Nuclease Activity

Authors: Indranil Chakraborty, Kalyan Mandal

Abstract:

Three new α-hydroxy carboxylate group functionalized MnFe₂O₄ nanoparticles (NPs) have been developed to explore the microscopic origin of ligand modified fluorescence and magnetic properties of nearly monodispersed MnFe₂O₄ NPs. The surface functionalization has been carried out with three small organic ligands (tartrate, malate, and citrate) having different number of α-hydroxy carboxylate functional group along with steric effect. Detailed study unveils that α-hydroxy carboxylate moiety of the ligands plays key role to generate intrinsic fluorescence in functionalized MnFe₂O₄ NPs through the activation of ligand to metal charge transfer transitions, associated with ligand-Mn²⁺/Fe³⁺ interactions along with d-d transition corresponding to d-orbital energy level splitting of Fe³⁺ ions on NP surface. Further, MnFe₂O₄ NPs show a maximum 140.88% increase in coercivity and 97.95% decrease in magnetization compared to its bare one upon functionalization. The ligands that induce smallest crystal field splitting of d-orbital energy level of transition metal ions are found to result in strongest ferromagnetic activation of the NPs. Finally, our developed tartrate functionalized MnFe₂O₄ (T-MnFe₂O₄) NPs have been utilized for studying DNA binding interaction and nuclease activity for stimulating their beneficial activities toward diverse biomedical applications. The spectroscopic measurements indicate that T-MnFe₂O₄ NPs bind calf thymus DNA by intercalative mode. The ability of T-MnFe₂O₄ NPs to induce DNA cleavage was studied by gel electrophoresis technique where the complex is found to promote the cleavage of pBR322 plasmid DNA from the super coiled form I to linear coiled form II and nicked coiled form III with good efficiency. This may be taken into account for designing new biomolecular detection agents and anti-cancer drug which can open up a new door toward diverse non-invasive biomedical applications.

Keywords: MnFe₂O₄ nanoparticle, α-hydroxy carboxylic acid, comparative fluorescence, magnetism study, DNA interaction, nuclease activity

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3233 How Social Support, Interaction with Clients and Work-Family Conflict Contribute to Mental Well-Being for Employees in the Human Service System

Authors: Uwe C. Fischer

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Mental health and well-being for employees working in the human service system are getting more and more important given the increasing rate of absenteeism at work. Besides individual capacities, social and community factors seem to be important in the working setting. Starting from a demand resource framework including the classical demand control aspects, social support systems, specific demands and resources of the client work, and work-family conflict were considered in the present study. We state hypothetically, that these factors have a meaningful association with the mental quality of life of employees working in the field of social, educational and health sectors. 1140 employees, working in human service organizations (education, youth care, nursing etc.) were asked for strains and resources at work (selected scales from Salutogenetic Subjective Work Assessment SALSA and own new scales for client work), work-family conflict, and mental quality of life from the German Short Form Health Survey. Considering the complex influences of the variables, we conducted a multiple hierarchical regression analysis. One third of the whole variance of the mental quality of life can be declared by the different variables of the model. When the variables concerning social influences were included in the hierarchical regression, the influence of work related control resource decreased. Excessive workload, work-family conflict, social support by supervisors, co-workers and other persons outside work, as well as strains and resources associated with client work had significant regression coefficients. Conclusions: Social support systems are crucial in the social, educational and health related service sector, regarding the influence on mental well-being. Especially the work-family conflict focuses on the importance of the work-life balance. Also the specific strains and resources of the client work, measured with new constructed scales, showed great impact on mental health. Therefore occupational health promotion should focus more on the social factors within and outside the working place.

Keywords: client interaction, human service system, mental health, social support, work-family conflict

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3232 Association Type 1 Diabetes and Celiac Disease in Adult Patients

Authors: Soumaya Mrabet, Taieb Ach, Imen Akkari, Amira Atig, Neirouz Ghannouchi, Koussay Ach, Elhem Ben Jazia

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Introduction: Celiac disease (CD) and type 1 diabetes mellitus (T1D) are complex disorders with shared genetic components. The association between CD and T1D has been reported in many pediatric series. The aim of our study is to describe the epidemiological, clinical and evolutive characteristics of adult patients presenting this association. Material and Methods: This is a retrospective study including patients diagnosed with CD and T1D, explored in Internal Medicine, Gastroenterology and Endocrinology and Diabetology Departments of the Farhat Hached University Hospital, between January 2005 and June 2016. Results: Among 57 patients with CD, 15 patients had also T1D (26.3%). There are 11 women and 4 men with a median age of 27 years (16-48). All patients developed T1D prior to the diagnosis of CD with an average duration of 47 months between the two diagnosis (6 months-5 years). CD was revealed by recurrent abdominal pain in 11 cases, diarrhea in 10 cases, bloating in 8 cases, constipation in 6 cases and vomiting in 2 cases. Three patients presented cycle disorders with secondary amenorrhea in 2 patients. Anti-Endomysium, anti-transglutaminase and Anti-gliadin antibodies were positive respectively in 57, 54 and 11 cases. The biological tests revealed anemia in 10 cases, secondary to iron deficiency in 6 cases and folate and vitamin B12 deficiency in 4 cases, hypoalbuminaemia in 4 cases, hypocalcemia in 3 cases and hypocholesterolemia in 1 patient. Upper gastrointestinal endoscopy showed an effacement of the folds of the duodenal mucosa in 6 cases and a congestive duodenal mucosa in 3 cases. The macroscopic appearance was normal in the others cases. Microscopic examination showed an aspect of villous atrophy in 57 cases, which was partial in 10 cases and total in 47 cases. After an average follow-up of 3 years 2 months, the evolution was favorable in all patients under gluten-free diet with the necessity of less important doses of insulin in 10 patients. Conclusion: In our study, the prevalence of T1D in adult patients with CD was 26.3%. This association can be attributed to overlapping genetic HLA risk loci. In recent studies, the role of gluten as an important player in the pathogenesis of CD and T1D has been also suggested.

Keywords: celiac disease, gluten, prevalence, type 1 diabetes

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3231 Management of the Asthma Crisis in the Unit of Intensive Care of the General Hospital of Reference of Kinshasa

Authors: Eddy K. Mukadi

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The aim of this study was to provide contributing elements to improve the management of the asthma crisis in the intensive care unit of the General Reference Hospital of Kinshasa. This was a descriptive study of all patients in the intensive care unit presenting with the asthma attack during the period from February 5, 2013 to February 5, 2014. The main data were obtained from consultation registry and medical records. A total of 35 patients, 21 of whom were male (majority) compared to 14 female. Average age of patients was 46.48 plus or minus 16.98 with extremes ranging from 21-75 years. The clinic was dominated by dyspnea in 100% of cases, followed by rales with 91.4% of cases. In spite of the control of the crisis obtained after the treatment with B2 mimetic by inhalation was introduced A 91.5%; 88% corticosteroids; 80% oxygen, the therapeutic principle recommended for the management of asthma attacks was not respected in the majority of cases. This is why we suggest that improving the quality of care to be administered to patients will yield more adequate results.

Keywords: asthma crisis, intensive care, general hospital, Kinshasa

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3230 Nazi Experiments during World War II: Dismal Period for Bioethics

Authors: Catharina O. Vianna Dias da Silva, Amanda F. Batista, Ana Clara C. Burgos Lessa, Carolina S. Lucchesi Ramacciotti, Maria Clara B. de Andrade, Roberto de B. Silva

Abstract:

This article aims to analyze the bioethical aspects related to the historical practices of experiments on humans that occurred in Nazi Germany during the period of World War II (1939-1945). The method was based on the bibliographic review of articles published in databases such as SciELO and Pubmed. In the discussion, historical and humanistic aspects that contributed to the construction of a genocidal culture practiced during this period were analyzed. Additionally, an ethical question arises: should the information acquired during this dark period be used by science? After analysis, it was found that these Nazi experiments went over medical and ethical principles, being a deplorable milestone in history. It was also concluded that, although they generated potentially 'useful' results in the scientific field, they should be discarded as an ethical question of principle, of never daring to validate such a deplorable way of obtaining knowledge.

Keywords: Nazism, bioethics, human experimentation, human rights, genocide, torture, medicine

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3229 Disaster Nursing Competency of Nurses in Surattani Province, Thailand: A Factor Analysis

Authors: Rungnapa Chantra

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As health care rapidly changes, the nursing profession is also evolving to improve quality of care while maintaining competency in their practice. The purpose of this study was to investigate the factors of disaster nurse competencies and investigate the predictable variables in disaster nurse competencies in Suratthani Province, Thailand. The sample consisted of 305 nurses who were recruited by simple random sampling. The development questionnaires from ICN Framework and research contains Pre/Mitigation, Preparedness, Response and Recovery/Rehabilitation Competencies (α=0.87). The data were analyzed using Principle Components Extraction and Orthogonal Rotation with Varimax Method. The findings were as follows; four significant factors of disaster nurse competencies in Suratthani Province, Thailand were identified. These factors were described by 62 variables that accounted for 50.01% of the total variance. The results of this study could be for agencies that are responsible for the development of nursing competencies and should be aware of the development of knowledge and skills in disaster management.

Keywords: disaster nursing competency of nurses, nursing informatics, health science, medical

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3228 Automatic Processing of Trauma-Related Visual Stimuli in Female Patients Suffering From Post-Traumatic Stress Disorder after Interpersonal Traumatization

Authors: Theresa Slump, Paula Neumeister, Katharina Feldker, Carina Y. Heitmann, Thomas Straube

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A characteristic feature of post-traumatic stress disorder (PTSD) is the automatic processing of disorder-specific stimuli that expresses itself in intrusive symptoms such as intense physical and psychological reactions to trauma-associated stimuli. That automatic processing plays an essential role in the development and maintenance of symptoms. The aim of our study was, therefore, to investigate the behavioral and neural correlates of automatic processing of trauma-related stimuli in PTSD. Although interpersonal traumatization is a form of traumatization that often occurs, it has not yet been sufficiently studied. That is why, in our study, we focused on patients suffering from interpersonal traumatization. While previous imaging studies on PTSD mainly used faces, words, or generally negative visual stimuli, our study presented complex trauma-related and neutral visual scenes. We examined 19 female subjects suffering from PTSD and examined 19 healthy women as a control group. All subjects did a geometric comparison task while lying in a functional-magnetic-resonance-imaging (fMRI) scanner. Trauma-related scenes and neutral visual scenes that were not relevant to the task were presented while the subjects were doing the task. Regarding the behavioral level, there were not any significant differences between the task performance of the two groups. Regarding the neural level, the PTSD patients showed significant hyperactivation of the hippocampus for task-irrelevant trauma-related stimuli versus neutral stimuli when compared with healthy control subjects. Connectivity analyses revealed altered connectivity between the hippocampus and other anxiety-related areas in PTSD patients, too. Overall, those findings suggest that fear-related areas are involved in PTSD patients' processing of trauma-related stimuli even if the stimuli that were used in the study were task-irrelevant.

Keywords: post-traumatic stress disorder, automatic processing, hippocampus, functional magnetic resonance imaging

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3227 Assessing the Impact of Low Carbon Technology Integration on Electricity Distribution Networks: Advancing towards Local Area Energy Planning

Authors: Javier Sandoval Bustamante, Pardis Sheikhzadeh, Vijayanarasimha Hindupur Pakka

Abstract:

In the pursuit of achieving net-zero carbon emissions, the integration of low carbon technologies into electricity distribution networks is paramount. This paper delves into the critical assessment of how the integration of low carbon technologies, such as heat pumps, electric vehicle chargers, and photovoltaic systems, impacts the infrastructure and operation of electricity distribution networks. The study employs rigorous methodologies, including power flow analysis and headroom analysis, to evaluate the feasibility and implications of integrating these technologies into existing distribution systems. Furthermore, the research utilizes Local Area Energy Planning (LAEP) methodologies to guide local authorities and distribution network operators in formulating effective plans to meet regional and national decarbonization objectives. Geospatial analysis techniques, coupled with building physics and electric energy systems modeling, are employed to develop geographic datasets aimed at informing the deployment of low carbon technologies at the local level. Drawing upon insights from the Local Energy Net Zero Accelerator (LENZA) project, a comprehensive case study illustrates the practical application of these methodologies in assessing the rollout potential of LCTs. The findings not only shed light on the technical feasibility of integrating low carbon technologies but also provide valuable insights into the broader transition towards a sustainable and electrified energy future. This paper contributes to the advancement of knowledge in power electrical engineering by providing empirical evidence and methodologies to support the integration of low carbon technologies into electricity distribution networks. The insights gained are instrumental for policymakers, utility companies, and stakeholders involved in navigating the complex challenges of energy transition and achieving long-term sustainability goals.

Keywords: energy planning, energy systems, digital twins, power flow analysis, headroom analysis

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3226 Towards a Critical Disentanglement of the ‘Religion’ Nexus in the Global East

Authors: Daan F. Oostveen

Abstract:

‘Religion’ as a term is not native to the Global East. The concept ‘religion’ is both understood in its meaning of ‘religious traditions’, commonly referring to the ‘World Religions’ and in its adjective meaning ‘the religious’ or ‘religiosity’ as a separate domain of human culture, commonly contrasted to the secular. Though neither of these understandings are native to the historical worldviews of East Asia, their development in modern Western scholarship has had an enormous impact on the self-understanding of cultural diversity in the Global East as well. One example is the identification and therefore elevation to the status of World Religion of ‘Buddhism’ which connected formerly dispersed religious practices throughout the Global East and subsumed them under this powerful label. On the other hand, we see how popular religiosity, shamanism and hybrid cultural expressions have become excluded from genuine religion; this had an immense impact on the sense of legitimacy of these practices, which became sometimes labeled as superstition are rejected as magic. Our theoretical frameworks on religion in the Global East do not always consider the complex power dynamics between religious actors, both elites and lay expressions of religion in everyday life, governments and religious studies scholars. In order to get a clear image of how religiosity functions in the context of the Global East, we have to take into account these power dynamics. What is important in particular is the issue of religious identity or absence of religious identity. The self-understanding of religious actors in the Global East is often very different from what scholars of religion observe. Religious practice, from an etic perspective, is often unrelated to religious identification from an emic perspective. But we also witness the rise of Christian churches in the Global East, in which religious identity and belonging does play a pivotal role. Finally, religion in the Global East has since the beginning of the 20th Century been conceptualized as the ‘other’ or republicanism or Marxist-Maoist ideology. It is important not to deny the key role of colonial thinking in the process of religion formation in the Global East. In this paper, it is argued that religious realities constituted emerging as a result from our theory of religion, and that these religious realities in turn inform our theory. Therefore, the relationship between phenomenology of religion and theory of religion can never be disentangled. In fact, we have to acknowledge that our conceptualizations of religious diversity are always already influenced by our valuation of those cultural expressions that we have come to call ‘religious’.

Keywords: global east, religion, religious belonging, secularity

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3225 Forecasting Future Society to Explore Promising Security Technologies

Authors: Jeonghwan Jeon, Mintak Han, Youngjun Kim

Abstract:

Due to the rapid development of information and communication technology (ICT), a substantial transformation is currently happening in the society. As the range of intelligent technologies and services is continuously expanding, ‘things’ are becoming capable of communicating one another and even with people. However, such “Internet of Things” has the technical weakness so that a great amount of such information transferred in real-time may be widely exposed to the threat of security. User’s personal data are a typical example which is faced with a serious security threat. The threats of security will be diversified and arose more frequently because next generation of unfamiliar technology develops. Moreover, as the society is becoming increasingly complex, security vulnerability will be increased as well. In the existing literature, a considerable number of private and public reports that forecast future society have been published as a precedent step of the selection of future technology and the establishment of strategies for competitiveness. Although there are previous studies that forecast security technology, they have focused only on technical issues and overlooked the interrelationships between security technology and social factors are. Therefore, investigations of security threats in the future and security technology that is able to protect people from various threats are required. In response, this study aims to derive potential security threats associated with the development of technology and to explore the security technology that can protect against them. To do this, first of all, private and public reports that forecast future and online documents from technology-related communities are collected. By analyzing the data, future issues are extracted and categorized in terms of STEEP (Society, Technology, Economy, Environment, and Politics), as well as security. Second, the components of potential security threats are developed based on classified future issues. Then, points that the security threats may occur –for example, mobile payment system based on a finger scan technology– are identified. Lastly, alternatives that prevent potential security threats are proposed by matching security threats with points and investigating related security technologies from patent data. Proposed approach can identify the ICT-related latent security menaces and provide the guidelines in the ‘problem – alternative’ form by linking the threat point with security technologies.

Keywords: future society, information and communication technology, security technology, technology forecasting

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3224 A Study on Personnel Commitment Factors in Hafes Hospital

Authors: Farzaneh Bayat

Abstract:

Successful and effective presence in regional and global markets along with optimal use of available utilities and proper utilization of new sources for offering desirable services based on customer satisfaction is inevitable. Commitment has a significant role in offering optimal services. Offering high quality job and desirable services to the customers are personnel’s commitment. Thus, Shiraz Chamran Hospital which is affiliated with Shiraz Medical School and is one of the orthopedic poles in southern Iran was studied. This hospital has 750 personnel and physicians which a sample of 200 of them were chosen as the statistic society for a 5 month period from June to November 2009. Main variables in this decision are: responsibility and responsiveness, job security, team work, task autonomy, gradation opportunity, information sharing, payments and commitment. The study approach is descriptive-correlative. With applied and segmental nature of the tests and statistic analysis, the 7 hypotheses were approved with 95% of certainty.

Keywords: commitment, information sharing, responsibility and responsiveness, job security, task autonomy

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3223 Malate Dehydrogenase Enabled ZnO Nanowires as an Optical Tool for Malic Acid Detection in Horticultural Products

Authors: Rana Tabassum, Ravi Kant, Banshi D. Gupta

Abstract:

Malic acid is an extensively distributed organic acid in numerous horticultural products in minute amounts which significantly contributes towards taste determination by balancing sugar and acid fractions. An enhanced concentration of malic acid is utilized as an indicator of fruit maturity. In addition, malic acid is also a crucial constituent of several cosmetics and pharmaceutical products. An efficient detection and quantification protocol for malic acid is thus highly demanded. In this study, we report a novel detection scheme for malic acid by synergistically collaborating fiber optic surface plasmon resonance (FOSPR) and distinctive features of nanomaterials favorable for sensing applications. The design blueprint involves the deposition of an assembly of malate dehydrogenase enzyme entrapped in ZnO nanowires forming the sensing route over silver coated central unclad core region of an optical fiber. The formation and subsequent decomposition of the enzyme-analyte complex on exposure of the sensing layer to malic acid solutions of diverse concentration results in modification of the dielectric function of the sensing layer which is manifested in terms of shift in resonance wavelength. Optimization of experimental variables such as enzyme concentration entrapped in ZnO nanowires, dip time of probe for deposition of sensing layer and working pH range of the sensing probe have been accomplished through SPR measurements. The optimized sensing probe displays high sensitivity, broad working range and a minimum limit of detection value and has been successfully tested for malic acid determination in real samples of fruit juices. The current work presents a novel perspective towards malic acid determination as the unique and cooperative combination of FOSPR and nanomaterials provides myriad advantages such as enhanced sensitivity, specificity, compactness together with the possibility of online monitoring and remote sensing.

Keywords: surface plasmon resonance, optical fiber, sensor, malic acid

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3222 Online Bakery Management System Proposal

Authors: Alexander Musyoki, Collins Odour

Abstract:

Over the past few years, the bakery industry in Kenya has experienced significant growth largely in part to the increased adoption of technology and automation in their processes; more specifically due to the adoption of bakery management systems to help in running bakeries. While they have been largely responsible for the improved productivity and efficiency in bakeries, most of them are now outdated and pose more challenges than benefits. The proposed online bakery management system mentioned in this paper aims to address this by allowing bakery owners to track inventory, budget, job progress, and data analytics on each job and in doing so, promote the Sustainable Development Goals 3 and 12, which aim to ensure healthy lives and promote sustainable economic growth as the proposed benefits of these features include scalability, easy accessibility, reduced acquisition costs, better reliability, and improved functionality that will allow bakeries to become more competitive, reduce waste and track inventory more efficiently. To better understand the challenges, a comprehensive study has been performed to assess these traditional systems and try to understand if an online bakery management system can prove to be advantageous to bakery owners. The study conducted gathered feedback from bakery owners and employees in Nairobi County, Kenya using an online survey with a response rate of about 86% from the target population. The responses cited complex and hard to use bakery management systems (59.7%), lack of portability from one device to the other (58.1%) and high acquisition costs (51.6%) as the top challenges of traditional bakery management systems. On the other hand, some of the top benefits that most of the respondents would realize from the online bakery management system was better reliability (58.1%) and reduced acquisition costs (58.1%). Overall, the findings suggest that an online bakery management system has a lot of advantages over traditional systems and is likely to be well-received in the market. In conclusion, the proposed online bakery management system has the potential to improve the efficiency and competitiveness of small-sized bakeries in Nairobi County. Further research is recommended to expand the sample size and diversity of respondents and to conduct more in-depth analyses of the data collected.

Keywords: ICT, technology and automation, bakery management systems, food innovation

Procedia PDF Downloads 86
3221 Clinical Experience and Perception of Risk affect the Acceptance and Trust of using AI in Medicine

Authors: Schulz Peter, Kee Kalya, Lwin May, Goh Wilson, Chia Kendrikck, Chueng Max, Lam Thomas, Sung Joseph

Abstract:

As Artificial Intelligence (AI) is progressively making inroads into clinical practice, questions have arisen as to whether acceptance of AI is skewed toward certain medical practitioner segments, even within particular specializations. This study examines distinct AI acceptance among gastroenterologists with contrasting levels of seniority/experience when interacting with AI typologies. Data from 319 gastroenterologists show the presence of four distinct clusters of clinicians based on experience levels and perceived risk typologies. Analysis of cluster-based responses further revealed that acceptance of AI was not uniform. Our findings showed that clinician experience and risk perspective have an interactive role in influencing AI acceptance. Senior clinicians with low-risk perceptions were highly accepting of AI, but those with high-risk perceptions of AI were substantially less accepting. In contrast, junior clinicians were more inclined to embrace AI when they perceived high risk, yet they hesitated to adopt AI when the perceived risk was minimal.

Keywords: risk perception, acceptance, trust, medicine

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3220 Students’ Perceptions Regarding Homosexuality at Sefako Makgatho Health Sciences University

Authors: Deborah O. Okusanya, Chris Vanrooyen, Stefan de Jager

Abstract:

Introduction: Homosexuality has been and continues to be a controversial subject across many disciplines; it has generated many debates around religious, academic institutions, political, socio-cultural as well as medical domains. The current study investigated students from a previously disadvantaged African university’s perception regarding homosexuality. Method: This qualitative study utilized two focus groups to collect data, which then was analyzed using thematic content analysis. Result: The study revealed that students’ level of awareness with regard to homosexuality is very high and their perceptions largely negative. Students predominantly found the practice unethical, and un-African. Discussion: Students tend to show a lot of stereotypical prejudicial responses and there seems to be a general lack of willingness to discuss this in a public discourse. In conclusion, there seems to be a tension between cultural values and the open environment such as academic institutions. Students’ perceptions go a long way in shaping public discourse and the larger population’s general attitude toward homosexuality.

Keywords: discourse, homosexuality, stereotypical, un-African

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3219 Directors’ Duties, Civil Liability, and the Business Judgment Rule under the Portuguese Legal Framework

Authors: Marisa Catarina da Conceição Dinis

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The commercial companies’ management has suffered an important material and legal transformation in the last years, mainly related to the changes in the Portuguese legal framework and because of the fact they were recently object of great expansion. In fact, next to the smaller family businesses, whose management is regularly assumed by partners, companies with social investment highly scattered, whose owners are completely out from administration, are now arising. In those particular cases, the business transactions are much more complex and require from the companies’ managers a highly technical knowledge and some specific professionals’ skills and abilities. This kind of administration carries a high-level risk that can both result in great success or in great losses. Knowing that the administration performance can result in important losses to the companies, the Portuguese legislator has created a legal structure to impute them some responsibilities and sanctions. The main goal of this study is to analyze the Portuguese law and some jurisprudence about companies’ management rules and about the conflicts between the directors and the company. In order to achieve these purposes we have to consider, on the one hand, the legal duties directly connected to the directors’ functions and on the other hand the disrespect for those same rules. The Portuguese law in this matter, influenced by the common law, determines that the directors’ attitude should be guided by loyalty and honesty. Consequently, we must reflect in which cases the administrators should respond to losses that they might cause to companies as a result of their duties’ disrespect. In this way is necessary to study the business judgment rule wich is a rule that refers to a liability exclusion rule. We intend, in the same way, to evaluate if the civil liability that results from the directors’ duties disrespect can extend itself to those who have elected them ignoring or even knowing that they don´t have the necessary skills or appropriate knowledge to the position they hold. To charge directors’, without ruining entrepreneurship, charging, in the same way, those who select them reinforces the need for more responsible and cautious attitudes which will lead consequently to more confidence in the markets.

Keywords: business judgment rule, civil liability of directors, duty of care, duty of care, Portuguese legal framework

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3218 Artificial Intelligence-Based Detection of Individuals Suffering from Vestibular Disorder

Authors: Dua Hişam, Serhat İkizoğlu

Abstract:

Identifying the problem behind balance disorder is one of the most interesting topics in the medical literature. This study has considerably enhanced the development of artificial intelligence (AI) algorithms applying multiple machine learning (ML) models to sensory data on gait collected from humans to classify between normal people and those suffering from Vestibular System (VS) problems. Although AI is widely utilized as a diagnostic tool in medicine, AI models have not been used to perform feature extraction and identify VS disorders through training on raw data. In this study, three machine learning (ML) models, the Random Forest Classifier (RF), Extreme Gradient Boosting (XGB), and K-Nearest Neighbor (KNN), have been trained to detect VS disorder, and the performance comparison of the algorithms has been made using accuracy, recall, precision, and f1-score. With an accuracy of 95.28 %, Random Forest Classifier (RF) was the most accurate model.

Keywords: vestibular disorder, machine learning, random forest classifier, k-nearest neighbor, extreme gradient boosting

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3217 Neuroprotective Effect of Vildagliptin against Cerebral Ischemia in Rats

Authors: Salma A. El-Marasy, Rehab F. Abdel-Rahman, Reham M. Abd-Elsalam

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The burden of stroke is intensely increasing worldwide. Brain injury following transient or permanent focal cerebral ischemia develops ischemic stroke as a consequence of a complex series of pathophysiological events. The aim of this study is to evaluate the possible neuroprotective effect of a dipeptidyl peptidase-4 inhibitor, vildagliptin, independent on its insulinotropic properties in non-diabetic rats subjected to cerebral ischemia. Anaesthetized Wistar rats were subjected to either left middle cerebral artery occlusion (MCAO) or sham operation followed by reperfusion after 30 min of MCAO. The other three groups were orally administered vildagliptin at 3 dose levels (2.5, 5, 10 mg/kg) for 3 successive weeks before subjected to left focal cerebral ischemia/reperfusion and till the end of the study. Neurological deficit scores and motor activity were assessed 24h following reperfusion. 48h following reperfusion, rats were euthanized and their left brain hemispheres were harvested and used in the biochemical, histopathological, and immunohistochemical investigations. Vildagliptin pretreatment improved neurological score deficit, locomotor activity and motor coordination in MCAO rats. Moreover, vildagliptin reduced malondialdehyde (MDA), elevated reduced glutathione (GSH), phosphotylinosital 3 kinase (PI3K), phosphorylated of protein kinase B (p-AKT), and mechanistic target of rapamycin (mTOR) brain contents in addition to reducing protein expression of caspase-3. Also, vildagliptin showed a dose-dependent attenuation in neuronal cell loss and histopathological alterations in MCAO rats. This study proves that vildagliptin exerted the neuroprotective effect in a dose-dependent manner as shown in amelioration of neuronal cell loss and histopathological damage in MCAO rats, which may be mediated by attenuating neuronal and motor deficits, it’s anti-oxidant property, activation of PI3K/AKT/mTOR pathway and its anti-apoptotic effect.

Keywords: caspase-3, cerebral ischemia, dipeptidyl peptidase-4 inhibitor, oxidative stress, PI3K/AKT/mTOR pathway, rats, vildagliptin

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3216 Effects of Kolavironon Liver Oxidative Stress and Beta-Cell Damage in Streptozotocin-Induced Diabetic Rats

Authors: Omolola R. Ayepola, Nicole L. Brooks, Oluwafemi O. Oguntibeju

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The liver plays an important role in the regulation of blood glucose and is a target organ of hyperglycaemia. Hyperglycemia plays a crucial role in the onset of various liver diseases and may culminate into hepatopathy if untreated. Alteration in antioxidant defense and increase in oxidative stress that results in tissue injury is characteristic of diabetes. We evaluated the protective effects of kolaviron-a biflavonoid complex, on hepatic antioxidants, lipid peroxidation and apoptosis in the liver of diabetic rats. To induce type I diabetes, rats were injected with streptozotocin intraperitoneally at a single dose of 50 mg/kg. Oral treatment of diabetic rats with kolaviron (100 mg/kg) started on the 6th day after diabetes induction and continued for 6 weeks (5 times weekly). Diabetic rats exhibited a significant increase in the peroxidation of hepatic lipids as observed from the elevated level of malondialdehyde (MDA) estimated by High-Performance Liquid Chromatography. In addition, Oxygen Radical Absorbance Capacity (ORAC), ratio of reduced to oxidized glutathione (GSH/GSSG) and catalase (CAT) activity was decreased in the liver of diabetic rats. TUNEL assay revealed increased apoptotic cell death in the liver of diabetic rats. Examination of Pancreatic beta-cells by immunohistochemical methods revealed beta cell degeneration and reduction in beta cell/ islet area in the diabetic controls. Kolaviron-treatment increased the area of insulin immunoreactive beta-cells significantly. Kolaviron attenuated lipid peroxidation and apoptosis in the liver of diabetic rats, increased CAT activity GSH levels and the resultant GSH: GSSG. The ORAC of kolaviron-treated diabetic liver was restored to near-normal values. Kolaviron protects the liver against oxidative and apoptotic damage induced by hyperglycemia. The antidiabetic effect of kolaviron may also be related to its beneficial effects on beta-cell function.

Keywords: diabetes mellitus, kolaviron, oxidative stress, liver, apoptosis

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3215 Evaluation of a Piecewise Linear Mixed-Effects Model in the Analysis of Randomized Cross-over Trial

Authors: Moses Mwangi, Geert Verbeke, Geert Molenberghs

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Cross-over designs are commonly used in randomized clinical trials to estimate efficacy of a new treatment with respect to a reference treatment (placebo or standard). The main advantage of using cross-over design over conventional parallel design is its flexibility, where every subject become its own control, thereby reducing confounding effect. Jones & Kenward, discuss in detail more recent developments in the analysis of cross-over trials. We revisit the simple piecewise linear mixed-effects model, proposed by Mwangi et. al, (in press) for its first application in the analysis of cross-over trials. We compared performance of the proposed piecewise linear mixed-effects model with two commonly cited statistical models namely, (1) Grizzle model; and (2) Jones & Kenward model, used in estimation of the treatment effect, in the analysis of randomized cross-over trial. We estimate two performance measurements (mean square error (MSE) and coverage probability) for the three methods, using data simulated from the proposed piecewise linear mixed-effects model. Piecewise linear mixed-effects model yielded lowest MSE estimates compared to Grizzle and Jones & Kenward models for both small (Nobs=20) and large (Nobs=600) sample sizes. It’s coverage probability were highest compared to Grizzle and Jones & Kenward models for both small and large sample sizes. A piecewise linear mixed-effects model is a better estimator of treatment effect than its two competing estimators (Grizzle and Jones & Kenward models) in the analysis of cross-over trials. The data generating mechanism used in this paper captures two time periods for a simple 2-Treatments x 2-Periods cross-over design. Its application is extendible to more complex cross-over designs with multiple treatments and periods. In addition, it is important to note that, even for single response models, adding more random effects increases the complexity of the model and thus may be difficult or impossible to fit in some cases.

Keywords: Evaluation, Grizzle model, Jones & Kenward model, Performance measures, Simulation

Procedia PDF Downloads 126