Search results for: healthy eating index (HEI)
Commenced in January 2007
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Edition: International
Paper Count: 5523

Search results for: healthy eating index (HEI)

153 Patterns of Libido, Sexual Activity and Sexual Performance in Female Migraineurs

Authors: John Farr Rothrock

Abstract:

Although migraine traditionally has been assumed to convey a relative decrease in libido, sexual activity and sexual performance, recent data have suggested that the female migraine population is far from homogenous in this regard. We sought to determine the levels of libido, sexual activity and sexual performance in the female migraine patient population both generally and according to clinical phenotype. In this single-blind study, a consecutive series of sexually active new female patients ages 25-55 initially presenting to a university-based headache clinic and having a >1 year history of migraine were asked to complete anonymously a survey assessing their sexual histories generally and as they related to their headache disorder and the 19-item Female Sexual Function Index (FSFI). To serve as 2 separate control groups, 100 sexually active females with no history of migraine and 100 female migraineurs from the general (non-clinic) population but matched for age, marital status, educational background and socioeconomic status completed a similar survey. Over a period of 3 months, 188 consecutive migraine patients were invited to participate. Twenty declined, and 28 of the remaining 160 potential subjects failed to meet the inclusion criterion utilized for “sexually active” (ie, heterosexual intercourse at a frequency of > once per month in each of the preceding 6 months). In all groups younger age (p<.005), higher educational level attained (p<.05) and higher socioeconomic status (p<.025) correlated with a higher monthly frequency of intercourse and a higher likelihood of intercourse resulting in orgasm. Relative to the 100 control subjects with no history of migraine, the two migraine groups (total n=232) reported a lower monthly frequency of intercourse and recorded a lower FSFI score (both p<.025), but the contribution to this difference came primarily from the chronic migraine (CM) subgroup (n=92). Patients with low frequency episodic migraine (LFEM) and mid frequency episodic migraine (MFEM) reported a higher FSFI score, higher monthly frequency of intercourse, higher likelihood of intercourse resulting in orgasm and higher likelihood of multiple active sex partners than controls. All migraine subgroups reported a decreased likelihood of engaging in intercourse during an active migraine attack, but relative to the CM subgroup (8/92=9%), a higher proportion of patients in the LFEM (12/49=25%), MFEM (14/67=21%) and high frequency episodic migraine (HFEM: 6/14=43%) subgroups reported utilizing intercourse - and orgasm specifically - as a means of potentially terminating a migraine attack. In the clinic vs no-clinic groups there were no significant differences in the dependent variables assessed. Research subjects with LFEM and MFEM may report a level of libido, frequency of intercourse and likelihood of orgasm-associated intercourse that exceeds what is reported by age-matched controls free of migraine. Many patients with LFEM, MFEM and HFEM appear to utilize intercourse/orgasm as a means to potentially terminate an acute migraine attack.

Keywords: migraine, female, libido, sexual activity, phenotype

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152 Spatiotemporal Changes in Drought Sensitivity Captured by Multiple Tree-Ring Parameters of Central European Conifers

Authors: Krešimir Begović, Miloš Rydval, Jan Tumajer, Kristyna Svobodová, Thomas Langbehn, Yumei Jiang, Vojtech Čada, Vaclav Treml, Ryszard Kaczka, Miroslav Svoboda

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Environmental changes have increased the frequency and intensity of climatic extremes, particularly hotter droughts, leading to altered tree growth patterns and multi-year lags in tree recovery. The effects of shifting climatic conditions on tree growth are inhomogeneous across species’ natural distribution ranges, with large spatial heterogeneity and inter-population variability, but generally have significant consequences for contemporary forest dynamics and future ecosystem functioning. Despite numerous studies on the impacts of regional drought effects, large uncertainties remain regarding the mechanistic basis of drought legacy effects on wood formation and the ability of individual species to cope with increasingly drier growing conditions and rising year-to-year climatic variability. To unravel the complexity of climate-growth interactions and assess species-specific responses to severe droughts, we combined forward modeling of tree growth (VS-lite model) with correlation analyses against climate (temperature, precipitation, and the SPEI-3 moisture index) and growth responses to extreme drought events from multiple tree-ring parameters (tree-width and blue intensity parameters). We used an extensive dataset with over 1000 tree-ring samples from 23 nature forest reserves across an altitudinal range in Czechia and Slovakia. Our results revealed substantial spatiotemporal variability in growth responses to summer season temperature and moisture availability across species and tree-ring parameters. However, a general trend of increasing spring moisture-growth sensitivity in recent decades was observed in the Scots pine mountain forests and lowland forests of both species. The VS-lite model effectively captured nonstationary climate-growth relationships and accurately estimated high-frequency growth variability, indicating a significant incidence of regional drought events and growth reductions. Notably, growth reductions during extreme drought years and discrete legacy effects identified in individual wood components were most pronounced in the lowland forests. Together with the observed growth declines in recent decades, these findings suggest an increasing vulnerability of Norway spruce and Scots pine in dry lowlands under intensifying climatic constraints.

Keywords: dendroclimatology, Vaganova–Shashkin lite, conifers, central Europe, drought, blue intensity

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151 Is Liking for Sampled Energy-Dense Foods Mediated by Taste Phenotypes?

Authors: Gary J. Pickering, Sarah Lucas, Catherine E. Klodnicki, Nicole J. Gaudette

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Two taste pheno types that are of interest in the study of habitual diet-related risk factors and disease are 6-n-propylthiouracil (PROP) responsiveness and thermal tasting. Individuals differ considerable in how intensely they experience the bitterness of PROP, which is partially explained by three major single nucleotide polymorphisms associated with the TAS2R38 gene. Importantly, this variable responsiveness is a useful proxy for general taste responsiveness, and links to diet-related disease risk, including body mass index, in some studies. Thermal tasting - a newly discovered taste phenotype independent of PROP responsiveness - refers to the capacity of many individuals to perceive phantom tastes in response to lingual thermal stimulation, and is linked with TRPM5 channels. Thermal tasters (TTs) also experience oral sensations more intensely than thermal non-tasters (TnTs), and this was shown to associate with differences in self-reported food preferences in a previous survey from our lab. Here we report on two related studies, where we sought to determine whether PROP responsiveness and thermal tasting would associate with perceptual differences in the oral sensations elicited by sampled energy-dense foods, and whether in turn this would influence liking. We hypothesized that hyper-tasters (thermal tasters and individuals who experience PROP intensely) would (a) rate sweet and high-fat foods more intensely than hypo-tasters, and (b) would differ from hypo-tasters in liking scores. (Liking has been proposed recently as a more accurate measure of actual food consumption). In Study 1, a range of energy-dense foods and beverages, including table cream and chocolate, was assessed by 25 TTs and 19 TnTs. Ratings of oral sensation intensity and overall liking were obtained using gVAS and gDOL scales, respectively. TTs and TnTs did not differ significantly in intensity ratings for most stimuli (ANOVA). In a 2nd study, 44 female participants sampled 22 foods and beverages, assessing them for intensity of oral sensations (gVAS) and overall liking (9-point hedonic scale). TTs (n=23) rated their overall liking of creaminess and milk products lower than did TnTs (n=21), and liked milk chocolate less. PROP responsiveness was negatively correlated with liking of food and beverages belonging to the sweet or sensory food grouping. No other differences in intensity or liking scores between hyper- and hypo-tasters were found. Taken overall, our results are somewhat unexpected, lending only modest support to the hypothesis that these taste phenotypes associate with energy-dense food liking and consumption through differences in the oral sensations they elicit. Reasons for this lack of concordance with expectations and some prior literature are discussed, and suggestions for future research are advanced.

Keywords: taste phenotypes, sensory evaluation, PROP, thermal tasting, diet-related health risk

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150 Concentrations of Leptin, C-Peptide and Insulin in Cord Blood as Fetal Origins of Insulin Resistance and Their Effect on the Birth Weight of the Newborn

Authors: R. P. Hewawasam, M. H. A. D. de Silva, M. A. G. Iresha

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Obesity is associated with an increased risk of developing insulin resistance. Insulin resistance often progresses to type-2 diabetes mellitus and is linked to a wide variety of other pathophysiological features including hypertension, hyperlipidemia, atherosclerosis (metabolic syndrome) and polycystic ovarian syndrome. Macrosomia is common in infants born to not only women with gestational diabetes mellitus but also non-diabetic obese women. During the past two decades, obesity in children and adolescents has risen significantly in Asian populations including Sri Lanka. There is increasing evidence to believe that infants who are born large for gestational age (LGA) are more likely to be obese in childhood. It is also established from previous studies that Asian populations have higher percentage body fat at a lower body mass index compared to Caucasians. High leptin levels in cord blood have been reported to correlate with fetal adiposity at birth. Previous studies have also shown that cord blood C-peptide and insulin levels are significantly and positively correlated with birth weight. Therefore, the objective of this preliminary study was to determine the relationship between parameters of fetal insulin resistance such as leptin, C-peptide and insulin and the birth weight of the newborn in a study population in Southern Sri Lanka. Umbilical cord blood was collected from 90 newborns and the concentration of insulin, leptin, and C-peptide were measured by ELISA technique. Birth weight, length, occipital frontal, chest, hip and calf circumferences of newborns were measured and characteristics of the mother such as age, height, weight before pregnancy and weight gain were collected. The relationship between insulin, leptin, C-peptide, and anthropometrics were assessed by Pearson’s correlation while the Mann-Whitney U test was used to assess the differences in cord blood leptin, C-peptide, and insulin levels between groups. A significant difference (p < 0.001) was observed between the insulin levels of infants born LGA (18.73 ± 0.64 µlU/ml) and AGA (13.08 ± 0.43 µlU/ml). Consistently, A significant increase in concentration (p < 0.001) was observed in C-peptide levels of infants born LGA (9.32 ± 0.77 ng/ml) compared to AGA (5.44 ± 0.19 ng/ml). Cord blood leptin concentration of LGA infants (12.67 ng/mL ± 1.62) was significantly higher (p < 0.001) compared to the AGA infants (7.10 ng/mL ± 0.97). Significant positive correlations (p < 0.05) were observed among cord leptin levels and the birth weight, pre-pregnancy maternal weight and BMI between the infants of AGA and LGA. Consistently, a significant positive correlation (p < 0.05) was observed between the birth weight and the C peptide concentration. Significantly high concentrations of leptin, C-peptide and insulin levels in the cord blood of LGA infants suggest that they may be involved in regulating fetal growth. Although previous studies suggest comparatively high levels of body fat in the Asian population, values obtained in this study are not significantly different from values previously reported from Caucasian populations. According to this preliminary study, maternal pre-pregnancy BMI and weight may contribute as significant indicators of cord blood parameters of insulin resistance and possibly the birth weight of the newborn.

Keywords: large for gestational age, leptin, C-peptide, insulin

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149 Benefits of The ALIAmide Palmitoyl-Glucosamine Co-Micronized with Curcumin for Osteoarthritis Pain: A Preclinical Study

Authors: Enrico Gugliandolo, Salvatore Cuzzocrea, Rosalia Crupi

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Osteoarthritis (OA) is one of the most common chronic pain conditions in dogs and cats. OA pain is currently viewed as a mixed phenomenon involving both inflammatory and neuropathic mechanisms at the peripheral (joint) and central (spinal and supraspinal) levels. Oxidative stress has been implicated in OA pain. Although nonsteroidal anti-inflammatory drugs are commonly prescribed for OA pain, they should be used with caution in pets because of adverse effects in the long term and controversial efficacy on neuropathic pain. An unmet need remains for safe and effective long-term treatments for OA pain. Palmitoyl-glucosamine (PGA) is an analogue of the ALIAamide palmitoylethanolamide, i.e., a body’s own endocannabinoid-like compound playing a sentinel role in nociception. PGA, especially in the micronized formulation, was shown safe and effective in OA pain. The aim of this study was to investigate the effect of a co-micronized formulation of PGA with the natural antioxidant curcumin (PGA-cur) on OA pain. Ten Sprague-Dawley male rats were used for each treatment group. The University of Messina Review Board for the care and use of animals authorized the study. On day 0, rats were anesthetized (5.0% isoflurane in 100% O2) and received intra-articular injection of MIA (3 mg in 25 μl saline) in the right knee joint, with the left being injected an equal volume of saline. Starting the third day after MIA injection, treatments were administered orally three times per week for 21 days, at the following doses: PGA 20 mg/kg, curcumin 10 mg/kg, PGA-cur (2:1 ratio) 30 mg/kg. On day 0 and 3, 7, 14 and 21 days post-injection, mechanical allodynia was measured using a dynamic plantar Von Frey hair aesthesiometer and expressed as paw withdrawal threshold (PWT) and latency (PWL). Motor functional recovery of the rear limb was evaluated on the same time points by walking track analysis using the sciatic functional index. On day 21 post-MIA injection, the concentration of the following inflammatory and nociceptive mediators was measured in serum using commercial ELISA kits: tumor necrosis factor alpha (TNF-α), interleukin-1 beta (IL-1β), nerve growth factor (NGF) and matrix metalloproteinase-1-3-9 (MMP-1, MMP-3, MMP-9). The results were analyzed by ANOVA followed by Bonferroni post-hoc test for multiple comparisons. Micronized PGA reduced neuropathic pain, as shown by the significant higher PWT and PWL values compared to vehicle group (p < 0.0001 for all the evaluated time points). The effect of PGA-cur was superior at all time points (p < 0.005). PGA-cur restored motor function already on day 14 (p < 0.005), while micronized PGA was effective a week later (D21). MIA-induced increase in the serum levels of all the investigated mediators was inhibited by PGA-cur (p < 0.01). PGA was also effective, except on IL-1 and MMP-3. Curcumin alone was inactive in all the experiments at any time point. The encouraging results suggest that PGA-cur may represent a valuable option in OA pain management and warrant further confirmation in well-powered clinical trials.

Keywords: ALIAmides, curcumin, osteoarthritis, palmitoyl-glucosamine

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148 Allylation of Active Methylene Compounds with Cyclic Baylis-Hillman Alcohols: Why Is It Direct and Not Conjugate?

Authors: Karim Hrratha, Khaled Essalahb, Christophe Morellc, Henry Chermettec, Salima Boughdiria

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Among the carbon-carbon bond formation types, allylation of active methylene compounds with cyclic Baylis-Hillman (BH) alcohols is a reliable and widely used method. This reaction is a very attractive tool in organic synthesis of biological and biodiesel compounds. Thus, in view of an insistent and peremptory request for an efficient and straightly method for synthesizing the desired product, a thorough analysis of various aspects of the reaction processes is an important task. The product afforded by the reaction of active methylene with BH alcohols depends largely on the experimental conditions, notably on the catalyst properties. All experiments reported that catalysis is needed for this reaction type because of the poor ability of alcohol hydroxyl group to be as a suitable leaving group. Within the catalysts, several transition- metal based have been used such as palladium in the presence of acid or base and have been considered as reliable methods. Furthemore, acid catalysts such as BF3.OEt2, BiX3 (X= Cl, Br, I, (OTf)3), InCl3, Yb(OTf)3, FeCl3, p-TsOH and H-montmorillonite have been employed to activate the C-C bond formation through the alkylation of active methylene compounds. Interestingly a report of a smoothly process for the ability of 4-imethyaminopyridine(DMAP) to catalyze the allylation reaction of active methylene compounds with cyclic Baylis-Hillman (BH) alcohol appeared recently. However, the reaction mechanism remains ambiguous, since the C- allylation process leads to an unexpected product (noted P1), corresponding to a direct allylation instead of conjugate allylation, which involves the most electrophilic center according to the electron withdrawing group CO effect. The main objective of the present theoretical study is to better understand the role of the DMAP catalytic activity as well as the process leading to the end- product (P1) for the catalytic reaction of a cyclic BH alcohol with active methylene compounds. For that purpose, we have carried out computations of a set of active methylene compounds varying by R1 and R2 toward the same alcohol, and we have attempted to rationalize the mechanisms thanks to the acid–base approach, and conceptual DFT tools such as chemical potential, hardness, Fukui functions, electrophilicity index and dual descriptor, as these approaches have shown a good prediction of reactions products.The present work is then organized as follows: In a first part some computational details will be given, introducing the reactivity indexes used in the present work, then Section 3 is dedicated to the discussion of the prediction of the selectivity and regioselectivity. The paper ends with some concluding remarks. In this work, we have shown, through DFT method at the B3LYP/6-311++G(d,p) level of theory that: The allylation of active methylene compounds with cyclic BH alcohol is governed by orbital control character. Hence the end- product denoted P1 is generated by direct allylation.

Keywords: DFT calculation, gas phase pKa, theoretical mechanism, orbital control, charge control, Fukui function, transition state

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147 Sustainable Urban Regenaration the New Vocabulary and the Timless Grammar of the Urban Tissue

Authors: Ruth Shapira

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Introduction: The rapid urbanization of the last century confronts planners, regulatory bodies, developers and most of all the public with seemingly unsolved conflicts regarding values, capital, and wellbeing of the built and un-built urban space. There is an out of control change of scale of the urban form and of the rhythm of the urban life which has known no significant progress in the last 2-3 decades despite the on-growing urban population. It is the objective of this paper to analyze some of these fundamental issues through the case study of a relatively small town in the center of Israel (Kiryat-Ono, 36,000 inhabitants), unfold the deep structure of qualities versus disruptors, present some cure that we have developed to bridge over and humbly suggest a practice that may bring about a sustainable new urban environment based on timeless values of the past, an approach that can be generic for similar cases. Basic Methodologies:The object, the town of Kiryat Ono, shall be experimented upon in a series of four action processes: De-composition, Re-composition, the Centering process and, finally, Controlled Structural Disintegration. Each stage will be based on facts, analysis of previous multidisciplinary interventions on various layers – and the inevitable reaction of the OBJECT, leading to the conclusion based on innovative theoretical and practical methods that we have developed and that we believe are proper for the open ended network, setting the rules for the contemporary urban society to cluster by – thus – a new urban vocabulary based on the old structure of times passed. The Study: Kiryat Ono, was founded 70 years ago as an agricultural settlement and rapidly turned into an urban entity. In spite the massive intensification, the original DNA of the old small town was still deeply embedded, mostly in the quality of the public space and in the sense of clustered communities. In the past 20 years, the recent demand for housing has been addressed to on the national level with recent master plans and urban regeneration policies mostly encouraging individual economic initiatives. Unfortunately, due to the obsolete existing planning platform the present urban renewal is characterized by pressure of developers, a dramatic change in building scale and widespread disintegration of the existing urban and social tissue.Our office was commissioned to conceptualize two master plans for the two contradictory processes of Kiryat Ono’s future: intensification and conservation. Following a comprehensive investigation into the deep structures and qualities of the existing town, we developed a new vocabulary of conservation terms thus redefying the sense of PLACE. The main challenge was to create master plans that should offer a regulatory basis to the accelerated and sporadic development providing for the public good and preserving the characteristics of the place consisting of a tool box of design guidelines that will have the ability to reorganize space along the time axis in a sustainable way. In conclusion: The system of rules that we have developed can generate endless possible patterns making sure that at each implementation fragment an event is created, and a better place is revealed. It takes time and perseverance but it seems to be the way to provide a healthy and sustainable framework for the accelerated urbanization of our chaotic present.

Keywords: sustainable urban design, intensification, emergent urban patterns, sustainable housing, compact urban neighborhoods, sustainable regeneration, restoration, complexity, uncertainty, need for change, implications of legislation on local planning

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146 Association between Obstetric Factors with Affected Areas of Health-Related Quality of Life of Pregnant Women

Authors: Cinthia G. P. Calou, Franz J. Antezana, Ana I. O. Nicolau, Eveliny S. Martins, Paula R. A. L. Soares, Glauberto S. Quirino, Dayanne R. Oliveira, Priscila S. Aquino, Régia C. M. B. Castro, Ana K. B. Pinheiro

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Introduction: As an integral part of the health-disease process, gestation is a period in which the social insertion of women can influence, in a positive or negative way, the course of the pregnancy-puerperal cycle. Thus, evaluating the quality of life of this population can redirect the implementation of innovative practices in the quest to make them more effective and real for the promotion of a more humanized care. This study explores the associations between the obstetric factors with affected areas of health-related quality of life of pregnant women with habitual risk. Methods: This is a cross-sectional, quantitative study conducted in three public facilities and a private service that provides prenatal care in the city of Fortaleza, Ceara, Brazil. The sample consisted of 261 pregnant women who underwent low-risk prenatal care and were interviewed from September to November 2014. The collection instruments were a questionnaire containing socio-demographic and obstetric variables, in addition to the Brazilian version of the Mother scale Generated Index (MGI) characterized by being a specific and objective instrument, consisting of a single sheet and subdivided into three stages. It allows identifying the areas of life of the pregnant woman that are most affected, which could go unnoticed by the pre-formulated measurement instruments. The obstetric data, as well as the data concerning the application of the MGI scale, were compiled and analyzed through the statistical program Statistical Package for the Social Sciences (SPSS), version 20.0. After the compilation, a descriptive analysis was carried out. Then, associations were made between some variables. The tests applied were the Pearson Chi-Square and the Fisher's exact test. The odds ratio was also calculated. These associations were considered statistically significant when the p (probability) value was less than or equal to a level of 5% (α = 0.05) in the tests performed. Results: The variables that negatively reflected the quality of life of the pregnant women and presented a significant association with the polaciuria were: gestational age (p = 0.022) and parity (p = 0.048). Episodes of nausea and vomiting also showed significant with gestational age correlation (p = 0.0001). Evaluating the crossing of stress, we observed a significant association with parity (p = 0.0001). In turn, emotional lability revealed dependence on the variable type of delivery (p = 0.009). Conclusion: The health professionals involved in the assistance to the pregnant woman can understand how the process of gestation is experienced, considering all its peculiar transformations; to meet their individual needs, stimulating their autonomy and their power of choice, envisaging the achievement of a better quality of life related to health in the perspective of health promotion.

Keywords: health-related quality of life, obstetric nursing, pregnant women, prenatal care

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145 A Quantitative Case Study Analysis of Store Format Contributors to U.S. County Obesity Prevalence in Virginia

Authors: Bailey Houghtaling, Sarah Misyak

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Food access; the availability, affordability, convenience, and desirability of food and beverage products within communities, is influential on consumers’ purchasing and consumption decisions. These variables may contribute to lower dietary quality scores and a higher obesity prevalence documented among rural and disadvantaged populations in the United States (U.S.). Current research assessing linkages between food access and obesity outcomes has primarily focused on distance to a traditional grocery/supermarket store as a measure of optimality. However, low-income consumers especially, including U.S. Department of Agriculture’s Supplemental Nutrition Assistance Program (SNAP) participants, seem to utilize non-traditional food store formats with greater frequency for household dietary needs. Non-traditional formats have been associated with less nutritious food and beverage options and consumer purchases that are high in saturated fats, added sugars, and sodium. Authors’ formative research indicated differences by U.S. region and rurality in the distribution of traditional and non-traditional SNAP-authorized food store formats. Therefore, using Virginia as a case study, the purpose of this research was to determine if a relationship between store format, rurality, and obesity exists. This research applied SNAP-authorized food store data (food access points for SNAP as well as non-SNAP consumers) and obesity prevalence data by Virginia county using publicly available databases: (1) SNAP Retailer Locator, and; (2) U.S. County Health Rankings. The alpha level was set a priori at 0.05. All Virginia SNAP-authorized stores (n=6,461) were coded by format – grocery, drug, mass merchandiser, club, convenience, dollar, supercenter, specialty, farmers market, independent grocer, and non-food store. Simple linear regression was applied primarily to assess the relationship between store format and obesity. Thereafter, multiple variables were added to the regression to account for potential moderating relationships (e.g., county income, rurality). Convenience, dollar, non-food or restaurant, mass merchandiser, farmers market, and independent grocer formats were significantly, positively related to obesity prevalence. Upon controlling for urban-rural status and income, results indicated the following formats to be significantly related to county obesity prevalence with a small, positive effect: convenience (p=0.010), accounting for 0.3% of the variance in obesity prevalence; dollar (p=0.005; 0.5% of the variance), and; non-food (p=0.030; 1.3% of the variance) formats. These results align with current literature on consumer behavior at non-traditional formats. For example, consumers’ food and beverage purchases at convenience and dollar stores are documented to be high in saturated fats, added sugars, and sodium. Further, non-food stores (i.e., quick-serve restaurants) often contribute to a large portion of U.S. consumers’ dietary intake and thus poor dietary quality scores. Current food access research investigates grocery/supermarket access and obesity outcomes. These results suggest more research is needed that focuses on non-traditional food store formats. Nutrition interventions within convenience, dollar, and non-food stores, for example, that aim to enhance not only healthy food access but the affordability, convenience, and desirability of nutritious food and beverage options may impact obesity rates in Virginia. More research is warranted utilizing the presented investigative framework in other U.S. and global regions to explore the role and the potential of non-traditional food store formats to prevent and reduce obesity.

Keywords: food access, food store format, non-traditional food stores, obesity prevalence

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144 Continuity Through Best Practice. A Case Series of Complex Wounds Manage by Dedicated Orthopedic Nursing Team

Authors: Siti Rahayu, Khairulniza Mohd Puat, Kesavan R., Mohammad Harris A., Jalila, Kunalan G., Fazir Mohamad

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The greatest challenge has been in establishing and maintaining the dedicated nursing team. Continuity is served when nurses are assigned exclusively for managing wound, where they can continue to build expertise and skills. In addition, there is a growing incidence of chronic wounds and recognition of the complexity involved in caring for these patients. We would like to share 4 cases with different techniques of wound management. 1st case, 39 years old gentleman with underlying rheumatoid arthritis with chronic periprosthetic joint infection of right total knee replacement presented with persistent drainage over right knee. Patient was consulted for two stage revision total knee replacement. However, patient only agreed for debridement and retention of implant. After debridement, large medial and lateral wound was treated with Instillation Negative Pressure Wound Therapy Dressings. After several cycle, the wound size reduced, and conventional dressing was applied. 2nd case, 58 years old gentleman with underlying diabetes presented with right foot necrotizing fasciitis with gangrene of 5th toe. He underwent extensive debridement of foot with rays’ amputation of 5th toe. Post debridement patient was started on Instillation Negative Pressure Wound Therapy Dressings. After several cycle of VAC, the wound bed was prepared, and he underwent split skin graft over right foot. 3 rd case, 60 years old gentleman with underlying diabetes mellitus presented with right foot necrotizing soft tissue infection. He underwent rays’ amputation and extensive wound debridement. Upon stabilization of general condition, patient was discharge with regular wound dressing by same nurse and doctor during each visit to clinic follow up. After 6 months of follow up, the wound healed well. 4th case, 38-year-old gentleman had alleged motor vehicle accident and sustained closed fracture right tibial plateau. Open reduction and proximal tibial locking plate were done. At 2 weeks post-surgery, the patient presented with warm, erythematous leg and pus discharge from the surgical site. Empirical antibiotic was started, and wound debridement was done. Intraoperatively, 50cc pus was evacuated, unhealthy muscle and tissue debrided. No loosening of the implant. Patient underwent multiple wound debridement. At 2 weeks post debridement wound healed well, but the proximal aspect was unable to close immediately. This left the proximal part of the implant to be exposed. Patient was then put on VAC dressing for 3 weeks until healthy granulation tissue closes the implant. Meanwhile, antibiotic was change according to culture and sensitivity. At 6 weeks post the first debridement, the wound was completely close, and patient was discharge home well. At 3 months post operatively, patient wound and fracture healed uneventfully and able to ambulate independently. Complex wounds are too serious to be dealt with. Team managing complex wound need continuous support through the provision of educational tools to support their professional development, engagement with local and international expert, as well as highquality products that increase efficiencies in services

Keywords: VAC (Vacuum Assisted Closure), empirical- initial antibiotics, NPWT- negative pressure wound therapy, NF- necrotizing fasciitis, gangrene- blackish discoloration due to poor blood supply

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143 Neutrophil-to-Lymphocyte Ratio: A Predictor of Cardiometabolic Complications in Morbid Obese Girls

Authors: Mustafa M. Donma, Orkide Donma

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Obesity is a low-grade inflammatory state. Childhood obesity is a multisystem disease, which is associated with a number of complications as well as potentially negative consequences. Gender is an important universal risk factor for many diseases. Hematological indices differ significantly by gender. This should be considered during the evaluation of obese children. The aim of this study is to detect hematologic indices that differ by gender in morbid obese (MO) children. A total of 134 MO children took part in this study. The parents filled an informed consent form and the approval from the Ethics Committee of Namik Kemal University was obtained. Subjects were divided into two groups based on their genders (64 females aged 10.2±3.1 years and 70 males aged 9.8±2.2 years; p ≥ 0.05). Waist-to-hip as well as head-to-neck ratios and body mass index (BMI) values were calculated. The children, whose WHO BMI-for age and sex percentile values were > 99 percentile, were defined as MO. Hematological parameters [haemoglobin, hematocrit, erythrocyte count, mean corpuscular volume, mean corpuscular haemoglobin, mean corpuscular haemoglobin concentration, red blood cell distribution width, leukocyte count, neutrophil %, lymphocyte %, monocyte %, eosinophil %, basophil %, platelet count, platelet distribution width, mean platelet volume] were determined by the automatic hematology analyzer. SPSS was used for statistical analyses. P ≤ 0.05 was the degree for statistical significance. The groups included children having mean±SD value of BMI as 26.9±3.4 kg/m2 for males and 27.7±4.4 kg/m2 for females (p ≥ 0.05). There was no significant difference between ages of females and males (p ≥ 0.05). Males had significantly increased waist-to-hip ratios (0.95±0.08 vs 0.91±0.08; p=0.005) and mean corpuscular hemoglobin concentration values (33.6±0.92 vs 33.1±0.83; p=0.001) compared to those of females. Significantly elevated neutrophil (4.69±1.59 vs 4.02±1.42; p=0.011) and neutrophil-to-lymphocyte ratios (1.70±0.71 vs 1.39±0.48; p=0.004) were detected in females. There was no statistically significant difference between groups in terms of C-reactive protein values (p ≥ 0.05). Adipose tissue plays important roles during the development of obesity and associated diseases such as metabolic syndrom and cardiovascular diseases (CVDs). These diseases may cause changes in complete blood cell count parameters. These alterations are even more important during childhood. Significant gender effects on the changes of neutrophils, one of the white blood cell subsets, were observed. The findings of the study demonstrate the importance of considering gender in clinical studies. The males and females may have distinct leukocyte-trafficking profiles in inflammation. Female children had more circulating neutrophils, which may be the indicator of an increased risk of CVDs, than male children within this age range during the late stage of obesity. In recent years, females represent about half of deaths from CVDs; therefore, our findings may be the indicator of the increasing tendency of this risk in females starting from childhood.

Keywords: children, gender, morbid obesity, neutrophil-to-lymphocyte ratio

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142 An Assessment of Health Hazards in Urban Communities: A Study of Spatial-Temporal Variations of Dengue Epidemic in Colombo, Sri Lanka

Authors: U. Thisara G. Perera, C. M. Kanchana N. K. Chandrasekara

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Dengue is an epidemic which is spread by Aedes Egyptai and Aedes Albopictus mosquitoes. The cases of dengue show a dramatic growth rate of the epidemic in urban and semi urban areas spatially in tropical and sub-tropical regions of the world. Incidence of dengue has become a prominent reason for hospitalization and deaths in Asian countries, including Sri Lanka. During the last decade the dengue epidemic began to spread from urban to semi-urban and then to rural settings of the country. The highest number of dengue infected patients was recorded in Sri Lanka in the year 2016 and the highest number of patients was identified in Colombo district. Together with the commercial, industrial, and other supporting services, the district suffers from rapid urbanization and high population density. Thus, drainage and waste disposal patterns of the people in this area exert an additional pressure to the environment. The district is situated in the wet zone and thus low lying lands constitute the largest portion of the district. This situation additionally facilitates mosquito breeding sites. Therefore, the purpose of the present study was to assess the spatial and temporal distribution patterns of dengue epidemic in Kolonnawa MOH area (Medical Officer of Health) in the district of Colombo. The study was carried out using 615 recorded dengue cases in Kollonnawa MOH area during the south east monsoon season from May to September 2016. The Moran’s I and Kernel density estimation were used as analytical methods. The analysis of data was accomplished through the integrated use of ArcGIS 10.1 software packages along with Microsoft Excel analytical tool. Field observation was also carried out for verification purposes during the study period. Results of the Moran’s I index indicates that the spatial distribution of dengue cases showed a cluster distribution pattern across the area. Kernel density estimation emphasis that dengue cases are high where the population has gathered, especially in areas comprising housing schemes. Results of the Kernel Density estimation further discloses that hot spots of dengue epidemic are located in the western half of the Kolonnawa MOH area, which is close to the Colombo municipal boundary and there is a significant relationship with high population density and unplanned urban land use practices. Results of the field observation confirm that the drainage systems in these areas function poorly and careless waste disposal methods of the people further encourage mosquito breeding sites. This situation has evolved harmfully from a public health issue to a social problem, which ultimately impacts on the economy and social lives of the country.

Keywords: Dengue epidemic, health hazards, Kernel density, Moran’s I, Sri Lanka

Procedia PDF Downloads 284
141 Engineering Topology of Photonic Systems for Sustainable Molecular Structure: Autopoiesis Systems

Authors: Moustafa Osman Mohammed

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This paper introduces topological order in descried social systems starting with the original concept of autopoiesis by biologists and scientists, including the modification of general systems based on socialized medicine. Topological order is important in describing the physical systems for exploiting optical systems and improving photonic devices. The stats of topological order have some interesting properties of topological degeneracy and fractional statistics that reveal the entanglement origin of topological order, etc. Topological ideas in photonics form exciting developments in solid-state materials, that being; insulating in the bulk, conducting electricity on their surface without dissipation or back-scattering, even in the presence of large impurities. A specific type of autopoiesis system is interrelated to the main categories amongst existing groups of the ecological phenomena interaction social and medical sciences. The hypothesis, nevertheless, has a nonlinear interaction with its natural environment 'interactional cycle' for exchange photon energy with molecules without changes in topology. The engineering topology of a biosensor is based on the excitation boundary of surface electromagnetic waves in photonic band gap multilayer films. The device operation is similar to surface Plasmonic biosensors in which a photonic band gap film replaces metal film as the medium when surface electromagnetic waves are excited. The use of photonic band gap film offers sharper surface wave resonance leading to the potential of greatly enhanced sensitivity. So, the properties of the photonic band gap material are engineered to operate a sensor at any wavelength and conduct a surface wave resonance that ranges up to 470 nm. The wavelength is not generally accessible with surface Plasmon sensing. Lastly, the photonic band gap films have robust mechanical functions that offer new substrates for surface chemistry to understand the molecular design structure and create sensing chips surface with different concentrations of DNA sequences in the solution to observe and track the surface mode resonance under the influences of processes that take place in the spectroscopic environment. These processes led to the development of several advanced analytical technologies: which are; automated, real-time, reliable, reproducible, and cost-effective. This results in faster and more accurate monitoring and detection of biomolecules on refractive index sensing, antibody-antigen reactions with a DNA or protein binding. Ultimately, the controversial aspect of molecular frictional properties is adjusted to each other in order to form unique spatial structure and dynamics of biological molecules for providing the environment mutual contribution in investigation of changes due to the pathogenic archival architecture of cell clusters.

Keywords: autopoiesis, photonics systems, quantum topology, molecular structure, biosensing

Procedia PDF Downloads 69
140 Spatial and Temporal Variability of Meteorological Drought Including Atmospheric Circulation in Central Europe

Authors: Andrzej Wałęga, Marta Cebulska, Agnieszka Ziernicka-Wojtaszek, Wojciech Młocek, Agnieszka Wałęga, Tommaso Caloiero

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Drought is one of the natural phenomena influencing many aspects of human activities like food production, agriculture, industry, and the ecological conditions of the environment. In the area of the Polish Carpathians, there are periods with a deficit of rainwater and an increasing frequency in dry months, especially in the cold half of the year. The aim of this work is a spatial and temporal analysis of drought, expressed as SPI in a heterogenous area of the Polish Carpathian and of the highland Region in the Central part of Europe based on long-term precipitation data. Also, to our best knowledge, for the first time in this work, drought characteristics analyzed via the SPI were discussed based on the atmospheric circulation calendar. The study region is the Upper Vistula Basin, located in the southern and south-eastern part of Poland. In this work, monthly precipitation from 56 rainfall stations was analysed from 1961 to 2022. The 3-, 6-, 9-, and 12-month Standardized Precipitation Index (SPI) were used as indicators of meteorological drought. For the 3-month SPI, the main climatic mechanisms determining extreme droughts were defined based on the calendar of synoptic circulations. The Mann-Kendall test was used to detect the trend of extreme droughts. Statistically significant trends of SPI were observed on 52.7% of all analyzed stations, and in most cases, a positive trend was observed. Statistically significant trends were more frequently observed in stations located in the western part of the analyzed region. Long-term droughts, represented by the 12-month SPI, occurred in all stations but not in all years. Short-term droughts (3-month SPI) were most frequent in the winter season, 6 and 9-month SPI in winter and spring, and 12-month SPI in winter and autumn, respectively. The spatial distribution of drought was highly diverse. The most intensive drought occurred in 1984, with the 6-month SPI covering 98% of the analyzed region and the 9 and 12-month SPI covering 90% of the entire region. Droughts exhibit a seasonal pattern, with a dominant 10-year periodicity for all analyzed variants of SPI. Additionally, Fourier analysis revealed a 2-year periodicity for the 3-, 6-, and 9-month SPI and a 31-year periodicity for the 12-month SPI. The results provide insights into the typical climatic conditions in Poland, with strong seasonality in precipitation. The study highlighted that short-term extreme droughts, represented by the 3-month SPI, are often caused by anticyclonic situations with high-pressure wedges Ka and Wa, and anticyclonic West as observed in 52.3% of cases. These findings are crucial for understanding the spatial and temporal variability of short and long-term extreme droughts in Central Europe, particularly for the agriculture sector dominant in the northern part of the analyzed region, where drought frequency is highest.

Keywords: atmospheric circulation, drought, precipitation, SPI, the Upper Vistula Basin

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139 Hybridization of Mathematical Transforms for Robust Video Watermarking Technique

Authors: Harpal Singh, Sakshi Batra

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The widespread and easy accesses to multimedia contents and possibility to make numerous copies without loss of significant fidelity have roused the requirement of digital rights management. Thus this problem can be effectively solved by Digital watermarking technology. This is a concept of embedding some sort of data or special pattern (watermark) in the multimedia content; this information will later prove ownership in case of a dispute, trace the marked document’s dissemination, identify a misappropriating person or simply inform user about the rights-holder. The primary motive of digital watermarking is to embed the data imperceptibly and robustly in the host information. Extensive counts of watermarking techniques have been developed to embed copyright marks or data in digital images, video, audio and other multimedia objects. With the development of digital video-based innovations, copyright dilemma for the multimedia industry increases. Video watermarking had been proposed in recent years to serve the issue of illicit copying and allocation of videos. It is the process of embedding copyright information in video bit streams. Practically video watermarking schemes have to address some serious challenges as compared to image watermarking schemes like real-time requirements in the video broadcasting, large volume of inherently redundant data between frames, the unbalance between the motion and motionless regions etc. and they are particularly vulnerable to attacks, for example, frame swapping, statistical analysis, rotation, noise, median and crop attacks. In this paper, an effective, robust and imperceptible video watermarking algorithm is proposed based on hybridization of powerful mathematical transforms; Fractional Fourier Transform (FrFT), Discrete Wavelet transforms (DWT) and Singular Value Decomposition (SVD) using redundant wavelet. This scheme utilizes various transforms for embedding watermarks on different layers by using Hybrid systems. For this purpose, the video frames are portioned into layers (RGB) and the watermark is being embedded in two forms in the video frames using SVD portioning of the watermark, and DWT sub-band decomposition of host video, to facilitate copyright safeguard as well as reliability. The FrFT orders are used as the encryption key that allows the watermarking method to be more robust against various attacks. The fidelity of the scheme is enhanced by introducing key generation and wavelet based key embedding watermarking scheme. Thus, for watermark embedding and extraction, same key is required. Therefore the key must be shared between the owner and the verifier via some safe network. This paper demonstrates the performance by considering different qualitative metrics namely Peak Signal to Noise ratio, Structure similarity index and correlation values and also apply some attacks to prove the robustness. The Experimental results are presented to demonstrate that the proposed scheme can withstand a variety of video processing attacks as well as imperceptibility.

Keywords: discrete wavelet transform, robustness, video watermarking, watermark

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138 Effects of Delphinidin on Lipid Metabolism in HepG2 Cells and Diet-Induced Obese Mice

Authors: Marcela Parra-Vargas, Ana Sandoval-Rodriguez, Roberto Rodriguez-Echevarria, Jose Dominguez-Rosales, Juan Armendariz-Borunda

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Non-alcoholic fatty liver disease (NAFLD) is characterized by an excess of hepatic lipids, and it is to author’s best knowledge, the most prevalent chronic liver disorder. Anthocyanin-rich food consumption is linked to health benefits in metabolic disorders associated with obesity and NAFLD, although the precise functional role of anthocyanidin delphinidin (Dp) has yet to be established. The aim of this study was to investigate the effect of the Dp in NAFLD metabolic alterations by evaluating prevention or amelioration of hepatic lipid accumulation, as well as molecular mechanisms in two experimental obesity-related models of NALFD. In vitro: HepG2 cells were incubated with sodium palmitate (PA, 1 mM) to induce lipotoxic damage, and concomitantly treated with Dp (180 uM) for 24 h. Subsequently, total lipid accumulation was measured by colorimetric staining with Oil Red O, and total intrahepatic triglycerides were determined by an enzymatic assay. To assess molecular mechanisms, cells were pre-treated with PA for 24 h and then exposed to Dp for 1 h. In vivo: four-week-old male C57BL/6Nhsd mice were allocated in two main groups. Mice were fed with standard diet (control) or high-fat and high-carbohydrate diet (45% fat, HFD) for 16 wk to induce NAFLD. Then HFD was divided into subgroups: one treated orally with Dp (15 mg/kg bw, HFD-Dp) every day for 4 wk, while HFD group treated with vehicle (DMSO). Weight and fasting glucose were recorded weekly, while dietary ingestion was measured daily. Insulin tolerance test was performed at the end of treatment. Liver histology was evaluated with H&E and Masson’s trichrome stain. RT-PCR was used to evaluate gene expression and Western Blot to determine levels of protein in both experimental models. Parametric data were analyzed with one-way ANOVA and Tukey’s post-hoc test. Kruskal-Wallis and Mann-Whitney U test for non-parametric data, and P < 0.5 were considered significant. Dp prevented hepatic lipid accumulation by PA in HepG2 hepatocytes. Furthermore, Dp down-regulated gene expression of SREBP1c, FAS, and CPT1a without modifying AMPK phosphorylation levels. In vivo, Dp oral administration did not ameliorate lipid metabolic alterations raised by HFD. Adiposity, dietary ingestion, fasting glucose, and insulin sensitivity after Dp treatment remained similar to HFD group. Histological analysis showed hepatic damage in HFD groups and no differences between HFD and HFD-Dp groups were found. Hepatic gene expression of ACC and FAS were not altered by HFD. SREBP1c was similar in both HFD and HFD-Dp groups. No significant changes were observed in SREBP1c, ACC, and FAS adipose tissue gene expression by HFD or Dp treatment. Additionally, immunoblotting analysis revealed no changes in pathway SIRT1-LKB-AMPK and PPAR alpha by both HFD groups compared to control. In conclusion, the antioxidant Dp may provoke beneficial effects in the prevention of hepatic lipid accumulation. Nevertheless, the oral dose administrated in mice that simulated the total intake of anthocyanins consumed daily by humans has no effect as a treatment on hepatic lipid metabolic alterations and histological abnormalities associated with exposure to chronic HFD. A healthy lifestyle with regular intake of antioxidants such as anthocyanins may prevent metabolic alterations in NAFLD.

Keywords: anthocyanins, antioxidants, delphinidin, non-alcoholic fatty liver disease, obesity

Procedia PDF Downloads 182
137 Agroecology Approaches Towards Sustainable Agriculture and Food System: Reviewing and Exploring Selected Policies and Strategic Documents through an Agroecological Lens

Authors: Dereje Regasa

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The global food system is at a crossroads, which requires prompt action to minimize the effects of the crises. Agroecology is gaining prominence due to its contributions to sustainable food systems. To support efforts in mitigating the crises, the Food and Agriculture Organization (FAO) established alternative approaches for sustainable agri-food systems. Agroecological elements and principles were developed to guide and support measures that countries need to achieve the Sustainable Development Goals (SDGs). The SDGs require the systemic integration of practices for a smart intensification or adaptation of traditional or industrial agriculture. As one of the countries working towards SDGs, the agricultural practices in Ethiopia need to be guided by these agroecological elements and principles. Aiming at the identification of challenging aspects of a sustainable agri-food system and the characterization of an enabling environment for agroecology, as well as exploring to what extent the existing policies and strategies support the agroecological transition process, five policy and strategy documents were reviewed. These documents are the Rural Development Policy and Strategy, the Environment Policy, the Biodiversity Policy, and the Soil Strategy of the Ministry of Agriculture (MoA). Using the Agroecology Criteria Tool (ACT), the contents were reviewed, focusing on agroecological requirements and the inclusion of sustainable practices. ACT is designed to support a self-assessment of elements supporting agroecology. For each element, binary values were assigned based on the inclusion of the minimum requirements index and then validated through discussion with the document owners. The results showed that the documents were well below the requirements for an agroecological transition of the agri-food system. The Rural Development Policy and Strategy only suffice to 83% in Human and Social Value. It does not support the transition concerning the other elements. The Biodiversity Policy and Soil Strategy suffice regarding the inclusion of Co-creation and Sharing of knowledge (100%), while the remaining elements were not considered sufficiently. In contrast, the Environment Policy supports the transition with three elements accounting for 100%. These are Resilience, Recycling, and Human and Social Care. However, when the four documents were combined, elements such as Synergies, Diversity, Efficiency, Human and Social value, Responsible governance, and Co-creation and Sharing of knowledge were identified as fully supportive (100%). This showed that the policies and strategies complemented one another to a certain extent. However, the evaluation results call for improvements concerning elements like Culture and food traditions, Circular and solidarity economy, Resilience, Recycling, and Regulation and balance since the majority of the elements were not sufficiently observed. Consequently, guidance for the smart intensification of local practices is needed, as well as traditional knowledge enriched with advanced technologies. Ethiopian agricultural and environmental policies and strategies should provide sufficient support and guidance for the intensification of sustainable practices and should provide a framework for an agroecological transition towards a sustainable agri-food system.

Keywords: agroecology, diversity, recycling, sustainable food system, transition

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136 Predictors of Response to Interferone Therapy in Chronic Hepatitis C Virus Infection

Authors: Ali Kassem, Ehab Fawzy, Mahmoud Sef el-eslam, Fatma Salah- Eldeen, El zahraa Mohamed

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Introduction: The combination of interferon (INF) and ribavirin is the preferred treatment for chronic hepatitis C viral (HCV) infection. However, nonresponse to this therapy remains common and is associated with several factors such as HCV genotype and HCV viral load in addition to host factors such as sex, HLA type and cytokine polymorphisms. Aim of the work: The aim of this study was to determine predictors of response to (INF) therapy in chronic HCV infected patients treated with INF alpha and ribavirin combination therapy. Patients and Methods: The present study included 110 patients (62 males, 48 females) with chronic HCV infection. Their ages ranged from 20-59 years. Inclusion criteria were organized according to the protocol of the Egyptian National Committee for control of viral hepatitis. Patients included in this study were recruited to receive INF ribavirin combination therapy; 54 patients received pegylated NF α-2a (180 μg) and weight based ribavirin therapy (1000 mg if < 75 kg, 1200 mg if > 75 kg) for 48 weeks and 53 patients received pegylated INF α-2b (1.5 ug/kg/week) and weight based ribavirin therapy (800 mg if < 65 kg, 1000 mg if 65-75 kg and 1200 mg if > 75kg). One hundred and seven liver biopsies were included in the study and submitted to histopathological examination. Hematoxylin and eosin (H&E) stained sections were done to assess both the grade and the stage of chronic viral hepatitis, in addition to the degree of steatosis. Modified hepatic activity index (HAI) grading, modified Ishak staging and Metavir grading and staging systems were used. Laboratory follow up including: HCV PCR at the 12th week to assess the early virologic response (EVR) and at the 24th week were done. At the end of the course: HCV PCR was done at the end of the course and tested 6 months later to document end virologic response (ETR) and sustained virologic response (SVR) respectively. Results One hundred seven patients; 62 males (57.9 %) and 45 females (42.1%) completed the course and included in this study. The age of patients ranged from 20-59 years with a mean of 40.39±10.03 years. Six months after the end of treatment patients were categorized into two groups: Group (1): patients who achieved sustained virological response (SVR). Group (2): patients who didn't achieve sustained virological response (non SVR) including non-responders, breakthrough and relapsers. In our study, 58 (54.2%) patients showed SVR, 18 (16.8%) patients were non-responders, 15 (14%) patients showed break-through and 16 (15 %) patients were relapsers. Univariate binary regression analysis of the possible risk factors of non SVR showed that the significant factors were higher age, higher fasting insulin level, higher Metavir stage and higher grade of hepatic steatosis. Multivariate binary regression analysis showed that the only independent risk factor for non SVR was high fasting insulin level. Conclusion: Younger age, lower Metavir stage, lower steatosis grade and lower fasting insulin level are good predictors of SVR and could be used in predicting the treatment response of pegylated interferon/ribavirin therapy.

Keywords: chronic HCV infection, interferon ribavirin combination therapy, predictors to antiviral therapy, treatment response

Procedia PDF Downloads 377
135 Dynamic Changes in NT-proBNP Levels in Unrelated Donors during Hematopoietic Stem Cells Mobilization

Authors: Natalia V. Minaeva, Natalia A. Zorina, Marina N. Khorobrikh, Philipp S. Sherstnev, Tatiana V. Krivokorytova, Alexander S. Luchinin, Maksim S. Minaev, Igor V. Paramonov

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Background. Over the last few decades, the Center for International Blood and Marrow Transplant Research (CIBMTR) and the World Marrow Donor Association (WMDA) have been actively working to ensure the safety of the hematopoietic stem cell (HSC) donation process. Registration of adverse events that may occur during the donation period and establishing a relationship between donation and side effects are included in the WMDA international standards. The level of blood serum N-terminal pro-brain natriuretic peptide (NT-proBNP) is an early marker of myocardial stress. Due to the high analytical sensitivity and specificity, laboratory assessment of NT-proBNP makes it possible to objectively diagnose myocardial dysfunction. It is well known that the main stimulus for proBNP synthesis and secretion from atrial and ventricular cardiac myocytes is myocyte stretch and increasement of myocardial extensibility and pressure in the heart chambers. Аim. The aim of the study was to assess the dynamic changes in the levels of blood serum N-terminal pro-brain natriuretic peptide of unrelated donors at various stages of hematopoietic stem cell mobilization. Materials. We have examined 133 unrelated donors, including 92 men and 41 women, that have been included into the study. The NT-proBNP levels were measured before the start of mobilization, then on the day of apheresis, and after the donation of allogeneic HSC. The relationship between NT-proBNP levels and body mass index (BMI), ferritin, hemoglobin, and white blood cells (WBC) levels was assessed on the day of apheresis. The median age of donors was 34 years. Mobilization of HSCs was managed with filgrastim administration at a dose of 10 μg/kg daily for 4-5 days. The first leukocytapheresis was performed on day 4 from the start of filgrastim administration. Quantitative values of the blood serum NT-proBNP level are presented as a median (Me), first and third quartiles (Q1-Q3). Comparative analysis was carried out using the t-test and correlation analysis as well by Spearman method. Results. The baseline blood serum NT-proBNP levels in all 133 donors were within the reference values (<125 pg/ml) and equaled 21,6 (10,0; 43,3) pg/ml. At the same time, the level of NT-proBNP in women was significantly higher than that of men. On the day of the HSC apheresis, a significant increase of blood serum NT-proBNP levels was detected and equald 131,2 (72,6; 165,3) pg/ml (p<0,001), with higher rates in female donors. A statistically significant weak inverse correleation was established between the level of NT-proBNP and the BMI of donors (-0.18, p = 0,03), as well as the level of hemoglobin (-0.33, p <0,001), and ferritin levels (-0.19, p = 0,03). No relationship has been established between the magnitude of WBC levels achieved as a result of the mobilization of HSC on the day of leukocytapheresis. A day after the apheresis, the blood serum NT-proBNP levels still exceeded the reference values, but there was a decreasing tendency. Conclusion. An increase of the blood serum NT-proBNP level in unrelated donors during the mobilization of HSC was established. Future studies should clarify the reason for this phenomenon, as well as its effects on donors' long-term health.

Keywords: unrelated donors, mobilization, hematopoietic stem cells, N-terminal pro-brain natriuretic peptide

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134 Influence of a High-Resolution Land Cover Classification on Air Quality Modelling

Authors: C. Silveira, A. Ascenso, J. Ferreira, A. I. Miranda, P. Tuccella, G. Curci

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Poor air quality is one of the main environmental causes of premature deaths worldwide, and mainly in cities, where the majority of the population lives. It is a consequence of successive land cover (LC) and use changes, as a result of the intensification of human activities. Knowing these landscape modifications in a comprehensive spatiotemporal dimension is, therefore, essential for understanding variations in air pollutant concentrations. In this sense, the use of air quality models is very useful to simulate the physical and chemical processes that affect the dispersion and reaction of chemical species into the atmosphere. However, the modelling performance should always be evaluated since the resolution of the input datasets largely dictates the reliability of the air quality outcomes. Among these data, the updated LC is an important parameter to be considered in atmospheric models, since it takes into account the Earth’s surface changes due to natural and anthropic actions, and regulates the exchanges of fluxes (emissions, heat, moisture, etc.) between the soil and the air. This work aims to evaluate the performance of the Weather Research and Forecasting model coupled with Chemistry (WRF-Chem), when different LC classifications are used as an input. The influence of two LC classifications was tested: i) the 24-classes USGS (United States Geological Survey) LC database included by default in the model, and the ii) CLC (Corine Land Cover) and specific high-resolution LC data for Portugal, reclassified according to the new USGS nomenclature (33-classes). Two distinct WRF-Chem simulations were carried out to assess the influence of the LC on air quality over Europe and Portugal, as a case study, for the year 2015, using the nesting technique over three simulation domains (25 km2, 5 km2 and 1 km2 horizontal resolution). Based on the 33-classes LC approach, particular emphasis was attributed to Portugal, given the detail and higher LC spatial resolution (100 m x 100 m) than the CLC data (5000 m x 5000 m). As regards to the air quality, only the LC impacts on tropospheric ozone concentrations were evaluated, because ozone pollution episodes typically occur in Portugal, in particular during the spring/summer, and there are few research works relating to this pollutant with LC changes. The WRF-Chem results were validated by season and station typology using background measurements from the Portuguese air quality monitoring network. As expected, a better model performance was achieved in rural stations: moderate correlation (0.4 – 0.7), BIAS (10 – 21µg.m-3) and RMSE (20 – 30 µg.m-3), and where higher average ozone concentrations were estimated. Comparing both simulations, small differences grounded on the Leaf Area Index and air temperature values were found, although the high-resolution LC approach shows a slight enhancement in the model evaluation. This highlights the role of the LC on the exchange of atmospheric fluxes, and stresses the need to consider a high-resolution LC characterization combined with other detailed model inputs, such as the emission inventory, to improve air quality assessment.

Keywords: land use, spatial resolution, WRF-Chem, air quality assessment

Procedia PDF Downloads 136
133 Assessing the Socio-Economic Problems and Environmental Implications of Green Revolution In Uttar Pradesh, India

Authors: Naima Umar

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Mid-1960’s has been landmark in the history of Indian agriculture. It was in 1966-67 when a New Agricultural Strategy was put into practice to tide over chronic shortages of food grains in the country. This strategy adopted was the use High-Yielding Varieties (HYV) of seeds (wheat and rice), which was popularly known as the Green Revolution. This phase of agricultural development has saved us from hunger and starvation and made the peasants more confident than ever before, but it has also created a number of socio-economic and environmental implications such as the reduction in area under forest, salinization, waterlogging, soil erosion, lowering of underground water table, soil, water and air pollution, decline in soil fertility, silting of rivers and emergence of several diseases and health hazards. The state of Uttar Pradesh in the north is bounded by the country of Nepal, the states of Uttrakhand on the northwest, Haryana on the west, Rajasthan on the southwest, Madhya Pradesh on the south and southwest, and Bihar on the east. It is situated between 23052´N and 31028´N latitudes and 7703´ and 84039´E longitudes. It is the fifth largest state of the country in terms of area, and first in terms of population. Forming the part of Ganga plain the state is crossed by a number of rivers which originate from the snowy peaks of Himalayas. The fertile plain of the Ganga has led to a high concentration of population with high density and the dominance of agriculture as an economic activity. Present paper highlights the negative impact of new agricultural technology on health of the people and environment and will attempt to find out factors which are responsible for these implications. Karl Pearson’s Correlation coefficient technique has been applied by selecting 1 dependent variable (i.e. Productivity Index) and some independent variables which may impact crop productivity in the districts of the state. These variables have categorized as: X1 (Cropping Intensity), X2 (Net irrigated area), X3 (Canal Irrigated area), X4 (Tube-well Irrigated area), X5 (Irrigated area by other sources), X6 (Consumption of chemical fertilizers (NPK) Kg. /ha.), X7 (Number of wooden plough), X8 (Number of iron plough), X9 (Number of harrows and cultivators), X10 (Number of thresher machines), X11(Number of sprayers), X12 (Number of sowing instruments), X13 (Number of tractors) and X14 (Consumption of insecticides and pesticides (in Kg. /000 ha.). The entire data during 2001-2005 and 2006- 2010 have been taken and 5 years average value is taken into consideration, based on secondary sources obtained from various government, organizations, master plan report, economic abstracts, district census handbooks and village and town directories etc,. put on a standard computer programmed SPSS and the results obtained have been properly tabulated.

Keywords: agricultural technology, environmental implications, health hazards, socio-economic problems

Procedia PDF Downloads 283
132 Economic Impacts of Nitrogen Fertilizer Use into Tropical Pastures for Beef Cattle in Brazil

Authors: Elieder P. Romanzini, Lutti M. Delevatti, Rhaony G. Leite, Ricardo A. Reis, Euclides B. Malheiros

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Brazilian beef cattle production systems are an important profitability source for the national gross domestic product. The main characteristic of these systems is forage utilization as the exclusive feed source. Forage utilization had been causing on owners the false feeling of low production costs. However, this low cost is followed to low profit causing a lot times worst animal index what can result in activities changes or until land sold. Aiming to evaluate economic impacts into Brazilian beef cattle systems were evaluated four nitrogen fertilizer (N) application levels (0, 90, 180 and 270 kg per hectare [kg.ha-1]). Research was developed during 2015 into Forage Crops and Grasslands section of São Paulo State University, “Júlio de Mesquita Filho” (Unesp) (Jaboticabal, São Paulo, Brazil). Pastures were seeded with Brachiaria brizantha Stapf. ‘Marandu’ (Palisade grass) handled using continuous grazing system, with variable stocking rate, sward height maintained at 25 cm. The economic evaluation was developed in rearing e finishing phases. We evaluated the cash flows inside each phase on different N levels. Economic valuations were considering: cost-effective operating (CEO), cost-total operating (CTO), gross revenue (GR), operating profit (OP) and net income (NI), every measured in US$. Complementary analyses were developed, profitability was calculated by [OP/GR]. Pay back (measured in years) was calculated considering average capital stocktaking pondered by area in use (ACS) divided by [GR-CEO]. And the internal rate of return (IRR) was calculated by 100/(pay back). Input prices were prices during 2015 and were obtained from Anuário Brasileiro da Pecuária, Centro de Estudos Avançados em Economia Aplicada and quotation in the same region of animal production (northeast São Paulo State) during the period above mentioned. Values were calculated in US$ according exchange rate US$1.00 equal R$3.34. The CEO, CTO, GR, OP and NI per hectare for each N level were respectively US$1,919.66; US$2,048.47; US$2,905.72; US$857.25 and US$986.06 to 0 kg.ha-1; US$2,403.20; US$2,551.80; US$3,530.19; US$978.39 and US$1,126.99 to 90 kg.ha-1; US$3,180.42; US$3,364.81; US$4,985.03; US$1,620.23 and US$1,804.62 to 180 kg.ha-1andUS$3,709.14; US$3,915.15; US$5,554.95; US$1,639.80 and US$1,845.81 to 270 kg.ha-1. Relationship to another economic indexes, profitability, pay back and IRR, the results were respectively 29.50%, 6.44 and 15.54% to 0 kg.ha-1; 27.72%, 6.88 and 14.54% to 90 kg.ha-1; 32.50%, 4.08 and 24.50% to 180 kg.ha-1 and 29.52%, 3.42 and 29.27% to 270 kg.ha-1. Values previously presented in this evaluation allowing to affirm that the best result was obtained to N level 270 kg.ha-1. These results among all N levels evaluated could be explained by improve occurred on stocking rate caused by increase on N level. However, a crucial information about high N level application into pastures is the efficiency of N utilization (associated to environmental impacts) that normally decrease with the increase on N level. Hence, considering all situations (efficiency of N utilization and economic results) into tropical pastures used to beef cattle production could be recommended N level equal to 180kg.ha-1, which had better profitability and cause lesser environmental impacts, proved by other studies developed in the same area.

Keywords: Brachiaria brizantha, cost-total operating, gross revenue, profitability

Procedia PDF Downloads 147
131 Psychophysiological Synchronization between the Manager and the Subordinate during a Performance Review Discussion

Authors: Mikko Salminen, Niklas Ravaja

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Previous studies have shown that emotional intelligence (EI) has an important role in leadership and social interaction. On the other hand, physiological synchronization between two interacting participants has been related to, for example, intensity of the interaction, and interestingly also to empathy. It is suggested that the amount of covariation in physiological signals between the two interacting persons would also be related to how the discussion is perceived subjectively. To study the interrelations between physiological synchronization, emotional intelligence, and subjective perception of the interaction, performance review discussions between real manager – subordinate dyads were studied using psychophysiological measurements and self-reports. The participants consisted of 40 managers, of which 24 were female, and 78 of their subordinates, of which 45 were female. The participants worked in various fields, for example banking, education, and engineering. The managers had a normal performance review discussion with two subordinates, except two managers who, due to scheduling issues, had discussion with only one subordinate. The managers were on average 44.5 years old, and the subordinates on average 45.5 years old. Written consent, in accordance with the Declaration of Helsinki, was obtained from all the participants. After the discussion, the participants filled a questionnaire assessing their emotions during the discussion. This included a self-assessment manikin (SAM) scale for the emotional valence during the discussion, with a 9-point graphical scale representing a manikin whose facial expressions ranged from smiling and happy to frowning and unhappy. In addition, the managers filled EI360, a 37-item self-report trait emotional intelligence questionnaire. The psychophysiological activity of the participants was recorded using two Varioport-B portable recording devices. Cardiac activity (ECG, electrocardiogram) was measured with two electrodes placed on the torso. Inter-beat interval (IBI, time between two successive heart beats) was calculated from the ECG signals. The facial muscle activation (EMG, electromyography) was recorded on three sites of the left side of the face: zygomaticus major (cheek muscle), orbicularis oculi (periocular muscle), and corrugator supercilii (frowning muscle). The facial-EMG signals were rectified and smoothed, and cross-coherences were calculated between members of each dyad, for all the three EMG signals, for the baseline and discussion periods. The values were natural-log transformed to normalize the distributions. Higher cross-coherence during the discussion between the manager’s and the subordinate’s zygomatic muscles was related to more positive valence self-reported emotions, F(1; 66,137) = 7,051; p=0,01. Thus, synchronized cheek muscle activation, either due to synchronous smiling or talking, was related to more positive perception of the discussion. In addition, higher IBI synchronization between the manager and the subordinate during the discussion was related to the manager’s higher self-reported emotional intelligence, F(1; 27,981)=4,58; p=0,041. That is, the EI was related to synchronous cardiac activity and possibly to similar physiological arousal levels. The results imply that the psychophysiological synchronization could be a potentially useful index in the study of social interaction and a valuable tool in the coaching of leadership skills in organizational contexts.

Keywords: emotional intelligence, leadership, psychophysiology, social interaction, synchronization

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130 Sensitivity Improvement of Optical Ring Resonator for Strain Analysis with the Direction of Strain Recognition Possibility

Authors: Tayebeh Sahraeibelverdi, Ahmad Shirazi Hadi Veladi, Mazdak Radmalekshah

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Optical sensors became attractive due to preciseness, low power consumption, and intrinsic electromagnetic interference-free characteristic. Among the waveguide optical sensors, cavity-based ones attended for the high Q-factor. Micro ring resonators as a potential platform have been investigated for various applications as biosensors to pressure sensors thanks to their sensitive ring structure responding to any small change in the refractive index. Furthermore, these small micron size structures can come in an array, bringing the opportunity to have any of the resonance in a specific wavelength and be addressed in this way. Another exciting application is applying a strain to the ring and making them an optical strain gauge where the traditional ones are based on the piezoelectric material. Making them in arrays needs electrical wiring and about fifty times bigger in size. Any physical element that impacts the waveguide cross-section, Waveguide elastic-optic property change, or ring circumference can play a role. In comparison, ring size change has a larger effect than others. Here an engineered ring structure is investigated to study the strain effect on the ring resonance wavelength shift and its potential for more sensitive strain devices. At the same time, these devices can measure any strain by mounting on the surface of interest. The idea is to change the" O" shape ring to a "C" shape ring with a small opening starting from 2π/360 or one degree. We used the Mode solution of Lumbrical software to investigate the effect of changing the ring's opening and the shift induced by applied strain. The designed ring radius is a three Micron silicon on isolator ring which can be fabricated by standard complementary metal-oxide-semiconductor (CMOS) micromachining. The measured wavelength shifts from1-degree opening of the ring to a 6-degree opening have been investigated. Opening the ring for 1-degree affects the ring's quality factor from 3000 to 300, showing an order of magnitude Q-factor reduction. Assuming a strain making the ring-opening from 1 degree to 6 degrees, our simulation results showing negligible Q-factor reduction from 300 to 280. A ring resonator quality factor can reach up to 108 where an order of magnitude reduction is negligible. The resonance wavelength shift showed a blue shift and was obtained to be 1581, 1579,1578,1575nm for 1-, 2-, 4- and 6-degree ring-opening, respectively. This design can find the direction of the strain-induced by applying the opening on different parts of the ring. Moreover, by addressing the specified wavelength, we can precisely find the direction. We can open a significant opportunity to find cracks and any surface mechanical property very specifically and precisely. This idea can be implemented on polymer ring resonators while they can come with a flexible substrate and can be very sensitive to any strain making the two ends of the ring in the slit part come closer or further.

Keywords: optical ring resonator, strain gauge, strain sensor, surface mechanical property analysis

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129 Assessing Moisture Adequacy over Semi-arid and Arid Indian Agricultural Farms using High-Resolution Thermography

Authors: Devansh Desai, Rahul Nigam

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Crop water stress (W) at a given growth stage starts to set in as moisture availability (M) to roots falls below 75% of maximum. It has been found that ratio of crop evapotranspiration (ET) and reference evapotranspiration (ET0) is an indicator of moisture adequacy and is strongly correlated with ‘M’ and ‘W’. The spatial variability of ET0 is generally less over an agricultural farm of 1-5 ha than ET, which depends on both surface and atmospheric conditions, while the former depends only on atmospheric conditions. Solutions from surface energy balance (SEB) and thermal infrared (TIR) remote sensing are now known to estimate latent heat flux of ET. In the present study, ET and moisture adequacy index (MAI) (=ET/ET0) have been estimated over two contrasting western India agricultural farms having rice-wheat system in semi-arid climate and arid grassland system, limited by moisture availability. High-resolution multi-band TIR sensing observations at 65m from ECOSTRESS (ECOsystemSpaceborne Thermal Radiometer Experiment on Space Station) instrument on-board International Space Station (ISS) were used in an analytical SEB model, STIC (Surface Temperature Initiated Closure) to estimate ET and MAI. The ancillary variables used in the ET modeling and MAI estimation were land surface albedo, NDVI from close-by LANDSAT data at 30m spatial resolution, ET0 product at 4km spatial resolution from INSAT 3D, meteorological forcing variables from short-range weather forecast on air temperature and relative humidity from NWP model. Farm-scale ET estimates at 65m spatial resolution were found to show low RMSE of 16.6% to 17.5% with R2 >0.8 from 18 datasets as compared to reported errors (25 – 30%) from coarser-scale ET at 1 to 8 km spatial resolution when compared to in situ measurements from eddy covariance systems. The MAI was found to show lower (<0.25) and higher (>0.5) magnitudes in the contrasting agricultural farms. The study showed the potential need of high-resolution high-repeat spaceborne multi-band TIR payloads alongwith optical payload in estimating farm-scale ET and MAI for estimating consumptive water use and water stress. A set of future high-resolution multi-band TIR sensors are planned on-board Indo-French TRISHNA, ESA’s LSTM, NASA’s SBG space-borne missions to address sustainable irrigation water management at farm-scale to improve crop water productivity. These will provide precise and fundamental variables of surface energy balance such as LST (Land Surface Temperature), surface emissivity, albedo and NDVI. A synchronization among these missions is needed in terms of observations, algorithms, product definitions, calibration-validation experiments and downstream applications to maximize the potential benefits.

Keywords: thermal remote sensing, land surface temperature, crop water stress, evapotranspiration

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128 Eosinophils and Platelets: Players of the Game in Morbid Obese Boys with Metabolic Syndrome

Authors: Orkide Donma, Mustafa M. Donma

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Childhood obesity, which may lead to increased risk for heart diseases in children as well as adults, is one of the most important health problems throughout the world. Prevalences of morbid obesity and metabolic syndrome (MetS) are being increased during childhood age group. MetS is a cluster of metabolic and vascular abnormalities including hypercoagulability and an increased risk of cardiovascular diseases (CVDs). There are also some relations between some components of MetS and leukocytes. The aim of this study is to investigate complete blood cell count parameters that differ between morbidly obese boys and girls with MetS diagnosis. A total of 117 morbid obese children with MetS consulted to Department of Pediatrics in Faculty of Medicine Hospital at Namik Kemal University were included into the scope of the study. The study population was classified based upon their genders (60 girls and 57 boys). Their heights and weights were measured and body mass index (BMI) values were calculated. WHO BMI-for age and sex percentiles were used. The values above 99 percentile were defined as morbid obesity. Anthropometric measurements were performed. Waist-to-hip and head-to-neck ratios as well as homeostatic model assessment of insulin resistance (HOMA-IR) were calculated. Components of MetS (central obesity, glucose intolerance, high blood pressure, high triacylglycerol levels, low levels of high density lipoprotein cholesterol) were determined. Hematological variables were measured. Statistical analyses were performed using SPSS. The degree for statistical significance was p ≤ 0.05. There was no statistically significant difference between the ages (11.2±2.6 years vs 11.2±3.0 years) and BMIs (28.6±5.2 kg/m2 vs 29.3±5.2 kg/m2) of boys and girls (p ≥ 0.05), respectively. Significantly increased waist-to-hip ratios were obtained for boys (0.94±0.08 vs 0.91±0.06; p=0.023). Significantly elevated values of hemoglobin (13.55±0.98 vs 13.06±0.82; p=0.004), mean corpuscular hemoglobin concentration (33.79±0.91 vs 33.21±1.14; p=0.003), eosinophils (0.300±0.253 vs 0.196±0.197; p=0.014), and platelet (347.1±81.7 vs 319.0±65.9; p=0.042) were detected for boys. There was no statistically significant difference between the groups in terms of neutrophil/lymphocyte ratios as well as HOMA-IR values (p ≥ 0.05). Statistically significant gender-based differences were found for hemoglobin as well as mean corpuscular hemoglobin concentration and hence, separate reference intervals for two genders should be considered for these parameters. Eosinophils may contribute to the development of thrombus in acute coronary syndrome. Eosinophils are also known to make an important contribution to mechanisms related to thrombosis pathogenesis in acute myocardial infarction. Increased platelet activity is observed in patients with MetS and these individuals are more susceptible to CVDs. In our study, elevated platelets described as dominant contributors to hypercoagulability and elevated eosinophil counts suggested to be related to the development of CVDs observed in boys may be the early indicators of the future cardiometabolic complications in this gender.

Keywords: children, complete blood count, gender, metabolic syndrome

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127 Identification of a Panel of Epigenetic Biomarkers for Early Detection of Hepatocellular Carcinoma in Blood of Individuals with Liver Cirrhosis

Authors: Katarzyna Lubecka, Kirsty Flower, Megan Beetch, Lucinda Kurzava, Hannah Buvala, Samer Gawrieh, Suthat Liangpunsakul, Tracy Gonzalez, George McCabe, Naga Chalasani, James M. Flanagan, Barbara Stefanska

Abstract:

Hepatocellular carcinoma (HCC), the most prevalent type of primary liver cancer, is the second leading cause of cancer death worldwide. Late onset of clinical symptoms in HCC results in late diagnosis and poor disease outcome. Approximately 85% of individuals with HCC have underlying liver cirrhosis. However, not all cirrhotic patients develop cancer. Reliable early detection biomarkers that can distinguish cirrhotic patients who will develop cancer from those who will not are urgently needed and could increase the cure rate from 5% to 80%. We used Illumina-450K microarray to test whether blood DNA, an easily accessible source of DNA, bear site-specific changes in DNA methylation in response to HCC before diagnosis with conventional tools (pre-diagnostic). Top 11 differentially methylated sites were selected for validation by pyrosequencing. The diagnostic potential of the 11 pyrosequenced probes was tested in blood samples from a prospective cohort of cirrhotic patients. We identified 971 differentially methylated CpG sites in pre-diagnostic HCC cases as compared with healthy controls (P < 0.05, paired Wilcoxon test, ICC ≥ 0.5). Nearly 76% of differentially methylated CpG sites showed lower levels of methylation in cases vs. controls (P = 2.973E-11, Wilcoxon test). Classification of the CpG sites according to their location relative to CpG islands and transcription start site revealed that those hypomethylated loci are located in regulatory regions important for gene transcription such as CpG island shores, promoters, and 5’UTR at higher frequency than hypermethylated sites. Among 735 CpG sites hypomethylated in cases vs. controls, 482 sites were assigned to gene coding regions whereas 236 hypermethylated sites corresponded to 160 genes. Bioinformatics analysis using GO, KEGG and DAVID knowledgebase indicate that differentially methylated CpG sites are located in genes associated with functions that are essential for gene transcription, cell adhesion, cell migration, and regulation of signal transduction pathways. Taking into account the magnitude of the difference, statistical significance, location, and consistency across the majority of matched pairs case-control, we selected 11 CpG loci corresponding to 10 genes for further validation by pyrosequencing. We established that methylation of CpG sites within 5 out of those 10 genes distinguish cirrhotic patients who subsequently developed HCC from those who stayed cancer free (cirrhotic controls), demonstrating potential as biomarkers of early detection in populations at risk. The best predictive value was detected for CpGs located within BARD1 (AUC=0.70, asymptotic significance ˂0.01). Using an additive logistic regression model, we further showed that 9 CpG loci within those 5 genes, that were covered in pyrosequenced probes, constitute a panel with high diagnostic accuracy (AUC=0.887; 95% CI:0.80-0.98). The panel was able to distinguish pre-diagnostic cases from cirrhotic controls free of cancer with 88% sensitivity at 70% specificity. Using blood as a minimally invasive material and pyrosequencing as a straightforward quantitative method, the established biomarker panel has high potential to be developed into a routine clinical test after validation in larger cohorts. This study was supported by Showalter Trust, American Cancer Society (IRG#14-190-56), and Purdue Center for Cancer Research (P30 CA023168) granted to BS.

Keywords: biomarker, DNA methylation, early detection, hepatocellular carcinoma

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126 The Evaluation of Subclinical Hypothyroidism in Children with Morbid Obesity

Authors: Mustafa M. Donma, Orkide Donma

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Cardiovascular pathology is one of the expected consequences of excessive fat gain. The role of zinc in thyroid hormone metabolism is an important matter. The concentrations of both thyroid stimulating hormone (TSH) and zinc are subject to variation in obese individuals. Zinc exhibits protective effects on cardiovascular health and is inversely correlated with cardiovascular markers in childhood obesity. The association between subclinical hypothyroidism (SCHT) and metabolic disorders is under investigation due to its clinical importance. Underactive thyroid gland causes high TSH levels. Subclinical hypothyroidism is defined as the elevated serum TSH levels in the presence of normal free thyroxin (T4) concentrations. The aim of this study was to evaluate the associations between TSH levels and zinc concentrations in morbid obese (MO) children exhibiting SCHT. The possibility of using the probable association between these parameters was also evaluated for the discrimination of metabolic syndrome positive (MetS+) and metabolic syndrome negative (MetS-) groups. Forty-two children were present in each group. Informed consent forms were obtained. Institutional Ethics Committee approved the study protocol. Tables prepared by World Health Organization were used for the definition of MO children. Children, whose age- and sex-dependent body mass index percentile values were above 99, were defined as MO. Children with at least two MetS components were included in MOMetS+ group. Elevated systolic/diastolic blood pressure values, increased fasting blood glucose, triglycerides (TRG)/decreased high density lipoprotein-cholesterol (HDL-C) concentrations in addition to central obesity were listed as MetS components. Anthropometric measures were recorded. Routine biochemical analyses were performed. Thirteen and fifteen children had SCHT in MOMetS- and MOMetS+ groups, respectively. Statistical analyses were performed. p<0.05 was accepted as statistically significant. In MOMetS- and MOMetS+ groups, TSH levels were 4.1±2.9 mU/L and 4.6±3.1 mU/L, respectively. Corresponding values for SCHT cases in these groups were 7.3±3.1 mU/L and 8.0±2.7 mU/L. Free T4 levels were within normal limits. Zinc concentrations were negatively correlated with TSH levels in both groups. The significant negative correlation calculated in MOMetS+ group (r= -0.909; p<0.001) was much stronger than that found in MOMetS- group (r= -0.706; p<0.05). This strong correlation (r= -0.909; p<0.001) calculated for cases with SCHT in MOMetS+ group was much lower (r= -0.793; p<0.001) when all MOMetS+ cases were considered. Zinc is closely related to T4 and TSH therefore, it participates in thyroid hormone metabolism. Since thyroid hormones are required for zinc absorption, hypothyroidism can lead to zinc deficiency. The presence of strong correlations between TSH and zinc in SCHT cases found in both MOMetS- and MOMetS+ groups pointed out that MO children were under the threat of cardiovascular pathologies. The detection of the much stronger correlation in MOMetS+ group in comparison with the correlation found in MOMetS- group was the indicator of greater cardiovascular risk due to the presence of MetS. In MOMetS+ group, correlation in SCHT cases found higher than correlation calculated for all cases confirmed much higher cardiovascular risk due to the contribution of SCHT.

Keywords: cardiovascular risk, children, morbid obesity, subclinical hypothyroidism, zinc

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125 Integrations of the Instructional System Design for Students Learning Achievement Motives and Science Attitudes with Stem Educational Model on Stoichiometry Issue in Chemistry Classes with Different Genders

Authors: Tiptunya Duangsri, Panwilai Chomchid, Natchanok Jansawang

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This research study was to investigate of education decisions must be made which a part of it should be passed on to future generations as obligatory for all members of a chemistry class for students who will prepare themselves for a special position. The descriptions of instructional design were provided and the recent criticisms are discussed. This research study to an outline of an integrative framework for the description of information and the instructional design model give structure to negotiate a semblance of conscious understanding. The aims of this study are to describe the instructional design model for comparisons between students’ genders of their effects on STEM educational learning achievement motives to their science attitudes and logical thinking abilities with a sample size of 18 students at the 11th grade level with the cluster random sampling technique in Mahawichanukul School were designed. The chemistry learning environment was administered with the STEM education method. To build up the 5-instrument lesson instructional plan issues were instructed innovations, the 30-item Logical Thinking Test (LTT) on 5 scales, namely; Inference, Recognition of Assumptions, Deduction, Interpretation and Evaluation scales was used. Students’ responses of their perceptions with the Test Of Chemistry-Related Attitude (TOCRA) were assessed of their attitude in science toward chemistry. The validity from Index Objective Congruence value (IOC) checked by five expert specialist educator in two chemistry classroom targets in STEM education, the E1/E2 process were equaled evidence of 84.05/81.42 which results based on criteria are higher than of 80/80 standard level with the IOC from the expert educators. Comparisons between students’ learning achievement motives with STEM educational model on stoichiometry issue in chemistry classes with different genders were differentiated at evidence level of .05, significantly. Associations between students’ learning achievement motives on their posttest outcomes and logical thinking abilities, the predictive efficiency (R2) values indicate that 69% and 70% of the variances in different male and female student groups of their logical thinking abilities. The predictive efficiency (R2) values indicate that 73%; and 74% of the variances in different male and female student groups of their science attitudes toward chemistry were associated. Statistically significant on students’ perceptions of their chemistry learning classroom environment and their science attitude toward chemistry when using the MCI and TOCRA, the predictive efficiency (R2) values indicated that 72% and 74% of the variances in different male and female student groups of their chemistry classroom climate, consequently. Suggestions that supporting chemistry or science teachers from science, technology, engineering and mathematics (STEM) in addressing complex teaching and learning issues related instructional design to develop, teach, and assess traditional are important strategies with a focus on STEM education instructional method.

Keywords: development, the instructional design model, students learning achievement motives, science attitudes with STEM educational model, stoichiometry issue, chemistry classes, genders

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124 Influence of Urban Design on Pain and Disability in Women with Chronic Low Back Pain in Urban Cairo

Authors: Maha E. Ibrahim, Mona Abdel Aziz

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Background: Chronic low back pain (CLBP) in urban communities represents a challenge to healthcare systems worldwide. The traditional biomedical approach to back pain has been particularly inadequate. Failure of the biomedical model to explain the poor correlation between pain and disability on the one hand, and biological and physical factors that explain those symptoms on the other has led to the adoption of the biopsychosocial model, to recognize the reciprocal influence of physical, social and psychological factors implicated in CLBP, a condition that shows higher prevalence among women residing in urban areas. Urban design of the built community has been shown to exert a significant influence on physical and psychological health. However, little research has investigated the relationship between elements of the built environment, and the level of pain and disability of women with CLBP. As Egypt embarks on building a new capital city, and new settlements proliferate, better understanding of this relationship could greatly reduce the economic and human costs of this widespread medical problem for women. Methods: This study was designed as an exploratory mixed qualitative and quantitative study. Twenty-Six women with CLBP living in two neighborhoods in Cairo, different in their urban structure, but adjacent in their locations (Old Maadi and New Maadi) were interviewed using semi-structured interviews (8 from Old Maadi and 18 from New Maadi). Located in the South of Cairo, New Maadi is a neighborhood with the characteristic modern urban style (narrow streets and tall, adjacent buildings), while Old Maadi is known for being greener, quieter and more relaxed than the usual urban districts of Cairo. The interviews examined their perceptions of the built environment, including building shapes and colors and street light, as well as their sense of safety and comfort, and how it affects their physical and psychological health in general, and their back condition in particular. In addition, they were asked to rate their level of pain and to fill the Oswestry Disability Index (ODI), and the General Health Questionnaire (GHQ-12) to rate their level of disability and psychological status, respectively. Results: Women in both districts had moderate to severe pain and moderate disability with no significant differences between the two districts. However, those living in New Maadi had significantly worse scores on the GHQ-12 than those living in Old Maadi. Most women did not feel that specific elements of the built environment affected their back pain, however, they expressed distress of the elements that were ugly, distorted or damaged, especially where there were no ways of avoiding or fixing them. Furthermore, most women affirmed that the unsightly and uncomfortable elements of their neighborhoods affected their mood states and were a constant source of stress. Conclusion: This exploratory study concludes that elements of the urban built environment do not exert a direct effect on CLBP. However, the perception of women regarding these elements does affect their mood states, and their levels of stress, making them a possible indirect cause of increased suffering in these women.

Keywords: built environment, chronic back pain, disability, urban Cairo

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