Search results for: body perception
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 5926

Search results for: body perception

376 Transformation of the Relationship between Tourism Activities and Residential Environment in the Center of a Historical Suburban City of a Tourism Metropolis: A Case Study of Naka-Uji Area, Uji City, Kyoto Prefecture

Authors: Shuailing CUI, Nakajima Naoto

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The tourism industry has experienced significant growth worldwide since the end of World War II. Tourists are drawn to suburban areas during weekends and holidays to explore historical and cultural heritage sites. Since the 1970s, there has been a resurgence in population growth in metropolitan areas, which has fueled the demand for suburban tourism and facilitated its development. The construction of infrastructure, such as railway lines and arterial roads, has also supported the growth of tourism. Tourists engaging in various activities can have a significant impact on the destinations they visit. Tourism has not only affected the local economy but has also begun to alter the social structures, culture, and lifestyle of the destinations visited. In addition, the growing number of tourists has affected the local commercial structure and daily life of suburban residents. Therefore, there is a need to figure out how tourism activities influence the residential environment of the tourist destination and how this influence changes over time. This study aims to analyze the transformation of the relationship between tourism activities and the residential environment in the Naka-Uji area of Uji City, Kyoto Prefecture. Specifically, it investigates how the growth of the tourism industry has influenced the local residential environment and how this influence has changed over time. The findings of the study indicate that the growth of tourism in the Naka-Uji area has had both positive and negative effects on the local residential environment. On the one hand, the tourism industry has created job opportunities and improved local economic conditions. On the other hand, it has also caused environmental degradation, particularly in terms of increased traffic and the construction of parking lots. The study also found that the development of the tourism industry has influenced the social structures, culture, and lifestyle of residents. For instance, the increase in the number of tourists has led to changes in the commercial structure and daily life of suburban residents. The study highlights the importance of collaboration and shared benefits among stakeholders in tourism development, particularly in terms of preserving the cultural and natural heritage of tourist destinations while promoting sustainable development. Overall, this study contributes to the growing body of research on the impact of tourism on suburban areas. It provides insights into the complex relationships between tourism, the natural environment, the local economy, and residential life, and emphasizes the need for sustainable tourism development in suburban areas. The findings of this study have important implications for policymakers, urban planners, and other stakeholders involved in promoting regional revitalization and sustainable tourism development.

Keywords: tourism, residential environment, suburban area, metropolis

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375 Unity in Diversity: Exploring the Psychological Processes and Mechanisms of the Sense of Community for the Chinese Nation in Ethnic Inter-embedded Communities

Authors: Jiamin Chen, Liping Yang

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In 2007, sociologist Putnam proposed a pessimistic forecast in the United States' "Social Capital Community Benchmark Survey," suggesting that "ethnic diversity would challenge social unity and undermine social cohesion." If this pessimistic assumption were proven true, it would indicate a risk of division in diverse societies. China, with 56 ethnic groups, is a multi-ethnic country. On May 26, 2014, General Secretary Xi Jinping proposed "building ethnically inter-embedded communities to promote deeper development in interactions, exchanges, and integration among ethnic groups." Researchers unanimously agree that ethnic inter-embedded communities can serve as practical arenas and pathways for solidifying the sense of the Chinese national community However, there is no research providing evidence that ethnic inter-embedded communities can foster the sense of the Chinese national community, and the influencing factors remain unclear. This study adopts a constructivist grounded theory research approach. Convenience sampling and snowball sampling were used in the study. Data were collected in three communities in Kunming City. Twelve individuals were eventually interviewed, and the transcribed interviews totaled 187,000 words. The research has obtained ethical approval from the Ethics Committee of Nanjing Normal University (NNU202310030). The research analyzed the data and constructed theories, employing strategies such as coding, constant comparison, and theoretical sampling. The study found that: firstly, ethnic inter-embedded communities exhibit characteristics of diversity, including ethnic diversity, cultural diversity, and linguistic diversity. Diversity has positive functions, including increased opportunities for contact, promoting self-expansion, and increasing happiness; negative functions of diversity include highlighting ethnic differences, causing ethnic conflicts, and reminding of ethnic boundaries. Secondly, individuals typically engage in interactions within the community using active embedding and passive embedding strategies. Active embedding strategies include maintaining openness, focusing on similarities, and pro-diversity beliefs, which can increase external group identification, intergroup relational identity, and promote ethnic integration. Individuals using passive embedding strategies tend to focus on ethnic stereotypes, perceive stigmatization of their own ethnic group, and adopt an authoritarian-oriented approach to interactions, leading to a perception of more identity threats and ultimately rejecting ethnic integration. Thirdly, the commonality of the Chinese nation is reflected in the 56 ethnic groups as an "identity community" and "interest community," and both active and passive embedding paths affect individual understanding of the commonality of the Chinese nation. Finally, community work and environment can influence the embedding process. The research constructed a social psychological process and mechanism model for solidifying sense of the Chinese national community in ethnic inter-embedded communities. Based on this theoretical model, future research can conduct more micro-level psychological mechanism tests and intervention studies to enhance Chinese national cohesion.

Keywords: diversity, sense of the chinese national community, ethnic inter-embedded communities, ethnic group

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374 Relationship between Different Heart Rate Control Levels and Risk of Heart Failure Rehospitalization in Patients with Persistent Atrial Fibrillation: A Retrospective Cohort Study

Authors: Yongrong Liu, Xin Tang

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Background: Persistent atrial fibrillation is a common arrhythmia closely related to heart failure. Heart rate control is an essential strategy for treating persistent atrial fibrillation. Still, the understanding of the relationship between different heart rate control levels and the risk of heart failure rehospitalization is limited. Objective: The objective of the study is to determine the relationship between different levels of heart rate control in patients with persistent atrial fibrillation and the risk of readmission for heart failure. Methods: We conducted a retrospective dual-centre cohort study, collecting data from patients with persistent atrial fibrillation who received outpatient treatment at two tertiary hospitals in central and western China from March 2019 to March 2020. The collected data included age, gender, body mass index (BMI), medical history, and hospitalization frequency due to heart failure. Patients were divided into three groups based on their heart rate control levels: Group I with a resting heart rate of less than 80 beats per minute, Group II with a resting heart rate between 80 and 100 beats per minute, and Group III with a resting heart rate greater than 100 beats per minute. The readmission rates due to heart failure within one year after discharge were statistically analyzed using propensity score matching in a 1:1 ratio. Differences in readmission rates among the different groups were compared using one-way ANOVA. The impact of varying levels of heart rate control on the risk of readmission for heart failure was assessed using the Cox proportional hazards model. Binary logistic regression analysis was employed to control for potential confounding factors. Results: We enrolled a total of 1136 patients with persistent atrial fibrillation. The results of the one-way ANOVA showed that there were differences in readmission rates among groups exposed to different levels of heart rate control. The readmission rates due to heart failure for each group were as follows: Group I (n=432): 31 (7.17%); Group II (n=387): 11.11%; Group III (n=317): 90 (28.50%) (F=54.3, P<0.001). After performing 1:1 propensity score matching for the different groups, 223 pairs were obtained. Analysis using the Cox proportional hazards model showed that compared to Group I, the risk of readmission for Group II was 1.372 (95% CI: 1.125-1.682, P<0.001), and for Group III was 2.053 (95% CI: 1.006-5.437, P<0.001). Furthermore, binary logistic regression analysis, including variables such as digoxin, hypertension, smoking, coronary heart disease, and chronic obstructive pulmonary disease as independent variables, revealed that coronary heart disease and COPD also had a significant impact on readmission due to heart failure (p<0.001). Conclusion: The correlation between the heart rate control level of patients with persistent atrial fibrillation and the risk of heart failure rehospitalization is positive. Reasonable heart rate control may significantly reduce the risk of heart failure rehospitalization.

Keywords: heart rate control levels, heart failure rehospitalization, persistent atrial fibrillation, retrospective cohort study

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373 Detection of Alzheimer's Protein on Nano Designed Polymer Surfaces in Water and Artificial Saliva

Authors: Sevde Altuntas, Fatih Buyukserin

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Alzheimer’s disease is responsible for irreversible neural damage of brain parts. One of the disease markers is Amyloid-β 1-42 protein that accumulates in the brain in the form plaques. The basic problem for detection of the protein is the low amount of protein that cannot be detected properly in body liquids such as blood, saliva or urine. To solve this problem, tests like ELISA or PCR are proposed which are expensive, require specialized personnel and can contain complex protocols. Therefore, Surface-enhanced Raman Spectroscopy (SERS) a good candidate for detection of Amyloid-β 1-42 protein. Because the spectroscopic technique can potentially allow even single molecule detection from liquid and solid surfaces. Besides SERS signal can be improved by using nanopattern surface and also is specific to molecules. In this context, our study proposes to fabricate diagnostic test models that utilize Au-coated nanopatterned polycarbonate (PC) surfaces modified with Thioflavin - T to detect low concentrations of Amyloid-β 1-42 protein in water and artificial saliva medium by the enhancement of protein SERS signal. The nanopatterned PC surface that was used to enhance SERS signal was fabricated by using Anodic Alumina Membranes (AAM) as a template. It is possible to produce AAMs with different column structures and varying thicknesses depending on voltage and anodization time. After fabrication process, the pore diameter of AAMs can be arranged with dilute acid solution treatment. In this study, two different columns structures were prepared. After a surface modification to decrease their surface energy, AAMs were treated with PC solution. Following the solvent evaporation, nanopatterned PC films with tunable pillared structures were peeled off from the membrane surface. The PC film was then modified with Au and Thioflavin-T for the detection of Amyloid-β 1-42 protein. The protein detection studies were conducted first in water via this biosensor platform. Same measurements were conducted in artificial saliva to detect the presence of Amyloid Amyloid-β 1-42 protein. SEM, SERS and contact angle measurements were carried out for the characterization of different surfaces and further demonstration of the protein attachment. SERS enhancement factor calculations were also completed via experimental results. As a result, our research group fabricated diagnostic test models that utilize Au-coated nanopatterned polycarbonate (PC) surfaces modified with Thioflavin-T to detect low concentrations of Alzheimer’s Amiloid – β protein in water and artificial saliva medium. This work was supported by The Scientific and Technological Research Council of Turkey (TUBITAK) Grant No: 214Z167.

Keywords: alzheimer, anodic aluminum oxide, nanotopography, surface enhanced Raman spectroscopy

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372 Robust Inference with a Skew T Distribution

Authors: M. Qamarul Islam, Ergun Dogan, Mehmet Yazici

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There is a growing body of evidence that non-normal data is more prevalent in nature than the normal one. Examples can be quoted from, but not restricted to, the areas of Economics, Finance and Actuarial Science. The non-normality considered here is expressed in terms of fat-tailedness and asymmetry of the relevant distribution. In this study a skew t distribution that can be used to model a data that exhibit inherent non-normal behavior is considered. This distribution has tails fatter than a normal distribution and it also exhibits skewness. Although maximum likelihood estimates can be obtained by solving iteratively the likelihood equations that are non-linear in form, this can be problematic in terms of convergence and in many other respects as well. Therefore, it is preferred to use the method of modified maximum likelihood in which the likelihood estimates are derived by expressing the intractable non-linear likelihood equations in terms of standardized ordered variates and replacing the intractable terms by their linear approximations obtained from the first two terms of a Taylor series expansion about the quantiles of the distribution. These estimates, called modified maximum likelihood estimates, are obtained in closed form. Hence, they are easy to compute and to manipulate analytically. In fact the modified maximum likelihood estimates are equivalent to maximum likelihood estimates, asymptotically. Even in small samples the modified maximum likelihood estimates are found to be approximately the same as maximum likelihood estimates that are obtained iteratively. It is shown in this study that the modified maximum likelihood estimates are not only unbiased but substantially more efficient than the commonly used moment estimates or the least square estimates that are known to be biased and inefficient in such cases. Furthermore, in conventional regression analysis, it is assumed that the error terms are distributed normally and, hence, the well-known least square method is considered to be a suitable and preferred method for making the relevant statistical inferences. However, a number of empirical researches have shown that non-normal errors are more prevalent. Even transforming and/or filtering techniques may not produce normally distributed residuals. Here, a study is done for multiple linear regression models with random error having non-normal pattern. Through an extensive simulation it is shown that the modified maximum likelihood estimates of regression parameters are plausibly robust to the distributional assumptions and to various data anomalies as compared to the widely used least square estimates. Relevant tests of hypothesis are developed and are explored for desirable properties in terms of their size and power. The tests based upon modified maximum likelihood estimates are found to be substantially more powerful than the tests based upon least square estimates. Several examples are provided from the areas of Economics and Finance where such distributions are interpretable in terms of efficient market hypothesis with respect to asset pricing, portfolio selection, risk measurement and capital allocation, etc.

Keywords: least square estimates, linear regression, maximum likelihood estimates, modified maximum likelihood method, non-normality, robustness

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371 L. rhamnosus GG Lysate Can Inhibit Cytotoxic Effects of S. aureus on Keratinocytes in vitro

Authors: W. Mohammed Saeed, A. J. Mcbain, S. M. Cruickshank, C. A. O’Neill

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In the gut, probiotics have been shown to protect epithelial cells from pathogenic bacteria through a number of mechanisms: 1-Increasing epithelial barrier function, 2-Modulation of the immune response especially innate immune response, 3-Inhibition of pathogen adherence and down regulation of virulence factors. Since probiotics have positive impacts on the gut, their potential effects on other body tissues, such as skin have begun to be investigated. The purpose of this project is to characterize the potential of probiotic bacteria lysate as therapeutic agent for preventing or reducing the S. aureus infection. Normal human primary keratinocytes (KCs) were exposed to S. aureus (106/ml) in the presence or absence of L. rhamnosus GG lysate (extracted from 108cfu/ml). The viability of the KCs was measured after 24 hours using a trypan blue exclusion assay. When KCs were treated with S aureus alone, only 25% of the KCs remained viable at 24 hours post infection. However, in the presence of L. rhamnosus GG lysate the viability of pathogen infected KCs increased to 58% (p=0.008, n=3). Furthermore, when KCs co-exposed, pre- exposed or post-exposed to L. rhamnosus GG lysate, the viability of the KCs increased to ≈60%, the L. rhamnosus GG lysate was afforded equal protection in different conditions. These data suggests that two possible separate mechanisms are involved in the protective effects of L. rhamnosus GG such as reducing S. aureus growth, or inhibiting of pathogenic adhesion. Interestingly, a lysate of L rhamnosus GG provided significant reduction in S. aureus growth and adhesion of S. aureus that being viable following 24 hours incubation with S aureus. Therefore, a series of Liquid Chromatography (RP-LC) methods were adopted to partially purify the lysate in combination with functional assays to elucidate in which fractions the efficacious molecules were contained. In addition, the Mass Spectrometry-based protein sequencing was used to identify putative proteins in the fractions. The data presented from purification process demonstrated that L. rhamnosus GG lysate has the potential to protect keratinocytes from the toxic effects of the skin pathogen, S. aureus. Three potential mechanisms were identified: inhibition of pathogen growth; competitive exclusion; and displacement of the pathogen from keratinocyte binding sites. In this study, ‘moonlight’ proteins were identified in the current study’s MS/MS data for L. rhamnosus GG lysate, which could elucidate the ability of lysate in the competitive exclusion and displacement of S. aureus from keratinocyte binding sites. Taken together, it can be speculated that L. rhamnosus GG lysate utilizes different mechanisms to protect keratinocytes from S. aureus toxicity. The present study indicates that the proteinaceous substances are involved in anti-adhesion activity. This is achieved by displacing the pathogen and preventing the severity of pathogen infection and the moonlight proteins might be involved in inhibiting the adhesion of pathogens.

Keywords: lysate, fractions, adhesion, L. rhamnosus GG, S. aureus toxicity

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370 Re-Designing Community Foodscapes to Enhance Social Inclusion in Sustainable Urban Environments

Authors: Carles Martinez-Almoyna Gual, Jiwon Choi

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Urban communities face risks of disintegration and segregation as a consequence of globalised migration processes towards urban environments. Linking social and cultural components with environmental and economic dimensions becomes the goal of all the disciplines that aim to shape more sustainable urban environments. Solutions require interdisciplinary approaches and the use of a complex array of tools. One of these tools is the implementation of urban farming, which provides a wide range of advantages for creating more inclusive spaces and integrated communities. Since food is strongly related to the values and identities of any cultural group, it can be used as a medium to promote social inclusion in the context of urban multicultural societies. By bringing people together into specific urban sites, food production can be integrated into multifunctional spaces while addressing social, economic and ecological goals. The goal of this research is to assess different approaches to urban agriculture by analysing three existing community gardens located in Newtown, a suburb of Wellington, New Zealand. As a context for developing research, Newtown offers different approaches to urban farming and is really valuable for observing current trends of socialization in diverse and multicultural societies. All three spaces are located on public land owned by Wellington City Council and confined to a small, complex and progressively denser urban area. The developed analysis was focused on social, cultural and physical dimensions, combining community engagement with different techniques of spatial assessment. At the same time, a detailed investigation of each community garden was conducted with comparative analysis methodologies. This multidirectional setting of the analysis was established for extracting from the case studies both specific and typological knowledge. Each site was analysed and categorised under three broad themes: people, space and food. The analysis revealed that all three case studies had really different spatial settings, different approaches to food production and varying profiles of supportive communities. The main differences identified were demographics, values, objectives, internal organization, appropriation, and perception of the space. The community gardens were approached as case studies for developing design research. Following participatory design processes with the different communities, the knowledge gained from the analysis was used for proposing changes in the physical environment. The end goal of the design research was to improve the capacity of the spaces to facilitate social inclusiveness. In order to generate tangible changes, a range of small, strategic and feasible spatial interventions was explored. The smallness of the proposed interventions facilitates implementation by reducing time frames, technical resources, funding needs, and legal processes, working within the community´s own realm. These small interventions are expected to be implemented over time as part of an ongoing collaboration between the different communities, the university, and the local council. The applied research methodology showcases the capacity of universities to develop civic engagement by working with real communities that have concrete needs and face overall threats of disintegration and segregation.

Keywords: community gardening, landscape architecture, participatory design, placemaking, social inclusion

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369 Bacteriological Spectrum and Resistance Patterns of Common Clinical Isolates from Infections in Cancer Patients

Authors: Vivek Bhat, Rohini Kelkar, Sanjay Biswas

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Introduction: Cancer patients are at increased risk of bacterial infections. This may due to the disease process itself, the effect of chemotherapeutic drugs or invasive procedures such as catheterization. A wide variety of bacteria including some emerging pathogens are increasingly being reported from these patients. The incidence of multidrug-resistant organisms particularly in the Gram negative group is also increasing, with higher resistance rates seen to cephalosporins, β-lactam/β-lactam inhibitor combinations, and the carbapenems. This study documents the bacteriological spectrum of infections and their resistance patterns in cancer patients. Methods: This study includes all bacterial isolates recovered from infections cancer patients over a period of 18 months. Samples included Blood cultures, Pus/wound swabs, urine, tissue biopsies, body fluids, catheter tips and respiratory specimens such as sputum and bronchoalveolar lavage (BAL). All samples were processed in the microbiology laboratory as per standard laboratory protocols. Organisms were identified to species level and antimicrobial susceptibility testing was performed manually by the disc diffusion technique or in the Vitek-2 (Biomereux, France) instrument. Interpretations were as per Clinical laboratory Standards Institute (CLSI) guidelines. Results: A total of 1150 bacterial isolates were cultured from 884 test samples during the study period. Of these 227 were Gram-positive and 923 were Gram-negative organisms. Staphylococcus aureus (99 isolates) was the commonest Gram-positive isolate followed by Enterococcus (79) and Gr A Streptococcus (30). Among the Gram negatives, E. coli (304), Pseudomonas aeruginosa (201) and Klebsiella pneumoniae (190) were the most common. Of the Staphylococcus aureus isolates 27.2% were methicillin resistant. Only 5.06% enterococci were vancomycin resistant. High rates of resistance to cefotaxime and ciprofloxacin were seen amongst E. coli (84.8% & 83.55%) and Klebsiella pneumoniae (71 & 62.1%) respectively. Resistance to carbapenems (meropenem) was high at 70% in Acinetobacter spp.; however all isolates were sensitive to colistin. Among the aminoglycosides, amikacin retained good efficacy against Escherichia coli (82.9%) and Pseudomonas aeruginosa (78.1%). Occasional isolates of emerging pathogens such as Chryseobacterium indologens, Roseomonas, and Achromobacter xyloxidans were also recovered. Conclusion: The common infections in cancer patients include respiratory, wound, tract infections and sepsis. The commonest isolates include Staphylococcus aureus, Enterococci, Escherichia coli, Klebsiella pneumoniae and Pseudomonas aeruginosa. There is a high level of resistance to the commonly used antibiotics among Gram-negative organisms.

Keywords: bacteria, resistance, infection, cancer

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368 Reagentless Detection of Urea Based on ZnO-CuO Composite Thin Film

Authors: Neha Batra Bali, Monika Tomar, Vinay Gupta

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A reagentless biosensor for detection of urea based on ZnO-CuO composite thin film is presented in following work. Biosensors have immense potential for varied applications ranging from environmental to clinical testing, health care, and cell analysis. Immense growth in the field of biosensors is due to the huge requirement in today’s world to develop techniques which are both cost effective and accurate for prevention of disease manifestation. The human body comprises of numerous biomolecules which in their optimum levels are essential for functioning. However mismanaged levels of these biomolecules result in major health issues. Urea is one of the key biomolecules of interest. Its estimation is of paramount significance not only for healthcare sector but also from environmental perspectives. If level of urea in human blood/serum is abnormal, i.e., above or below physiological range (15-40mg/dl)), it may lead to diseases like renal failure, hepatic failure, nephritic syndrome, cachexia, urinary tract obstruction, dehydration, shock, burns and gastrointestinal, etc. Various metal nanoparticles, conducting polymer, metal oxide thin films, etc. have been exploited to act as matrix to immobilize urease to fabricate urea biosensor. Amongst them, Zinc Oxide (ZnO), a semiconductor metal oxide with a wide band gap is of immense interest as an efficient matrix in biosensors by virtue of its natural abundance, biocompatibility, good electron communication feature and high isoelectric point (9.5). In spite of being such an attractive candidate, ZnO does not possess a redox couple of its own which necessitates the use of electroactive mediators for electron transfer between the enzyme and the electrode, thereby causing hindrance in realization of integrated and implantable biosensor. In the present work, an effort has been made to fabricate a matrix based on ZnO-CuO composite prepared by pulsed laser deposition (PLD) technique in order to incorporate redox properties in ZnO matrix and to utilize the same for reagentless biosensing applications. The prepared bioelectrode Urs/(ZnO-CuO)/ITO/glass exhibits high sensitivity (70µAmM⁻¹cm⁻²) for detection of urea (5-200 mg/dl) with high stability (shelf life ˃ 10 weeks) and good selectivity (interference ˂ 4%). The enhanced sensing response obtained for composite matrix is attributed to the efficient electron exchange between ZnO-CuO matrix and immobilized enzymes, and subsequently fast transfer of generated electrons to the electrode via matrix. The response is encouraging for fabricating reagentless urea biosensor based on ZnO-CuO matrix.

Keywords: biosensor, reagentless, urea, ZnO-CuO composite

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367 Deconstructing and Reconstructing the Definition of Inhuman Treatment in International Law

Authors: Sonia Boulos

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The prohibition on ‘inhuman treatment’ constitutes one of the central tenets of modern international human rights law. It is incorporated in principal international human rights instruments including Article 5 of the Universal Declaration of Human Rights, and Article 7 of the International Covenant on Civil and Political Rights. However, in the absence of any legislative definition of the term ‘inhuman’, its interpretation becomes challenging. The aim of this article is to critically analyze the interpretation of the term ‘inhuman’ in international human rights law and to suggest a new approach to construct its meaning. The article is composed of two central parts. The first part is a critical appraisal of the interpretation of the term ‘inhuman’ by supra-national human rights law institutions. It highlights the failure of supra-national institutions to provide an independent definition for the term ‘inhuman’. In fact, those institutions consistently fail to distinguish the term ‘inhuman’ from its other kin terms, i.e. ‘cruel’ and ‘degrading.’ Very often, they refer to these three prohibitions as ‘CIDT’, as if they were one collective. They were primarily preoccupied with distinguishing ‘CIDT’ from ‘torture.’ By blurring the conceptual differences between these three terms, supra-national institutions supplemented them with a long list of specific and purely descriptive subsidiary rules. In most cases, those subsidiary rules were announced in the absence of sufficient legal reasoning explaining how they were derived from abstract and evaluative standards embodied in the prohibitions collectively referred to as ‘CIDT.’ By opting for this option, supra-national institutions have created the risk for the development of an incoherent body of jurisprudence on those terms at the international level. They also have failed to provide guidance for domestic courts on how to enforce these prohibitions. While blurring the differences between the terms ‘cruel,’ ‘inhuman,’ and ‘degrading’ has consequences for the three, the term ‘inhuman’ remains the most impoverished one. It is easy to link the term ‘cruel’ to the clause on ‘cruel and unusual punishment’ originating from the English Bill of Rights of 1689. It is also easy to see that the term ‘degrading’ reflects a dignatarian ideal. However, when we turn to the term ‘inhuman’, we are left without any interpretative clue. The second part of the article suggests that the ordinary meaning of the word ‘inhuman’ should be our first clue. However, regaining the conceptual independence of the term ‘inhuman’ requires more than a mere reflection on the word-meaning of the term. Thus, the second part introduces philosophical concepts related to the understanding of what it means to be human. It focuses on ‘the capabilities approach’ and the notion of ‘human functioning’, introduced by Amartya Sen and further explored by Martha Nussbaum. Nussbaum’s work on the basic human capabilities is particularly helpful or even vital for understanding the moral and legal substance of the prohibition on ‘inhuman’ treatment.

Keywords: inhuman treatment, capabilities approach, human functioning, supra-national institutions

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366 Modification of Escherichia coli PtolT Expression Vector via Site-Directed Mutagenesis

Authors: Yakup Ulusu, Numan Eczacıoğlu, İsa Gökçe, Helen Waller, Jeremy H. Lakey

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Besides having the appropriate amino acid sequence to perform the function of proteins, it is important to have correct conformation after this sequence to process. To consist of this conformation depends on the amino acid sequence at the primary structure, hydrophobic interaction, chaperones and enzymes in charge of folding etc. Misfolded proteins are not functional and tend to be aggregated. Cysteine originating disulfide cross-links make stable this conformation of functional proteins. When two of the cysteine amino acids come side by side, disulfide bond is established that forms a cystine bridge. Due to this feature cysteine plays an important role on the formation of three-dimensional structure of many proteins. There are two cysteine amino acids (C44, C69) in the Tol-A-III protein. Unlike protein disulfide bonds from within his own, any non-specific cystine bridge causes a change in the three dimensional structure of the protein. Proteins can be expressed in various host cells as directly or fusion (chimeric). As a result of overproduction of the recombinant proteins, aggregation of insoluble proteins in the host cell can occur by forming a crystal structure called inclusion body. In general fusion proteins are produced for provide affinity tags to make proteins more soluble and production of some toxic proteins via fusion protein expression system like pTolT. Proteins can be modified by using a site-directed mutagenesis. By this way, creation of non-specific disulfide crosslinks can be prevented at fusion protein expression system via the present cysteine replaced by another amino acid such as serine, glycine or etc. To do this, we need; a DNA molecule that contains the gene that encodes for the target protein, required primers for mutation to be designed according to site directed mutagenesis reaction. This study was aimed to be replaced cysteine encoding codon TGT with serine encoding codon AGT. For this sense and reverse primers designed (given below) and used site-directed mutagenesis reaction. Several new copy of the template plasmid DNA has been formed with above mentioned mutagenic primers via polymerase chain reaction (PCR). PCR product consists of both the master template DNA (wild type) and the new DNA sequences containing mutations. Dpn-l endonuclease restriction enzyme which is specific for methylated DNA and cuts them to the elimination of the master template DNA. E. coli cells obtained after transformation were incubated LB medium with antibiotic. After purification of plasmid DNA from E. coli, the presence of the mutation was determined by DNA sequence analysis. Developed this new plasmid is called PtolT-δ.

Keywords: site directed mutagenesis, Escherichia coli, pTolT, protein expression

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365 How the Writer Tells the Story Should Be the Primary Concern rather than Who Can Write about Whom: The Limits of Cultural Appropriation Vis-à-Vis The Ethics of Narrative Empathy

Authors: Alexandra Cheira

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Cultural appropriation has been theorised as a form of colonialism in which members of a dominant culture reduce cultural elements that are deeply meaningful to a minority culture to the category of the “exotic other” since they do not experience the oppression and discriminations faced by members of the minority culture. Yet, in the particular case of literature, writers such as Lionel Shriver and Bernardine Evaristo have argued that authors from a cultural majority have a right to write in the voice of someone from a cultural minority, hence attacking the idea that this is a form of cultural appropriation. By definition, Shriver and Evaristo claim, writers are supposed to write beyond their own culture, gender, class, and/ or race. In this light, this paper discusses the limits of cultural appropriation vis-à-vis the ethics of narrative empathy by addressing the mixed critical reception of Kathryn Stockett’s The Help (2009) and Jeanine Cummins’s American Dirt (2020). In fact, both novels were acclaimed as global eye-openers regarding the struggles of respectively South American migrants and African American maids. At the same time, both novelists have been accused of cultural appropriation by telling a story that is not theirs to tell, given the fact that they are white women telling these stories in what critics have argued is really an American voice telling a story to American readers.These claims will be investigated within the framework of Edward Said’s foundational examination of Orientalism in the field of postcolonial studies as a Western style for authoritatively restructuring the Orient. This means that Orientalist stereotypes regarding Eastern cultures have implicitly validated colonial and imperial pursuits, in the specific context of literary representations of African American and Mexican cultures by white writers. At the same time, the conflicted reception of American Dirt and The Help will be examined within the critical framework of narrative empathy as theorised by Suzanne Keen. Hence, there will be a particular focus on the way a reader’s heated perception that the author’s perspective is purely dishonest can result from a friction between an author’s intention and a reader’s experience of narrative empathy, while a shared sense of empathy between authors and readers can be a rousing momentum to move beyond literary response to social action.Finally, in order to assess that “the key question should not be who can write about whom, but how the writer tells the story”, the recent controversy surrounding Dutch author Marieke Lucas Rijneveld’s decision to resign the translation of American poet Amanda Gorman’s work into Dutch will be duly investigated. In fact, Rijneveld stepped out after journalist and activist Janice Deul criticised Dutch publisher Meulenhoff for choosing a translator who was not also Black, despite the fact that 22-year-old Gorman had selected the 29-year-old Rijneveld herself, as a fellow young writer who had likewise come to fame early on in life. In this light, the critical argument that the controversial reception of The Help reveals as much about US race relations in the early twenty-first century as about the complex literary transactions between individual readers and the novel itself will also be discussed in the extended context of American Dirt and white author Marieke Rijneveld’s withdrawal from the projected translation of Black poet Amanda Gorman.

Keywords: cultural appropriation, cultural stereotypes, narrative empathy, race relations

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364 Association of Brain Derived Neurotrophic Factor with Iron as well as Vitamin D, Folate and Cobalamin in Pediatric Metabolic Syndrome

Authors: Mustafa M. Donma, Orkide Donma

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The impact of metabolic syndrome (MetS) on cognition and functions of the brain is being investigated. Iron deficiency and deficiencies of B9 (folate) as well as B12 (cobalamin) vitamins are best-known nutritional anemias. They are associated with cognitive disorders and learning difficulties. The antidepressant effects of vitamin D are known and the deficiency state affects mental functions negatively. The aim of this study is to investigate possible correlations of MetS with serum brain-derived neurotrophic factor (BDNF), iron, folate, cobalamin and vitamin D in pediatric patients. 30 children, whose age- and sex-dependent body mass index (BMI) percentiles vary between 85 and 15, 60 morbid obese children with above 99th percentiles constituted the study population. Anthropometric measurements were taken. BMI values were calculated. Age- and sex-dependent BMI percentile values were obtained using the appropriate tables prepared by the World Health Organization (WHO). Obesity classification was performed according to WHO criteria. Those with MetS were evaluated according to MetS criteria. Serum BDNF was determined by enzyme-linked immunosorbent assay. Serum folate was analyzed by an immunoassay analyzer. Serum cobalamin concentrations were measured using electrochemiluminescence immunoassay. Vitamin D status was determined by the measurement of 25-hydroxycholecalciferol [25-hydroxy vitamin D3, 25(OH)D] using high performance liquid chromatography. Statistical evaluations were performed using SPSS for Windows, version 16. The p values less than 0.05 were accepted as statistically significant. Although statistically insignificant, lower folate and cobalamin values were found in MO children compared to those observed for children with normal BMI. For iron and BDNF values, no alterations were detected among the groups. Significantly decreased vitamin D concentrations were noted in MO children with MetS in comparison with those in children with normal BMI (p ≤ 0.05). The positive correlation observed between iron and BDNF in normal-BMI group was not found in two MO groups. In THE MetS group, the partial correlation among iron, BDNF, folate, cobalamin, vitamin D controlling for waist circumference and BMI was r = -0.501; p ≤ 0.05. None was calculated in MO and normal BMI groups. In conclusion, vitamin D should also be considered during the assessment of pediatric MetS. Waist circumference and BMI should collectively be evaluated during the evaluation of MetS in children. Within this context, BDNF appears to be a key biochemical parameter during the examination of obesity degree in terms of mental functions, cognition and learning capacity. The association observed between iron and BDNF in children with normal BMI was not detected in MO groups possibly due to development of inflammation and other obesity-related pathologies. It was suggested that this finding may contribute to mental function impairments commonly observed among obese children.

Keywords: brain-derived neurotrophic factor, iron, vitamin B9, vitamin B12, vitamin D

Procedia PDF Downloads 121
363 In vitro Antioxidant, Anti-Diabetic and Nutritional Properties of Breynia retusa

Authors: Parimelazhagan Thangaraj

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Natural products serves human kind as a source of all drugs and higher plants provide most of these therapeutic agents. These products are widely recognized in the pharmaceutical industry for their broad structural diversity as well as their wide range of pharmacological activities. Euphorbiaceae is one of the important families with significant pharmacological activities, of which many species has been used traditionally for the treatment of various ailments. Breynia retusa belongs to the family Euphorbiaceae is used to cure ailments like body pain, skin inflammation, hyperglycaemia, diarrhoea, dysentery and toothache. Flowers and young leaves of B. retusa are cooked and eaten, roots are used for meningitis. The juice of the stem is used in conjunctivtis and leaves as poultice to hasten suppuration. Based on the strong evidences of traditional uses of Breynia retusa, the present study was focused on neutraceuticals evaluation of the species with special reference to oxidative stress and diabetes. Both leaves and stem of B. retusa were extracted with different solvents and analyzed for radical scavenging ability wherein ABTS.+ (8396.95±1529.01 µM TEAC/g extract), phosphomolybdenum (17.34±0.08 g AAE/100 g extract) and FRAP (6075.66±414.28 µM Fe (II) E/mg extract) assays showed good radical scavenging activity in stem. Furthermore, leaf extracts showed good radical inhibition in DPPH (2.4 µg/mL), metal ion (27.44±0.09 mg EDTAE/g extract) scavenging methods. The α-amylase and α-glucosidase inhibitors are currently used for diabetic treatment as oral hypoglycemic agents. The inhibitory effects of the B. retusa leaf and stem ethyl acetate extracts showed good inhibition on α-amylase (96.25% and 95.69 respectively) and α-glucosidase (54.50% and 50.87% respectively) enzymes compared to standard acarbose. The proximate composition analysis of B. retusa leaves contains higher amount of total carbohydrates (14.08 g Glucose equivalents/100 g sample), ash (19.04 %) and crude fibre (0.52 %). The examination of mineral profile explored that the leaves was rich in calcium (1891 ppm), sulphur (1406 ppm), copper (2600 ppm) and magnesium (778 ppm). Leaves sample revealed very minimal amount of anti-nutrient contents like trypsin (14.08±0.03 TIU/mg protein) and tannin (0.011±0.001 mg TAE/g sample). The low anti nutritional factors may not pose any serious nutritional problems when these leaves are consumed. In conclusion, it is very clear that dietary compounds from B. retusa are suitable and promising for the development of safe food products and natural additives. Based on the studies, it may be concluded that nutritional composition, antioxidant and anti-diabetic activities this species can be used as future therapeutic medicine.

Keywords: Breynia retusa, nutraceuticals, antioxidant, anti diabetic

Procedia PDF Downloads 334
362 The Implementation of Human Resource Information System in the Public Sector: An Exploratory Study of Perceived Benefits and Challenges

Authors: Aneeqa Suhail, Shabana Naveed

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The public sector (in both developed and developing countries) has gone through various waves of radical reforms in recent decades. In Pakistan, under the influence of New Public Management(NPM) Reforms; best practices of private sector are introduced in the public sector to modernize public organizations. Human Resource Information System (HRIS) has been popular in the private sector and proven to be a successful system, therefore it is being adopted in the public sector too. However, implementation of private business practices in public organizations us very challenging due to differences in context. This implementation gets further critical in Pakistan due to a centralizing tendency and lack of autonomy in public organizations. Adoption of HRIS by public organizations in Pakistan raises several questions: What challenges are faced by public organizations in implementation of HRIS? Are benefits of HRIS such as efficiency, process integration and cost reduction achieved? How is the previous system improved with this change and what are the impacts? Yet, it is an under-researched topic, especially in public enterprises. This study contributes to the existing body of knowledge by empirically exploring benefits and challenges of implementation of HRIS in public organizations. The research adopts a case study approach and uses qualitative data based on in-depth interviews conducted at various levels in the hierarchy including top management, departmental heads and employees. The unit of analysis is LESCO, the Lahore Electric Supply Company, a state-owned entity that generates, transmits and distributes electricity to 4 big cities in Punjab, Pakistan. The findings of the study show that LESCO has not achieved the benefits of HRIS as established in literature. The implementation process remained quite slow and costly. Various functions of HR are still in isolation and integration is a big challenge for the organization. Although the data is automated, the previous system of manually record maintenance and paperwork is still in work, resulting in the presence of parallel practices. The findings also identified resistance to change from top management and labor workforce, lack of commitment and technical knowledge, and costly vendors as major barriers that affect the effective implementation of HRIS. The paper suggests some potential actions to overcome these barriers and to enhance effective implementation of HR-technology. The findings are explained in light of an institutional logics perspective. HRIS’ new logic of automated and integrated HR system is in sharp contrast with the prevailing logic of process-oriented manual data maintenance, leading to resistance to change and deadlock.

Keywords: human resource information system, technological changes, state-owned enterprise, implementation challenges

Procedia PDF Downloads 146
361 The Development of Group Counseling Program for Elderly's Caregivers by Base on Person-Centered Theory to Promoting for the Resilience Quotient in Elderly People

Authors: Jirapan Khruesarn, Wimwipa Boonklin

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Background: Currently, Thailand has an aging population. In 2017, the elderly population was over 11.14 million. There will be an increase in the number of elderly people, 8.39 million, some people grumble to themselves and have conflicts with their offspring or those close to them. It is a source of stress. Mental health promotion should be given to the elderly in order to cope with these changes. Due to the family characteristics of Thai society, these family members will act as caregivers for the elderly. Therefore, a group-counseling program based on Personnel-Centered Theory for Elderly Caregivers in Mental Health Promotion for Older People in Na Kaeo Municipality, Kau Ka District, Lampang Province, has been developed to compare the elderly care behavior before and after the participation. Methods: This research was study for 20 elderly' caregiver: Those aimed to compare the before and after use of group program for caregiver to promoting for the elderly by the following methods: Step 1 Establish a framework for evaluating elderly care behaviors and develop a group counseling program for promote mental health for elderly on: 1) Body 2) Willpower 3) Social and community management and 4) Organizing learning process. Step 2 Assessing an Elderly Care Behaviors by using "The behavior assessment on caring for the elderly" and assessing the mental health power level of the elderly and follow the counseling program 9 times and compare of the elderly care behaviors before and after joined a group program, and compare of mental health level of caregiver attends a group program. Results: This study is developing a group counseling program to promoting for the resilience quotient in elderly people that the results of the study could be summarized as follows: 1) Before the elderly's caregivers join a group counseling program: Mental health promotion behaviors of the elderly were at the high level of (3.32), and after: were at the high level of (3.44). 2) Before the elderly's caregiver attends a group counseling program: the mental health level of the elderly the mean score was (47.85 percent), and the standard deviation was (0.21 percent) and after. The elderly had a higher score of (51.45 percent) In summary, after the elderly caregivers joined the group, the elderly are higher in all aspects promote mental health for elderly and the statistically significance at the 0.05, It shows that programs are fit for personal and community condition in promoting the mental health of the elderly because this theory has the idea that: Humans have the ability to use their intelligence to solve problems or make decisions effectively, And member of group counseling program have ventured and express grievances that the counselor is a facilitator who focuses on personal development by building relationships among people. In other words, the factors contributing to higher levels of elderly care behaviors is group counseling, that isn't a hypothetical process but focus on building relationships that are based on mutual trust and Unconditional acceptance.

Keywords: group counseling base on person-centered theory, elderly person, resilience quotient: RQ, caregiver

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360 Architecture, Politics and Religion Synthesis: Political Legitimacy in Early Islamic Iran

Authors: Fahimeh Ghorbani, Alam Saleh

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Ideology, politics and art have always been omnipresent patterns of Islam since its early age. The Islamic empire, expanded from China to Andalusia, has instrumentalized art and architecture to enhance political legitimacy of different dynasties or states throughout its history. Quranic verses utilized to convey ideological messages in the major mosques and mausoleums. Iranians had already been employing art and architecture to propagate their political legitimacy prior to Islam. The land of Iran and its art with strong civilizational pre-Islamic history has been profoundly politicized since the rise of Islam in the region. Early Islamic period in Iran has witnessed introduction of a new architectural language, new formulas for spatial configuration in built spaces, as well as new system of architectural decoration. Studying Iran’s Early Islamic architecture helps in better understanding the process of socio-political identity making of Iranian-Islamic culture, and thus art and architecture. This period also set the stage for formation of glorious architectural movements through Persianate world in later periods. During the Early Islamic period in Iran, the innovative combination of Islamic ideology and Iranian Architecture created formidable ideological tools in politicizing art in the region and beyond. As such, this paper aims to investigate the political history and architectural legacy from late Sassanid to Early Islamic period, delves into the ways in which Early Islamic architecture played role in transforming Persian concepts of kingship, administration, and social organization. In so doing, the study focuses on the Perso-Islamic architectural synthesis under the Samanids and Seljuk dynasty as case studies. The paper also explores how the newly introduced Islamic architecture has been employed to address the question of political legitimacy and to propagate states’ political agenda in early Islamic Iran (650-1250). As for the existing literature, despite its uniqueness and significance, Early Islamic architecture of Iran has received little scholarly attention. However, there exists a sizeable body of scholarship on socio-historic condition of the land of Iran during Early Islamic period which provide a solid base for the project. Methodologically speaking, the authors look into the subject through various lenses. They will conduct historic and archival research in libraries, private collections, and archives in Iran and the related neighbouring countries in Persian, Arabic and English. The methods of visual and formal analysis are applied to examine architectural features of the period. There are also a high number of intriguing, yet poorly examined, published and unpublished documents, old plans, drawings and photos of monuments preserved in Cultural Heritage of Iran Organization which will be consulted.

Keywords: Iran, Islamic architecture, early Islamic Iran, early Islamic architecture, politicized art, political legitimacy, propaganda, aesthetics

Procedia PDF Downloads 119
359 Legal Considerations in Fashion Modeling: Protecting Models' Rights and Ensuring Ethical Practices

Authors: Fatemeh Noori

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The fashion industry is a dynamic and ever-evolving realm that continuously shapes societal perceptions of beauty and style. Within this industry, fashion modeling plays a crucial role, acting as the visual representation of brands and designers. However, behind the glamorous façade lies a complex web of legal considerations that govern the rights, responsibilities, and ethical practices within the field. This paper aims to explore the legal landscape surrounding fashion modeling, shedding light on key issues such as contract law, intellectual property, labor rights, and the increasing importance of ethical considerations in the industry. Fashion modeling involves the collaboration of various stakeholders, including models, designers, agencies, and photographers. To ensure a fair and transparent working environment, it is imperative to establish a comprehensive legal framework that addresses the rights and obligations of each party involved. One of the primary legal considerations in fashion modeling is the contractual relationship between models and agencies. Contracts define the terms of engagement, including payment, working conditions, and the scope of services. This section will delve into the essential elements of modeling contracts, the negotiation process, and the importance of clarity to avoid disputes. Models are not just individuals showcasing clothing; they are integral to the creation and dissemination of artistic and commercial content. Intellectual property rights, including image rights and the use of a model's likeness, are critical aspects of the legal landscape. This section will explore the protection of models' image rights, the use of their likeness in advertising, and the potential for unauthorized use. Models, like any other professionals, are entitled to fair and ethical treatment. This section will address issues such as working conditions, hours, and the responsibility of agencies and designers to prioritize the well-being of models. Additionally, it will explore the global movement toward inclusivity, diversity, and the promotion of positive body image within the industry. The fashion industry has faced scrutiny for perpetuating harmful standards of beauty and fostering a culture of exploitation. This section will discuss the ethical responsibilities of all stakeholders, including the promotion of diversity, the prevention of exploitation, and the role of models as influencers for positive change. In conclusion, the legal considerations in fashion modeling are multifaceted, requiring a comprehensive approach to protect the rights of models and ensure ethical practices within the industry. By understanding and addressing these legal aspects, the fashion industry can create a more transparent, fair, and inclusive environment for all stakeholders involved in the art of modeling.

Keywords: fashion modeling contracts, image rights in modeling, labor rights for models, ethical practices in fashion, diversity and inclusivity in modeling

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358 The Concept of Dharma under Hindu, Buddhist and Sikh Religions: A Comparative Analysis

Authors: Venkateswarlu Kappara

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The term ‘Dharma’ is complex and ubiquitous. It has no equivalent word in English Initially applied to Aryans. In Rig Veda, it appears in a number of places with different meanings. The word Dharma comes from the roots word ‘dhr’ (Dhri-Dharayatetiiti Dharmaha). Principles of Dharma are all pervading. The closest synonyms for Dharma in English is ‘Righteousness.’ In a holy book Mahabharata, it is mentioned that Dharma destroys those who destroy it, Dharma Protects those who protect it. Also, Dharma might be shadowed, now and then by evil forces, but at the end, Dharma always triumphs. This line embodies the eternal victory of good over evil. In Mahabharata, Lord Krishna says Dharma upholds both, this worldly and other worldly affairs. Rig Veda says, ‘O Indra! Lead us on the path of Rta, on the right path over all evils.’ For Buddhists, Dharma most often means the body of teachings expounded by the Buddha. The Dharma is one of the three Jewels (Tri Ratnas) of Buddhism under which the followers take refuge. They are: the ‘Buddha’ meaning the minds perfection or enlightenment, the Dharma, meaning the teachings and the methods of the Buddha, and the Sangha meaning those awakened people who provide guidance and support followers. Buddha denies a separate permanent ‘I.’ Buddha Accepts Suffering (Dukka). Change / impermanence (Anicca) and not– self (Annatta) Dharma in the Buddhist scriptures has a variety of meanings including ‘phenomenon’ and ‘nature’ or ‘characteristic.’ For Sikhs, the word ‘Dharma’ means the ‘path’ of righteousness’ The Sikh scriptures attempt to answer the exposition of Dharma. The main Holy Scripture of the Sikh religion is called the Guru Granth Sahib. The faithful people are fully bound to do whatever the Dharma wants them to do. Such is the name of the Immaculate Lord. Only one who has faith comes to know such a state of mind. The righteous judge of Dharma, by the Hukam of God’s Command, sits and Administers true justice. From Dharma flow wealth and pleasure. The study indicates that in Sikh religion, the Dharma is the path of righteousness; In Buddhism, the mind’s perfection of enlightenment, and in Hinduism, it is non-violence, purity, truth, control of senses, not coveting the property of others. The comparative study implies that all religions dealt with Dharma for welfare of the mankind. The methodology adapted is theoretical, analytical and comparative. The present study indicates how far Indian philosophical systems influenced the present circumstances and how far the present system is not compatible with Ancient philosophical systems. A tentative generalization would be that the present system which is mostly influenced by the British Governance may not totally reflect the ancient norms. However, the mental make-up continues to be influenced by Ancient philosophical systems.

Keywords: Dharma, Dukka (suffering), Rakshati, righteous

Procedia PDF Downloads 170
357 Natural Monopolies and Their Regulation in Georgia

Authors: Marina Chavleishvili

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Introduction: Today, the study of monopolies, including natural monopolies, is topical. In real life, pure monopolies are natural monopolies. Natural monopolies are used widely and are regulated by the state. In particular, the prices and rates are regulated. The paper considers the problems associated with the operation of natural monopolies in Georgia, in particular, their microeconomic analysis, pricing mechanisms, and legal mechanisms of their operation. The analysis was carried out on the example of the power industry. The rates of natural monopolies in Georgia are controlled by the Georgian National Energy and Water Supply Regulation Commission. The paper analyzes the positive role and importance of the regulatory body and the issues of improving the legislative base that will support the efficient operation of the branch. Methodology: In order to highlight natural monopolies market tendencies, the domestic and international markets are studied. An analysis of monopolies is carried out based on the endogenous and exogenous factors that determine the condition of companies, as well as the strategies chosen by firms to increase the market share. According to the productivity-based competitiveness assessment scheme, the segmentation opportunities, business environment, resources, and geographical location of monopolist companies are revealed. Main Findings: As a result of the analysis, certain assessments and conclusions were made. Natural monopolies are quite a complex and versatile economic element, and it is important to specify and duly control their frame conditions. It is important to determine the pricing policy of natural monopolies. The rates should be transparent, should show the level of life in the country, and should correspond to the incomes. The analysis confirmed the significance of the role of the Antimonopoly Service in the efficient management of natural monopolies. The law should adapt to reality and should be applied only to regulate the market. The present-day differential electricity tariffs varying depending on the consumed electrical power need revision. The effects of the electricity price discrimination are important, segmentation in different seasons in particular. Consumers use more electricity in winter than in summer, which is associated with extra capacities and maintenance costs. If the price of electricity in winter is higher than in summer, the electricity consumption will decrease in winter. The consumers will start to consume the electricity more economically, what will allow reducing extra capacities. Conclusion: Thus, the practical realization of the views given in the paper will contribute to the efficient operation of natural monopolies. Consequently, their activity will be oriented not on the reduction but on the increase of increments of the consumers or producers. Overall, the optimal management of the given fields will allow for improving the well-being throughout the country. In the article, conclusions are made, and the recommendations are developed to deliver effective policies and regulations toward the natural monopolies in Georgia.

Keywords: monopolies, natural monopolies, regulation, antimonopoly service

Procedia PDF Downloads 87
356 Impact of Lack of Testing on Patient Recovery in the Early Phase of COVID-19: Narratively Collected Perspectives from a Remote Monitoring Program

Authors: Nicki Mohammadi, Emma Reford, Natalia Romano Spica, Laura Tabacof, Jenna Tosto-Mancuso, David Putrino, Christopher P. Kellner

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Introductory Statement: The onset of the COVID-19 pandemic demanded an unprecedented need for the rapid development, dispersal, and application of infection testing. However, despite the impressive mobilization of resources, individuals were incredibly limited in their access to tests, particularly during the initial months of the pandemic (March-April 2020) in New York City (NYC). Access to COVID-19 testing is crucial in understanding patients’ illness experiences and integral to the development of COVID-19 standard-of-care protocols, especially in the context of overall access to healthcare resources. Succinct Description of basic methodologies: 18 Patients in a COVID-19 Remote Patient Monitoring Program (Precision Recovery within the Mount Sinai Health System) were interviewed regarding their experience with COVID-19 during the first wave (March-May 2020) of the COVID-19 pandemic in New York City. Patients were asked about their experiences navigating COVID-19 diagnoses, the health care system, and their recovery process. Transcribed interviews were analyzed for thematic codes, using grounded theory to guide the identification of emergent themes and codebook development through an iterative process. Data coding was performed using NVivo12. References for the domain “testing” were then extracted and analyzed for themes and statistical patterns. Clear Indication of Major Findings of the study: 100% of participants (18/18) referenced COVID-19 testing in their interviews, with a total of 79 references across the 18 transcripts (average: 4.4 references/interview; 2.7% interview coverage). 89% of participants (16/18) discussed the difficulty of access to testing, including denial of testing without high severity of symptoms, geographical distance to the testing site, and lack of testing resources at healthcare centers. Participants shared varying perspectives on how the lack of certainty regarding their COVID-19 status affected their course of recovery. One participant shared that because she never tested positive she was shielded from her anxiety and fear, given the death toll in NYC. Another group of participants shared that not having a concrete status to share with family, friends and professionals affected how seriously onlookers took their symptoms. Furthermore, the absence of a positive test barred some individuals from access to treatment programs and employment support. Concluding Statement: Lack of access to COVID-19 testing in the first wave of the pandemic in NYC was a prominent element of patients’ illness experience, particularly during their recovery phase. While for some the lack of concrete results was protective, most emphasized the invalidating effect this had on the perception of illness for both self and others. COVID-19 testing is now widely accessible; however, those who are unable to demonstrate a positive test result but who are still presumed to have had COVID-19 in the first wave must continue to adapt to and live with the effects of this gap in knowledge and care on their recovery. Future efforts are required to ensure that patients do not face barriers to care due to the lack of testing and are reassured regarding their access to healthcare. Affiliations- 1Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, NY 2Abilities Research Center, Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, NY

Keywords: accessibility, COVID-19, recovery, testing

Procedia PDF Downloads 196
355 Real-world Characterization of Treatment Intensified (Add-on to Metformin) Adults with Type 2 Diabetes in Pakistan: A Multi-center Retrospective Study (Converge)

Authors: Muhammad Qamar Masood, Syed Abbas Raza, Umar Yousaf Raja, Imran Hassan, Bilal Afzal, Muhammad Aleem Zahir, Atika Shaheer

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Background: Cardiovascular disease (CVD) is a major burden among people with type 2 diabetes (T2D) with 1 in 3 reported to have CVD. Therefore, understanding real-world clinical characteristics and prescribing patterns could help in better care. Objective: The CONVERGE (Cardiovascular Outcomes and Value in the Real world with GLP-1RAs) study characterized demographics and medication usage patterns in T2D intensified (add-on to metformin) overall population. The data were further divided into subgroups {dipeptidyl peptidase-4 inhibitors (DPP-4is), sulfonylureas (SUs), insulins, glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and sodium-glucose cotransporter-2 inhibitors (SGLT-2is)}, according to the latest prescribed antidiabetic agent (ADA) in India/Pakistan/Thailand. Here, we report findings from Pakistan. Methods: A multi-center retrospective study utilized data from medical records between 13-Sep-2008 (post-market approval of GLP-1RAs) and 31-Dec-2017 in adults (≥18-year-old). The data for this study were collected from 05 centers / institutes located in major cities of Pakistan, including Karachi, Lahore, Islamabad, and Multan. These centers included National Hospital, Aga Khan University Hospital, Diabetes Endocrine Clinic Lahore, Shifa International Hospital, Mukhtar A Sheikh Hospital Multan. Data were collected at start of medical record and at 6 or 12-months prior to baseline based on variable type; analyzed descriptively. Results: Overall, 1,010 patients were eligible. At baseline, overall mean age (SD) was 51.6 (11.3) years, T2D duration was 2.4 (2.6) years, HbA1c was 8.3% (1.9) and 35% received ≥1CVD medications in the past 1-year (before baseline). Most frequently prescribed ADAs post-metformin were DPP-4is and SUs (~63%). Only 6.5% received GLP-1RAs and SGLT-2is were not available in Pakistan during the study period. Overall, it took a mean of 4.4 years and 5 years to initiate GLP-1RAs and SGLT-2is, respectively. In comparison to other subgroups, more patients from GLP-1RAs received ≥3 types of ADA (58%), ≥1 CVD medication (64%) and had higher body mass index (37kg/m2). Conclusions: Utilization of GLP-1RAs and SGLT-2is was low, took longer time to initiate and not before trying multiple ADAs. This may be due to lack of evidence for CV benefits for these agents during the study period. The planned phase 2 of the CONVERGE study can provide more insights into utilization and barriers to prescribe GLP-1RAs and SGLT-2is post 2018 in Pakistan.

Keywords: type 2 diabetes, GLP-1RA, treatment intensification, cardiovascular disease

Procedia PDF Downloads 60
354 Exploring Neural Responses to Urban Spaces in Older People Using Mobile EEG

Authors: Chris Neale, Jenny Roe, Peter Aspinall, Sara Tilley, Steve Cinderby, Panos Mavros, Richard Coyne, Neil Thin, Catharine Ward Thompson

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This research directly assesses older people’s neural activation in response to walking through a changing urban environment, as measured by electroencephalography (EEG). As the global urban population is predicted to grow, there is a need to understand the role that the urban environment may play on the health of its older inhabitants. There is a large body of evidence suggesting green space has a beneficial restorative effect, but this effect remains largely understudied in both older people and by using a neuroimaging assessment. For this study, participants aged 65 years and over were required to walk between a busy urban built environment and a green urban environment, in a counterbalanced design, wearing an Emotiv EEG headset to record real-time neural responses to place. Here we report on the outputs for these responses derived from both the proprietary Affectiv Suite software, which creates emotional parameters with a real time value assigned to them, as well as the raw EEG output focusing on alpha and beta changes, associated with changes in relaxation and attention respectively. Each walk lasted around fifteen minutes and was undertaken at the natural walking pace of the participant. The two walking environments were compared using a form of high dimensional correlated component regression (CCR) on difference data between the urban busy and urban green spaces. For the Emotiv parameters, results showed that levels of ‘engagement’ increased in the urban green space (with a subsequent decrease in the urban busy built space) whereas levels of ‘excitement’ increased in the urban busy environment (with a subsequent decrease in the urban green space). In the raw data, low beta (13 – 19 Hz) increased in the urban busy space with a subsequent decrease shown in the green space, similar to the pattern shown with the ‘excitement’ result. Alpha activity (9 – 13 Hz) shows a correlation with low beta, but not with dependent change in the regression model. This suggests that alpha is acting as a suppressor variable. These results suggest that there are neural signatures associated with the experience of urban spaces which may reflect the age of the cohort or the spatiality of the settings themselves. These are shown both in the outputs of the proprietary software as well as the raw EEG output. Built busy urban spaces appear to induce neural activity associated with vigilance and low level stress, while this effect is ameliorated in the urban green space, potentially suggesting a beneficial effect on attentional capacity in urban green space in this participant group. The interaction between low beta and alpha requires further investigation, in particular the role of alpha in this relationship.

Keywords: ageing, EEG, green space, urban space

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353 A Case Study on Quantitatively and Qualitatively Increasing Student Output by Using Available Word Processing Applications to Teach Reluctant Elementary School-Age Writers

Authors: Vivienne Cameron

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Background: Between 2010 and 2017, teachers in a suburban public school district struggled to get students to consistently produce adequate writing samples as measured by the Pennsylvania state writing rubric for measuring focus, content, organization, style, and conventions. A common thread in all of the data was the need to develop stamina in the student writers. Method: All of the teachers used the traditional writing process model (prewrite, draft, revise, edit, final copy) during writing instruction. One teacher taught the writing process using word processing and incentivizing with publication instead of the traditional pencil/paper/grading method. Students did not have instruction in typing/keyboarding. The teacher submitted resulting student work to real-life contests, magazines, and publishers. Results: Students in the test group increased both the quantity and quality of their writing over a seven month period as measured by the Pennsylvania state writing rubric. Reluctant writers, as well as students with autism spectrum disorder, benefited from this approach. This outcome was repeated consistently over a five-year period. Interpretation: Removing the burden of pencil and paper allowed students to participate in the writing process more fully. Writing with pencil and paper is physically tiring. Students are discouraged when they submit a draft and are instructed to use the Add, Remove, Move, Substitute (ARMS) method to revise their papers. Each successive version becomes shorter. Allowing students to type their papers frees them to quickly and easily make changes. The result is longer writing pieces in shorter time frames, allowing the teacher to spend more time working on individual needs. With this additional time, the teacher can concentrate on teaching focus, content, organization, style, conventions, and audience. S/he also has a larger body of works from which to work on whole group instruction such as developing effective leads. The teacher submitted the resulting student work to contests, magazines, and publishers. Although time-consuming, the submission process was an invaluable lesson for teaching about audience and tone. All students in the test sample had work accepted for publication. Students became highly motivated to succeed when their work was accepted for publication. This motivation applied to special needs students, regular education students, and gifted students.

Keywords: elementary-age students, reluctant writers, teaching strategies, writing process

Procedia PDF Downloads 176
352 Mirna Expression Profile is Different in Human Amniotic Mesenchymal Stem Cells Isolated from Obese Respect to Normal Weight Women

Authors: Carmela Nardelli, Laura Iaffaldano, Valentina Capobianco, Antonietta Tafuto, Maddalena Ferrigno, Angela Capone, Giuseppe Maria Maruotti, Maddalena Raia, Rosa Di Noto, Luigi Del Vecchio, Pasquale Martinelli, Lucio Pastore, Lucia Sacchetti

Abstract:

Maternal obesity and nutrient excess in utero increase the risk of future metabolic diseases in the adult life. The mechanisms underlying this process are probably based on genetic, epigenetic alterations and changes in foetal nutrient supply. In mammals, the placenta is the main interface between foetus and mother, it regulates intrauterine development, modulates adaptive responses to sub optimal in uterus conditions and it is also an important source of human amniotic mesenchymal stem cells (hA-MSCs). We previously highlighted a specific microRNA (miRNA) profiling in amnion from obese (Ob) pregnant women, here we compared the miRNA expression profile of hA-MSCs isolated from (Ob) and control (Co) women, aimed to search for any alterations in metabolic pathways that could predispose the new-born to the obese phenotype. Methods: We isolated, at delivery, hA-MSCs from amnion of 16 Ob- and 7 Co-women with pre-pregnancy body mass index (mean/SEM) 40.3/1.8 and 22.4/1.0 kg/m2, respectively. hA-MSCs were phenotyped by flow cytometry. Globally, 384 miRNAs were evaluated by the TaqMan Array Human MicroRNA Panel v 1.0 (Applied Biosystems). By the TargetScan program we selected the target genes of the miRNAs differently expressed in Ob- vs Co-hA-MSCs; further, by KEGG database, we selected the statistical significant biological pathways. Results: The immunophenotype characterization confirmed the mesenchymal origin of the isolated hA-MSCs. A large percentage of the tested miRNAs, about 61.4% (232/378), was expressed in hA-MSCs, whereas 38.6% (146/378) was not. Most of the expressed miRNAs (89.2%, 207/232) did not differ between Ob- and Co-hA-MSCs and were not further investigated. Conversely, 4.8% of miRNAs (11/232) was higher and 6.0% (14/232) was lower in Ob- vs Co-hA-MSCs. Interestingly, 7/232 miRNAs were obesity-specific, being expressed only in hA-MSCs isolated from obese women. Bioinformatics showed that these miRNAs significantly regulated (P<0.001) genes belonging to several metabolic pathways, i.e. MAPK signalling, actin cytoskeleton, focal adhesion, axon guidance, insulin signaling, etc. Conclusions: Our preliminary data highlight an altered miRNA profile in Ob- vs Co-hA-MSCs and suggest that an epigenetic miRNA-based mechanism of gene regulation could affect pathways involved in placental growth and function, thereby potentially increasing the newborn’s risk of metabolic diseases in the adult life.

Keywords: hA-MSCs, obesity, miRNA, biosystem

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351 Investigation Studies of WNbMoVTa and WNbMoVTaCr₀.₅Al Refractory High Entropy Alloys as Plasma-Facing Materials

Authors: Burçak Boztemur, Yue Xu, Laima Luo, M. Lütfi Öveçoğlu, Duygu Ağaoğulları

Abstract:

Tungsten (W) is used chiefly as plasma-facing material. However, it has some problems, such as brittleness after plasma exposure. High-entropy alloys (RHEAs) are a new opportunity for this deficiency. So, the neutron shielding behavior of WNbMoVTa and WNbMoVTaCr₀.₅Al compositions were examined against He⁺ irradiation in this study. The mechanical and irradiation properties of the WNbMoVTa base composition were investigated by adding the Al and Cr elements. The mechanical alloying (MA) for 6 hours was applied to obtain RHEA powders. According to the X-ray diffraction (XRD) method, the body-centered cubic (BCC) phase and NbTa phase with a small amount of WC impurity that comes from vials and balls were determined after 6 h MA. Also, RHEA powders were consolidated with the spark plasma sintering (SPS) method (1500 ºC, 30 MPa, and 10 min). After the SPS method, (Nb,Ta)C and W₂C₀.₈₅ phases were obtained with the decomposition of WC and stearic acid that is added during MA based on XRD results. Also, the BCC phase was obtained for both samples. While the Al₂O₃ phase with a small intensity was seen for the WNbMoVTaCr₀.₅Al sample, the Ta₂VO₆ phase was determined for the base sample. These phases were observed as three different regions according to scanning electron microscopy (SEM). All elements were distributed homogeneously on the white region by measuring an electron probe micro-analyzer (EPMA) coupled with a wavelength dispersive spectroscope (WDS). Also, the grey region of the WNbMoVTa sample was rich in Ta, V, and O elements. However, the amount of Al and O elements was higher for the grey region of the WNbMoVTaCr₀.₅Al sample. The high amount of Nb, Ta, and C elements were determined for both samples. Archimedes’ densities that were measured with alcohol media were closer to the theoretical densities of RHEAs. These values were important for the microhardness and irradiation resistance of compositions. While the Vickers microhardness value of the WNbMoVTa sample was measured as ~11 GPa, this value increased to nearly 13 GPa with the WNbMoVTaCr₀.₅Al sample. These values were compatible with the wear behavior. The wear volume loss was decreased to 0.16×10⁻⁴ from 1.25×10⁻⁴ mm³ by the addition of Al and Cr elements to the WNbMoVTa. The He⁺ irradiation was conducted on the samples to observe surface damage. After irradiation, the XRD patterns were shifted to the left because of defects and dislocations. He⁺ ions were infused under the surface, so they created the lattice expansion. The peak shifting of the WNbMoVTaCr₀.₅Al sample was less than the WNbMoVTa base sample, thanks to less impact. A small amount of fuzz was observed for the base sample. This structure was removed and transformed into a wavy structure with the addition of Cr and Al elements. Also, the deformation hardening was actualized after irradiation. A lower amount of hardening was obtained with the WNbMoVTaCr₀.₅Al sample based on the changing microhardness values. The surface deformation was decreased in the WNbMoVTaCr₀.₅Al sample.

Keywords: refractory high entropy alloy, microhardness, wear resistance, He⁺ irradiation

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350 The Invaluable Contributions of Radiography and Radiotherapy in Modern Medicine

Authors: Sahar Heidary

Abstract:

Radiography and radiotherapy have emerged as crucial pillars of modern medical practice, revolutionizing diagnostics and treatment for a myriad of health conditions. This abstract highlights the pivotal role of radiography and radiotherapy in favor of healthcare and society. Radiography, a non-invasive imaging technique, has significantly advanced medical diagnostics by enabling the visualization of internal structures and abnormalities within the human body. With the advent of digital radiography, clinicians can obtain high-resolution images promptly, leading to faster diagnoses and informed treatment decisions. Radiography plays a pivotal role in detecting fractures, tumors, infections, and various other conditions, allowing for timely interventions and improved patient outcomes. Moreover, its widespread accessibility and cost-effectiveness make it an indispensable tool in healthcare settings worldwide. On the other hand, radiotherapy, a branch of medical science that utilizes high-energy radiation, has become an integral component of cancer treatment and management. By precisely targeting and damaging cancerous cells, radiotherapy offers a potent strategy to control tumor growth and, in many cases, leads to cancer eradication. Additionally, radiotherapy is often used in combination with surgery and chemotherapy, providing a multifaceted approach to combat cancer comprehensively. The continuous advancements in radiotherapy techniques, such as intensity-modulated radiotherapy and stereotactic radiosurgery, have further improved treatment precision while minimizing damage to surrounding healthy tissues. Furthermore, radiography and radiotherapy have demonstrated their worth beyond oncology. Radiography is instrumental in guiding various medical procedures, including catheter placement, joint injections, and dental evaluations, reducing complications and enhancing procedural accuracy. On the other hand, radiotherapy finds applications in non-cancerous conditions like benign tumors, vascular malformations, and certain neurological disorders, offering therapeutic options for patients who may not benefit from traditional surgical interventions. In conclusion, radiography and radiotherapy stand as indispensable tools in modern medicine, driving transformative improvements in patient care and treatment outcomes. Their ability to diagnose, treat, and manage a wide array of medical conditions underscores their favor in medical practice. As technology continues to advance, radiography and radiotherapy will undoubtedly play an ever more significant role in shaping the future of healthcare, ultimately saving lives and enhancing the quality of life for countless individuals worldwide.

Keywords: radiology, radiotherapy, medical imaging, cancer treatment

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349 Human Wildlife Conflict Outside Protected Areas of Nepal: Causes, Consequences and Mitigation Strategies

Authors: Kedar Baral

Abstract:

This study was carried out in Mustang, Kaski, Tanahun, Baitadi, and Jhapa districts of Nepal. The study explored the spatial and temporal pattern of HWC, socio economic factors associated with it, impacts of conflict on life / livelihood of people and survival of wildlife species, and impact of climate change and forest fire onHWC. Study also evaluated people’s attitude towards wildlife conservation and assessed relevant policies and programs. Questionnaire survey was carried out with the 250 respondents, and both socio-demographic and HWC related information werecollected. Secondary information were collected from Divisional Forest Offices and Annapurna Conservation Area Project.HWC events were grouped by season /months/sites (forest type, distances from forest, and settlement), and the coordinates of the events were exported to ArcGIS. Collected data were analyzed using descriptive statistics in Excel and R Program. A total of 1465 events were recorded in 5 districts during 2015 and 2019. Out of that, livestock killing, crop damage, human attack, and cattle shed damage events were 70 %, 12%, 11%, and 7%, respectively. Among 151 human attack cases, 23 people were killed, and 128 were injured. Elephant in Terai, common leopard and monkey in Middle Mountain, and snow leopard in high mountains were found as major problematic animals. Common leopard attacks were found more in the autumn, evening, and on human settlement area. Whereas elephant attacks were found higher in winter, day time, and on farmland. Poor people farmers were found highly victimized, and they were losing 26% of their income due to crop raiding and livestock depredation. On the other hand, people are killing many wildlife in revenge, and this number is increasing every year. Based on the people's perception, climate change is causing increased temperature and forest fire events and decreased water sources within the forest. Due to the scarcity of food and water within forests, wildlife are compelled to dwell at human settlement area, hence HWC events are increasing. Nevertheless, more than half of the respondents were found positive about conserving entire wildlife species. Forests outside PAs are under the community forestry (CF) system, which restored the forest, improved the habitat, and increased the wildlife.However, CF policies and programs were found to be more focused on forest management with least priority on wildlife conservation and HWC mitigation. Compensation / relief scheme of government for wildlife damage was found some how effective to manage HWC, but the lengthy process, being applicable to the damage of few wildlife species and highly increasing events made it necessary to revisit. Based on these facts, the study suggest to carry out awareness generation activities to the poor farmers, linking the property of people with the insurance scheme, conducting habitat management activities within CF, promoting the unpalatable crops, improvement of shed house of livestock, simplifying compensation scheme and establishing a fund at the district level and incorporating the wildlife conservation and HWCmitigation programs in CF. Finally, the study suggests to carry out rigorous researches to understand the impacts of current forest management practices on forest, biodiversity, wildlife, and HWC.

Keywords: community forest, conflict mitigation, wildlife conservation, climate change

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348 Modeling Engagement with Multimodal Multisensor Data: The Continuous Performance Test as an Objective Tool to Track Flow

Authors: Mohammad H. Taheri, David J. Brown, Nasser Sherkat

Abstract:

Engagement is one of the most important factors in determining successful outcomes and deep learning in students. Existing approaches to detect student engagement involve periodic human observations that are subject to inter-rater reliability. Our solution uses real-time multimodal multisensor data labeled by objective performance outcomes to infer the engagement of students. The study involves four students with a combined diagnosis of cerebral palsy and a learning disability who took part in a 3-month trial over 59 sessions. Multimodal multisensor data were collected while they participated in a continuous performance test. Eye gaze, electroencephalogram, body pose, and interaction data were used to create a model of student engagement through objective labeling from the continuous performance test outcomes. In order to achieve this, a type of continuous performance test is introduced, the Seek-X type. Nine features were extracted including high-level handpicked compound features. Using leave-one-out cross-validation, a series of different machine learning approaches were evaluated. Overall, the random forest classification approach achieved the best classification results. Using random forest, 93.3% classification for engagement and 42.9% accuracy for disengagement were achieved. We compared these results to outcomes from different models: AdaBoost, decision tree, k-Nearest Neighbor, naïve Bayes, neural network, and support vector machine. We showed that using a multisensor approach achieved higher accuracy than using features from any reduced set of sensors. We found that using high-level handpicked features can improve the classification accuracy in every sensor mode. Our approach is robust to both sensor fallout and occlusions. The single most important sensor feature to the classification of engagement and distraction was shown to be eye gaze. It has been shown that we can accurately predict the level of engagement of students with learning disabilities in a real-time approach that is not subject to inter-rater reliability, human observation or reliant on a single mode of sensor input. This will help teachers design interventions for a heterogeneous group of students, where teachers cannot possibly attend to each of their individual needs. Our approach can be used to identify those with the greatest learning challenges so that all students are supported to reach their full potential.

Keywords: affective computing in education, affect detection, continuous performance test, engagement, flow, HCI, interaction, learning disabilities, machine learning, multimodal, multisensor, physiological sensors, student engagement

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347 The Cooperation among Insulin, Cortisol and Thyroid Hormones in Morbid Obese Children and Metabolic Syndrome

Authors: Orkide Donma, Mustafa M. Donma

Abstract:

Obesity, a disease associated with a low-grade inflammation, is a risk factor for the development of metabolic syndrome (MetS). So far, MetS risk factors such as parameters related to glucose and lipid metabolisms as well as blood pressure were considered for the evaluation of this disease. There are still some ambiguities related to the characteristic features of MetS observed particularly in pediatric population. Hormonal imbalance is also important, and quite a lot information exists about the behaviour of some hormones in adults. However, the hormonal profiles in pediatric metabolism have not been cleared yet. The aim of this study is to investigate the profiles of cortisol, insulin, and thyroid hormones in children with MetS. The study population was composed of morbid obese (MO) children without (Group 1) and with (Group 2) MetS components. WHO BMI-for age and sex percentiles were used for the classification of obesity. The values above 99 percentile were defined as morbid obesity. Components of MetS (central obesity, glucose intolerance, high blood pressure, high triacylglycerol levels, low levels of high density lipoprotein cholesterol) were determined. Anthropometric measurements were performed. Ratios as well as obesity indices were calculated. Insulin, cortisol, thyroid stimulating hormone (TSH), free T3 and free T4 analyses were performed by electrochemiluminescence immunoassay. Data were evaluated by statistical package for social sciences program. p<0.05 was accepted as the degree for statistical significance. The mean ages±SD values of Group 1 and Group 2 were 9.9±3.1 years and 10.8±3.2 years, respectively. Body mass index (BMI) values were calculated as 27.4±5.9 kg/m2 and 30.6±8.1 kg/m2, successively. There were no statistically significant differences between the ages and BMI values of the groups. Insulin levels were statistically significantly increased in MetS in comparison with the levels measured in MO children. There was not any difference between MO children and those with MetS in terms of cortisol, T3, T4 and TSH. However, T4 levels were positively correlated with cortisol and negatively correlated with insulin. None of these correlations were observed in MO children. Cortisol levels in both MO as well as MetS group were significantly correlated. Cortisol, insulin, and thyroid hormones are essential for life. Cortisol, called the control system for hormones, orchestrates the performance of other key hormones. It seems to establish a connection between hormone imbalance and inflammation. During an inflammatory state, more cortisol is produced to fight inflammation. High cortisol levels prevent the conversion of the inactive form of the thyroid hormone T4 into active form T3. Insulin is reduced due to low thyroid hormone. T3, which is essential for blood sugar control- requires cortisol levels within the normal range. Positive association of T4 with cortisol and negative association of it with insulin are the indicators of such a delicate balance among these hormones also in children with MetS.

Keywords: children, cortisol, insulin, metabolic syndrome, thyroid hormones

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