Search results for: familial functioning
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 898

Search results for: familial functioning

358 Cognitive Effects of Repetitive Transcranial Magnetic Stimulation in Patients with Parkinson's Disease

Authors: Ana Munguia, Gerardo Ortiz, Guadalupe Gonzalez, Fiacro Jimenez

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Parkinson's disease (PD) is a neurodegenerative disorder that causes motor and cognitive symptoms. The first-choice treatment for these patients is pharmacological, but this generates several side effects. Because of that new treatments were introduced such as Repetitive Transcranial Magnetic Stimulation (rTMS) in order to improve the life quality of the patients. Several studies suggest significant changes in motor symptoms. However, there is a great diversity in the number of pulses, amplitude, frequency and stimulation targets, which results in inconsistent data. In addition, these studies do not have an analysis of the neuropsychological effects of the treatment. The main purpose of this study is to evaluate the impact of rTMS on the cognitive performance of 6 patients with H&Y III and IV (45-65 years, 3 men and 3 women). An initial neuropsychological and neurological evaluation was performed. Patients were randomized into two groups; in the first phase one received rTMS in the supplementary motor area, the other group in the dorsolateral prefrontal cortex contralateral to the most affected hemibody. In the second phase, each group received the stimulation in the area that he had not been stimulated previously. Reassessments were carried out at the beginning, at the end of each phase and a follow-up was carried out 6 months after the conclusion of the stimulation. In these preliminary results, it is reported that there's no statistically significant difference before and after receiving rTMS in the neuropsychological test scores of the patients, which suggests that the cognitive performance of patients is not detrimental. There are even tendencies towards an improvement in executive functioning after the treatment. What added to motor improvement, showed positive effects in the activities of the patients' daily life. In a later and more detailed analysis, will be evaluated the effects in each of the patients separately in relation to the functionality of the patients in their daily lives.

Keywords: Parkinson's disease, rTMS, cognitive, treatment

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357 Cognitive Rehabilitation in Schizophrenia: A Review of the Indian Scenario

Authors: Garima Joshi, Pratap Sharan, V. Sreenivas, Nand Kumar, Kameshwar Prasad, Ashima N. Wadhawan

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Schizophrenia is a debilitating disorder and is marked by cognitive impairment, which deleteriously impacts the social and professional functioning along with the quality of life of the patients and the caregivers. Often the cognitive symptoms are in their prodromal state and worsen as the illness progresses; they have proven to have a good predictive value for the prognosis of the illness. It has been shown that intensive cognitive rehabilitation (CR) leads to improvements in the healthy as well as cognitively-impaired subjects. As the majority of population in India falls in the lower to middle socio-economic status and have low education levels, using the existing packages, a majority of which are developed in the West, for cognitive rehabilitation becomes difficult. The use of technology is also restricted due to the high costs involved and the limited availability and familiarity with computers and other devices, which pose as an impedance for continued therapy. Cognitive rehabilitation in India uses a plethora of retraining methods for the patients with schizophrenia targeting the functions of attention, information processing, executive functions, learning and memory, and comprehension along with Social Cognition. Psychologists often have to follow an integrative therapy approach involving social skills training, family therapy and psychoeducation in order to maintain the gains from the cognitive rehabilitation in the long run. This paper reviews the methodologies and cognitive retaining programs used in India. It attempts to elucidate the evolution and development of methodologies used, from traditional paper-pencil based retraining to more sophisticated neuroscience-informed techniques in cognitive rehabilitation of deficits in schizophrenia as home-based or supervised and guided programs for cognitive rehabilitation.

Keywords: schizophrenia, cognitive rehabilitation, neuropsychological interventions, integrated approached to rehabilitation

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356 Investigating Role of Traumatic Events in a Pakistani Sample

Authors: Khadeeja Munawar, Shamsul Haque

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The claim that traumatic events influence the recalled memories and mental health has received mixed empirical support. This study examines the memories of a sample drawn from Pakistan, a country that has witnessed many life-changing socio-political events, wars, and natural disasters in 72 years of its history. A sample of 210 senior citizens (Mage = 64.35, SD = 6.33) was recruited from Pakistan. The aim was to investigate if participants retrieved more memories related to past traumatic events using a word-cueing technique. Each participant reported ten memories to ten neutral cue words. The results revealed that past traumatic events were not adversely affecting the memories and mental health of participants. When memories were plotted with respect to the ages at which the events happened, a pronounced bump at 11-20 years of age was seen. Memories within as well as outside of the bump were mostly positive. The multilevel logistic regression modelling showed that the memories recalled were personally important and played a role in enhancing resilience. The findings revealed that despite facing an array of ethnic, religious, political, economic, and social conflicts, the participants were resilient, recalled predominantly positive memories, and had intact mental health. The findings have clinical implications in Cognitive Behavioral Therapy (CBT). The patients can be made aware of their negative emotions, troublesome/traumatic memories, and the distorted thinking patterns and their memories can be restructured. The findings can also be used to teach Memory Specificity Training (MEST) by psycho-educating the patients around changes in memory functioning and enhancing the recall of memories, which are more specific, vivid, and filled with sensory details.

Keywords: cognitive behavioral therapy, memories, mental health, resilience, trauma

Procedia PDF Downloads 127
355 Lighting Consumption Analysis in Retail Industry: Comparative Study

Authors: Elena C. Tamaş, Grațiela M. Țârlea, Gianni Flamaropol, Dragoș Hera

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This article is referring to a comparative study regarding the electrical energy consumption for lighting on diverse types of big sizes commercial buildings built in Romania after 2007, having 3, 4, 5 versus 8, 9, 10 operational years. Some buildings have installed building management systems (BMS) to monitor also the lighting performances starting with the opening days till the present days but some have chosen only local meters to implement. Firstly, for each analyzed building, the total required energy power and the energy power consumption for lighting were calculated depending on the lamps number, the unit power and the average daily running hours. All objects and installations were chosen depending on the destination/location of the lighting (exterior parking or access, interior or covering parking, building interior and building perimeter). Secondly, to all lighting objects and installations, mechanical counters were installed, and to the ones linked to BMS there were installed the digital meters as well for a better monitoring. Some efficient solutions are proposed to improve the power consumption, for example the 1/3 lighting functioning for the covered and exterior parking lighting to those buildings if can be done. This type of lighting share can be performed on each level, especially on the night shifts. Another example is to use the dimmers to reduce the light level, depending on the executed work in the respective area, and a 30% power energy saving can be achieved. Using the right BMS to monitor, the energy consumption depending on the average operational daily hours and changing the non-performant unit lights with the ones having LED technology or economical ones might increase significantly the energy performances and reduce the energy consumption of the buildings.

Keywords: commercial buildings, energy performances, lightning consumption, maintenance

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354 Influence of Genetic Counseling in Family Dynamics in Patients with Deafness in Merida, Yucatán, Mexico

Authors: Damaris Estrella Castillo, Zacil ha Vilchis Zapata, Leydi Peraza Gómez

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Hearing loss is an etiologically heterogeneous condition, where almost 60% is genetic in origin, 20% is due to environmental factors, and 20% have unknown causes. However, it is now known that the gene, GJB2, which encodes the connexin 26 protein, accounts for a large percentage of non-syndromic genetic hearing loss, and variants in this gene have been identified to be a common cause of hereditary hearing loss in many populations. The literature reports that the etiology in deafness helps improve family functioning but low-income countries this is difficult. Therefore, it is difficult to contribute the right of families to know about the genetic risk in future pregnancies as well as determining the certainty of being a carrier or affected. In order to assess the impact of genetic counseling and the functionality, 100 families with at least one child with profound hearing loss, were evaluated by specialists in audiology, clinical genetics and psychology. Targeted mutation analysis for one of the two known large deletions of upstream of GJB2/GJB6 gene (35delG; and including GJB2 regulatory sequences and GJB6) were performed in patients with diagnosis of non-syndromic hearing loss. Genetic counseling was given to all parents and primary caregivers, and APGAR family test was applied before and after the counseling. We analyzed a total of 300 members (children, parents) to determine the presence of the GJB2 gene mutation. Twelve patients (carriers and affected) were positive for the mutation, from 5 different families. The subsequent family APGAR testing and genetic counseling, showed that 14% perceived their families as functional, 62 % and 24 % moderately functional dysfunctional. This shows the importance of genetic counseling in the perception of family function that can directly impact the quality of life of these families.

Keywords: family dynamics, deafness, APGAR, counseling

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353 Chitosan Stabilized Oil-in-Water Pickering Emulsion Optimized for Food-Grade Application

Authors: Ankit Patil, Tushar D. Deshpande, Yogesh M. Nimdeo

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Pickering emulsions (PE) were developed in response to increased demand for organic, eco-friendly, and biocompatible products. These emulsions are usually stabilized by solid particles. In this research, we created chitosan-based sunflower oil-in-water (O/W) PE without the need for a surfactant. In our work, we employed chitosan, a biopolymer derived from chitin, as a stabilizer. This decision was influenced by chitosan's biocompatibility and biodegradability, as well as its anti-inflammatory and antibacterial capabilities. It also has other functional properties, such as antioxidant activity, a probiotic delivery mechanism, and the ability to encapsulate bioactive compounds. The purpose of this study was to govern key parameters that can be changed to obtain stable PE, such as the concentration of chitosan (0.3-0.5 wt.%), the concentration of oil (0.8-1 vol%), the pH of the emulsion (3-7) manipulated by the addition of 1M HCl/ 4M NaOH, and the amount of electrolyte (NaCl-0-300mM) added to increase or decrease ionic strength. A careful combination of these properties resulted in the production of the most stable and optimal PE. Particle size study found that emulsions with pH 6, 0.4% chitosan, and 300 mM salts were exceptionally stable, with droplet size 886 nm, PI of 0.1702, and zeta potential of 32.753.83 mV. It is fair to infer that when ionic strength rises, particle size, zeta potential, and PI value decrease. A lower PI value suggests that emulsion nanoparticles are more homogeneous. The addition of sodium chloride increases the ionic strength of the emulsion, facilitating the formation of more compact and ordered particle layers. These findings provide light on the creation of stimulus-responsive chitosan-based PE capable of encapsulating bioactive materials, functioning as antioxidants, and serving as food-grade emulsifiers.

Keywords: pickering emulsion, biocompatibility, eco-friendly, chitosan

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352 Rhizosphere Microbiome Involvement in the Natural Suppression of Soybean Cyst Nematode in Disease Suppressive Soil

Authors: M. Imran Hamid, Muzammil Hussain, Yunpeng Wu, Meichun Xiang, Xingzhong Liu

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The rhizosphere microbiome elucidate multiple functioning in the soil suppressiveness against plant pathogens. Soybean rhizosphere microbial communities may involve in the natural suppression of soybean cyst nematode (SCN) populations in disease suppressive soils. To explore these ecological mechanisms of microbes, a long term monoculture suppressive soil were taken into account for further investigation to test the disease suppressive ability by using different treatments. The designed treatments are as, i) suppressive soil (S), ii) conducive soil (C), iii) conducive soil mixed with 10% (w/w) suppressive soil (CS), iv) suppressive soil treated at 80°C for 1 hr (S80), and v) suppressive soil treated with formalin (SF). By using an ultra-high-throughput sequencing approach, we identified the key bacterial and fungal taxa involved in SCN suppression. The Phylum-level investigation of bacteria revealed that Actinobacteria, Bacteroidetes, and Proteobacteria in the rhizosphere soil of soybean seedlings were more abundant in the suppressive soil than in the conducive soil. The phylum-level analysis of fungi in rhizosphere soil indicated that relative abundance of Ascomycota was higher in suppressive soil than in the conducive soil, where Basidiomycota was more abundant. Transferring suppressive soil to conducive soil increased the population of Ascomycota in the conducive soil by lowering the populations of Basidiomycota. The genera, such as, Pochonia, Purpureocillium, Fusarium, Stachybotrys that have been well documented as bio-control agents of plant nematodes were far more in the disease suppressive soils. Our results suggested that the plants engage a subset of functional microbial groups in the rhizosphere for initial defense upon nematode attack and protect the plant roots later on by nematodes to response for suppression of SCN in disease-suppressive soils.

Keywords: disease suppressive soil, high-throughput sequencing, rhizosphere microbiome, soybean cyst nematode

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351 O-LEACH: The Problem of Orphan Nodes in the LEACH of Routing Protocol for Wireless Sensor Networks

Authors: Wassim Jerbi, Abderrahmen Guermazi, Hafedh Trabelsi

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The optimum use of coverage in wireless sensor networks (WSNs) is very important. LEACH protocol called Low Energy Adaptive Clustering Hierarchy, presents a hierarchical clustering algorithm for wireless sensor networks. LEACH is a protocol that allows the formation of distributed cluster. In each cluster, LEACH randomly selects some sensor nodes called cluster heads (CHs). The selection of CHs is made with a probabilistic calculation. It is supposed that each non-CH node joins a cluster and becomes a cluster member. Nevertheless, some CHs can be concentrated in a specific part of the network. Thus, several sensor nodes cannot reach any CH. to solve this problem. We created an O-LEACH Orphan nodes protocol, its role is to reduce the sensor nodes which do not belong the cluster. The cluster member called Gateway receives messages from neighboring orphan nodes. The gateway informs CH having the neighboring nodes that not belong to any group. However, Gateway called (CH') attaches the orphaned nodes to the cluster and then collected the data. O-Leach enables the formation of a new method of cluster, leads to a long life and minimal energy consumption. Orphan nodes possess enough energy and seeks to be covered by the network. The principal novel contribution of the proposed work is O-LEACH protocol which provides coverage of the whole network with a minimum number of orphaned nodes and has a very high connectivity rates.As a result, the WSN application receives data from the entire network including orphan nodes. The proper functioning of the Application requires, therefore, management of intelligent resources present within each the network sensor. The simulation results show that O-LEACH performs better than LEACH in terms of coverage, connectivity rate, energy and scalability.

Keywords: WSNs; routing; LEACH; O-LEACH; Orphan nodes; sub-cluster; gateway; CH’

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350 Neuroprotective Effect of Germinated Dolichos lablab on 6-Hydroxy Dopamine (6-OHDA) Induced Toxicity in SH-SY5Y Neuroblastoma Cell

Authors: Taek Hwan Lee, Moon Ho Do, Lalita Subedi, Young Un Park, Sun Yeou Kim

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Natural and artificial toxic substances namely neurotoxins induce the bitter effect in the nervous system termed as neurotoxicity. It can modulate the normal functioning of the nervous system either hyperactivate it or damage homeostasis of neuronal system. Neurotoxins induced toxicity ultimately kills the neuron. The present study investigated the neuroprotective effects of germinated Dolichos lablab on 6-hydroxydopamine (6-OHDA)-induced neurotoxicity using SH-SY5Y neuroblastoma cells. Germination is a process of plant growth from a seed. Sprouting of a seedling from a seed induced many molecular changes in the seed in order to prepare it for further growth. Because of these molecular and chemical changes, the neuroprotective effect of Dolichos lablab is higher in the germinated form than in the normal condition. SH-SY5Y cells were treated with Dolichos lablab extract (50, 100 g/ml) followed by 6-OHDA (25M) induced toxicity. Cell Viability was measured to check the cell survival against 6-OHDA induced toxicity using MTT assay. Dolichos lablab showed a neuroprotective effect against 6-OHDA induced neuronal cell death in neuroblastoma cell at a higher concentration of 100g/ml however the effect is much better even at the lower concentration after germination 50g/ml. Cell survival was increased dramatically after 15 h of germination and increased with time of germination in concentration dependent manner. Trigonelline as a representative compound was validated in germinated Dolichos lablab by HPLC analysis that might enhance the neuroprotective effect of Dolichos lablab. This result suggests that Dolichos lablab possess neuroprotective effect in neuroblastoma cells against 6-OHDA however its activity was more potent in the germinated form.

Keywords: dolichos lablab, germination, neuroprotection, trigonelline

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349 Use of a Symptom Scale Based on Degree of Functional Impairment for Acute Concussion

Authors: Matthew T. McCarthy, Sarah Janse, Natalie M. Pizzimenti, Anthony K. Savino, Brian Crosser, Sean C. Rose

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Concussion is diagnosed clinically using a comprehensive history and exam, supported by ancillary testing. Frequently, symptom checklists are used as part of the evaluation of concussion. Existing symptom scales are based on a subjective Likert scale, without relation of symptoms to clinical or functional impairment. This is a retrospective review of 133 patients under age 30 seen in an outpatient neurology practice within 30 days of a probable or definite concussion. Each patient completed 2 symptom checklists at the initial visit – the SCAT-3 symptom evaluation (22 symptoms, 0-6 scale) and a scale based on the degree of clinical impairment for each symptom (22 symptoms, 0-3 scale related to functional impact of the symptom). Final clearance date was determined by the treating physician. 60.9% of patients were male with mean age 15.7 years (SD 2.3). Mean time from concussion to first visit was 6.9 days (SD 6.2), and 101 patients had definite concussions (75.9%), while 32 were diagnosed as probable (24.1%). 94 patients had a known clearance date (70.7%) with mean clearance time of 20.6 days (SD 18.6) and median clearance time of 19 days (95% CI 16-21). Mean total symptom score was 27.2 (SD 22.9) on the SCAT-3 and 14.7 (SD 11.9) for the functional impairment scale. Pearson’s correlation between the two scales was 0.98 (p < 0.001). After adjusting for patient and injury characteristics, an equivalent increase in score on each scale was associated with longer time to clearance (SCAT-3 hazard ratio 0.885, 95%CI 0.835-0.938, p < 0.001; functional impairment scale hazard ratio 0.851, 95%CI 0.802-0.902, p < 0.001). A concussion symptom scale based on degree of functional impairment correlates strongly with the SCAT-3 scale and demonstrates a similar association with time to clearance. By assessing the degree of impact on clinical functioning, this symptom scale reflects a more intuitive approach to rating symptoms and can be used in the management of concussion.

Keywords: checklist, concussion, neurology, scale, sports, symptoms

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348 Ergosterol Regulated Functioning of Rubisco in Tomato

Authors: Prabir Kumar Paul, Joyeeta Mitra

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Ergosterol, is an important fungal metabolite on phylloplane which is not synthesised by plants. However, the functional requirement of ergosterol to the plants is still an enigma. Being ubiquitously present in all plants except algae needs an insight into its physiological implication. The present study aimed at understanding if and how ergosterol influences the physiology of chloroplast particularly the activity of RuBisCo and carbonic anhydrase. The concept of the study was based on one of our earlier observation of enhanced Hills reaction in plants treated with fungal metabolites which contained ergosterol. The fungal metabolite treated plants had a significantly high concentration of photosynthetic pigments. Eight-week-old tomato plants raised under aseptic conditions at 25 + 10 C, 75 % relative humidity and 12 hour L/D photoperiod. Metabolites of Aspergillus niger and Fusarium oxysporum were sprayed on plants either singly or in a 1: 1 combination. A separate group of plants was also treated with 0.5, 1.0, 3.0, 5.0. 7.0 mg ergosterol / ml of n- heptane. Control plants were treated with sterile distilled water only. Plants were sampled at 24, 48, 72 and 96 hours of treatment. RuBisCo and carbonic anhydrase was estimated from sampled leaves. RuBisCo was separated on 1D SDS-PAGE and subjected to MALDI – TOF- TOF – MS analysis. The presence of ergosterol in fungal metabolites was confirmed. Fungal metabolites significantly enhanced the concentration and activity of RuBisCo and carbonic anhydrase. The Vmax activity of the enzymes was significantly high in metabolite treated plants. 1:1 mix of metabolite was more effective than when applied individually. Insilico analysis revealed, RuBisCo subunits had a binding site for ergosterol and in its presence affinity of Co2 to the enzyme increased by several folds. Invivo activity of RuBisCo was significantly elicited by ergosterol. Results of the present study indicate that ergosterol from phylloplane microfungi probably regulates the binding of Co2 to RuBisCo along with activity of carbonic anhydrase thereby modulating the physiology of choloroplast.

Keywords: carbonic anhydrase, ergosterol, phylloplane, RuBisCo

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347 The Shrinking Nature of Parliamentary Immunity in Kenya: A Proposal for Judicial Restraint

Authors: Oscar Sang, Shadrack David Rotich

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Parliamentary immunity is grounded on the notion that parliaments need certain rights or immunities to ensure they can operate independently make fair and impartial decisions without capitulating to political pressure or intimidation. The 2013 election in Kenya marked an important milestone in the development of the law of parliamentary privilege. Such importance relates to the dramatic increase in the number of legislatures in the country from one unicameral parliament, to a bicameral national parliament and forty-seven other regional legislative assemblies. The increase in legislatures has resulted in a dramatic increase in political contestations which have led to legal wrangles. The judiciary in Kenya, once considered submissive, has been invited to arbitrate on various matters pitting individual rights and parliamentary privilege and have invalidated a number of legislative action. While judicial intervention is indeed necessary to ensure that legislatures in Kenya live true to the constitutional aspirations of the Kenyan people, certain judicial decisions have had an effect on eroding parliamentary immunity. This paper highlights a number of instances in which it could be argued that parliamentary privilege came under attack by the courts in Kenya. The paper aims to make a case that while Kenya’s progressive constitution necessitates the scope and extent of legislature’s immunities and privilege to be determined by the courts, it is important that courts exercise restraint in its review of legislative action. The paper makes the argument that unrestrained judicial action in Kenya on questions within the realm parliamentary privilege may undermine the functioning of Kenya’s legislatures. The paper explores approaches taken by a number of jurisdictions in establishing a proper balance between maintaining a viable parliamentary privilege regime in a rights-based constitutional system.

Keywords: Kenya, constitution, judicial restraint, parliamentary privilege

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346 Participatory Democracy to the Contemporary Problems of Polish Social Policy

Authors: Agnieszka Szczudlińska-Kanoś

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Nowadays the participation of citizens in public life increasingly effect on management at all levels of public authority. Today, however, democratic systems in many countries, also in Poland, based on the first - on the institutions of representative democracy, which is mainly on elections, party activity, on the other hand - on the basic instruments of direct democracy, which, in particular, we can include a referendum or initiative of citizenship - although these are often rather complementary. Other forms of participatory democracy, such as deliberative democracy, participatory budgeting, public consultation in practice in many countries are still rare. Appropriate use of the potential invested in participatory democracy can bring enormous and multilateral benefits. On the one hand, local and regional communities taking an active part in public life express their needs, point out problems and thus affect the decisions of public authorities. Authorities using knowledge acquired from the citizens also implement the policy tailored to their needs, thus obtaining support in the next election. The purpose of this study is to show how the Polish citizens affect to resolve issues of social policy pursued at different levels of government. This problem is very important because today the observed changes seen in virtually all fields of life create new social problems, which nowadays are no longer only the problems of the region, the country but they are international, global issues. From such this perspective we should talk about them, discuss, try to solve at all levels. Article will be useful not only theorists involved in the management of the public, local government, or social but also practitioners - local government acting as their functions at different levels of government. Conclusions drawn from the publication will also be useful to politicians and those directly affecting for: functioning social security systems, the scope and quality of public services and the overall shape of the contemporary social policy in different countries.

Keywords: social policy, local government, social participation, social services

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345 Consequences of Transformation of Modern Monetary Policy during the Global Financial Crisis

Authors: Aleksandra Szunke

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Monetary policy is an important pillar of the economy, directly affecting on the condition of banking sector. Depending on the strategy may both support functioning of banking institutions, as well as limit their excessively risky activities. The literature studies indicate a large number of publications, which include characteristics of initiatives, implemented by central banks during the global financial crisis and the potential effects of the use of non-standard monetary policy instruments. However, the empirical evidence about their effects and real consequences for the financial markets are still not final. Even before the escalation of instability, Bernanke, Reinhart, and Sack (2004) analyzed the effectiveness of various unconventional monetary tools in lowering long-term interest rates in the United States and Japan. The obtained results largely confirmed the effectiveness of the zero-interest-rate policy and Quantitative Easing (QE) in achieving the goal of reducing long-term interest rates. Japan, considered as the precursor of QE policy, also conducted research about the consequences of non-standard instruments, implemented to restore financial stability of the country. Although the literature about the effectiveness of Quantitative Easing in Japan is extensive, it does not uniquely specify whether it brought permanent effects. The main aim of the study is to identify the implications of non-standard monetary policy, implemented by selected central banks (the Federal Reserve System, Bank of England and European Central Bank), paying particular attention to the consequences into three areas: the size of money supply, financial markets, and the real economy.

Keywords: consequences of modern monetary policy, quantitative easing policy, banking sector instability, global financial crisis

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344 A Study on Soil Micro-Arthropods Assemblage in Selected Plantations in The Nilgiris, Tamilnadu

Authors: J. Dharmaraj, C. Gunasekaran

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Invertebrates are the reliable ecological indicators of disturbance of the forest ecosystems and they respond to environment changes more quickly than other fauna. Among these the terrestrial invertebrates are vital to functioning ecosystems, contributing to processes such as decomposition, nutrient cycling and soil fertility. The natural ecosystems of the forests have been subject to various types of disturbances, which lead to decline of flora and fauna. The comparative diversity of micro-arthropods in natural forest, wattle plantation and eucalyptus plantations were studied in Nilgiris. The study area was divided in to five major sites (Emerald (Site-I), Thalaikundha (Site-II), Kodapmund (Site-III), Aravankad (Site-IV), Kattabettu (Site-V). The research was conducted during period from March 2014 to August 2014. The leaf and soil samples were collected and isolated by using Berlese funnel extraction methods. Specimens were isolated and identified according to their morphology (Balogh 1972). In the present study results clearly showed the variation in soil pH, NPK (Major Nutrients) and organic carbon among the study sites. The chemical components of the leaf litters of the plantation decreased the diversity of micro-arthropods and decomposition rate leads to low amount of carbon and other nutrients present in the soil. Moreover eucalyptus and wattle plantations decreases the availability of the ground water source to other plantations and micro-arthropods and hences affects the soil fertility. Hence, the present study suggests to minimize the growth of wattle and eucalyptus tree plantations in the natural areas which may help to reduce the decline of forests.

Keywords: micro-arthropods, assemblage, berlese funnel, morphology, NPK, nilgiris

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343 Assessing Renewal Needs of Urban Water Infrastructure Systems: Case Study of Linköping in Sweden

Authors: Eman Hegazy, Stefan Anderberg, Joakim Krook

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Urban water infrastructure systems are central to functioning cities. For securing a continuous and efficient supply of the systems services, continuous investment, maintenance, and renewal are needed. Neglecting maintenance and renewal can lead to recurrent breakdown problems as systems age, which makes it more and more difficult to secure efficient long-term supply. Globally, many cities struggle with aging water infrastructure, often due to competing funding priorities. Investment in maintenance and renewal is not prioritized. The problem primarily stems from the challenge of reaping the benefits of investments promptly. The long-term benefits gained from investing in the renewal of water infrastructure may be achievable in the long run, resulting in the oversight of such investments. This leads to a build-up of "renewal debt" for future generations to inherit. Addressing this issue is difficult due to various contributing factors and the complex nature of the systems. The study aims to contribute to an increased understanding of the long-term management challenges of urban water infrastructure, the development of improved maintenance and renewal strategies through the examination of water infrastructure management, and the assessment of the adequacy of the maintenance and renewal in a case study, the city of Linköping, Sweden. Employing a multi-methods approach, this study utilized both qualitative and quantitative methods, including interviews, workshops, and data analysis. The findings of the study provided insights into the current status of the water and sewerage networks in Linkoping, highlighting the risks to ensuring reliable and sustainable water supply and discussing strategies for improving maintenance and renewal.

Keywords: case study, infrastructure management, renewal needs, Sweden, urban water infrastructure

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342 An Integrative Model of Job Characteristics Key Attitudes and Intention to Leave Among Faculty in Higher Education

Authors: Bhavna Malik

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The study is build on a theoretical framework that links characteristics of job, key attitudes and intention to leave, why faculty may be disengaging from institutional service. The literature indicates that job characteristics, key attitudes and intention to leave are very important for effective organizational functioning. In general, the literature showed that some job characteristics might be the antecedents of job satisfaction and the aggregate variable job scope was positively associated with organizational commitment, and these key attitudes predicted intention to leave negatively. The present study attempted to propose a new integrative model of the relationships among job characteristics, key attitudes, and intention to leave. The main purpose of the present study is to examine the effects of job characteristics on intention to leave. While examining the role of job characteristics, the mediating roles of key attitudes were taken into account in order to better understand how job characteristics affect the exhibition of intention to leave. The secondary purpose is to investigate the effects of job characteristics on key attitudes, and the effects of key attitudes on intention to leave. Job characteristics of remuneration, resource for professional activities, career opportunities were positively associated with the work attitude of job satisfaction. The aggregate job scope was positively associated with the work attitude of organizational commitment although no single job characteristic was significantly associated with organizational commitment. Commitment, however, did not significantly affect time spent on institutional service. Two job characteristics—time spent on research and time spent on teaching—were negatively associated with this behavior. In general, the literature showed that some job characteristics might be the antecedents of job satisfaction and the aggregate variable job scope was positively associated with organizational commitment, and these key attiudes predicted intention to leave negatively. In turn, job satisfaction and organizational commitment were negatively associated with the intention to leave. In addition to these, organizational commitment was negatively associated with the intention to leave. However, no significant direct association was found between job characteristics and intention to leave.

Keywords: Job Characteristics Model, job satisfaction, organizational commitment, intention to leave

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341 A Rapid Prototyping Tool for Suspended Biofilm Growth Media

Authors: Erifyli Tsagkari, Stephanie Connelly, Zhaowei Liu, Andrew McBride, William Sloan

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Biofilms play an essential role in treating water in biofiltration systems. The biofilm morphology and function are inextricably linked to the hydrodynamics of flow through a filter, and yet engineers rarely explicitly engineer this interaction. We develop a system that links computer simulation and 3-D printing to optimize and rapidly prototype filter media to optimize biofilm function with the hypothesis that biofilm function is intimately linked to the flow passing through the filter. A computational model that numerically solves the incompressible time-dependent Navier Stokes equations coupled to a model for biofilm growth and function is developed. The model is imbedded in an optimization algorithm that allows the model domain to adapt until criteria on biofilm functioning are met. This is applied to optimize the shape of filter media in a simple flow channel to promote biofilm formation. The computer code links directly to a 3-D printer, and this allows us to prototype the design rapidly. Its validity is tested in flow visualization experiments and by microscopy. As proof of concept, the code was constrained to explore a small range of potential filter media, where the medium acts as an obstacle in the flow that sheds a von Karman vortex street that was found to enhance the deposition of bacteria on surfaces downstream. The flow visualization and microscopy in the 3-D printed realization of the flow channel validated the predictions of the model and hence its potential as a design tool. Overall, it is shown that the combination of our computational model and the 3-D printing can be effectively used as a design tool to prototype filter media to optimize biofilm formation.

Keywords: biofilm, biofilter, computational model, von karman vortices, 3-D printing.

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340 Prevalence of Visual Impairment among School Children in Ethiopia: A Systematic Review and Meta-Analysis

Authors: Merkineh Markos Lorato, Gedefaw Diress Alene

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Introduction: Visual impairment is any condition of the eye or visual system that results in loss/reduction of visual functioning. It significantly influences the academic routine and social activities of children, and the effect is severe for low-income countries like Ethiopia. So, this study aimed to determine the pooled prevalence of visual impairment among school children in Ethiopia. Methods: Databases such as Medical Literature Analysis and Retrieval System Online, Excerpta Medica dataBASE, World Wide Web of Science, and Cochrane Library searched to retrieve eligible articles. In addition, Google Scholar and a reference list of the retrieved eligible articles were addressed. Studies that reported the prevalence of visual impairment were included to estimate the pooled prevalence. Data were extracted using a standardized data extraction format prepared in Microsoft Excel and analysis was held using STATA 11 statistical software. I² was used to assess the heterogeneity. Because of considerable heterogeneity, a random effect meta-analysis model was used to estimate the pooled prevalence of visual impairment among school children in Ethiopia. Results: The result of 9 eligible studies showed that the pooled prevalence of visual impairment among school children in Ethiopia was 7.01% (95% CI: 5.46, 8.56%). In the subgroup analysis, the highest prevalence was reported in South Nations Nationalities and Tigray region together (7.99%; 3.63, 12.35), while the lowest prevalence was reported in Addis Ababa (5.73%; 3.93, 7.53). Conclusion: The prevalence of visual impairment among school children is significantly high in Ethiopia. If it is not detected and intervened early, it will cause a lifetime threat to visually impaired school children, so that school vision screening program plan and its implementation may cure the life quality of future generations in Ethiopia.

Keywords: visual impairment, school children, Ethiopia, prevalence

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339 The Nutritional Status and the Kidney Function in Older Patients

Authors: Magdalena Barbara Kaziuk, Waldemar Kosiba

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Background: Obesity, particularly abdominal type, lead to accelerated progress of atherosclerosis and thus affects the functioning of various human organs. Non-HDL cholesterol includes residual risk of the cardiovascular diseases which persists in patients after achieved recommended level of LDL cholesterol. The maintenance of normal body mass index plays a particularly important role in both the prevention and treatment of chronic diseases. Materials and Methods: The study covered 96 patients (55 females, 42 males, age 66,9 +/-10,2 years). The nutritional status was determined with the Waist to Height Ratio (WHtR) and the Waist to Hip Ratio (WHR). A function of the kidney was evaluated by calculating the estimated glomerular filtration rate (eGFR) using the MDRD formula. Non-high-density lipoprotein cholesterol (non-HDL) is simply the difference between the total cholesterol concentration and the HDL cholesterol concentration. Results: The higher was level of non-HDL cholesterol, the lower eGFR had studied subjects (p<0.001). Significant correlation was found between higher WHtR and lower the eGFR (p=0.002). Also underweight (30% of patient) led to obtaining lower values of eGFR in subjects over 65 years old. The poorer nutrition the lower was glomerular filtration rate. Conclusions: Nutritional statuses of patients have a significant impact on the level of kidney function. Not only accumulated excess fat in the abdominal area, but also its deficiency affects the deterioration in renal filtration. Higher level of non-HDL not only raises the residual risk of the heart disease but also influences on kidney by worsening eGFR. Proper diet in connection with physical activity should lead to achieving good nutrition in these patients and protect their kidney function.

Keywords: nutrition, non-HDL cholesterol, glomerular filtration rate, lifestyle

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338 Comparing the Effects of Systemic Family Intervention on End Stage Renal Disease: Families of Different Modalities

Authors: Fenni Sim

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Background: The application of systemic family therapy approaches to community health cases have not gathered traction. In National Kidney Foundation, Singapore, the belief is that community support has great potential in helping End Stage Renal Failure (ESRF) patients manage the demands of their treatment regime, whether Hemodialysis (HD) or Peritoneal Dialysis(PD) and sustain them on the treatment. However, the current community support does not include family interventions and is largely nursing based. Although nursing support is well provided to patients, and their family members in issues related to treatment and compliance, complex family issues and dynamics arising from caregiver strain or pre-dialysis relationship strain might deter efforts in managing the challenges of the treatment. Objective: The objective of the study is to understand the potential scope of work provided by a social worker who is trained in systemic family therapy and the effects of these interventions. Methodology: 3 families on HD and 3 families on PD who have been receiving family intervention for the past 6 months would be chosen for the study. A qualitative interview would be conducted to review the effectiveness for the family. Scales such as SCORE-15, PHQ-9, and Zarit Burden were used to measure family functioning, depression, and caregiver’s burden for the families. Results: The research is still in preliminary phase. Conclusion: The study highlights the importance of family intervention for families with multiple stressors on different treatment modalities who might have different needs and challenges. Nursing support needs to be complemented with family-based support to manage complex family issues in order to achieve better health outcomes and improved family coping.

Keywords: complementing nursing support, end stage renal failure, healthcare, systemic approaches

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337 World Peace and Conflict Resolution: A Solution from a Buddhist Point of View

Authors: Samitharathana R. Wadigala

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The peace will not be established until the self-consciousness would reveal in the human beings. In this nuclear age, the establishment of a lasting peace on the earth represents the primary condition for the preservation of human civilization and survival of human beings. Nothing perhaps is so important and indispensable as the achievement and maintenance of peace in the modern world today. Peace in today’s world implies much more than the mere absence of war and violence. In the interdependent world of today the United Nations needs to be representative of the modern world and democratic in its functioning because it came into existence to save the generations from the scourge of war and conflict. Buddhism is the religion of peaceful co-existence and philosophy of enlightenment. Violence and conflict from the perspective of the Buddhist theory of interdependent origination (Paṭiccasamuppāda) are same with everything else in the world a product of causes and conditions. Buddhism is totally compatible with the congenial and peaceful global order. The canonical literature, doctrines, and philosophy of Buddhism are the best suited for inter-faith dialogue, harmony, and universal peace. Even today Buddhism can resurrect the universal brotherhood, peaceful co-existence and harmonious surroundings in the comity of nations. With its increasing vitality in regions around the world, many people today turn to Buddhism for relief and guidance at the time when peace seems to be a deferred dream more than ever. From a Buddhist point of view the roots of all unwholesome actions (Conflict) i. e. greed, hatred and delusion are viewed as the root cause of all human conflicts. Conflict often emanates from attachment to material things: pleasures, property, territory, wealth, economic dominance or political superiority. Buddhism has some particularly rich resources for deployment in dissolving conflict. Buddhism addresses the Buddhist perspective on the causes of conflict and ways to resolve conflict to realize world peace. The world has enough to satisfy every body’s needs but not every body’s greed.

Keywords: Buddhism, conflict-violence, peace, self-consciousness

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336 A Psychoanalytic Lens: Unmasked Layers of the Self among Post-Graduate Psychology Students in Surviving the COVID-19 Lockdown

Authors: Sharon Sibanda, Benny Motileng

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The World Health Organisation (WHO) identified the Sars-Cov-2 (COVID-19) as a pandemic on the 12ᵗʰ of March 2020, with South Africa recording its first case on the 5ᵗʰ of March 2020. The rapidly spreading virus led the South African government to implement one of the strictest nationwide lockdowns globally, resulting in the closing down of all institutions of higher learning effective March 18ᵗʰ 2020. Thus, this qualitative study primarily aimed to explore whether post-graduate psychology students were in a state of a depleted or cohesive self, post the psychological isolation of COVID-19 risk-adjusted level 5 lockdown. Semi-structured interviews from a qualitative interpretive approach comprising N=6 psychology post-graduate students facilitated a rich understanding of their intra-psychic experiences of the self. Thematic analysis of data gathered from the interviews illuminated how students were forced into the self by the emotional isolation of hard lockdown, with the emergence of core psychic conflict often defended against through external self-object experiences. The findings also suggest that lockdown stripped off this sample of psychology post-graduate students’ defensive escape from the inner self through external self-object distractions. The external self was stripped to the core of the internal self by the isolation of hard lockdown, thereby uncovering the psychic function of roles and defenses amalgamated throughout modern cultural consciousness that dictates self-functioning. The study suggests modelling reflexivity skills in the integration of internal and external self-experience dynamics as part of a training model for continued personal and professional development for psychology students.

Keywords: COVID-19, fragmentation, self-object experience, true/false self

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335 Endocrine Disruptors Effects on the 20-Hydroxyecdysone Concentration and the Vitellogenin Gene Expression in Gammarus sp.

Authors: Eric Gismondi, Aurelie Bigot-Clivot

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Endocrine disruptors (EDCs) are well known to disrupt the development and the reproduction of exposed organisms. Although this point has been studied in vertebrate models, the limited knowledge of the endocrine system of invertebrates makes the evaluation of EDCs effects difficult. However, invertebrates represent the major part of aquatic ecosystems, such as amphipods Gammaridea, which are crucial for their functioning (e.g., litter degradation, food resource). Moreover, gammarids are hosts of parasites such as vertically-transmitted microsporidia (microsporidia VT), which could be confounding factors in assessment of EDC effects. Indeed, some microsporidia VT could have endocrine effects by their own present in the host since it was observed for example, a feminization of juvenile males, which become phenotypic females. This work evaluated the impact of ethinylestradiol (EE₂, estrogenic), cyproterone acetate (CPA, anti-androgenic), 4-hydroxytamoxifen (4HT, anti-estrogenic) and 17α-methyltestosterone (17MT - androgenic), on the 20-hydroxyecdysone concentration (i.e. 20HE - molt process) and the vitellogenin gene expression (i.e. reproduction) in the freshwater amphipod Gammarus pulex, after a 96h laboratory exposure. In addition, the presence of microsporidia VT was verified in order to analyze the effect of this confounding factor. Results of this study shown that, although endocrine systems of invertebrates and vertebrates are different, EDCs proved in vertebrates could also affect biological functions hormonally controlled in invertebrates. Indeed, the molt process of crustaceans was disrupted in the first stage (i.e. 20-HE concentration) and therefore, could affect, at the long term, the population dynamic. In addition, it was observed that G. pulex was differently impacted according to the gender and parasitism, which underline the importance to take into account these confounding factors to better evaluate the EDCs impact on invertebrate populations.

Keywords: endocrine disruption, gammarus sp., molt, parasitism

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334 The Causes of Governance Inefficiency in the Financial Institutions: An Interdisciplinary Approach to the Theory of Corporate Governance

Authors: Emilia Klepczarek

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The Basel Committee on Banking Supervision and the OECD found problems with the mechanisms of corporate governance as one of the major causes of destabilization of the financial system and the subprime crisis in the years 2007-2010. In response to these allegations, there were formulated a number of recommendations aimed at improving the quality of supervisory standards in financial institutions. They relate mainly to risk management, remuneration policy, the competence of managers and board members and transparency issues. Nevertheless, a review of the empirical research conducted by the author does not allow for an unambiguous confirmation of the positive impact of the postulated standards on the stability of banking entities. There is, therefore, a presumption of the existence of hidden variables determining the effectiveness of the governance mechanisms. According to the author, this involves concepts arising from behavioral economics and economic anthropology, which allow for an explanation of the effectiveness of corporate governance institutions on the basis of the socio-cultural profile of its members. The proposed corporate governance culture theory indicates that the attributes of the members of the organization and organizational culture can determine the different effectiveness level of the governance processes in similar formal corporate governance structures. The aim of the presentation is, firstly, to draw attention to the vast discrepancies existing within the results of research on the effectiveness of the standards of corporate governance in the banking sector. Secondly, the author proposes an explanation of these differences on the basis of governance theory breaking with common paradigms. The corporate governance culture theory is focused on the identity of the individual and the scope of autonomy offered within his or her institution. The coexistence of these two conditions - the adequate behavioral profile and enough freedom to decide - is a prerequisite for the efficient functioning of the institutions of corporate governance, which can contribute to rehabilitating and strengthening the stability of the financial sector.

Keywords: autonomy, corporate governance, efficiency, governance culture

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333 The Economics of Ecosystem Services and Biodiversity: Valuing Ecotourism-Local Perspectives to Global Discourses-Stakeholders’ Analysis

Authors: Diptimayee Nayak

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Ecotourism has been recognised as a popular component of alternative tourism, which claims to guard host local environment and economy. This concept of ecological tourism (eco-tourism) has become more meaningful in evaluating the recreational function and services of any pristine ecosystem in context of ‘The Economics of Ecosystem and Biodiversity (TEEB)’. This ecotourism is said to be a local solution to the global problem of conserving ecosystems and optimising the utilisations of their services. This paper takes a case of recreational services of an Indian protected area ecosystems ‘Bhitarakanika mangrove protected area’ discussing how ecotourism is functioning taking the perspectives of different stakeholders. Specific stakeholders are taken for analysis, viz., tourists and local people, as they are believed to be the major beneficiaries of ecotourism. The stakeholders’ analysis is evaluated on the basis of travel cost techniques (by using truncated Poisson distribution model) for tourists and descriptive and analytical tools for local people. The evaluation of stakeholders’ analysis of ecotourism has gained its impetus after the formulation of Ecotourism guidelines by the Ministry of Environment and Forest (MoEF), Government of India. The paper concludes that ecotourism issues and challenges are site-specific and region-specific; without critically focussing challenges of ecotourism faced at local level the discourses of ecotourism at global level cannot be tackled. Mere integration and replication of policies at global level to be followed at local level will not be successful (top down policies). Rather mainstreaming the decision making process at local level with the global policy stature helps to solve global issues to a bigger extent (bottom up).

Keywords: ecosystem services, ecotourism, TEEB, economic valuation, stakeholders, travel cost techniques

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332 Effect of Physical and Breathing Exercises on Quality of Life and Psychophysical Status among Haemodialysis Patients: A Scoping Review

Authors: Noof Eid Al Shammari

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Background: Living with haemodialysis (HD) can impose several physical and social restrictions on the lives of individuals. Usually, the patient has three dialysis sessions per week that each run for three to four hours. This limits the social life of patients and causes a lower quality of life, in conjunction with the fact that people with chronic kidney disease must follow strict fluid and food regimens and use multiple medications. Given these factors, patients undergoing HD generally need psychological support. Objective: This scoping review study aims to evaluate the effectiveness of physical and breathing exercises on quality of life (QOL) and psychophysical status in patients undergoing HD. Methodology: Searches for relevant studies were performed in four databases (MEDLINE, CINAHL, Google Scholar, and PubMed) for articles published between 2011 and 2021. Out of all the searched literature, ten studies met the inclusion criteria (8 randomised controlled trials, one quasi-experimental study, and one pilot study), with a total of 588 patients. Different types of physical and breathing exercises were used (breathing, cardiopulmonary, and physical exercises). Results: All included studies in this scoping review revealed that most of the aerobic or anaerobic exercises, as well as breathing exercises, had a positive effect and significantly improved patients’ QOL, physical functioning, and psychological status. Conclusions: In this review, most of the articles demonstrated a positive effect of physical and breathing exercises on the QOL and psychophysical status of HD patients. Based on the findings of these studies, physical and breathing exercises were shown to improve muscle strength and other health-related aspects of QOL, including sexual, social, cognitive, and physical functions. However, more studies will need to be conducted with a larger sample to determine the best intervention that could be implemented and standardised in nursing care for patients undergoing HD.

Keywords: physical exercise, breathing exercises, quality of life, depression, hemodialysis

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331 Digital Environment as a Factor of the City's Competitiveness in Attracting Tourists: The Case of Yekaterinburg

Authors: Alexander S. Burnasov, Anatoly V. Stepanov, Maria Y. Ilyushkina

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In the conditions of transition to the digital economy, the digital environment of the city becomes one of the key factors of its tourism attractiveness. Modern digital environment makes travelling more accessible, improves the quality of travel services and the attractiveness of many tourist destinations. The digitalization of the industry allows to use resources more efficiently, to simplify business processes, to minimize risks, and to improve travel safety. The city promotion as a tourist destination in the foreign market becomes decisive in the digital environment. Information technologies are extremely important for the functioning of not only any tourist enterprise but also the city as a whole. In addition to solving traditional problems, it is also possible to implement some innovations from the tourism industry, such as the availability of city services in international systems of booking tickets and booking rooms in hotels, the possibility of early booking of theater and museum tickets, the possibility of non-cash payment by cards of international payment systems, Internet access in the urban environment for travelers. The availability of the city's digital services makes it possible to reduce ordering costs, contributes to the optimal selection of tourist products that meet the requirements of the tourist, provides increased transparency of transactions. The users can compare prices, features, services, and reviews of the travel service. The ability to share impressions with friends thousands of miles away directly affects the image of the city. It is possible to promote the image of the city in the digital environment not only through world-scale events (such as World Cup 2018, international summits, etc.) but also through the creation and management of services in the digital environment aimed at supporting tourism services, which will help to improve the positioning of the city in the global tourism market.

Keywords: competitiveness, digital environment, travelling, Yekaterinburg

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330 Extent to Which Various Academic Factors Cause Stress in Undergraduate Students at a University in Karachi and What Unhealthy Coping Strategies They Use

Authors: Sumara Khanzada

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This research investigated how much stress is induced by various study-related factors, in undergraduate students belonging to a renowned university in Karachi along with the unhealthy coping strategy the students use to manage the stress. The study related factors considered for the purpose of the study were curriculum and instruction based stress, teacher-student relationship, assessment system and different components related to academic work. A survey in which questionnaires were administered to hundred students was conducted. The data were analyzed quantitatively to determine the percentages of stress induced by the various factors. The study found that student-teacher relationship is the strongest factor that causes stress in the undergraduate students specifically when teachers do not deliver the lectures effectively and give assignments and presentations to students without clear guidelines and instructions. The second important factor that causes stress was the different components of academic life, such as, parental expectations and pressures to achieve one's goals. Assessment system was found to be the third key factor inducing stress and affecting students' cognitive and psychological functioning. The most commonly used unhealthy coping strategy for stress management was procrastination. In light of the findings, it is recommended that importance be given to teacher training to ensure that instruction is proper and healthy teacher student relationship exists. Effective support programs, workshops, seminars, and different awareness programs should be arranged for promoting awareness regarding mental health in educational institutions. Moreover, additional zero credit courses should be offered to teach students how to learn stress management and healthy coping skills. Sumara Khanzada Clinical Psychologist [email protected]

Keywords: Stress, coping stretigies, acadamic stress, relationship

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329 A Meta-Analysis on the Efficacy and Safety of TRC101/Veverimer 6g/Day in Increasing Serum Bicarbonate Levels of Chronic Kidney Disease Patients with Metabolic Acidosis

Authors: Hazel Ann Gianelli Cu, Stephanie Co, Radcliff Cobankiat

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Objectives: TRC101/Veverimer is an orally administered, non absorbed, sodium- and counterion-free hydrochloric acid binder for the treatment of metabolic acidosis associated with chronic kidney disease. The main objective of this study is to determine the efficacy of TRC 101/ Veverimer 6g/day in increasing serum bicarbonate levels of chronic kidney disease patients with metabolic acidosis. In this meta analysis, we also aim to look at safety outcomes, adverse effects and if the level of serum bicarbonate reached metabolic alkalosis when given TRC101/Veverimer. Methodology: Pubmed, Cochrane, Google Scholar and Science direct were used to search for randomized controlled trials about TRC101/Veverimer use in Chronic kidney disease patients with metabolic acidosis. Search strategy according to the Prisma checklist was done with evaluation of biases and synthesis of results using the Cochrane Review Manager software 5.4. Results: Two randomized controlled trials involving 371 chronic kidney disease patients were included in this study. Results show there was a significant increase in the serum bicarbonate level when given TRC101/Veverimer compared to the placebo. Both studies had a significant number of participants who completed the studies until the end. P value of <0.00001 was used in both studies with a confidence interval of 95%. Conclusion: TRC101/Veverimer 6g/day was shown to effectively and safely increase serum bicarbonate or achieve normalization in chronic kidney disease patients with metabolic acidosis as compared with a placebo. This was associated with delayed progression of kidney disease with improvement of physical functioning, however longer duration of future studies is ideal in order to assess further the long advantages and consequences of TRC 101/Veverimer.

Keywords: chronic kidney disease, metabolic acidosis, Veverimer, TRC101

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