Search results for: damage index

Authors: Thais O. de Paula, Marjorie R. A. Sarmiento, Francis M. Borges, Alessandra B. Ferreira-Machado, Juliana A. Resende, Dioneia E. Cesar, Vania L. Silva, Claudio G. Diniz

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Obesity is currently a worldwide public health threat, being considered a pandemic multifactorial disease related to the human gut microbiota (GM). Add to that GM is considered an important reservoir of antimicrobial resistance genes (ARG) and little is known on GM and ARG in obesity, considering the altered physiology and xenobiotics intake. As regional and social behavior may play important roles in GM modulation, and most of the studies are based on small sample size and various methodological approaches resulting in difficulties for data comparisons, this study was focused on the investigation of GM bacterial diversity in obese (OB), overweight (OW) and eutrophic individuals (ET) considering their nutritional, clinical and social characteristics; and comparative screening of AGR related to their physiology and xenobiotics intake. Microbial community was accessed by FISH considering phyla as a taxonomic level, and PCR-DGGE followed by dendrograms evaluation (UPGMA method) from fecal metagenome of 72 volunteers classified according to their body mass index (BMI). Nutritional, clinical, social parameters and xenobiotics intake were recorded for correlation analysis. The fecal metagenome was also used as template for PCR targeting 59 different ARG. Overall, 62% of OB were hypertensive, and 12% or 4% were, regarding the OW and ET individuals. Most of the OB were rated as low income (80%). Lower relative bacterial densities were observed in the OB compared to ET for almost all studied taxa (p < 0.05) with Firmicutes/Bacteroidetes ratio increased in the OB group. OW individuals showed a bacterial density representative of GM more likely to the OB. All the participants were clustered in 3 different groups based on the PCR-DGGE fingerprint patterns (C1, C2, C3), being OB mostly grouped in C1 (83.3%) and ET mostly grouped in C3 (50%). The cluster C2 showed to be transitional. Among 27 ARG detected, a cluster of 17 was observed in all groups suggesting a common core. In general, ARG were observed mostly within OB individuals followed by OW and ET. The ratio between ARG and bacterial groups may suggest that AGR were more related to enterobacteria. Positive correlations were observed between ARG and BMI, calories and xenobiotics intake (especially use of sweeteners). As with nutritional and clinical characteristics, our data may suggest that GM of OW individuals behave in a heterogeneous pattern, occasionally more likely to the OB or to the ET. Regardless the regional and social behaviors of our population, the methodological approaches in this study were complementary and confirmatory. The imbalance of GM over the health-disease interface in obesity is a matter of fact, but its influence in host's physiology is still to be clearly elucidated to help understanding the multifactorial etiology of obesity. Although the results are in agreement with observations that GM is altered in obesity, the altered physiology in OB individuals seems to be also associated to the increased xenobiotics intake and may interfere with GM towards antimicrobial resistance, as observed by the fecal metagenome and ARG screening. Support: FAPEMIG, CNPQ, CAPES, PPGCBIO/UFJF.

Keywords: antimicrobial resistance, bacterial diversity, gut microbiota, obesity

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Authors: Charalabos Antonatos, Mariza Panoutsopoulou, Georgios K. Georgakilas, Evangelos Evangelou, Yiannis Vasilopoulos

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The extended tissue damage and severe clinical outcomes of autoimmune diseases, accompanied by the high annual costs to the overall health care system, highlight the need for an efficient therapy. Increasing knowledge over the pathophysiology of specific chronic inflammatory diseases, namely Psoriasis (PsO), Inflammatory Bowel Diseases (IBD) consisting of Crohn’s disease (CD) and Ulcerative colitis (UC), and Rheumatoid Arthritis (RA), has provided insights into the underlying mechanisms that lead to the maintenance of the inflammation, such as Tumor Necrosis Factor alpha (TNF-α). Hence, the anti-TNFα biological agents pose as an ideal therapeutic approach. Despite the efficacy of anti-TNFα agents, several clinical trials have shown that 20-40% of patients do not respond to treatment. Nowadays, high-throughput technologies have been recruited in order to elucidate the complex interactions in multifactorial phenotypes, with the most ubiquitous ones referring to transcriptome quantification analyses. In this context, a random effects meta-analysis of available gene expression cDNA microarray datasets was performed between responders and non-responders to anti-TNFα therapy in patients with IBD, PsO, and RA. Publicly available datasets were systematically searched from inception to 10th of November 2020 and selected for further analysis if they assessed the response to anti-TNFα therapy with clinical score indexes from inflamed biopsies. Specifically, 4 IBD (79 responders/72 non-responders), 3 PsO (40 responders/11 non-responders) and 2 RA (16 responders/6 non-responders) datasetswere selected. After the separate pre-processing of each dataset, 4 separate meta-analyses were conducted; three disease-specific and a single combined meta-analysis on the disease-specific results. The MetaVolcano R package (v.1.8.0) was utilized for a random-effects meta-analysis through theRestricted Maximum Likelihood (RELM) method. The top 1% of the most consistently perturbed genes in the included datasets was highlighted through the TopConfects approach while maintaining a 5% False Discovery Rate (FDR). Genes were considered as Differentialy Expressed (DEGs) as those with P ≤ 0.05, |log2(FC)| ≥ log2(1.25) and perturbed in at least 75% of the included datasets. Over-representation analysis was performed using Gene Ontology and Reactome Pathways for both up- and down-regulated genes in all 4 performed meta-analyses. Protein-Protein interaction networks were also incorporated in the subsequentanalyses with STRING v11.5 and Cytoscape v3.9. Disease-specific meta-analyses detected multiple distinct pro-inflammatory and immune-related down-regulated genes for each disease, such asNFKBIA, IL36, and IRAK1, respectively. Pathway analyses revealed unique and shared pathways between each disease, such as Neutrophil Degranulation and Signaling by Interleukins. The combined meta-analysis unveiled 436 DEGs, 86 out of which were up- and 350 down-regulated, confirming the aforementioned shared pathways and genes, as well as uncovering genes that participate in anti-inflammatory pathways, namely IL-10 signaling. The identification of key biological pathways and regulatory elements is imperative for the accurate prediction of the patient’s response to biological drugs. Meta-analysis of such gene expression data could aid the challenging approach to unravel the complex interactions implicated in the response to anti-TNFα therapy in patients with PsO, IBD, and RA, as well as distinguish gene clusters and pathways that are altered through this heterogeneous phenotype.

Keywords: anti-TNFα, autoimmune, meta-analysis, microarrays

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Authors: Suzanne Zazycki, Bamidele Osamika, Heather Craska, Kaelyn Conaway, Reena Murphy, Stephanie Spence

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Invasive Plant Species (IPS) are an important component of effective preservation and conservation of natural lands management. IPS are non-native plants which can aggressively encroach upon native species and pose a significant threat to the ecology, public health, and social welfare of a community. The presence of IPS in U.S. nature preserves has caused economic costs, which has estimated to exceed $26 billion a year. While different methods have been identified to control IPS, few methods have been recognized for early detection of IPS. This study examined identified methods for early detection of IPS in Hueston Woods State Nature Preserve. Mixed methods research design was adopted in this four-phased study. The first phase entailed data gathering, the phase described the characteristics and qualities of IPS and the importance of early detection (ED). The second phase explored ED methods, Geographic Information Systems (GIS) and Citizen Science were discovered as ED methods for IPS. The third phase of the study involved the creation of hotspot maps to identify likely areas for IPS growth. While the fourth phase involved testing and evaluating mobile applications that can support the efforts of citizen scientists in IPS detection. Literature reviews were conducted on IPS and ED methods, and four regional experts from ODNR and Miami University were interviewed. A questionnaire was used to gather information about ED methods used across the state. The findings revealed that geospatial methods, including Unmanned Aerial Vehicles (UAVs), Multispectral Satellites (MSS), and Normalized Difference Vegetation Index (NDVI), are not feasible for early detection of IPS, as they require GIS expertise, are still an emerging technology, and are not suitable for every habitat for the ED of IPS. Therefore, Other ED methods options were explored, which include predicting areas where IPS will grow, which can be done through monitoring areas that are like the species’ native habitat. Through literature review and interviews, IPS are known to grow in frequently disturbed areas such as along trails, shorelines, and streambanks. The research team called these areas “hotspots” and created maps of these hotspots specifically for HW NP to support and narrow the efforts of citizen scientists and staff in the ED of IPS. The results further showed that utilizing citizen scientists in the ED of IPS is feasible, especially through single day events or passive monitoring challenges. The study concluded that the creation of hotspot maps to direct the efforts of citizen scientists are effective for the early detection of IPS. Several recommendations were made, among which is the creation of hotspot maps to narrow the ED efforts as citizen scientists continues to work in the preserves and utilize citizen science volunteers to identify and record emerging IPS.

Keywords: early detection, hueston woods state nature preserve, invasive plant species, hotspots

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Authors: Mustafa M. Donma, Orkide Donma

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Zinc is a vital element required for growth and development. This fact makes zinc important, particularly for children. It maintains normal cellular structure and functions. This essential element appears to have protective effects against coronary artery disease and cardiomyopathy. Higher serum zinc levels are associated with lower risk of cardiovascular diseases (CVDs). There is a significant association between low serum zinc levels and heart failure. Zinc may be a potential biomarker of cardiovascular health. High sensitive cardiac troponin T (hs-cTnT) and cardiac myosin binding protein C (cMyBP-C) are new generation markers used for prediagnosis, diagnosis, and prognosis of CVDs. The aim of this study is to determine zinc as well as new generation cardiac markers profiles in children with normal body mass index (N-BMI), obese (OB), morbid obese (MO) children, and children with metabolic syndrome (MetS) findings. The association among them will also be investigated. Four study groups were constituted. The study protocol was approved by the institutional Ethics Committee of Tekirdag Namik Kemal University. Parents of the participants filled informed consent forms to participate in the study. Group 1 is composed of 44 children with N-BMI. Group 2 and Group 3 comprised 43 OB and 45 MO children, respectively. Forty-five MO children with MetS findings were included in Group 4. World Health Organization age- and sex-adjusted BMI percentile tables were used to constitute groups. These values were 15-85, 95-99, and above 99 for N-BMI, OB, and MO, respectively. Criteria for MetS findings were determined. Routine biochemical analyses, including zinc, were performed. High sensitive-cTnT and cMyBP-C concentrations were measured by kits based on enzyme-linked immunosorbent assay principle. Appropriate statistical tests within the scope of SPSS were used for the evaluation of the study data. p<0.05 was accepted as statistically significant. Four groups were matched for age and gender. Decreased zinc concentrations were measured in Groups 2, 3, and 4 compared to Group 1. Groups did not differ from one another in terms of hs-cTnT. There were statistically significant differences between cMyBP-C levels of MetS group and N-BMI as well as OB groups. There was an increasing trend going from N-BMI group to MetS group. There were statistically significant negative correlations between zinc and hs-cTnT as well as cMyBP-C concentrations in MetS group. In conclusion, inverse correlations detected between zinc and new generation cardiac markers (hs-TnT and cMyBP-C) have pointed out that decreased levels of this physiologically essential trace element accompany increased levels of hs-cTnT as well as cMyBP-C in children with MetS. This finding emphasizes that both zinc and these new generation cardiac markers may be evaluated as biomarkers of cardiovascular health during severe childhood obesity precipitated with MetS findings and also suggested as the messengers of the future risk in the adulthood periods of children with MetS.

Keywords: cardiac myosin binding protein-C, cardiovascular diseases, children, high sensitive cardiac troponin T, obesity

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Authors: Aliyu Bello Mohammed

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Vital registration or registration of vital events is one of the three major sources of demographic data in Nigeria. The other two are the population census and sample survey. The former is judged to be an indispensable source of demographic data because, it provide information on vital statistics and population trends between two census periods. Various literacy works however depict the vital registration in Nigeria as incapable of providing accurate data for the country. The study has both theoretical and practical significances. The trends and pattern of vital registration has not received adequate research interest in Sub-Saharan Africa in general and Nigeria in particular. This has created a gap in understanding the extent and consequence of the scourge in Africa sub-region. Practically, the study also captures the policy interventions of government and Non-Governmental Organizations (NGOs) that would help enlighten the public on the importance of vital registration in Nigeria. Furthermore, feasible policy strategies that will enhance trends and pattern vital registration in the society would emanate from the study. The study adopted a cross sectional survey design and applied multi stage sampling techniques to sample 230 respondents from the general public in the study area. The first stage involved the splitting of the local government into wards. The second stage involves selecting streets, while the third stage was the households. In all, 6 wards were sampled for the study. The study utilized both primary and secondary sources of data. The primary sources of data used were the questionnaire, focus group discussion (FGD) and in-depth interview (IDI) guides while the secondary sources of data were journals and books, newspapers and magazines. Twelve FGD sessions with 96 study participants and five IDI sessions with the heads of vital registration facilities were conducted. The quantitative data were analyzed using Statistical Package for Social Sciences (SPSS). Descriptive statistics like tables, frequencies and percentages were employed in presenting and interpreting the data. Information from the qualitative data was transcribed and ordered in themes to ensure that outstanding points of the responses are noted. The following conclusions were drawn from the study: the available vital registration facilities are not adequate and were not evenly distributed in the study area; lack of awareness and knowledge of the existence and the importance of vital registration by majority of the people in the local government; distance to vital registration centres from their residents; most births in the area were not registered, and even among the few births that were registered, majority of them were registered after the limited period for registration. And the study reveals that socio-economic index, educational level and distance of facilities to residents are determinants of access to vital registration facility. The study concludes by discussing the need for a reliable and accurate vital registration system if Nigeria’s vision of becoming one of the top 20 economies in the world in 2020 would be realized.

Keywords: trends, patterns, vital, registration and assessment

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Authors: Silvia Di Giacomo, Marcello Locatelli, Simone Carradori, Francesco Cacciagrano, Chiara Toniolo, Gabriela Mazzanti, Luisa Mannina, Stefania Cesa, Antonella Di Sotto

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Hyperglycemia represents the main pathogenic factor in the development of diabetes complications and has been found associated with mitochondrial dysfunction and oxidative stress, which in turn increase cell dysfunction. Therefore, counteract oxidative species appears to be a suitable strategy for preventing the hyperglycemia-induce cell damage and support the pharmacotherapy of diabetes and metabolic diseases. Antidiabetic potential of many food sources has been linked to the presence of polyphenolic metabolites, particularly flavonoids such as quercetin and its glycosylated form rutin. In line with this evidence, in the present study, we assayed the potential anti-hyperglycemic activity of an ethyl acetate extract from the peel of Punica granatum L. var. Dente di Cavallo (PGE), a fruit well known to traditional medicine for the beneficial properties of its edible juice. The effect of the extract on the glucidic metabolism has been evaluated by assessing its ability to inhibit α-amylase and α-glucosidase, two digestive enzymes responsible for the hydrolysis of dietary carbohydrates: their inhibition can delay the carbohydrate digestion and reduce glucose absorption, thus representing an important strategy for the management of hyperglycemia. Also, the PGE ability to block the release of advanced glycated end-products (AGEs), whose accumulation is known to be responsible for diabetic vascular complications, was studied. The iron-reducing and chelating activities, which are the primary mechanisms by which AGE inhibitors stop their metal-catalyzed formation, were evaluated as possible antioxidant mechanisms. At last, the phenolic content of PGE was characterized by chromatographic and spectrophotometric methods. Our results displayed the ability of PGE to inhibit α-amylase enzyme with a similar potency to the positive control: the IC₅₀ values were 52.2 (CL 27.7 - 101.2) µg/ml and 35.6 (CL 22.8 - 55.5) µg/ml for acarbose and PGE, respectively. PGE also inhibited the α-glucosidase enzyme with about a 25 higher potency than the positive controls of acarbose and quercetin. Furthermore, the extract exhibited ferrous and ferric ion chelating ability, with a maximum effect of 82.1% and 80.6% at a concentration of 250 µg/ml respectively, and reducing properties, reaching the maximum effect of 80.5% at a concentration of 10 µg/ml. At last, PGE was found able to inhibit the AGE production (maximum inhibition of 82.2% at the concentration of 1000 µg/ml), although with lower potency with respect to the positive control rutin. The phytochemical analysis of PGE displayed the presence of high levels of total polyphenols, tannins, and flavonoids, among which ellagic acid, gallic acid and catechin were identified. Altogether these data highlight the ability of PGE to control the carbohydrate metabolism at different levels, both by inhibiting the metabolic enzymes and by affecting the AGE formation likely by chelating mechanisms. It is also noteworthy that peel from pomegranate, although being a waste of juice production, can be reviewed as a nutraceutical source. In conclusion, present results suggest the possible role of PGE as a remedy for preventing hyperglycemia complications and encourage further in vivo studies.

Keywords: anti-hyperglycemic activity, antioxidant properties, nutraceuticals, polyphenols, pomegranate

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Authors: Mary Farrell, Maria Soubra, Sandra Vega, Dorothy Kakraba, Joanne Fontanilla, Moira Kendra, Danielle Tonzola, Stephanie Chiu

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Pneumonia is the most common infectious cause of hospitalizations in the United States, with more than one million admissions annually and costs of $10 billion every year, making it the 8th leading cause of death. Aspiration pneumonia is an aggressive type of pneumonia that results from inhalation of oropharyngeal secretions and/or gastric contents and is preventable. The authors hypothesized that an evidence-based aspiration pneumonia clinical care pathway could reduce 30-day hospital readmissions and mortality rates, while improving the overall care of patients. We conducted a retrospective chart review on 979 patients discharged with aspiration pneumonia from January 2021 to December 2022 at Overlook Medical Center. The authors identified patients who were coded with aspiration pneumonia and/or stable sepsis. Secondarily, we identified 30-day readmission rates for aspiration pneumonia from a SNF. The Aspiration Pneumonia Clinical Care Pathway starts in the emergency department (ED) with the initiation of antimicrobials within 4 hours of admission and early recognition of aspiration. Once this is identified, a swallow test is initiated by the bedside nurse, and if the patient demonstrates dysphagia, they are maintained on strict nothing by mouth (NPO) followed by a speech and language pathologist (SLP) referral for an appropriate modified diet recommendation. Aspiration prevention techniques included the avoidance of straws, 45-degree positioning, no talking during meals, taking small bites, placement of the aspiration wrist band, and consuming meals out of the bed in a chair. Nursing education was conducted with a newly created online learning module about aspiration pneumonia. The authors identified 979 patients, with an average age of 73.5 years old, who were diagnosed with aspiration pneumonia on the index hospitalization. These patients were reviewed for a 30-day readmission for aspiration pneumonia or stable sepsis, and mortality rates from January 2021 to December 2022 at Overlook Medical Center (OMC). The 30-day readmission rates were significantly lower in the cohort that received the clinical care pathway (35.0% vs. 27.5%, p = 0.011). When evaluating the mortality rates in the pre and post intervention cohort the authors discovered the mortality rates were lower in the post intervention cohort (23.7% vs 22.4%, p = 0.61) Mortality among non-white (self-reported as non-white) patients were lower in the post intervention cohort (34.4% vs. 21.0% , p = 0.05). Patients who reported as a current smoker/vaper in the pre and post cohorts had increased mortality rates (5.9% vs 22%). There was a decrease in mortality for the male population but an increase in mortality for women in the pre and post cohorts (19% vs. 25%). The authors attributed this increase in mortality in the post intervention cohort to more active smokers, more former smokers, and more being admitted from a SNF. This research identified that implementation of an Aspiration Pneumonia Clinical Care Pathway showed a statistically significant decrease in readmission rates and mortality rates in non-whites. The 30-day readmission rates were lower in the cohort that received the clinical care pathway (35.0% vs. 27.5%, p = 0.011).

Keywords: aspiration pneumonia, mortality, quality improvement, 30-day pneumonia readmissions

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Authors: Abhisek Chakrabarty, Subhraprakash Mandal

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Flash flood is one of the catastrophic natural hazards in the mountainous region of India. The recent flood in the Mandakini River in Kedarnath (14-17th June, 2013) is a classic example of flash floods that devastated Uttarakhand by killing thousands of people.The disaster was an integrated effect of high intensityrainfall, sudden breach of Chorabari Lake and very steep topography. Every year in Himalayan Region flash flood occur due to intense rainfall over a short period of time, cloud burst, glacial lake outburst and collapse of artificial check dam that cause high flow of river water. In Sikkim-Derjeeling Himalaya one of the probable flash flood occurrence zone is Teesta Watershed. The Teesta River is a right tributary of the Brahmaputra with draining mountain area of approximately 8600 Sq. km. It originates in the Pauhunri massif (7127 m). The total length of the mountain section of the river amounts to 182 km. The Teesta is characterized by a complex hydrological regime. The river is fed not only by precipitation, but also by melting glaciers and snow as well as groundwater. The present study describes an attempt to model surface runoff in upper Teesta basin, which is directly related to catastrophic flood events, by creating a system based on GIS technology. The main object was to construct a direct unit hydrograph for an excess rainfall by estimating the stream flow response at the outlet of a watershed. Specifically, the methodology was based on the creation of a spatial database in GIS environment and on data editing. Moreover, rainfall time-series data collected from Indian Meteorological Department and they were processed in order to calculate flow time and the runoff volume. Apart from the meteorological data, background data such as topography, drainage network, land cover and geological data were also collected. Clipping the watershed from the entire area and the streamline generation for Teesta watershed were done and cross-sectional profiles plotted across the river at various locations from Aster DEM data using the ERDAS IMAGINE 9.0 and Arc GIS 10.0 software. The analysis of different hydraulic model to detect flash flood probability ware done using HEC-RAS, Flow-2D, HEC-HMS Software, which were of great importance in order to achieve the final result. With an input rainfall intensity above 400 mm per day for three days the flood runoff simulation models shows outbursts of lakes and check dam individually or in combination with run-off causing severe damage to the downstream settlements. Model output shows that 313 Sq. km area were found to be most vulnerable to flash flood includes Melli, Jourthang, Chungthang, and Lachung and 655sq. km. as moderately vulnerable includes Rangpo,Yathang, Dambung,Bardang, Singtam, Teesta Bazarand Thangu Valley. The model was validated by inserting the rain fall data of a flood event took place in August 1968, and 78% of the actual area flooded reflected in the output of the model. Lastly preventive and curative measures were suggested to reduce the losses by probable flash flood event.

Keywords: flash flood, GIS, runoff, simulation model, Teesta river basin

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Authors: Ivana Knezevic, Kenneth D. Candido, N. Nick Knezevic

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Background: While pain intensity scales remain generally accepted assessment tool, and the numeric pain rating score is highly subjective, we nevertheless rely on them to make a judgment about treatment effects. Misinterpretation of pain can lead practitioners to underestimate or overestimate the patient’s medical condition. The purpose of this study was to analyze how the numeric rating pain scores given by patients with low back pain correlate with their functional activity levels. Methods: We included 100 consecutive patients with radicular low back pain (LBP) after the Institutional Review Board (IRB) approval. Pain scores, numeric rating scale (NRS) responses at rest and in the movement,Oswestry Disability Index (ODI) questionnaire answers were collected 10 times through 12 months. The ODI questionnaire is targeting a patient’s activities and physical limitations as well as a patient’s ability to manage stationary everyday duties. Statistical analysis was performed by using SPSS Software version 20. Results: The average duration of LBP was 14±22 months at the beginning of the study. All patients included in the study were between 24 and 78 years old (average 48.85±14); 56% women and 44% men. Differences between ODI and pain scores in the range from -10% to +10% were considered “normal”. Discrepancies in pain scores were graded as mild between -30% and -11% or +11% and +30%; moderate between -50% and -31% and +31% and +50% and severe if differences were more than -50% or +50%. Our data showed that pain scores at rest correlate well with ODI in 65% of patients. In 30% of patients mild discrepancies were present (negative in 21% and positive in 9%), 4% of patients had moderate and 1% severe discrepancies. “Negative discrepancy” means that patients graded their pain scores much higher than their functional ability, and most likely exaggerated their pain. “Positive discrepancy” means that patients graded their pain scores much lower than their functional ability, and most likely underrated their pain. Comparisons between ODI and pain scores during movement showed normal correlation in only 39% of patients. Mild discrepancies were present in 42% (negative in 39% and positive in 3%); moderate in 14% (all negative), and severe in 5% (all negative) of patients. A 58% unknowingly exaggerated their pain during movement. Inconsistencies were equal in male and female patients (p=0.606 and p=0.928).Our results showed that there was a negative correlation between patients’ satisfaction and the degree of reporting pain inconsistency. Furthermore, patients talking opioids showed more discrepancies in reporting pain intensity scores than did patients taking non-opioid analgesics or not taking medications for LBP (p=0.038). There was a highly statistically significant correlation between morphine equivalents doses and the level of discrepancy (p<0.0001). Conclusion: We have put emphasis on the patient education in pain evaluation as a vital step in accurate pain level reporting. We have showed a direct correlation with patients’ satisfaction. Furthermore, we must identify other parameters in defining our patients’ chronic pain conditions, such as functionality scales, quality of life questionnaires, etc., and should move away from an overly simplistic subjective rating scale.

Keywords: pain score, functionality scales, low back pain, lumbar

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Authors: Mustafa M. Donma, Orkide Donma

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Metabolisms of macrominerals, those of calcium, phosphorus and magnesium, are closely associated with the metabolism of vitamin D. Particularly magnesium, the second most abundant intracellular cation, is related to biochemical and metabolic processes in the body, such as those of carbohydrates, proteins and lipids. The status of each mineral was investigated in obesity to some extent. Their products and ratios may possibly give much more detailed information about the matter. The aim of this study is to investigate possible relations between each macromineral and some obesity-related parameters. This study was performed on 235 children, whose ages were between 06-18 years. Aside from anthropometric measurements, hematological analyses were performed. TANITA body composition monitor using bioelectrical impedance analysis technology was used to establish some obesity-related parameters including basal metabolic rate (BMR), total fat, mineral and muscle masses. World Health Organization body mass index (BMI) percentiles for age and sex were used to constitute the groups. The values above 99^th percentile were defined as morbid obesity. Those between 95^th and 99^th percentiles were included into the obese group. The overweight group comprised of children whose percentiles were between 95 and 85. Children between the 85^th and 15^th percentiles were defined as normal. Metabolic syndrome (MetS) components (waist circumference, fasting blood glucose, triacylglycerol, high density lipoprotein cholesterol, systolic pressure, diastolic pressure) were determined. High performance liquid chromatography was used to determine Vitamin D status by measuring 25-hydroxy cholecalciferol (25-hydroxy vitamin D₃, 25(OH)D). Vitamin D values above 30.0 ng/ml were accepted as sufficient. SPSS statistical package program was used for the evaluation of data. The statistical significance degree was accepted as p < 0.05. The important points were the correlations found between vitamin D and magnesium as well as phosphorus (p < 0.05) that existed in the group with normal BMI values. These correlations were lost in the other groups. The ratio of phosphorus to magnesium was even much more highly correlated with vitamin D (p < 0.001). The negative correlation between magnesium and total fat mass (p < 0.01) was confined to the MetS group showing the inverse relationship between magnesium levels and obesity degree. In this group, calcium*magnesium product exhibited the highest correlation with total fat mass (p < 0.001) among all groups. Only in the MetS group was a negative correlation found between BMR and calcium*magnesium product (p < 0.05). In conclusion, magnesium is located at the center of attraction concerning its relationships with vitamin D, fat mass and MetS. The ratios and products derived from macrominerals including magnesium have pointed out stronger associations other than each element alone. Final considerations have shown that unique correlations of magnesium as well as calcium*magnesium product with total fat mass have drawn attention particularly in the MetS group, possibly due to the derangements in some basic elements of carbohydrate as well as lipid metabolism.

Keywords: macrominerals, metabolic syndrome, pediatric obesity, vitamin D

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Authors: Vijaya Kumar, Vidayasagar Pagilla, Abraham Joshua, Rakshith Kedambadi, Prasanna Mithra

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Background: Post stroke rehabilitation are aimed to accelerate for optimal sensorimotor recovery, functional gain and to reduce long-term dependency. Intensive physical therapy interventions can enhance this recovery as experience-dependent neural plastic changes either directly act at cortical neural networks or at distal peripheral level (muscular components). Neuromuscular Electrical Stimulation (NMES), a traditional bottom-up approach, mirror therapy (MT), a relatively new top down approach have found to be an effective adjuvant treatment methods for lower extremity motor and functional recovery in stroke rehabilitation. However there is a scarcity of evidence to compare their therapeutic gain in stroke recovery.Aim: To compare the efficacy of neuromuscular electrical stimulation (NMES) and mirror therapy (MT) in very early phase of post stroke rehabilitation addressed to lower extremity motor recovery and balance. Design: observer blinded Randomized Clinical Trial. Setting: Neurorehabilitation Unit, Department of Physical Therapy, Tertiary Care Hospitals. Subjects: 32 acute stroke subjects with first episode of unilateral stroke with hemiparesis, referred for rehabilitation (onset < 3 weeks), Brunnstorm lower extremity recovery stages ≥3 and MMSE score more than 24 were randomized into two group [Group A-NMES and Group B-MT]. Interventions: Both the groups received eclectic approach to remediate lower extremity recovery which includes treatment components of Roods, Bobath and Motor learning approaches for 30 minutes a day for 6 days. Following which Group A (N=16) received 30 minutes of surface NMES training for six major paretic muscle groups (gluteus maximus and medius,quadriceps, hamstrings, tibialis anterior and gastrocnemius). Group B (N=16) was administered with 30 minutes of mirror therapy sessions to facilitate lower extremity motor recovery. Outcome measures: Lower extremity motor recovery, balance and activities of daily life (ADLs) were measured by Fugyl Meyer Assessment (FMA-LE), Berg Balance Scale (BBS), Barthel Index (BI) before and after intervention. Results: Pre Post analysis of either group across the time revealed statistically significant improvement (p < 0.001) for all the outcome variables for the either group. All parameters of NMES had greater change scores compared to MT group as follows: FMA-LE (25.12±3.01 vs. 23.31±2.38), BBS (35.12±4.61 vs. 34.68±5.42) and BI (40.00±10.32 vs. 37.18±7.73). Between the groups comparison of pre post values showed no significance with FMA-LE (p=0.09), BBS (p=0.80) and BI (p=0.39) respectively. Conclusion: Though either groups had significant improvement (pre to post intervention), none of them were superior to other in lower extremity motor recovery and balance among acute stroke subjects. We conclude that eclectic approach is an effective treatment irrespective of NMES or MT as an adjunct.

Keywords: balance, motor recovery, mirror therapy, neuromuscular electrical stimulation, stroke

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Authors: S. Jimenez, R.Duarte, J.Sanchez-Choliz, I. Villanua

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There is a certain consensus in economic literature about the factors that have influenced in historical differences in growth rates observed between developed and developing countries. However, it is less clear what elements have marked different paths of growth in developed economies in recent decades. R&D has always been seen as one of the major sources of technological progress, and productivity growth, which is directly influenced by technological developments. Following recent literature, we can say that ‘innovation pushes the technological frontier forward’ as well as encourage future innovation through the creation of externalities. In other words, productivity benefits from innovation are not fully appropriated by innovators, but it also spread through the rest of the economies encouraging absorptive capacities, what have become especially important in a context of increasing fragmentation of production This paper aims to contribute to this literature in two ways, first, exploring alternative indexes of R&D flows embodied in inter-country, inter-sectorial flows of good and services (as approximation to technology spillovers) capturing structural and technological characteristic of countries and, second, analyzing the impact of direct and embodied R&D on the evolution of labor productivity at the country/sector level in recent decades. The traditional way of calculation through a multiregional input-output framework assumes that all countries have the same capabilities to absorb technology, but it is not, each one has different structural features and, this implies, different capabilities as part of literature, claim. In order to capture these differences, we propose to use a weight based on specialization structure indexes; one related with the specialization of countries in high-tech sectors and the other one based on a dispersion index. We propose these two measures because, as far as we understood, country capabilities can be captured through different ways; countries specialization in knowledge-intensive sectors, such as Chemicals or Electrical Equipment, or an intermediate technology effort across different sectors. Results suggest the increasing importance of country capabilities while increasing the trade openness. Besides, if we focus in the country rankings, we can observe that with high-tech weighted R&D embodied countries as China, Taiwan and Germany arose the top five despite not having the highest intensities of R&D expenditure, showing the importance of country capabilities. Additionally, through a fixed effects panel data model we show that, in fact, R&D embodied is important to explain labor productivity increases, in fact, even more that direct R&D investments. This is reflecting that globalization is more important than has been said until now. However, it is true that almost all analysis done in relation with that consider the effect of t-1 direct R&D intensity over economic growth. Nevertheless, from our point of view R&D evolve as a delayed flow and it is necessary some time to be able to see its effects on the economy, as some authors have already claimed. Our estimations tend to corroborate this hypothesis obtaining a gap between 4-5 years.

Keywords: economic growth, embodied, input-output, technology

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Authors: Muluwerk Ayele Derebe

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Background: Antenatal care (ANC) is an essential element in the continuum of reproductive health care for preventing preventable pregnancy-related morbidity and mortality. Objective: The aim of this study is to assess the spatial pattern and predictors of ANC visits in Ethiopia. Method: This study was done using Ethiopian Demographic and Health Survey data of 2016 among 7,174 pregnant women aged 15-49 years which was a nationwide community-based cross-sectional survey. Spatial analysis was done using Getis-Ord Gi* statistics to identify hot and cold spot areas of ANC visits. Multilevel glmmTMB packages adjusted for spatial effects were used in R software. Spatial multilevel count regression was conducted to identify predictors of antenatal care visits for pregnant women, and proportional change in variance was done to uncover the effect of individual and community-level factors of ANC visits. Results: The distribution of ANC visits was spatially clustered Moran’s I = 0.271, p<.0.001, ICC = 0.497, p<0.001). The highest spatial outlier areas of ANC visit was found in Amhara (South Wollo, Weast Gojjam, North Shewa), Oromo (west Arsi and East Harariga), Tigray (Central Tigray) and Benishangul-Gumuz (Asosa and Metekel) regions. The data was found with excess zeros (34.6%) and over-dispersed. The expected ANC visit of pregnant women with pregnancy complications was higher at 0.7868 [ARR= 2.1964, 95% CI: 1.8605, 2.5928, p-value <0.0001] compared to pregnant women who had no pregnancy complications. The expected ANC visit of a pregnant woman who lived in a rural area was 1.2254 times higher [ARR=3.4057, 95% CI: 2.1462, 5.4041, p-value <0.0001] as compared to a pregnant woman who lived in an urban. The study found dissimilar clusters with a low number of zero counts for a mean number of ANC visits surrounded by clusters with a higher number of counts of an average number of ANC visits when other variables held constant. Conclusion: This study found that the number of ANC visits in Ethiopia had a spatial pattern associated with socioeconomic, demographic, and geographic risk factors. Spatial clustering of ANC visits exists in all regions of Ethiopia. The predictor age of the mother, religion, mother’s education, husband’s education, mother's occupation, husband's occupation, signs of pregnancy complication, wealth index and marital status had a strong association with the number of ANC visits by each individual. At the community level, place of residence, region, age of the mother, sex of the household head, signs of pregnancy complications and distance to health facility factors had a strong association with the number of ANC visits.

Keywords: Ethiopia, ANC, spatial, multilevel, zero inflated Poisson

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Authors: Sanjeev Gupta, Ankit Prabhakar, K. Rajkumar Singh

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Sunni Dam Hydroelectric Project (382 MW) is a run of river type development with an underground powerhouse, proposed to harness the hydel potential of river Satluj in Himachal Pradesh, India. The project is located in the inner lesser Himalaya between Dhauladhar Range in the south and the higher Himalaya in the north. The project comprises two large underground caverns, a Powerhouse cavern (171m long, 22.5m wide and 51.2m high) and another transformer hall cavern (175m long, 18.7m wide and 27m high) and the rock pillar between the two caverns is 50m. The highly jointed, fractured, anisotropic rock mass is a key challenge in Himalayan geology for an underground structure. The concern for the stability of rock mass increases when weak/shear zones are encountered in the underground structure. In the Sunni Dam project, 1.7m to 2m thick weak/shear zone comprising of deformed, weak material with gauge has been encountered in powerhouse cavern at 70m having dip direction 325 degree and dip amount 38 degree which also intersects transformer hall at initial reach. The rock encountered in the powerhouse area is moderate to highly jointed, pink quartz arenite belonging to the Khaira Formation, a transition zone comprising of alternate grey, pink & white quartz arenite and shale sequence and dolomite at higher reaches. The rock mass is intersected by mainly 3 joint sets excluding bedding joints and a few random joints. The rock class in powerhouse mainly varies from poor class (class IV) to lower order fair class (class III) and in some reaches, very poor rock mass has also been encountered. To study the stability of the underground structure in weak/shear rock mass, a 3D numerical model analysis has been carried out using RS3 software. Field studies have been interpreted and analysed to derive Bieniawski’s RMR, Barton’s “Q” class and Geological Strength Index (GSI). The various material parameters, in-situ characteristics have been determined based on tests conducted by Central Soil and Materials Research Station, New Delhi. The behaviour of the cavern has been studied by assessing the displacement contours, major and minor principal stresses and plastic zones for different stage excavation sequences. For optimisation of the support system, the stability of the powerhouse cavern with different powerhouse orientations has also been studied. The numerical modeling results indicate that cavern will not likely face stress governed by structural instability with the support system to be applied to the crown and side walls.

Keywords: 3D analysis, Himalayan geology, shear zone, underground power house

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Authors: Sean E. Gregory P. Igano, Ranz Brendan D. Gabor, Baron Arthur M. Cabalona, Numeriano Amer E. Gutierrez

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Distribution patterns and abundance of butterflies respond in the long term to variations in habitat quality. Studying butterfly populations would give evidence on how vegetation types influence their diversity. In this research, the Rhopalocera diversity of PC Hills was assessed to provide information on diversity trends in varying vegetation types. PC Hills, located in Palo, Leyte, Philippines, is a relatively undisturbed area having forests and rivers. Despite being situated nearby inhabited villages; the area is observed to have a possible rich butterfly population. To assess the Rhopalocera species richness and diversity, transect sampling technique was applied to monitor and document butterflies. Transects were placed in locations that can be mapped, described and relocated easily. Three transects measuring three hundred meters each with a 5-meter diameter were established based on the different vegetation types present. The three main vegetation types identified were the agroecosystem (transect 1), dipterocarp forest (transect 2), and riparian (transect 3). Sample collections were done only from 9:00 A.M to 3:00 P.M. under warm and bright weather, with no more than moderate winds and when it was not raining. When weather conditions did not permit collection, it was moved to another day. A GPS receiver was used to record the location of the selected sample sites and the coordinates of where each sample was collected. Morphological analysis was done for the first phase of the study to identify the voucher specimen to the lowest taxonomic level possible using books about butterfly identification guides and species lists as references. For the second phase, DNA barcoding will be used to further identify the voucher specimen into the species taxonomic level. After eight (8) sampling sessions, seven hundred forty-two (742) individuals were seen, and twenty-two (22) Rhopalocera genera were identified through morphological identification. Nymphalidae family of genus Ypthima and the Pieridae family of genera Eurema and Leptosia were the most dominant species observed. Twenty (20) of the thirty-one (31) voucher specimen were already identified to their species taxonomic level using DNA Barcoding. Shannon-Weiner index showed that the highest diversity level was observed in the third transect (H’ = 2.947), followed by the second transect (H’ = 2.6317) and the lowest being in the first transect (H’ = 1.767). This indicates that butterflies are likely to inhabit dipterocarp and riparian vegetation types than agroecosystem, which influences their species composition and diversity. Moreover, the appearance of a river in the riparian vegetation supported its diversity value since butterflies have the tendency to fly into areas near rivers. Species identification of other voucher specimen will be done in order to compute the overall species richness in PC Hills. Further butterfly sampling sessions of PC Hills is recommended for a more reliable diversity trend and to discover more butterfly species. Expanding the research by assessing the Rhopalocera diversity in other locations should be considered along with studying factors that affect butterfly species composition other than vegetation types.

Keywords: distribution patterns, DNA barcoding, morphological analysis, Rhopalocera

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Authors: Geanderson Eduardo Ambrósio, Dênis Antônio Da Cunha, Marcel Viana Pires

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Historically, human development has been based on economic gains associated with intensive energy activities, which often are exhaustive in the emission of Greenhouse Gases (GHGs). It requires the establishment of targets for mitigation of GHGs in order to disassociate the human development from emissions and prevent further climate change. Brazil presents itself as one of the most GHGs emitters and it is of critical importance to discuss such reductions in intra-national framework with the objective of distributional equity to explore its full mitigation potential without compromising the development of less developed societies. This research displays some incipient considerations about which Brazil’s micro-regions should reduce, when the reductions should be initiated and what its magnitude should be. We started with the methodological assumption that human development and GHGs emissions arise in the future as their behavior was observed in the past. Furthermore, we assume that once a micro-region became developed, it is able to maintain gains in human development without the need of keep growing GHGs emissions rates. The human development index and the carbon dioxide equivalent emissions (CO2e) were extrapolated to the year 2050, which allowed us to calculate when the micro-regions will become developed and the mass of GHG’s emitted. The results indicate that Brazil must throw 300 GT CO2e in the atmosphere between 2011 and 2050, of which only 50 GT will be issued by micro-regions before it’s develop and 250 GT will be released after development. We also determined national mitigation targets and structured reduction schemes where only the developed micro-regions would be required to reduce. The micro-region of São Paulo, the most developed of the country, should be also the one that reduces emissions at most, emitting, in 2050, 90% less than the value observed in 2010. On the other hand, less developed micro-regions will be responsible for less impactful reductions, i.e. Vale do Ipanema will issue in 2050 only 10% below the value observed in 2010. Such methodological assumption would lead the country to issue, in 2050, 56.5% lower than that observed in 2010, so that the cumulative emissions between 2011 and 2050 would reduce by 130 GT CO2e over the initial projection. The fact of associating the magnitude of the reductions to the level of human development of the micro-regions encourages the adoption of policies that favor both variables as the governmental planner will have to deal with both the increasing demand for higher standards of living and with the increasing magnitude of reducing emissions. However, if economic agents do not act proactively in local and national level, the country is closer to the scenario in which emits more than the one in which mitigates emissions. The research highlighted the importance of considering the heterogeneity in determining individual mitigation targets and also ratified the theoretical and methodological feasibility to allocate larger share of contribution for those who historically emitted more. It is understood that the proposals and discussions presented should be considered in mitigation policy formulation in Brazil regardless of the adopted reduction target.

Keywords: greenhouse gases, human development, mitigation, intensive energy activities

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Authors: Harvey Sanchez-Restrepo, Jorge Louca

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Equity and education are major focus of government policies around the world due to its relevance for addressing the sustainable development goals launched by Unesco. In this research, we developed a primary analysis of a data set of more than one hundred educational and non-educational factors associated with learning, coming from a census-based large-scale assessment carried on in Ecuador for 1.038.328 students, their families, teachers, and school directors, throughout 2014-2018. Each participating student was assessed by a standardized computer-based test. Learning outcomes were calibrated through item response theory with two-parameters logistic model for getting raw scores that were re-scaled and synthetized by a learning index (LI). Our objective was to develop a network for modelling educational deprivation and analyze the structure of inequality gaps, as well as their relationship with socioeconomic status, school financing, and student's ethnicity. Results from the model show that 348 270 students did not develop the minimum skills (prevalence rate=0.215) and that Afro-Ecuadorian, Montuvios and Indigenous students exhibited the highest prevalence with 0.312, 0.278 and 0.226, respectively. Regarding the socioeconomic status of students (SES), modularity class shows clearly that the system is out of equilibrium: the first decile (the poorest) exhibits a prevalence rate of 0.386 while rate for decile ten (the richest) is 0.080, showing an intense negative relationship between learning and SES given by R= –0.58 (p < 0.001). Another interesting and unexpected result is the average-weighted degree (426.9) for both private and public schools attending Afro-Ecuadorian students, groups that got the highest PageRank (0.426) and pointing out that they suffer the highest educational deprivation due to discrimination, even belonging to the richest decile. The model also found the factors which explain deprivation through the highest PageRank and the greatest degree of connectivity for the first decile, they are: financial bonus for attending school, computer access, internet access, number of children, living with at least one parent, books access, read books, phone access, time for homework, teachers arriving late, paid work, positive expectations about schooling, and mother education. These results provide very accurate and clear knowledge about the variables affecting poorest students and the inequalities that it produces, from which it might be defined needs profiles, as well as actions on the factors in which it is possible to influence. Finally, these results confirm that network analysis is fundamental for educational policy, especially linking reliable microdata with social macro-parameters because it allows us to infer how gaps in educational achievements are driven by students’ context at the time of assigning resources.

Keywords: complex network, educational deprivation, evidence-based policy, large-scale assessments, policy informatics

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Authors: Sudipto Sarkar, Anamika Paul

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Pseudoplastic (n<1, n is the power index) fluids have great importance in food, pharmaceutical and chemical process industries which require a lot of attention. Unfortunately, due to its complex flow behavior inadequate research works can be found even in laminar flow regime. A practical problem is solved in the present research work by numerical simulation where we tried to control the vortex shedding from a square cylinder using a horizontal splitter plate placed at the downstream flow region. The position of the plate is at the centerline of the cylinder with varying distance from the cylinder to calculate the critical gap-ratio. If the plate is placed inside this critical gap, the vortex shedding from the cylinder suppressed completely. The Reynolds number considered here is in unsteady laminar vortex shedding regime, Re = 100 (Re = U∞a/ν, where U∞ is the free-stream velocity of the flow, a is the side of the cylinder and ν is the maximum value of kinematic viscosity of the fluid). Flow behavior has been studied for three different gap-ratios (G/a = 2, 2.25 and 2.5, where G is the gap between cylinder and plate) and for a fluid with three different flow behavior indices (n =1, 0.8 and 0.5). The flow domain is constructed using Gambit 2.2.30 and this software is also used to generate the mesh and to impose the boundary conditions. For G/a = 2, the domain size is considered as 37.5a × 16a with 316 × 208 grid points in the streamwise and flow-normal directions respectively after a thorough grid independent study. Fine and equal grid spacing is used close to the geometry to capture the vortices shed from the cylinder and the boundary layer developed over the flat plate. Away from the geometry meshes are unequal in size and stretched out. For other gap-ratios, proportionate domain size and total grid points are used with similar kind of mesh distribution. Velocity inlet (u = U∞), pressure outlet (Neumann condition), symmetry (free-slip boundary condition) at upper and lower domain boundary conditions are used for the simulation. Wall boundary condition (u = v = 0) is considered both on the cylinder and the splitter plate surfaces. Discretized forms of fully conservative 2-D unsteady Navier Stokes equations are then solved by Ansys Fluent 14.5. SIMPLE algorithm written in finite volume method is selected for this purpose which is a default solver inculcate in Fluent. The results obtained for Newtonian fluid flow agree well with previous works supporting Fluent’s usefulness in academic research. A thorough analysis of instantaneous and time-averaged flow fields are depicted both for Newtonian and pseudoplastic fluid flow. It has been observed that as the value of n reduces the stretching of shear layers also reduce and these layers try to roll up before the plate. For flow with high pseudoplasticity (n = 0.5) the nature of vortex shedding changes and the value of critical gap-ratio reduces. These are the remarkable findings for laminar periodic vortex shedding regime in pseudoplastic flow environment.

Keywords: CFD, pseudoplastic fluid flow, wake-boundary layer interactions, critical gap-ratio

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Authors: Basma Hussein Abdelaziz Hassan, Kareem Kamel, Philobater Bahgat Adly Awad, Karim Fahmy

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Background: Laparoscopic adjustable gastric band was one of the most applied and common bariatric procedures in the last 8 years. However; the failure rate was very high, reaching approximately 60% of the patients not achieving the desired weight loss. Most patients sought another revisional surgery. In which, we compared two of the most common weight loss surgeries performed nowadays: the laparoscopic sleeve gastrectomy and laparoscopic one- anastomosis gastric bypass. Objective: To compare the weight loss and postoperative outcomes among patients undergoing conversion laparoscopic one-anastomosis gastric bypass (cOAGB) and laparoscopic sleeve gastrectomy (cSG) after a failed laparoscopic adjustable gastric band (LAGB). Patients and Methods: A prospective cohort study was conducted from June 2020 to June 2022 at a single medical center, which included 77 patients undergoing single-stage conversion to (cOAGB) vs (cSG). Patients were reassessed for weight loss, comorbidities remission, and post-operative complications at 6, 12, and 18 months. Results: There were 77 patients with failed LAGB in our study. Group (I) was 43 patients who underwent cOAGB and Group (II) was 34 patients who underwent cSG. The mean age of the cOAGB group was 38.58. While in the cSG group, the mean age was 39.47 (p=0.389). Of the 77 patients, 10 (12.99%) were males and 67 (87.01%) were females. Regarding Body mass index (BMI), in the cOAGB group the mean BMI was 41.06 and in the cSG group the mean BMI was 40.5 (p=0.042). The two groups were compared postoperative in relation to EBWL%, BMI, and the co-morbidities remission within 18 months follow-up. The BMI was calculated post-operative at three visits. After 6 months of follow-up, the mean BMI in the cOAGB group was 34.34, and the cSG group was 35.47 (p=0.229). In 12-month follow-up, the mean BMI in the cOAGB group was 32.69 and the cSG group was 33.79 (p=0.2). Finally, the mean BMI after 18 months of follow-up in the cOAGB group was 30.02, and in the cSG group was 31.79 (p=0.001). Both groups had no statistically significant values at 6 and 12 months follow-up with p-values of 0.229, and 0.2 respectively. However, patients who underwent cOAGB after 18 months of follow-up achieved lower BMI than those who underwent cSG with a statistically significant p-value of 0.005. Regarding EBWL% there was a statistically significant difference between the two groups. After 6 months of follow-up, the mean EBWL% in the cOAGB group was 35.9% and the cSG group was 33.14%. In the 12-month follow-up, the EBWL % mean in the cOAGB group was 52.35 and the cSG group was 48.76 (p=0.045). Finally, the mean EBWL % after 18 months of follow-up in the cOAGB group was 62.06 ±8.68 and in the cSG group was 55.58 ±10.87 (p=0.005). Regarding comorbidities remission; Diabetes mellitus remission was found in 22 (88%) patients in the cOAGB group and 10 (71.4%) patients in the cSG group with (p= 0.225). Hypertension remission was found in 20 (80%) patients in the cOAGB group and 14 (82.4%) patients in the cSG group with (p=1). In addition, dyslipidemia remission was found in 27(87%) patients in cOAGB group and 17(70%) patients in the cSG group with (p=0.18). Finally, GERD remission was found in about 15 (88.2%) patients in the cOAGB group and 6 (60%) patients in the cSG group with (p=0.47). There are no statistically significant differences between the two groups in the post-operative data outcomes. Conclusion: This study suggests that the conversion of LAGB to either cOAGB or cSG could be feasibly performed in a single-stage operation. cOAGB had a significant difference as regards the weight loss results than cSG among the mid-term follow-up. However, there is no significant difference in the postoperative complications and the resolution of the co-morbidities. Therefore, cOAGB could provide a reliable alternative but needs to be substantiated in future long-term studies.

Keywords: laparoscopic, gastric banding, one-anastomosis gastric bypass, Sleeve gastrectomy, revisional surgery, weight loss

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Authors: Sanaz Alizadeh, Yves Comeau, Arshath Abdul Rahim, Sunhasis Ghoshal

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The application of silver nanoparticles (AgNPs) in personal care products, various household and industrial products has resulted in an inevitable environmental exposure of such engineered nanoparticles (ENPs). Ag ENPs, released via household and industrial wastes, reach water resource recovery facilities (WRRFs), yet the fate and transport of ENPs in WRRFs and their potential risk in the biological wastewater processes are poorly understood. Accordingly, our main objective was to elucidate the impact of long-term continuous exposure to AgNPs on biological activity of aerobic wastewater biofilm. The fate, transport and toxicity of 10 μg.L-1and 100 μg.L-1 PVP-stabilized AgNPs (50 nm) were evaluated in an attached growth biological treatment process, using lab-scale moving bed bioreactors (MBBRs). Two MBBR systems for organic matter removal were fed with a synthetic influent and operated at a hydraulic retention time (HRT) of 180 min and 60% volumetric filling ratio of Anox-K5 carriers with specific surface area of 800 m2/m3. Both reactors were operated for 85 days after reaching steady state conditions to develop a mature biofilm. The impact of AgNPs on the biological performance of the MBBRs was characterized over a period of 64 days in terms of the filtered biodegradable COD (SCOD) removal efficiency, the biofilm viability and key enzymatic activities (α-glucosidase and protease). The AgNPs were quantitatively characterized using single-particle inductively coupled plasma mass spectroscopy (spICP-MS), determining simultaneously the particle size distribution, particle concentration and dissolved silver content in influent, bioreactor and effluent samples. The generation of reactive oxygen species and the oxidative stress were assessed as the proposed toxicity mechanism of AgNPs. Results indicated that a low concentration of AgNPs (10 μg.L-1) did not significantly affect the SCOD removal efficiency whereas a significant reduction in treatment efficiency (37%) was observed at 100 μg.L-1AgNPs. Neither the viability nor the enzymatic activities of biofilm were affected at 10 μg.L-1AgNPs but a higher concentration of AgNPs induced cell membrane integrity damage resulting in 31% loss of viability and reduced α-glucosidase and protease enzymatic activities by 31% and 29%, respectively, over the 64-day exposure period. The elevated intercellular ROS in biofilm at a higher AgNPs concentration over time was consistent with a reduced biological biofilm performance, confirming the occurrence of a nanoparticle-induced oxidative stress in the heterotrophic biofilm. The spICP-MS analysis demonstrated a decrease in the nanoparticles concentration over the first 25 days, indicating a significant partitioning of AgNPs into the biofilm matrix in both reactors. The concentration of nanoparticles increased in effluent of both reactors after 25 days, however, indicating a decreased retention capacity of AgNPs in biofilm. The observed significant detachment of biofilm also contributed to a higher release of nanoparticles due to cell-wall destabilizing properties of AgNPs as an antimicrobial agent. The removal efficiency of PVP-AgNPs and the biofilm biological responses were a function of nanoparticle concentration and exposure time. This study contributes to a better understanding of the fate and behavior of AgNPs in biological wastewater processes, providing key information that can be used to predict the environmental risks of ENPs in aquatic ecosystems.

Keywords: biofilm, silver nanoparticle, single particle ICP-MS, toxicity, wastewater

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Authors: Zermina Q., Wasif Y., Naeem S., Urooj S., Sajid R. A.

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Land degradation, a leading environemtnal problem and a decrease in the quality of land has become a major global issue, caused by human activities. By land degradation, more than half of the world’s drylands are affected. The worldwide scope of main saline soils is approximately 955 M ha, whereas inferior salinization affected approximately 77 M ha. In irrigated areas, a total of 58% of these soils is found. As most of the vegetation types requires fertile soil for their growth and quality production, salinity causes serious problem to the production of these vegetation types and agriculture demands. This research aims to identify the salt affected areas in the selected part of Indus Delta, Sindh province, Pakistan. This particular mangroves dominating coastal belt is important to the local community for their crop growth. Object based image analysis approach has been adopted on Landsat TM imagery of year 2011 by incorporating different mathematical band ratios, thermal radiance and salinity index. Accuracy assessment of developed salinity landcover map was performed using Erdas Imagine Accuracy Assessment Utility. Rain factor was also considered before acquiring satellite imagery and conducting field survey, as wet soil can greatly affect the condition of saline soil of the area. Dry season considered best for the remote sensing based observation and monitoring of the saline soil. These areas were trained with the ground truth data w.r.t pH and electric condutivity of the soil samples. The results were obtained from the object based image analysis of Keti bunder and Kharo chan shows most of the region under low saline soil.Total salt affected soil was measured to be 46,581.7 ha in Keti Bunder, which represents 57.81 % of the total area of 80,566.49 ha. High Saline Area was about 7,944.68 ha (9.86%). Medium Saline Area was about 17,937.26 ha (22.26 %) and low Saline Area was about 20,699.77 ha (25.69%). Where as total salt affected soil was measured to be 52,821.87 ha in Kharo Chann, which represents 55.87 % of the total area of 94,543.54 ha. High Saline Area was about 5,486.55 ha (5.80 %). Medium Saline Area was about 13,354.72 ha (14.13 %) and low Saline Area was about 33980.61 ha (35.94 %). These results show that the area is low to medium saline in nature. Accuracy of the soil salinity map was found to be 83 % with the Kappa co-efficient of 0.77. From this research, it was evident that this area as a whole falls under the category of low to medium saline area and being close to coastal area, mangrove forest can flourish. As Mangroves are salt tolerant plant so this area is consider heaven for mangrove plantation. It would ultimately benefit both the local community and the environment. Increase in mangrove forest control the problem of soil salinity and prevent sea water to intrude more into coastal area. So deforestation of mangrove should be regularly monitored.

Keywords: indus delta, object based image analysis, soil salinity, thematic mapper

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Authors: K. M. S. Weerasinghe, A. H. K. Balasooriya, S. L. Ransingha, G. D. Krishantha, R. S. Brhakamanagae, L. C. Wijethilke

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Tomato (Lycopersicon esculentum Mill.) is a major horticultural crop with an estimated global production of over 120 million metric tons and ranks first as a processing crop. The average tomato productivity in Sri Lanka (11 metric tons/ha) is much lower than the world average (24 metric tons/ha).To meet the tomato demand for the increasing population the productivity has to be intensified through the agronomic-techniques. Nutrition is one of the main factors which govern the growth and yield of tomato and the main nutrient source soil affect the plant growth and quality of the produce. Continuous cropping, improper fertilizer usage etc., cause widespread nutrient deficiencies. Therefore synthetic fertilizers and organic manures were introduced to enhance plant growth and maximize the crop yields. In this study, effects of macro and micronutrient supplementations on improvement of growth and yield of tomato were investigated. Selected tomato variety is Maheshi and plants were grown in Regional Agricultural and Research Centre Makadura under the Department of Agriculture recommended (DOA) macro nutrients and various combination of Ontario recommended dosages of secondary and micro fertilizer supplementations. There were six treatments in this experiment and each treatment was replicated in three times and each replicate consisted of six plants. Other than the DOA recommendation, five combinations of Ontario recommended dosage of secondary and micronutrients for tomato were also used as treatments. The treatments were arranged in a Randomized Complete Block Design. All cultural practices were carried out according to the DOA recommendations. The mean data was subjected to the statistical analysis using SAS package and mean separation (Duncan’s Multiple Range test at 5% probability level) procedures. Secondary and micronutrients containing treatments significantly increased most of the growth parameters. Plant height, plant girth, number of leaves, leaf area index etc. Fruits harvested from pots amended with macro, secondary and micronutrients performed best in terms of total yield; yield quality; to pots amended with DOA recommended dosage of fertilizer for tomato. It could be due to the application of all essential macro and micro nutrients that rise in photosynthetic activity, efficient translocation and utilization of photosynthates causing rapid cell elongation and cell division in actively growing region of the plant leading to stimulation of growth and yield were caused. The experiment revealed and highlighted the requirements of essential macro, secondary and micro nutrient fertilizer supplementations for tomato farming. The study indicated that, macro and micro nutrient supplementation practices can influence growth and yield performances of tomato fruits and it is a promising approach to get potential tomato yields.

Keywords: macro and micronutrients, tomato, SAS package, photosynthates

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Authors: Saleh Gorji, Sahil Gulati, Ana Pakzad

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Continuous electron diffraction tomography, also known as microcrystal electron diffraction (MicroED) or three-dimensional electron diffraction (3DED), is a powerful technique, which in combination with cryo-electron microscopy (cryo-ED), can provide atomic-scale 3D information about the crystal structure and composition of different classes of crystalline materials such as proteins, peptides, and small molecules. Unlike the well-established X-ray crystallography method, 3DED does not require large single crystals and can collect accurate electron diffraction data from crystals as small as 50 – 100 nm. This is a critical advantage as growing larger crystals, as required by X-ray crystallography methods, is often very difficult, time-consuming, and expensive. In most cases, specimens studied via 3DED method are electron beam sensitive, which means there is a limitation on the maximum amount of electron dose one can use to collect the required data for a high-resolution structure determination. Therefore, collecting data using a conventional scintillator-based fiber coupled camera brings additional challenges. This is because of the inherent noise introduced during the electron-to-photon conversion in the scintillator and transfer of light via the fibers to the sensor, which results in a poor signal-to-noise ratio and requires a relatively higher and commonly specimen-damaging electron dose rates, especially for protein crystals. As in other cryo-EM techniques, damage to the specimen can be mitigated if a direct detection camera is used which provides a high signal-to-noise ratio at low electron doses. In this work, we have used two classes of such detectors from Gatan, namely the K3® camera (a monolithic active pixel sensor) and Stela™ (that utilizes DECTRIS hybrid-pixel technology), to address this problem. The K3 is an electron counting detector optimized for low-dose applications (like structural biology cryo-EM), and Stela is also a counting electron detector but optimized for diffraction applications with high speed and high dynamic range. Lastly, data collection workflows, including crystal screening, microscope optics setup (for imaging and diffraction), stage height adjustment at each crystal position, and tomogram acquisition, can be one of the other challenges of the 3DED technique. Traditionally this has been all done manually or in a partly automated fashion using open-source software and scripting, requiring long hours on the microscope (extra cost) and extensive user interaction with the system. We have recently introduced Latitude® D in DigitalMicrograph® software, which is compatible with all pre- and post-energy-filter Gatan cameras and enables 3DED data acquisition in an automated and optimized fashion. Higher quality 3DED data enables structure determination with higher confidence, while automated workflows allow these to be completed considerably faster than before. Using multiple examples, this work will demonstrate how to direct detection electron counting cameras enhance 3DED results (3 to better than 1 Angstrom) for protein and small molecule structure determination. We will also show how Latitude D software facilitates collecting such data in an integrated and fully automated user interface.

Keywords: continuous electron diffraction tomography, direct detection, diffraction, Latitude D, Digitalmicrograph, proteins, small molecules

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Authors: Eric Spruth, Lindsey Herbert, Danielle DiCristofano, Isis Violet Spruth, Drake Von Spruth

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Turning dreams into reality, the lifelong passion of Mr. Spruth and the company is to transform garbage-filled courtyards into flourishing flower and vegetable gardens, bringing light, hope, and wellness to not just the space but to the populations served within these public and private spaces. As an Expressive Art Therapist at Cook County Jail, Eric Spruth has implemented gardening projects, mobile radish carts, plant fostering systems, and large-scale murals. Lindsey Herbert, the Manager of Operations and Events at the International Museum of Surgical Science, supports gardening projects with Mr. Spruth along the front lawn of the museum, which will eventually accumulate into a community wellness garden. Mr. Spruth and Ms. Herbert both have dedicated efforts towards fostering awareness of hope and help and accountability for physical and mental wellbeing. Medicinal plants can rightfully be called one of nature’s wonderful healing tools with therapeutic powers. They can inhibit and kill bacteria, lower blood pressure, blood cholesterol, and blood sugar, prevent blood clotting, boost the immune system, and serve as a digestive aid. Some plants have the ability to stimulate the lymphatic system, which expedites the removal of waste products from the body to fight off evil toxins. Many plants are considered effective antioxidants to protect cells against free radical damage, serving to prevent some forms of cancer, heart disease, strokes, and viral infections. Garlic alone can provide us with over two hundred unusual chemicals that have the capability of protecting the human body from a wide variety of diseases. Besides the medicinal qualities of plants, plant and vegetable gardens also have an echoing effect on non-participants to look at something beautiful rather than a concrete courtyard or an unkempt lawn in front of a beautiful building. Plants also purify spaces and affect mood with color therapy. Collective gardening can foster a sense of community and purpose. Additionally, by recognizing the ever-evolving planet with global warming, horticulture therapy teaches important lessons in responsibility, accountability, and sustainability. Growing local food provides an opportunity to be involved in your own mental and physical health and gives you a chance for your own self-resilience, combating depression and a lack of nutrition. In adolescents, the process of watering and caring for plants can teach important life lessons that transcend beyond the garden by providing knowledge on how to care for yourself and how to be an active member of society. It also gives a sense of purpose and pride in transforming a small seed into a plant that can be consumed or enjoyed by others. Mr. Spruth and Ms. Herbert recognize the importance of bringing more green spaces to urban areas, both to serve a nutritional benefit and provide a beautiful transformation to underutilized areas. Gardens can bring beauty, wellness, and hope to dark spaces and provide immeasurable benefits for all.

Keywords: growth, hope, mental health, sustainability, transformation, wellness

Procedia PDF Downloads 92

Authors: Yu-Chi Liao, Nai-Wen Guo, Chun‑Hung Lee, Yung-Chin Lu, Cheng-Hung Ko

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Objective: The incidence of behavioral addictions, especially substance use disorders (SUDs), is gradually be taken seriously with various physical health problems. Mindfulness-based relapse prevention (MBRP) is a treatment option for promoting long-term health behavior change in recent years. MBRP is a structured protocol that integrates formal meditation practices with the cognitive-behavioral approach of relapse prevention treatment by teaching participants not to engage in reappraisal or savoring techniques. However, considering SUDs as a complex brain disease, questionnaires and symptom evaluation are not sufficient to evaluate the effect of MBRP. Neurophysiological biomarkers such as quantitative electroencephalogram (QEEG) may improve accurately represent the curative effects. This study attempted to find out the neurophysiological indicator of MBRP in various severity SUD involuntary clients. Participants and Methods: Thirteen participants (all males) completed 8-week mindfulness-based treatment provided by trained, licensed clinical psychologists. The behavioral data were from the Severity of Dependence Scale (SDS) and Negative Mood Regulation Scale (NMR) before and afterMBRP treatment. The QEEG data were simultaneously recorded with executive attention tasks, called comprehensive nonverbal attention test(CNAT). The two-way repeated-measures (treatment * severity) ANOVA and independent t-test were used for statistical analysis. Results: Thirteen participants regrouped into high substance dependence (HS) and low substance dependence (LS) by SDS cut-off. The HS group showed more SDS total score and lower gamma wave in the Go/No Go task of CNAT at pretest. Both groups showed the main effect that they had a lower frontal theta/beta ratio (TBR) during the simple reaction time task of CNAT. The main effect showed that the delay errors of CNAT were lower after MBRP. There was no other difference in CNAT between groups. However, after MBRP, compared to LS, the HS group have resonant progress in improving SDS and NMR scores. The neurophysiological index, the frontal TBR of the HS during the Go/No Go task of CNATdecreased than that of the LS group. Otherwise, the LS group’s gamma wave was a significant reduction on the Go/No Go task of CNAT. Conclusion: The QEEG data supports the MBRP can restore the prefrontal function of involuntary addicts and lower their errors in executive attention tasks. However, the improvement of MBRPfor the addict with high addiction severity is significantly more than that with low severity, including QEEG’s indicators and negative emotion regulation. Future directions include investigating the reasons for differences in efficacy among different severity of the addiction.

Keywords: mindfulness, involuntary clients, QEEG, emotion regulation

Procedia PDF Downloads 147

Authors: Wiolene Montanari Nordi, Debora Botequio Moretti, Mariana Caroline Pontin, Jessica Pampolini, Raul Machado-Neto

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Gills are organs responsible for respiration and osmoregulation between the fish internal environment and water. Under stress conditions, oxidative response and gill plasticity to attempt to increase gas exchange area are noteworthy, compromising the physiological processes and therefore fish health. Colostrum is a dietary source of nutrients, immunoglobulin, antioxidant and bioactive molecules, essential for immunological protection and development of the gastrointestinal epithelium. The hypothesis of this work is that antioxidant factors present in the colostrum, unprecedentedly tested in gills, can minimize or reduce the alteration of its epithelium structure of juvenile pacu (Piaractus mesopotamicus) subjected to high stocking density. The histological changes in the gills architecture were characterized by the frequency, incidence and severity of the tissue alteration and ionic status. Juvenile (50 kg fish/m3) were fed with pelleted diets containing 0, 10, 20 or 30% of lyophilized bovine colostrum (LBC) inclusion and at 30 experimental days, gill and blood samples were collected in eight fish per treatment. The study revealed differences in the type, frequency and severity (histological alterations index – HAI) of tissue alterations among the treatments, however, no distinct differences in the incidence of alteration (mean alteration value – MAV) were observed. The main histological changes in gill were elevation of the lamellar epithelium, excessive cell proliferation of the filament and lamellar epithelium causing total or partial melting of the lamella, hyperplasia and hypertrophy of lamellar and filament epithelium, uncontrolled thickening of filament and lamellar tissues, mucous and chloride cells presence in the lamella, aneurysms, vascular congestion and presence of parasites. The MAV obtained per treatment were 2.0, 2.5, 1.8 and 2.5 to fish fed diets containing 0, 10, 20 and 30% of LBC inclusion, respectively, classifying the incidence of gill alterations as slightly to moderate. The severity of alteration of individual fish of treatment 0, 10 and 20% LBC ranged values from 5 to 40 (HAI average of 20.1, 17.5 and 17.6, respectively, P > 0.05), and differs from 30% LBC, that ranged from 6 to 129 (HAI mean of 77.2, P < 0.05). The HAI value in the treatments 0, 10 and 20% LBC reveals gill tissue with injuries classified from slightly to moderate, while in 30% LBC moderate to severe, consequence of the onset of necrosis in the tissue of two fish that compromises the normal functioning of the organ. In relation to frequency of gill alterations, evaluated according to absence of alterations (0) to highly frequent (+++), histological alterations were observed in all evaluated fish, with a trend of higher frequency in 0% LBC. The concentration of Na+, Cl-, K+ and Ca2+ did not changed in all treatments (P > 0.05), indicating similar capacity of ion exchange. The concentrations of bovine colostrum used in diets of present study did not impair the alterations observed in the gills of juvenile pacu.

Keywords: histological alterations of gill tissue, ionic status, lyophilized bovine colostrum, optical microscopy

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Authors: Anatoliy A. Alabugin, Nikolay K. Topuzov, Sergei V. Aliukov

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It is well known, that while we do a quantitative evaluation of the quality control of some economic processes (in particular, resource saving) with help innovation factors, there are three groups of problems: high uncertainty of indicators of the quality management, their considerable ambiguity, and high costs to provide a large-scale research. These problems are defined by the use of contradictory objectives of enhancing of the quality control in accordance with innovation factors and preservation of economic stability of the enterprise. The most acutely, such factors are felt in the countries lagging behind developed economies of the world according to criteria of innovativeness and effectiveness of management of the resource saving. In our opinion, the following two methods for reconciling of the above-mentioned objectives and reducing of conflictness of the problems are to solve this task most effectively: 1) the use of paradigms and concepts of evolutionary improvement of quality of resource-saving management in the cycle "from the project of an innovative product (technology) - to its commercialization and update parameters of customer value"; 2) the application of the so-called integrative-cyclical approach which consistent with complexity and type of the concept, to studies allowing to get quantitative assessment of the stages of achieving of the consistency of these objectives (from baseline of imbalance, their compromise to achievement of positive synergies). For implementation, the following mathematical tools are included in the integrative-cyclical approach: index-factor analysis (to identify the most relevant factors); regression analysis of relationship between the quality control and the factors; the use of results of the analysis in the model of fuzzy sets (to adjust the feature space); method of non-parametric statistics (for a decision on the completion or repetition of the cycle in the approach in depending on the focus and the closeness of the connection of indicator ranks of disbalance of purposes). The repetition is performed after partial substitution of technical and technological factors ("hard") by management factors ("soft") in accordance with our proposed methodology. Testing of the proposed approach has shown that in comparison with the world practice there are opportunities to improve the quality of resource-saving management using innovation factors. We believe that the implementation of this promising research, to provide consistent management decisions for reducing the severity of the above-mentioned contradictions and increasing the validity of the choice of resource-development strategies in terms of parameters of quality management and sustainability of enterprise, is perspective. Our existing experience in the field of quality resource-saving management and the achieved level of scientific competence of the authors allow us to hope that the use of the integrative-cyclical approach to the study and evaluation of the resulting and factor indicators will help raise the level of resource-saving characteristics up to the value existing in the developed economies of post-industrial type.

Keywords: integrative-cyclical approach, quality control, evaluation, innovation factors. economic sustainability, innovation cycle of management, disbalance of goals of development

Procedia PDF Downloads 245

Authors: Tak Mau Simon Chan

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While there is growing reflection of the adverse impacts instigated by the flourishing gaming industry on the physical health and job satisfaction of those who work in Macau casinos, there is also a critical void in our understanding of the mental health of croupiers and how casino employment interacts with the family system. From a systemic approach, it would be most effective to examine the ‘dealer issues’ collectively and offer assistance to both the individual dealer and the family system of dealers. Therefore, with the use of a mixed method study design, the levels of anxiety, depression and sleeping quality of a sample of 1124 dealers who are working in Macau casinos have been measured in the present study, and 113 dealers have been interviewed about the impacts of casino employment on their family life. This study presents some very important findings. First, the quantitative study indicates that gender is a significant predictor of depression and anxiety levels, whilst lower income means less quality sleep. The Pearson’s correlation coefficients show that as the Zung Self-rating Anxiety Scale (ZSAS) scores increase, the Zung Self-rating Depression Scale (ZSDS) and Pittsburgh Sleep Quality Index (PSQI) scores will also simultaneously increase. Higher income, therefore, might partly explain for the reason why mothers choose to work in the gaming industry even with shift work involved and a stressful work environment. Second, the findings from the qualitative study show that aside from the positive impacts on family finances, the shift work and job stress to some degree negatively affect family responsibilities and relationships. There are resultant family issues, including missed family activities, and reduced parental care and guidance, marital intimacy, and communication with family members. Despite the mixed views on the gender role differences, the respondents generally agree that female dealers have more family and child-minding responsibilities at home, and thus it is more difficult for them to balance work and family. Consequently, they may be more vulnerable to stress at work. Thirdly, there are interrelationships between work and family, which are based on a systemic inquiry that incorporates work- individual- family. Poor physical and psychological health due to shift work or a harmful work environment could affect not just work performance, but also life at home. Therefore, a few practice points about 1) work-family conflicts in Macau; 2) families-in- transition in Macau; and 3) gender and class sensitivity in Macau; are provided for social workers and family practitioners who will greatly benefit these families, especially whose family members are working in the gaming industry in Macau. It is concluded that in addressing the cultural phenomenon of “dealer’s complex” in Macau, a systemic approach is recommended that addresses both personal psychological needs and family issue of dealers.

Keywords: family, work stress, mental health, Macau, dealers, gaming industry

Procedia PDF Downloads 304

Authors: Savas Yildiz

Abstract:

The article assesses the performance of international aid donors to determine the sub-national distribution of their aid projects dependent on recipient countries’ governance. The present paper extends the scope from a cross-country perspective to a more detailed analysis by looking at the effects of institutional qualities on the sub-national distribution of foreign aid. The analysis examines geo-referenced aid project in 37 countries and 404 regions at the first administrative division level in Sub-Saharan Africa from the World Bank (WB) and the African Development Bank (ADB) that were approved between the years 2000 and 2011. To measure the influence of institutional qualities on the distribution of aid the following measures are used: control of corruption, government effectiveness, regulatory quality and rule of law from the World Governance Indicators (WGI) and the corruption perception index from Transparency International. Furthermore, to assess the importance of ethnic heterogeneity on the sub-national distribution of aid projects, the study also includes interaction terms measuring ethnic fragmentation. The regression results indicate a general skew of aid projects towards regions which hold capital cities, however, being incumbent presidents’ birth region does not increase the allocation of aid projects significantly. Nevertheless, with increasing quality of institutions aid projects are less skewed towards capital regions and the previously estimated coefficients loose significance in most cases. Higher ethnic fragmentation also seems to impede the possibility to allocate aid projects mainly in capital city regions and presidents’ birth places. Additionally, to assess the performance of the WB based on its own proclaimed goal to aim the poor in a country, the study also includes sub-national wealth data from the Demographic and Health Surveys (DSH), and finds that, even with better institutional qualities, regions with a larger share from the richest quintile receive significantly more aid than regions with a larger share of poor people. With increasing ethnic diversity, the allocation of aid projects towards regions where the richest citizens reside diminishes, but still remains high and significant. However, regions with a larger share of poor people still do not receive significantly more aid. This might imply that the sub-national distribution of aid projects increases in general with higher ethnic fragmentation, independent of the diverse regional needs. The results provide evidence that institutional qualities matter to undermine the influence of incumbent presidents on the allocation of aid projects towards their birth regions and capital regions. Moreover, even for countries with better institutional qualities the WB and the ADB do not seem to be able to aim the poor in a country with their aid projects. Even, if one considers need-based variables, such as infant mortality and child mortality rates, aid projects do not seem to be allocated in districts with a larger share of people in need. Therefore, the study provides further evidence using more detailed information on the sub-national distribution of aid projects that aid is not being allocated effectively towards regions with a larger share of poor people to alleviate poverty in recipient countries directly. Institutions do not have any significant influence on the sub-national distribution of aid towards the poor.

Keywords: aid allocation, georeferenced data, institutions, spatial analysis

Procedia PDF Downloads 119

Authors: Shreyas Kumar, Mili Shangari

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Integrating artificial intelligence (AI) in the cyber insurance sector represents a significant advancement, offering the potential to revolutionize risk assessment, fraud detection, and claims processing. However, this integration introduces a range of regulatory and economic challenges that must be addressed to ensure responsible and effective deployment of AI technologies. This paper examines the multifaceted regulatory landscape governing AI in cyber insurance and explores the economic implications of compliance, innovation, and market dynamics. AI's capabilities in processing vast amounts of data and identifying patterns make it an invaluable tool for insurers in managing cyber risks. Yet, the application of AI in this domain is subject to stringent regulatory scrutiny aimed at safeguarding data privacy, ensuring algorithmic transparency, and preventing biases. Regulatory bodies, such as the European Union with its General Data Protection Regulation (GDPR), mandate strict compliance requirements that can significantly impact the deployment of AI systems. These regulations necessitate robust data protection measures, ethical AI practices, and clear accountability frameworks, all of which entail substantial compliance costs for insurers. The economic implications of these regulatory requirements are profound. Insurers must invest heavily in upgrading their IT infrastructure, implementing robust data governance frameworks, and training personnel to handle AI systems ethically and effectively. These investments, while essential for regulatory compliance, can strain financial resources, particularly for smaller insurers, potentially leading to market consolidation. Furthermore, the cost of regulatory compliance can translate into higher premiums for policyholders, affecting the overall affordability and accessibility of cyber insurance. Despite these challenges, the potential economic benefits of AI integration in cyber insurance are significant. AI-enhanced risk assessment models can provide more accurate pricing, reduce the incidence of fraudulent claims, and expedite claims processing, leading to overall cost savings and increased efficiency. These efficiencies can improve the competitiveness of insurers and drive innovation in product offerings. However, balancing these benefits with regulatory compliance is crucial to avoid legal penalties and reputational damage. The paper also explores the potential risks associated with AI integration, such as algorithmic biases that could lead to unfair discrimination in policy underwriting and claims adjudication. Regulatory frameworks need to evolve to address these issues, promoting fairness and transparency in AI applications. Policymakers play a critical role in creating a balanced regulatory environment that fosters innovation while protecting consumer rights and ensuring market stability. In conclusion, the integration of AI in cyber insurance presents both regulatory and economic challenges that require a coordinated approach involving regulators, insurers, and other stakeholders. By navigating these challenges effectively, the industry can harness the transformative potential of AI, driving advancements in risk management and enhancing the resilience of the cyber insurance market. This paper provides insights and recommendations for policymakers and industry leaders to achieve a balanced and sustainable integration of AI technologies in cyber insurance.

Keywords: artificial intelligence (AI), cyber insurance, regulatory compliance, economic impact, risk assessment, fraud detection, cyber liability insurance, risk management, ransomware

Procedia PDF Downloads 33