Search results for: target groups
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 9217

Search results for: target groups

8647 Career Development for Benjarong Porcelain Handicraft Communities in Central Thailand

Authors: Chutikarn Sriwiboon, Suwaree Yordchim

Abstract:

Benjarong handicraft product is one of the most important handicraft products from Thailand. It involves the management of traditional wisdom of arts and Thai culture. This paper drew upon data collection from local communities by using an in-depth interview technique which was conducted in Thailand during summer of 2014. The survey was structured primarily to obtain local wisdom and concerns toward their career development. This research paper was a qualitative research conducted by focus groups with a total of 51 cooperative women and occupational groups around Thailand which produced the Benjarong products. The data were significantly collected from many sources and many communities, which totaled 24,430 handicraft products, in which the 668 different patterns of Benjarong products were produced by 51 local community network groups in Thailand. The findings revealed that after applying the Philosophy of Sufficiency Economy, there was a significantly positive change in their career development and the process of knowledge management enables local community to enhance their personal development and career.

Keywords: Benjarong, career development, community, handicraft

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8646 Performance Based Seismic Retrofit of Masonry Infiled Reinforced Concrete Frames Using Passive Energy Dissipation Devices

Authors: Alok Madan, Arshad K. Hashmi

Abstract:

The paper presents a plastic analysis procedure based on the energy balance concept for performance based seismic retrofit of multi-story multi-bay masonry infilled reinforced concrete (R/C) frames with a ‘soft’ ground story using passive energy dissipation (PED) devices with the objective of achieving a target performance level of the retrofitted R/C frame for a given seismic hazard level at the building site. The proposed energy based plastic analysis procedure was employed for developing performance based design (PBD) formulations for PED devices for a simulated application in seismic retrofit of existing frame structures designed in compliance with the prevalent standard codes of practice. The PBD formulations developed for PED devices were implemented for simulated seismic retrofit of a representative code-compliant masonry infilled R/C frame with a ‘soft’ ground story using friction dampers as the PED device. Non-linear dynamic analyses of the retrofitted masonry infilled R/C frames is performed to investigate the efficacy and accuracy of the proposed energy based plastic analysis procedure in achieving the target performance level under design level earthquakes. Results of non-linear dynamic analyses demonstrate that the maximum inter-story drifts in the masonry infilled R/C frames with a ‘soft’ ground story that is retrofitted with the friction dampers designed using the proposed PBD formulations are controlled within the target drifts under near-field as well far-field earthquakes.

Keywords: energy methods, masonry infilled frame, near-field earthquakes, seismic protection, supplemental damping devices

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8645 Calcitriol Improves Plasma Lipoprotein Profile by Decreasing Plasma Total Cholesterol and Triglyceride in Hypercholesterolemic Golden Syrian Hamsters

Authors: Xiaobo Wang, Zhen-Yu Chen

Abstract:

Higher plasma total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) are independent risk factors of cardiovascular disease while high-density lipoprotein cholesterol (HDL-C) is protective. Vitamin D is well-known for its regulatory role in calcium homeostasis. Its potential important role in cardiovascular disease has recently attracted much attention. This study was conducted to investigate effects of different dosage of calcitriol on plasma lipoprotein profile and the underlying mechanism. Sixty male Syrian Golden hamsters were randomly divided into 6 groups: no-cholesterol control (NCD), high-cholesterol control (HCD), groups with calcitriol supplementation at 10/20/40/80ng/kg body weight (CA, CB, CC, CD), respectively. Calcitriol in medium-chain triacylglycerol (MCT) oil was delivered to four experimental groups via oral gavage every other day, while NCD and HCD received MCT oil in the equivalent amount. NCD hamsters were fed with non-cholesterol diet while other five groups were maintained on diet containing 0.2% cholesterol to induce a hypercholesterolemic condition. The treatment lasts for 6 weeks followed by sample collection after hamsters sacrificed. Four experimental groups experienced a reduction in average food intake around 11% compared to HCD with slight decrease in body weight (not exceeding 10%). This reduction reflects on the deceased relative weights of testis, epididymal and perirenal adipose tissue in a dose-dependent manner. Plasma calcitriol levels were measured and was corresponding to oral gavage. At the end of week 6, lipoprotein profiles were improved with calcitriol supplementation with TC, non-HDL-C and plasma triglyceride (TG) decreased in a dose-dependent manner (TC: r=0.373, p=0.009, non-HDL-C: r=0.479, p=0.001, TG: r=0.405, p=0.004). Since HDL-C of four experiment groups showed no significant difference compared to HCD, the ratio of nHDL-C to HDL-C and HDL-C to TC had been restored in a dose-dependent manner. For hamsters receiving the highest level of calcitriol (80ng/kg) showed a reduction of TC by 11.5%, nHDL-C by 24.1% and TG by 31.25%. Little difference was found among six groups on the acetylcholine-induced endothelium-dependent relaxation or contraction of thoracic aorta. To summarize, calcitriol supplementation in hamster at maximum 80ng/kg body weight for 6 weeks lead to an overall improvement in plasma lipoprotein profile with decreased TC and TG level. The molecular mechanism of its effects is under investigation.

Keywords: cholesterol, vitamin D, calcitriol, hamster

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8644 A Shift in Approach from Cereal Based Diet to Dietary Diversity in India: A Case Study of Aligarh District

Authors: Abha Gupta, Deepak K. Mishra

Abstract:

Food security issue in India has surrounded over availability and accessibility of cereal which is regarded as the only food group to check hunger and improve nutrition. Significance of fruits, vegetables, meat and other food products have totally been neglected given the fact that they provide essential nutrients to the body. There is a need to shift the emphasis from cereal-based approach to a more diverse diet so that aim of achieving food security may change from just reducing hunger to an overall health. This paper attempts to analyse how far dietary diversity level has been achieved across different socio-economic groups in India. For this purpose, present paper sets objectives to determine (a) percentage share of different food groups to total food expenditure and consumption by background characteristics (b) source of and preference for all food items and, (c) diversity of diet across socio-economic groups. A cross sectional survey covering 304 households selected through proportional stratified random sampling was conducted in six villages of Aligarh district of Uttar Pradesh, India. Information on amount of food consumed, source of consumption and expenditure on food (74 food items grouped into 10 major food groups) was collected with a recall period of seven days. Per capita per day food consumption/expenditure was calculated through dividing consumption/expenditure by household size and number seven. Food variety score was estimated by giving 0 values to those food groups/items which had not been eaten and 1 to those which had been taken by households in last seven days. Addition of all food group/item score gave result of food variety score. Diversity of diet was computed using Herfindahl-Hirschman index. Findings of the paper show that cereal, milk, roots and tuber food groups contribute a major share in total consumption/expenditure. Consumption of these food groups vary across socio-economic groups whereas fruit, vegetables, meat and other food consumption remain low and same. Estimation of dietary diversity show higher concentration of diet due to higher consumption of cereals, milk, root and tuber products and dietary diversity slightly varies across background groups. Muslims, Scheduled caste, small farmers, lower income class, food insecure, below poverty line and labour families show higher concentration of diet as compared to their counterpart groups. These groups also evince lower mean intake of number of food item in a week due to poor economic constraints and resultant lower accessibility to number of expensive food items. Results advocate to make a shift from cereal based diet to dietary diversity which not only includes cereal and milk products but also nutrition rich food items such as fruits, vegetables, meat and other products. Integrating a dietary diversity approach in food security programmes of the country would help to achieve nutrition security as hidden hunger is widespread among the Indian population.

Keywords: dietary diversity, food Security, India, socio-economic groups

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8643 Tranexamic Acid in Orthopedic Surgery in Children

Authors: K. Amanzoui, A. Erragh, M. Elharit, A. Afif, K. Elfakhr, S. Kalouch, A. Chlilek

Abstract:

Orthopedic surgery is a provider of pre and postoperative bleeding; patients are exposed to several risks, and different measures are proposed to reduce bleeding during surgery, called the transfusion-sparing method, including tranexamic acid, which has shown its effectiveness in numerous studies. A prospective analytical study in 50 children was carried out in the orthopedic traumatology operating room of the EL HAROUCHI hospital of the CHU IBN ROCHD in Casablanca over a period of six months (April to October 2022). Two groups were randomized: one receiving tranexamic acid (Group A) and a non-receiving control group (Group B). The average age was 10.3 years, of which 58.8% were female. The first type of surgery was thoracolumbar scoliosis (52%). The average preoperative hemoglobin was 12.28 g/dl in group A, against 12.67 g/dl in the control group. There was no significant difference between the two groups (p=0.148). Mean intraoperative bleeding was 396.29 ml in group A versus 412 ml in the control group. No significant difference was observed for this parameter (p=0.632). The average hemoglobin level in the immediate postoperative period in our patients is 10.2 g/dl. In group A, it was 10.95 g/dl versus 10.93 g/dl in group B. At H24 postoperative, the mean hemoglobin value was 10.29 g/dl in group A against 9.5 g/dl in group B. For group A, the blood loss recorded during the first 24 hours was 209.43 ml, against 372 ml in group B, with a significant difference between the two groups (p=0.001). There is no statistically significant difference between the 2 groups in terms of the use of fillers, ephedrine or intraoperative transfusion. While for postoperative transfusion, we note the existence of a statistically significant difference between group A and group B. It is suggested that the use of tranexamic acid is an effective, simple, and low-cost way to limit postoperative blood loss and the need for transfusion.

Keywords: tranexamic acid, blood loss, orthopedic surgery, children

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8642 Phonological Characteristics of Severe to Profound Hearing Impaired Children

Authors: Akbar Darouie, Mamak Joulaie

Abstract:

In regard of phonological skills development importance and its influence on other aspects of language, this study has been performed. Determination of some phonological indexes in children with hearing impairment and comparison with hearing children was the objective. A sample of convenience was selected from a rehabilitation center and a kindergarten in Karaj, Iran. Participants consisted of 12 hearing impaired and 12 hearing children (age range: 5 years and 6 months to 6 years and 6 months old). Hearing impaired children suffered from severe to profound hearing loss while three of them were cochlear implanted and the others were wearing hearing aids. Conversational speech of these children was recorded and 50 first utterances were selected to analyze. Percentage of consonant correct (PCC) and vowel correct (PVC), initial and final consonant omission error, cluster consonant omission error and syllabic structure variety were compared in two groups. Data were analyzed with t test (version 16th SPSS). Comparison between PCC and PVC averages in two groups showed a significant difference (P< 0/01). There was a significant difference about final consonant emission error (P<0/001) and initial consonant emission error (P<0/01) too. Also, the differences between two groups on cluster consonant omission were significant (P<0/001). Therefore, some changes were seen in syllabic structures in children with hearing impairment compared to typical group. This study demonstrates some phonological differences in Farsi language between two groups of children. Therefore, it seems, in clinical practices we must notice this issue.

Keywords: hearing impairment, phonology, vowel, consonant

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8641 The Implementation of Poisson Impedance Inversion to Improve Hydrocarbon Reservoir Characterization in Poseidon Field, Browse Basin, Australia

Authors: Riky Tri Hartagung, Mohammad Syamsu Rosid

Abstract:

The lithology prediction process, as well as the fluid content is the most important part in the reservoir characterization. One of the methods used in this process is the simultaneous seismic inversion method. In the Posseidon field, Browse Basin, Australia, the parameters generated through simultaneous seismic inversion are not able to characterize the reservoir accurately because of the overlapping impedance values between hydrocarbon sand, water sand, and shale, which causes a high level of ambiguity in the interpretation. The Poisson Impedance inversion provides a solution to this problem by rotating the impedance a few degrees, which is obtained through the coefficient c. Coefficient c is obtained through the Target Correlation Coefficient Analysis (TCCA) by finding the optimum correlation coefficient between Poisson Impedance and the target log, namely gamma ray, effective porosity, and resistivity. Correlation of each of these target logs will produce Lithology Impedance (LI) which is sensitive to lithology sand, Porosity Impedance (ϕI) which is sensitive to porous sand, and Fluid Impedance (FI) which is sensitive to fluid content. The results show that PI gives better results in separating hydrocarbon saturated reservoir zones. Based on the results of the LI-GR crossplot, the ϕI-effective porosity crossplot, and the FI-Sw crossplot with optimum correlations of 0.74, 0.91, and 0.82 respectively, it shows that the lithology of hidrocarbon-saturated porous sand is at the value of LI ≤ 2800 (m/s)(g *cc), ϕI ≤ 5500 (m/s)(g*cc), and FI ≤ 4000 (m/s)(g*cc). The presence of low values of LI, ϕI, and FI correlates accurately with the presence of hydrocarbons in the well. Each value of c is then applied to the seismic data. The results show that the PI inversion gives a good distribution of Hydrocarbon-saturated porous sand lithology. The distribution of hydrocarbon saturated porous sand on the seismic inversion section is seen in the northeast – southwest direction, which is estimated as the direction of gas distribution.

Keywords: reservoir characterization, poisson impedance, browse basin, poseidon field

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8640 The Effect of the Structural Arrangement of Binary Bisamide Organogelators on their Self-Assembly Behavior

Authors: Elmira Ghanbari, Jan Van Esch, Stephen J. Picken, Sahil Aggarwal

Abstract:

Low-molecular-weight organogelators form gels by self-assembly into the crystalline network which immobilizes the organic solvent. For single bisamide organogelator systems, the effect of the molecular structure on the molecular interaction and their self-assembly behavior has been explored. The spatial arrangement of bisamide molecules in the gel-state is driven by a combination of hydrogen bonding and Van der Waals interactions. The hydrogen-bonding pattern between the amide groups of bisamide molecules is regulated by the number of methylene spacers; the even number of methylene spacers between two amide groups, in even-spaced bisamides, leads to the antiparallel position of amide groups within a molecule. An even-spaced bisamide molecule with antiparallel amide groups can make two pairs of hydrogen bonding with the molecules on the same plane. The odd-spaced bisamide with a parallel directionality of amide groups can form four independent hydrogen bonds with four other bisamide molecules on different planes. The arrangement of bisamide molecules in the crystalline state and the interaction of these molecules depends on the molecular structure, particularly the parity of the spacer length between the amide groups in the bisamide molecule. In this study, the directionality of amide groups has been exploited as a structural characteristic to affect the arrangement of molecules in the crystalline state and produce different binary bisamide gelators with different degrees of crystallinities. Single odd- and even-spaced single bisamides were synthesized and blended to produce binary bisamide organogelators to be characterized in order to understand the effect of the different directionality of amide groups on the molecular interaction in the crystalline state. The pattern of molecular interactions between these blended molecules, mixing or phase separation, has been monitored via differential scanning calorimetry (DSC) and crystallography techniques; X-ray powder diffraction (XRD) and Small-angle X-ray scattering (SAXS). The formation of lamellar structures for odd- and even-spaced bisamide gelators was confirmed by using SAXS and XRD techniques. DSC results have shown that binary bisamide organogelators with different parity of methylene spacers (odd-even binary blends) have a higher tendency for phase separation compared to the binary bisamides with the same parity (odd-odd or even-even binary blends). Phase separation in binary odd-even bisamides was confirmed by the presence of individual (100) reflections of odd and even lamellar structures. The structural characteristic of bisamide organogelators, the parity of spacer length in binary systems, is a promising tool to control the arrangement of molecules and their crystalline structure.

Keywords: binary bisamide organogelators, crystalline structure, phase separation, self-assembly behavior

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8639 Cultural Collisions, Ethics and HIV: On Local Values in a Globalized Medical World

Authors: Norbert W. Paul

Abstract:

In 1988, parts of the scientific community still heralded findings to support that AIDS was likely to remain largely a ‘gay disease’. The value-ladden terminology of some of the articles suggested that rectum and fragile urethra are not sufficiently robust to provide a barrier against infectious fluids, especially body fluids contaminated with HIV while the female vagina, would provide natural protection against injuries and trauma facilitating HIV-infection. Anal sexual intercourse was constituted not only as dangerous but also as unnatural practice, while penile-vaginal intercourse would follow natural design and thus be relatively safe practice minimizing the risk of HIV. Statements like the latter were not uncommon in the early times of HIV/AIDS and contributed to captious certainties and an underestimation of heterosexual risks. Pseudo-scientific discourses on the origin of HIV were linked to local and global health politics in the 1980ies. The pathways of infection were related to normative concepts like deviant, subcultural behavior, cultural otherness, and guilt used to target, tag and separate specific groups at risk from the ‘normal’ population. Controlling populations at risk became the top item on the agenda rather than controlling modes of transmission and the virus. Hence, the Thai strategy to cope with HIV/AIDS by acknowledging social and sexual practices as they were – not as they were imagined – has become a role model for successful prevention in the highly scandalized realm of sexually transmitted disease. By accepting the globalized character of local HIV-risk and projecting the risk onto populations which are neither particularly vocal groups nor vested with the means to strive for health and justice Thailand managed to culturally implement knowledge-based tools of prevention. This paper argues, that pertinent cultural collisions regarding our strategies to cope with HIV/AIDS are deeply rooted in misconceptions, misreadings and scandalizations brought about in the early history of HIV in the 1980ties. The Thai strategy is used to demonstrate how local values can be balanced against globalized health risk and used to effectuated prevention by which knowledge and norms are translated into local practices. Issues of global health and injustice will be addressed in the final part of the paper dealing with the achievability of health as a human right.

Keywords: bioethics, HIV, global health, justice

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8638 Development of an Information System Based on the Establishment and Evaluation of Performance Rating by Application Part/Type of Remodeling Element Technologies

Authors: Sungwon Jung

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The percentage of 20 years or older apartment houses in South Korea is approximately 20% (1.55 million houses), and the explosive increase of aged houses is expected around the first planned new towns. Accordingly, we should prepare for social issues such as difficulty of housing lease and degradation of housing performance. The improvement of performance of aged houses is essential for achieving the national energy and carbon reduction goals, and we should develop techniques to respond to the changing construction environment. Furthermore, we should develop a performance evaluation system that is appropriate for the demands of residents such as the improvement of remodeling floor plan by performance improvement in line with the residence type of the housing vulnerable groups such as low-income group and elderly people living alone. For this purpose, remodeling techniques and business models optimized for the target complexes must be spread through the development of various business models. In addition, it is necessary to improve the remodeling business by improving the laws and systems related to the improvement of the residential performance and to prepare techniques to respond to the increasing business demands. In other words, performance improvement and evaluation and knowledge systems need to be researched as new issues related to remodeling that has not been addressed in the existing research.

Keywords: remodelling, performance evaluation, web-based system, big data

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8637 Shear Strength and Consolidation Behavior of Clayey Soil with Vertical and Radial Drainage

Authors: R. Pillai Aparna, S. R. Gandhi

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Soft clay deposits having low strength and high compressibility are found all over the world. Preloading with vertical drains is a widely used method for improving such type of soils. The coefficient of consolidation, irrespective of the drainage type, plays an important role in the design of vertical drains and it controls accurate prediction of the rate of consolidation of soil. Also, the increase in shear strength of soil with consolidation is another important factor considered in preloading or staged construction. To our best knowledge no clear guidelines are available to estimate the increase in shear strength for a particular degree of consolidation (U) at various stages during the construction. Various methods are available for finding out the consolidation coefficient. This study mainly focuses on the variation of, consolidation coefficient which was found out using different methods and shear strength with pressure intensity. The variation of shear strength with the degree of consolidation was also studied. The consolidation test was done using two types of highly compressible clays with vertical, radial and a few with combined drainage. The test was carried out at different pressures intensities and for each pressure intensity, once the target degree of consolidation is achieved, vane shear test was done at different locations in the sample, in order to determine the shear strength. The shear strength of clayey soils under the application of vertical stress with vertical and radial drainage with target U value of 70% and 90% was studied. It was found that there is not much variation in cv or cr value beyond 80kPa pressure intensity. Correlations were developed between shear strength ratio and consolidation pressure based on laboratory testing under controlled condition. It was observed that the shear strength of sample with target U value of 90% is about 1.4 to 2 times than that of 70% consolidated sample. Settlement analysis was done using Asaoka’s and hyperbolic method. The variation of strength with respect to the depth of sample was also studied, using large-scale consolidation test. It was found, based on the present study that the gain in strength is more on the top half of the clay layer, and also the shear strength of the sample ensuring radial drainage is slightly higher than that of the vertical drainage.

Keywords: consolidation coefficient, degree of consolidation, PVDs, shear strength

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8636 A Monocular Measurement for 3D Objects Based on Distance Area Number and New Minimize Projection Error Optimization Algorithms

Authors: Feixiang Zhao, Shuangcheng Jia, Qian Li

Abstract:

High-precision measurement of the target’s position and size is one of the hotspots in the field of vision inspection. This paper proposes a three-dimensional object positioning and measurement method using a monocular camera and GPS, namely the Distance Area Number-New Minimize Projection Error (DAN-NMPE). Our algorithm contains two parts: DAN and NMPE; specifically, DAN is a picture sequence algorithm, NMPE is a relatively positive optimization algorithm, which greatly improves the measurement accuracy of the target’s position and size. Comprehensive experiments validate the effectiveness of our proposed method on a self-made traffic sign dataset. The results show that with the laser point cloud as the ground truth, the size and position errors of the traffic sign measured by this method are ± 5% and 0.48 ± 0.3m, respectively. In addition, we also compared it with the current mainstream method, which uses a monocular camera to locate and measure traffic signs. DAN-NMPE attains significant improvements compared to existing state-of-the-art methods, which improves the measurement accuracy of size and position by 50% and 15.8%, respectively.

Keywords: monocular camera, GPS, positioning, measurement

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8635 Phytochemical Screening and Hepatotoxic Effect of Datura metel Linn. Aqueous Seed Extract in Albino Wistar Rats

Authors: I. M. Fakai, A. Abdulhamid, I. Sani, F. Bello, E. O. Olusesi

Abstract:

The phytochemical screening and hepatotoxic effect of Datura metel aqueous seeds extract in Albino Wistar rats were evaluated. Phytochemicals were screened using standard methods. The enzymes activity and liver function indices were also determined using standard methods of analysis. The phytochemicals screening revealed the presence of alkaloid, tannin, glycoside and flavonoid. The organ-body weight decreased significantly (P<0.05) at all the doses of the extract treated groups compared to the control. The activity of alkaline phosphatase decreased significantly (P<0.05) in the liver and increased significantly in the serum at all the doses of the extract treated groups compared to the control. The activity of serum alanine transaminase increased significantly (P<0.05) while there is no significant difference (P>0.05) in the activity liver alanine transaminase at all the doses of the extract treated groups compared to the control. The result also revealed significant increase (P<0.05) in the aspartate transaminase activity in both liver and serum at all doses of the extract treated groups compared to the control. Serum total protein, albumin, globulin, and total bilirubin concentration decreased significantly (P<0.05), while direct bilirubin concentration increased significantly (P<0.05) at all the doses of the extract treated groups compared to the control. The present study therefore revealed that, the present of some phytochemicals in the plant extract attributed the plant to its hepatotoxic effects as revealed in the alteration of marker enzymes and some liver function indices analyzed.

Keywords: datura metel, transaminases, hepatotoxic effect, phytochemicals, rats

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8634 Reliability Assessment Using Full Probabilistic Modelling for Carbonation and Chloride Exposures, Including Initiation and Propagation Periods

Authors: Frank Papworth, Inam Khan

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Fib’s model code 2020 has four approaches for design life verification. Historically ‘deemed to satisfy provisions have been the principal approach, but this has limited options for materials and covers. The use of an equation in fib’s model code for service life design to predict time to corrosion initiation has become increasingly popular to justify further options, but in some cases, the analysis approaches are incorrect. Even when the equations are computed using full probabilistic analysis, there are common mistakes. This paper reviews the work of recent fib commissions on implementing the service life model to assess the reliability of durability designs, including initiation and propagation periods. The paper goes on to consider the assessment of deemed to satisfy requirements in national codes and considers the influence of various options, including different steel types, various cement systems, quality of concrete and cover, on reliability achieved. As modelling is based on achieving agreed target reliability, consideration is given to how a project might determine appropriate target reliability.

Keywords: chlorides, marine, exposure, design life, reliability, modelling

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8633 Influence of HbA1c on Nitric Oxide Level in Patients with Type 2 Diabetes Mellitus

Authors: Dara Kutsyk, Olga Bondarenko, Mariya Sorochka

Abstract:

In 21-century type 2 diabetes (T2D) has become a global health and social problem in the whole world. The goal of treatment for patients with T2D is to prevent complications of diabetes - macrovascular diseases (heart disease, stroke, and peripheral vascular disease) and microvascular diseases (retinopathy, neuropathy and nephropathy). Nitric oxide (NO) plays an important role in maintaining vascular homeostasis. Loss of NO function is one of the earliest indicators of disease and its progression especially in patients with T2D. Aim: To compare NO level between patients with well and bad controlled glycemia in T2D. Methods: The study included 32 patients with T2D. The diagnosis of T2D was confirmed due to International Diabetes Federation (IDF) criteria 2015. Patients were divided into two groups: with well controlled glycaemia (HbA1c < 7%) and bad controlled glycaemia (HbA1c > 7%). The control group consists of 15 healthy subjects. Results: NO level in patients with T2D is significantly higher (27,2 ±3,1 µmol), compared to controls (18,86±0,9 µmol; p < 0,001). A significant difference in NO level was found between patients with bad controlled glycaemia (25,9±2,2 µmol) and well controlled glycaemia (28,7 ± 3,0 µmol; p<0,01). The study showed a moderate negative correlation between NO level and HbA1c (-0,399; р< 0,05). Conclusions: Production of NO is impaired in patients with T2D, especially with badly controlled glycaemia. With the increase in HbAc serum NO decreases. This can be the main target for prevention vascular complication in T2D.

Keywords: type 2 diabetes, glycated hemoglobin, nitric oxide, Diabetes mellitus

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8632 A Comparative Study on Multimodal Metaphors in Public Service Advertising of China and Germany

Authors: Xing Lyu

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Multimodal metaphor promotes the further development and refinement of multimodal discourse study. Cultural aspects matter a lot not only in creating but also in comprehending multimodal metaphor. By analyzing the target domain and the source domain in 10 public service advertisements of China and Germany about environmental protection, this paper compares the source when the target is alike in each multimodal metaphor in order to seek similarities and differences across cultures. The findings are as follows: first, the multimodal metaphors center around three major topics: the earth crisis, consequences of environmental damage, and appeal for environmental protection; second, the multimodal metaphors mainly grounded in three universal conceptual metaphors which focused on high level is up; earth is mother and all lives are precious. However, there are five Chinese culture-specific multimodal metaphors which are not discovered in Germany ads: east is high leve; a purposeful life is a journey; a nation is a person; good is clean, and water is mother. Since metaphors are excellent instruments on studying ideology, this study can be helpful on intercultural/cross-cultural communication.

Keywords: multimodal metaphor, cultural aspects, public service advertising, cross-cultural communication

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8631 Customer Relations and Use of Online Shopping Sites

Authors: Bahar Urhan Torun, Havva Nur Tarakcı

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At the present time, online marketing has become the common target of small and full-scale organizations. Today’s humanbeing who has to spend most of their time in front of the computer because of his job, prefers to socialize by internet due to the easy access to technology. So online marketing area expands day by day. All business organizations from the smallest to the biggest are in a race in order to get a cut from the virtual market share in an extreme competitive environment. However these organizations which use the internet to reach more consumers cannot determine their target group accurately, so this is the biggest handicap of online marketing sales nowadays. The aim of this study is to determine some significant elements about need for communicating efficiently with the consumer on the internet on online marketing. The strategies that can be used in order to increase sales and the limitations of virtual environment where cannot be communicated with the consumer face to face are argued in this study’s scope. As a consequence it is thought that to study on this subject because of lacking and also being limited efficiency of researches and outputs. Within this scope suggesting some proposals about how to communicate efficiently with the consumer and also offering the consumers’ demands efficiently is the essential objective of this study.

Keywords: online marketing, competition, consumer, communication

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8630 A Delphi Study to Build Consensus for Tuberculosis Control Guideline to Achieve Who End Tb 2035 Strategy

Authors: Pui Hong Chung, Cyrus Leung, Jun Li, Kin On Kwok, Ek Yeoh

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Introduction: Studies for TB control in intermediate tuberculosis burden countries (IBCs) comprise a relatively small proportion in TB control literature, as compared to the effort put in high and low burden counterparts. It currently lacks of consensus in the optimal weapons and strategies we can use to combat TB in IBCs; guidelines of TB control are inadequate and thus posing a great obstacle in eliminating TB in these countries. To fill-in the research and services gap, we need to summarize the findings of the effort in this regard and to seek consensus in terms of policy making for TB control, we have devised a series of scoping and Delphi studies for these purposes. Method: The scoping and Delphi studies are conducted in parallel to feed information for each other. Before the Delphi iterations, we have invited three local experts in TB control in Hong Kong to participate in the pre-assessment round of the Delphi study to comments on the validity, relevance, and clarity of the Delphi questionnaire. Result: Two scoping studies, regarding LTBI control in health care workers in IBCs and TB control in elderly of IBCs respectively, have been conducted. The result of these two studies is used as the foundation for developing the Delphi questionnaire, which tapped on seven areas of question, namely: characteristics of IBCs, adequacy of research and services in LTBI control in IBCs, importance and feasibility of interventions for TB control and prevention in hospital, screening and treatment of LTBI in community, reasons of refusal to/ default from LTBI treatment, medical adherence of LTBI treatment, and importance and feasibility of interventions for TB control and prevention in elderly in IBCs. The local experts also commented on the two scoping studies conducted, thus act as the sixth phase of expert consultation in Arksey and O’Malley framework of scoping studies, to either nourish the scope and strategies used in these studies or to supplement ideas for further scoping or systematic review studies. In the subsequent stage, an international expert panel, comprised of 15 to 20 experts from IBCs in Western Pacific Region, will be recruited to join the two-round anonymous Delphi iterations. Four categories of TB control experts, namely clinicians, policy makers, microbiologists/ laboratory personnel, and public health clinicians will be our target groups. A consensus level of 80% is used to determine the achievement of consensus on particular issues. Key messages: 1. Scoping review and Delphi method are useful to identify gaps and then achieve consensus in research. 2. Lots of resources are put in the high burden countries now. However, the usually neglected intermediate-burden countries with TB is an indispensable part for achieving the ambitious WHO End TB 2035 target.

Keywords: dephi questionnaire, tuberculosis, WHO, latent TB infection

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8629 Understanding the Nature of Blood Pressure as Metabolic Syndrome Component in Children

Authors: Mustafa M. Donma, Orkide Donma

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Pediatric overweight and obesity need attention because they may cause morbid obesity, which may develop metabolic syndrome (MetS). Criteria used for the definition of adult MetS cannot be applied for pediatric MetS. Dynamic physiological changes that occur during childhood and adolescence require the evaluation of each parameter based upon age intervals. The aim of this study is to investigate the distribution of blood pressure (BP) values within diverse pediatric age intervals and the possible use and clinical utility of a recently introduced Diagnostic Obesity Notation Model Assessment Tension (DONMA tense) Index derived from systolic BP (SBP) and diastolic BP (DBP) [SBP+DBP/200]. Such a formula may enable a more integrative picture for the assessment of pediatric obesity and MetS due to the use of both SBP and DBP. 554 children, whose ages were between 6-16 years participated in the study; the study population was divided into two groups based upon their ages. The first group comprises 280 cases aged 6-10 years (72-120 months), while those aged 10-16 years (121-192 months) constituted the second group. The values of SBP, DBP and the formula (SBP+DBP/200) covering both were evaluated. Each group was divided into seven subgroups with varying degrees of obesity and MetS criteria. Two clinical definitions of MetS have been described. These groups were MetS3 (children with three major components), and MetS2 (children with two major components). The other groups were morbid obese (MO), obese (OB), overweight (OW), normal (N) and underweight (UW). The children were included into the groups according to the age- and sex-based body mass index (BMI) percentile values tabulated by WHO. Data were evaluated by SPSS version 16 with p < 0.05 as the statistical significance degree. Tension index was evaluated in the groups above and below 10 years of age. This index differed significantly between N and MetS as well as OW and MetS groups (p = 0.001) above 120 months. However, below 120 months, significant differences existed between MetS3 and MetS2 (p = 0.003) as well as MetS3 and MO (p = 0.001). In comparison with the SBP and DBP values, tension index values have enabled more clear-cut separation between the groups. It has been detected that the tension index was capable of discriminating MetS3 from MetS2 in the group, which was composed of children aged 6-10 years. This was not possible in the older group of children. This index was more informative for the first group. This study also confirmed that 130 mm Hg and 85 mm Hg cut-off points for SBP and DBP, respectively, are too high for serving as MetS criteria in children because the mean value for tension index was calculated as 1.00 among MetS children. This finding has shown that much lower cut-off points must be set for SBP and DBP for the diagnosis of pediatric MetS, especially for children under-10 years of age. This index may be recommended to discriminate MO, MetS2 and MetS3 among the 6-10 years of age group, whose MetS diagnosis is problematic.

Keywords: blood pressure, children, index, metabolic syndrome, obesity

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8628 Effects of Virgin Coconut Oil on the Histomorphometric Parameters in the Aortae and Hearts of Rats Fed with Repeatedly Heated Palm Oil

Authors: K. Subermaniam, Q. H. M. Saad, S. N. A. Bakhtiar, J. A. Hamid, F. Z .J. Sidek, F. Othman

Abstract:

Objective: To investigate the effects of virgin coconut oil (VCO) on histomorphometric changes in the aorta and heart of thermoxidized palm oil-fed rats. Methods: Thirty two male Sprague-Dawley rats were divided into four groups: control group fed with normal diet; 5 times heated palm oil-fed group (5HPO) fortified with 15% w/w of 5HPO; VCO group supplemented with 1.42 ml/kg of VCO; and 5HPO + VCO group. The treatment lasted for four months. Upon sacrifice, aortic and heart tissues were processed for light microscopic studies. Results: Light microscopic studies showed thickened intima and media of the aorta in two out of eight rats in the 5HPO group only, while the rest of the rats did not show any thickening of either the intima or media of the aorta. Intima media area (IMA) in the VCO, 5HPO and 5HPO+VCO was significantly increased compared to the control group. Circumferential wall tension (CWT) and tensile stress (TS) in the aorta of 5HPO showed significant increase compared to the other groups. Cardiomyofibre width in 5HPO group showed significant increase in size compared to the control, VCO and 5HPO+VCO groups. Cardiomyofibre nuclear size in the 5HPO group decreased in size significantly compared to the control, VCO and 5HPO+VCO groups. Conclusion: VCO supplementation at a dose of 1.42 ml/kg showed protectives effect on the aorta and heart of thermoxidized palm oil fed rats.

Keywords: aorta, heart, histomorphometric changes, thermoxidized palm oil, virgin coconut oil

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8627 Effects of Dietary Canola Oil and Vitamin E on Sperm Motility in Kurdish Ram

Authors: A. Pirestani, M. Alirezaie, S. Safavipour

Abstract:

The present study was designed to investigate the effect of dietary canola oil and Vit E on sperm motility parameters. Sixteen Kurdish rams were selected with weight average 54.47±2.58 and with year of 3 to 4 approximately and divided to four experimental groups as randomly. Experimental groups were control, Vit E (20 IU in diet), canola oil (2.5% of DMI) and Vit E (20 IU in diet) + Canola oil (2.5% of DMI). Sperm was collected by electroejaculation at 6 week and 11 week after begging of experiment and sperm motility was analyzed by using CASA software. The results showed that motility parameter wasn’t significant difference between whole experimental groups at first time (week 6) but PM% and TM% was significant difference in canola oil and Vit E at second time (week 11), separately. It was concluded that Vit E and canola oil improvement sperm motility in Kurdish ram. The present study was designed to investigate the effect of dietary canola oil and Vit E on sperm motility parameters. Sixteen Kurdish rams were selected with weight average 54.47±2.58 and with year of 3 to 4 approximately and divided to four experimental groups as randomly. Experimental groups were control, Vit E (20 IU in diet), canola oil (2.5% of DMI) and Vit E (20 IU in diet) + Canola oil (2.5% of DMI). Sperm was collected by electroejaculation at 6 week and 11 week after begging of experiment and sperm motility was analyzed by using CASA software. The results showed that motility parameter was not significant difference between whole experimental groups at first time (week 6) but PM% and TM% was significant difference in canola oil and Vit E at second time (week 11), separately. It was concluded that Vit E and canola oil improvement sperm motility in Kurdish ram. The present study was designed to investigate the effect of dietary canola oil and Vit E on sperm motility parameters. Sixteen Kurdish rams were selected with weight average 54.47±2.58 and with year of 3 to 4 approximately and divided to four experimental groups as randomly. Experimental groups were control, Vit E (20 IU in diet), canola oil (2.5% of DMI) and Vit E (20 IU in diet) + Canola oil (2.5% of DMI). Sperm was collected by electroejaculation at 6 week and 11 week after begging of experiment and sperm motility was analyzed by using CASA software. The results showed that motility parameter wasn’t significant difference between whole experimental groups at first time (week 6) but PM% and TM% was significant difference in canola oil and Vit E at second time (week 11), separately. It was concluded that Vit E and canola oil improvement sperm motility in Kurdish ram. The present study was designed to investigate the effect of dietary canola oil and Vit E on sperm motility parameters. Sixteen Kurdish rams were selected with weight average 54.47±2.58 and with year of 3 to 4 approximately and divided to four experimental groups as randomly. Experimental groups were control, Vit E (20 IU in diet), canola oil (2.5% of DMI) and Vit E (20 IU in diet) + Canola oil (2.5% of DMI). Sperm was collected by electroejaculation at 6 week and 11 week after begging of experiment and sperm motility was analyzed by using CASA software. The results showed that motility parameter wasn’t significant difference between whole experimental groups at first time (week 6) but PM% and TM% was significant difference in canola oil and Vit E at second time (week 11), separately. It was concluded that Vit E and canola oil improvement sperm motility in Kurdish ram.

Keywords: canola oil, motility, ram, sperm, Vit E

Procedia PDF Downloads 629
8626 Examining Audiology Students: Clinical Reasoning Skills When Using Virtual Audiology Cases Aided With no Collaboration, Live Collaboration, and Virtual Collaboration

Authors: Ramy Shaaban

Abstract:

The purpose of this study was to examine the difference in clinical reasoning skills of students when using virtual audiology cases with and without collaborative assistance from major learning approaches important to clinical reasoning skills and computer-based learning models: Situated Learning Theory, Social Development Theory, Scaffolding, and Collaborative Learning. A quasi-experimental design was conducted at two United States universities to examine whether there is a significant difference in clinical reasoning skills between three treatment groups using IUP Audiosim software. Two computer-based audiology case simulations were developed, and participants were randomly placed into the three groups: no collaboration, virtual collaboration, and live collaboration. The clinical reasoning data were analyzed using One-Way ANOVA and Tukey posthoc analyses. The results show that there was a significant difference in clinical reasoning skills between the three treatment groups. The score obtained by the no collaboration group was significantly less than the scores obtained by the virtual and live collaboration groups. Collaboration, whether virtual or in person, has a positive effect on students’ clinical reasoning. These results with audiology students indicate that combining collaboration models with scaffolding and embedding situated learning and social development theories into the design of future virtual patients has the potential to improve students’ clinical reasoning skills.

Keywords: clinical reasoning, virtual patients, collaborative learning, scaffolding

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8625 Ultra-High Frequency Passive Radar Coverage for Cars Detection in Semi-Urban Scenarios

Authors: Pedro Gómez-del-Hoyo, Jose-Luis Bárcena-Humanes, Nerea del-Rey-Maestre, María-Pilar Jarabo-Amores, David Mata-Moya

Abstract:

A study of achievable coverages using passive radar systems in terrestrial traffic monitoring applications is presented. The study includes the estimation of the bistatic radar cross section of different commercial vehicle models that provide challenging low values which make detection really difficult. A semi-urban scenario is selected to evaluate the impact of excess propagation losses generated by an irregular relief. A bistatic passive radar exploiting UHF frequencies radiated by digital video broadcasting transmitters is assumed. A general method of coverage estimation using electromagnetic simulators in combination with estimated car average bistatic radar cross section is applied. In order to reduce the computational cost, hybrid solution is implemented, assuming free space for the target-receiver path but estimating the excess propagation losses for the transmitter-target one.

Keywords: bistatic radar cross section, passive radar, propagation losses, radar coverage

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8624 Explanation of the Main Components of the Unsustainability of Cooperative Institutions in Cooperative Management Projects to Combat Desertification in South Khorasan Province

Authors: Yaser Ghasemi Aryan, Firoozeh Moghiminejad, Mohammadreza Shahraki

Abstract:

Background: The cooperative institution is considered the first and most essential pillar of strengthening social capital, whose sustainability is the main guarantee of survival and continued participation of local communities in natural resource management projects. The Village Development Group and the Microcredit Fund are two important social and economic institutions in the implementation of the International Project for the Restoration of Degraded Forest Lands (RFLDL) in Sarayan City, South Khorasan Province, which has learned positive lessons from the participation of the beneficiaries in the implementation. They have brought more effective projects to deal with desertification. However, the low activity or liquidation of some of these institutions has become one of the important challenges and concerns of project executive experts. The current research was carried out with the aim of explaining the main components of the instability of these institutions. Materials and Methods: This research is descriptive-analytical in terms of method, practical in terms of purpose, and the method of collecting information is two documentary and survey methods. The statistical population of the research included all the members of the village development groups and microcredit funds in the target villages of the RFLDL project of Sarayan city, based on the Kochran formula and matching with the Karjesi and Morgan table. Net people were selected as a statistical sample. After confirming the validity of the expert's opinions, the reliability of the questionnaire was 0.83, which shows the appropriate reliability of the researcher-made questionnaire. Data analysis was done using SPSS software. Results: The results related to the extraction of obstacles to the stability of social and economic networks were classified and prioritized in the form of 5 groups of social-cultural, economic, administrative, educational-promotional and policy-management factors. Based on this, in the socio-cultural factors, the items ‘not paying attention to the structural characteristics and composition of groups’, ‘lack of commitment and moral responsibility in some members of the group,’ and ‘lack of a clear pattern for the preservation and survival of groups’, in the disciplinary factors, The items ‘Irregularity in holding group meetings’ and ‘Irregularity of members to participate in meetings’, in the economic factors of the items "small financial capital of the fund’, ‘the low amount of loans of the fund’ and ‘the fund's inability to conclude contracts and attract capital from other sources’, in the educational-promotional factors of the items ‘non-simultaneity of job training with the granting of loans to create jobs’ and ‘insufficient training for the effective use of loans and job creation’ and in the policy-management factors of the item ‘failure to provide government facilities for support From the funds, they had the highest priority. Conclusion: In general, the results of this research show that policy-management factors and social factors, especially the structure and composition of social and economic institutions, are the most important obstacles to their sustainability. Therefore, it is suggested to form cooperative institutions based on network analysis studies in order to achieve the appropriate composition of members.

Keywords: cooperative institution, social capital, network analysis, participation, Sarayan.

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8623 The Asia-European Union (EU) Traffic Safety Benchmarking

Authors: Ghazwan Al-Haji

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Traffic safety has become a major concern in Southeast Asia due to the increasing number of road accidents resulting in fatalities and injuries. Southeast Asia has one of the highest road traffic fatality rates in the world, in terms of both population and number of cars, nearly six times higher than the EU region. One of the reasons for this concerning trend is the increasing share of motorcycles as a form of transportation throughout Southeast Asia. The purpose of this study is to benchmark traffic safety situations and statistics in six countries in Asia and the EU, which Indonesia, Malaysia, Vietnam, Italy, Portugal and Sweden. The research will assess the priorities and causes of road accidents in the target nations. Further, the study will analyze the existing practices and promote best practices that can be implemented toward safer roads in Asian target countries. In order to achieve this goal, the study categorizes various factors contributing to traffic accidents and best practices into 4 pillars (Safer Behavior, Safer Roads, Safer Vehicles and Road Safety Management). The result of the study consists of a list of recommendations that can be applied by policymakers to promote safer roads in Asia towards 2030. The study is co-financed by the EU project ASIASAFE.

Keywords: traffic safety, ASIASAFE, Southeast Asia, EU project

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8622 The Effect of Low Power Laser on CK and Some of Markers Delayed Onset Muscle Soreness (DOMS)

Authors: Bahareh Yazdanparast Chaharmahali

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The study showed effect of low power laser therapy on knee range of motion (flexion and extension), resting angle of knee joint, knee circumference and rating of delayed onset muscle soreness induced pain, 24 and 48 hours after eccentric training of knee flexor muscle (hamstring muscle). We investigate the effects of pulsed ultrasound on swelling, relaxed, flexion and extension knee angle and pain. 20 volunteers among girl students of college voluntary participated in this research. After eccentric training, subjects were randomly divided into two groups, control and laser therapy. In day 1 and in order to induce delayed onset muscle soreness, subjects eccentrically trained their knee flexor muscles. In day 2, subjects were randomly divided into two groups: control and low power laser therapy. 24 and 48 hours after eccentric training. Variables (knee flexion and extension, srang of motion, resting knee joint angle and knee circumferences) were measured and analyzed. Data are reported as means ± standard error (SE) and repeated measured was used to assess differences within groups. Methods of treatment (low power laser therapy) have significant effects on delayed onset muscle soreness markers. 24 and 48 hours after training a significant difference was observed between mean pains of 2 groups. This difference was significant between low power laser therapy and C groups. The Bonferroni post hock is significant. Low power laser therapy trophy as used in this study did significantly diminish the effects of delayed – onset muscle soreness on swelling, relaxed – knee extension and flexion angle.

Keywords: creatine kinase, DOMS, eccentric training, low power laser

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8621 Error Analysis of the Pronunciation of English Consonants and Arabic Consonants by Egyptian Learners

Authors: Marwa A. Nasser

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This is an empirical study that provides an investigation of the most significant errors of Egyptian learners in producing English consonants and Arabic consonants, and advice on how these can be remedied. The study adopts a descriptive approach and the analysis is based on audio recordings of two groups of people. The first group includes six volunteers of Egyptian learners belonging to the English Department at Faculty of Women who learn English as a foreign language. The other group includes six Egyptian learners who are studying Tajweed (how to recite Quran correctly). The audio recordings were examined, and sounds were analyzed in an attempt to highlight the most common error done by the learners while reading English or reading (or reciting) Quran. Results show that the two groups of learners have problems with certain phonemic contrasts. Both groups share common errors although both languages are different and not related (e.g. pre-aspiration of fortis stops, incorrect articulation of consonants and velarization of certain sounds).

Keywords: consonant articulations, Egyptian learners of English, Egyptian learners of Quran, empirical study, error analysis, pronunciation problems

Procedia PDF Downloads 261
8620 Simultaneous Measurement of Displacement and Roll Angle of Object

Authors: R. Furutani, K. Ishii

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Laser interferometers are now widely used for length and displacement measurement. In conventional methods, the optical path difference between two mirrors, one of which is a reference mirror and the other is a target mirror, is measured, as in Michelson interferometry, or two target mirrors are set up and the optical path difference between the two targets is measured, as in differential interferometry. In these interferometers, the two laser beams pass through different optical elements so that the measurement result is affected by the vibration and other effects in the optical paths. In addition, it is difficult to measure the roll angle around the optical axis. The proposed interferometer simultaneously measures both the translational motion along the optical axis and the roll motion around it by combining the retroreflective principle of the ball lens (BL) and the polarization. This interferometer detects the interferogram by the two beams traveling along the identical optical path from the beam source to BL. This principle is expected to reduce external influences by using the interferogram between the two lasers in an identical optical path. The proposed interferometer uses a BL so that the reflected light from the lens travels on the identical optical path as the incident light. After reaching the aperture of the He-Ne laser oscillator, the reflected light is reflected by a mirror with a very high reflectivity installed in the aperture and is irradiated back toward the BL. Both the first laser beam that enters the BL and the second laser beam that enters the BL after the round trip interferes with each other, enabling the measurement of displacement along the optical axis. In addition, for the measurement of the roll motion, a quarter-wave plate is installed on the optical path to change the polarization state of the laser. The polarization states of the first laser beam and second laser beam are different by the roll angle of the target. As a result, this system can measure the displacement and the roll angle of BL simultaneously. It was verified by the simulation and the experiment that the proposed optical system could measure the displacement and the roll angle simultaneously.

Keywords: common path interferometer, displacement measurement, laser interferometer, simultaneous measurement, roll angle measurement

Procedia PDF Downloads 76
8619 mRNA Expression of NFKB1 with Parkinson's Disease

Authors: Ali Bayram, Burak Uz, Remzi Yiğiter

Abstract:

The aim of the present study was to investigate the expression levels of homo sapiens nuclear factor of kappa light polypeptide gene enhancer in B-cells 1, transcript variant 1 (NFKB1*1) mRNA in the peripheral blood of patients with Parkinson to elucidate the role in the pathogenesis of Parkinson disease (PD). The study group comprised 50 patients with the diagnosis of PD who have applied to Gaziantep University Faculty of Medicine, and Department of Neurology. 50 healthy individuals without any neuro degenerative disease are included as controls. Ribonucleic acid (RNA) was obtained from blood samples of patient and control groups. Complementary deoxyribonucleic acid (cDNA) was obtained from RNA samples using reverse transcription polymerase chain reaction (RT-PCR) technique. The gene expression of NFKB1*1 in patient/control groups were observed to decrease significantly, and the differences between groups with the Mann-Whitney method within 95% confidence interval (p<0.05) were analyzed. This salient finding provide a clue for our hypothesis that reduced activity of NFKB1*1 gene might play a role, at least partly, in the pathophysiology of PD.

Keywords: Parkinson’s Disease, NFKB1, mRNA expression, RT-PCR

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8618 A Study to Identify Resistant Hypertension and Role of Spironolactone in its Management

Authors: A. Kumar, D. Himanshu, Ak Vaish, K. Usman , A. Singh, R. Misra, V. Atam, S. P. Verma, S. Singhal

Abstract:

Introduction: Resistant and uncontrolled hypertension offer great challenge, in terms of higher risk of morbidity, mortality and not the least, difficulty in diagnosis and management. Our study tries to identify the importance of two crucial aspects of hypertension management, i.e. drug compliance and optimum dosing and also the effect of spironolactone on blood pressure in cases of resistant hypertension. Methodology: A prospective study was carried out among patients, who were referred as case of resistant hypertension to Hypertension Clinic at Gandhi memorial and associated hospital, Lucknow, India from August, 2013 to July 2014. A total of 122 Subjects having uncontrolled BP with ≥3 antihypertensives were selected. After ruling out secondary resistance and with appropriate lifestyle modifications, effect of adherence and optimum doses was seen with monitoring of BP. Only those having blood pressure still uncontrolled were true resistant. These patients were given spironolactone to see its effect on BP over next 12 weeks. Results: Mean baseline BP of all (n=122) patients was 150.4±7.2 mmHg systolic and 92.1±5.7 mmHg diastolic. After promoting adherence to the regimen, there was reduction of 4.20±3.65 mmHg systolic and 2.08±4.74 mmHg Diastolic blood pressure, with 26 patients achieving target blood pressure goal. Further reduction of 6.66±5.99 mmHg in systolic and 2.59±3.67 mmHg in diastolic BP was observed after optimizing the drug doses with another 66 patients achieving target blood pressure goal. Only 30 patients were true resistant hypertensive and prescribed spironolactone. Over 12 weeks, mean reduction of 20.62±3.65 mmHg in systolic and 10.08 ± 6.46 mmHg in diastolic BP was observed. Out of these 30, BP was controlled in 24 patients. Side effects observed were hyperkalemia in 2 patients and breast tenderness in 2 patients. Conclusion: Improper adherence and suboptimal regimen appear to be the important reasons for uncontrolled hypertension. By virtue of maintaining proper adherence to an optimum regimen, target BP goal can be reached in many without adding much to the regimen. Spironolactone is effective in patients with resistant hypertension, in terms of blood pressure reduction with minimal side effects.

Keywords: resistant, hypertension, spironolactone, blood pressure

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