Search results for: statistical simulation

Authors: Elżbieta Turska

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Introduction: One of the most difficult times in a person’s life is adolescence. The experiences in this period may shape the future life of this person to a large extent. This is the reason why many young people experience sadness, dejection, hopelessness, sense of worthlessness, as well as losing interest in various activities and social relationships, all of which are often classified as mood disorders. As many as 15-40% adolescents experience depressed moods and for most of them they resolve and are not carried into adulthood. However, (5-6%) of those affected by mood disorders develop the depressive syndrome and as many as (1-3%) develop full-blown clinical depression. Materials: A large questionnaire was given to 2508 students, aged 13–16 years old, and one of its parts was the Burns checklist, i.e. the standard test for identifying depressed mood. The questionnaire asked about many aspects of the student’s life, it included a total of 53 questions, most of which had subquestions. It is important to note that the data suffered from many problems, the most important of which were missing data and collinearity. Aim: In order to identify the correlates of mood disorders we built predictive models which were then trained and validated. Our aim was not to be able to predict which students suffer from mood disorders but rather to explore the factors influencing mood disorders. Methods: The problems with data described above practically excluded using all classical statistical methods. For this reason, we attempted to use the following Artificial Intelligence (AI) methods: classification trees with surrogate variables, random forests and xgboost. All analyses were carried out with the use of the mlr package for the R programming language. Resuts: The predictive model built by classification trees algorithm outperformed the other algorithms by a large margin. As a result, we were able to rank the variables (questions and subquestions from the questionnaire) from the most to least influential as far as protection against mood disorder is concerned. Thirteen out of twenty most important variables reflect the relationships with parents. This seems to be a really significant result both from the cognitive point of view and also from the practical point of view, i.e. as far as interventions to correct mood disorders are concerned.

Keywords: mood disorders, adolescents, family, artificial intelligence

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Authors: Venkatesh Kumar, Kasun Hewage, Rehan Sadiq

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Residential buildings consume significant amounts of energy and produce a large amount of emissions and waste. However, there is a substantial potential for energy savings in this sector which needs to be evaluated over the life cycle of residential buildings. Life Cycle Assessment (LCA) methodology has been employed to study the primary energy uses and associated environmental impacts of different phases (i.e., product, construction, use, end of life, and beyond building life) for residential buildings. Four different alternatives of residential buildings in Vancouver (BC, Canada) with a 50-year lifespan have been evaluated, including High Rise Apartment (HRA), Low Rise Apartment (LRA), Single family Attached House (SAH), and Single family Detached House (SDH). Life cycle performance of the buildings is evaluated for embodied energy, embodied environmental impacts, operational energy, operational environmental impacts, total life-cycle energy, and total life cycle environmental impacts. Estimation of operational energy and LCA are performed using DesignBuilder software and Athena Impact estimator software respectively. The study results revealed that over the life span of the buildings, the relationship between the energy use and the environmental impacts are identical. LRA is found to be the best alternative in terms of embodied energy use and embodied environmental impacts; while, HRA showed the best life-cycle performance in terms of minimum energy use and environmental impacts. Sensitivity analysis has also been carried out to study the influence of building service lifespan over 50, 75, and 100 years on the relative significance of embodied energy and total life cycle energy. The life-cycle energy requirements for SDH is found to be a significant component among the four types of residential buildings. The overall disclose that the primary operations of these buildings accounts for 90% of the total life cycle energy which far outweighs minor differences in embodied effects between the buildings.

Keywords: building simulation, environmental impacts, life cycle assessment, life cycle energy analysis, residential buildings

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Authors: Taha Anjamrooz, Sareh Rajabi, Hasan Mahmmud, Ghassan Abulebdeh

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Water availability, as well as water demand, are not uniformly distributed in time and space. Numerous extra-large water diversion projects are launched in Amazon to alleviate water scarcities. This research utilizes statistical analysis to examine the temporal and spatial features of 40 extra-large water diversion projects in Amazon. Using a network analysis method, the correlation between seven major basins is measured, while the impact analysis method is employed to explore the associated economic, environmental, and social impacts. The study unearths that the development of water diversion in Amazon has witnessed four stages, from a preliminary or initial period to a phase of rapid development. It is observed that the length of water diversion channels and the quantity of water transferred have amplified significantly in the past five decades. As of 2015, in Amazon, more than 75 billion m³ of water was transferred amidst 12,000 km long channels. These projects extend over half of the Amazon Area. The River Basin E is currently the most significant source of transferred water. Through inter-basin water diversions, Amazon gains the opportunity to enhance the Gross Domestic Product (GDP) by 5%. Nevertheless, the construction costs exceed 70 billion US dollars, which is higher than any other country. The average cost of transferred water per unit has amplified with time and scale but reduced from western to eastern Amazon. Additionally, annual total energy consumption for pumping exceeded 40 billion kilowatt-hours, while the associated greenhouse gas emissions are assessed to be 35 million tons. Noteworthy to comprehend that ecological problems initiated by water diversion influence the River Basin B and River Basin D. Due to water diversion, more than 350 thousand individuals have been relocated, away from their homes. In order to enhance water diversion sustainability, four categories of innovative measures are provided for decision-makers: development of water tradeoff projects strategies, improvement of integrated water resource management, the formation of water-saving inducements, and pricing approach, and application of ex-post assessment.

Keywords: sustainability, water trade-off projects, environment, Amazon

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Authors: Mohamed Ghoz, Hala Alsabeh

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Context: Macroscopic Nose Macroneedling (MNM) is a new non-surgical procedure for lifting and tightening the nose. It is a tissue-non-invasive technique that uses a needle to create micro-injuries in the skin. These injuries stimulate the production of collagen and elastin, which results in the tightening and lifting of the skin. Research Aim: The research aim of this study was to investigate the efficacy and safety of MNM for the treatment of nasal deformities. Methodology A total of 100 patients with nasal deformities were included in this study. The patients were randomly assigned to either the MNM group or the control group. The MNM group received a single treatment of MNM, while the control group received no treatment. The patients were evaluated at baseline, 6 months, and 12 months after treatment. Findings: The results of this study showed that MNM was effective in improving the appearance of the nose in patients with nasal deformities. At 6 months after treatment, the patients in the MNM group had significantly improved nasal tip projection, nasal bridge height, and nasal width compared to the patients in the control group. The improvements in nasal appearance were maintained at 12 months after treatment. Theoretical Importance: The findings of this study provide support for the use of MNM as a safe and effective treatment for nasal deformities. MNM is a non-surgical procedure that is associated with minimal downtime and no risk of scarring. This makes it an attractive option for patients who are looking for a minimally invasive treatment for their nasal deformities. Data Collection: Data was collected from the patients using a variety of methods, including clinical assessments, photographic assessments, and patient-reported outcome measures. Analysis Procedures: The data was analyzed using a variety of statistical methods, including descriptive statistics, inferential statistics, and meta-analysis. Question Addressed: The research question addressed in this study was whether MNM is an effective and safe treatment for nasal deformities. Conclusion: The findings of this study suggest that MNM is an effective and safe treatment for nasal deformities. MNM is a non-surgical procedure that is associated with minimal downtime and no risk of scarring. This makes it an attractive option for patients who are looking for a minimally invasive treatment for their nasal deformities.

Keywords: nose, surgery, tie, suture

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Authors: Nadia Nisar

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Background: In the temperate regions Influenza activities occur sporadically all year round with peaks coinciding during cold months. Meteorological and environmental conditions play significant role in the transmission of influenza globally. In this study, we assessed the relationship between meteorological parameters and influenza activity in two geographical areas of Pakistan. Methods: Influenza data were collected from Islamabad (north) and Multan (south) regions of national influenza surveillance system during 2010-2015. Meteorological database was obtained from National Climatic Data Center (Pakistan). Logistic regression model with a stepwise approach was used to explore the relationship between meteorological parameters with influenza peaks. In statistical model, we used the weekly proportion of laboratory-confirmed influenza positive samples to represent Influenza activity with metrological parameters as the covariates (temperature, humidity and precipitation). We also evaluate the link between environmental conditions associated with seasonal influenza epidemics: 'cold-dry' and 'humid-rainy'. Results: We found that temperature and humidity was positively associated with influenza in north and south both locations (OR = 0.927 (0.88-0.97)) & (OR = 0.1.078 (1.027-1.132)) and (OR = 1.023 (1.008-1.037)) & (OR = 0.978 (0.964-0.992)) respectively, whilst precipitation was negatively associated with influenza (OR = 1.054 (1.039-1.070)) & (OR = 0.949 (0.935-0.963)). In both regions, temperature and humidity had the highest contribution to the model as compared to the precipitation. We revealed that the p-value for all of climate parameters is <0.05 by Independent-sample t-test. These results demonstrate that there were significant relationships between climate factors and influenza infection with correlation coefficients: 0.52-0.90. The total contribution of these three climatic variables accounted for 89.04%. The reported number of influenza cases increased sharply during the cold-dry season (i.e., winter) when humidity and temperature are at minimal levels. Conclusion: Our findings showed that measures of temperature, humidity and cold-dry season (winter) can be used as indicators to forecast influenza infections. Therefore integrating meteorological parameters for influenza forecasting in the surveillance system may benefit the public health efforts in reducing the burden of seasonal influenza. More studies are necessary to understand the role of these parameters in the viral transmission and host susceptibility process.

Keywords: influenza, climate, metrological, environmental

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Authors: Azadeh Jafari, Robert G. Owens

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In this study, a geometrical multiscale approach which means coupling together the 2-D Navier-Stokes equations, constitutive equations and 0-D lumped parameter models is investigated. A multiscale approach, suggest a natural way of coupling detailed local models (in the flow domain) with coarser models able to describe the dynamics over a large part or even the whole cardiovascular system at acceptable computational cost. In this study we introduce a new velocity correction scheme to decouple the velocity computation from the pressure one. To evaluate the capability of our new scheme, a comparison between the results obtained with Neumann outflow boundary conditions on the velocity and Dirichlet outflow boundary conditions on the pressure and those obtained using coupling with the lumped parameter model has been performed. Comprehensive studies have been done based on the sensitivity of numerical scheme to the initial conditions, elasticity and number of spectral modes. Improvement of the computational algorithm with stable convergence has been demonstrated for at least moderate Weissenberg number. We comment on mathematical properties of the reduced model, its limitations in yielding realistic and accurate numerical simulations, and its contribution to a better understanding of microvascular blood flow. We discuss the sophistication and reliability of multiscale models for computing correct boundary conditions at the outflow boundaries of a section of the cardiovascular system of interest. In this respect the geometrical multiscale approach can be regarded as a new method for solving a class of biofluids problems, whose application goes significantly beyond the one addressed in this work.

Keywords: geometrical multiscale models, haemorheology model, coupled 2-D navier-stokes 0-D lumped parameter modeling, computational fluid dynamics

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Authors: Z. Abdollahi Biron, P. Pisu

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Connected vehicles are one of the promising technologies for future Intelligent Transportation Systems (ITS). A connected vehicle system is essentially a set of vehicles communicating through a network to exchange their information with each other and the infrastructure. Although this interconnection of the vehicles can be potentially beneficial in creating an efficient, sustainable, and green transportation system, a set of safety and reliability challenges come out with this technology. The first challenge arises from the information loss due to unreliable communication network which affects the control/management system of the individual vehicles and the overall system. Such scenario may lead to degraded or even unsafe operation which could be potentially catastrophic. Secondly, faulty sensors and actuators can affect the individual vehicle’s safe operation and in turn will create a potentially unsafe node in the vehicular network. Further, sending that faulty sensor information to other vehicles and failure in actuators may significantly affect the safe operation of the overall vehicular network. Therefore, it is of utmost importance to take these issues into consideration while designing the control/management algorithms of the individual vehicles as a part of connected vehicle system. In this paper, we consider a connected vehicle system under Co-operative Adaptive Cruise Control (CACC) and propose a fault diagnosis scheme that deals with these aforementioned challenges. Specifically, the conventional CACC algorithm is modified by adding a Kalman filter-based estimation algorithm to suppress the effect of lost information under unreliable network. Further, a sliding mode observer-based algorithm is used to improve the sensor reliability under faults. The effectiveness of the overall diagnostic scheme is verified via simulation studies.

Keywords: fault diagnostics, communication network, connected vehicles, packet drop out, platoon

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Authors: Anna M. N. Shifotoka, Richard Walker, Katie Haighton, Richard McNally

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An analysis of trends in Case Notification Rates (CNR) can be used to monitor the impact of Tuberculosis (TB) control interventions over time in order to inform the implementation of current and future TB interventions. A retrospective analysis of trends in TB CNR for two urban regions in Namibia, namely Khomas and Erongo regions, was conducted. TB case notification data were obtained from annual TB reports of the national TB programme, Ministry of Health and Social Services, covering the period from 1997 to 2015. Joinpoint regression was used to analyse trends in CNR for different types of TB groups. A trend was considered to be statistically significant when a p-value was less than 0.05. During the period under review, the crude CNR for all forms of TB declined from 808 to 400 per 100 000 population in Khomas, and from 1051 to 611 per 100 000 population in Erongo. In both regions, significant change points in trends were observed for all types of TB groups examined. In Khomas region, the trend for new smear positive pulmonary TB increased significantly by an annual rate of 4.1% (95% Confidence Interval (CI): 0.3% to 8.2%) during the period 1997 to 2004, and thereafter declined significantly by -6.2% (95%CI: -7.7% to -4.3%) per year until 2015. Similarly, the trend for smear negative pulmonary TB increased significantly by 23.7% (95%CI: 9.7 to 39.5) per year from 1997 to 2004 and thereafter declined significantly by an annual change of -26.4% (95%CI: -33.1% to -19.8%). The trend for all forms of TB CNR in Khomas region increased significantly by 8.1% (95%CI: 3.7 to 12.7) per year from 1997 to 2004 and thereafter declined significantly a rate of -8.7% (95%CI: -10.6 to -6.8). In Erongo region, the trend for smear positive pulmonary TB increased at a rate of 1.2% (95%CI: -1.2% to 3.6%) annually during the earlier years (1997 to 2008), and thereafter declined significantly by -9.3% (95%CI: -13.3% to -5.0%) per year from 2008 to 2015. Also in Erongo, the trend for all forms of TB CNR increased significantly by an annual rate of 4.0% (95%CI: 1.4% to 6.6%) during the years between 1997 to 2006 and thereafter declined significantly by -10.4% (95%CI: -12.7% to -8.0%) per year during 2006 to 2015. The trend for extra-pulmonary TB CNR declined but did not reach statistical significance in both regions. In conclusion, CNRs declined for all types of TB examined in both regions. Further research is needed to study trends for other TB dimensions such as treatment outcomes and notification of drug resistant TB cases.

Keywords: epidemiology, Namibia, temporal trends, tuberculosis

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Authors: Enyia James Diwa, Dodeye Ina Igbong, Archibong Archibong Eso

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Gas turbine operators have been faced with the dramatic financial setback resulting from compressor fouling. In a highly deregulated power industry where there is stiffness in the market competition, has made it imperative to improvise means of reducing maintenance cost in other to yield maximum profit. Compressor fouling results from the deposition of contaminants in the presence of oil and moisture on the compressor blade or annulus surfaces, which leads to a loss in flow capacity and compressor efficiency. These combined effects reduce power output, increase heat rate and cause creep life reduction. This paper also contains a model of two gas turbine engines via Cranfield University software known as TURBOMATCH, which is simulation software for detecting engine fouling rate. The model engines are of different configurations and capacities, and are operating in two different modes of constant output power and turbine inlet temperature for a two and three stage filter system. The idea is to investigate the more economically viable filtration systems by gas turbine users based on performance only. It has been demonstrated in the results that the two spool engine is a little more beneficial compared to the single spool. This is as a result of a higher pressure ratio of the two spools as well as the deceleration of the high-pressure compressor and high-pressure turbine speed in a constant TET. Meanwhile, the inlet filtration system was properly designed and balanced with a well-timed and economical compressor washing regime/scheme to control compressor fouling. The different technologies of inlet air filtration and compressor washing are considered and an attempt at optimization with respect to the cost of a combination of both control measures are made.

Keywords: inlet filtration, pressure loss, single spool, two spool

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Authors: Amanda Julia Binay, Patricia Elise Suarez

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Female representation in media is an important subject in the discussion of gender equality, especially in impactful and influential media like film. As the Filipino film industry continues to grow and evolve, the need for analysis on Filipino female representation on screen is imperative. Additionally, there has been limited research made on female representation in the Philippine film scene. Thus, the paper aims to analyze the presence and evolution of female representation in Philippine cinema and compare the findings with that of American films to see how Filipino filmmakers hold their own against the standards of international movements that call for more and better female representation, especially in Hollywood. The participants selected were Filipino and American films released within the years 1975 to 2020 in five (5) year intervals. Twenty (20) critically acclaimed and highest-grossing Filipino films and twenty (20) critically acclaimed and highest-grossing Hollywood films were then subject to the Bechdel and Peirce tests to obtain statistical measures of their female representation. The findings of the study reveal that the presence of female representation in Philippine film history has been consistent and has continued to grow and evolve throughout the years, with strong female leads with vibrant characteristics and diverse stories. However, analysis of female representation regarding American films has shown an extreme lack thereof with more misogynistic, sexist, and limiting ideals. Thus, the study concludes that the state of female representation in Philippine cinema and film industry holds its own when compared to American cinema and film industry and even outperforms it in many aspects of female representation, such as consistent inclusion and depiction of multi-dimensional female leads and female relationships. Hence, the study implies that women’s consistent presence in Philippine cinema mirrors Filipino women’s prominent role in Philippine society and that American cinema must continue to make efforts to change their portrayals of female characters, leads, and relationships to make them more grounded in reality.

Keywords: female representation, gender studies, feminism, philippine cinema, American cinema, bechdel test, peirce test, comparative analysis

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Authors: Omnia Elkommos

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Language is communication on several discourse levels. The target of teaching a language and the literature of a foreign language is to communicate a message. Reading, appreciating, analysing, and interpreting poetry as a sophisticated rhetorical expression of human thoughts, emotions, and philosophical messages is more feasible through the use of linguistic pragmatic tools from a communicative discourse perspective. The poet's intention, speech act, illocutionary act, and perlocutionary goal can be better understood when communicative situational context as well as linguistic discourse structure theories are employed. The use of linguistic theories in the teaching of poetry is, therefore, intrinsic to students' comprehension, interpretation, and appreciation of poetry of the different ages. It is the purpose of this study to show how both teachers as well as students can apply these linguistic theories and tools to dramatic poetic texts for an engaging, enlightening, and effective interpretation and appreciation of the language. Theories drawn from areas of pragmatics, discourse analysis, embedded discourse level, communicative situational context, and other linguistic approaches were applied to selected poetry texts from the different centuries. Further, in a simple statistical count of the number of poems with dialogic dramatic discourse with embedded two or three levels of discourse in different anthologies outweighs the number of descriptive poems with a one level of discourse, between the poet and the reader. Poetry is thus discourse on one, two, or three levels. It is, therefore, recommended that teachers and students in the area of ESL/EFL use the linguistics theories for a better understanding of poetry as communicative discourse. The practice of applying these linguistic theories in classrooms and in research will allow them to perceive the language and its linguistic, social, and cultural aspect. Texts will become live illocutionary acts with a perlocutionary acts goal rather than mere literary texts in anthologies.

Keywords: coda, commissives, communicative situation, context of culture, context of reference, context of utterance, dialogue, directives, discourse analysis, dramatic discourse interaction, duologue, embedded discourse levels, language for communication, linguistic structures, literary texts, poetry, pragmatic theories, reader response, speech acts (macro/micro), stylistics, teaching literature, TEFL, terms of address, turn-taking

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Authors: L. R. Ferreira, R. Biscaro, C. C. Danziger, C. M. Galhardi, L. C. Biscaro, R. C. Biscaro, I. S. Vasconcelos, L. C. R. Ferreira, R. Reis, L. H. Oliveira

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Introduction: There is a worldwide trend for the employer to be aware of investing in health promotion that goes beyond occupational hygiene approaches with the implementation of a comprehensive program with integration between occupational health and safety, and social/psychosocial responsibility in the workplace. Work accommodation is a necessity in most companies as it allows the worker to return to its function respecting its physical limitations. This study had the objective to verify if the integration of health and safety in the companies, with the inclusion of the concept of TWH promoted by an occupational health service has impacted in the management of absenteeism of workers in work accommodation. Method: A retrospective and paired cohort study was used, in which the impact of the implementation of the Program for the Health/Safety Integration and Total Worker Health Concept (PHSITWHC) was evaluated using the indices of absenteeism, health attestations, days and hours of sick leave of workers that underwent job accommodation/rehabilitation. This was a cohort study and the data were collected from January to September of 2017, prior to the initiation of the integration program, and compared with the data obtained from January to September of 2018, after the implementation of the program. For the statistical analysis, the student's t-test was used, with statistically significant differences being made at p < 0.05. Results: The results showed a 35% reduction in the number of absenteeism rate in 2018 compared to the same period in 2017. There was also a significant reduction in the total numbers of days of attestations/absences (mean of 2,8) as well as days of attestations, absence and sick leaves (mean of 5,2) in 2018 data after the implementation of PHSITWHC compared to 2017 data, means of 4,3 and 25,1, respectively, prior to the program. Conclusion: It can be concluded that the inclusion of the PHSITWHC was associated with a reduction in the rate of absenteeism of workers that underwent job accommodation. It was observed that, once health and safety were approached and integrated with the inclusion of the TWH concept, it was possible to reduce absenteeism, and improve worker’s quality of life and wellness, and work accommodation management.

Keywords: absenteeism, health/safety integration, work accommodation management, total worker health

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Authors: D. S. Gomes, A. T. Silva

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Analysis of the uncertainty quantification related to nuclear safety margins applied to the nuclear reactor is an important concept to prevent future radioactive accidents. The nuclear fuel performance code may involve the tolerance level determined by traditional deterministic models producing acceptable results at burn cycles under 62 GWd/MTU. The behavior of nuclear fuel can simulate applying a series of material properties under irradiation and physics models to calculate the safety limits. In this study, theoretical predictions of nuclear fuel failure under transient conditions investigate extended radiation cycles at 75 GWd/MTU, considering the behavior of fuel rods in light-water reactors under reactivity accident conditions. The fuel pellet can melt due to the quick increase of reactivity during a transient. Large power excursions in the reactor are the subject of interest bringing to a treatment that is known as the Fuchs-Hansen model. The point kinetic neutron equations show similar characteristics of non-linear differential equations. In this investigation, the multivariate logistic regression is employed to a probabilistic forecast of fuel failure. A comparison of computational simulation and experimental results was acceptable. The experiments carried out use the pre-irradiated fuels rods subjected to a rapid energy pulse which exhibits the same behavior during a nuclear accident. The propagation of uncertainty utilizes the Wilk's formulation. The variables chosen as essential to failure prediction were the fuel burnup, the applied peak power, the pulse width, the oxidation layer thickness, and the cladding type.

Keywords: logistic regression, reactivity-initiated accident, safety margins, uncertainty propagation

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Authors: Suchithra V., Shreedhanya, Kavya Menon, Vidya Niranjan

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Skin metagenomics has a wide range of applications with direct relevance to the health of the organism. It gives us insight to the diverse community of microorganisms (the microbiome) harbored on the skin. In the recent years, it has become increasingly apparent that the interaction between skin microbiome and the human body plays a prominent role in immune system development, cancer development, disease pathology, and many other biological implications. Next Generation Sequencing has led to faster and better understanding of environmental organisms and their mutual interactions. This project is studying the human skin microbiome of different individuals having varied skin conditions. Bacterial 16S rRNA data of skin microbiome is downloaded from SRA toolkit provided by NCBI to perform metagenomics analysis. Twelve samples are selected with two controls, and 3 different categories, i.e., sex (male/female), skin type (moist/intermittently moist/sebaceous) and occlusion (occluded/intermittently occluded/exposed). Quality of the data is increased using Cutadapt, and its analysis is done using FastQC. USearch, a tool used to analyze an NGS data, provides a suitable platform to obtain taxonomy classification and abundance of bacteria from the metagenome data. The statistical tool used for analyzing the USearch result is METAGENassist. The results revealed that the top three abundant organisms found were: Prevotella, Corynebacterium, and Anaerococcus. Prevotella is known to be an infectious bacterium found on wound, tooth cavity, etc. Corynebacterium and Anaerococcus are opportunist bacteria responsible for skin odor. This result infers that Prevotella thrives easily in sebaceous skin conditions. Therefore it is better to undergo intermittently occluded treatment such as applying ointments, creams, etc. to treat wound for sebaceous skin type. Exposing the wound should be avoided as it leads to an increase in Prevotella abundance. Moist skin type individuals can opt for occluded or intermittently occluded treatment as they have shown to decrease the abundance of bacteria during treatment.

Keywords: bacterial 16S rRNA , next generation sequencing, skin metagenomics, skin microbiome, taxonomy

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Authors: Naridchaya Aberdour, Joanna Kao, Anne Miller, Timothy Shore, Richard Maher, Zhixin Liu

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Background: COVID-19 has and continues to be a strain on healthcare globally, with the number of patients requiring hospitalization exceeding the level of medical support available in many countries. As chest x-rays are the primary respiratory radiological investigation, the Radiological Assessment of Lung Edema (RALE) score was used to quantify the extent of pulmonary infection on baseline imaging. Assessment of RALE score's reproducibility and associations with clinical outcome parameters were then evaluated to determine implications for patient management and prognosis. Methods: A retrospective study was performed with the inclusion of patients testing positive for COVID-19 on nasopharyngeal swab within a single Local Health District in Sydney, Australia and baseline x-ray imaging acquired between January to June 2020. Two independent Radiologists viewed the studies and calculated the RALE scores. Clinical outcome parameters were collected and statistical analysis was performed to assess RALE score reproducibility and possible associations with clinical outcomes. Results: A total of 78 patients met inclusion criteria with the age range of 4 to 91 years old. RALE score concordance between the two independent Radiologists was excellent (interclass correlation coefficient = 0.93, 95% CI = 0.88-0.95, p<0.005). Binomial logistics regression identified a positive correlation with hospital admission (1.87 OR, 95% CI= 1.3-2.6, p<0.005), oxygen requirement (1.48 OR, 95% CI= 1.2-1.8, p<0.005) and invasive ventilation (1.2 OR, 95% CI= 1.0-1.3, p<0.005) for each 1-point increase in RALE score. For each one year increased in age, there was a negative correlation with recovery (0.05 OR, 95% CI= 0.92-1.0, p<0.01). RALE scores above three were positively associated with hospitalization (Youden Index 0.61, sensitivity 0.73, specificity 0.89) and above six were positively associated with ICU admission (Youden Index 0.67, sensitivity 0.91, specificity 0.78). Conclusion: The RALE score can be used as a surrogate to quantify the extent of COVID-19 infection and has an excellent inter-observer agreement. The RALE score could be used to prognosticate and identify patients at high risk of deterioration. Threshold values may also be applied to predict the likelihood of hospital and ICU admission.

Keywords: chest radiography, coronavirus, COVID-19, RALE score

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Authors: M. Ezzat, Y. Zaghloul, T. Sorour, A. Hefny, M. Eid

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Ultimate capacity of large diameter bored piles is usually determined from pile loading tests as recommended by several international codes and foundation design standards. However, loading of this type of piles till achieving apparent failure is practically seldom. In this paper, numerical analyses are carried out to simulate load test of a large diameter bored pile performed at the location of Alzey highway bridge project (Germany). Test results of pile load settlement relationship till failure as well as results of the base and shaft resistances are available. Apparent failure was indicated in this test by the significant increase of the induced settlement during the last load increment applied on the pile head. Measurements of this pile load test are used to assess the quality of the numerical models investigated. Three different material soil models are implemented in the analyses: Mohr coulomb (MC), Soft soil (SS), and Modified Mohr coulomb (MMC). Very good agreement is obtained between the field measured settlement and the calculated settlement using the MMC model. Results of analysis showed also that the MMC constitutive model is superior to MC, and SS models in predicting the ultimate base and shaft resistances of the large diameter bored pile. After calibrating the numerical model, behavior of large diameter bored piles under axial loads is discussed and the formation of the plastic zone around the pile is explored. Results obtained showed that the plastic zone below the base of the pile at failure extended laterally to about four times the pile diameter and vertically to about three times the pile diameter.

Keywords: ultimate capacity, large diameter bored piles, plastic zone, failure, pile load test

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Authors: Ridhish Kumar, Sudeep Nadukkandy, Anirban Roy

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The development of reverse osmosis happened in 1960. Along the years this technique has been widely accepted all over the world for varied applications ranging from seawater desalination to municipal water treatment. Forward osmosis (FO) is one of the foremost technologies for low energy consuming solutions for water purification. In this study, we have carried out a detailed analysis on selection, design, and pricing for a prototype of potable water system for purifying water in emergency situations. The portable and light purification system is envisaged to be driven by FO. This pouch will help to serve as an emergency water filtration device. The current effort employs a model to understand the interplay of permeability and area on the rate of purification of water from any impure source/brackish water. The draw solution for the FO pouch is considered to be a combination of salt and sugar such that dilution of the same would result in an oral rehydration solution (ORS) which is a boon for dehydrated patients. However, the effort takes an extra step to actually estimate the cost and pricing of designing such a prototype. While the mathematical model yields the best membrane (compositions are taken from literature) combination in terms of permeability and area, the pricing takes into account the feasibility of such a solution to be made available as a retail item. The product is envisaged to be a market competitor for packaged drinking water and ORS combination (costing around $0.5 combined) and thus, to be feasible has to be priced around the same range with greater margins in order to have a better distribution. Thus a proper business plan and production of the same has been formulated in order to be a feasible solution for unprecedented calamities and emergency situations.

Keywords: forward osmosis, water treatment, oral rehydration solution, prototype

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Authors: Bei Zhang, Zhaoxin Zhang, Lidong Zhao

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Green infrastructures (GIs) for rainwater management can directly meet the multiple purposes of urban greening and non-point source pollution control. To reveal the overall layout law of GIs dominated by typical woody plants and their impact on urban environmental effects, we constructed a HYDRUS-1D and Stormwater management (SWMM) coupling model to simulate the response of typical root woody plant planting methods on urban hydrological. The results showed that the coupling model had high adaptability to the simulation of urban surface runoff control effect under different woody plant planting methods (NSE ≥0.64 and R² ≥ 0.71). The regulation effect on surface runoff showed that the average runoff reduction rate of GIs increased from 60 % to 71 % with the increase of planting area (5% to 25%) under the design rainfall event of the 2-year recurrence interval. Sophora japonica with tap roots was slightly higher than that of without plants (control) and Malus baccata (M. baccata) with fibrous roots. The comprehensive benefit evaluation system of rainwater utilization technology was constructed by using an analytic hierarchy process. The coupling model was used to evaluate the comprehensive benefits of woody plants with different planting areas in the study area in terms of environment, economy, and society. The comprehensive benefit value of planting 15% M. baccata was the highest, which was the first choice for the planting of woody plants in the study area. This study can provide a scientific basis for the decision-making of green facility layouts of woody plants.

Keywords: green infrastructure, comprehensive benefits, runoff regulation, woody plant layout, coupling model

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Authors: Umi Pudji Astuti, Dedi Sugandi

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The effectiveness of agricultural extension is determined by the component in the agricultural extension system among others are agricultural extension methods. Effective methods should be selected and defined based on the characteristics of the target, the resources, the materials, and the objectives to be achieved. Citrus agribusiness development in Lebong is certainly supported by the role of stakeholders and citrus farmers, as well as the proper dissemination methods. Adoption in the extension process substantially can be interpreted as the changes of behavior process such as knowledge (cognitive), attitudes (affective), and skill (psycho-motoric) in a person after receiving "innovation" from extension submitted by target communities. Knowledge and perception are needed as a first step in adopting a innovation, especially of citrus agribusiness development in Lebong. The process of Specific technology adoption is influenced by internal factors and farmer perceptions of technological innovation. Internal factors such as formal education, experience trying to farm, owned land, production farm goods. The output of this study: 1) to analyze the effectiveness of field trial methods in improving cognitive and affective farmers; 2) Knowing the relationship of adoption level and knowledge of farmers; 3) to analyze the factors that influence farmers' adoption of citrus technology innovation. The method of this study is through the survey to 40 respondents in Rimbo Pengadang Sub District, Lebong District in 2014. Analyzing data is done by descriptive and statistical parametric (multiple linear functions). The results showed that: 1) Field trip method is effective to improve the farmer knowledge (23,17% ) and positively affect the farmer attitude; 2) the knowledge level of PTKJS innovation farmers "positively and very closely related".; 3) the factors that influence the level of farmers' adoption are internal factors (education, knowledge, and the intensity of training), and external factors respondents (distance from the house to the garden and from the house to production facilities shop).

Keywords: affect, adoption technology, citrus gerga, effectiveness dissemination

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Authors: Niloofar Zebarjad

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This research aims at finding a tool to provide basketball players with real-time audio feedback on their shooting form in free throw shots. Free throws played a pivotal role in taking the lead in fierce competitions. The major problem in performing an accurate free throw seems to be improper training. Since the arm movement during the free throw shot is complex, the coach or the athlete might miss the movement details during practice. Hence, there is a necessity to create a system that measures arm movements' critical characteristics and control for improper kinematics. The proposed setup in this study quantifies arm kinematics and provides real-time feedback as an audio signal consisting of a gyroscope sensor. Spatial shoulder angle data are transmitted in a mobile application in real-time and can be saved and processed for statistical and analysis purposes. The proposed system is easy to use, inexpensive, portable, and real-time applicable. Objectives: This research aims to modify and control the free throw using audio feedback and determine if and to what extent the new setup reduces errors in arm formations during throws and finally assesses the successful throw rate. Methods: One group of elite basketball athletes and two novice athletes (control and study group) participated in this study. Each group contains 5 participants being studied in three separate sessions over a week. Results: Empirical results showed enhancements in the free throw shooting style, shot pocket (SP), and locked position (LP). The mean values of shoulder angle were controlled on 25° and 45° for SP and LP, respectively, recommended by valid FIBA references. Conclusion: Throughout the experiments, the system helped correct and control the shoulder angles toward the targeted pattern of shot pocket (SP) and locked position (LP). According to the desired results for arm motion, adding another sensor to measure and control the elbow angle is recommended.

Keywords: audio-feedback, basketball, free-throw, locked-position, motor-control, shot-pocket

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Authors: Arash Parehkar, S. Jamshid Mousavi, Shoubo Bayazidi, Vahid Karami, Laleh Shahidi, Arash Azaranfar, Ali Moridi, M. Shabakhti, Tayebeh Ariyan, Mitra Tofigh, Kaveh Masoumi, Alireza Motahari

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Water resource systems modelling have constantly been a challenge through history for human being. As the innovative methodological development is evolving alongside computer sciences on one hand, researches are likely to confront more complex and larger water resources systems due to new challenges regarding increased water demands, climate change and human interventions, socio-economic concerns, and environment protection and sustainability. In this research, an automatic calibration scheme has been applied on the Gilan’s large-scale water resource model using mathematical programming. The water resource model’s calibration is developed in order to attune unknown water return flows from demand sites in the complex Sefidroud irrigation network and other related areas. The calibration procedure is validated by comparing several gauged river outflows from the system in the past with model results. The calibration results are pleasantly reasonable presenting a rational insight of the system. Subsequently, the unknown optimized parameters were used in a basin-scale linear optimization model with the ability to evaluate the system’s performance against a reduced inflow scenario in future. Results showed an acceptable match between predicted and observed outflows from the system at selected hydrometric stations. Moreover, an efficient operating policy was determined for Sefidroud dam leading to a minimum water shortage in the reduced inflow scenario.

Keywords: auto-calibration, Gilan, large-scale water resources, simulation

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Authors: Juntip Kanjanasilp, Ratree Sawangjit, Kanokporn Meelap, Kwanchanok Kruthakool

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Depression is a common mental health disorder. Antidepressants are effective pharmacological treatments, but most patients have low medication adherence. This study aims to systematic review and meta-analysis what method increase the antidepressants adherence efficiently and improve clinical outcome. Systematic review of articles of randomized controlled trials obtained by a computerized literature search of The Cochrane, Library, Pubmed, Embase, PsycINFO, CINAHL, Education search, Web of Science and ThaiLIS (28 December 2017). Twenty-three studies were included and assessed the quality of research by ROB 2.0. The results reported that printing media improved in number of people who had medication adherence statistical significantly (p= 0.018), but education, phone call, and program utilization were no different (p=0.172, p=0.127, p=0.659). There was no significant difference in pharmacist’s group, health care team’s group and physician’s group (p=0.329, p=0.070, p=0.040). Times of intervention at 1 month and 6 months improved medication adherence significantly (p= 0.0001, p=0.013). There was significantly improved adherence in single intervention (p=0.027) but no different in multiple interventions (p=0.154). When we analyzed medication adherence with the mean score, no improved adherence was found, not relevant with who gives the intervention and times to intervention. However, the multiple interventions group was statistically significant improved medication adherence (p=0.040). Phone call and the physician’s group were statistically significant improved clinical outcomes in number of improved patients (0.025 and 0.020, respectively). But in the pharmacist’s group and physician’s group were not found difference in the mean score of clinical outcomes (p=0.993, p=0.120, respectively). Times to intervention and number of intervention were not significant difference than usual care. The overall intervention can increase antidepressant adherence, especially the printing media, and the appropriate timing of the intervention is at least 6 months. For effective treatment, the provider should have experience and expert in caring for patients with depressive disorders, such as a psychiatrist. Medical personnel should have knowledge in caring for these patients also.

Keywords: depression, medication adherence, clinical outcomes, systematic review, meta-analysis

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Authors: Machimontorn Promtong, Sherman C. P. Cheung, Guan H. Yeoh, Sara Vahaji, Jiyuan Tu

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The wide range of industrial applications involved with boiling flows promotes the necessity of establishing fundamental knowledge in boiling flow phenomena. For this purpose, a number of experimental and numerical researches have been performed to elucidate the underlying physics of this flow. In this paper, the improved wall boiling models, implemented on ANSYS CFX 14.5, were introduced to study subcooled boiling flow at elevated pressure. At the heated wall boundary, the Fractal model, Force balance approach and Mechanistic frequency model are given for predicting the nucleation site density, bubble departure diameter, and bubble departure frequency. The presented wall heat flux partitioning closures were modified to consider the influence of bubble sliding along the wall before the lift-off, which usually happens in the flow boiling. The simulation was performed based on the Two-fluid model, where the standard k-ω SST model was selected for turbulence modelling. Existing experimental data at around 5 bars were chosen to evaluate the accuracy of the presented mechanistic approach. The void fraction and Interfacial Area Concentration (IAC) are in good agreement with the experimental data. However, the predicted bubble velocity and Sauter Mean Diameter (SMD) are over-predicted. This over-prediction may be caused by consideration of only dispersed and spherical bubbles in the simulations. In the future work, the important physical mechanisms of bubbles, such as merging and shrinking during sliding on the heated wall will be incorporated into this mechanistic model to enhance its capability for a wider range of flow prediction.

Keywords: subcooled boiling flow, computational fluid dynamics (CFD), mechanistic approach, two-fluid model

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Authors: Esam Jassim

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Industries using conventional fossil fuels have an interest in better understanding the mechanism of particulate formation during combustion since such is responsible for emission of undesired inorganic elements that directly impact the atmospheric pollution level. Fine and ultrafine particulates have tendency to escape the flue gas cleaning devices to the atmosphere. They also preferentially collect on surfaces in power systems resulting in ascending in corrosion inclination, descending in the heat transfer thermal unit, and severe impact on human health. This adverseness manifests particularly in the regions of world where coal is the dominated source of energy for consumption. This study highlights the behavior of calcium transformation as mineral grains verses organically associated inorganic components during pulverized coal combustion. The influence of existing type of calcium on the coarse, fine and ultrafine mode formation mechanisms is also presented. The impact of two sub-bituminous coals on particle size and calcium composition evolution during combustion is to be assessed. Three mixed blends named Blends 1, 2, and 3 are selected according to the ration of coal A to coal B by weight. Calcium percentage in original coal increases as going from Blend 1 to 3. A mathematical model and a new approach of describing constituent distribution are proposed. Analysis of experiments of calcium distribution in ash is also modeled using Poisson distribution. A novel parameter, called elemental index λ, is introduced as a measuring factor of element distribution. Results show that calcium in ash that originally in coal as mineral grains has index of 17, whereas organically associated calcium transformed to fly ash shown to be best described when elemental index λ is 7. As an alkaline-earth element, calcium is considered the fundamental element responsible for boiler deficiency since it is the major player in the mechanism of ash slagging process. The mechanism of particle size distribution and mineral species of ash particles are presented using CCSEM and size-segregated ash characteristics. Conclusions are drawn from the analysis of pulverized coal ash generated from a utility-scale boiler.

Keywords: coal combustion, inorganic element, calcium evolution, fluid dynamics

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Authors: Mark P. Mayala, Henry Mayala, Khuzeima Khanbhai

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Background: Heart failure has been a rising concern in Tanzania. New drugs have been introduced, including the group of drugs called Angiotensin receptor Neprilysin Inhibitor (ARNI), but due to their high cost, angiotensin-converting enzymes inhibitors (ACEIs) and Angiotensin receptor blockers (ARBs) have been mostly used in Tanzania. However, according to our knowledge, the efficacy comparison of the two groups is yet to be studied in Tanzania. The aim of this study was to compare the efficacy of ACEIs and ARBs among patients with heart failure. Methodology: This was a hospital-based prospective cohort study done at Jakaya Kikwete Cardiac Institution (JKCI), Tanzania, from June to December 2020. Consecutive enrollment was done until fulfilling the inclusion criteria. Clinical details were measured at baseline. We assessed the relationship between ARBs and ACEIs users with N-terminal pro-brain natriuretic peptide (NT pro-BNP) levels at admission and at 1-month follow-up using a chi-square test. A Kaplan-Meier curve was used to estimate the survival time of the two groups. Results: 155 HF patients were enrolled, with a mean age of 48 years, whereby 52.3% were male, and their mean left ventricular ejection fraction (LVEF) was 37.3%. 52 (33.5%) heart failure patients were on ACEIs, 57 (36.8%) on ARBs, and 46 (29.7%) were neither using ACEIs nor ARBs. At least half of the patients did not receive a guideline-directed medical therapy (GDMT), with only 82 (52.9%) receiving a GDMT. A drop in NT pro-BNP levels was observed during admission and at 1-month follow-up on both groups, from 6389.2 pg/ml to 4000.1 pg/ml for ARB users and 5877.7 pg/ml to 1328.2 pg/ml for the ACEIs users. There was no statistical difference between the two groups when estimated by the Kaplan-Meier curve, though more deaths were observed in those who were neither on ACEIs nor ARBs, with a calculated P value of 0.01. Conclusion: This study demonstrates that ACEIs have more efficacy and overall better clinical outcome than ARBs, but this should be taken under the patient-based case, considering the side effects of ACEIs and patients’ adherence.

Keywords: angiotensin converting enzymes inhibitors, angiotensin receptor blockers, guideline direct medical therapy, N-terminal pro-brain natriuretic peptide

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Authors: Zahra Khodaee

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Background and Objective: The attractive potential for tourism in the southern islands of Iran, Kish, and Qeshm and recently Hendurabi, are becoming more and more popular and object of increased attention from the investors. The Iranian coral reef islands, with the exception of Kish and Qeshm, have not undergone sufficient development. The southern islands of Iran have faced two problems with climate change and the desire for the presence of tourists. The lack of proper planning, inefficient management, and lack of adequate knowledge of ecosystems of offshore regions have severely damaged the world natural heritage. This study was conducted to consider the correlation of tourism, development, and ecosystem because there is a need for further addressing the ecotourism in coral islands. Method: Through qualitative research, this paper was used of library studies and field studies and surveying to study the physical (objective-subjective) physical factors of ecotourism development in Honduran Island. Using SPSS software and descriptive-analytical method was shown the results. The survey was conducted with the participation of 150 tourists on Kish islands, who were chosen at random and who expressed their desire to travel to Hendurabi Island. Information was gathered using SPSS software and unique statistical T-test. The questionnaire was put together using AMOS software to ensure that the questions asked were sufficiently relevant. Findings: The results of this study presented that physical factors affecting the development of ecotourism in two categories are objective and subjective factors because IFI factor = 0.911 and CFI Factor = 0.907 into the target community. Discussion and conclusion: The results were satisfactory in that they showed that eco-tourists attached importance to see views, quiet, secluded areas, tranquility security, quality of the area being visited, easy access to services these were the top criteria for those visiting the area while they adhere to environmental compliance. Developing Management of these regions should maintain appropriate utilization along with sustainable and ecological responsibility.

Keywords: ecotourism, coral reef island, development management, Hendurabi Island

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Authors: Roongtiwa Chobchuen, Siriporn Mongkholthawornchai, Boonsong Hatawaikarn, Uriwan Chaichangreet, Kobkaew Thongtid, Pusda Pukdeekumjorn, Panita Limpawattana

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Background: Age-friendly nursing service system in Srinagarind Hospital has been developed continuously based on the value and cultural background of Thailand which corporates with the modified WHO’s Age friendly Primary Care Service System. It consists of 3 issues; 1) development of staff training, 2) age-friendly service and 3) appropriate physical environment. Objective: To evaluate the efficacy of Age-friendly Nursing Service System: KKU (AFNS:KKU) model and to evaluate factors associated with nursing perception with AFN:KKU. Study design: Descriptive study Setting: 31 wards that served older patients in Srinagarind Hospital Populations: Nursing staff from 11 departments (31 wards) Instrument: Age-friendly nursing care scale as perceived by hospitalized older person Procedure and statistical analysis: All participants were asked questions using age-friendly nursing care scale as perceived by hospitalized older person questionnaires. Descriptive statistics and multiple logistic regression analyses were used to analyse the outcomes. Results: There were 337 participants recruited in this study. The majority of them were women (92%) with the mean ages of 29 years and 77.45% were nurse practitioners. They had average nursing experiences of 5 years. The average scores of age-friendly nursing care scale were high and highest in the area of attitude and communication. Age, sex, educational level, duration of work among, and having experience in aging training were not associated with nursing perception where type of department was an independent factor. Nurses from department of Surgery and Orthopedic, Eye and ENT, special ward and Obstetrics and Gynecological had significant greater perception than nurses from Internal Medicine Department (p < 0.05). Conclusion: Nurses had high scores in all dimensions of age-friendly concept. The result indicates that nurses have good attitude to aging care which can lead to improve quality of care. Organization should support other domains of ageing care to achieve greater effectiveness in geriatric care.

Keywords: age-friendly, nursing service system, excellence model, geriatric care

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Authors: Jerzy Merkisz, Pawel Fuc, Piotr Lijewski, Andrzej Ziolkowski, Pawel Czarkowski

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The paper presents preliminary results of the development of an automotive exhaust gas energy recovery module. The aim of the performed analyses was to select the geometry of the heat exchanger that would ensure the highest possible transfer of heat at minimum heat flow losses. The starting point for the analyses was a straight portion of a pipe, from which the exhaust system of the tested vehicle was made. The design of the heat exchanger had a cylindrical cross-section, was 300 mm long and was fitted with a diffuser and a confusor. The model works were performed for the mentioned geometry utilizing the finite volume method based on the Ansys CFX v12.1 and v14 software. This method consisted in dividing of the system into small control volumes for which the exhaust gas velocity and pressure calculations were performed using the Navier-Stockes equations. The heat exchange in the system was modeled based on the enthalpy balance. The temperature growth resulting from the acting viscosity was not taken into account. The heat transfer on the fluid/solid boundary in the wall layer with the turbulent flow was done based on an arbitrarily adopted dimensionless temperature. The boundary conditions adopted in the analyses included the convective condition of heat transfer on the outer surface of the heat exchanger and the mass flow and temperature of the exhaust gas at the inlet. The mass flow and temperature of the exhaust gas were assumed based on the measurements performed in actual traffic using portable PEMS analyzers. The research object was a passenger vehicle fitted with a 1.9 dm3 85 kW diesel engine. The tests were performed in city traffic conditions.

Keywords: waste heat recovery, heat exchanger, CFD simulation, pems

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Authors: Anthony John Walker, Glen Bright

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The challenge faced by manufactures, when producing custom products, is that each product needs exact components. This can cause work-in-process instability due to component matching constraints imposed on assembly cells. Clearing type flow control policies have been used extensively in mediating server access between multiple arrival processes. Although the stability and performance of clearing policies has been well formulated and studied in the literature, the growth in arrival to departure sequence disorder for each arriving job, across a serving resource, is still an area for further analysis. In this paper, a closed form industrial model has been formulated that characterizes arrival-to-departure sequence disorder through stable manufacturing systems under clearing type flow control policy. Specifically addressed are the effects of sequence disorder imposed on a downstream assembly cell in terms of work-in-process instability induced through component matching constraints. Results from a simulated manufacturing system show that steady state average sequence disorder in parallel upstream processing cells can be balanced in order to decrease downstream assembly system instability. Simulation results also show that the closed form model accurately describes the growth and limiting behavior of average sequence disorder between parts arriving and departing from a manufacturing system flow controlled via clearing policy.

Keywords: assembly system constraint, custom products, discrete sequence disorder, flow control

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Authors: Sunil Kumar, Uday C. Ghoshal

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Background and aims: Serotonin (5-hydroxtryptamine, 5-HT) is an important factor in gut function, playing key roles in intestinal peristalsis and secretion, and in sensory signaling in the brain-gut axis. Removal from its sites of action is mediated by a specific protein called the serotonin reuptake transporter (SERT). Polymorphisms in the promoter region of the SERT gene have effects on transcriptional activity, resulting in altered 5-HT reuptake efficiency. Functional polymorphisms may underlie disturbance in gut function in individuals suffering with disorders such as irritable bowel syndrome (IBS). The aim of this study was to assess the potential association between SERT polymorphisms and the diarrhea predominant IBS (D-IBS) phenotype Subjects: A total of 36 northern Indian female patients and 55 female northern Indian healthy controls (HC) were subjected to genotyping. Methods: Leucocyte DNA of all subjects was analyzed by polymerase chain reaction based technologies for SERT polymorphisms, specifically the insertion/deletion polymorphism in the promoter (SERT-P). Statistical analysis was performed to assess association of SERT polymorphism allele with the D-IBS phenotype. Results: The frequency of distribution of SERT-P gene was comparable between female patients with IBS and HC (p = 0.086). However, frequency of SERT-P deletion/deletion genotype was significantly higher in female patients with D-IBS compared to C-IBS and A-IBS [17/19 (89.5%) vs. 4/12 (33.3%) vs. 1/5 (20%), p=0.001, respectively]. The mucosal level of serotonin was higher in D-IBS compared to C-IBS and A-IBS [Median, range (159.26, 98.78–212.1) vs. 110.4, 67.87–143.53 vs. 92.34, 78.8–166.3 pmol/mL, p=0.001, respectively]. The mucosal level of serotonin was higher in female patients with IBS with SERT-P deletion/deletion genotype compared deletion/insertion and insertion/insertion [157.65, 67.87–212.1 vs. 110.4, 78.1–143.32 vs. 100.5, 69.1–132.03 pmol/mL, p=0.001, respectively]. Patients with D-IBS with deletion/deletion genotype more often reported symptoms of abdominal pain, discomfort (p=0.025) and bloating (p=0.039). Symptoms development following lactose ingestion was strongly associated with D-IBS and SERT-P deletion/deletion genotype (p=0.004). Conclusions: Significant association was observed between D-IBS and the SERT-P deletion/deletion genotype, suggesting that the serotonin transporter is a potential candidate gene for D-IBS in women.

Keywords: serotonin, SERT, inflammatory bowel disease, genetic polymorphism

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