Search results for: disease activity

Authors: Milena Trevisan Pelegrino, Bruna De Araujo Lima, Mônica H. M. Do Nascimento, Christiane B. Lombello, Marcelo Brocchi, Amedea B. Seabra

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Nitric oxide (NO) is a small molecule involved in a wide range of physiological and pathophysiological processes, including vasodilatation, control of inflammatory pain, wound healing, and antibacterial activities. As NO is a free radical, the design of drugs that generates therapeutic amounts of NO in controlled spatial and time manners is still a challenge. In this study, the NO donor S-nitrosoglutathione (GSNO) was incorporated into the thermoresponsive Pluronic F-127 (PL) - chitosan (CS) hydrogel, in an easy and economically feasible methodology. CS is a polysaccharide with known antimicrobial and biocompatibility properties. Scanning electron microscopy, rheology and differential scanning calorimetry techniques were used for hydrogel characterization. The results demonstrated that the hydrogel has a smooth surface, thermoresponsive behavior, and good mechanical stability. The kinetics of NO release and GSNO diffusion from GSNO-containing PL/CS hydrogel demonstrated a sustained NO/GSNO release, in concentrations suitable for biomedical applications, at physiological and skin temperatures. The GSNO-PL/CS hydrogel demonstrated a concentration-dependent toxicity to Vero cells, and antimicrobial activity to Pseudomonas aeruginosa (minimum inhibitory concentration and minimum bactericidal concentration values of 0.5 µg·mL-1 of hydrogel, which correspondents to 1 mmol·L-1 of GSNO). Interesting, the concentration range in which the NO-releasing hydrogel demonstrated antibacterial effect was not found toxic to Vero mammalian cell. Thus, GSNO-PL/CS hydrogel is suitable biomaterial for topical NO delivery applications.

Keywords: antimicrobial, chitosan, biocompatibility, S-nitrosothiols

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Authors: Alan Lai, Wilson Yik

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With rapid urbanization, there has been a dramatic increase in global urban population in Asia and over half of population in Asia will live in urban regions in the near future. Facing with increasing exposure to climate-related stresses and shocks, most of the Asian cities will very likely to experience more frequent heat waves and flooding with rising sea levels, particularly the coastal cities will grapple for intense typhoons and storm surges. These climate changes have severe impacts in urban areas at the costs of infrastructure and population, for example, human health, wellbeing and high risks of dengue fever, malaria and diarrheal disease. With the increasing prominence of adaptation to climate changes, there have been changes in corresponding policies. Smaller cities have greater potentials for integrating the concept of resilience into their infrastructure as well as keeping pace with their rapid growths in population. It is therefore important to explore the potentials of Asian cities adapting to climate change and the opportunities of building climate resilience in urban planning and building design. Furthermore, previous studies have mainly attempted at exploiting the potential of resilience on a macro-level within urban planning rather than that on micro-level within the context of individual building. The resilience of individual building as a research field has not yet been much explored. Nonetheless, recent studies define that the resilience of an individual building is the one which is able to respond to physical damage and recover from such damage in a quickly and cost-effectively manner, while maintain its primary functions. There is also a need to develop an assessment tool to evaluate the resilience on building scale which is still largely uninvestigated as it should be regarded as a basic function of a building. Due to the lack of literature reporting metric for assessing building resilience with sustainability, the research will be designed as a case study to provide insight into the issue. The aim of this research project is to encourage and assist in developing neighborhood climate resilience design strategies for Hong Kong so as to bridge the gap between difference scales and that between theory and practice.

Keywords: resilience cities, building resilience, resilient buildings and infrastructure, climate resilience, hot and humid southeast area, high-density cities

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Authors: Huseyin Arasli, Maryam Abdullahi, Tugrul Gunay

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One of the prominence elements used by the destination marketing organization (DMO) as a marketing strategy is the application of Social media tools. During the current spread of coronavirus disease (COVID-19), travel restriction was placed in most countries of the world, leading to the closure of borders movement. It should be noted that most tourism travelers depend on social media to obtain and exchange different kinds of information about COVID-19 in an unprecedented scale. The situational information people received is valued, which calls for the response of the tourism industry on the epidemic. Therefore, it is highly important to recognize such situational information and to understand how people spread this propaganda on social media platforms so that suitable information that relates the COVID-19 epidemic is available in a manner that will not tarnish the marketing strategies, festival planners. Data for this research study was collected from the desk review, which is a secondary source data, online blogs, and interview through social media chat. The results of this research show that the widespread of COVID-19 pandemics led to rapid lockdown in states and cities all over Nigeria, causing declining demands in hotels, airlines, recreation, and tourism centers. Additionally, billions of dollars lost has been recorded in the high increase of hotels and travel bookings cancellations which caused hundreds and thousands of job loss in the country. The result of this research also revealed that COVID-19 is causing more havoc on the unemployment rate indices of the country. Similarly, the over-dependence of government on petroleum has further caused considerable revenue loss, thereby raising a high poverty rate among less privileged Nigerians. Based on this result, the study suggested that there is an urgent need for the government to diversify its economy by looking at other different sectors such as tourism and agricultural farm produce to harmonize other commercial trades sectors in the country.

Keywords: social media, destination marketing organizations, DMOs, cultural COVID-19, coronavirus, hospitality, travel tour, tourism

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Authors: Anjum Afrooze

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The curriculum at General Sciences department in Prince Sultan University includes ‘Physical science’ for Computer Science, Information Technology and Business courses. Students are apathetic towards Physical Science and question, as to, ‘How this course is related to their majors?’ English is not a native language for the students and also for many instructors. More than sixty percent of the students come from institutions where English is not the medium of instruction, which makes student learning and academic achievement challenging. After observing the less enthusiastic student cohort for two consecutive semesters, the instructor was keen to find effective strategies to enhance learning and further encourage deep learning by engaging students in different tasks to empower them with necessary skills and motivate them. This study is participatory action research, in which instructor designs effective tasks to engage students in their learning. The study is conducted through two semesters with a total of 200 students. The effectiveness of this approach is studied using questionnaire at the end of each semester and teacher observation. Major outcomes of this study were overall improvement in students attitude towards science learning, enhancement of multiple skills like note taking, problem solving, language proficiency and also fortifying confidence. This process transformed instructor into engaging and reflecting practitioner. Also, these strategies were implemented by other instructors teaching the course and proved effective in opening a path to changes in related areas of the course curriculum. However, refinement in the strategies could be done based on student evaluation and instructors observation.

Keywords: group activity, language proficiency, reasoning skills, science learning

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Authors: Nadia Konstantina Zygouri

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This paper aims to provide a concise analysis of the symbolic nature of cinematic light portrayed in Apichatpong Weerasethakul's film Cemetery of Splendour (2015). The study explores the philosophical hypostasis of lighting mechanisms, the idea of which is based on political motives and, in addition, metaphysical theories originating from the Isan region of Thailand. In the film, the colourful hospital space and narcoleptic soldiers represent the deep and tumultuous history of the Thai nation, revealing a symbolic allegory through an incurable disease that the protagonists suffer from, addressing with this metaphor a collective political apathy. Specifically, the film follows Jen, a woman with a leg disability who takes care of Itt, an ex-soldier fallen into narcolepsy amidst a multi-coloured roomful of other comatose soldiers. The film's central theme, as well as the central setting, concerns an abandoned former school now used as a treatment clinic for military patients, each connected to a mechanism of light that can affect their dreams while sleeping. The audience later discovers from two mythological figures emerging from Thailand's ancient religious past that the hospital grounds are built over the ruins of an ancient kingdom's cemetery. The symbolic political implication is that ancient rulers have captured the soldiers’ spirits to fight their eternal battles, leaving their unconscious bodies in torpor, as similar politics of the past and present affect the nation to this day and enforce political apathy. In a contrasting tone, the colourful tubes are present to relieve the soldiers' symptoms and create better memories in their subconscious minds. As a result, the concluding argument of this hypothesis places Apichatpong's direction of cinematic light towards a philosophical and political commentary that, although derived from ancient national history, remains thoroughly contemporary.

Keywords: Apichatpong Weerasethakul, cemetery of Splendour, filmosophy, politics, aesthetics, direction of photography, light in cinema, metaphysics, visual philosophy

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Authors: S. B. Bhandare, K. S. Laddha

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Podphyllum hexandrum belonging to family berberidaceae has gained attention in phytochemical and pharmacological research as it shows excellent anticancer activity and has been used in treatment of skin diseases, sunburns and radioprotection. Chemically it contains lignans and flavonoids such as kaempferol, quercetin and their glycosides. Objective: To isolate and identify Kaempferol and Quercetin from Podophyllum rhizome. Method: The powdered rhizome of Podophyllum hexandrum was subjected to soxhlet extraction with methanol. This methanolic extract is used to obtain podophyllin. Podohyllin was extracted with ethyl acetate and this extract was then concentrated and subjected to column chromatography to obtain purified kaempferol and quercetin. Result: Isolated kaempferol, quercetin were light yellow and dark yellow in colour respectively. TLC of the isolated compounds was performed using chloroform: methanol (9:1) which showed single band on silica plate at Rf 0.6 and 0.4 for kaempferol and quercetin. UV spectrometric studies showed UV maxima (methanol) at 259, 360 nm and 260, 370 nm which are identical with standard kaempferol and quercetin respectively. Both IR spectra exhibited prominent absorption bands for free phenolic OH at 3277 and 3296.2 cm-1 and for conjugated C=O at 1597 and 1659.7 cm-1 respectively. The mass spectrum of kaempferol and quercetin showed (M+1) peak at m/z 287 and 303.09 respectively. 1H NMR analysis of both isolated compounds exhibited typical four-peak pattern of two doublets at δ 6.86 and δ 8.01 which was assigned to H-3’,5’ and H-2’,6’ respectively. Absence of signals less than δ 6.81 in the 1H NMR spectrum supported the aromatic nature of compound. Kaempferol and Quercetin showed 98.1% and 97% purity by HPLC at UV 370 nm. Conclusion: Easy and simple method for isolation of Kaempferol and Quercetin was developed and their structures were confirmed by UV, IR, NMR and mass studies. Method has shown good reproducibility, yield and purity.

Keywords: flavonoids, kaempferol, podophyllum rhizome, quercetin

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Authors: Mohammad Hossein Habibi, Atena Sadat Hosseini

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Colorectal cancer is the third leading cause of cancer-related death in the world. Colorectal cancer screening, early detection, and treatment programs could benefit from the most up-to-date information on the disease's burden, given the present worldwide trend of increasing colorectal cancer incidence. Tumor recurrence and resistance are exacerbated by the presence of chemotherapy-resistant cancer stem cells that can generate rapidly proliferating tumor cells. In addition, tumor cells can evolve chemoresistance through adaptation mechanisms. In this work, we used in silico analysis to select suitable GEO datasets. In this study, we compared slow-growing cancer stem cells with high-growth colorectal cancer-derived cancer stem cells. We then evaluated the signal pathways, transcription factors, and kinases associated with these two types of cancer stem cells. A total of 980 upregulated genes and 870 downregulated genes were clustered. MAPK signaling pathway, AGE-RAGE signaling pathway in diabetic complications, Fc gamma R-mediated phagocytosis, and Steroid biosynthesis signaling pathways were observed in upregulated genes. Also, caffeine metabolism, amino sugar and nucleotide sugar metabolism, TNF signaling pathway, and cytosolic DNA-sensing pathway were involved in downregulated genes. In the next step, we evaluated the best transcription factors and kinases in two types of cancer stem cells. In this regard, NR2F2, ZEB2, HEY1, and HDGF as transcription factors and PRDM5, SMAD, CBP, and KDM2B as critical kinases in upregulated genes. On the other hand, IRF1, SPDEF, NCOA1, and STAT1 transcription factors and CTNNB1 and CDH7 kinases were regulated low expression genes. Using bioinformatics analysis in the present study, we conducted an in-depth study of colorectal cancer stem cells at low and high growth rates so that we could take further steps to detect and even target these cells. Naturally, more additional tests are needed in this direction.

Keywords: colorectal cancer, bioinformatics analysis, transcription factor, kinases, cancer stem cells

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Authors: Hilal Al Shamsi, Abdullah Almutairi

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Introduction: As primary healthcare centres play an important role in implementing Saudi Arabia’s health strategy, this paper offers a review of publications on the quality of the country’s primary health care. With the aim of deciding on solutions for improvement, it provides an overview of healthcare quality in this context and indicates barriers to quality. Method: Using two databases, ProQuest and Scopus, data extracted from published articles were systematically analysed for determining the care quality in Saudi primary health centres and obstacles to achieving higher quality. Results: Twenty-six articles met the criteria for inclusion in this review. The components of healthcare quality were examined in terms of the access to and effectiveness of interpersonal and clinical care. Good access and effective care were identified in such areas as maternal health care and the control of epidemic diseases, whereas poor access and effectiveness of care were shown for chronic disease management programmes, referral patterns (in terms of referral letters and feedback reports), health education and interpersonal care (in terms of language barriers). Several factors were identified as barriers to high-quality care. These included problems with evidence-based practice implementation, professional development, the use of referrals to secondary care and organisational culture. Successful improvements have been implemented by other systems, such as mobile medical units, electronic referrals, online translation tools and mobile devices and their applications; these can be implemented in Saudi Arabia for improving the quality of the primary healthcare system in this country. Conclusion: The quality of primary health care in Saudi Arabia varies among the different services. To improve quality, management programmes and organisational culture must be promoted in primary health care. Professional development strategies are also needed for improving the skills and knowledge of healthcare professionals. Potential improvements can be implemented to improve the quality of the primary health system.

Keywords: quality, primary health care, Saudi Arabia, health centres, general medical

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Authors: Cherif Y., Ghariani R., Derbal S., Farhati S., Ben Dahmen F., Abdallah M.

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Introduction: Tuberculosis (TBC) is a frequent infection and is still a major public health problem in Tunisia. The aim of this work is to focus on diagnostic and therapeutic characteristics of TBC in patients referred to our internal medicine department. Patients and Methods: The study was retrospective and descriptive of a cohort of consecutive cases treated from January 2016 to December 2019, collecting patients with latent or patent TBC. Twenty-eight medical records of adults diagnosed with TBC were reviewed. Results: Twenty-eight patients, including 18 women and 10 men, were diagnosed with TBC. Their mean age is 48 years (range: 22-78 years). Five patients have a medical history of diabetes mellitus, 1 patient was followed for systemic lupus erythematosus treated with corticosteroids and immunosuppressant drugs, and another was treated with corticosteroids for Mac Duffy syndrome. The TBC is latent in 12 cases and patent in 16 cases. The most common symptoms were fever and weight loss and were found in 10 cases, a cough in 2 cases, sputum in 3 cases, lymph nodes in 4 cases, erythema nodosum in 2 cases, and neurological signs in 3 cases. Lymphopenia is noticed in 3 cases and a biological inflammatory syndrome in 18 of the cases. The purified protein derivate reaction was positive in 17 cases, anergic in 3 cases, negative in 5 cases, and not done in 3 cases. The acid-fast bacilli stain culture was strongly positive in one patient. The histopathological study was conclusive in 11 patients and showed granulomatosis with caseous necrosis. TBC was pulmonary in 7 patients, lymph node in 7 cases, peritoneal in 7 cases, digestive in 1 case, neuromeningeal in 3 cases, and thyroïd in 1 case. Seven patients had multifocal TBC. All the patients received anti-tuberculosis treatment with a mean duration of 8 months with no failure or relapse with an average follow-up time of 10.58 months. Conclusion: Diagnosis and management of TBC remain essential to avoid serious complications. The survey is necessary to ensure timely detection and treatment of infected adults to decrease its incidence. The best treatment remains preventive through vaccination and improving social and economic conditions.

Keywords: tuberculosis, infection, autoimmune disease, granulomatosis

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Authors: M. McHugh, D. Lillis

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Mobile applications are being used to perform a wide variety of tasks in day-to-day life, ranging from checking email to controlling your home heating. Application developers have recognized the potential to transform a smart device into a medical device, by using a mobile medical application i.e. a mobile phone or a tablet. When initially conceived these mobile medical applications performed basic functions e.g. BMI calculator, accessing reference material etc.; however, increasing complexity offers clinicians and patients a range of functionality. As this complexity and functionality increases, so too does the potential risk associated with using such an application. Examples include any applications that provide the ability to inflate and deflate blood pressure cuffs, as well as applications that use patient-specific parameters and calculate dosage or create a dosage plan for radiation therapy. If an unapproved mobile medical application is marketed by a medical device organization, then they face significant penalties such as receiving an FDA warning letter to cease the prohibited activity, fines and possibility of facing a criminal conviction. Regulatory bodies have finalized guidance intended for mobile application developers to establish if their applications are subject to regulatory scrutiny. However, regulatory controls appear contradictory with the approaches taken by mobile application developers who generally work with short development cycles and very little documentation and as such, there is the potential to stifle further improvements due to these regulations. The research presented as part of this paper details how by adopting development techniques, such as agile software development, mobile medical application developers can meet regulatory requirements whilst still fostering innovation.

Keywords: agile, applications, FDA, medical, mobile, regulations, software engineering, standards

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Authors: Marina Kartseva, Polina Kuznetsova

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In our work, we estimate the contribution of inequality of opportunity to inequality in the health of the Russian population aged 25 to 74 years. The empirical basis of the study is the nationally representative data of the RLMS for 2018. Individual health is measured using a self-reported status on five-point scale. The startconditions are characterized by parental education and place of birth (country, type of settlement). Personal efforts to maintain health include the level of education, smoking status, and physical activity. To understand how start opportunities affect an individual's health, we use the methodology proposed in (Trannoy et al., 2010), which takes into account both direct and indirect (through the influence on efforts) effects. Regression analysis shows that all other things being equal, the starting capabilities of individuals have a significant impact on their health. In particular, parental education has a positive effect on self-reported health. Birth in another country, in another settlement, and in an urban area, on the contrary, reduceself-reported health. This allows to conclude that there exists an unfair inequality in health, namely inequality caused by factors that are independent of a person's own efforts. We estimate the contribution of inequality of opportunity to inequality in health using a nonparametric approach (Checchi, Peragine, 2010; Lazar, 2013). According to the obtained results, the contribution of unfair inequality as 72-74% for the population as a whole, being slightly higher for women (62-74% and 60-69% for men and women, respectively) and for older age (59- 62% and 67-75% for groups 25-44 years old and 45-74 years old, respectively). The obtained estimates are comparable with the results for other countries and indicate the importance of the problem of inequality of opportunities in health in Russia.

Keywords: inequality of opportunity, inequality in health, self-reported health, efforts, health-related lifestyle, Russia, RLMS

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Authors: Zuliani Mahmood, Thirumulu Ponnuraj Kannan, Yean Yean Chan, Salahddin A. Al-Hudhairy

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Caries is the most common childhood disease which develops due to disturbances in the physiological equilibrium in the dental plaque resulting in demineralization of tooth structures. Plaque and dentine samples were collected from three different tooth surfaces representing caries progression (intact, over carious lesion and dentine) in children with early childhood caries (ECC, n=36). In caries free (CF) children, plaque samples were collected from sound tooth surfaces at baseline and after one year (n=12). The genomic DNA was extracted from all samples and subjected to 16S rRNA PCR amplification. The end products were cloned into pCR®2.1-TOPO® Vector. Five randomly selected positive clones collected from each surface were sent for sequencing. Identification of the bacterial clones was performed using BLAST against GenBank database. In the ECC group, the frequency of Lactobacillus sp. detected was significantly higher in the dentine surface (p = 0.031) than over the cavitated lesion. The highest frequency of bacteria detected in the intact surfaces was Fusobacterium nucleatum subsp. polymorphum (33.3%) while Streptococcus mutans was detected over the carious lesions and dentine surfaces at a frequency of 33.3% and 52.7% respectively. Fusobacterium nucleatum subsp. polymorphum was also found to be highest in the CF group (41.6%). Follow up at the end of one year showed that the frequency of Corynebacterium matruchotii detected was highest in those who remained caries free (16.6%), while Porphyromonas catoniae was highest in those who developed caries (25%). In conclusion, Streptococcus mutans and Porphyromonas catoniae are strongly associated with caries progression, while Lactobacillus sp. is restricted to deep carious lesions. Fusobacterium nucleatum subsp. polymorphum and Corynebacterium matruchotii may play a role in sustaining the healthy equilibrium in the dental plaque. These identified bacteria show promise as potential biomarkers in diagnosis which could help in the management of dental caries in children.

Keywords: early childhood caries, genotypic identification, oral bacteria, 16S rRNA

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Authors: Jinge Liu, Shuyuan Min, Bingchuan Liu, Bangzhao Yin, Bo Peng, Peng Wen, Yun Tian

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WE43 magnesium alloy can be additively manufactured via laser powder bed fusion (LPBF) for biodegradable applications, but the as-built WE43 exhibits an excessively rapid corrosion rate. High-temperature oxidation (HTO) was performed on the as-built WE43 to improve its biodegradation behavior. A sandwich structure including an oxide layer at the surface, a transition layer in the middle, and the matrix was generated influenced by the oxidation reaction and diffusion of RE atoms when heated at 525 ℃for 8 hours. The oxide layer consisted of Y₂O₃ and Nd₂O₃ oxides with a thickness of 2-3 μm. The transition layer is composed of α-Mg and Y₂O₃ with a thickness of 60-70 μm, while Mg24RE5 could be observed except α-Mg and Y₂O₃. The oxide layer and transition layer appeared to have an effective passivation effect. The as-built WE43 lost 40% weight after the in vitro immersion test for three days and finally broke into debris after seven days of immersion. The high-temperature oxidation samples kept the structural integrity and lost only 6.88 % weight after 28-day immersion. The corrosion rate of HTO samples was significantly controlled, which improved the biocompatibility of the as-built WE43 at the same time. The samples after HTO had better osteogenic capability according to ALP activity. Moreover, as built WE43 performed unqualified in cell adhesion and hemolytic test due to its excessively rapid corrosion rate. While as for HTO samples, cells adhered well, and the hemolysis ratio was only 1.59%.

Keywords: laser powder bed fusion, biodegradable metal, high temperature oxidation, biodegradation behavior, WE43

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Authors: Karina Lõbus, Silver Muld, Kadri Kööp, Mare Tupits

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Aim: The aim of the research is to describe the experiences and needs of fathers’ of children with cancer in coping with the child's disease. Background: Today, about 80% of children diagnosed with malignancy in developed countries survive. Despite the positive statistics, recovery is not always certain, treatment is often very intensive and long-term. Cancer is affecting an increasing number of the population, which is increasing the demand for quality care, but the nature of expected care is currently unclear. This topic is important for the development of professional practice, as nurses complain that their knowledge to deal with the relatives of a patient with a difficult diagnosis is limited and would therefore like additional information to deal with the situation. Design: Qualitative, empirical, descriptive research. Method: The data were collected through semi-structured interviews and analysed by inductive content analysis method. Interviews were conducted during Autumn 2020. 4 subjects participated in the research. Results and Conclusions: The thesis revealed that fathers had different experiences and needs in dealing with the child's illness. Fathers' experiences of coping with child's diseases encompassed experiences with information, social relationships, healthcare, changes in personal health and experiences regarding the child. Regarding information, the respondents pointed out bad experiences with the availability of information and the ability to convey the necessary information. Experiences regarding social relationships included experiences with relatives and strangers. Regarding healthcare, fathers mentioned experiences related to the child's health and healthcare professionals. In regards to personal health, fathers pointed out negative changes in their mental and physical health. In relation to the child, the subjects revealed experiences regarding changed values, way of life and raising the child. According to the research, fathers’ needs in relation to dealing with child's cancer included material, social, and spiritual needs. In regard to material needs, fathers pointed out the need for state assistance and the needs related to the surrounding environment. The needs concerning social belonging involved needs for a driving force and involvement in the treatment process. Regarding spiritual needs, fathers expressed mixed feelings towards the need for outside and professional help.

Keywords: father, coping, cancer, child, experience, need

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Authors: Sarocha Vivatvakin, Thanaporn Ratchataswan, Thiratest Leesutipornchai, Komkrit Ruangritchankul, Somboon Keelawat, Virachai Kerekhanjanarong, Patnarin Mahattanasakul, Saknan Bongsebandhu-Phubhakdi

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In this globalization era, much attention has been drawn to various molecular biomarkers, which may have the potential to predict the progression of cancer. Epidermal growth factor receptor (EGFR) is the classic member of the ErbB family of membrane-associated intrinsic tyrosine kinase receptors. EGFR expression was found in several organs throughout the body as its roles involve in the regulation of cell proliferation, survival, and differentiation in normal physiologic conditions. However, anomalous expression, whether over- or under-expression is believed to be the underlying mechanism of pathologic conditions, including carcinogenesis. Even though numerous discussions regarding the EGFR as a prognostic tool in head and neck cancer have been established, the consensus has not yet been met. The aims of the present study are to assess the correlation between the level of EGFR expression and demographic data as well as clinicopathological features and to evaluate the ability of EGFR as a reliable prognostic marker. Furthermore, another aim of this study is to investigate the probable pathophysiology that explains the finding results. This retrospective study included 30 squamous cell laryngeal carcinoma patients treated at King Chulalongkorn Memorial Hospital from January 1, 2000, to December 31, 2004. EGFR expression level was observed to be significantly downregulated with the progression of the laryngeal cancer stage. (one way ANOVA, p = 0.001) A statistically significant lower EGFR expression in the late stage of the disease compared to the early stage was recorded. (unpaired t-test, p = 0.041) EGFR overexpression also showed the tendency to increase recurrence of cancer (unpaired t-test, p = 0.128). A significant downregulation of EGFR expression was documented in advanced stage laryngeal cancer. The results indicated that EGFR level correlates to prognosis in term of stage progression. Thus, EGFR expression might be used as a prevailing biomarker for laryngeal squamous cell carcinoma prognostic prediction.

Keywords: downregulation, epidermal growth factor receptor, immunohistochemistry, laryngeal squamous cell carcinoma

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Authors: Navodit Goel, Prabir K. Paul

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Tomato (Solanum lycopersicum) is attacked by Pseudomonas syringae pv. tomato causing speck lesions on the leaves leading to severe economic casualty. In the present study, aqueous fruit extracts of Azadirachta indica (neem) were sprayed on a single node of tomato plants grown under controlled contamination-free conditions. The treatment of plants was performed with neem fruit extract either alone or along with the pathogen. The parameters of observation were activities of polyphenol oxidase (PPO) and lysozyme, and isoform analysis of PPO; both at the treated leaves as well as untreated leaves away from the site of extract application. Polyphenol oxidase initiates phenylpropanoid pathway resulting in the synthesis of quinines from cytoplasmic phenols and production of reactive oxygen species toxic to broad spectrum microbes. Lysozyme is responsible for the breakdown of bacterial cell wall. The results indicate the upregulation of PPO and lysozyme activities in both the treated and untreated leaves along with de novo expression of newer PPO isoenzymes (which were absent in control samples). The appearance of additional PPO isoenzymes in bioelicitor-treated plants indicates that either the isoenzymes were expressed after bioelicitor application or the already expressed but inactive isoenzymes were activated by it. Lysozyme activity was significantly increased in the plants when treated with the bioelicitor or the pathogen alone. However, no new isoenzymes of lysozyme were expressed upon application of the extract. Induction of resistance by neem fruit extract could be a potent weapon in eco-friendly plant protection strategies.

Keywords: Azadirachta indica, lysozyme, polyphenol oxidase, Solanum lycopersicum

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Authors: Christina Hagen, Pragathi Kamale Gurmurthy, Thorsten M. Buzug

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CFD simulations are performed in the upper airway of a patient suffering from obstructive sleep apnea (OSA) that is a sleep related breathing disorder characterized by repetitive partial or complete closures of the upper airways. The simulations are aimed at getting a better understanding of the pathophysiological flow patterns in an OSA patient. The simulation is compared to medical data of a sleep endoscopic examination under sedation. A digital model consisting of surface triangles of the upper airway is extracted from the MR images by a region growing segmentation process and is followed by a careful manual refinement. The computational domain includes the nasal cavity with the nostrils as the inlet areas and the pharyngeal volume with an outlet underneath the larynx. At the nostrils a flat inflow velocity profile is prescribed by choosing the velocity such that a volume flow rate of 150 ml/s is reached. Behind the larynx at the outlet a pressure of -10 Pa is prescribed. The stationary incompressible Navier-Stokes equations are numerically solved using finite elements. A grid convergence study has been performed. The results show an amplification of the maximal velocity of about 2.5 times the inlet velocity at a constriction of the pharyngeal volume in the area of the tongue. It is the same region that also shows the highest pressure drop from about 5 Pa. This is in agreement with the sleep endoscopic examinations of the same patient under sedation showing complete contractions in the area of the tongue. CFD simulations can become a useful tool in the diagnosis and therapy of obstructive sleep apnea by giving insight into the patient’s individual fluid dynamical situation in the upper airways giving a better understanding of the disease where experimental measurements are not feasible. Within this study, it could been shown on one hand that constriction areas within the upper airway lead to a significant pressure drop and on the other hand a good agreement of the area of pressure drop and the area of contraction could be shown.

Keywords: biomedical engineering, obstructive sleep apnea, pharynx, upper airways

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Authors: Ioannis Boutas, Vasilios Pergialiotis, Nicolaos Salakos, George Agrogiannis, Panagiotis Konstantopoulos, Laskarina-Maria Korou, Theodoros Kalampokas, Odysseas Gregoriou, George Creatsas, Despina Perrea

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Introduction: The effect of third generation aromatase inhibitors in the lipid profile among women with breast cancer, present diversities. It has been also shown that low levels of estrogens affect liver metabolism in mice in numerous ways, such as lipid accumulation and hepatic steatosis. Materials and Methods: Forty-five female Wistar rats underwent surgical ovariectomy. The animals were anesthetized with a combination of ketamine (75 mg/kg) and xylazine (10 mg/kg) which were administered intraperitoneally. After the ovariectomy, the operated animals were randomized in three groups. The first group did not receive any drug regimen (ovariectomized control group). The second group received Anastrazole and the third group received Letrozole. Four months after the initiation of the study, the animals were euthanized and livers were dissected immediately for further histopathological analysis. The histological features were grouped into 4 broad categories: steatosis, ballooning, portal inflammation and lobular activity. A score from 0 (absence) to 3 (severe) was assigned to each parameter. Results: The liver pathology analysis revealed significant differences among groups with favored mild steatosis and ballooning among animals that received Anastrazole or Letrozole. Conclusion: The effect of Anastrazole and Letrozole on liver function have not yet been clarified. In our study mild histological liver alterations seem also to occur and these alterations should be taken in mind in future clinical studies

Keywords: anastrazole, letrozole, liver, rats

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Authors: Priscila Vitorino, Jeeziane Rezende, Edison Pereira, Adrielly Silva, Weimar Barroso

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Body composition insight during physical activity is relevant to follow up sports income since it can be important and actuate in velocity, resistance, potency, and has an effect on force and agility. The purpose of this study was to identify anthropometric profile, evaluate and correlate body mass index and bioimpedance behavior during the days of Caminhada Ecológica de Goiás - Brasil. A longitudinal study was performed with 25 male participants, with an average age of 45.6±9.1 years. All patients were actives. Body composition was evaluated by body mass index (BMI) measurement and bioimpedance procedures. Both were collected 20 days before walking beginning (A0) and in the four days along the same (A1, A2, A3 e A4). Data were collected in the end of each walking day at athletes accommodations. Final distance during walking route was 308 km in five days, with an average of 62km/day and 7,6 km/hour, and an average temperature of 30°C. Data are represented with mean and standard deviation. ANOVA (Bonferroni pos test) was used to compare frequent measurements between the days. Pearson's correlation test was used to correlate BMI with lean mass, fat mass, and water. BMI decreased from A0 to A1, A2 and A3 (p < 0,01) and increased on A4 (p < 0,01). No changes were observed concerning fat percentage (p=0,60), lean mass (p=0,10) and body water composition (p=0,09). A positive and moderate correlation between BMI and fat percentage was observed; an inverse and moderate correlation between BMI, lean mass and body water composition occurred. Total body mass increased during high intensity and long term walking distance. However, the values of body fat, lean mass and water were maintained.

Keywords: aerobic exercise, body composition, metabolism, sports

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Authors: Shramana Mondal

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As a city is growing in population, sprawl, and complexity, use of public spaces increases variably and thus ensuring safety for the people becomes an utmost priority. While active monitoring measures may be necessary in some places, urban design can play a major role in devising self-policing and encourage active public life. This paper aims to explore the various spatial and psychological reasons for the occurrence of crime and the role of ‘urban design’ to address this issue. In this research, the principles of urban design are examined, as well as projected on actual site by addressing the issue with urban design principles. In this review the sociological, psychological, typological and morphological factors are addressed which affect the safety of a space and the possible framing guidelines, controls and urban design strategies are explored to address a safe neighborhood. On the basis of statistical survey, the residential and street network of Malviya Nagar in Delhi is chosen as the area of demonstration. The programs inhibit a safe neighborhood and a movement network that are addressed based on the four principles of natural surveillance, territoriality, community building, and connectivity. The paper concludes with a discussion of the urban design as an effective tool by creating an intense active zone with mixed use feature to ensure throughout activity and also ensuring safe pedestrian zone by introducing sense of community feeling and territoriality thus achieving active, useful and public friendly space.

Keywords: crime, public life, safety, urban design

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Authors: Malkanthi S. H. P., Ishana A. S. F., Sivashankar P.

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This research was conducted to study prospective visitors’ expectation and future behavior regarding agro tourism destinations in spice gardens (spice tourism) in Kolonna. A field survey was conducted for the 40 randomly selected local and foreign visitors who have come to visit three famous tourism destinations in Kolonna namely “Maduwanwela Walawwa”, “Wawulpane Limestone cave” and “Panamure Eth gala” during three month of time period from February to April 2014. Descriptive and Chi square statistical tests were used to analyze the data. The results revealed that 98% of visitors were willing to visit the spice tourism destinations. Furthermore, visitors with urban residency, higher education level and employment opportunities revealed an association with having awareness on agro tourism. Moreover, visitors having higher age, higher level of education and higher amount of monthly income revealed an association with the willingness to visit spice tourism destinations. Nevertheless, out of eight demographic factors, three factors; gender, occupation and income had significant effect on willingness to purchase spice products from Kolonna. According to research findings it can be concluded that there are large number of perspective visitors for spice tourism and they are middle aged, educated and having significant monthly income and they are also very much interest to visit spice tourism destinations and buy spice products (high demand). Therefore, it is significantly beneficial to establish spice tourism destinations in spice gardens by successful spice cultivating farmers or owners as an extra income earning activity in Kolonna area.

Keywords: agro tourism, spice gardens, perception, prospective visitors, Sri Lanka

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Authors: Caspar S. Carson, Gabriel W. Prather, Nicholas E. Wong, Jeffery R. Anton, William H. McCoy

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Cutibacterium acnes is a commensal bacterium found on human skin that has been linked to acne. C. acnes can also be an opportunistic pathogen when it infiltrates the body during surgery. This pathogen can cause dangerous infections of medical implants, such as shoulder replacements, leading to life-threatening blood infections. Compounding this issue, C. acnes resistance to many antibiotics has become an increasing problem worldwide, creating a need for special forms of treatment. C. acnes expresses the protein RoxP, and it requires this protein to colonize human skin. Though this protein is required for C. acnes skin colonization, its function is not yet understood. Inhibition of RoxP function might be an effective treatment for C. acnes infections. To develop such reagents, the McCoy Laboratory generated four unique anti-RoxP antibodies. Preliminary studies in the McCoy Lab have established that each antibody binds a distinct site on RoxP. To assess the potential of these antibodies as therapeutics, it is necessary to specifically characterize these antibody epitopes and evaluate them in assays that assess their ability to inhibit RoxP-dependent C. acnes growth. To provide material for these studies, an antibody expression construct, Fv-clasp(v2), was adapted to encode anti-RoxP antibody sequences. The author hypothesizes that this expression strategy can produce sufficient amounts of >95% pure antibody fragments for further characterization of these antibodies. Four anti-RoxP Fv-clasp(v2) expression constructs (pET vector-based) were transformed into E. coli BL21-Gold(DE3) cells and a small-scale expression and purification trial was performed for each construct to evaluate anti-RoxP Fv-clasp(v2) yield and purity. Successful expression and purification of these antibody constructs will allow for their use in structural studies, such as protein crystallography and cryogenic electron microscopy. Such studies would help to define the antibody binding sites on RoxP, which could then be leveraged in the development of certain methods to treat C. acnes infection through RoxP inhibition.

Keywords: structural biology, protein expression, infectious disease, antibody, therapeutics, E. coli

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Authors: Iyabode A. Kehinde, Joshua O. Oyekanmi, Jumoke T. Abimbola, Olajumoke E. Ayanda

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African yam bean (AYB), (Sphenostylis stenocarpa) is a leguminous crop that provides nutritionally rich seeds, tubers and leaves for human consumption. AYB potentials as an important food security crop is yet to be realized and thus classified as underutilized crop. Underutilization of the crop has been partly associated with scarce information on the incidence and characterization of fungal endophytes infecting vascular parts of AYB. Accurate and robust detection of these endophytic fungi is essential for diagnosis, modeling, surveillance and protection of germplasm (seed) health. This work aimed at isolating and identifying fungal endophytes associated with leaves, stems and roots of AYB in Ogun State, Nigeria. This study investigated both cultural and molecular properties of endophytic fungi in AYB for its characterization and diversity. Fungal endophytes were isolated and culturally identified. DNA extraction, PCR amplification using ITS primers and analyses of nucleotide sequences of ribosomal DNA fragments were conducted on selected isolates. BLAST analysis was conducted on consensus nucleotide sequences of 28 out of 30 isolates and results showed similar homology with genera of Rhizopus, Cunninghamella, Fusarium, Aspergillus, Penicillium, Alternaria, Diaporthe, Nigrospora, Purpureocillium, Corynespora, Magnaporthe, Macrophomina, Curvularia, Acrocalymma, Talaromyces and Simplicillium. Slight similarity was found with endophytes associated with soybean. Phylogenetic analysis by maximum likelihood method showed high diversity among the general. These organisms have high economic importance in crop improvement. For an instance, Purpureocillium lilacinum showed high potential in control of root rot caused by nematodes in tomatoes. Though some can be pathogens, but many of the fungal endophytes have beneficial attributes to plant in host health, uptake of nutrients, disease suppression, and host immunity.

Keywords: molecular characterization, African Yam Bean, fungal endophyte, plant parts

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Authors: Waleed K. Saib, Abdulsalam M. Alhawsawi, Essam Banoqitah

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The idea of this research is to design a radiation spectrometer using LSO scintillation detector coupled to a C series of SiPM (silicon photomultiplier). The device can be used to detects gamma and X-ray radiation. This device is also designed to estimates the activity of the source contamination. The SiPM will detect light in the visible range above the threshold and read them as counts. Three gamma sources were used for these experiments Cs-137, Am-241 and Co-60 with various activities. These sources are applied for four experiments operating the SiPM as a spectrometer, energy resolution, pile-up set and efficiency. The SiPM is connected to a MCA to perform as a spectrometer. Cerium doped Lutetium Silicate (Lu₂SiO₅) with light yield 26000 photons/Mev coupled with the SiPM. As a result, all the main features of the Cs-137, Am-241 and Co-60 are identified in MCA. The experiment shows how photon energy and probability of interaction are inversely related. Total attenuation reduces as photon energy increases. An analytical calculation was made to obtain the FWHM resolution for each gamma source. The FWHM resolution for Am-241 (59 keV) is 28.75 %, for Cs-137 (662 keV) is 7.85 %, for Co-60 (1173 keV) is 4.46 % and for Co-60 (1332 keV) is 3.70%. Moreover, the experiment shows that the dead time and counts number decreased when the pile-up rejection was disabled and the FWHM decreased when the pile-up was enabled. The efficiencies were calculated at four different distances from the detector 2, 4, 8 and 16 cm. The detection efficiency was observed to declined exponentially with increasing distance from the detector face. Conclusively, the SiPM board operated with an LSO scintillator crystal as a spectrometer. The SiPM energy resolution for the three gamma sources used was a decent comparison to other PMTs.

Keywords: PMT, radiation, radiation detection, scintillation detectors, silicon photomultiplier, spectrometer

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Authors: Elhamalsadat Ghaffari, Moghan Amirhosseinian, Amir Khaleghipour

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Multifunctional bioactive glasses (BGs) are designed with a focus on the provision of bactericidal and biological properties desired for angiogenesis, osteogenesis, and ultimately potential applications in bone tissue engineering. To achieve these, six sol-gel copper/magnesium substituted derivatives of 58S-BG, i.e. a mol% series of 60SiO₂-4P₂O₅-5CuO-(31-x) CaO/xMgO (where x=0, 1, 3, 5, 8, and 10), were synthesized. Afterwards, the effect of MgO/CaO substitution on the in vitro formation of nano-hydroxyapatite (HA), osteoblast-like cell responses and BGs antibacterial performance were studied. During the BGs synthesis, the elimination of nitrates was achieved at 700 °C that prevented the BGs crystallization and stabilized the obtained dried gels. The structural and morphological evaluations were performed with X-ray diffraction (XRD), Fourier transform infrared spectroscopy (FTIR), and scanning electron microscopy (SEM). These characterizations revealed that Cu-substituted 58S-BG consisting of 5 mol% MgO (BG-5/5) slightly had retarded the formation of HA. In addition, Cu-substituted 58S-BGs consisting 8 mol% and 10 mol% MgO (BG-5/8 and BG-5/10) displayed lower bioactivity probably due to the lower ion release rate of Ca–Si into the simulated body fluid (SBF). The determination of 3-(4, 5 dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide (MTT) and alkaline phosphate (ALP) activities proved that the highest values of both differentiation and proliferation of MC3T3-E1 cells can be obtained from a 5 mol% MgO substituted BG, while the over addition of MgO (8 mol% and 10 mol%) decreased the bioactivity. Furthermore, these novel Cu/Mg-substituted 58S-BGs displayed antibacterial effect against methicillin-resistant Staphylococcus aureus bacteria. Taken together, the results suggest the equally-substituted BG-5/5 (i.e. the one consists of 5 mol% of both CuO and MgO) as a promising candidate for bone tissue engineering, among all newly designed BGs in this work, owing to its desirable cell proliferation, ALP activity and antibacterial properties.

Keywords: apatite, bioactivity, biomedical applications, sol-gel processes

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Authors: Swapnil A. Dharaskar, Kailas L. Wasewar, Mahesh N. Varma, Diwakar Z. Shende

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Owing to the stringent environmental regulations in many countries for production of ultra low sulfur petroleum fractions intending to reduce sulfur emissions results in enormous interest in this area among the scientific community. The requirement of zero sulfur emissions enhances the prominence for more advanced techniques in desulfurization. Desulfurization by extraction is a promising approach having several advantages over conventional hydrodesulphurization. Present work is dealt with various new approaches for desulfurization of ultra clean gasoline, diesel and other liquid fuels by extraction with ionic liquids. In present paper experimental data on extractive desulfurization of liquid fuel using trihexyl tetradecyl phosphonium chloride has been presented. The FTIR, 1H-NMR, and 13C-NMR have been discussed for the molecular confirmation of synthesized ionic liquid. Further, conductivity, solubility, and viscosity analysis of ionic liquids were carried out. The effects of reaction time, reaction temperature, sulfur compounds, ultrasonication, and recycling of ionic liquid without regeneration on removal of dibenzothiphene from liquid fuel were also investigated. In extractive desulfurization process, the removal of dibenzothiophene in n-dodecane was 84.5% for mass ratio of 1:1 in 30 min at 30OC under the mild reaction conditions. Phosphonium ionic liquids could be reused five times without a significant decrease in activity. Also, the desulfurization of real fuels, multistage extraction was examined. The data and results provided in present paper explore the significant insights of phosphonium based ionic liquids as novel extractant for extractive desulfurization of liquid fuels.

Keywords: ionic liquid, PPIL, desulfurization, liquid fuel, extraction

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Authors: Helen Johnson-Egemba

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This paper will discuss the current effectiveness of music therapy for a range of conditions, such as depression and anxiety. Indeed, traditional forms of therapy have often been effective in treating various mental and physical health conditions. However, they are not with their limitations. Music therapy, on the other hand, is a non-invasive and cost-effective alternative that can produce similar or even better results. Music therapy can produce longer-lasting results. The research also highlights the underlying mechanisms of traditional music therapy, such as its complementary treatment. A systematic review of existing literature was conducted to gather relevant studies and establish a comprehensive understanding of the topic. Various research methods, including experimental studies, qualitative research, surveys, were utilized to explore the therapeutic potential of traditional music interventions. The findings reveal that traditional music therapy shows promise in managing anxiety and depression symptoms, with positive outcomes impacting brain activity, emotions, and stress regulation. The outcomes of this study contribute to evidence-based practice, providing insights for clinicians and therapists to incorporate traditional music therapy into their treatment approaches. Furthermore, the research promotes awareness and acceptance of traditional music as a legitimate and effective therapeutic intervention for anxiety and depression, potentially enhancing access to alternative and complementary treatment options. Overall, this study demonstrates the potential benefits of traditional music therapy in addressing anxiety and depression, offering valuable implications for mental health care and improving the well-being of individuals struggling with these conditions.

Keywords: anxiety, effectiveness, depression, traditional music, therapy, treatment

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Authors: Vanessa De Carvalho, Chad MacPherson, Julien Tremblay, Julie Champagne, Stephanie-Anne Girard

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Background: The interactions between bacteria and fungi in the human vaginal microbiome are fundamental to the concept of health and disease. The means by which the microbiota and mycobiota interact is still poorly understood and further studies are necessary to properly characterize this complex ecosystem. The aim of this study was to select a DNA extraction method capable of recovering high qualities of fungal and bacterial DNA from a single vaginal swab. Methods: 11 female volunteers ( ≥ 20 to < 55 years old) self-collected vaginal swabs in triplicates. Three commercial extraction kits: Masterpure Yeast Purification kit (Epicenter), PureLink™ Microbiome DNA Purification kit (Invitrogen), and Quick-DNA™ Fecal/Soil Microbe Miniprep kit (Zymo) were evaluated on the ability to recover fungal and bacterial DNA simultaneously. The extraction kits were compared on the basis of recovery, yield, purity, and the community richness of bacterial (16S rRNA - V3-V4 region) and fungal (ITS1) microbiota composition by Illumina MiSeq amplicon sequencing. Results: Recovery of bacterial DNA was achieved with all three kits while fungal DNA was only consistently recovered with Masterpure Yeast Purification kit (yield and purity). Overall, all kits displayed similar microbiota profiles for the top 20 OTUs; however, Quick-DNA™ Fecal/Soil Microbe Miniprep kit (Zymo) showed more species richness than the other two kits. Conclusion: In the present study, Masterpure Yeast purification kit proved to be a good candidate for purification of high quality fungal and bacterial DNA simultaneously. These findings have potential benefits that could be applied in future vaginal microbiome research. Whilst the use of a single extraction method would lessen the burden of multiple swab sampling, decrease laboratory workload and off-set costs associated with multiple DNA extractions, thoughtful consideration must be taken when selecting an extraction kit depending on the desired downstream application.

Keywords: bacterial vaginosis, DNA extraction, microbiota, mycobiota, vagina, vulvovaginal candidiasis, women’s health

Procedia PDF Downloads 201

Authors: Achitphol Chookaew, Paramee Thongsukhsai, Patamarerk Engsontia, Narongwit Nakwan, Pritsana Raugrut

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Lung cancer is one of the most common malignancies and primary cause of death due to cancer worldwide. Non-small cell lung cancer (NSCLC) is the main subtype in which majority of patients present with advanced-stage disease. Herein, we analyzed differentially expressed genes to find potential biomarkers for lung cancer diagnosis as well as prognostic markers. We used transcriptome data from our 2 NSCLC patients and public data (GSE81089) composing of 8 NSCLC and 10 normal lung tissues. Differentially expressed genes (DEGs) between NSCLC and normal tissue and between early-stage and late-stage NSCLC were analyzed by the DESeq2. Pairwise correlation was used to find the DEGs with false discovery rate (FDR) adjusted p-value £ 0.05 and |log2 fold change| ³ 4 for NSCLC versus normal and FDR adjusted p-value £ 0.05 with |log2 fold change| ³ 2 for early versus late-stage NSCLC. Bioinformatic tools were used for functional and pathway analysis. Moreover, the top ten genes in each comparison group were verified the expression and survival analysis via GEPIA. We found 150 up-regulated and 45 down-regulated genes in NSCLC compared to normal tissues. Many immnunoglobulin-related genes e.g., IGHV4-4, IGHV5-10-1, IGHV4-31, IGHV4-61, and IGHV1-69D were significantly up-regulated. 22 genes were up-regulated, and five genes were down-regulated in late-stage compared to early-stage NSCLC. The top five DEGs genes were KRT6B, SPRR1A, KRT13, KRT6A and KRT5. Keratin 6B (KRT6B) was the most significantly increased gene in the late-stage NSCLC. From GEPIA analysis, we concluded that IGHV4-31 and IGKV1-9 might be used as diagnostic biomarkers, while KRT6B and KRT6A might be used as prognostic biomarkers. However, further clinical validation is needed.

Keywords: differentially expressed genes, early and late-stages, gene ontology, non-small cell lung cancer transcriptomics

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Authors: Panas Gerasimos, Kotidou Varvara, Halkiopoulos Constantinos, Gkintoni Evgenia

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As a result of growing technology and briefing by the internet, users resort to the internet and subsequently to the opinion of an expert. In many cases, they take control of their health in their hand and make a decision without the contribution of a doctor. According to that, this essay intends to analyze the confidence of searching health issues on the internet. For the fulfillment of this study, there has been a survey among doctors in order to find out the reasons a patient uses the internet about their health problems and the consequences that health information could lead by searching on the internet, as well. Specifically, the results regarding the research of the users demonstrate: a) the majority of users make use of the internet about health issues once or twice a month, b) individuals that possess chronic disease make health search on the internet more frequently, c) the most important topics that the majority of users usually search are pathological, dietary issues and the search of issues that are associated with doctors and hospitals. However, it observed that topic search varies depending on the users’ age, d) the most common sources of information concern the direct contact with doctors, as there is a huge preference from the majority of users over the use of the electronic form for their briefing and e) it has been observed that there is large lack of knowledge about e-health services. From the doctor's point of view, the following conclusions occur: a) almost all doctors use the internet as their main source of information, b) the internet has great influence over doctors’ relationship with the patients, c) in many cases a patient first makes a visit to the internet and then to the doctor, d) the internet significantly has a psychological impact on patients in order to for them to reach a decision, e) the most important reason users choose the internet instead of the health professional is economic, f) the negative consequence that emerges is inaccurate information, g) and the positive consequences are about the possibility of online contact with the doctor and contributes to the easy comprehension of the doctor, as well. Generally, it’s observed from both sides that the use of the internet in health issues is intense, which declares that the new means the doctors have at their disposal, produce the conditions for radical changes in the way of providing services and in the doctor-patient relationship.

Keywords: cognitive models, health marketing, e-health, psychological factors, digital marketing, e-health services

Procedia PDF Downloads 206