Search results for: clinical trial development

Authors: Majeda Hammoud

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Background: Anemia during pregnancy increases the risk of delivery by cesarean section, low birth weight, preterm birth, perinatal mortality, stillbirth, and maternal mortality. In this study, we aimed to assess the prevalence of anemia in pregnant women and its associated factors in the Kuwait birth cohort study. Methods: The Kuwait birth cohort (N=1108) was a prospective cohort study in which pregnant women were recruited in the third trimester. Data were collected through personal interviews with mothers who attend antenatal care visits, including data on socio-economic status and lifestyle factors. Blood samples were taken after the recruitment to measure multiple laboratory indicators. Clinical data were extracted from the medical records by a clinician including data on comorbidities. Anemia was defined as having Hemoglobin (Hb) <110 g/L with further classification as mild (100-109 g/L), moderate (70-99 g/L), or severe (<70 g/L). Predictors of anemia were classified as underlying or direct factors, and logistic regression was used to investigate their association with anemia. Results: The mean Hb level in the study group was 115.21 g/L (95%CI: 114.56- 115.87 g/L), with significant differences between age groups (p=0.034). The prevalence of anemia was 28.16% (95%CI: 25.53-30.91%), with no significant difference by age group (p=0.164). Of all 1108 pregnant women, 8.75% had moderate anemia, and 19.40% had mild anemia, but no pregnant women had severe anemia. In multivariable analysis, getting pregnant while using contraception, adjusted odds ratio (AOR) 1.73(95%CI:1.01-2.96); p=0.046 and current use of supplements, AOR 0.50 (95%CI: 0.26-0.95); p=0.035 were significantly associated with anemia (underlying factors). From the direct factors group, only iron and ferritin levels were significantly associated with anemia (P<0.001). Conclusion: Although the severe form of anemia is low among pregnant women in Kuwait, mild and moderate anemia remains a significant health problem despite free access to antenatal care.

Keywords: anemia, pregnancy, hemoglobin, ferritin

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Authors: Priyanka Tamta, Sukanya Sharma

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The Kamakhya Temple in Assam plays a very important role in the development of Assam as not only a historical place but also as an archaeologically important site. Temple building activity on the site began in 5th century AD when a cave temple dedicated to Lord Balabhadraswami was constructed here by King Maharajadhiraja Sri Surendra Varman. In the history of Assam, the name of this king is not found and neither the name of this form of Vishnu is known in this region. But this inscription sanctified the place as it recorded the first ever temple building activity in this region. The fifteen hundred years habitation history of the Kamakhya temple sites shows a gradual progression of the site from a religious site to an archaeological site and finally as a historical landmark. Here, in this paper, our main objective is to understand the evolution of Kamakhya temple site as a historical landscape and as an important landmark in the history of Assam. The central theme of the paper is the gradual development of the religious site to a historical landmark. From epigraphical records, it is known that the site received patronage from all ruling dynasties of Assam and its adjoining regions. Royal households of Kashmir, Nepal, Bengal, Orissa, Bihar, etc. have left their footprints on the site. According to records they donated wealth, constructed or renovated temples and participated in the overall maintenance of the deity. This made Kamakhya temple a ground of interaction of faiths, communities, and royalties of the region. Since the 5th century AD, there was a continuous struggle between different beliefs, faiths, and power on the site to become the dominant authority of the site. In the process, powerful beliefs system subsumed minor ones into a larger doctrine of beliefs. This can be seen in the case of the evolution of the Kamakhya temple site as one of the important Shakta temples in India. Today, it is cultural identity marker of the state of Assam within which it is located. Its diverse faiths and beliefs have been appropriated by powerful legends to the dominant faith of the land. The temple has evolved from a cave temple to a complex of seventeen temples. The faith has evolved from the worship of water, an element of nature to the worship of the ten different forms of the goddess with their five male consorts or Bhairavas. Today, it represents and symbolizes the relationship of power and control out of which it has emerged. During different periods of occupation certain architectural and iconographical characters developed which indicated diffusion and cultural adaptation. Using this as sources and the epigraphical records this paper will analyze the interactive and dynamic processes which operated in the building of this cultural marker, the archaeological site of Kamakhya.

Keywords: cultural adaptation and diffusion, cultural and historical landscape, Kamakhya, Saktism, temple art and architecture, historiography

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Authors: Feng Yue, Fei Dai

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With the rapid development of urbanization process in China, its environmental protection pressure is severely tested. So, analyzing and optimizing the landscape pattern is an important measure to ease the pressure on the ecological environment. This paper takes Wuhan Urban Development Zone as the research object, and studies its landscape pattern evolution and quantitative optimization strategy. First, remote sensing image data from 1990 to 2015 were interpreted by using Erdas software. Next, the landscape pattern index of landscape level, class level, and patch level was studied based on Fragstats. Then five indicators of ecological environment based on National Environmental Protection Standard of China were selected to evaluate the impact of landscape pattern evolution on the ecological environment. Besides, the cost distance analysis of ArcGIS was applied to simulate wildlife migration thus indirectly measuring the improvement of ecological environment quality. The result shows that the area of land for construction increased 491%. But the bare land, sparse grassland, forest, farmland, water decreased 82%, 47%, 36%, 25% and 11% respectively. They were mainly converted into construction land. On landscape level, the change of landscape index all showed a downward trend. Number of patches (NP), Landscape shape index (LSI), Connection index (CONNECT), Shannon's diversity index (SHDI), Aggregation index (AI) separately decreased by 2778, 25.7, 0.042, 0.6, 29.2%, all of which indicated that the NP, the degree of aggregation and the landscape connectivity declined. On class level, the construction land and forest, CPLAND, TCA, AI and LSI ascended, but the Distribution Statistics Core Area (CORE_AM) decreased. As for farmland, water, sparse grassland, bare land, CPLAND, TCA and DIVISION, the Patch Density (PD) and LSI descended, yet the patch fragmentation and CORE_AM increased. On patch level, patch area, Patch perimeter, Shape index of water, farmland and bare land continued to decline. The three indexes of forest patches increased overall, sparse grassland decreased as a whole, and construction land increased. It is obvious that the urbanization greatly influenced the landscape evolution. Ecological diversity and landscape heterogeneity of ecological patches clearly dropped. The Habitat Quality Index continuously declined by 14%. Therefore, optimization strategy based on greenway network planning is raised for discussion. This paper contributes to the study of landscape pattern evolution in planning and design and to the research on spatial layout of urbanization.

Keywords: landscape pattern, optimization strategy, ArcGIS, Erdas, landscape metrics, landscape architecture

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Authors: Arif Sikander, Imran Saeed

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The behavioral pattern and performance of airline pilots are influenced by the level of stress, their ethical decision-making ability and above all their leadership style as part of the Crew Management process. Cultural differences of pilots, especially while working in ex-country airlines, could influence the stress perception. Culture also influences ethical decision making. Leadership style is also a variable dimension, and pilots need to adapt to the cultural settings while flying with the local pilots as part of their team. Studies have found that age, education, gender, and management experience are statistically significant factors in ethical maturity. However, in the decades to come, more studies are required to validate the results over and over again; thereby, providing support for the validity of the Moral Development Theory. Leadership style plays a vital role in ethical decision making. This study is grounded in the Moral Development theory and seeks to analyze the styles of leadership of airline pilots related to ethical decision making and also the influence of the culture on their stress perception. The sample for the study included commercial pilots from a National Airline. It is expected that these results should provide useful input to the literature in the context of developing appropriate Talent Management strategies. The authors intend to extend this study (carried out in one country) to major national carriers (many countries) to be able to develop a ultimate framework on Talent Management which should serve as a benchmark for any international airline as most of them (e.g., Emirates, Etihad, Cathay Pacific, China Southern, etc.) are dependent on the supply of this scarce resource from outside countries.

Keywords: ethics, leadership, pilot, stress

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Authors: Ahmad Hashim, Thariq Khan Azizuddin Khan, Zulakbal Abd Karim, Nohazira Abdul Karim

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This research aims to obtain the validity and reliability of a survey instrument to evaluate the values, attitudes, and professionalism of sports science students, from the Faculty of Sports Science and Coaching, Universiti Pendidikan Sultan Idris (UPSI). It is a survey which is divided into two components namely first; moral, self-esteem, proactive, self-reliant and voluntary and second; ethics and professionalism. Development of the survey instrument is based on the Malaysian Education Development Plan, Higher Education Malaysia. There are 50 items prepared based on the five-point Likert scale which were tested at the pilot test level. It involved 212 research subjects selected based on random sampling. In addition, the research method applied is in the form of pre-experimental one group pre-test-post-test. Results of the analysis showed that overall field expert validity is r = .89, while the Cronbach alpha reliability correlation value of outdoor education instrument evaluation survey is r = .85. Next, this survey was tested again for construct validity using the factor analysis method for statistical analysis which would validate each item tested was supposed to be in the right component. From the analysis, results show that Bartlett's test is significant p < .05 and Kaiser-Meyer-Olkin index range is r = .87. The result showed 39 survey items are produced out of 50 items of the survey based on this factor analysis method. Research has shown that the survey instrument developed is valid and reliable to be used for the Faculty of Sports Sciences and Coaching, UPSI.

Keywords: values, attitudes, professionalism, ethics, professionalism

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Authors: Lian Zeng

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Double-Spear 1-H2-1 (DS1-H2-1) is an oncolytic virus and an innovative biological drug candidate. The chemical composition of the drug product is a live attenuated West Nile virus (WNV) containing the human T cell costimulator (CD86) gene. After intratumoral injection, the virus can rapidly self-replicate in the injected site and lyse/kill the tumor by repeated infection among tumor cells. We also established xenograft tumor models in mice to evaluate the drug candidate's efficacy on those tumors. The results from preclinical studies on transplanted tumors in immunodeficient mice showed that DS1-H2-1 had significant oncolytic effects on human-origin cancers: it completely (100%) shrieked human glioma; limited human neuroblastoma growth reached as high as 95% growth inhibition rate (%TGITW). The safety data of preclinical animal experiments confirmed that DS1-H2-1 is safe as a biological drug for clinical use. In the preclinical drug efficacy experiment, virus-drug administration with different doses did not show abnormal signs and disease symptoms in more than 300 tested mice, and no side effects or death occurred through various administration routes. Intravenous administration did not cause acute infectious disease or other side effects. However, the replication capacity of the virus in tumor tissue via intravenous administration is only 1% of that of direct intratumoral administration. The direct intratumoral administration of DS1-H2-1 had a higher rate of viral replication. Therefore, choosing direct intratumoral injection can ensure both efficacy and safety.

Keywords: oncolytic virus, WNV-CD86, immunotherapy drugs, glioma, neuroblastoma

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Authors: Supakij Saisopon

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The process of economic development incurs spatial transformation. This spatial alternation also causes environmental impacts, leading to higher pollution. In the case of Thailand, there is still a lack of price-endogenous quantitative analysis incorporating relationships among economic growth, land-use change, and environmental impact. Therefore, this paper aimed at developing the Computable General Equilibrium (CGE) model with the capability of stimulating such mutual effects. The developed CGE model has also incorporated the nested constant elasticity of transformation (CET) structure that describes the spatial redistribution mechanism between agricultural land and urban area. The simulation results showed that the 1% decrease in the availability of agricultural land lowers the value-added of agricultural by 0.036%. Similarly, the 1% reduction of availability of urban areas can decrease the value-added of manufacturing and service sectors by 0.05% and 0.047%, respectively. Moreover, the outcomes indicate that the increasing farming and urban areas induce higher volumes of solid waste, wastewater, and air pollution. Specifically, the 1% increase in the urban area can increase pollution as follows: (1) the solid waste increase by 0.049%, (2) water pollution ̶ indicated by biochemical oxygen demand (BOD) value ̶ increase by 0.051% and (3) air pollution ̶ indicated by the volumes of CO₂, N₂O, NOₓ, CH₄, and SO₂ ̶ increase within the range of 0.045%–0.051%. With the simulation for exploring the sustainable development path, a 1% increase in agricultural land use efficiency leads to the shrinking demand for agricultural land. But this is not happening in urban, a 1% scale increase in urban utilization results in still increasing demand for land. Therefore, advanced clean production technology is necessary to align the increasing land-use efficiency with the lowered pollution density.

Keywords: CGE model, CET structure, environmental impact, land use

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Authors: Mardianto

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Education and learning are now grown rapidly. Synergy of techonology especially instructional technology in the learning activities are very big influence on the effectiveness of learning and creativity to achieve optimal results. But on the other hand there is a education value that is difficult to be articulated through character-forming technology such as honesty, discipline, hard work, heroism, and so forth. Learning strategy and storytelling from the past until today is still an option for teachers to convey the message of character values. With the material was loaded from the local culture (stories folklore), the combination of learning objectives (build character child) strategy, and traditional methods (storytelling and story), and the preservation of local culture (dig tale folklore) is critical to maintaining the nation's culture. In the context of maintaining the nation's culture, then since the age of the child at the level of government elementary school a necessity. Globalization, the internet and technology sometimes feel can displace the role of the teacher in the learning activities. To the oral tradition is a mainstay of storytelling should be maintained and preserved. This research was conducted at the elementary school in the city of Medan, North Sumatra Indonesia, with a random sampling technique, the 27 class teachers were respondents who were randomly assigned to the Madrasah Ibtdaiyah (Islamic Elementary School) both public and private. Research conducted at the beginning of 2014 refers to a curriculum that is being transformed in the environment ministry Republic Religion Indonesia. The results of this study indicate that; the declining skills of teachers to develop storytelling this can be seen from; 74.07% of teachers have never attended a special training storytelling, 85.19% no longer nasakah new stories, only 22.22% are teachers who incorporate methods of stories in the learning plan. Most teachers are no longer concerned with storytelling, among those experiencing difficulty in developing methods because the story; 66.67% of children are more interested in children's cartoons like Bobo boy, Angrybirds and others, 59.26 children prefer other activities than listening to a story. The teachers hope, folklore books should be preserved, storytelling training should be provided by the government through the ministry of religion, race or competition of storytelling should be scheduled, writing a new script-based populist storytelling should be provided immediately. The teachers’ hope certainly not excessive, by realizing the story method becomes articulation as the efforts of child character development based populist, therefore the local knowledge can be a strong fortress facing society in the era of progress as at present, and future.

Keywords: story telling, local wisdom, education, technology development

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Authors: A. T. Muruviwa

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Empirical studies of the current CSR agenda have been dominated by literature from the North at the expense of the nations from the South where most TNCs are located. Therefore, owing to the limitations of the current discourse that is dominated by Western ideas such as voluntarism, philanthropy, business case and economic gains, scholars have been calling for a new CSR agenda that is South-centred and addresses the needs of developing nations. The development theme has dominated in the recent literature as scholars concerned with the relationship between business and society have tried to understand its relationship with CSR. Despite a plethora of literature on the roles of corporations in local communities and the impact of CSR initiatives, there is lack of adequate empirical evidence to help us understand the nexus between CSR and development. For all the claims made about the positive and negative consequences of CSR, there is surprisingly little information about the outcomes it delivers. This study is a response to these claims made about the developmental aspect of CSR in developing countries. It offers some empirical bases for assessing the major CSR projects that have been fulfilled by a major mining company, Zimplats in Mhondoro-Ngezi Zimbabwe. The neo-liberal idea of capitalism and market dominations has empowered TNCs to stamp their authority in the developing countries. TNCs have made their mark in developing nations as they stamp their global private authority, rivalling or implicitly challenging the state in many functions. This dominance of corporate power raises great concerns over their tendencies of abuses in terms of environmental, social and human rights concerns as well as how to make them increasingly accountable. The hegemonic power of TNCs in the developing countries has had a tremendous impact on the overall CSR practices. While TNCs are key drivers of globalization they may be acting responsibly in their Global Northern home countries where there is a combination of legal mechanisms and the fear of civil society activism associated with corporate scandals. Using a triangulated approach in which both qualitative and quantitative methods were used the study found out that most CSR projects in Zimbabwe are dominated and directed by Zimplats because of the power it possesses. Most of the major CSR projects are beneficial to the mining company as they serve the business plans of the mining company. What was deduced from the study is that the infrastructural development initiatives by Zimplats confirm that CSR is a tool to advance business obligations. This shows that although proponents of CSR might claim that business has a mandate for social obligations to society, we need not to forget the dominant idea that the primary function of CSR is to enhance the firm’s profitability.

Keywords: hegemonic power, projects, reciprocity, stakeholders

Procedia PDF Downloads 238

Authors: Giorgi Gaprindashvili

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One of the best examples, in evolution of the public procurement, from post-soviet countries are reforms carried out in Georgia, which brought them close to international standards of procurement. In Georgia, public procurement legislation started functioning in 1998. The reform has passed several stages and came in the form as it is today. It should also be noted, that countries with economy in transition, including Georgia, implemented all the reforms in public procurement based on recommendations and support of World Bank, the United Nations and other international organizations. The first law on public procurement in Georgia was adopted on December 9, 1998 which aimed regulation of the procurement process of budget-organizations, transparent and competitive environment for private companies to access state funds legally. The priorities were identified quite clearly in the wording of the law, but operation/function of this law could not be reached on its level, because of some objective and subjective reasons. The high level of corruption in all levels of governance, can be considered as a main obstacle reason and of course, it is natural, that it had direct impact on the procurement process, as well as on transparency and rational use of state funds. This circumstances were the reasons that reforms in this sphere continued, to improve procurement process, in particular, the first wave of reforms began in 2001. Public procurement agency carried out reform with World Bank with main purpose of smartening the procurement legislation and its harmonization with international treaties and agreements. Also with the support of World Bank various activities were carried out to raise awareness of participants involved in procurement system. Further major changes in the legislation were filed in May 2005, which was also directed towards the improvement and smarten of the procurement process. The third wave of the reform began in 2010, which more or less guaranteed the transparency of the procurement process, which later became the basis for the rational spending of state funds. The reform of the procurement system completely changed the procedures. Carried out reform in Georgia resulted in introducing new electronic tendering system, which benefit the transparency of the process, after this became the basis for the further development of a competitive environment, which become a prerequisite for the state rational spending. Increased number of supplier organizations participating in the procurement process resulted in reduction of the estimated cost and the actual cost from 20% up to 40%, it is quite large saving for the procuring organizations and allows them to use the freed-up funds for their other needs. Assessment of the reforms in Georgia in the field of public procurement can be concluded, that proper regulation of the sector and relevant policy may proceed to rational and transparent spending of the budget from country’s state institutions. Also, the business sector has the opportunity to work in competitive market conditions and to make a preliminary analysis, which is a prerequisite for future strategy and development.

Keywords: public administration, public procurement, reforms, transparency

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Authors: Saimir Heta, Kastriot Haxhirexha, Virtut Velmishi, Nevila Alliu, Ilma Robo

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Background: Testicular rotation can occur at any age. The possibility to save the testicle is the fastest possible surgical intervention which is indicated by the presence of acute pain even at rest. The time element is more important to diagnose and proceed further with surgical intervention. Testicular damage is a consequence which mainly depends on the moment of onset of symptoms, at the time when the symptoms are diagnosed, the earliest action to be performed is surgical intervention. Sometimes medical tests are needed to confirm a diagnosis, or to help identify another cause for symptoms; for example, the urine test, that is used to check for infection, associated with the scrotal ultrasound test. Control of blood flow to the longitudinal supply vessels of the testicles is indicated. The sign that indicates testicular rotation is a reduction in blood flow. This is the element which is distinguished from ultrasound examination. Surgery may be needed to determine if the patient’s symptoms are caused by the rotation of the testis or any other condition. Discussion: As a surgical intervention of the emergency, the torsion of the test depends very much on the duration of the torsion, as the success in the life of the testicle depends on the fastest surgical intervention. From the previous clinic, it is noted that in any case presented to the pediatric patient diagnosed with testicular rotation, there is always a link with personal history that the patient refers to the presence of a previous episode of testicular trauma. Literature supports this fact very logically. Conclusions: Salvation without testicular atrophy depends closely on establishing the diagnosis of testicular rotation as soon as possible. Following the logic above, it can be said that the diagnosis for rotation should be performed as soon as possible, to avoid consequences that will not be favorable for the patient.

Keywords: acute scrotum, test torsion, newborns, clinical presentation

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Authors: Adey Nigatu Mersha, Ilyas Masih, Charlotte de Fraiture, Tena Alamirew

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Conflicts over water are increasing mainly as a result of water scarcity in response to higher water demand and climatic variability. There is often not enough water to meet all demands for different uses. Thus, decisions have to be made as to how the available resources can be managed and utilized. Correspondingly water allocation goals, practically national water policy goals, need to be revised accordingly as the pressure on water increases from time to time. A case study is conducted in the Upper Awash Basin, Ethiopia, to assess and evaluate prioritized comprehensive water demand management options based on the framework of integrated water resources management in account of stakeholders’ knowledge and preferences as well as practical prominence within the Upper Awash Basin. Two categories of alternative management options based on policy analysis and stakeholders' consultation were evaluated against the business-as-usual scenario by using WEAP21 model as an analytical tool. Strong effects on future (unmet) demands are observed with major socio-economic assumptions and forthcoming water development plans. Water management within the basin will get more complex with further abstraction which may lead to an irreversible damage to the ecosystem. It is further confirmed through this particular study that efforts to maintain users’ preferences alone cannot insure economically viable and environmentally sound development and vice versa. There is always a tradeoff between these factors. Hence, all of these facets must be analyzed separately, related with each other in equal footing, and ultimately taken up in decision making in order for the whole system to function properly.

Keywords: water demand, water availability, WEAP21, scenarios

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Authors: Sharafat Karimi, Jamil Jafari

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The impact of Western Literature on other nations' pieces of literature (including Arabic) has caused critics to ignore the importance of Arabic cultural & literary heritage in the formation of contemporary Arabic fiction; but on the contrary, an important part of literary genres in any society, especially fiction has been formed in the past and depends on ancient literary events. The current paper, utilizing the descriptive-analytical method and by means of library studies, tries to challenge those critics who regard Western Literature as the only effective factor on the appearance of Arabic fiction. Furthermore, this research tries to find out effective Islamic-Arabic elements on the development of Arabic novel by the investigation of some fictional works. The results show that in addition to regarding Western literature as an important factor, Arab novelists have applied their heritage, culture, and ancient history, either written or orally transmitted to the current generation, in their innovations. Among great historical works containing moral stories, allegorical legends, myths, tales of heroes, and folklore, we can refer to Arabian Nights, Kalila & Dimna, romantic stories, historical puzzles, history of Islam, history of ancient Egypt, Maqama, and Quranic stories. Famous novels like 'Hadith Isa ibn-Hisham', 'Layali Alif Layla', 'Abas al-Aqdar', 'Radoubis', 'Ahlam Shahrzad, and 'Alam Bela Kharaet' were compiled on the basis of ancient literary heritage not only in the theme but also in the structure; so one can conclude that the ancient literary-cultural heritage and Islamic-Arabian history have been influential on Arabic novel appearance and development.

Keywords: Arabic fictional literature, culture, heritage, history, language, novel

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Authors: Khadeeja Munawar, Shamsul Haque

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

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

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Authors: Patrick Strefford, Michael Davies, Masahiko Iguchi

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The Sustainable Development Goals (SDGs) were adopted in 2015 to end poverty, protect the planet, and ensure prosperity for all. Sustainable tourism is firmly positioned in these Goals, since tourism has significant potential to contribute to inclusive and sustainable economic growth, as well as to promote sustainable use of natural capital. Recognizing this, the new quasi-democratic government of Myanmar has embraced Sustainable Tourism as a core component of its economic reforms and opening up of the country. However, it is also highly likely that the Democrats within the government also support Sustainable Tourism as a potential contributor to the democratization of the country. This paper outlines how the government of Myanmar has understood the concept of Sustainable Tourism, and how it intends to implement and facilitate Sustainable Tourism. This paper, therefore, focuses primarily on the institutional frameworks that have been put in place, a specific one being the Inlay Lake Destination Management Plan, which is one of the four priority destinations identified by the government. The plan aims to improve local infrastructure, manage the local environment and develop local human resources. Importantly, the Plan also includes the establishment of a Destination Management Organization (DMO) to implement and manage Inlay Lake as a Sustainable Tourism destination. This research aims to investigate, for example, the equality in both input to the DMO and benefits accrued to the various stakeholders. How such equality can be ensured and how this can be reliably quantified will be crucial to ultimately evaluating the success of any such plans to implement Sustainable Tourism in Myanmar in the coming years. However, this research paper concludes that while the establishment of the DMO is a positive development, there are considerable institutional, economic and cultural factors that severely limit the ability of the DMO to function as an agent of sustainable tourism implementation.

Keywords: sustainable tourism, myanmar, country in transition, destination management organizations

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Authors: Raymond Awinbilla

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The call for tree planting has long been set in motion by the government of Ghana. The Forestry Commission encourages plantation development through numerous interventions including formulating policies and enacting legislations. However, forest policies have failed and that has generated a major concern over the vast gap between the intentions of national policies and the realities established. This study addresses three objectives;1) Assessing the farmers' response and contribution to the tree planting initiative, 2) Identifying socio-economic factors hindering the development of smallholder plantations as a livelihood strategy, and 3) Determining the level of support available for smallholder tree growers and the factors influencing it. The field work was done in 12 farming communities in Ghana. The article illuminates that farmers have responded to the call for tree planting and have planted both exotic and indigenous tree species. Farmers have converted 17.2% (369.48ha) of their total land size into plantations and have no problem with land tenure. Operations and marketing constraints include lack of funds for operations, delay in payment, low price of wood, manipulation of price by buyers, documentation by buyers, and no ready market for harvesting wood products. Environmental institutions encourage tree planting; the only exception is with the Lands Commission. Support availed to farmers includes capacity building in silvicultural practices, organisation of farmers, linkage to markets and finance. Efforts by the Government of Ghana to enhance forest resources in the country could rely on the input of local populations.

Keywords: livelihood strategy, marketing constraints, environmental institutions, silvicultural practices

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Authors: Vladyslav Povoroznyuk, Anna Musiienko, Nataliia Zaverukha, Roksolana Povoroznyuk

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Along with the global aging of population, the number of people with somatic diseases is increasing, including such interrelated pathologies as obesity, osteoarthritis (OA) and osteoporosis (OP). The objective of the study is to examine the connection between body mass index (BMI), OA and bone mineral density (BMD) of lumbar spine, femoral neck and trabecular bone score (TBS) in postmenopausal women with OA. We have observed 359 postmenopausal women (50-89 years old) and divided them into four groups by age: 50-59 yrs, 60-69 yrs, 70-79 yrs and over 80 years old. In addition, according to the American College of Rheumatology (ACR) Clinical classification criteria for knee and hip OA, we divided them into 2 groups: group I – 117 females with symptomatic OA (including 89 patients with knee OA, 28 patients with hip OA) and group II –242 women with a normal functional activity of large joints. Analysis of data was performed taking into account their BMI, classified by World Health Organization (WHO). Diagnosis of obesity was established when BMI was above 30 kg/m². In woman with obesity, a symptomatic OA was detected in 44 postmenopausal women (41.1%), a normal functional activity of large joints - in 63 women (58.9%). However, in women with normal BMI – 73 women, who account for 29.0% of cases, a symptomatic OA was detected. According to a chi-squared (χ2) test, a significantly higher level of BMI was detected in postmenopausal women with OA (χ2 = 5.05, p = 0.02). Women with a symptomatic OA had a significantly higher BMD of lumbar spine compared with women who had a normal functional activity of large joints. No significant differences of BMD of femoral necks or TBS were detected in either the group with OA or with a normal functional activity of large joints.

Keywords: bone mineral density, body mass index, obesity, overweight, postmenopausal women, osteoarthritis

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Authors: Magarò Floriana, Zinno Raffaele

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Since 2009, with the coming into force of the January 14, 2008 Ministerial Decree "New technical standards for construction", and the explanatory ministerial circular N°.617 of February 2, 2009, the question of seismic hazard and the design of seismic-resistant structures in Italy has acquired increasing importance. One of the most discussed aspects in recent Italian and international scientific literature concerns the dynamic interaction between land and structure, and the effects which dynamic coupling may have on individual buildings. In effect, from systems dynamics, it is well known that resonance can have catastrophic effects on a stimulated system, leading to a response that is not compatible with the previsions in the design phase. The method used in this study to estimate the frequency of oscillation of the structure is as follows: the analysis of HVSR (Horizontal to Vertical Spectral Ratio) relations. This allows for evaluation of very simple oscillation frequencies for land and structures. The tool used for data acquisition is an experimental digital tromograph. This is an engineered development of the experimental Languamply RE 4500 tromograph, equipped with an engineered amplification circuit and improved electronically using extremely small electronic components (size of each individual amplifier 16 x 26 mm). This tromograph is a modular system, completely "free" and "open", designed to interface Windows, Linux, OSX and Android with the outside world. It an amplifier designed to carry out microtremor measurements, yet which will also be useful for seismological and seismic measurements in general. The development of single amplifiers of small dimension allows for a very clean signal since being able to position it a few centimetres from the geophone eliminates cable “antenna” phenomena, which is a necessary characteristic in seeking to have signals which are clean at the very low voltages to be measured.

Keywords: microtremor, HVSR, tromograph, structural engineering

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Authors: Qing Wu, Xuchun Ye, Qiuchen Wang, Kirsten Corazzini

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Objective: It’s increasing acknowledged that patient engagement in healthcare and health literacy both have positive impact on patient outcome. Health literacy emphasizes the ability of individuals to understand and apply health information and manage health. Patients' health literacy affected their willingness to participate in decision-making, but its impact on the behavior and willingness of patient engagement in healthcare is not clear, especially in China. Therefore, this study aimed to explore the correlation between the behavior and willingness of patient engagement and health literacy. Methods: A cross-sectional survey was employed using the behavior and willingness of patient engagement in healthcare questionnaire, Chinese version All Aspects of Health Literacy Scale (AAHLS). A convenient sample of 443 patients was recruited from 8 general hospitals in Shanghai, Jiangsu Province and Zhejiang Province, from September 2016 to January 2017. Results: The mean score for the willingness was (4.41±0.45), and the mean score for the patient engagement behavior was (4.17±0.49); the mean score for the patient's health literacy was (2.36±0.29)，the average score of its three dimensions- the functional literacy, the Communicative/interactive literacy and the Critical literacy, was (2.26±0.38), (2.28±0.42), and (2.61±0.43), respectively. Patients' health literacy was positively correlated with their willingness of engagement (r = 0.367, P < 0.01), and positively correlated with patient engagement behavior (r = 0.357, P < 0.01). All dimensions of health literacy were positively correlated with the behavior and willingness of patient engagement in healthcare; the dimension of Communicative/interactive literacy (r = 0.312, P < 0.01; r = 0.357, P < 0.01) and the Critical literacy (r = 0.357, P < 0.01; r = 0.357, P < 0.01) are more relevant to the behavior and willingness than the dimension of basic/functional literacy (r=0.150, P < 0.01; r = 0.150, P < 0.01). Conclusions: The behavior and willingness of patient engagement in healthcare are positively correlated with health literacy and its dimensions. In clinical work, medical staff should pay attention to patients’ health literacy, especially the situation that low literacy leads to low participation and provide health information to patients through health education or communication to improve their health literacy as well as guide them to actively and rationally participate in their own health care.

Keywords: patient engagement, health literacy, healthcare, correlation

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Authors: Vadim A. Kuznetsov, Anna M. Soldatova, Tatyana N. Enina, Elena A. Gorbatenko, Dmitrii V. Krinochkin

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The aim of the study was to evaluate potential parameters related with super-response to CRT. Methods: 60 CRT patients (mean age 54.3 ± 9.8 years; 80% men) with congestive heart failure (CHF) II-IV NYHA functional class, left ventricular ejection fraction < 35% were enrolled. At baseline, 1 month, 3 months and each 6 months after implantation clinical, electrocardiographic and echocardiographic parameters, NT-proBNP level were evaluated. According to the best decrease of left ventricular end-systolic volume (LVESV) (mean follow-up period 33.7 ± 15.1 months) patients were classified as super-responders (SR) (n=28; reduction in LVESV ≥ 30%) and non-SR (n=32; reduction in LVESV < 30%). Results: At baseline groups differed in age (58.1 ± 5.8 years in SR vs 50.8 ± 11.4 years in non-SR; p=0.003), gender (female gender 32.1% vs 9.4% respectively; p=0.028), width of QRS complex (157.6 ± 40.6 ms in SR vs 137.6 ± 33.9 ms in non-SR; p=0.044). Percentage of LBBB was equal between groups (75% in SR vs 59.4% in non-SR; p=0.274). All parameters of mechanical dyssynchrony were higher in SR, but only difference in left ventricular pre-ejection period (LVPEP) was statistically significant (153.0 ± 35.9 ms vs. 129.3 ± 28.7 ms p=0.032). NT-proBNP level was lower in SR (1581 ± 1369 pg/ml vs 3024 ± 2431 pg/ml; p=0.006). The survival rates were 100% in SR and 90.6% in non-SR (log-rank test P=0.002). Multiple logistic regression analysis showed that LVPEP (HR 1.024; 95% CI 1.004–1.044; P = 0.017), baseline NT-proBNP level (HR 0.628; 95% CI 0.414–0.953; P=0.029) and age at baseline (HR 1.094; 95% CI 1.009-1.168; P=0.30) were independent predictors for CRT super-response. ROC curve analysis demonstrated sensitivity 71.9% and specificity 82.1% (AUC=0.827; p < 0.001) of this model in prediction of super-response to CRT. Conclusion: Super-response to CRT is associated with better survival in long-term period. Presence of LBBB was not associated with super-response. LVPEP, NT-proBNP level, and age at baseline can be used as independent predictors of CRT super-response.

Keywords: cardiac resynchronisation therapy, superresponse, congestive heart failure, left bundle branch block

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Authors: Tristance Kee

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With an unprecedented increase in elderly population around the world, the severe lack of quality housing and health-and-safety provisions to serve this cohort cannot be ignored any longer. Many elderly citizens, especially singletons, live in unsafe housing conditions with poorly executed planning and design. Some suffer from deteriorating mobility, sight and general alertness and their sub-standard living conditions further hinder their daily existence. This research explains how concepts such as Universal Design and Co-Design operate in a high density city such as Hong Kong, China where innovative design can become an alternative solution where government and the private sector fail to provide quality elderly friendly facilities to promote a sustainable urban development. Unlike other elderly research which focuses more on housing policies, nursing care and theories, this research takes a more progressive approach by providing an in-depth impact assessment on how innovative design can be practical solutions for creating a more sustainable built environment. The research objectives are to: 1) explain the relationship between innovative design for elderly and a healthier and sustainable environment; 2) evaluate the impact of human ergonomics with the use of universal design; and 3) explain how innovation can enhance the sustainability of a city in improving citizen’s sight, sound, walkability and safety within the ageing population. The research adopts both qualitative and quantitative methodologies to examine ways to improve elderly population’s relationship to our built environment. In particular, the research utilizes collected data from questionnaire survey and focus group discussions to obtain inputs from various stakeholders, including designers, operators and managers related to public housing, community facilities and overall urban development. In addition to feedbacks from end-users and stakeholders, a thorough analysis on existing elderly housing facilities and Universal Design provisions are examined to evaluate their adequacy. To echo the theme of this conference on Innovation and Sustainable Development, this research examines the effectiveness of innovative design in a risk-benefit factor assessment. To test the hypothesis that innovation can cater for a sustainable development, the research evaluated the health improvement of a sample size of 150 elderly in a period of eight months. Their health performances, including mobility, speech and memory are monitored and recorded on a regular basis to assess if the use of innovation does trigger impact on improving health and home safety for an elderly cohort. This study was supported by district community centers under the auspices of Home Affairs Bureau to provide respondents for questionnaire survey, a standardized evaluation mechanism, and professional health care staff for evaluating the performance impact. The research findings will be integrated to formulate design solutions such as innovative home products to improve elderly daily experience and safety with a particular focus on the enhancement on sight, sound and mobility safety. Some policy recommendations and architectural planning recommendations related to Universal Design will also be incorporated into the research output for future planning of elderly housing and amenity provisions.

Keywords: elderly population, innovative design, sustainable built environment, universal design

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Authors: Alban Igwe, Ijeoma Kalu, Alloy Ezirim

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Food insecurity is a global problem, and the search for food security has assumed a central stage in the global development agenda as the United Nations currently placed zero hunger as a goal number in its sustainable development goals. Nigeria currently ranks 107th out of 113 countries in the global food security index (GFSI), a metric that defines a country's ability to furnish its citizens with food and nutrients for healthy living. Paradoxically, Nigeria is a global leader in food production, ranking 1st in yam (over 70% of global output), beans (over 41% of global output), cassava (20% of global output) and shea nuts, where it commands 53% of global output. Furthermore, it ranks 2nd in millet, sweet potatoes, and cashew nuts. It is Africa's largest producer of rice. So, it is apparent that Nigeria's food insecurity woes must relate to a factor other than food production. We investigated the nexus between food security and downstream supply chain losses in the yam industry with secondary data from the Food and Agricultural Organization (FAOSTAT) and the National Bureau of Statics for the decade 2012-2021. In analyzing the data, multiple regression techniques were used, and findings reveal that downstream losses have a strong positive correlation with food security (r = .763*) and a 58.3% variation in food security is explainable by post-downstream supply chain food losses. The study discovered that yam supply chain losses within the period under review averaged 50.6%, suggestive of the fact that downstream supply chain losses are the drainpipe and the major source of food insecurity in Nigeria. Therefore, the study concluded that there is a significant relationship between downstream supply chain losses and food insecurity and recommended the establishment of food supply chain structures and policies to enhance food security in Nigeria.

Keywords: food security, downstream supply chain losses, yam, nigeria, supply chain

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Authors: Khalid Mehmood, Riaz Hussain, Rao Z. Abbas, Tariq Abbas, Abdul Ghaffar, Ahmad J. Sabir

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Blood born diseases such as trypanosomiasis have negative impacts on health, production and working efficiency of camels in different camel-rearing areas of the world including Pakistan. In present study blood samples were collected from camels kept at the desert condition of cholistan to estimate the prevalence of trypanosomiasis and hemato-biochemical changes in naturally infected cases. Results showed an overall 9.31% prevalence of trypanosomiasis in camels. Various clinical signs such as pyrexia, occasional shivering, inappetence, urticaria, swelling, lethargy, going down in condition and edema of pads were observed in few cases. The statistical analysis did not show significant association of age and sex with trypanosomiasis. However, results revealed significantly decreased values of total erythrocyte counts, packed cell volume, hemoglobin concentration, mean corpuscular hemoglobin concentration, serum total proteins and albumin while increased values of mean corpuscular volume was recorded in infected animals as compared to healthy. A significant (P<0.01) increased values of total leukocyte count, monocyte, lymphocyte, neutrophils, and eosinophils was recorded in infected animals. Moreover, microscopic examination of blood films obtained from naturally infected cases showed the presence of parasite and various morphological changes in cells such as stomatocyte, hyperchromasia, and polychromasia. Significantly increased values of different hepatic enzymes including alanine aminotransferase (ALT), aspartate aminotransferase (AST) and alkaline phosphatase (ALP) were also recorded.

Keywords: camel, hematological indices, serum enzymes, Trypanosomiasis

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Authors: Isomar Lima da Silva, Aristeu Jonatas Leite de Oliveira, Roberto Maia Augusto

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Biological isolation capsules are equipment commonly used in the control and prevention of infectious diseases in the hospital environment. This type of equipment, combined with pre-established medical protocols, contributes significantly to the containment of highly transmissible pathogens such as COVID-19. Due to its hermetic isolation, it allows more excellent patient safety, protecting companions and the health team. In this context, this work presents the development, testing, and validation of a medical capsule to treat patients affected by COVID-19. To this end, requirements such as low cost and easy handling were considered to meet the demand of people infected with the virus in remote locations in the Amazon region and/or where there are no ICU beds and mechanical ventilators for orotracheal intubation. Conceived and developed in a partnership between SAMEL Planos de Saúde and Instituto Conecthus, the device entitled "Vanessa Capsule" was designed to be used together with the NIV protocol (non-invasive ventilation), has an automatic exhaust system and filters performing the CO2 exchange, in addition to having BiPaps ventilatory support equipment (mechanical fans) in the Cabin Kit. The results show that the degree of effectiveness in protecting against infection by aerosols, with the protection cabin, is satisfactory, implying the consideration of the Vanessa capsule as an auxiliary method to be evaluated by the health team. It should also be noted that the medical observation of the evaluated patients found that the treatment against the COVID-19 virus started earlier with non-invasive mechanical ventilation reduces the patient's suffering and contributes positively to their recovery, in association with isolation through the Vanessa capsule.

Keywords: COVID-19, mechanical ventilators, medical capsule, non-invasive ventilation

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Authors: Dwitya Elvira, Eryati Darwin

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Background: Graves’ disease (GD) is an autoimmune thyroid disease. Imbalance of Th1/Th2 cells and T-regulatory (Treg)/Th17 cells was thought to play pivotal role in the pathogenesis of GD. Treg FoxP3 produced TGF-β to maintain regulatory function, and Th17 cells produced IL-17 as cytokines that were thought in mediating several autoimmune diseases. The aim of this study is to assess the role of IL-17 and TGF-β in the pathogenesis of GD and to investigate its correlation with Thyroid Stimulating Hormone Receptor Antibody (TRAb) and Treg FoxP3 expression. Method: 30 GD patients and 27 age and sex-matched controls were enrolled in this study. Diagnosis of GD was based on clinical and biochemical of GD. Serum IL-17, TGF-β, TRAb, and FoxP3 were measured by enzyme-linked immunosorbent assay (ELISA). Data were analyzed by using SPSS 21.0 (SPSS Inc.). Spearman rank correlation test was used for assessment of correlation. The statistical significance was accepted as P<0.05. Result: There was no significant correlation between IL-17 and TGF-β serum with expression of FoxP3 level in GD, but there was significant correlation between TGF-β and TRAb serum level (P<0.05). Serum levels of IL-17 and TGF-β were found to be elevated in patient group compared to control, where mean values of IL-17 were 14.43±2.15 pg/mL and TGF-β were 10.44±3.19 pg/mL in patients group; and in control group, level of IL-17 were 7.1±1.45 pg/mL and TGF-β were 4.95±1.35 pg/mL. Conclusion: Serum Il-17 and TGF-β were elevated in GD patients that reflect the role of inflammatory and regulatory cytokines activation in pathogenesis of GD. There was significant correlation between TGF-β and TRAb, revealing that Treg cytokines may play a role in pathogenesis of GD.

Keywords: IL-17, TGF-B, FoxP3, TRAb, Graves’ disease

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Authors: Maydariana Ayuningtyas, Bambang Riyanto, Akhiruddin Maddu

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Industrial waste of crustacean shells, such as shrimp and crab, has been considered as one of the major issues contributing to environmental pollution. The waste processing mechanisms to form new, practical substances with added value have been developed. Chitosan, a derived matter from chitin, which is obtained from crab and shrimp shells, performs prodigiously in broad range applications. A chitosan composite-based diaphragm is a new inspiration in fiber optic acoustic sensor advancement. Elastic modulus, dynamic response, and sensitivity to acoustic wave of chitosan-based composite film contribute great potentials of organic-based sound-detecting material. The objective of this research was to develop chitosan diaphragm application in fiber optic microphone system. The formulation was conducted by blending 5% polyvinyl alcohol (PVA) solution with dissolved chitosan at 0%, 1% and 2% in 1:1 ratio, respectively. Composite diaphragms were characterized for the morphological and mechanical properties to predict the desired acoustic sensor sensitivity. The composite with 2% chitosan indicated optimum performance with 242.55 µm thickness, 67.9% relative humidity, and 29-76% light transmittance. The Young’s modulus of 2%-chitosan composite material was 4.89×104 N/m2, which generated the voltage amplitude of 0.013V and performed sensitivity of 3.28 mV/Pa at 1 kHz. Based on the results above, chitosan from crustacean shell waste can be considered as a viable alternative material for fiber optic acoustic sensor sensing pad development. Further, the research in chitosan utilisation is proposed as novel optical microphone development in anthropogenic noise controlling effort for environmental and biodiversity conservation.

Keywords: acoustic sensor, chitosan, composite, crab shell, diaphragm, waste utilisation

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Authors: Tamer ElSerafi

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In recent approaches to heritage conservation, the whole context of historic areas becomes as important as the single historic building. This makes the provision of infrastructure and network of mobility an effective element in the urban conservation. Sustainable urban conservation projects consider the high density of activities, the need for a good quality access system to the transit system, and the importance of the configuration of the mobility network by identifying the best way to connect the different districts of the urban area through a complex unique system that helps the synergic development to achieve a sustainable mobility system. A sustainable urban mobility is a key factor in maintaining the integrity between socio-cultural aspects and functional aspects. This paper illustrates the mobility aspects, mobility problems in historic districts, and the needs of the mobility systems in the first part. The second part is a practical analysis for different mobility plans. It is challenging to find innovative and creative conservation solutions fitting modern uses and needs without risking the loss of inherited built resources. Urban mobility management is becoming an essential and challenging issue in the urban conservation projects. Depending on literature review and practical analysis, this paper tries to define and clarify the guidelines for mobility management in historic districts as a key element in sustainability of urban conservation and development projects. Such rules and principles could control the conflict between the socio–cultural and economic activities, and the different needs for mobility in these districts in a sustainable way. The practical analysis includes a comparison between mobility plans which have been implemented in four different cities; Freiburg in Germany, Zurich in Switzerland and Bray Town in Ireland. This paper concludes with a matrix of guidelines that considers both principles of sustainability and livability factors in urban historic districts.

Keywords: sustainable mobility, urban mobility, mobility management, historic districts

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Authors: Stefan Gruden, Charlott Brunmark, Bo Holmqvist, Erwin D. Brenndorfer, Martin Johansson, Jian Liu, Ying Zhao, Niklas Axen, Moustapha Hassan

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Aim: The study was designed to evaluate the ability of the calcium sulfate-based NanoZolid® drug delivery technology to locally release the epidermal growth factor (EGF) protein while maintaining its biological activity. Methods: NanoZolid-formulated EGF protein labelled with a near-infrared dye (EGF-NIR) depots or EGF-NIR dissolved in PBS were injected subcutaneously into mice bearing EGF receptor (EGFR) positive human A549 lung cancer tumors inoculated subcutaneously. The release and biodistribution of the EGF-NIR were investigated in vivo longitudinally up to 96 hours post-administration, utilizing whole-body fluorescence imaging. In order to confirm the in vivo findings, histological analysis of tumor cryosections was performed to investigate EGF-NIR fluorescent signal and EGFR expression level by immunofluorescence labelling. Results: The in vivo fluorescence imaging showed a controlled release profile of the EGF-NIR loaded in the NanoZolid depots compared to free EGF-NIR. Histological analysis of the tumors further demonstrated a prevailing distribution of EGF-NIR in regions with high levels of EGFR expression. Conclusion: Calcium sulfate based depots can be used to formulate EGF while maintaining its biological activity, e.g., receptor binding capability. This may have good clinical potential for local delivery of biomolecules to enhance treatment efficacy and minimize systemic adverse effects.

Keywords: bioresorbable, calcium sulfate, controlled release, NanoZolid

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Authors: Sushila Jaiswal, Awadhesh Kumar Jaiswal

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Background: Primary melanocytic tumors of the central nervous system (CNS) are uncommon lesions and arise from the melanocytes located within the leptomeninges. Aim and objective: The aim of the study was to evaluate the clinical details, histomorphology of the primary melanocytic tumor of CNS. Method: The study was performed by the retrospective review of the case records of the primary melanocytic tumors of CNS diagnosed in our department. The formalin-fixed, paraffin embedded tissue blocks and tissue sections were retrieved and reviewed. Results: Seven cases (6 males, 1 female; age range- 16-40 years; mean age- 27 years) of primary melanocytic tumors of CNS were retrieved over last seven years. The tumor was intracranial (n=5; frontal – 1 case, parietal – 1 case, cerebello-pontine angle- 1 case, occipital -1 case, foramen magnum-1 case) and intra spinal (n=2; cervical – 2 cases). All patients presented with the neurological deficits related to the location of the tumor. Four cases were malignant melanoma; two were melanocytoma of intermediate grade and remaining one was melanocytoma. On histopathology, melanocytoma and melanoma both displayed sheets of well-differentiated melanocytes having round to oval nuclei with finely dispersed chromatin, occasional single eosinophilic nucleoli and a moderate amount of cytoplasm with abundant granular melanin pigment. The absence of mitosis and macronucleoli was noticed in melanocytoma while melanoma showed frequent mitosis and macronucleoli. On immunohistochemistry, both showed diffuse strong HMB45 and S-100 immunopositivity. Conclusion: Primary melanocytic tumors of CNS are rare and predominantly seen in males. It is important to differentiate melanoma from melanocytoma as prognosis of later is good.

Keywords: melanocytoma, melanoma, brain tumor, melanin

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Authors: Chu Wan-Loy, Kok Yih-Yih, Choong Siew-Ling

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The human health risks due to poor air quality caused by a wide array of microorganisms have attracted much interest. Airborne algae have been reported as early as 19th century and they can be found in the air of tropic and warm atmospheres. Airborne algae normally originate from water surfaces, soil, trees, buildings and rock surfaces. It is estimated that at least 2880 algal cells are inhaled per day by human. However, there are relatively little data published on airborne algae and its related adverse health effects except sporadic reports of algae associated clinical allergenicity. A collection of airborne algae cultures has been established following a recent survey on the occurrence of airborne algae in indoor and outdoor environments in Kuala Lumpur. The aim of this study was to investigate the allergenic potential of the isolated airborne green and blue-green algae, namely Scenedesmus sp., Cylindrospermum sp. and Hapalosiphon sp.. The suspensions of freeze-dried airborne algae were adminstered into balb-c mice model through intra-nasal route to determine their allergenic potential. Results showed that Scenedesmus sp. (1 mg/mL) increased the systemic Ig E levels in mice by 3-8 fold compared to pre-treatment. On the other hand, Cylindrospermum sp. and Hapalosiphon sp. at similar concentration caused the Ig E to increase by 2-4 fold. The potential of airborne algae causing Ig E mediated type 1 hypersensitivity was elucidated using other immunological markers such as cytokine interleukin (IL)- 4, 5, 6 and interferon-ɣ. When we compared the amount of interleukins in mouse serum between day 0 and day 53 (day of sacrifice), Hapalosiphon sp. (1mg/mL) increased the expression of IL4 and 6 by 8 fold while the Cylindrospermum sp. (1mg/mL) increased the expression of IL4 and IFɣ by 8 and 2 fold respectively. In conclusion, repeated exposure to the three selected airborne algae may stimulate the immune response and generate Ig E in a mouse model.

Keywords: airborne algae, respiratory, allergenic, immune response, Malaysia

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