Search results for: burning mouth syndrome
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1304

Search results for: burning mouth syndrome

404 A Prospective Study of a Modified Pin-In-Plaster Technique for Treatment of Distal Radius Fractures

Authors: S. alireza Mirghasemi, Shervin Rashidinia, Mohammadsaleh Sadeghi, Mohsen Talebizadeh, Narges Rahimi Gabaran, S. Shahin Eftekhari, Sara Shahmoradi

Abstract:

Purpose: There are various pin-in-plaster methods for treating distal radius fractures. This study is meant to introduce a modified technique of pin-in-plaster. Materials and methods: Fifty-four patients with distal radius fractures were followed up for one year. Patients were excluded if they had type B fractures according to AO classification, multiple injuries or pathological fractures, and were treated more than 7 days after injury. Range of motion and functional results were evaluated. Radiographic parameters including radial inclination, tilt, and height, were measured preoperatively and postoperatively. Results: The average radial tilt was 10.6° and radial height was 10.2 mm at the sixth month postoperatively. Three cases of pin tract infection were recorded, who were treated totally with oral antibiotics. There was no case of pin loosening. Of total 73 patients underwent surgery, three cases of radial nerve irritation were recorded at the time of cast removal. All of them resolved at the 6th month follow up. No median nerve compression and carpal tunnel syndrome have found. We also had no case of tendon injury. Conclusion: Our modified technique is effective to restore anatomic congruity and maintain reduction.

Keywords: distal radius fracture, percutaneous pinning, pin-in-plaster, modified method of pin-in-plaster, operative treatment

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403 Poverty Alleviation and Agricultural Management Policies in Nasarawa State of Nigeria: Lessons from the Roots and Tuber Crops Expansion for Increased Food Production (1996-2011)

Authors: Yahaya Abdullahi Adadu, Canice Erunke Esidene

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The problems of socio-economic development have been a major challenge bedeviling the Nigerian post-colonial state since her political independence from Britain in October I,1960. Critics have argued that the dilemma of Nigeria’s economic survival started since the early 1970s when the agricultural sector which supposedly was the economic mainstay has been literally substituted with the gains of the oil petro-dollars coming from the foreign exchange earnings. Agriculture therefore, which used to be a major player in terms of human and national upliftment in Nigeria have been given a back seat while oil and gas has taken over the front burner in virtually every aspect of Nigeria’s national life. This study is therefore an exposition of the efforts of the Nasarawa state government in reversing the dangerous trend in which the over reliance on oil wealth has caused to persons, individuals and groups in terms of the prevailing levels of poverty and other attendant vices therein. The study focuses on the management policies of the various regimes in the state since its inception in 1996, with particular reference to the regime types-military and civilian alike in propelling the needed policy change, which could transform the economy in line with international best practices. Particular emphasis will be paid to the BADA-KOSHI agricultural scheme whose interest was to recover the lost glory of rural agriculture through series of roots and tuber expansion, and particularly such crops as yam minissetts, cassava, sweet potatoes and coco-yam, respectively. The paper covers the period between 1996 -2011, a period considered to be critical in the agricultural revolution of the state. The study adopts a theoretical approach via secondary methods of analysis for the efficient explanations of the burning issues under consideration. The paper sums up with policy recommendations and conclusion.

Keywords: poverty, agriculture, Badakoshi, rural policy management

Procedia PDF Downloads 437
402 Tracking and Classifying Client Interactions with Personal Coaches

Authors: Kartik Thakore, Anna-Roza Tamas, Adam Cole

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The world health organization (WHO) reports that by 2030 more than 23.7 million deaths annually will be caused by Cardiovascular Diseases (CVDs); with a 2008 economic impact of $3.76 T. Metabolic syndrome is a disorder of multiple metabolic risk factors strongly indicated in the development of cardiovascular diseases. Guided lifestyle intervention driven by live coaching has been shown to have a positive impact on metabolic risk factors. Individuals’ path to improved (decreased) metabolic risk factors are driven by personal motivation and personalized messages delivered by coaches and augmented by technology. Using interactions captured between 400 individuals and 3 coaches over a program period of 500 days, a preliminary model was designed. A novel real time event tracking system was created to track and classify clients based on their genetic profile, baseline questionnaires and usage of a mobile application with live coaching sessions. Classification of clients and coaches was done using a support vector machines application build on Apache Spark, Stanford Natural Language Processing Library (SNLPL) and decision-modeling.

Keywords: guided lifestyle intervention, metabolic risk factors, personal coaching, support vector machines application, Apache Spark, natural language processing

Procedia PDF Downloads 428
401 Physical and Mechanical Behavior of Compressed Earth Blocks Stabilized with Ca(OH)2 on Sub-Humid Warm Weather

Authors: D. Castillo T., Luis F. Jimenez

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The compressed earth blocks (CEBs) constitute an alternative as a constructive element for building homes in regions with high levels of poverty and marginalization. Such is the case of Southeastern Mexico, where the population, predominantly indigene, build their houses with feeble materials like wood and palm, vulnerable to extreme weather in the area, because they do not have the financial resources to acquire concrete blocks. There are several advantages that can provide BTCs compared to traditional vibro-compressed concrete blocks, such as the availability of materials, low manufacturing cost and reduced CO2 emissions to the atmosphere for not be subjected to a burning process. However, to improve its mechanical properties and resistance to adverse weather conditions in terms of humidity and temperature of the sub-humid climate zones, it requires the use of a chemical stabilizer; in this case we chose Ca(OH)2. The stabilization method Eades-Grim was employed, according to ASTM C977-03. This method measures the optimum amount of lime required to stabilize the soil, increasing the pH to 12.4 or higher. The minimum amount of lime required in this experiment was 1% and the maximum was 10%. The employed material was clay unconsolidated low to medium plasticity (CL type according to the Unified Soil Classification System). Based on these results, the CEBs manufacturing process was determined. The obtained blocks were from 10x15x30 cm using a mixture of soil, water and lime in different proportions. Later these blocks were put to dry outdoors and subjected to several physical and mechanical tests, such as compressive strength, absorption and drying shrinkage. The results were compared with the limits established by the Mexican Standard NMX-C-404-ONNCCE-2005 for the construction of housing walls. In this manner an alternative and sustainable material was obtained for the construction of rural households in the region, with better security conditions, comfort and cost.

Keywords: calcium hydroxide, chemical stabilization, compressed earth blocks, sub-humid warm weather

Procedia PDF Downloads 395
400 Use of McCloskey/Mueller Satisfaction Scale in Evaluating Satisfaction with Working Conditions of Nurses in Slovakia

Authors: Vladimir Siska, Lukas Kober

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Introduction: The research deals with the work satisfaction of nurses working in healthcare institutions in the Slovak Republic, and factors influencing it. Employers should create working conditions that are consonant with the requirements of their employees and make the most of motivation strategies to help them answer to the employess' needs in concordance with various needs and motivation process theories. Methodology: In our research, we aimed to investigate the level of work satisfaction in nurses by carrying out a quantitative analysis using the standardized McCloskey/Mueller Satisfaction scale questionnaire. We used the descriptive positioning characteristics (average, median and variability, standard deviation, minimum and maximum) to process the collected data and, to verify our hypotheses; we employed the double-selection Student T-test, Mann-Whitney U test, and a one-way analysis of variance (One-way ANOVA). Results: Nurses´satisfaction with external rewards is influenced by their age, years of experience, and level of completed education, with all of the abovementioned factors also impacting on the nurses' satisfaction with their work schedule. The type of founding authority of the healthcare institution also constitutes an influence on the nurses' satisfaction concerning relationships in the workplace. Conclusion: The feelling of work dissatisfaction can influence employees in many ways, e.g., it can take the form of burn-out syndrome, absenteeism, or increased fluctuation. Therefore, it is important to pay increased attention to all employees of an organisation, regardless of their position.

Keywords: motivation, nurse, work satisfaction, McCloskey/Mueller satisfaction scale

Procedia PDF Downloads 126
399 Morphosyntactic Abilities in Speakers with Broca’s Aphasia: A Preliminary Examination

Authors: Mile Vuković, Lana Jerkić Rajić

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Introduction: Broca's aphasia is a non-fluent type of aphasic syndrome, which is primarily manifested by impairment of language production. In connected speech, patients with this type of aphasia produce short sentences in which they often omit function words and morphemes or choose inadequate forms. Aim: This research was conducted to examine the morphosyntactic abilities of people with Broca's aphasia, comparing them with neurologically healthy subjects without a language disorder. Method: The sample included 15 patients with Broca's post-stroke aphasia, who had the relatively intact ability of auditory comprehension. The diagnosis of aphasia was based on the Boston Diagnostic Aphasia Examination. The control group comprised 16 neurologically healthy subjects without data on the presence of disorders in speech and language development. The patients' mother tongue was Serbian. The new Serbian Morphosyntactic Abilities Test (SMAT) was used. Descriptive (frequency, percentage, mean, SD, min, max) and inferential (Mann-Whitney U-test) statistics were used in data processing. Results: We noticed statistically significant differences between people with Broca's aphasia and neurotypical subjects on the SMAT (U = 1.500, z = -4.982, p = 0.000). The results showed that people with Broca's aphasia had achieved low scores on the SMAT, regardless of age (ρ = -0.045, p = 0.873) and time post onset (ρ = 0.330, p = 0.229). Conclusion: Preliminary results show that the SMAT has the potential to detect morphosyntactic deficits in Serbian speakers with Broca's aphasia.

Keywords: Broca’s aphasia, morphosyntactic abilities, agrammatism, Serbian language

Procedia PDF Downloads 58
398 Knowledge and Awareness of HIV/AIDS among Male Prisoners in Kuwait

Authors: Saroj Bala Grover, Al Munther Alhasawi, Prem N. Sharma, P. S. N. Menon

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Background: Prisoners are considered one of the high-risk populations for the transmission of human immunodeficiency virus (HIV) infection. Targeting this group is one of the strategies to reduce the incidence of acquired immune deficiency syndrome (AIDS) in the community. Subjects and Methods: A cross-sectional study was conducted among male inmates in Kuwait’s prison by administering three sets of questionnaires to assess the level of their knowledge and awareness about the mode of transmission of HIV/AIDS, their risky personal behavior that may lead to HIV infection, and the presence of any negative attitudes and stigmatization towards HIV infected individuals. Results: The study included 123 male inmates, with a mean ± SD age of 30.9 ± 8.4 years. Most participants had good general knowledge (90%) about the mode of transmission of HIV/AIDS, including sharing contaminated syringes, risky personal behaviors such as having unprotected sex and increased number of extramarital relationships (66%), and the avoidance of the regular use of condoms. The younger age group (< 35 years) had more extramarital relationships than those > 35 years (71.4% Vs. 46.4%; p=0.016). There was a perceived attitude of stigmatization among inmates towards HIV-infected persons. Conclusions: This vulnerable group of prisoners, especially young adults, need educational programs to improve knowledge about the transmission of HIV and to correct and change their risky personal behaviors to protect themselves and the community against HIV transmission.

Keywords: HIV/AIDS, Kuwait, prisoners, knowledge, awareness, personal behavior, extramarital relationships, safe sex, discrimination, stigmatization

Procedia PDF Downloads 69
397 Tracking the Mind's Mouth: Use of Smart Technology for Effective Teaching of Speaking to Pupils with Developmental Co-ordination Disorder

Authors: Sadeq Al Yaari, Muhammad Alkhunayn, Ayah Al Yaari, Ayman Al Yaari, Montaha Al Yaari, Adham Al Yaari, Sajedah Al Yaari, Fatehi Eissa

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Developmental co-ordination disorder (DCD) (also known as dyspraxia) causes a child to speak less well than expected in social conversations. We propose that the smart speaking technology could help improve sound production mechanism at both phonetic and phonological levels, which leads to better articulation of an utterance. The participants are twelve privately beginner pupils aged between 6-12 years old and diagnosed with DCD (apraxia) divided into two groups: Experimental group (n=6) and control group (called apraxic control group) (n=6). A total of fifty typically developing and achieving (TD) pupils participated as control group 2 in both groups and were preassigned into two groups (27 pupils with the treatment group and 23 with the apraxic control group). Weekly quizzes were given to all participants each week for four continuous months and results were analyzed by psychoneurolinguists and a statistician. Although being taught by the same speech-language therapist (SLT), treatment group along with TD groups were taught a full-time speaking course with sociolinguistic themes covering both phonetic and phonological properties. The course lasted for a whole semester whereby smart speaking aids have become dominant while apraxic control group and its TD group were not. Compared with apraxic control group and its TD subgroup, results show obvious changes in speaking behavioral mechanism of the DCD experimental group and its TD subgroup. Improvement could be taken from the scores where the zero marks disappeared in the fourth week (end of the first month of treatment). Good marks (5 +/10) were seen starting from the eighth week and culminating with full marks in the week number 15 of treatment where some participants scored full mark. This study concludes to support the primacy of the smart educational technology for speaking purposes and also shows that such aids can expand the range of academic performance differential categories. Further research is required to evaluate the current demonizing of smart educational aids and weighting more reasonably the relationship specificity that speaking aids can offer to other language skills, as well as their limitations.

Keywords: smart educational technology, speaking aids, pupils with SCD, apraxia

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396 Markers for Predicting Overweight or Obesity of Riding Egyptian Broodmares Mares

Authors: Amal Abo El-Maaty, Amira Mohamed, Nashwa Abu-Aita, Hisham Morgan

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For estimating markers of overweight or obesity of brood mares used for riding and training, 17 mares of different body conditions were subjected to blood sampling and ultrasound examination to measure rump fat thickness and monitor ovulation for six consecutive weeks. Also length (L), heart girth (G) and withers height (H) were measured to estimate body weight (BW), body fat %, body fat mass (BFM) and body mass index (BMI). Mares were classified into three groups according to both body condition score (BCS) and rump back fat (BF). Overweight mares (O) were having BCS > 7 and BF thickness >7mm, moderate body condition (M) mares were having BCS >3and ≤7and BF <3and <7mm, and emaciated mares (E) were having BCS ≤3 and BF ≤3mm. glucose, triglycerides, nitric oxide, ovarian, thyroid, insulin, insulin like growth factor-I (IGF-1), and leptin hormones were measured. Results revealed that BCS, G, L, L*G*H, BW, BF, fat %, BFM were significantly (P<0.0001) decreasing linearly from O to E. T4 concentrations of E were significantly high (P=0.04) compared to M and O but T3 concentrations tended to decrease in E (P>0.05). Insulin and IGF-1 concentrations tended to be high in O (P>0.05) and decrease with the decrease of body condition. M had (P=0.007) the highest leptin, but E mares had the lowest P4 concentrations (P=0.01). Concentrations of glucose and NO decreased with the decrease of BCS and BF but triglycerides of O were insignificantly high. In conclusion, exercise could prevent the development of metabolic syndrome in horses and back fat and morphometric measurements were the easiest and simple assessment of overweight and deviation to obesity.

Keywords: body condition score, insulin, leptin, mares, rump fat

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395 TCTN2 Maintains the Transition Zone Stability and Controls the Entrance of the Ciliary Membrane Protein into Primary Cilia

Authors: Rueyhung Weng, Chia-En Huang, Jung-Chi-Liao

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The transition zone (TZ) serves as a diffusion barrier to regulate the ins and outs of the proteins recruited to the primary cilia. TCTN2 is one of the TZ proteins and its mutation causes Joubert syndrome, a serious multi-organ disease. Despite its important medical relevance, the functions of TCTN2 remain elusive. Here we created a TCTN2 gene deleted retinal pigment epithelial cells (RPE1) using CRISPR/Cas9-based genome editing technique and used this knockout line to reveal roles of TCTN2. TCTN2 knockout RPE1 cells displayed a significantly reduced ciliogenesis or a shortened primary cilium length in the cilium-remaining population. Intraflagellar transport protein IFT88 aberrantly accumulated at the tip of TCTN2 deficient cells. Guanine nucleotide exchange factor Arl13B was mostly absent from the ciliary compartment, with a small population localizing at the ciliary tip. The deficient TZ was corroborated with the mislocalization of two other TZ proteins TMEM67 and MKS1. In addition, TCTN2 deficiency induced TZ impairment led to the suppression of Sonic hedgehog signaling in response to Smoothened (Smo) agonist. Together, depletion of TCTN2 destabilizes other TZ proteins and considerably alters the localization of key transport and signaling-associated proteins, including IFT88, Arl13B, and Smo.

Keywords: CRISPR/Cas9, primary cilia, Sonic hedgehog signaling, transition zone

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394 Transition in Protein Profile, Maillard Reaction Products and Lipid Oxidation of Flavored Ultra High Temperature Treated Milk

Authors: Muhammad Ajmal

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- Thermal processing and subsequent storage of ultra-heat treated (UHT) milk leads to alteration in protein profile, Maillard reaction and lipid oxidation. Concentration of carbohydrates in normal and flavored version of UHT milk is considerably different. Transition in protein profile, Maillard reaction and lipid oxidation in UHT flavored milk was determined for 90 days at ambient conditions and analyzed at 0, 45 and 90 days of storage. Protein profile, hydroxymethyl furfural, furosine, Nε-carboxymethyl-l-lysine, fatty acid profile, free fatty acids, peroxide value and sensory characteristics were determined. After 90 days of storage, fat, protein, total solids contents and pH were significantly less than the initial values determined at 0 day. As compared to protein profile normal UHT milk, more pronounced changes were recorded in different fractions of protein in UHT milk at 45 and 90 days of storage. Tyrosine content of flavored UHT milk at 0, 45 and 90 days of storage were 3.5, 6.9 and 15.2 µg tyrosine/ml. After 45 days of storage, the decline in αs1-casein, αs2-casein, β-casein, κ-casein, β-lactoglobulin, α-lactalbumin, immunoglobulin and bovine serum albumin were 3.35%, 10.5%, 7.89%, 18.8%, 53.6%, 20.1%, 26.9 and 37.5%. After 90 days of storage, the decline in αs1-casein, αs2-casein, β-casein, κ-casein, β-lactoglobulin, α-lactalbumin, immunoglobulin and bovine serum albumin were 11.2%, 34.8%, 14.3%, 33.9%, 56.9%, 24.8%, 36.5% and 43.1%. Hydroxy methyl furfural content of UHT milk at 0, 45 and 90 days of storage were 1.56, 4.18 and 7.61 (µmol/L). Furosine content of flavored UHT milk at 0, 45 and 90 days of storage intervals were 278, 392 and 561 mg/100g protein. Nε-carboxymethyl-l-lysine content of UHT flavored milk at 0, 45 and 90 days of storage were 67, 135 and 343mg/kg protein. After 90 days of storage of flavored UHT milk, the loss of unsaturated fatty acids 45.7% from the initial values. At 0, 45 and 90 days of storage, free fatty acids of flavored UHT milk were 0.08%, 0.11% and 0.16% (p<0.05). Peroxide value of flavored UHT milk at 0, 45 and 90 days of storage was 0.22, 0.65 and 2.88 (MeqO²/kg). Sensory analysis of flavored UHT milk after 90 days indicated that appearance, flavor and mouth feel score significantly decreased from the initial values recorded at 0 day. Findings of this investigation evidenced that in flavored UHT milk more pronounced changes take place in protein profile, Maillard reaction products and lipid oxidation as compared to normal UHT milk.

Keywords: UHT flavored milk , hydroxymethyl furfural, lipid oxidation, sensory properties

Procedia PDF Downloads 193
393 A Method for Clinical Concept Extraction from Medical Text

Authors: Moshe Wasserblat, Jonathan Mamou, Oren Pereg

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Natural Language Processing (NLP) has made a major leap in the last few years, in practical integration into medical solutions; for example, extracting clinical concepts from medical texts such as medical condition, medication, treatment, and symptoms. However, training and deploying those models in real environments still demands a large amount of annotated data and NLP/Machine Learning (ML) expertise, which makes this process costly and time-consuming. We present a practical and efficient method for clinical concept extraction that does not require costly labeled data nor ML expertise. The method includes three steps: Step 1- the user injects a large in-domain text corpus (e.g., PubMed). Then, the system builds a contextual model containing vector representations of concepts in the corpus, in an unsupervised manner (e.g., Phrase2Vec). Step 2- the user provides a seed set of terms representing a specific medical concept (e.g., for the concept of the symptoms, the user may provide: ‘dry mouth,’ ‘itchy skin,’ and ‘blurred vision’). Then, the system matches the seed set against the contextual model and extracts the most semantically similar terms (e.g., additional symptoms). The result is a complete set of terms related to the medical concept. Step 3 –in production, there is a need to extract medical concepts from the unseen medical text. The system extracts key-phrases from the new text, then matches them against the complete set of terms from step 2, and the most semantically similar will be annotated with the same medical concept category. As an example, the seed symptom concepts would result in the following annotation: “The patient complaints on fatigue [symptom], dry skin [symptom], and Weight loss [symptom], which can be an early sign for Diabetes.” Our evaluations show promising results for extracting concepts from medical corpora. The method allows medical analysts to easily and efficiently build taxonomies (in step 2) representing their domain-specific concepts, and automatically annotate a large number of texts (in step 3) for classification/summarization of medical reports.

Keywords: clinical concepts, concept expansion, medical records annotation, medical records summarization

Procedia PDF Downloads 128
392 Speaking Anxiety: Sources, Coping Mechanisms and Teacher Management

Authors: Mylene T. Caytap-Milan

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This study was materialized with the purpose of determining the anxieties of students towards spoken English, sources of the specified anxiety, coping mechanisms to counter the apprehensions, and teacher management to reduce the anxiety within the classroom. Being qualitative in nature, interview as the data gathering tool was utilized with an audio-recorder. Participants of the study included thirteen teachers and students of speech classes in a state university in Region I, Philippines. Data elicited were transcribed in verbatim, confirmed by the participants, coded and categorized, and themed accordingly. A triangulation method was applied to establish the stronger validity of the data. Findings confirmed teachers’ and students’ awareness of the existence of Anxiety in speaking English (ASE). Based on the data gathered from the teachers, the following themes on students’ ASE were identified: (1) No Brain and Mouth Coordination, (2) Center of Attention, and (3) Acting Out Loud. However, the following themes were formulated based on the responses made by the students themselves: (1) The Common Feeling, (2) The Incompetent Me, and (3) The Limelight. With regard the sources of students’ ASE according to teachers are the following: (1) It Began at Home, (2) It Continued in School, (3) It’s not for me at all. On the other hand, the sources of students’ ASE according to students themselves are: (1) It Comes from Within, (2) It wasn’t Nursed Well, and (3) They’re Looking for Errors. In terms of coping with ASE, students identified the following mechanisms, which were themed into: (1) Acceptance, (2) Application, and (3) Apathy. Moreover, to reduce the ASE phenomenon within the classroom, the teachers demonstrate the following roles according to themes: (1) The Compass, (2) The Counselor, (3) The Referee, (4) The Polyglot, and (5) The English Nazi. Based on the findings, the following conclusions were drawn: (1) ASE can both serve positive and negative influences to the English speaking skills of students, (2) ASE can be reduced with teachers’ provision of more English speaking opportunities and with students’ initiative of personal training, (3) ASE can be reduced when English is introduced and practiced by children at an early age, and (4) ASE is inevitable in the affective domain thus teachers are encouraged to apply psychological positivism in the classroom. Studies related to the present undertaking may refer to the succeeding recommendations: (1) experiment on activities that will reduce anxiety ASE, (2) involve a psychologist for more critical but reliable results and recommendations, and (3) conduct the study among high school and primary students.

Keywords: coping mechanisms, sources, speaking anxiety, teacher management

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391 Non Pharmacological Approach to IBS (Irritable Bowel Syndrome)

Authors: A. Aceranti, L. Moretti, S. Vernocchi, M. Colorato, P. Caristia

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Irritable bowel syndrome (IBS) is the association between abdominal pain, abdominal distension and intestinal dysfunction for recurring periods. About 10% of the world's population has IBS at any given time in their life, and about 200 people per 100,000 receive an initial diagnosis of IBS each year. Persistent pain is recognized as one of the most pervasive and challenging problems facing the medical community today. Persistent pain is considered more as a complex pathophysiological, diagnostic and therapeutic situation rather than as a persistent symptom. The low efficiency of conventional drug treatments has led many doctors to become interested in the non-drug alternative treatment of IBS, especially for more severe cases. Patients and providers are often dissatisfied with the available drug remedies and often seek complementary and alternative medicine (CAM), a unique and holistic approach to treatment that is not a typical component of conventional medicine. Osteopathic treatment may be of specific interest in patients with IBS. Osteopathy is a complementary health approach that emphasizes the role of the musculoskeletal system in health and promotes optimal function of the body's tissues using a variety of manual techniques to improve body function. Osteopathy has been defined as a patient-centered health discipline based on the principles of interrelation between body structure and function, the body's innate capacity for self-healing and the adoption of a whole person health approach. mainly by practicing manual processing. Studies reported that osteopathic manual treatment (OMT) reduced IBS symptoms, such as abdominal pain, constipation, diarrhea, and improved general well-being. The focus in the treatment of IBS with osteopathy has gone beyond simple spinal alignment, to directly address the abnormal physiology of the body using a series of direct and indirect techniques. The topic of this study was chosen for different reasons: due to the large number of people involved who suffer from this disorder and for the dysfunction itself, since nowadays there is still little clarity about the best type of treatment and, above all, to its origin. The visceral component in the osteopathic field is still a world to be discovered, although it is related to a large part of patient series, it has contents that affect numerous disciplines and this makes it an enigma yet to be solved. The study originated in the didactic practice where the curiosity of a topic is marked that, even today, no one is able to explain and, above all, cure definitively. The main purpose of this study is to try to create a good basis on the osteopathic discipline for subsequent studies that can be exhaustive in the best possible way, resolving some doubts about which treatment modality can be used with more relevance. The path was decided to structure it in such a way that 3 types of osteopathic treatment are used on 3 groups of people who will be selected after completing a questionnaire, which will deem them suitable for the study. They will, in fact, be divided into three groups where: - the first group was given a visceral osteopathic treatment. - The second group was given a manual osteopathic treatment of neurological stimulation. - The third group received a placebo treatment. At the end of the treatment, questionnaires will be re-proposed respectively one week after the session and one month after the treatment from which any data will be collected that will demonstrate the effectiveness or otherwise of the treatment received. The sample of 50 patients examined underwent an oral interview to evaluate the inclusion and exclusion criteria to participate in the study. Of the 50 patients questioned, 17 people who underwent different osteopathic techniques were eligible for the study. Comparing the data related to the first assessment of tenderness and frequency of symptoms with the data related to the first follow-up shows a significant improvement in the score assigned to the different questions, especially in the neurogenic and visceral groups. We are aware of the fact that it is a study performed on a small sample of patients, and this is a penalizing factor. We remain, however, convinced that having obtained good results in terms of subjective improvement in the quality of life of the subjects, it would be very interesting to re-propose the study on a larger sample and fill the gaps.

Keywords: IBS, osteopathy, colon, intestinal inflammation

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390 The Role of Chemerin and Myostatin after Physical Activity

Authors: M. J. Pourvaghar, M. E. Bahram

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Obesity and overweight is one of the most common metabolic disorders in industrialized countries and in developing countries. One consequence of pathological obesity is cardiovascular disease and metabolic syndrome. Chemerin is an adipocyne that plays a role in the regulation of the adipocyte function and the metabolism of glucose in the liver and musculoskeletal system. Most likely, chemerin is involved in obesity-related disorders such as type 2 diabetes and cardiovascular disease. Aerobic exercises reduce the level of chemerin and cause macrophage penetration into fat cells and inflammatory factors. Several efforts have been made to clarify the cellular and molecular mechanisms of hypertrophy and muscular atrophy. Myostatin, a new member of the TGF-β family, is a transforming growth factor β that its expression negatively regulates the growth of the skeletal muscle; and the increase of this hormone has been observed in conditions of muscular atrophy. While in response to muscle overload, its levels decrease after the atrophy period, TGF-β is the most important cytokine in the development of skeletal muscle. Myostatin plays an important role in muscle control, and animal and human studies show a negative role of myostatin in the growth of skeletal muscle. Separation of myostatin from Golgi begins on the ninth day of the onset period and continues until birth at all times of muscle growth. Higher levels of myostatin are found in obese people. Resistance training for 10 weeks could reduce levels of plasma myostatin.

Keywords: chemerin, myostatin, obesity, physical activity

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389 Human Rights, Ethics, Medical Care and HIV/AIDS in Bangladesh: A Philosophical Investigation

Authors: Asm Habibullah Choudhury

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Background: This study is an investigation into medical care, ethics, and human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) in the context of Bangladesh. The low prevalence of HIV and high prevalence of STDs in Bangladesh, in common with the global experience of HIV epidemics, has been characterized by tremendous stigmatization of those affected. Stigmatization has resulted in an extraordinary degree of unjust discrimination and in numerous human rights violations of PLWHA. Methodology: This will be a cross-sectional descriptive study and will be conducted at different points of Bangladesh. Result: PLWHA will be identified as many as possible and will be interviewed. Medical care providers will be interviewed to assess their attitude and will be observed for stigma while providing medical services. Some of the religious leaders, local influential people will be interviewed to assess their attitude towards PLWHA. Conclusion: If effective responses to HIV/AIDS-related stigma and discrimination are to be promoted in the region, work has to occur simultaneously on several fronts: Legal challenge, where necessary, to bring to account governments, employers, institutions and individuals. To create enabling environment in which PLWHA and their families, women, boys, and girls are able to access prevention and care services. Access to quality and comprehensive care. The fundamental objective, however, is to strive for action based on this understanding—action that will promote egalitarian and gender-progressive role models, and that will help guide the manner in which we interact with one another.

Keywords: HIV, AIDS, Bangladesh, human rights

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388 Promoting Social Advocacy through Digital Storytelling: The Case of Ocean Acidification

Authors: Chun Chen Yea, Wen Huei Chou

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Many chemical changes in the atmosphere and the ocean are invisible to the naked eye, but they have profound impacts. These changes not only confirm the phenomenon of global carbon pollution, but also forewarn that more changes are coming. The carbon dioxide gases emitted from the burning of fossil fuels dissolve into the ocean and chemically react with seawater to form carbonic acid, which increases the acidity of the originally alkaline seawater. This gradual acidification is occurring at an unprecedented rate and will affect the effective formation of carapace of some marine organisms such as corals and crustaceans, which are almost entirely composed of calcium carbonate. The carapace of these organisms will become more dissoluble. Acidified seawater not only threatens the survival of marine life, but also negatively impacts the global ecosystem via the food chain. Faced with the threat of ocean acidification, all humans are duty-bound. The industrial sector outputs the highest level of carbon dioxide emissions in Taiwan, and the petrochemical industry is the major contributor. Ever since the construction of Formosa Plastics Group's No. 6 Naphtha Cracker Plant in Yunlin County, there have been many environmental concerns such as air pollution and carbon dioxide emission. The marine life along the coast of Yunlin is directly affected by ocean acidification arising from the carbon emissions. Societal change demands our willingness to act, which is what social advocacy promotes. This study uses digital storytelling for social advocacy and ocean acidification as the subject of a visual narrative in visualization to demonstrate the subsequent promotion of social advocacy. Storytelling can transform dull knowledge into an engaging narrative of the crisis faced by marine life. Digital dissemination is an effective social-work practice. The visualization promoting awareness on ocean acidification disseminated via social media platforms, such as Facebook and Instagram. Social media enables users to compose their own messages and share information across different platforms, which helps disseminate the core message of social advocacy.

Keywords: digital storytelling, visualization, ocean acidification, social advocacy

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387 Effect of Manual Progressive Ischemic Pressure versus Post Isometric Facilitation in the Treatment of Latent Myofascial Trigger Points in Mechanical Neck Pain

Authors: Mohamed M. Diab, Fahmy E. Mohamed, Alaa Balbaa

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Background: Myofascial pain syndrome a common type of non-articular musculoskeletal pain, is a condition associated with regional pain and muscle tenderness characterized by the presence of hypersensitive nodules. Objectives: the purpose of this study is to compare between the effects of manual progressive ischemic pressure versus the effect of post isometric facilitation in the treatment of Rhomboid latent myofascial trigger points. Methods: six patients had participated in this study. Patients divided into two groups. Group A treated by manual progressive ischemic pressure and traditional physical therapy program. Group B treated by post isometric facilitation and traditional physical therapy program. Treatment program was for 6 sessions over two week’s period. Result: Statistical analysis revealed that there is no significant difference in post treatment from pretreatment in pain severity (VAS) in myofascial trigger points with Rhomboid muscles) and Pain pressure threshold (PPT) for tenderness at both groups (A,B). Conclusion: ischemic pressure technique appear to be no more effective than post isometric facilitation in treatment of rhomboids latent myofacial trigger point.

Keywords: Rhmoiboid trigger point, myofacila trigger point, ischemic pressure, post isometric facilitation

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386 Possible Impact of Shunt Surgeries on the Spatial Learning of Congenitally-Blind Children

Authors: Waleed Jarjoura

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In various cases of visual impairments, the individuals are referred to expert Ophthalmologists in order to establish a correct diagnosis. Children with visual-impairments confront various challenging experiences in life since early childhood throughout lifespan. In some cases, blind infants, especially due to congenital hydrocephalus, suffer from high intra-cranial pressure and, consequently, go through a ventriculo-peritoneal shunt surgery in order to limit the neurological symptoms or decrease the cognitive impairments. In this article, a detailed description of numerous crucial implications of the V/P shunt surgery, through the right posterior-inferior parieto-temporal cortex, on the observed preliminary capabilities that are pre-requisites for the acquisition of literacy skills in braille, basic Math competencies, braille printing which suggest Gerstmann syndrome in the blind. In addition, significant difficultiesorientation and mobility skills using the Cane, in general, organizational skills, and social interactions were observed. The primary conclusion of this report focuses on raising awareness among neuro-surgeons towards the need for alternative intracranial routes for V/P shunt implantation in blind infants that preserve the right posterior-inferior parieto-temporal cortex that is hypothesized to modulate the tactual-spatial cues in braille discrimination. A second conclusion targets educators and therapists that address the acquired dysfunctionsin blind individuals due to V/P shunt surgeries.

Keywords: congenital blindness, hydrocephalus, shunt surgery, spatial orientation

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385 The Impact of Civil Disobedience on Tourist and Local Residents in Cameroon: Case Study the North West Region

Authors: Zita Fomukong Andam

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Civil disobedience according to John Rawls (1971) is a public nonviolent and conscientious breach of laws undertaken with the aim of bringing about a change in government laws and policies. Thus individuals who engage themselves in such an act are aware and ready to accept the consequences of their actions. Cameroon more precisely the Northwest and the Southwest region which are the English part are considered as one of the societies facing this act of civil disobedience. It has been a tormenting issue in the country affecting its economy and the tourism sector. This is because these regions known as one of the best touristic sites of the country is not more considered as a destination to be visited by tourist because of its insecurities. Many commercial buildings have been burning down, leaving many young Cameroonians jobless. Education has been hindered, and youths are forced to relocate to nearby cities in order to continue their education. This crisis has created a lot of insecurity throughout the regions thus youths now have one common interest to travel abroad either to seek refuge or to continue their education and even search for jobs. The purpose of this research is to assess the issue of civil disobedience, trying to understand why it is affected only by a specific region in a country while the others are doing fine. A deep research discourse was conducted with randomly selected individuals aging between 15 to 40 years living both in the destination and abroad. Survey questionnaires and interviews were carried out as a method to collect data. The results show that this crisis has impacted the local residents psychologically and has injected a lot of fears into tourists and they are no more willing to visit the destination. In addition, it has brought a negative impact on the county’s economy since tourism is considered as the key sector in a country’s economy. On the other hand, the results showed that many local residents have remained jobless, others have lost family members, and the daily routine life has been affected. Understanding these results, the national government and international bodies might be able to propose possible and efficient solutions in order to attain stability and security in this region.

Keywords: civil disobedience, economic impact, local residents, tourist

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384 Analyzing the Impact of Migration on HIV and AIDS Incidence Cases in Malaysia

Authors: Ofosuhene O. Apenteng, Noor Azina Ismail

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The human immunodeficiency virus (HIV) that causes acquired immune deficiency syndrome (AIDS) remains a global cause of morbidity and mortality. It has caused panic since its emergence. Relationships between migration and HIV/AIDS have become complex. In the absence of prospectively designed studies, dynamic mathematical models that take into account the migration movement which will give very useful information. We have explored the utility of mathematical models in understanding transmission dynamics of HIV and AIDS and in assessing the magnitude of how migration has impact on the disease. The model was calibrated to HIV and AIDS incidence data from Malaysia Ministry of Health from the period of 1986 to 2011 using Bayesian analysis with combination of Markov chain Monte Carlo method (MCMC) approach to estimate the model parameters. From the estimated parameters, the estimated basic reproduction number was 22.5812. The rate at which the susceptible individual moved to HIV compartment has the highest sensitivity value which is more significant as compared to the remaining parameters. Thus, the disease becomes unstable. This is a big concern and not good indicator from the public health point of view since the aim is to stabilize the epidemic at the disease-free equilibrium. However, these results suggest that the government as a policy maker should make further efforts to curb illegal activities performed by migrants. It is shown that our models reflect considerably the dynamic behavior of the HIV/AIDS epidemic in Malaysia and eventually could be used strategically for other countries.

Keywords: epidemic model, reproduction number, HIV, MCMC, parameter estimation

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383 Relationship of Level of Knowledge on HIV/AIDS and Attitude towards People Living with HIV/AIDS (PLWHA) among Selected Philippine Institution 100 (PI 100) Students of the University of the Philippines Diliman

Authors: John Angelo Labuguen, Sarah Joy Salvio

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Despite the low prevalence rate of Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS) in the Philippines, the country is one of the seven countries in the world and the only country in Southeast Asia which reported an increasing trend in the number of people infected with HIV. Furthermore, people getting infected with HIV are becoming younger every year. Eighty-five percent (7,103) of the total number of youth (15-24 years old) with HIV were recorded in the past five years. The rising rates of HIV infection suggest the need to understand HIV knowledge, attitudes, and sexual behaviors among the youth in the Philippines. The University of the Philippines (UP), having a population that represents all regions of the country, can be reflective of the current situation of the Filipino youth in the issue of HIV/AIDS. This paper attempted to: (1) assess the level of knowledge on HIV/AIDS; (2) describe the attitude towards people living with HIV/AIDS; (3) identify socio-demographic and sexual behaviors associated with the level of HIV/AIDS knowledge; and (4) determine how knowledge on HIV/AIDS is related with attitude towards people living with HIV/AIDS among tertiary students of the UP Diliman. Self-administered survey was used to collect data from 308 randomly selected respondents. Data was encoded using CS Pro 6.2 and it was exported to SPSS v23 for further analysis. Findings of the study revealed that comprehensive correct knowledge on HIV/AIDS is associated with a somewhat accepting attitude towards PLWHA. Sociodemographic and sexual behavior characteristics do not contribute to the association between level of knowledge about HIV/AIDS and attitude towards PLWHA.

Keywords: attitude towards people living with HIV/AIDS, comprehensive HIV/AIDS knowledge, Philippines, university students

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382 White-Rot Hymenomycetes as Oil Palm Log Treatments: Accelerating Biodegradation of Basal Stem Rot-Affected Oil Palm Stumps

Authors: Yuvarani Naidu, Yasmeen Siddiqui, Mohd Yusof Rafii , Abu Seman Idris

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Sustainability of oil palm production in Southeast Asia, especially in Indonesia and Malaysia, is jeopardized by Ganoderma boninense, the fungus which causes basal stem rot (BSR) in oil palm. The root contact with unattended infected debris left in the plantations during replanting is known to be the primary source of inoculum. Abiding by the law, potentially effective technique of managing Ganoderma infected oil palm debris is deemed necessary because of the zero-burning policy in Malaysian oil palm plantations. White-rot hymenomycetes antagonistic to Ganoderma sp were selected to test their efficacy as log treatments in degrading Ganoderma infected oil palm logs and to minimize the survival of Ganoderma inoculum. Decay rate in terms of mass loss was significantly higher after the application of solid-state cultivation (SSC) of Trametes lactinea FBW (64% ±1.2), followed by Pycnoporus sanguineus FBR (55% ±1.7) in infected log block tissues, after 10 months of treatments. The degradation pattern was clearly distinguished between the treated and non-treated log blocks with the developed SSC formulations. The control infected log blocks showed the highest, whereas infected log blocks treated with either P. sanguineus FBR or T. lactinea FBW SSC formulations exhibited statistically lowest number of Ganoderma spp. recovery on Ganoderma Selective Medium (GSM), after 8 months of treatment. Out of that, the lowest recovery of Ganoderma spp. was reported in infected log blocks inoculated with the strain T. lactinea FBW (21% ± 0.9) followed by P. sanguineus FBR (33% ± 2.2), after 8 months, Further, no recovery of Ganoderma was noticeable, 10 months after treatment applications in log blocks treated with both of the formulations. This is the first nursery-base study to substantiate the initial colonization of white-rot hymenomycetes on oil palm log blocks previously infected with BSR pathogen, G. boninense. The present study has indicated that log blocks treatment with white-rot hymenomycetes significantly affected the mass loss of diseased and healthy log block tissues. This study provides a basis of biotechnological approaches inefficient degradation of oil palm-generated crop debris, under natural conditions with an ultimate aim of reducing the Ganoderma inoculum under heavy BSR infection pressure in eco-friendly manner.

Keywords: basal stem rot disease, ganoderma boninense, oil palm, white-rot fungi

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381 Evaluation of Transfusion-Related Acute Lung Injury

Authors: Hossein Barri Ghazani

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Transfusion-related acute lung injury is the main reason of transfusion-related death, and it’s assigned to white blood cell reactive antibodies present in the blood product (anti-HLA class I and class II or anti granulocyte antibodies). TRALI may occur in the COVID-19 patients who are treated by convalescent plasma. The rate of TRALI’s reactions is the same in both males and females and can happen in all age groups. TRALI’s occurrence is higher for people who receive plasma from female donors because the parous female donors have multiple HLA antibodies in their plasma. Patients with chronic liver disease have an augmented risk of transfusion-related acute lung injuries from plasma containing blood products like FFP and PRP. The condition of TRALI suddenly starts with a non‐cardiogenic pulmonary Edema, often accompanied by marked systemic hypovolemic and hypotension. The conditions occur during or within a few hours of transfusion. Chest X-ray shows a nodular penetration or bats’ wing pattern of Edema which can be seen in acute respiratory distress syndrome as well. TRALI can occur with any type of blood products and can occur with as little as one unit. The blood donor center should be informed of the suspected TRALI reactions when the symptoms of TRALI are observed. After a review of the clinical data, the donors must be screened for granulocyte and HLA antibodies. The diagnosis and management of TRALI is not simple and is best done with a professional team and a specialty skilled nurse experienced with the upkeep of these patients.

Keywords: TRALI, transfusion-related death, anti-granulocyte antibodies, anti-HLA antibodies, COVID-19

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380 Peer Support Groups as a Tool to Increase Chances of Passing General Practice UK Qualification Exams

Authors: Thomas Abraham, Garcia de la Vega Felipe, Lubna Nishath, Nzekwe Nduka, Powell Anne-Marie

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Introduction: The purpose of this paper is to discuss the effectiveness of a peer support network created to provide medical education, pastoral support, and reliable resources to registrars to help them pass the MRCGP exams. This paper will include a description of the network and its purpose, discuss how it has been used by trainees since its creation, and explain how this methodology can be applied to other areas of medical education and primary care. Background: The peer support network was created in February 2021, using Facebook, Telegram, and WhatsApp platforms to facilitate discussion of cases and answer queries about the exams, share resources, and offer peer support from qualified GPs and specialists. The network was created and is maintained by the authors of this paper and is open to anyone who is registered with the General Medical Council (GMC) and is studying for the MRCGP exams. Purpose: The purpose of the network is to provide medical education, pastoral support, and reliable resources to registrars to help them pass the exams. The network is free to use and is designed to take the onus away from a single medical educator and collate a vast amount of information from multiple medical educators/trainers; thereby creating a digital library of information for all trainees - exam related or otherwise. Methodology The network is managed by a team of moderators who respond to queries and facilitate discussion. Smaller study groups are created from the main group and provide a platform for trainees to work together, share resources, and provide peer support. The network has had thousands of trainees using it since February 2021, with positive feedback from all trainees. Results: The feedback from trainees has been overwhelmingly positive. Word of mouth has spread rapidly, growing the groups exponentially. Trainees add colleagues to the groups and often stay after they pass their exams to 'give back' to their fellow trainees. To date, thousands of trainees have passed the MRCGP exams using the resources and support provided by the network. Conclusion The success of this peer support network demonstrates the effectiveness of creating a network of thousands of doctors to provide medical education and support.

Keywords: peer support, medical education, pastoral support, MRCGP exams

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379 Effects of Low Sleep Efficiency and Sleep Deprivation on Driver Physical Fatigue

Authors: Chen-Yu Tsai, Wen-Te Liu, Chen-Chen Lo, Kang Lo, Yin-Tzu Lin

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Background: Driving drowsiness related to insufficient or disordered sleep accounts for a major percentage of vehicular accidents. Sleep deprivation is the primary reason related to low sleep efficiency. Nevertheless, the mechanism of sleep deprivation induces driving fatigue to remain unclear. Objective: The objective of this study is to associate the relationship between insufficient sleep efficiency and driving fatigue. Methodologies: The physical condition while driving was obtained from the questionnaires to classify the state of driving fatigue. Sleep efficiency was quantified as the polysomnography (PSG), and the sleep stages were sentenced by the reregistered Technologist during examination in a hospital in New Taipei City (Taiwan). The independent T-test was used to investigate the correlation between sleep efficiency, sleep stages ratio, and driving drowsiness. Results: There were 880 subjects recruited in this study, who had been done polysomnography for evaluating severity for obstructive sleep apnea syndrome (OSAS) as well as completed the driver condition questionnaire. Four-hundred-eighty-four subjects (55%) were classified as fatigue group, and 396 subjects (45%) were served as the control group. The ratio of stage three sleep (N3) (0.032 ± 0.056) in fatigue group were significantly lower than the control group (p < 0.01). The significantly higher value of snoring index (242.14 ± 205.51 /hours) was observed in the fatigue group (p < 0.01). Conclusion: We observe the considerable correlation between deep sleep reduce and driving drowsiness. To avoid drowsy driving, the sleep deprivation, and the snoring events during the sleeping time should be monitored and alleviated.

Keywords: driving drowsiness, sleep deprivation, stage three sleep, snoring index

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378 Role of Surfactant Protein D (SP-D) as a Biomarker of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection

Authors: Lucia Salvioni, Pietro Giorgio Lovaglio, Valerio Leoni, Miriam Colombo, Luisa Fiandra

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The involvement of plasmatic surfactant protein-D (SP-D) in pulmonary diseases has been long investigated, and over the last two years, more interest has been directed to determine its role as a marker of COVID-19. In this direction, several studies aimed to correlate pulmonary surfactant proteins with the clinical manifestations of the virus indicated SP-D as a prognostic biomarker of COVID-19 pneumonia severity. The present work has performed a retrospective study on a relatively large cohort of patients of Hospital Pio XI of Desio (Lombardia, Italy) with the aim to assess differences in the hematic SP-D concentrations among COVID-19 patients and healthy donors and the role of SP-D as a prognostic marker of severity and/or of mortality risk. The obtained results showed a significant difference in the mean of log SP-D levels between COVID-19 patients and healthy donors, so as between dead and survived patients. SP-D values were significantly higher for both hospitalized COVID-19 and dead patients, with threshold values of 150 and 250 ng/mL, respectively. SP-D levels at admission and increasing differences among follow-up and admission values resulted in the strongest significant risk factors of mortality. Therefore, this study demonstrated the role of SP-D as a predictive marker of SARS-CoV-2 infection and its outcome. A significant correlation of SP-D with patient mortality indicated that it is also a prognostic factor in terms of mortality, and its early detection should be considered to design adequate preventive treatments for COVID-19 patients.

Keywords: SARS-CoV-2 infection, COVID-19, surfactant protein-D (SP-D), mortality, biomarker

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377 Reflections of Nocturnal Librarian: Attaining a Work-Life Balance in a Mega-City of Lagos State Nigeria

Authors: Oluwole Durodolu

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The rationale for this study is to explore the adaptive strategy that librarians adopt in performing night shifts in a mega-city like Lagos state. Maslach Burnout Theory would be used to measure the three proportions of burnout in understanding emotional exhaustion, depersonalisation, and individual accomplishment to scrutinise job-related burnout syndrome allied with longstanding, unsolved stress. The qualitative methodology guided by a phenomenological research paradigm, which is an approach that focuses on the commonality of real-life experience in a particular group, would be used, focus group discussion adopted as a method of data collection from library staff who are involved in night-shift. The participant for the focus group discussion would be selected using a convenience sampling technique in which staff at the cataloguing unit would be included in the sample because of the representative characteristics of the unit. This would be done to enable readers to understand phenomena as it is reasonable than from a remote perspective. The exploratory interviews which will be in focus group method to shed light on issues relating to security, housing, transportation, budgeting, energy supply, employee duties, time management, information access, and sustaining professional levels of service and how all these variables affect the productivity of all the 149 library staff and their work-life balance.

Keywords: nightshift, work-life balance, mega-city, academic library, Maslach Burnout Theory, Lagos State, University of Lagos

Procedia PDF Downloads 126
376 The Association Between CYP2C19 Gene Distribution and Medical Cannabis Treatment

Authors: Vichayada Laohapiboolkul

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Introduction: As the legal use of cannabis is being widely accepted throughout the world, medical cannabis has been explored in order to become an alternative cure for patients. Tetrahydrocannabinol (THC) and Cannabidiol (CBD) are natural cannabinoids found in the Cannabis plant which is proved to have positive treatment for various diseases and symptoms such as chronic pain, neuropathic pain, spasticity resulting from multiple sclerosis, reduce cancer-associated pain, autism spectrum disorders (ASD), dementia, cannabis and opioid dependence, psychoses/schizophrenia, general social anxiety, posttraumatic stress disorder, anorexia nervosa, attention-deficit hyperactivity disorder, and Tourette's disorder. Regardless of all the medical benefits, THC, if not metabolized, can lead to mild up to severe adverse drug reactions (ADR). The enzyme CYP2C19 was found to be one of the metabolizers of THC. However, the suballele CYP2C19*2 manifests as a poor metabolizer which could lead to higher levels of THC than usual, possibly leading to various ADRs. Objective: The aim of this study was to investigate the distribution of CYP2C19, specifically CYP2C19*2, genes in Thai patients treated with medical cannabis along with adverse drug reactions. Materials and Methods: Clinical data and EDTA whole blood for DNA extraction and genotyping were collected from patients for this study. CYP2C19*2 (681G>A, rs4244285) genotyping was conducted using the Real-time PCR (ABI, Foster City, CA, USA). Results: There were 42 medical cannabis-induced ADRs cases and 18 medical cannabis tolerance controls who were included in this study. A total of 60 patients were observed where 38 (63.3%) patients were female and 22 (36.7%) were male, with a range of age approximately 19 - 87 years. The most apparent ADRs for medical cannabis treatment were dry mouth/dry throat (76.7%), followed by tachycardia (70%), nausea (30%) and a few arrhythmias (10%). In the total of 27 cases, we found a frequency of 18 CYP2C19*1/*1 alleles (normal metabolizers, 66.7%), 8 CYP2C19*1/*2 alleles (intermediate metabolizers, 29.6%) and 1 CYP2C19*2/*2 alleles (poor metabolizers, 3.7%). Meanwhile, 63.6% of CYP2C19*1/*1, 36.3% and 0% of CYP2C19*1/*2 and *2/*2 in the tolerance controls group, respectively. Conclusions: This is the first study to confirm the distribution of CYP2C19*2 allele and the prevalence of poor metabolizer genes in Thai patients who received medical cannabis for treatment. Thus, CYP2C19 allele might serve as a pharmacogenetics marker for screening before initiating treatment.

Keywords: medical cannabis, adverse drug reactions, CYP2C19, tetrahydrocannabinol, poor metabolizer

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375 Locally Produced Solid Biofuels – Carbon Dioxide Emissions and Competitiveness with Conventional Ways of Individual Space Heating

Authors: Jiri Beranovsky, Jaroslav Knapek, Tomas Kralik, Kamila Vavrova

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The paper deals with the results of research focused on the complex aspects of the use of intentionally grown biomass on agricultural land for the production of solid biofuels as an alternative for individual household heating. . The study primarily deals with the analysis of CO2 emissions of the logistics cycle of biomass for the production of energy pellets. Growing, harvesting, transport and storage are evaluated in the pellet production cycle. The aim is also to take into account the consumption profile during the year in terms of heating of common family houses, which are typical end-market segment for these fuels. It is assumed that in family houses, bio-pellets are able to substitute typical fossil fuels, such as brown coal and old wood burning heating devices and also electric boilers. One of the competing technology with the pellets are heat pumps. The results show the CO2 emissions related with considered fuels and technologies for their utilization. Comparative analysis is aimed biopellets from intentionally grown biomass, brown coal, natural gas and electricity used in electric boilers and heat pumps. Analysis combines CO2 emissions related with individual fuels utilization with costs of these fuels utilization. Cost of biopellets from intentionally grown biomass is derived from the economic models of individual energy crop plantations. At the same time, the restrictions imposed by EU legislation on Ecodesign's fuel and combustion equipment requirements and NOx emissions are discussed. Preliminary results of analyzes show that to achieve the competitiveness of pellets produced from specifically grown biomass, it would be necessary to either significantly ecological tax on coal (from about 0.3 to 3-3.5 EUR/GJ), or to multiply the agricultural subsidy per area. In addition to the Czech Republic, the results are also relevant for other countries, such as Bulgaria and Poland, which also have a high proportion of solid fuels for household heating.

Keywords: CO2 emissions, heating costs, energy crop, pellets, brown coal, heat pumps, economical evaluation

Procedia PDF Downloads 106