Search results for: apnea and hypopnea index

Authors: Ella Abaev, Shany Segal, Miri Gabay

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Background: Choking is a blockage of airways that prevents efficient breathing and air flow to the lungs. Choking may be partial or full and is an emergency situation. Complete or prolonged choking leads to apnea, lack of oxygen in the tissues of the body and brain, and can cause death. There are three mechanisms of choking: obstruction of internal respiratory tracts by food or object aspiration, any material that blocks or covers external air passages, external pressure on the neck or trapping between objects. Children's airways are narrower than that of adults and therefore the risk of choking is greater, due to the aspiration of food and other foreign bodies into the lungs. In the Child Development Center at Safra Children’s Hospital, Tel Hashomer in Israel are treated infants, toddlers, and children aged 0-18 years with various developmental disabilities. Due to the increase in reports of ‘almost an event’ of choking in the past year and the serious consequences of choking event, it was decided to give an emphasis to the issue. Incidence and methods: The number of reports of ‘almost an event’ or a choking event was examined at the center during the years 2013-2018 and a thorough research work was conducted on the subject in order to build a prevention program. Findings: Between 2013 and 2018 the center reported about ten cases of ‘almost choking events’. In the middle of 2018 alone three cases of ‘almost an event’ were reported. Objective: Providing knowledge leads to awareness raise, change of perception, change in behavior and prevention. The center employs more than 130 staff members from various sectors so that it is the work of multi-professional teams to promote the quality and safety of the treatment. The familiarity of the staff with risk factors, prevention guidelines, identification of choking signs, and treatment are most important and significant in determining the outcome of a choking event. Conclusions and recommendations: After in-depth research work was carried out in cooperation with the Risk Management Unit on the subject of choking, which include a description of the definitions, mechanisms, risk factors, treatment methods and extensive recommendations for prevention (e.g. using treatment and stimulation accessories with standards association stamps and adjustment of the type of food and the way it is served to match to the child's age and the ability to swallow). The expected stages of development and emphasis on the population of children with special needs were taken into account. The research findings will be published by the staff and parents of the patients, professional publications, and lectures and there is an expectation to decrease the number of choking events in the next years.

Keywords: children with special needs, choking, educational system, prevention guidelines

Procedia PDF Downloads 179

Authors: M. E. Hammond, R. Pokorny

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Not much research has gone into the dynamics of natural regeneration of trees species in tropical forest regions. This study seeks to investigate the impact of gap sizes and light distribution in forest floors on the regeneration of Celtis mildbraedii (CEM), Nesogordonia papaverine (NES) and Terminalia superba (TES). These are selected economically important tree species with different shade tolerance attributes. The spatial distribution patterns and the potential regeneration competition index (RCI) among species using height to diameter ratio (HDR) have been assessed. Gap sizes ranging between 287 – 971 m² were selected at the Bia Tano forest reserve, a tropical moist semi-deciduous forest in Ghana. Four (4) transects in the cardinal directions were constructed from the center of each gap. Along each transect, ten 1 m² sampling zones at 2 m spacing were established. Then, three gap microsites (labeled ecozones I, II, III) were delineated within these sampling zones based on the varying temporal light distribution on the forest floor. Data on height (H), root collar diameter (RCD) and regeneration census were gathered from each of the ten sampling zones. CEM and NES seedlings (≤ 50 cm) and saplings (≥ 51 cm) were present in all ecozones of the large gaps. Seedlings of TES were observed in all ecozones of large and small gaps. Regression analysis showed a significant negative linear relationship between independent RCD and H growth variables on dependent HDR index in ecozones II and III of both large and small gaps. There was a correlation between RCD and H in both large and small gaps. A strong regeneration competition was observed among species in ecozone II in large (df 2, F=3.6, p=0.035) and small (df 2, F=17.9, p=0.000) gaps. These results contribute to the understanding of the natural regeneration of different species with regards to light regimes in forest floors.

Keywords: Celtis mildbraedii, ecozones, gaps, Nesogordonia papaverifera, regeneration, Terminalia superba

Procedia PDF Downloads 139

Authors: I. Szer, J. Szer, K. Czarnocki, E. Błazik-Borowa

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People on construction scaffoldings work in dynamically changing, often unfavourable climate. Additionally, this kind of work is performed on low stiffness structures at high altitude, which increases the risk of accidents. It is therefore desirable to define the parameters of the work environment that contribute to increasing the construction worker occupational safety level. The aim of this article is to present how changes in microclimate parameters on scaffolding can impact the development of dangerous situations and accidents. For this purpose, indicators based on the human thermal balance were used. However, use of this model under construction conditions is often burdened by significant errors or even impossible to implement due to the lack of precise data. Thus, in the target model, the modified parameter was used – apparent environmental temperature. Apparent temperature in the proposed Scaffold Use Risk Assessment Model has been a perceived outdoor temperature, caused by the combined effects of air temperature, radiative temperature, relative humidity and wind speed (wind chill index, heat index). In the paper, correlations between component factors and apparent temperature for facade scaffolding with a width of 24.5 m and a height of 42.3 m, located at south-west side of building are presented. The distribution of factors on the scaffolding has been used to evaluate fitting of the microclimate model. The results of the studies indicate that observed ranges of apparent temperature on the scaffolds frequently results in a worker’s inability to adapt. This leads to reduced concentration and increased fatigue, adversely affects health, and consequently increases the risk of dangerous situations and accidental injuries

Keywords: apparent temperature, health, safety work, scaffoldings

Procedia PDF Downloads 182

Authors: Amina Smaï, Habiba Idouhar-Saadi, Safia Zenia, Fairouz Haddadj, Salaheddine Doumandji

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The poultry industry (chicken and egg consumption) has become important in Algeria, but that does not prevent other farms from beginning to position themselves on the ground like the turkey, guinea fowl, partridge and quail Japanese. The breeding importance of this last, reside, also in game meat, egg quality and their therapeutic role without forgetting its growth performance. To the same effect, a study was held at the center of Zeralda hunting on various parameters such as the weight and number of eggs laid and this in order to know better the potential of production and reproduction of domestic quail. Egg laying has started from the 8th week of reproductive age, their harvest and their counts are performed daily up to 32 weeks of age and more. We have given the biometrics of incubated eggs and unhatched eggs. The parameters studied were the weight, large and small diameter, density, volume, shell index and the shape index. The work revealed that the maximum weight in males is reached in the 11th week, against the female, he reached the 13th week of age. Indeed, there is a good correlation (R = 0.79) between the weight of females and egg production. The rate of unhatched eggs varies between 11 and 43%, these values are recorded respectively in breeding under the age of 25 and 43 weeks. Furthermore, the biometric parameters of hatched and unhatched eggs have differences that are marked, especially during the beginning and end of lay. Further results will be subsequently exploited. Indeed, rearing Japanese quail is easy in technical terms and does not require big investment but its practical application vigilance and daily presence of the breeder within the farm who oversees the hygiene and well-being of its poultry.

Keywords: Japanese quail, biometrics, eggs, unhatching eggs, reproduction

Procedia PDF Downloads 194

Authors: A. Shirazibeheshti, T. Radwan, A. Ettefaghian, G. Wilson, C. Luca, Farbod Khanizadeh

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Anticholinergic medication has been associated with events such as falls, delirium, and cognitive impairment in older patients. To further assess this, anticholinergic burden scores have been developed to quantify risk. A risk model based on clustering was deployed in a healthcare management system to cluster patients into multiple risk groups according to anticholinergic burden scores of multiple medicines prescribed to patients to facilitate clinical decision-making. To do so, anticholinergic burden scores of drugs were extracted from the literature, which categorizes the risk on a scale of 1 to 3. Given the patients’ prescription data on the healthcare database, a weighted anticholinergic risk score was derived per patient based on the prescription of multiple anticholinergic drugs. This study was conducted on over 300,000 records of patients currently registered with a major regional UK-based healthcare provider. The weighted risk scores were used as inputs to an unsupervised learning algorithm (mean-shift clustering) that groups patients into clusters that represent different levels of anticholinergic risk. To further evaluate the performance of the model, any association between the average risk score within each group and other factors such as socioeconomic status (i.e., Index of Multiple Deprivation) and an index of health and disability were investigated. The clustering identifies a group of 15 patients at the highest risk from multiple anticholinergic medication. Our findings also show that this group of patients is located within more deprived areas of London compared to the population of other risk groups. Furthermore, the prescription of anticholinergic medicines is more skewed to female than male patients, indicating that females are more at risk from this kind of multiple medications. The risk may be monitored and controlled in well artificial intelligence-equipped healthcare management systems.

Keywords: anticholinergic medicines, clustering, deprivation, socioeconomic status

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Authors: Kanika Taneja, V. K. Soni, Kafeel Ahmad, Shamshad Ahmad

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A severe dust storm generated from a western disturbance over north Pakistan and adjoining Afghanistan affected the north-west region of India between May 28 and 31, 2014, resulting in significant reductions in air quality and visibility. The air quality of the affected region degraded drastically. PM10 concentration peaked at a very high value of around 1018 μgm-3 during dust storm hours of May 30, 2014 at New Delhi. The present study depicts aerosol optical properties monitored during the dust days using ground based multi-wavelength Sky radiometer over the National Capital Region of India. High Aerosol Optical Depth (AOD) at 500 nm was observed as 1.356 ± 0.19 at New Delhi while Angstrom exponent (Alpha) dropped to 0.287 on May 30, 2014. The variation in the Single Scattering Albedo (SSA) and real n(λ) and imaginary k(λ) parts of the refractive index indicated that the dust event influences the optical state to be more absorbing. The single scattering albedo, refractive index, volume size distribution and asymmetry parameter (ASY) values suggested that dust aerosols were predominant over the anthropogenic aerosols in the urban environment of New Delhi. The large reduction in the radiative flux at the surface level caused significant cooling at the surface. Direct Aerosol Radiative Forcing (DARF) was calculated using a radiative transfer model during the dust period. A consistent increase in surface cooling was evident, ranging from -31 Wm-2 to -82 Wm-2 and an increase in heating of the atmosphere from 15 Wm-2 to 92 Wm-2 and -2 Wm-2 to 10 Wm-2 at top of the atmosphere.

Keywords: aerosol optical properties, dust storm, radiative transfer model, sky radiometer

Procedia PDF Downloads 377

Authors: Joo-Hack Lee, Jin-Seung Choi, Dong-Won Kang, Jeong-Woo Seo, Ju-Young Kim, Dae-Hyeok Kim, Seung-Tae Yang, Gye-Rae Tack

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For cycling, the analysis of the pedal force is one of the important factors in the study of exercise ability assessment and overuse injuries. In past studies, a two-axis measurement sensor was used at the sagittal plane to measure the force only in the anterior, posterior, and vertical directions and to analyze the loss of force and the injury on the frontal plane due to the forces in the right and left directions. In this study, which is a basic study on diverse analyses of the pedal force that consider the forces on the sagittal plane and the frontal plane, a three-axis pedal force measurement sensor was developed to measure the anterior-posterior (Fx), medio-lateral (Fz), and vertical (Fy) forces. The sensor was fabricated with a size and shape similar to those of the general flat pedal, and had a 550g weight that allowed smooth pedaling. Its measurement range was ±1000 N for Fx and Fz and ±2000 N for Fy, and its non-linearity, hysteresis, and repeatability were approximately 0.5%. The data were sampled at 1000 Hz using a signal collector. To use the developed sensor, the pedaling efficiency (index of efficiency, IE) and the range of left and right (medio-lateral, ML) forces were measured with two seat heights (low and high). The results of the measurement showed that the IE was higher and the force range in the ML direction was lower with the high position than with the low position. The developed measurement sensor and its application results will be useful in understanding and explaining the complicated pedaling technique, and will enable diverse kinematic analyses of the pedal force on the sagittal plane and the frontal plane.

Keywords: cycling, pedal force, index of effectiveness, measuring

Procedia PDF Downloads 661

Authors: Hassan Sbiga

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Laboratory measurements methods were undertaken on core samples selected from three different fields (A, B, and C) from the Nubian Sandstone Formation of the central graben reservoirs in Libya. These measurements were conducted in order to determine the factors which affect resistivity parameters, and to investigate the effect of rock heterogeneity and wettability on these parameters. This included determining the saturation exponent (n) in the laboratory at two stages. The first stage was before wettability measurements were conducted on the samples, and the second stage was after the wettability measurements in order to find any effect on the saturation exponent. Another objective of this work was to quantify experimentally pores and porosity types (macro- and micro-porosity), which have an affect on the electrical properties, by integrating capillary pressure curves with other routine and special core analysis. These experiments were made for the first time to obtain a relation between pore size distribution and saturation exponent n. Changes were observed in the formation resistivity factor and cementation exponent due to ambient conditions and changes of overburden pressure. The cementation exponent also decreased from GHE-5 to GHE-8. Changes were also observed in the saturation exponent (n) and water saturation (Sw) before and after wettability measurement. Samples with an oil-wet tendency have higher irreducible brine saturation and higher Archie saturation exponent values than samples with an uniform water-wet surface. The experimental results indicate that there is a good relation between resistivity and pore type depending on the pore size. When oil begins to penetrate micro-pore systems in measurements of resistivity index versus brine saturation (after wettability measurement), a significant change in slope of the resistivity index relationship occurs.

Keywords: part of thesis, cementation, wettability, resistivity

Procedia PDF Downloads 246

Authors: Roya Yumul, Ofelia Loani Elvir-Lazo, Sevan Komshian, Ruby Wang, Jun Tang

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BACKGROUND: An objective means for monitoring the anti-nociceptive effects of perioperative medications has long been desired as a way to provide anesthesiologists information regarding a patient’s level of antinociception and preclude any untoward autonomic responses and reflexive muscular movements from painful stimuli intraoperatively. To this end, electroencephalogram (EEG) based tools including BIS and qCON were designed to provide information about the depth of sedation while qNOX was produced to inform on the degree of antinociception. The goal of this study was to compare the reliability of qCON/qNOX to BIS as specific indicators of response to nociceptive stimulation. METHODS: Sixty-two patients undergoing general anesthesia with LMA were included in this study. Institutional Review Board (IRB) approval was obtained, and informed consent was acquired prior to patient enrollment. Inclusion criteria included American Society of Anesthesiologists (ASA) class I-III, 18 to 80 years of age, and either gender. Exclusion criteria included the inability to consent. Withdrawal criteria included conversion to the endotracheal tube and EEG malfunction. BIS and qCON/qNOX electrodes were simultaneously placed on all patients prior to induction of anesthesia and were monitored throughout the case, along with other perioperative data, including patient response to noxious stimuli. All intraoperative decisions were made by the primary anesthesiologist without influence from qCON/qNOX. Student’s t-distribution, prediction probability (PK), and ANOVA were used to statistically compare the relative ability to detect nociceptive stimuli for each index. Twenty patients were included for the preliminary analysis. RESULTS: A comparison of overall intraoperative BIS, qCON and qNOX indices demonstrated no significant difference between the three measures (N=62, p> 0.05). Meanwhile, index values for qNOX (62±18) were significantly higher than those for BIS (46±14) and qCON (54±19) immediately preceding patient responses to nociceptive stimulation in a preliminary analysis (N=20, * p= 0.0408). Notably, certain hemodynamic measurements demonstrated a significant increase in response to painful stimuli (MAP increased from 74 ±13 mm Hg at baseline to 84 ± 18 mm Hg during noxious stimuli [p= 0.032] and HR from 76 ± 12 BPM at baseline to 80 ± 13 BPM during noxious stimuli [p=0.078] respectively). CONCLUSION: In this observational study, BIS and qCON/qNOX provided comparable information on patients’ level of sedation throughout the course of an anesthetic. Meanwhile, increases in qNOX values demonstrated a superior correlation to an imminent response to stimulation relative to all other indices

Keywords: antinociception, BIS, general anesthesia, LMA, qCON/qNOX

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Authors: Najlae Bendou, Jean-Jacques Lilti, Khalid Elbadraoui

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In this paper, we examine stock market integration of emerging markets around the global financial turmoil of 2007-2008. Following Pukthuanthong and Roll (2009), we measure the integration of 46 emerging countries using the adjusted R-square from the regression of each country's daily index returns on global factors extracted from the covariance matrix computed using dollar-denominated daily index returns of 17 developed countries. Our sample surrounds the global financial crisis and ranges between 2000 and 2018. We analyze results using four cohorts of emerging countries: East Asia & Pacific and South Asia, Europe & Central Asia, Latin America & Caribbean, Middle East & Africa. We find that the level of integration of emerging countries increases at the commencement of the crisis and during the booming phase of the business cycles. It reaches a maximum point in the middle of the crisis and then tends to revert to its pre-crisis level. This pattern tends to be common among the four geographic zones investigated in this study. Finally, we investigate the determinants of stock market integration of emerging countries in our sample using panel regressions. Our results suggest that the degree of stock market integration of these countries should be put into perspective by some macro-economic factors, such as the size of the equity market, school enrollment rate, international liquidity level, stocks traded volume, tax revenue level, imports and exports volumes.

Keywords: correlations, determinants of integration, diversification, emerging markets, financial crisis, integration, markets co-movement, panel regressions, r-square, stock markets

Procedia PDF Downloads 183

Authors: Emily Wood, James K. Westphal, Itamar Lerner

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Background: Polysomnography (PSG) recordings are regularly used in research and clinical settings to study sleep and sleep-related disorders. Typical PSG studies are conducted in professional laboratories and performed by qualified researchers. However, the number of sleep labs worldwide is disproportionate to the increasing number of individuals with sleep disorders like sleep apnea and insomnia. Consequently, there is a growing need to supply cheaper yet reliable means to measure sleep, preferably autonomously by subjects in their own home. Over the last decade, a variety of devices for self-monitoring of sleep became available in the market; however, very few have been directly validated against PSG to demonstrate their ability to perform reliable automatic sleep scoring. Two popular mobile EEG-based systems that have published validation results, the DREEM 3 headband and the Z-Machine, have never been directly compared one to the other by independent researchers. The current study aimed to compare the performance of DREEM 3 and the Z-Machine to help investigators and clinicians decide which of these devices may be more suitable for their studies. Methods: 26 participants have completed the study for credit or monetary compensation. Exclusion criteria included any history of sleep, neurological or psychiatric disorders. Eligible participants arrived at the lab in the afternoon and received the two devices. They then spent two consecutive nights monitoring their sleep at home. Participants were also asked to keep a sleep log, indicating the time they fell asleep, woke up, and the number of awakenings occurring during the night. Data from both devices, including detailed sleep hypnograms in 30-second epochs (differentiating Wake, combined N1/N2, N3; and Rapid Eye Movement sleep), were extracted and aligned upon retrieval. For analysis, the number of awakenings each night was defined as four or more consecutive wake epochs between sleep onset and termination. Total sleep time (TST) and the number of awakenings were compared to subjects’ sleep logs to measure consistency with the subjective reports. In addition, the sleep scores from each device were compared epoch-by-epoch to calculate the agreement between the two devices using Cohen’s Kappa. All analysis was performed using Matlab 2021b and SPSS 27. Results/Conclusion: Subjects consistently reported longer times spent asleep than the time reported by each device (M= 448 minutes for sleep logs compared to M= 406 and M= 345 minutes for the DREEM and Z-Machine, respectively; both ps<0.05). Linear correlations between the sleep log and each device were higher for the DREEM than the Z-Machine for both TST and the number of awakenings, and, likewise, the mean absolute bias between the sleep logs and each device was higher for the Z-Machine for both TST (p<0.001) and awakenings (p<0.04). There was some indication that these effects were stronger for the second night compared to the first night. Epoch-by-epoch comparisons showed that the main discrepancies between the devices were for detecting N2 and REM sleep, while N3 had a high agreement. Overall, the DREEM headband seems superior for reliably scoring sleep at home.

Keywords: DREEM, EEG, seep monitoring, Z-machine

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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: Kiran Bala Das

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This paper examines the Ukraine wheat export condition after Russian-Ukrainian military confrontation. The political conflict in Ukraine and the recent military intervention of Russia in Crimea is raising concern full effect of the events there is still uncertain, but some hints can be seen in the wheat market by analyzing the trend and pattern of Ukraine wheat export. Crimea is extremely important as it is where most of Ukraine grain exported by ship from its ports of the black sea. Ukraine is again seeking to establish itself a significant exporter of agricultural product with its rich black soil, it is chornozem the top soil layer that makes the country soil so fertile and become one of the major exporter of wheat in the world, its generous supplier of wheat make Ukraine 'Bread basket of Europe'. Ukraine possesses 30% of the world’s richest black soil; its agricultural industry has huge potential especially in grains. European Union (EU) is a significant trading partner of Ukraine but geopolitical tension adversely affects the wheat trade from black sea, which threatens Europe breadbasket. This study also highlights an index of export intensity to analyze the intensity of existing trade for the period 2011-2014 between Ukraine and EU countries. The result show export has intensified over the years, but this year low trade intensity. The overall consequence is hard to determine but if the situation deteriorates and Ukraine cutoff export, international wheat price will hike and grain prices (wheat) also come under the current circumstances and the recent development indicates how the grain market get affected and Agri future now in danger in Ukraine, and its forecast that Ukraine harvest low wheat crop this year and projected decline in export of wheat.

Keywords: breadbasket of Europe, export intensity index, growth rate, wheat export

Procedia PDF Downloads 349

Authors: Septiany Trisnaningtyas

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Purpose: This research aims to examine the factors affecting the profitability of pharmaceutical company during the Covid-19 Pandemic in Indonesia. A sharp decline in the number of patients coming to the hospital for treatment during the pandemic has an impact on the growth of the pharmaceutical sector and brought major changes in financial position and business performance. Pharmaceutical companies that provide products related to the Covid-19 pandemic can survive and continue to grow. This study investigates the factors affecting the profitability of pharmaceutical company during the Covid-19 Pandemic in Indonesia associated with the number of Covid-19 cases. Design/methodology/approach: This study uses panel-data regression models to evaluate the influence of the number of Covid-19 confirmed cases on profitability of ninelisted pharmaceuticalcompanies in Indonesia. This research is based on four independent variables that were empirically examined for their relationship with profitability. These variables are liquidity (current ratio), growth rate (sales growth), firm size (total sales), and market power (the Lerner index). Covid-19 case is used as moderating variable. Data of nine pharmaceutical companies listed on the Indonesia Stock Exchange covering the period of 2018–2021 were extracted from companies’ quarterly annual reports. Findings: In the period during Covid-19, company growth (sales growth) and market power (lerner index) have a positive and significant relationship to ROA and ROE. Total of confirmed Covid-19 cases has a positive and significant relationship to ROA and is proven to have a moderating effect between company’s growth (sales growth) to ROA and ROE and market power (Lerner index) to ROA. Research limitations/implications: Due to data availability, this study only includes data from nine listed pharmaceutical companies in Indonesian Stock exchange and quarterly annual reportscovering the period of 2018-2021. Originality/value: This study focuses onpharmaceutical companies in Indonesia during Covid-19 pandemic. Previous study analyzes the data from pharmaceutical companies’ annual reports since 2014 and focus on universal health coverage (national health insurance) implementation from the Indonesian government. This study analyzes the data using fixed effect panel-data regression models to evaluate the influence of Covid-19 confirmed cases on profitability. Pooled ordinary least squares regression and fixed effects were used to analyze the data in previous study. This study also investigate the moderating effect of Covid-19 confirmed cases to profitability in relevant with the pandemic situation.

Keywords: profitability, indonesia, pharmaceutical, Covid-19

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Authors: Firas Rashad Al-Samarai

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Introduction: Benign prostatic hyperplasia (BPH) is a common condition as men get older. An enlarged prostate gland can cause uncomfortable urinary symptoms, such as blocking the flow of urine out of the bladder. It can also cause bladder, urinary tract, or kidney problems. Objective: to evaluate the efficacy and interaction of tamsulosin with finasteride treatment on induced benign prostate hyperplasia (BPH) in mice. Methods: BPH was induced by subcutaneous injection of testosterone propionate (20 mg/kg) for 30 days. Eighty-five mice were divided into five groups. The first group (G1): twenty-five mice induced BPH treated with tamsulosin orally and divided into five equal subgroups with doses (0.017, 0.052, 0.087, 0. 123, and 0.158) mg/kg, the second group (G2): twenty-five mice induced BPH treated with finasteride orally and divided into five equal subgroups with doses (0.175, 0.527, 0.878, 1.23, and 1.580) mg/kg. the third group (G3): twenty-five mice induced BPH treated with a combination of tamsulosin with finasteride orally, and divided into five equal subgroups with doses (0.0085, 0.0875), (0.026, 0.2635), (0.0435, 0.439) , (0.0615, 0.615) and ( 0.079 , 0.790 ) mg/kg respectively. Fourth group (G4): five mice induced BPH and treated distilled water. Fifth group (G5): five mice were not inducing BPH and without any treatment. Results: The results showed a gradual significant increase in prostate weight % and prostate index % Inhibitions until reached saturation in the last two doses of tamsulosin, finasteride, and combination groups, the maximum effective dose of tamsulosin and finasteride were (0.156) and (1.495) mg/kg respectively. Moreover, the effective dose of the combination (tamsulosin and finasteride) was estimated (0.06876, 0.6876) mg/kg, respectively, as well as the type of interaction was synergism and the value of the combination index was 0.046. Conclusions: We concluded that the combination of tamsulosin with finasteride showed a synergistic effect in BPH treatment by minimizing the side effect of each drug as s result of decreasing the dose of each one.

Keywords: Tamsulosin, Finasteride, combination, BPH

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Authors: M. Y. Abubakar, M. Yunisa, A. N. Muhammad

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Constraining the production Clarias gariepinus and Oreochromis niloticus culture is the prohibitive cost of feed. We assess the performance of the species fingerlings on diets substituted with composite. Four dietary treatments (0%, 25%, 45%, and 75%) for C. gariepinus and five (0%, 25%, 50%, 75%, and whole food composite) for O. niloticus were formulated and each fed to 15 fingerlings for C. gariepinus and 10 fingerlings for O. niloticus stocked in 75ltrs plastic bowls, replicated trice in a completely randomized design. The experiment lasted 56 days. Percent survival rate was significantly (p < 0.05) higher (57.78 ± 9.69) in C. gariepinus fed diet III. The growth and nutrient utilization indices were least in the fish fed diet IV, which was significantly (p < 0.05) lower than in other treatments. Fish fed dietary treatment III, recorded the best in growth and nutrient utilization indices and was significantly higher (p < 0.05) than those fed dietary treatments I & II which were non-significant (p > 0.05) and higher than those fed 75% substitution. Better profit index was in the fish fed diet with 50% substitution level. For O. niloticus, the survival (172.62 ± 39.03) was significantly higher (p < 0.05) in those fed 25% substituted diet. For growth indices, the least performed were those fed whole composite while other treatments were non-significant (p > 0.05) different from each other. In terms of nutrient utilization, fish fed diet substituted at 0%, 25%, 50% and 75% food composite had similar food conversion ratio and protein efficiency ratio. However, there was no significant difference in the profit index among the whole treatment. It can be concluded that food composite from Sokoto house-holds can optimally replace groundnut cake up to 50% level as a protein source in the diets of Clarias gariepinus and O. niloticus fingerlings without adverse effects on survival, growth, and nutrient utilization.

Keywords: food composite, nutrient utilization, C. gariepinus, O. niloticus household, substitution levels

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Authors: Che Hsiu Chen, Su Yun Chen, Hon Wen Cheng

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Greater core stability may benefit sports performance by providing a foundation for greater force production in the upper and lower extremities. Core stability exercises on instability device (such as the TRX suspension systems) were found to be able to induce higher core muscle activity than performing on a stable surface. However, high intensity interval TRX suspension exercises training on sport performances remain unclear. The purpose of this study was to examine whether high intensity TRX suspension training could improve sport performance. Twenty-four healthy university female students (age 19.0 years, height 157.9 cm, body mass 51.3 kg, fat mass 25.2 %) were voluntarily participated in this study. After a familiarization session, each participant underwent five suspension exercises (e.g., hip abduction in plank alternative, hamstring curl, 45-degree row, lunge and oblique crunch). Each type of exercise was performed for 30 seconds, followed by 30 seconds break, two times per week for eight weeks while each exercise session was increased by 10 seconds every week. The results showed that the fat mass (about 12.92%) decreased significantly, sit and reach test (9%), 1 minute sit-up test (17.5%), standing broad jump (4.8%), physical fitness index (10.3%) increased significantly after 8-week high intensity TRX suspension training. Hence, eight weeks of high intensity interval TRX suspension exercises training can improve hamstring flexibility, trunk endurance, jump ability, aerobic fitness and fat mass percentage decreased substantially.

Keywords: core endurance, jump, flexibility, cardiovascular fitness

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Authors: Alireza Nikbakht Shahbazi

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There are various factors that affect climate changes; drought is one of those factors. Investigation of efficient methods for estimating climate change impacts on drought should be assumed. The aim of this paper is to investigate climate change impacts on drought in Karoon3 watershed located south-western Iran in the future periods. The atmospheric general circulation models (GCM) data under Intergovernmental Panel on Climate Change (IPCC) scenarios should be used for this purpose. In this study, watershed drought under climate change impacts will be simulated in future periods (2011 to 2099). Standard precipitation index (SPI) as a drought index was selected and calculated using mean monthly precipitation data in Karoon3 watershed. SPI was calculated in 6, 12 and 24 months periods. Statistical analysis on daily precipitation and minimum and maximum daily temperature was performed. LRAS-WG5 was used to determine the feasibility of future period's meteorological data production. Model calibration and verification was performed for the base year (1980-2007). Meteorological data simulation for future periods under General Circulation Models and climate change IPCC scenarios was performed and then the drought status using SPI under climate change effects analyzed. Results showed that differences between monthly maximum and minimum temperature will decrease under climate change and spring precipitation shall increase while summer and autumn rainfall shall decrease. The precipitation occurs mainly between January and May in future periods and summer or autumn precipitation decline and lead up to short term drought in the study region. Normal and wet SPI category is more frequent in B1 and A2 emissions scenarios than A1B.

Keywords: climate change impact, drought severity, drought frequency, Karoon3 watershed

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Authors: H. E. M. W. G. M. K. Ekanayake, J. Dharmasena

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Natural Landscape fragmentation and habitat loss are emerging issues in Sri Lanka, which is due to rapid urban development and inadequate concern of managing Landscape connectivity. Urban Wetlands are the most vulnerable ecosystem effects from the fragmentation. Therefore, management of landscape connectivity with proper analysis and understanding has become a most important measure for urban wetland habitats. This study aimed to introduce spatial planning strategy to identify and locate landscape developments appropriately in order to restore landscape connectivity. Therefore, the study focuses on understanding the relationship between habitat patch metrics and landscape connectivity with reference to Colombo wetlands. Geographic Information Systems (GIS) was used to measure the wetland patch metrics; Patch area, Total edge, Perimeter-area ratio, Core area index and Inter-patch distances. Further, GIS-enabled least-cost path tool was used to measure the Landscape connectivity and calculate the number of species flow paths per wetland patch. According to the research findings; increasing the patch area, maintaining a mean perimeter-area ratio and core area index also reducing the inter-patch distances could enhance the landscape connectivity. Further, this study introduces three patch typologies; ‘active patches,' ‘open patches’ and ‘closed patches’ that severs to landscape connectivity in different levels. In the end, the study proposes a strategy for Landscape Architects to select most suitable locations to implement ecological based landscape developments with adjacent to the existing urban habitat in order to enhance habitat patch metrics and to restore the landscape connectivity.

Keywords: landscape fragmentation, urban wetlands, landscape connectivity, patch metrics

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Authors: Adewale Oladapo, C. A. Afolami

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The study analyzed the effect of micro credit access on poverty reduction among small scale women entrepreneurs in Ondo state, Nigeria. Primary data were collected in a cross-sectional survey of 100 randomly selected woman entrepreneurs. These were drawn in multistage sampling process covering four local government areas (LGAS). Data collected include socio economics characteristics of respondents, access to micro credit, sources of micro credit, and constraints faced by the entrepreneur in sourcing for micro credit. Data were analyzed using descriptive statistics, Foster, Greer and Thorbecke (FGT) index of poverty measure, Gini coefficients and probit regression analysis. The study found that respondents sampled for the survey were within the age range of 31-40 years with mean age 38.6%. Mostly (56.0%) of the respondents were educated to the tune of primary school. Majority (87.0%) of the respondents were married with fairly large household size of (4-5). The poverty index analysis revealed that most (67%) of the sample respondents were poor. The result of the Probit regression analyzed showed that income was a significant variable in micro credit access, while the result of the Gini coefficient revealed a very high income inequality among the respondents. The study concluded that most of the respondents were poor and return on investment (income) was an important variable that increased the chance of respondents in sourcing for micro-credit loan and recommended that income realized by entrepreneur should be properly documented to facilitate loan accessibility.

Keywords: entrepreneurs, income, micro-credit, poverty

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Authors: Fellah Sihem

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The optimal use of soil moisture by culture, is related to the leaf area index, which stood in the cycle and its modulation according to the prevailing stress intensity. For a given stock of water in the soil, cultivar adapted and saving water is one that is no luxury consumption during the preanthesis. It modulates the leaf area index to regulate sweating in the degree of its water supply. In plants water saving, avoidance of dehydration is related to the reduction of water loss by cuticular and stomatal pathways. Muchow and Sinclair reported that the test of relative water content (TRE) is considered the best indicator of leaf water status. The search for indicators of the ability of the plant to make good use of the water, under water stress is a prerequisite for progress in improving performance under water stress. This experiment aims to characterize a set of durum wheat varieties, tested jars and vegetation under different levels of water stress to the surface of the leaf, relative water content, cell integrity, the accumulated biomass and efficiency of water use. The experiment was conducted during the 2005/2006 academic year, at the Agricultural Research Station of the Field Crop Institute of Setif, under semi-controlled conditions. Five genotypes of durum wheat (Triticum durum Desf) were evaluated for their ability to tolerate moderate and severe water stress. The results showed that geno types respond differently to water stress. Dry matter accumulation and growth rate varied among geno types and were significantly reduced. At severe water stress biomass accumulated by Boussalam was the least affected.

Keywords: water stress, triticum durum, biomass, cell membrane integrity, relative water content

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Authors: Wajih Abbassi, Zouhaier Ben Khelifa

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The present research points towards the empirical validation of three options valuation models, the ad-hoc Black-Scholes model as proposed by Berkowitz (2001), the constant elasticity of variance model of Cox and Ross (1976) and the Kou jump-diffusion model (2002). Our empirical analysis has been conducted on a sample of 26,974 options written on three indexes, the S&P 500, Nasdaq 100 and the Russell 2000 that were negotiated during the year 2007 just before the sub-prime crisis. We start by presenting the theoretical foundations of the models of interest. Then we use the technique of trust-region-reflective algorithm to estimate the structural parameters of these models from cross-section of option prices. The empirical analysis shows the superiority of the Kou jump-diffusion model. This superiority arises from the ability of this model to portray the behavior of market participants and to be closest to the true distribution that characterizes the evolution of these indices. Indeed the double-exponential distribution covers three interesting properties that are: the leptokurtic feature, the memory less property and the psychological aspect of market participants. Numerous empirical studies have shown that markets tend to have both overreaction and under reaction over good and bad news respectively. Despite of these advantages there are not many empirical studies based on this model partly because probability distribution and option valuation formula are rather complicated. This paper is the first to have used the technique of nonlinear curve-fitting through the trust-region-reflective algorithm and cross-section options to estimate the structural parameters of the Kou jump-diffusion model.

Keywords: jump-diffusion process, Kou model, Leptokurtic feature, trust-region-reflective algorithm, US index options

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Authors: T. Nakpun, T. Kanjanarach, T. Kittisopee

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Turnover of community pharmacist can affect continuity of patient care and most importantly the quality of care and also the costs of a pharmacy. It was hypothesized that organizational resources, job characteristics, and social supports had direct effect on pharmacist turnover intention, and indirect effect on pharmacist turnover intention via pharmacist engagement. This research aimed to study influencing factors on pharmacist engagement and pharmacist turnover intention by testing the proposed structural hypothesized model to explain the relationship among organizational resources, job characteristics, and social supports that effect on pharmacist turnover intention and pharmacist engagement in Thai community pharmacists. A cross sectional study design with self-administered questionnaire was conducted in 209 Thai community pharmacists. Data were analyzed using Structural Equation Modeling technique with analysis of a moment structures AMOS program. The final model showed that only organizational resources had significant negative direct effect on pharmacist turnover intention (β =-0.45). Job characteristics and social supports had significant positive relationship with pharmacist engagement (β = 0.44, and 0.55 respectively). Pharmacist engagement had significant negative relationship with pharmacist turnover intention (β = - 0.24). Thus, job characteristics and social supports had significant negative indirect effect on turnover intention via pharmacist engagement (β =-0.11 and -0.13, respectively). The model fit the data well (χ2/ degree of freedom (DF) = 2.12, the goodness of fit index (GFI)=0.89, comparative fit index (CFI) = 0.94 and root mean square error of approximation (RMSEA) = 0.07). This study can be concluded that organizational resources were the most important factor because it had direct effect on pharmacist turnover intention. Job characteristics and social supports were also help decrease pharmacist turnover intention via pharmacist engagement.

Keywords: community pharmacist, influencing factor, turnover intention, work engagement

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Authors: Hasna Mekkaoui Alaoui, Mariem Mekkaoui Alaoui

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In a context marked by a growing and pressing demand for online training within Moroccan universities, massive open online courses (Moocs) are undergoing constant evolution, amplified by the widespread use of digital technology and accentuated by the Coronavirus pandemic. However, despite their growing popularity and expansion, these courses are still lacking in terms of tools, enabling teachers and researchers to carry out a fine-grained analysis of the learning processes taking place within them. What's more, the circulation and sharing of knowledge within these environments is becoming increasingly important. The crucial aspect of traceability emerges here, as MOOCs record and generate traces from the most minute to the most visible. This leads us to consider traceability as a valuable approach in the field of educational research, where the trace is envisaged as a research tool in its own right. In this exploratory research project, we are looking at aspects of community knowledge sharing based on traces observed in the "Communication des organisations" Mooc. Focusing in particular on the mediating trace and its impact in identifying knowledge circulation processes in this learning space, we have mobilized the traces of video capsules as an index of knowledge circulation in the Mooc device. Our study uses a methodological approach based on thematic analysis, and although the results show that learners reproduce knowledge from different video vignettes in almost identical ways, they do not limit themselves to the knowledge provided to them. This research offers concrete perspectives for improving the dynamics of online devices, with a potentially positive impact on the quality of online university teaching.

Keywords: circulation, index, digital environments, mediation., trace

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Authors: Guanghua Lu, Zhenhua Yan

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To investigate the estrogenic contamination and potential risk of Taihu Lake, eight active biomonitoring points in the northern section of Taihu Lake were set up and located in Wangyuhe River outlet (P1), Gonghu Bay (P2 and P3), Meiliang Bay (P4 and P5), Zhushan Bay (P6 and P7) and Lake Centre (P8). A suite of biomarkers in caged fish after in situ exposure for 28 days, coupled with six selected exogenous estrogens in water, were determined in May and December 2011. Six target estrogens, namely estrone (E1), 17b-estradiol (E2), ethinylestradiol (EE2), estriol (E3), diethylstilbestrol (DES) and bisphenol A (BPA), were quantified using UPLC/MS/MS. The concentrations of E1, E2, E3, EE2, DES and BPA ranged from ND to 3.61 ng/L, ND to 17.3 ng/L, ND to 1.65 ng/L, ND to 10.2 ng/L, ND to 34.6 ng/L, and 3.95 to 207 ng/L, respectively. BPA was detected at all sampling points at all test periods, E2 was detected at 95% of samples, E1 and EE2 was detected at 75% of samples, and E3 was detected only in December 2011 with quite low concentrations. Each individual estrogen concentration measured at each sampling point was multiplied by its relative potency to gain the estradiol equivalent (EEQ). The total EEQ values in all the monitoring points ranged from 5.69 to 17.8 ng/L in May 2011, and from 4.46 to 21.1 ng/L in December 2011. E2 and EE2 were thought to be the major causal agents responsible for the estrogenic activities. Serum vitellogenin and E2 levels, gonadal DNA damage, and gonadosomatic index were measured in the in situ exposed fish. An enhanced integrated biomarker response (EIBR) was calculated and used to evaluate potential feminization risk of fish in the polluted area of Taihu Lake. EIBR index showed good agreement with the observed total EEQ levels in water. Our results indicated that Gong bay and the lake center had a low estrogenic risk, whereas Wangyuhe River, Meiliang Bay, and Zhushan Bay might present a higher risk to fish.

Keywords: active biomonitoring, estrogen, feminization risk, Taihu Lake

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Authors: Jin Liang, Q. Li, Yue Qi, Liying Wang, Wenhua Yu, Xun Liu

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Fertility is very important for women. The gender role of women gives them the fertility ability. Giving birth to a boy or a girl might have effect on the mother’s life in the past in China. However, with the shifting of traditional attitudes and views, the women's social status and living situation have been transformed. Although the pregnancy and childbirth can still bring them a major impact on their lives, the form and content of the impact have changed. So we investigated the rural women of Hebei province after birth to reflect their living situation changes before and after birth and the differences of their living situation from women in the past by using a self-made rural women life situation change questionnaire, the index of well-being, and the index of general effect questionnaire. It has shown that women’s living situation after babybirth in Hebei province is well in general, and their mind and body, as well as their interpersonal relationships and social status, were all enhanced. The women’s living situation after babybirth was positively related to and could anticipate subjective happiness, and specifically, the rural women’s mind and body, their interpersonal relationship and social status in rural women life situation change questionnaire are the main predicted factors to subjective happiness. Furthermore, the women’s self-identification on female roles was influenced by the children’s gender. Specifically, women with only one daughter had highest self-identification on female roles, consisting with their families' concept about children’s gender, which indicated family values have a great effect on women’s self-identification on female roles in rural. Moreover, the women’s living situation and subjective happiness are both impacted by home incomes.

Keywords: rural women, parturition, well-being, life quality

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Authors: Juan Huang, Hugo Ninanya

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Oil has been used as a source of energy and supply to make materials, such as asphalt or rubber for many years. This is the reason why new technologies have been implemented through time. However, research still needs to continue increasing due to new challenges engineers face every day, just like unconventional reservoirs. Various numerical methodologies have been applied in petroleum engineering as tools in order to optimize the production of reservoirs before drilling a wellbore, although not all of these have the same efficiency when talking about studying fracture propagation. Analytical methods like those based on linear elastic fractures mechanics fail to give a reasonable prediction when simulating fracture propagation in ductile materials whereas numerical methods based on the cohesive zone method (CZM) allow to represent the elastoplastic behavior in a reservoir based on a constitutive model; therefore, predictions in terms of displacements and pressure will be more reliable. In this work, a hydro-geomechanical coupled model of horizontal wells in fractured rock was developed using ABAQUS; both extended element method and cohesive elements were used to represent predefined fractures in a model (2-D). A power law for representing the rheological behavior of fluid (shear-thinning, power index <1) through fractures and leak-off rate permeating to the matrix was considered. Results have been showed in terms of aperture and length of the fracture, pressure within fracture and fluid loss. It was showed a high infiltration rate to the matrix as power index decreases. A sensitivity analysis is conclusively performed to identify the most influential factor of fluid loss.

Keywords: fracture, hydro-geomechanical model, non-Newtonian fluid, numerical analysis, sensitivity analysis

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Authors: Irina M. Kolesnikova, Andrey M. Gaponov, Sergey A. Roumiantsev, Tatiana V. Grigoryeva, Dilyara R. Khusnutdinova, Dilyara R. Kamaldinova, Alexander V. Shestopalov

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Background. Obese patients have unequal risks of metabolic disorders. It is accepted to distinguish between metabolically healthy obesity (MHO) and metabolically unhealthy obesity (MUHO). MUHO patients have a high risk of metabolic disorders, insulin resistance, and diabetes mellitus. Among the other things, the gut microbiota also contributes to the development of metabolic disorders in obesity. Obesity is accompanied by significant changes in the gut microbial community. In turn, bacterial translocation from the intestine is the basis for the blood microbiome formation. The aim was to study the features of the blood microbiome in patients with various metabolic types of obesity. Patients, materials, methods. The study included 116 healthy donors and 101 obese patients. Depending on the metabolic type of obesity, the obese patients were divided into subgroups with MHO (n=36) and MUHO (n=53). Quantitative and qualitative assessment of the blood microbiome was based on metagenomic analysis. Blood samples were used to isolate DNA and perform sequencing of the variable v3-v4 region of the 16S rRNA gene. Alpha diversity indices (Simpson index, Shannon index, Chao1 index, phylogenetic diversity, the number of observed operational taxonomic units) were calculated. Moreover, we compared taxa (phyla, classes, orders, and families) in terms of isolation frequency and the taxon share in the total bacterial DNA pool between different patient groups. Results. In patients with MHO, the characteristics of the alpha-diversity of the blood microbiome were like those of healthy donors. However, MUHO was associated with an increase in all diversity indices. The main phyla of the blood microbiome were Bacteroidetes, Firmicutes, Proteobacteria, and Actinobacteria. Cyanobacteria, TM7, Thermi, Verrucomicrobia, Chloroflexi, Acidobacteria, Planctomycetes, Gemmatimonadetes, and Tenericutes were found to be less significant phyla of the blood microbiome. Phyla Acidobacteria, TM7, and Verrucomicrobia were more often isolated in blood samples of patients with MUHO compared with healthy donors. Obese patients had a decrease in some taxonomic ranks (Bacilli, Caulobacteraceae, Barnesiellaceae, Rikenellaceae, Williamsiaceae). These changes appear to be related to the increased diversity of the blood microbiome observed in obesity. An increase of Lachnospiraceae, Succinivibrionaceae, Prevotellaceae, and S24-7 was noted for MUHO patients, which, apparently, is explained by a magnification in intestinal permeability. Conclusion. Blood microbiome differs in obese patients and healthy donors at class, order, and family levels. Moreover, the nature of the changes is determined by the metabolic type of obesity. MUHO linked to increased diversity of the blood microbiome. This appears to be due to increased microbial translocation from the intestine and non-intestinal sources.

Keywords: blood microbiome, blood bacterial DNA, obesity, metabolically healthy obesity, metabolically unhealthy obesity

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Authors: Jenan Abu Qadourah

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With the depletion of traditional fossil resources and the growing human population, it is now more important than ever to reduce our energy usage and harmful emissions. In the Mediterranean region, the intense solar radiation contributes to summertime overheating, which raises energy costs and building carbon footprints, alternatively making it suitable for the installation of solar energy systems. In urban settings, where multi-story structures predominate and roof space is limited, photovoltaic integrated shading devices (PVSD) are a clean solution for building designers. However, incorporating photovoltaic (PV) systems into a building's envelope is a complex procedure that, if not executed correctly, might result in the PV system failing. As a result, potential PVSD design solutions must be assessed based on their overall energy performance from the project's early design stage. Therefore, this paper aims to investigate and compare the possible impact of various PVSDs on the energy performance of new apartments in the Mediterranean region, with a focus on Amman, Jordan. To achieve the research aim, computer simulations were performed to assess and compare the energy performance of different PVSD configurations. Furthermore, an energy index was developed by taking into account all energy aspects, including the building's primary energy demand and the PVSD systems' net energy production. According to the findings, the PVSD system can meet 12% to 43% of the apartment building's electricity needs. By highlighting the potential interest in PVSD systems, this study aids the building designer in producing more energy-efficient buildings and encourages building owners to install PV systems on the façade of their buildings.

Keywords: photovoltaic integrated shading device, solar energy, architecture, energy performance, simulation, overall energy index, Jordan

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Authors: Roman Khanferyan, Levon Gevorkyan, Ivan Radysh

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Skin barrier dysfunction induces multiple inflammatory skin diseases. Epidemiological studies clearly support the link between most dermatological pathologies, immune disorders and metabolic disorders. Among them most common are psoriasis (PS) and Atopic dermatitis (AD). Psoriasis is a chronic immune-mediated inflammatory skin disease that affects 1.5 to 3.0% of the world's population. Comorbid metabolic disorders play an important role in the progression of PS and AD, as well. It is well known that PS, AD and overweight/obesity are associated with common pathophysiological mechanisms of mild chronic inflammation. The goal of the study was to study the immune disturbances in patients with PS, AD and comorbid metabolic disorders. To study the prevalence of comorbidity of PS and AD (data from 1406 patient’s histories of diseases) were analyzed. The severity of the disease is assessed using the PASI index (Psoriasis Area and Severity Index). 59 patients with psoriasis of different localizations of lesions and severity, as well as with different body mass index (BMI), were examined. The determination of the concentration of pro-inflammatory cytokines (IL-6, IL-8, IFNγ, IL-17, L-18 and TNFa) and chemokines (RANTES, IP-10, MCP-1 and Eotaxin) in sera and supernatants of 48h-cultivated peripheral blood mononuclear cell (PBMC) of psoriasis patients and healthy volunteers (36 adults) have been carried out by multiplex assay (Luminex Corporation, USA). It has been demonstrated that 42% of PS patients had comorbidity with different types of atopies. The most common was bronchial asthma and allergic rhinitis. At the same time, the prevalence of AD in PS patients was determined in 8.7% of patients. It has been shown that serum levels of all studied cytokines (IL-6, IL-8, IFNγ, IL-17, L-18 and TNF) in most of the studied patients were higher in PS patients than in those with AD and healthy controls (p<0.05). An in vitro synthesis of the IL-6 and IFNγ by PBMC demonstrated similar results to those determined in blood sera. There was a high correlation between BMI, immune mediators and the concentrations of adipokines and chemokines (p<0.05). The concentrations of Leptin and Resistin in obese psoriatic patients were greater by 28.6% and 17%, respectively, compared to non-obese psoriatic patients. In obese patients with psoriasis the serum levels of adiponectin were decreased up to 1.3-fold. The mean serum RANTES, IP-10, MCP-1, EOTAXIN levels in obese psoriatic patients were decreased by up to 13.1%, 21.9%, 40.4% and 28.2%, respectively. Similar results have been demonstrated in AD patients with comorbid overweight and obesity. Thus, the study demonstrated the important role of cytokines and chemokines dysregulation in inflammatory skin diseases, especially in patients with comorbid obesity and overweight. Metabolic disorders promote the severity of PS and AD, highly increase immune dysregulation, and synthesis of adipokines, which correlates with the production of proinflammatory immune mediators in comorbid obesity and overweight.

Keywords: psoriasis, atopic dermatitis, pro-inflammatory cytokines, chemokines, comorbid obesity

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