Search results for: clinical quality and safety

Authors: Christi Jackson, Chuka Onaga

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Introduction: We report a case of delayed diagnosis of extra-pulmonary INH-mono-resistant Tuberculosis (TB) in a South African patient with drug-resistant HIV. Case Presentation: A 36-year old male was initiated on 1st line (NNRTI-based) anti-retroviral therapy (ART) in September 2009 and switched to 2nd line (PI-based) ART in 2011, according to local guidelines. He was following up at the outpatient wellness unit of a public hospital, where he was diagnosed with Protease Inhibitor resistant HIV in March 2016. He had an HIV viral load (HIVVL) of 737000 copies/mL, CD4-count of 10 cells/µL and presented with complaints of productive cough, weight loss, chronic diarrhoea and a septic buttock wound. Several investigations were done on sputum, stool and pus samples but all were negative for TB. The patient was treated with antibiotics and the cough and the buttock wound improved. He was subsequently started on a 3rd-line ART regimen of Darunavir, Ritonavir, Etravirine, Raltegravir, Tenofovir and Emtricitabine in May 2016. He continued losing weight, became too weak to stand unsupported and started complaining of abdominal pain. Further investigations were done in September 2016, including a urine specimen for Line Probe Assay (LPA), which showed M. tuberculosis sensitive to Rifampicin but resistant to INH. A lymph node biopsy also showed histological confirmation of TB. Management and outcome: He was started on Rifabutin, Pyrazinamide and Ethambutol in September 2016, and Etravirine was discontinued. After 6 months on ART and 2 months on TB treatment, his HIVVL had dropped to 286 copies/mL, CD4 improved to 179 cells/µL and he showed clinical improvement. Pharmacy supply of his individualised drugs was unreliable and presented some challenges to continuity of treatment. He successfully completed his treatment in June 2017 while still maintaining virological suppression. Discussion: Several laboratory-related factors delayed the diagnosis of TB, including the unavailability of urine-lipoarabinomannan (LAM) and urine-GeneXpert (GXP) tests at this facility. Once the diagnosis was made, it presented a treatment dilemma due to the expected drug-drug interactions between his 3rd-line ART regimen and his INH-resistant TB regimen, and specialist input was required. Conclusion: TB is more difficult to diagnose in patients with severe immunosuppression, therefore additional tests like urine-LAM and urine-GXP can be helpful in expediting the diagnosis in these cases. Patients with non-standard drug regimens should always be discussed with a specialist in order to avoid potentially harmful drug-drug interactions.

Keywords: drug-resistance, HIV, line probe assay, tuberculosis

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Authors: Patricia N. Baguio, Angel Amy M. Bunag, Paul Bryan E. Ornopia, John Paul C. Suel

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This research investigates the viability and efficiency of employing ceramic tile additives derived from horn snail shell material, specifically calcium carbonate (CaCO₃). The study aims to evaluate the mechanical properties of ceramic tiles with Calcium Carbonate with varying amounts of CaCO₃, focusing on breaking and flexural strength. The research employs a comprehensive methodology, including material collection, slurry forming, shaping, drying, firing, and statistical analysis using paired sample T-tests. The result indicates a positive correlation between calcium carbonate (CaCO₃) application and ceramic tile strength, revealing increased breaking strength from 29.41 N (non-calcium Carbonate) to 46.02 N (70g CaCO3) and a substantial enhancement to 82.61 N with 150g CaCO₃. Comparative analyses show higher breaking and flexural strength in tiles with Calcium Carbonate with 150g CaCO₃ analysis (p = 0.011), indicating its feasibility for ceramic tile manufacturing, while 70g CaCO₃ shows no significant difference from non-calcium Carbonate tiles (p = 0.135). The addition of horn snail shells shows potential for improving ceramic tile quality and contributes positively to waste management in standard tile production processes.

Keywords: Horn snail shell, calcium carbonate, breaking strength, flexural strength

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Authors: Patricia N. Baguio, Angel Amy M. Buñag, Paul Bryan E. Ornopia, John Paul C. Suel

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This research investigates the viability and efficiency of employing ceramic tile additives derived from horn snail shell material, specifically calcium carbonate (CaCO₃). The study aims to evaluate the mechanical properties of ceramic tiles with calcium carbonate with varying amounts of CaCO₃, focusing on breaking and flexural strength. The research employs a comprehensive methodology, including material collection, slurry forming, shaping, drying, firing, and statistical analysis using paired sample T-tests. The result indicates a positive correlation between calcium carbonate (CaCO₃) application and ceramic tile strength, revealing increased breaking strength from 29.41 N (non-calcium carbonate) to 46.02 N (70g CaCO₃) and a substantial enhancement to 82.61 N with 150g CaCO₃. Comparative analyses show higher breaking and flexural strength in tiles calcium carbonate with 150g CaCO₃ analysis (p = 0.011), indicating its feasibility for ceramic tile manufacturing, while 70g CaCO₃ shows no significant difference from non-calcium carbonate tiles (p = 0.135). The addition of horn snail shells shows potential for improving ceramic tile quality and contributes positively to waste management in standard tile production processes.

Keywords: horn snail shell, calcium carbonate, breaking strength, flexural strength

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Authors: Khalid Omari, Rene Chenier, Enrique Blondel, Ryan Ahola

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Northern Canadian coasts have vulnerable and very dynamic intertidal zones with very high tides occurring in several areas. The impact of climate change presents challenges not only for maintaining this biodiversity but also for navigation safety adaptation due to the high sediment mobility in these coastal areas. Thus, frequent mapping of shorelines and intertidal changes is of high importance. To help in quantifying the changes in these fragile ecosystems, remote sensing provides practical monitoring tools at local and regional scales. Traditional methods based on high-resolution optical sensors are often used to map intertidal areas by benefiting of the spectral response contrast of intertidal classes in visible, near and mid-infrared bands. Tidal areas are highly reflective in visible bands mainly because of the presence of fine sand deposits. However, getting a cloud-free optical data that coincide with low tides in intertidal zones in northern regions is very difficult. Alternatively, the all-weather capability and daylight-independence of the microwave remote sensing using synthetic aperture radar (SAR) can offer valuable geophysical parameters with a high frequency revisit over intertidal zones. Multi-polarization SAR parameters have been used successfully in mapping intertidal zones using incoherence target decomposition. Moreover, the crustal displacements caused by ocean tide loading may reach several centimeters that can be detected and quantified across differential interferometric synthetic aperture radar (DInSAR). Soil moisture change has a significant impact on both the coherence and the backscatter. For instance, increases in the backscatter intensity associated with low coherence is an indicator for abrupt surface changes. In this research, we present primary results obtained following our investigation of the potential of the fully polarimetric Radarsat-2 data for mapping an inter-tidal zone located on Tasiujaq on the south-west shore of Ungava Bay, Quebec. Using the repeat pass cycle of Radarsat-2, multiple seasonal fine quad (FQ14W) images are acquired over the site between 2016 and 2018. Only 8 images corresponding to low tide conditions are selected and used to build an interferometric stack of data. The observed displacements along the line of sight generated using HH and VV polarization are compared with the changes noticed using the Freeman Durden polarimetric decomposition and Touzi degree of polarization extrema. Results show the consistency of both approaches in their ability to monitor the changes in intertidal zones.

Keywords: SAR, degree of polarization, DInSAR, Freeman-Durden, polarimetry, Radarsat-2

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Authors: Mohammad Sohail Yunis, Hina Hashim, Alistair R. Anderson

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Entrepreneurship is gendered with masculine qualities, yet social enterprise epitomizes caring a feminine quality. However enterprising practices may have little to do with gender. Consequently, the purpose of this paper is to examine practices using two very different explanatory theories, feminist and institutional theory, to establish the role played by gender. This study is situated in KP, the poor but traditional north of Pakistan. Utilising on an interpretive qualitative research approach, this research collected data through in-depth interviews with ten women social entrepreneurs of KP, Pakistan and analyzed using thematic analysis. Empirically, this paper identifies and describes on a number of interesting themes that relate to the women entrepreneurship such as 'women empowerment, patriarchal culture, role of culture and societal norms, religious extremism and terrorism, forced entrepreneurs, change creators, institutional corruption, and security issues'. In addition, female social enterprise in KP is set in a patriarchal, masculine culture, but the practices negotiate institutional obstacles to bring benefits to the disenfranchised. Finally, this research claims to present an original insight into female social entrepreneurship in a developing country context and provide fresh theoretical and empirical perspectives to advance knowledge and scholarship.

Keywords: female social entrepreneurship, institutional theory, feminist theory, developing countries

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Authors: Shidrokh Goudarzi, Wan Haslina Hassan

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Heterogeneous wireless networks are converging towards an all-IP network as part of the so-called next-generation network. In this paradigm, different access technologies need to be interconnected; thus, vertical handovers or vertical handoffs are necessary for seamless mobility. In this paper, we conduct a review of existing vertical handover decision-making mechanisms that aim to provide ubiquitous connectivity to mobile users. To offer a systematic comparison, we categorize these vertical handover measurement and decision structures based on their respective methodology and parameters. Subsequently, we analyze several vertical handover approaches in the literature and compare them according to their advantages and weaknesses. The paper compares the algorithms based on the network selection methods, complexity of the technologies used and efficiency in order to introduce our vertical handover decision framework. We find that vertical handovers on heterogeneous wireless networks suffer from the lack of a standard and efficient method to satisfy both user and network quality of service requirements at different levels including architectural, decision-making and protocols. Also, the consolidation of network terminal, cross-layer information, multi packet casting and intelligent network selection algorithm appears to be an optimum solution for achieving seamless service continuity in order to facilitate seamless connectivity.

Keywords: heterogeneous wireless networks, vertical handovers, vertical handover metric, decision-making algorithms

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Authors: Pedro Batista, André Vinha, Filipe Castelo, Bárbara Costa, Ricardo Sousa, Raquel Ricardo, André Pinto

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Background: Septic arthritis is a diagnosis that must be considered in any patient presenting with acute joint swelling and fever. Among the several risk factors for septic arthritis, such as age, rheumatoid arthritis, recent surgery, or skin infection, diabetes mellitus can sometimes be the main risk factor. Staphylococcus aureus is the most common pathogen isolated in septic arthritis; however, it is uncommon in monomicrobial necrotizing fasciitis. Objectives: A case report of concomitant septic arthritis and necrotizing fasciitis in a patient with undiagnosed diabetes based on clinical history. Study Design & Methods: We report a case of a 58-year-old Portuguese previously healthy man who presented to the emergency department with fever and left knee swelling and pain for two days. The blood work revealed ketonemia of 6.7 mmol/L and glycemia of 496 mg/dL. The vital signs were significant for a temperature of 38.5 ºC and 123 bpm of heart rate. The left knee had edema and inflammatory signs. Computed tomography of the left knee showed diffuse edema of the subcutaneous cellular tissue and soft tissue air bubbles. A diagnosis of septic arthritis and necrotising fasciitis was made. He was taken to the operating room for surgical debridement. The samples collected intraoperatively were sent for microbiological analysis, revealing infection by multi-sensitive Staphylococcus aureus. Given this result, the empiric flucloxacillin (500 mg IV) and clindamycin (1000 mg IV) were maintained for 3 weeks. On the seventh day of hospitalization, there was a significant improvement in subcutaneous and musculoskeletal tissues. After two weeks of hospitalization, there was no purulent content and partial closure of the wounds was possible. After 3 weeks, he was switched to oral antibiotics (flucloxacillin 500 mg). A week later, a urinary infection by Pseudomonas aeruginosa was diagnosed and ciprofloxacin 500 mg was administered for 7 days without complications. After 30 days of hospital admission, the patient was discharged home and recovered. Results: The final diagnosis of concomitant septic arthritis and necrotizing fasciitis was made based on the imaging findings, surgical exploration and microbiological tests results. Conclusions: Early antibiotic administration and surgical debridement are key in the management of septic arthritis and necrotizing fasciitis. Furthermore, risk factors control (euglycemic blood glucose levels) must always be taken into account given the crucial role in the patient's recovery.

Keywords: septic arthritis, Necrotizing fasciitis, diabetes, Staphylococcus Aureus

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Authors: Ali Fuad Ashour

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Introduction: Contrary to the common belief that physical training for multiple sclerosis (MS) patients might exacerbate fatigue and provoke other symptoms of the illness, it is now widely accepted that exercise can be actually beneficial in terms of activities of daily living, reduced fatigue, and improved quality of life. The aim of this study was to assess the attitude of MS patients toward exercise. Methodology: 112 MS patients who were recruited from the local community participated in this study. We utilised a self-developed questionnaire targeting attitudes and perceptions of MS patients towards physical exercise. The questionnaire was piloted and tested for validity and reliability. Results: Before being diagnosed with MS, 49.9% of our MS patients’ respondents used to engage in different types of physical activities and sports, namely aerobics/walking (35.3%), stretching exercise (18.7%), and strengthening exercise (11.4%). After being diagnosed with MS, 40.8% of our sample showed determination to remain physically active. The interest in sports activities was consistent after the diagnoses with MS and included aerobics/walking (33.8%), stretching exercise (22.6%), and strengthening exercise (19.7%). Discussion: The Kuwaiti respondents thought that lack of encouragement was the main reason for them not exercise. Aptly put, if they try to exercise, they will be discouraged by the loved ones lest the worse happens. On the other side, British patients are generally aware of the benefits of physical and mental health-promoting activities; they can seek help from a wide range of professionals and are more actively involved in the management of their condition. It is therefore important that the benefits of physical activity are promoted among MS patients, and that attitude towards MS and MS patients is changed through education.

Keywords: perception, multiple sclerosis, exercise, physical training

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Authors: Karla Hrbackova, Irena Balaban Cakirpaloglu

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This paper is a report on self-regulation in socially rejected pupils. A certain form of social rejection can be found in almost every class within the school environment. Research shows that due to social rejection mechanisms supporting the individual´s effort of reintegration into the group are not triggered. Paradoxically the opposite tendency arises, i.e., an increase in selfish and defeating behaviour. The link between peer exposure and self-regulation is likely to vary as a function of a type and quality of peer interaction (e.g., rejection or acceptance). The paper aims to clarify the level of self-regulation related to interpersonal cognitive problem-solving within the process of social rejection in a school class. The research was done on a sample of 1,133 upper-primary school pupils using the Means-Ends Problem Solving technique (MEPS) and peer sociometric nomination. The results showed that the level of self-regulated skills is related to the status of social rejection. Socially rejected pupils achieve lower levels of self-regulation than other classmates. We found deficiency in the regulation of behaviour, emotions and the regulation of will in the peer rejected pupils with the exception of cognitive regulation in which no differences were detected between socially rejected pupils and other classmates. The results have implications for early prevention and intervention efforts to foster adaptive self-regulation and reduce the risk of later social rejection.

Keywords: interpersonal cognitive problem-solving, self-regulation, socially rejected pupils, upper-primary school pupils

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Authors: Ankur Dixit, Hiroaki Wagatsuma

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The crack detection on a concrete bridge is an important and constant task in civil engineering. Chronically, humans are checking the bridge for inspection of cracks to maintain the quality and reliability of bridge. But this process is very long and costly. To overcome such limitations, we have used a drone with a digital camera, which took some images of bridge deck and these images are processed by morphological component analysis (MCA). MCA technique is a very strong application of sparse coding and it explores the possibility of separation of images. In this paper, MCA has been used to decompose the image into coarse and fine components with the effectiveness of two dictionaries namely anisotropic diffusion and wavelet transform. An anisotropic diffusion is an adaptive smoothing process used to adjust diffusion coefficient by finding gray level and gradient as features. These cracks in image are enhanced by subtracting the diffused coarse image into the original image and the results are treated by Sobel edge detector and binary filtering to exhibit the cracks in a fine way. Our results demonstrated that proposed MCA framework using anisotropic diffusion followed by Sobel operator and binary filtering may contribute to an automation of crack detection even in open field sever conditions such as bridge decks.

Keywords: anisotropic diffusion, coarse component, fine component, MCA, Sobel edge detector and wavelet transform

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Authors: Maxim Kravchenko

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The paper looks into the structure and contents of the concept of empire in the social consciousness of modern Americans. To construct the model of this socially and politically relevant concept we have conducted an experiment with respondents born and living in the USA. Empire is seen as a historic notion describing such entities as the British empire, the Russian empire, the Ottoman empire and others. It seems that the democratic regime adopted by most countries worldwide is incompatible with imperial status of a country. Yet there are countries which tend to dominate in the contemporary world and though they are not routinely referred to as empires, in many respects they are reminiscent of historical empires. Thus, the central hypothesis of the study is that the concept of empire is cultivated in some states through the intermediary of the mass media though it undergoes a certain transformation to meet the expectations of a democratic society. The transformation implies that certain components which were historically embedded in its structure are drawn to the margins of the hierarchical structure of the concept whereas other components tend to become central to the concept. This process can be referred to as restructuration of the concept of empire. To verify this hypothesis we have conducted a study which falls into two stages. First we looked into the definition of empire featured in dictionaries, the dominant conceptual components of empire are: importance, territory/lands, recognition, independence, authority/power, supreme/absolute. However, the analysis of 100 articles from American newspapers chosen at random revealed that authors rarely use the word «empire» in its basic meaning (7%). More often «empire» is used when speaking about countries, which no longer exist or when speaking about some corporations (like Apple or Google). At the second stage of the study we conducted an associative experiment with the citizens of the USA aged 19 to 45. The purpose of the experiment was to find out the dominant components of the concept of empire and to construct the model of the transformed concept. The experiment stipulated that respondents should give the first association, which crosses their mind, on reading such stimulus phrases as “strong military”, “strong economy” and others. The list of stimuli features various words and phrases associated with empire including the words representing the dominant components of the concept of empire. Then the associations provided by the respondents were classified into thematic clusters. For instance, the associations to the stimulus “strong military” were compartmentalized into three groups: 1) a country with strong military forces (North Korea, the USA, Russia, China); 2) negative impression of strong military (war, anarchy, conflict); 3) positive impression of strong military (peace, safety, responsibility). The experiment findings suggest that the concept of empire is currently undergoing a transformation which brings about a number of changes. Among them predominance of positively assessed components of the concept; emergence of two poles in the structure of the concept, that is “hero” vs. “enemy”; marginalization of any negatively assessed components.

Keywords: associative experiment, conceptual components, empire, restructurasation of the concept

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Authors: Maria Toader, Gheorghe Valentin Roman

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The importance of fruit trees and bushes growing for Romania is due the concordance that exists between the different ecological conditions in natural basins, and the requirements of different species and varieties. There are, in Romania, natural areas dedicated to the main trees species: plum, apple, pear, cherry, sour cherry, finding optimal conditions for harnessing the potential of fruitfulness, making fruit quality both in terms of ratio commercial, and content in active principles. The share of fruits crops in the world economy of agricultural production is due primarily to the role of fruits in nourishment for human, and in the prevention and combating of diseases, in increasing the national income of cultivator countries and to improve comfort for human life. For Romania, the perspectives of the sector are positive, and are due to European funding opportunities, which provide farmers a specialized program that meets the needs of development and modernization of fruit growing industry, cultivation technology and equipment, organization and grouping of producers, creating storage facilities, conditioning, marketing and the joint use of fresh fruit. This paper shows the evolution of fruit growing, in Romania compared to other states. The document presents the current situation of the main tree species both in terms of surface but also of the productions and the role that this activity may have for the development of rural communities.

Keywords: fruit growing, fruits trees, productivity, rural development

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Authors: Isabel Moscol, Carlos J. Díaz, Ciro Rodríguez

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Hip replacement becomes necessary when a person suffers severe pain or considerable functional limitations and the best option to enhance their quality of life is through the replacement of the damaged joint. One of the main components in femoral prostheses is the stem which distributes the loads from the joint to the proximal femur. To preserve more bone stock and avoid weakening of the diaphysis, a short starting stem was selected, generated from the intramedullary morphology of the patient's femur. It ensures the implantability of the design and leads to geometric delimitation for personalized optimization with machine learning (ML) and metaheuristic algorithms. The present study attempts to design a cementless short stem to make the strain deviation before and after implantation close to zero, promoting its fixation and durability. Regression models developed to estimate the percentage change of maximum principal stresses were used as objective optimization functions by the metaheuristic algorithm. The latter evaluated different geometries of the short stem with the modification of certain parameters in oblique sections from the osteotomy plane. The optimized geometry reached a global stress shielding (SS) of 18.37% with a determination factor (R²) of 0.667. The predicted results favour implantability integration in the short stem optimization to effectively reduce SS in the proximal femur.

Keywords: machine learning techniques, metaheuristic algorithms, short-stem design, stress shielding, hip replacement

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Authors: S. Sehar, S. Khan, N. Ali, S. Ahmed

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In the last decade, the hunt for cost-effective, eco-friendly and energy sustainable technologies for waste water treatment are gaining much attention due to emerging water crisis and rapidly depleting existing water reservoirs all over the world. In this scenario, constructed wetland being a “green technology” could be a reliable mean for waste water treatment especially in small communities due to cost-effectiveness, ease in management, less energy consumption and sludge production. Therefore, a low cost, lab-scale sub-surface flow hybrid constructed wetland (SS-HCW) was established for domestic waste water treatment.It was observed that not only the presence but also choice of suitable vegetation along with hydraulic retention time (HRT) are key intervening ingredients which directly influence pollutant removals in constructed wetlands. Another important aspect of vegetation is that it may facilitate microbial attachment in rhizosphere, thus promote biofilm formation via microbial interactions. The major factors that influence initial aggregation and subsequent biofilm formation i.e. divalent cations (Ca2+) and extra cellular DNA (eDNA) were also studied in detail. The presence of Ca2+ in constructed wetland demonstrate superior performances in terms of effluent quality, i.e BOD5, COD, TDS, TSS, and PO4- than in absence of Ca2+. Finally, light and scanning electron microscopies coupled with EDS were carried out to get more insights into the mechanics of biofilm formation with or without Ca addition. Therefore, the same strategy can be implemented in other waste water treatment technologies.

Keywords: hybrid constructed wetland, biofilm formation, waste water treatment, waste water

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Authors: Nasir Sulman

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In Pakistan, the inclusion of persons with disabilities in higher education institutions has significantly been increased with every passing year and anyone can observe a sizeable number of these students in each faculty. The study executes to conduct a baseline survey for measuring faculty understanding about the special needs, experiences of students with disabilities and support provided by university administration in order to teach these students effectively. The researcher has used mixed methods and the University of Karachi was selected through non-probability-based sampling method. This university is one of the largest universities in Pakistan where more than 40,000 students have been enrolled. Data was gathered through a questionnaire and focused group discussion from three stakeholders including students with disabilities, faculty members and members of the university administration. The key findings show that students with disabilities experience a number of problems related to accommodating their special needs. However, the most encouraging factors identified are the attitude, support, and motivation they received from various faculty members and university administration. On the basis of the findings of the study the researcher has prepared a faculty guidebook and established a ‘Model Learning Assistance Centre for Students with Disabilities’ in the Department of Special Education, University of Karachi. Both these efforts will be helpful for improving the support services for students with disabilities to strengthen the existing laws, policies, and practices in institutions of higher education.

Keywords: persons with disabilities, higher education, learning assistance center, faculty guidebook

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Authors: Mohd Kamil Vakil

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Air Pollution is caused by the introduction of chemicals in the biosphere. Primary pollutants on reaction with the components of the earth produce Secondary Pollutants like Smog. Ozone is the main ingredient of Smog. The ground level ozone is created by the chemical reactions between Nitrogen Oxides (NOx) and Volatile Organic Compounds (VOCs) in the presence of Sunlight. This ozone can enter inside and call as indoor ozone. The automobile emissions in both moving and idling conditions contribute to the indoor ozone formation. During engine ignition and shutdown, motor vehicles emit the ozone forming pollutants like NOx and VOCs, and the phenomena are called Cold Start and Hot-Soak respectively. Subjects like Chronic Obstructive Pulmonary Disease (COPD) and asthma associated with chronic respiratory diseases are susceptible to the harmful effects of Indoor Ozone. The most common cause of COPD other than smoking is the long-term contract with harmful pollutants like ground-level ozone. It is estimated by WHO that COPD will become the third leading cause of all deaths worldwide by 2030. In this paper, the cold-start and hot-soak vehicle emissions are studied in the context of accumulation of oxides of nitrogen at the outer walls of the building which may cause COPD. The titanium oxide coated building material is further discussed as an absorber of NOx when applied to the walls and roof.

Keywords: indoor air quality, cold start emission, hot-soak, ozone

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Authors: Jo Parsons, Cath Grimley, Debra Bick, Sarah Hillman, Louise Clarke, Helen Atherton

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The problem: Vaccinations are routinely offered to pregnant women in the UK for influenza (flu), pertussis (whooping cough), and COVID-19, yet the uptake of these vaccinations in pregnancy remains low. Pregnant women are at increased risk of hospitalisation, morbidity, and mortality from these preventable illnesses, which can also expose their unborn babies to an increased risk of serious complications, including in utero death. This research aims to explore how pregnant women feel about vaccinations offered during pregnancy (flu, whooping cough, and COVID-19), particularly following the COVID-19 pandemic. It also aims to examine factors influencing women’s decisions about vaccinations during pregnancy and how they feel about their health and vulnerabilities to illness arising from the COVID-19 pandemic. The approach: This is a qualitative study involving semi-structured interviews with pregnant women and midwives in the UK. Interviews with pregnant women explored their views since the COVID-19 pandemic about vaccinations offered during pregnancy and whether the pandemic has influenced perceptions of vulnerability to illness in pregnant women. Interviews with midwives explored vaccination discussions they routinely have with pregnant women and identified some of the barriers to vaccination that pregnant women discuss with them. Pregnant women were recruited via participating hospitals and community groups. Midwives were recruited via participating hospitals and midwife-specific social media groups. All interviews were conducted remotely (using telephone or Microsoft Teams) and analysed using thematic analysis. Findings: 43 pregnant women and 16 midwives were recruited and interviewed. The findings presented will focus on data from pregnant women. Pregnant women reported a wide range of views and vaccination behaviour, and identified several factors influencing their decision whether to accept vaccinations or not. These included internal factors (comprised of beliefs about susceptibility to illness, perceptions of immunity, fear, and feelings of responsibility), other influences (including visibility of illness and external influences such as healthcare professional recommendations), vaccination-related factors (comprised of beliefs about effectiveness and safety of vaccinations, availability and accessibility of vaccinations and preferences for alternative forms of protection to vaccination) and COVID-19 specific factors (including COVID-19 vaccinations and COVID-19 specific influences). Implications: Findings identified some of the factors that affect pregnant women’s decisions when deciding to have a vaccination or not and how these decisions have been influenced by COVID-19. Findings highlight areas where healthcare professional advice needs to focus, such as the provision of information about the increased vulnerability to illnesses during pregnancy and consideration of opportunistic vaccination at hospital appointments to maximise uptake of vaccinations during pregnancy. Findings of this study will inform the development of an intervention to increase vaccination uptake amongst pregnant women.

Keywords: vaccination, pregnancy, qualitative, interviews, COVID-19

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Authors: Ling-Ling E., Hong-Chen Liu, Dong-Sheng Wang, Fang Su, Xia Wu, Zhan-Ping Shi, Yan Lv, Jia-Zhu Wang

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Objective: The objective of the present study is to evaluate the capacity of a tissue-engineered bone complex of recombinant human bone morphogenetic protein 2 (rhBMP-2) mediated dental pulp stem cells (DPSCs) and nano-hydroxyapatite/collagen/poly(L-lactide)(nHAC/PLA) to reconstruct critical-size alveolar bone defects in New Zealand rabbit. Methods: Autologous DPSCs were isolated from rabbit dental pulp tissue and expanded ex vivo to enrich DPSCs numbers, and then their attachment and differentiation capability were evaluated when cultured on the culture plate or nHAC/PLA. The alveolar bone defects were treated with nHAC/PLA, nHAC/PLA+rhBMP-2, nHAC/PLA+DPSCs, nHAC/PLA+DPSCs+rhBMP-2, and autogenous bone (AB) obtained from iliac bone or were left untreated as a control. X-ray and a polychrome sequential fluorescent labeling were performed post-operatively and the animals were sacrificed 12 weeks after operation for histological observation and histomorphometric analysis. Results: Our results showed that DPSCs expressed STRO-1 and vementin, and favoured osteogenesis and adipogenesis in conditioned media. DPSCs attached and spread well, and retained their osteogenic phenotypes on nHAC/PLA. The rhBMP-2 could significantly increase protein content, alkaline phosphatase (ALP) activity/protein, osteocalcin (OCN) content, and mineral formation of DPSCs cultured on nHAC/PLA. The X-ray graph, the fluorescent, histological observation and histomorphometric analysis showed that the nHAC/PLA+DPSCs+rhBMP-2 tissue-engineered bone complex had an earlier mineralization and more bone formation inside the scaffold than nHAC/PLA, nHAC/PLA+rhBMP-2 and nHAC/PLA+DPSCs, or even autologous bone. Implanted DPSCs contribution to new bone were detected through transfected eGFP genes. Conclutions: Our findings indicated that stem cells existed in adult rabbit dental pulp tissue. The rhBMP-2 promoted osteogenic capability of DPSCs as a potential cell source for periodontal bone regeneration. The nHAC/PLA could serve as a good scaffold for autologous DPSCs seeding, proliferation and differentiation. The tissue-engineered bone complex with nHAC/PLA, rhBMP-2, and autologous DPSCs might be a better alternative to autologous bone for the clinical reconstruction of periodontal bone defects.

Keywords: nano-hydroxyapatite/collagen/poly (L-lactide), dental pulp stem cell, recombinant human bone morphogenetic protein, bone tissue engineering, alveolar bone

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Authors: Minnie Y. Teng, Kathy Xie, Jarus Tal

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Rationale: The traditional approach to community programs for children with mental and/or developmental challenges often involves segregation from typically-developing peers. However, studies show that inclusive education improves children’s quality of life, self-concept, and long term health outcomes. Investigating factors that influence inclusion can thus have important implications in the design and facilitation of community programs such that all children - across a spectrum of needs and abilities - may benefit. Objectives: This study explores barriers and facilitators to inclusive community programming for children aged 0 to 12 with developmental/mental challenges. Methods: Using a participatory-action research methodology, semi-structured focus groups and interviews will be used to explore perspectives of sighted students, instructors, and staff. Data will be transcribed and coded thematically. Practice Implications or Results: By having a deeper understanding of the barriers and facilitators to inclusive programming in the community, researchers can work with the broader community to facilitate inclusion in children’s community programs. Conclusions: Expanding inclusive practices may improve the health and wellbeing of the pediatric populations with disabilities, which consistently reports lower levels of participation. These findings may help to identify gaps in existing practices and ways to approach them.

Keywords: aquatic programs, children, disabilities, inclusion, community programs

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Authors: Madhumita Roy

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Kolkata, the city of joy, is an organic city with 45 lakhs of people till date. The increasing population stress is creating a constant pressure on the ground surface which in turn reducing the possible area for plantation. Humans, plants, and birds have a mutualistic relationship, and all are dependent on each other for their survival. Vegetation structure is very important for a bird life because it can be used as a residence, foraging, life cycle, and shelter from predators. On the other hand, in urban areas, buildings and structures also plays a major role for birds habitat w.r.t, nesting, resting, etc. City birds are constantly upgrading their adaptative mechanism with changing urban pattern with modern architectural designs. Urbanisation and unplanned development lead to environmental degradation and bird habitat fragmentation, which have impacts on the degradation of the quality and quantity of bird habitat. Declining green cover and habitat loss affects the diversity and population structure of birds. Their reducing number is an increasing threat not only to the bird community but also to the city as birds are considered as one of the most important environmental indicator. This study aims to check the present avian status like species richness, relative abundance, and diversity of bird species in the context of changing urban pattern in Kolkata city. Nesting strategy in the urban habitat of the avian community is another avenue of interest.

Keywords: urbanisation, avian species, kolkata metropolis, planning

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Authors: Erika K. Méndez, Carlos E. Orrego, Diana L. Manrique, Juan D. Gonzalez, Doménica Vallejo

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High moisture content in fruits generates post-harvest problems such as mechanical, biochemical, microbial and physical losses. Dehydration, which is based on the reduction of water activity of the fruit, is a common option for overcoming such losses. However, regular hot air drying could affect negatively the quality properties of the fruit due to the long residence time at high temperature. Power ultrasound (US) application during the convective drying has been used as a novel method able to enhance drying rate and, consequently, to decrease drying time. In the present study, a new approach was tested to evaluate the effect of US on the drying time, the final antioxidant activity (AA) and the total polyphenol content (TPC) of banana slices (BS), mango slices (MS) and guava slices (GS). There were also studied the drying kinetics with nine different models from which water effective diffusivities (Deff) (with or without shrinkage corrections) were calculated. Compared with the corresponding control tests, US assisted drying for fruit slices showed reductions in drying time between 16.23 and 30.19%, 11.34 and 32.73%, and 19.25 and 47.51% for the MS, BS and GS respectively. Considering shrinkage effects, Deff calculated values ranged from 1.67*10-10 to 3.18*10-10 m2/s, 3.96*10-10 and 5.57*10-10 m2/s and 4.61*10-10 to 8.16*10-10 m2/s for the BS, MS and GS samples respectively. Reductions of TPC and AA (as DPPH) were observed compared with the original content in fresh fruit data in all kinds of drying assays.

Keywords: banana, drying, effective diffusivity, guava, mango, ultrasound

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Authors: Prapin Nuchpiam

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The importance of social innovation has become increasingly significant as the process of developing effective solutions to social problems and being a force of change for people’s better quality of life. In order to promote social innovation, active collaboration between government, business organizations, and the civil society sector is needed. A proper legal framework also plays an important role in building the social innovation ecosystem. Currently, there is no specific law designed for social innovation or a so-called “social innovation law”. One of the legal frameworks for social innovation is the development of hybrid legal forms for social enterprises such as the UK’s Community Interest Company (CIC), the US’s Low-Profit Limited Liability Company (L3C) and the US’s Benefit Corporation (B-Corp), among others. This is because social enterprise is recognized as an organizational form of social innovation with its aim for social benefit goals and the achievement of financial sustainability. Nonetheless, there has been a debate over the differences and similarities between social innovation and social enterprise. Thus, social enterprise law might not fit well with social innovation, resulting in a search for a legal framework specially designed for social innovation. This paper aims to study the interrelationship between social innovation, social enterprise, and the role of law to see whether we need a specific law for social innovation. If so, what should such a legal framework look like? The paper will provide a critical analysis of innovative legal forms for social enterprise as a type of social innovation law. A proper legal framework for social innovation could help promote the sector, which could result in finding new solutions to social problems. It will also bring about a greater common understanding of the exciting development of legal scholarship in this way, which will, in turn, serve as a productive basis or direction for further research on this increasingly important topic.

Keywords: social innovation, social enterprise, legal framework, regulation

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Authors: Priyanka Bhowmik, Subrata Majumdar, Debprasad Chattopadhyay

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Background: Cervical cancer is the third major cause of cancer in women and the second most frequent cause of cancer related deaths causing 300,000 deaths annually worldwide. Evasion of immune response by Human Papilloma Virus (HPV), the key contributing factor behind cancer and pre-cancerous lesions of the uterine cervix, makes immunotherapy a necessity to treat this disease. Objective: A Heat killed fraction of Mycobacterium indicus pranii (MIP), a non-pathogenic Mycobacterium has been shown to exhibit cytotoxic effects on different cancer cells, including human cervical carcinoma cell line HeLa. However, the underlying mechanisms remain unknown. The aim of this study is to decipher the mechanism of MIP induced HeLa cell death. Methods: The cytotoxicity of Mycobacterium indicus pranii against HeLa cells was evaluated by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. Apoptosis was detected by annexin V and Propidium iodide (PI) staining. The assessment of reactive oxygen species (ROS) generation and cell cycle analysis were measured by flow cytometry. The expression of apoptosis associated genes was analyzed by real time PCR. Result: MIP could inhibit the proliferation of HeLa cell in a time and dose dependent manner but caused minor damage to normal cells. The induction of apoptosis was confirmed by the cell surface presentation of phosphatidyl serine, DNA fragmentation, and mitochondrial damage. MIP caused very early (as early as 30 minutes) transcriptional activation of p53, followed by a higher activation (32 fold) at 24 hours suggesting prime importance of p53 in MIP-induced apoptosis in HeLa cell. The up regulation of p53 dependent pro-apoptotic genes Bax, Bak, PUMA, and Noxa followed a lag phase that was required for the transcriptional p53 program. MIP also caused the transcriptional up regulation of Toll like receptor 2 and 4 after 30 minutes of MIP treatment suggesting recognition of MIP by toll like receptors. Moreover, MIP caused the inhibition of expression of HPV anti apoptotic gene E6, which is known to interfere with p53/PUMA/Bax apoptotic cascade. This inhibition might have played a role in transcriptional up regulation of PUMA and subsequently apoptosis. ROS was generated transiently which was concomitant with the highest transcription activation of p53 suggesting a plausible feedback loop network of p53 and ROS in the apoptosis of HeLa cells. Scavenger of ROS, such as N-acetyl-L-cysteine, decreased apoptosis suggesting ROS is an important effector of MIP induced apoptosis. Conclusion: Taken together, MIP possesses full potential to be a novel therapeutic agent in the clinical treatment of cervical cancer.

Keywords: cancer, mycobacterium, immunity, immunotherapy.

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Authors: Rashmi Shukla, Yamini Bhusan Tripathi

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Diabetic nephropathy (DN) is characterized as diabetic kidney disease which involves many pathways e.g. hyperactivated protein kinase c (PKC), polyol pathway, excess production of advanced glycation end product (AGEs) & free radical accumulation etc. All of them results to hypoxia followed by apoptosis of podocytes, glomerulosclerosis, extracellular matrix (ECM) accumulation and fibrosis resulting to irreversible changes in kidney. This is continuously rising worldwide and there are not enough specific drugs, to retard its progress. Due to increasing side effects of allopathic drugs, interest in herbal remedies is growing. Earlier, we have reported that PTY-2 (a phytomedicine, derived from Pueraria tuberosa Linn.) inhibits the accumulation of extracellular matrix (ECM) through activation of MMP-9. Present study exhibited the therapeutic potential of Pueraria tuberosa in the prevention of podocytes apoptosis and modulation of nephrin expression in streptozotocin (STZ) induced DN rats. DN rats were produced by maintaining persistent hyperglycemia for 8 weeks by intra-peritoneal injection of 55 mg/kg streptozotocin (STZ). These rats were randomly divided in 2 groups, i.e. DN control, and DN+ water extract of Pueraria tuberosa (PTW). One group of age-matched normal rats served as non-diabetic control (group-1), The STZ induced DN rats (group-2) and DN+PTW treated rats (group-3). The PTW was orally administered (0.3g/kg) daily to group-2 rats and drug vector (1 ml of 10% tween 20) in control rats. The treatments were continued for 20 days and blood and urine samples were collected. Rats were then sacrificed to investigate the expression Bcl2, Bax and nephroprotective protein i.e. nephrin in kidney glomerulus. The effect of PTW was evaluated, we have found that the PTW significantly(p < .001) reversed the raised serum urea, serum creatinine, urine protein and improved the creatinine clearance in STZ induce diabetic nephropathy in rats and also significantly(p < .001) prevented the rise in urine albumin excretion. The Western blot analysis of kidney tissue homogenate showed increased expression of Bcl2 in PTW treated rats. The RT-PCR showed the increased expression and accumulation of nephrin mRNA. The confocal photomicrographs also supported the reduction of Bax and a simultaneous increase in Bcl2 and nephrin in glomerular podocytes. Hence, our finding suggests that the nephroprotective role of PTW is mediated via restoration of nephrin thus prevents the podocytes apoptosis and ameliorates diabetic nephropathy. The clinical trial of PTW would prove to be a potential food supplement/ drug of alternative medicine for patients with diabetic nephropathy in early stage.

Keywords: Pueraria tuberosa, diabetic nephropathy, anti-apoptosis, nephrin

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Authors: H. Fraga, J. A. Santos

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Vitiviniculture in Portugal is a key socio-economic sector, with a strong connection to local traditions and culture. Despite being a relatively small country, with prevailing Mediterranean environments, Portugal comprises an exceptionally large diversity of growth conditions (Terroirs). The vineyard area in Portugal is over 190 thousand hectares, being the eleventh wine producer and ninth wine exporter worldwide. Owing to the strong impact of weather and climate conditions on grapevine physiological development, grape berry quantity and quality show important inter-annual variability. Grapevines are also susceptible to climate change, as their responses will be unavoidably different under future climates. These impacts may change wine typicity of a given region or even its viticultural suitability. The current study reveals that the projected warming and drying trends for Portugal under the Representative Concentration Pathway (RCP) 4.5 and 8.5, are projected to 1) significantly shift current grapevine growing thermal conditions (e.g., heat and chill accumulation), 2) enhance water stress, 3) anticipate phenological timings and 4) modify yields. Moreover, the present study provides some hints regarding the effectiveness of mulching and irrigation as climate change adaptation measures. Our results show that the effectiveness of these adaptation measures will strongly rest on the strength of the climate change signal at a local scale, thus emphasizing the need for local-to-regional climate change assessments.

Keywords: viticulture, climate change, adaptation measures, Portugal

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Authors: Rifqi Irvansyah, Abdullah Abdullah, Yunita Idris, Bunga Raihanda

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Banda Aceh is particularly susceptible to heightened vulnerability during natural disasters due to its concentrated exposure to multi-hazard risks. Despite urgent priorities during the aftermath of natural disasters, such as the 2004 Indian Ocean earthquake and tsunami, several public facilities, including school buildings, sustained damage yet continued operations without adequate repairs, even though they were submerged by the tsunami. This research aims to evaluate the consequences of column damage induced by tsunami inundation on the structural integrity of buildings. The investigation employs interaction diagrams for columns to assess their capacity, taking into account factors such as rebar deterioration and corrosion. The analysis result shows that one-fourth of the K1 columns on the first floor fall outside of the column interaction diagram, indicating that the column structure cannot handle the load above it, as evidenced by the presence of Pu and Mu, which are greater than the column's design strength. This suggests that the five columns of K1 should be cause for concern, as the column's capacity is decreasing. These results indicate that the structure of the building cannot sustain the applied load because the column cross-section has deteriorated. In contrast, all K2 columns meet the design strength, indicating that the column structure can withstand the structural loads.

Keywords: tsunami inundation, column damage, column interaction diagram, mitigation effort

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Authors: Gannouni Sonia, Hammami Asma, Saidi Salwa, Rebai Noamen

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Water resources in Tunisia have experienced quantitative and qualitative degradation, especially when talking about wetlands and Sbekhas. Indeed, the objective of this work is to study the spatio-temporal evolution of salinity for 29 years (from 1987 to 2016). A study of the connection between surface water and groundwater is necessary to know the degree of influence of the Sebkha brines on the water table. The evolution of surface salinity is determined by remote sensing based on Landsat TM and OLI/TIRS satellite images of the years 1987, 2007, 2010, and 2016. The processing of these images allowed us to determine the NDVI(Normalized Difference Vegetation Index), the salinity index, and the surface temperature around Sebkha. In addition, through a geographic information system(GIS), we could establish a map of the distribution of salinity in the subsurface of the water table of Chott Mariem and Hergla/SidiBouAli/Kondar. The results of image processing and the calculation of the index and surface temperature show an increase in salinity downstream of in addition to the sebkha and the development of vegetation cover upstream and the western part of the sebkha. This richness may be due both to contamination by seawater infiltration from the barrier beach of Hergla as well as the passage of groundwater to the sebkha.

Keywords: spatio-temporal monitoring, salinity, satellite images, NDVI, sebkha

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Authors: Bijad Alqahtani, Graham Arnold, Weijie Wang

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Background—Tai Chi Chuan (TCC) is a type of traditional Chinese martial art and is considered a benefiting physical fitness. Advanced techniques of motion analysis have been routinely used in the clinical assessment. However, so far, little research has been done on the biomechanical assessment of TCC players in terms of gait and balance using motion analysis. Objectives—The aim of this study was to investigate whether TCC improves the lower limb conditions and balance ability using the state of the art motion analysis technologies, i.e. motion capture system, electromyography and force platform. Methods—Twenty TCC (9 male, 11 female) with age between (42-77) years old and weight (56.2-119 Kg), and eighteen Non-TCC participants (7 male, 11 female), weight (50-110 Kg) with age (43- 78) years old at the matched age as a control group were recruited in this study. Their gait and balance were collected using Vicon Nexus® to obtain the gait parameters, and kinematic parameters of hip, knee, and ankle joints in three planes of both limbs. Participants stood on force platforms to perform a single leg balance test. Then, they were asked to walk along a 10 m walkway at their comfortable speed. Participants performed 5 trials of single-leg balance for the dominant side. Also, the participants performed 3 trials of four square step balance and 10 trials of walking. From the recorded trials, three good ones were analyzed using the Vicon Plug-in-Gait model to obtain gait parameters, e.g. walking speed, cadence, stride length, and joint parameters, e.g. joint angle, force, moments, etc. Result— The temporal-spatial variables of TCC subjects were compared with the Non-TCC subjects, it was found that there was a significant difference (p < 0.05) between the groups. Moreover, it was observed that participants of TCC have significant differences in ankle, hip, and knee joints’ kinematics in the sagittal, coronal, and transverse planes such as ankle angle (19.90±19.54 deg) for TCC while (15.34±6.50 deg) for Non-TCC, and knee angle (14.96±6.40 deg) for TCC while (17.63±5.79 deg) for Non-TCC in the transverse plane. Also, the result showed that there was a significant difference between groups in the single-leg balance test, e.g. maintaining single leg stance time in the TCC participants showed longer duration (20.85±10.53 s) in compared to Non-TCC people group (13.39±8.78 s). While the result showed that there was no significant difference between groups in the four square step balance. Conclusion—Our result showed that there are significant differences between Tai Chi Chuan and Non-Tai Chi Chuan participants in the various aspects of gait analysis and balance test, as a consequence of these findings some of biomechanical parameters such as joints kinematics, gait parameters and single leg stance balance test, the Tai Chi Chuan could improve the lower limb conditions and could reduce a risk of fall for the elderly with ageing.

Keywords: gait analysis, kinematics, single leg stance, Tai Chi Chuan

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Authors: Strahinja Kovačević, Lidija Jevrić, Miloš Kuzmanović, Sanja Podunavac-Kuzmanović

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In this paper, various derivatives of benzimidazole have been evaluated against Gram-negative bacteria Escherichia coli. For all investigated compounds the minimum inhibitory concentration (MIC) was determined. Quantitative structure-activity relationships (QSAR) attempts to find consistent relationships between the variations in the values of molecular properties and the biological activity for a series of compounds so that these rules can be used to evaluate new chemical entities. The correlation between MIC and some absorption, distribution, metabolism and excretion (ADME) parameters was investigated, and the mathematical models for predicting the antibacterial activity of this class of compounds were developed. The quality of the multiple linear regression (MLR) models was validated by the leave-one-out (LOO) technique, as well as by the calculation of the statistical parameters for the developed models and the results are discussed on the basis of the statistical data. The results of this study indicate that ADME parameters have a significant effect on the antibacterial activity of this class of compounds. Principal component analysis (PCA) and agglomerative hierarchical clustering algorithms (HCA) confirmed that the investigated molecules can be classified into groups on the basis of the ADME parameters: Madin-Darby Canine Kidney cell permeability (MDCK), Plasma protein binding (PPB%), human intestinal absorption (HIA%) and human colon carcinoma cell permeability (Caco-2).

Keywords: benzimidazoles, QSAR, ADME, in silico

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Authors: Showkat Ahmad Bhat, Iqra Reyaz, Falaque ul Afshan, Ahmad Arif Reshi, Muneeb U. Rehman, Manzoor R. Mir, Sabhiya Majid, Sonallah, Sheikh Bilal, Ishraq Hussain

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Background: Gastric cancer is the fourth most common cancer and the second leading cause of worldwide cancer-related deaths, with a wide variation in incidence rates across different geographical areas. The current view of cancer is that a malignancy arises from a transformation of the genetic material of a normal cell, followed by successive mutations and by chain of alterations in genes such as DNA repair genes, oncogenes, Tumor suppressor genes. Minerals are necessary for the functioning of several transcriptional factors, proteins that recognize certain DNA sequences and have been found to play a role in gastric cancer. Material Methods:The present work was a case control study and its aim was to ascertain the role of minerals and promoter hypermethylation of CpG islands of DAP-K gene in Gastric cancer patients among the Kashmiri population. Serum was extracted from all the samples and mineral estimation was done by AAS from serum, DNA was also extracted and was modified using bisulphite modification kit. Methylation-specific PCR was used for the analysis of the promoter hypermethylation status of DAP-K gene. The epigenetic analysis revealed that unlike other high risk regions, Kashmiri population has a different promoter hypermethylation profile of DAP-K gene and has different mineral profile. Results: In our study mean serum copper levels were significantly different for the two genders (p<0.05), while as no significant differences were observed for iron and zinc levels. In Methylation-specific PCR the methylation status of the promoter region of DAP-K gene was as 67.50% (27/40) of the gastric cancer tissues showed methylated DAP-K promoter and 32.50% (13/40) of the cases however showed unmethylated DAP-K promoter. Almost all 85% (17/20) of the histopathologically confirmed normal tissues showed unmethylated DAP-K promoter except only in 3 cases where DAP-K promoter was found to be methylated. The association of promoter hypermethylation with gastric cancer was evaluated by χ2 (Chi square) test and was found to be significant (P=0.0006). Occurrence of DAP-K methylation was found to be unequally distributed in males and females with more frequency in males than in females but the difference was not statistically significant (P =0.7635, Odds ratio=1.368 and 95% C.I=0.4197 to 4.456). When the frequency of DAP-K promoter methylation was compared with clinical staging of the disease, DAP-K promoter methylation was found to be certainly higher in Stage III/IV (85.71%) compared to Stage I/ II (57.69%) but the difference was not statistically significant (P =0.0673). These results suggest that DAP-K aberrant promoter hypermethylation in Kashmiri population contributes to the process of carcinogenesis in Gastric cancer and is reportedly one of the commonest epigenetic changes in the development of Gastric cancer.

Keywords: gastric cancer, minerals, AAS, hypermethylation, CpG islands, DAP-K gene

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