Search results for: systemic methods
15673 Autoimmune Diseases Associated with Celiac Disease in Adults
Authors: Soumaya Mrabet, Taieb Ach, Imen Akkari, Amira Atig, Neirouz Ghannouchi, Koussay Ach, Elhem Ben Jazia
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Introduction: Celiac disease (CD) is an immune-mediated small intestinal disorder that occurs in genetically susceptible people. It is significantly associated with other autoimmune disorders represented mainly by type 1 diabetes and autoimmune dysthyroidism. The aim of our study is to determine the prevalence and the type of the various autoimmune diseases associated with CD in adult patients. Material and methods: This is a retrospective study including patients diagnosed with CD, explored in Internal Medicine, Gastroenterology and Endocrinology and Diabetology Departments of the Farhat Hached University Hospital, between January 2005 and January 2016. The diagnosis of CD was confirmed by serological tests and duodenal biopsy. The screening of autoimmune diseases was based on physical examination, biological and serological tests. Results: Sixty five patients with a female predominance were included, 48women (73.8%) and 17 men (26.2%). The mean age was 31.8 years (17-75). A family history of CD or other autoimmune diseases was present in 5 and 10 patients respectively. Clinical presentation of CD was made by recurrent abdominal pain in 49 cases, diarrhea in 29 cases, bloating in 17 cases, constipation in 25 cases and vomiting in 8 cases. Autoimmune diseases associated with CD were found in 30 cases (46.1%): type 1 diabetes in 15 patients attested by the positivity of anti-GAD antibodies in 11 cases and anti-IA2 in 4 cases, Hashimoto thyroiditis in 8 cases confirmed by the positivity of anti-TPO antibodies, Addison's disease in 2 patients, Anemia of Biermer in 2 patients, autoimmune hepatitis, Systemic erythematosus lupus, Gougerot Sjögren syndrome, rheumatoid arthritis, Vitiligo and antiphospholipid syndrome in one patient each. CD was associated with more than one autoimmune disease defining multiple autoimmune syndrome in 2 female patients. The first patient had Basedow disease, Addison disease and type 1 diabetes. The second patient had systemic erythematosus lupus and Gougerot Sjögren syndrome. Conclusion: In our study autoimmune diseases were associated with CD in 46.1% of cases and were dominated by diabetes and dysthroidism. After establishing the diagnosis of CD the search of associated autoimmune diseases is necessary in order to avoid any therapeutic delay which can alter the prognosis of the patient.Keywords: association, autoimmune thyroiditis, celiac disease, diabetes
Procedia PDF Downloads 28315672 Language and Power Relations in Selected Political Crisis Speeches in Nigeria: A Critical Discourse Analysis
Authors: Isaiah Ifeanyichukwu Agbo
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Human speech is capable of serving many purposes. Power and control are not always exercised overtly by linguistic acts, but maybe enacted and exercised in the myriad of taken-for-granted actions of everyday life. Domination, power control, discrimination and mind control exist in human speech and may lead to asymmetrical power relations. In discourse, there are persuasive and manipulative linguistic acts that serve to establish solidarity and identification with the 'we group' and polarize with the 'they group'. Political discourse is crafted to defend and promote the problematic narrative of outright controversial events in a nation’s history thereby sustaining domination, marginalization, manipulation, inequalities and injustices, often without the dominated and marginalized group being aware of them. They are designed and positioned to serve the political and social needs of the producers. Political crisis speeches in Nigeria, just like in other countries concentrate on positive self-image, de-legitimization of political opponents, reframing accusation to one’s advantage, redefining problematic terms and adopting reversal strategy. In most cases, the people are ignorant of the hidden ideological positions encoded in the text. Few researches have been conducted adopting the frameworks of critical discourse analysis and systemic functional linguistics to investigate this situation in the political crisis speeches in Nigeria. In this paper, we focus attention on the analyses of the linguistic, semantic, and ideological elements in selected political crisis speeches in Nigeria to investigate if they create and sustain unequal power relations and manipulative tendencies from the perspectives of Critical Discourse Analysis (CDA) and Systemic Functional Linguistics (SFL). Critical Discourse Analysis unpacks both opaque and transparent structural relationships of power dominance, power relations and control as manifested in language. Critical discourse analysis emerged from a critical theory of language study which sees the use of language as a form of social practice where social relations are reproduced or contested and different interests are served. Systemic function linguistics relates the structure of texts to their function. Fairclough’s model of CDA and Halliday’s systemic functional approach to language study are adopted in this paper. This paper probes into language use that perpetuates inequalities. This study demystifies the hidden implicature of the selected political crisis speeches and reveals the existence of information that is not made explicit in what the political actors actually say. The analysis further reveals the ideological configurations present in the texts. These ideological standpoints are the basis for naturalizing implicit ideologies and hegemonic influence in the texts. The analyses of the texts further uncovered the linguistic and discursive strategies deployed by text producers to manipulate the unsuspecting members of the public both mentally and conceptually in order to enact, sustain and maintain unhealthy power relations at crisis times in the Nigerian political history.Keywords: critical discourse analysis, language, political crisis, power relations, systemic functional linguistics
Procedia PDF Downloads 34215671 Assessing the Empowerment of Muslim Women in Malawi: A Case Study of the Muslim Women's Organization
Authors: Ulemu Maseko
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This study critically examines the empowerment of Muslim women in Malawi, focusing on the Muslim Women’s Organization (MWO) and its impact on gender equality within Islamic communities. It explores MWO's interpretation of Islamic women's rights, the stereotypes Muslim women face, and the factors limiting their rights. Utilizing qualitative methods, including interviews, focus groups, and participant observations, the research adopts phenomenological and feminist frameworks. Findings indicate that since its establishment in 1985, MWO has significantly advocated for gender equality by leveraging Islamic teachings and policy to support women’s empowerment, enabling Muslim women to participate in social change. However, entrenched cultural traditions, patriarchal structures, and systemic poverty remain barriers to empowerment.Keywords: Islam, women empowerment, Malawi, Islamic feminism
Procedia PDF Downloads 2915670 Functionalized Nanoparticles for Drug Delivery Applications
Authors: Temesgen Geremew
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Functionalized nanoparticles have emerged as a revolutionary platform for drug delivery, offering significant advantages over traditional methods. By strategically modifying their surface properties, these nanoparticles can be designed to target specific tissues and cells, significantly reducing off-target effects and enhancing therapeutic efficacy. This targeted approach allows for lower drug doses, minimizing systemic exposure and potential side effects. Additionally, functionalization enables controlled release of the encapsulated drug, improving drug stability and reducing the frequency of administration, leading to improved patient compliance. This work explores the immense potential of functionalized nanoparticles in revolutionizing drug delivery, addressing limitations associated with conventional therapies and paving the way for personalized medicine with precise and targeted treatment strategies.Keywords: nanoparticles, drug, nanomaterials, applications
Procedia PDF Downloads 6715669 Adjunct Placement in Educated Nigerian English
Authors: Juliet Charles Udoudom
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In nonnative language use environments, language users have been known to demonstrate marked variations both in the spoken and written productions of the target language. For instance, analyses of the written productions of Nigerian users of English have shown inappropriate sequencing of sentence elements resulting in distortions in meaning and/or other problems of syntax. This study analyses the structure of sentences in the written production of 450 educated Nigerian users of English to establish their sensitivity to adjunct placement and the extent to which it exerts on meaning interpretation. The respondents were selected by a stratified random sampling technique from six universities in south-south Nigeria using education as the main yardstick for stratification. The systemic functional grammar analytic format was used in analyzing the sentences selected from the corpus. Findings from the analyses indicate that of the 8,576 tokens of adjuncts in the entire corpus, 4,550 (53.05%) of circumstantial adjuncts were appropriately placed while 2,839 (33.11%) of modal adjuncts occurred at appropriate locations in the clauses analyzed. Conjunctive adjunct placement accounted for 1,187 occurrences, representing 13.84% of the entire corpus. Further findings revealed that prepositional phrases (PPs) were not well construed by respondents to be capable of realizing adjunct functions, and were inappropriately placed.Keywords: adjunct, adjunct placement, conjunctive adjunct, circumstantial adjunct, systemic grammar
Procedia PDF Downloads 1515668 The Study of Strength and Weakness Points of Various Techniques for Calculating the Volume of Done Work in Civil Projects
Authors: Ali Fazeli Moslehabadi
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One of the topics discussed in civil projects, during the execution of the project, which the continuous change of work volumes is usually the characteristics of these types of projects, is how to calculate the volume of done work. The difference in volumes announced by the execution unit with the estimated volume by the technical office unit, has direct effect on the announced progress of the project. This issue can show the progress of the project more or less than actual value and as a result making mistakes for stakeholders and project managers and misleading them. This article intends to introduce some practical methods for calculating the volume of done work in civil projects. It then reviews the strengths and weaknesses of each of them, in order to resolve these contradictions and conflicts.Keywords: technical skills, systemic skills, communication skills, done work volume calculation techniques
Procedia PDF Downloads 15715667 Bulbar Conjunctival Kaposi's Sarcoma Unmasked by Immune Reconstitution Syndrome
Authors: S. Mohd Afzal, R. O'Connell
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Kaposi's sarcoma (KS) is the most common HIV-related cancer, and ocular manifestations constitute at least 25% of all KS cases. However, ocular presentations often occur in the context of systemic KS, and isolated lesions are rare. We report a unique case of ocular KS masquerading as subconjunctival haemorrhage, and only developing systemic manifestations after initiation of HIV treatment. Case: A 49-year old man with previous hypertensive stroke and newly diagnosed HIV infection presented with an acutely red left eye following repeated bouts of coughing. Given the convincing history of poorly controlled hypertension and cough, a diagnosis of subconjunctival haemorrhage was made. Over the next week, his ocular lesion began to improve and he subsequently started anti-retroviral therapy. Prior to receiving anti-retroviral therapy, his CD4+ lymphocyte count was 194 cells/mm3 with HIV viral load greater than 1 million/ml. This rapidly improved to a viral load of 150 copies/ml within 2 weeks of starting treatment. However, a few days after starting HIV treatment, his ocular lesion recurred. Ophthalmic examination was otherwise normal. He also developed widespread lymphadenopathy and multiple dark lesions on his torso. Histology and virology confirmed KS, systemically triggered by Immune Reconstitution Syndrome (KS-IRIS). The patient has since undergone chemotherapy successfully. Discussion: Kaposi's sarcoma is an atypical tumour caused by human herpesvirus 8 (HHV-8), also known as Kaposi’s sarcoma-associated herpesvirus (KSHV). In immunosuppressed patients, KSHV can also cause lymphoproliferative disorders such as primary effusion lymphoma and Castleman's disease (in our patient’s case, this was excluded through histological analysis of lymph nodes). KSHV is one of the seven currently known human oncoviruses, and its pathogenesis is poorly understood. Up to 13% of patients with HIV-related KS experience worsening of the disease after starting anti-retroviral treatment, due to a sudden increase in CD4 cell counts. Histology remains the diagnostic gold standard. Current British HIV Association (BHIVA) guidelines recommend treatment using anti-retroviral drugs, with either intralesional vinblastine for local disease or systemic chemotherapy for disseminated KS. Conclusion: This case is unique as ocular KS as initial presentation is rare and our patient's diagnosis was only made after systemic lesions were triggered by immune reconstitution. KS should be considered as an important differential diagnosis for red eyes in all patients at risk of acquiring HIV infection.Keywords: human herpesvirus 8, human immunodeficiency virus, immune reconstitution syndrome, Kaposi’s sarcoma, Kaposi’s sarcoma-associated herpesvirus
Procedia PDF Downloads 33615666 Real-Time Classification of Hemodynamic Response by Functional Near-Infrared Spectroscopy Using an Adaptive Estimation of General Linear Model Coefficients
Authors: Sahar Jahani, Meryem Ayse Yucel, David Boas, Seyed Kamaledin Setarehdan
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Near-infrared spectroscopy allows monitoring of oxy- and deoxy-hemoglobin concentration changes associated with hemodynamic response function (HRF). HRF is usually affected by natural physiological hemodynamic (systemic interferences) which occur in all body tissues including brain tissue. This makes HRF extraction a very challenging task. In this study, we used Kalman filter based on a general linear model (GLM) of brain activity to define the proportion of systemic interference in the brain hemodynamic. The performance of the proposed algorithm is evaluated in terms of the peak to peak error (Ep), mean square error (MSE), and Pearson’s correlation coefficient (R2) criteria between the estimated and the simulated hemodynamic responses. This technique also has the ability of real time estimation of single trial functional activations as it was applied to classify finger tapping versus resting state. The average real-time classification accuracy of 74% over 11 subjects demonstrates the feasibility of developing an effective functional near infrared spectroscopy for brain computer interface purposes (fNIRS-BCI).Keywords: hemodynamic response function, functional near-infrared spectroscopy, adaptive filter, Kalman filter
Procedia PDF Downloads 16415665 The Hypoglycemic Grab Back (HOGG): Preparing Hypo-Screen-Bags to Streamline the Time-Consuming Process of Administering Glucose Systemic Correction
Authors: Mai Ali
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Background: Preparing Hypo-screen-bags in advance streamlines the time-consuming process of administering glucose systemic correction. Additionally, Hypo-Screen Grab Bags are widely adopted in UK hospitals. Aim: The aim of the study is to improve hypoglycemia screening efficiency and equipment accessibility by streamlining item access to grab bag restocking staff. Methodology: The study centered on neonatal wards at LGI & St. James Neonatal Unit and related units. A web-based survey was conducted to evaluate local practices, gathering 21 responses from relevant general staff. The survey outcomes: (1) The demand for accessible grab bags is evident for smoother processes. (2) The potential to enhance efficiency through improved preparation of hypo-screen grab bags. Intervention: A Hypo-Screen Grab Bag was designed, including checklists for stocked items and required samples. Medical staff oversee restocking after use. Conclusion: The study successfully improved hypoglycemia screening efficiency and aided junior staff with accessible supplies and a user-friendly checklist.Keywords: neonatal hypoglycemia, grab bag, hypo-screening, junior staff
Procedia PDF Downloads 6315664 An Eco-Systemic Typology of Fashion Resale Business Models in Denmark
Authors: Mette Dalgaard Nielsen
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The paper serves the purpose of providing an eco-systemic typology of fashion resale business models in Denmark while pointing to possibilities to learn from its wisdom during a time when a fundamental break with the dominant linear fashion paradigm has become inevitable. As we transgress planetary boundaries and can no longer continue the unsustainable path of over-exploiting the Earth’s resources, the global fashion industry faces a tremendous need for change. One of the preferred answers to the fashion industry’s sustainability crises lies in the circular economy, which aims to maximize the utilization of resources by keeping garments in use for longer. Thus, in the context of fashion, resale business models that allow pre-owned garments to change hands with the purpose of being reused in continuous cycles are considered to be among the most efficient forms of circularity. Methodologies: The paper is based on empirical data from an ongoing project and a series of qualitative pilot studies that have been conducted on the Danish resale market over a 2-year time period from Fall 2021 to Fall 2023. The methodological framework is comprised of (n) ethnography and fieldwork in selected resale environments, as well as semi-structured interviews and a workshop with eight business partners from the Danish fashion and textiles industry. By focusing on the real-world circulation of pre-owned garments, which is enabled by the identified resale business models, the research lets go of simplistic hypotheses to the benefit of dynamic, vibrant and non-linear processes. As such, the paper contributes to the emerging research field of circular economy and fashion, which finds itself in a critical need to move from non-verified concepts and theories to empirical evidence. Findings: Based on the empirical data and anchored in the business partners, the paper analyses and presents five distinct resale business models with different product, service and design characteristics. These are 1) branded resale, 2) trade-in resale, 3) peer-2-peer resale, 4) resale boutiques and consignment shops and 5) resale shelf/square meter stores and flea markets. Together, the five business models represent a plurality of resale-promoting business model design elements that have been found to contribute to the circulation of pre-owned garments in various ways for different garments, users and businesses in Denmark. Hence, the provided typology points to the necessity of prioritizing several rather than single resale business model designs, services and initiatives for the resale market to help reconfigure the linear fashion model and create a circular-ish future. Conclusions: The article represents a twofold research ambition by 1) presenting an original, up-to-date eco-systemic typology of resale business models in Denmark and 2) using the typology and its eco-systemic traits as a tool to understand different business model design elements and possibilities to help fashion grow out of its linear growth model. By basing the typology on eco-systemic mechanisms and actual exemplars of resale business models, it becomes possible to envision the contours of a genuine alternative to business as usual that ultimately helps bend the linear fashion model towards circularity.Keywords: circular business models, circular economy, fashion, resale, strategic design, sustainability
Procedia PDF Downloads 5815663 Epistemic Stance in Chinese Medicine Translation: A Systemic Functional Perspective
Authors: Yan Yue
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Epistemic stance refers to the writer’s judgement about the certainty of the proposition, which demonstrates writer’s degree of commitment and confidence to the status of the information. Epistemic stance can exert great consequence to the validity or reliability of the values of a statement, however, to date, it receives little attention in translations studies, especially from the perspective of systemic functional linguistics (SFL) and with the relation to translator’s domain knowledge. This study is corpus-based research carried out in SFL perspective, which investigates translator’s epistemic stance pattern in Chinese medicine discourse translations by translators with and without medical domain knowledge. Overall, our findings show that all translators tend to be neither too assertive nor too doubted about Chinese medicine statements, and they all tend to express their epistemic stance in a subjective rather than objective way. Individually, there is a clear pattern of epistemic stance marked off by translators’ medical expertise, which further consolidates the previous finding that epistemic asymmetry is found most salient between lay people and professionals. However, contrary to our hypothesis, translators as clinicians who have more medical knowledge are found to be more tentative to TCM statements than translators as non-clinicians. This finding could serve to refine the statements about the relation between writer’s domain knowledge and epistemic stance-taking and the current debate whether Chinese medicine texts should only be translated by clinicians.Keywords: epistemic stance, domain knowledge, SFL, medical translation
Procedia PDF Downloads 14515662 Connecting Critical Macro-Finance to Theories of Capitalism
Authors: Vithul Kalki
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The mainstream political economy failed to explain the nature and causes of systemic failures and thus to compare and comprehend how contemporary capitalist systems work. An alternative research framework of Critical Macro-Finance (CMF) is an attempt to collaborate political theory with post-Keynesian economics with an objective to find answers to unresolved questions that emerged since the international financial crisis and repeated failures of capital systems. This unorthodox approach brings out four main propositions, namely : (a) that the adoption of American financial practices has anchored financial globalization in market-based finance; (b) that global finance is a set of interconnected, hierarchical balance sheets, increasingly subject to time-critical liquidity; (c) that credit creation in market-based finance involves new forms of money; and (d) that market-based finance structurally requires a de-risking state capable both of protecting systemic liabilities and creating new investment opportunities. The ongoing discussion of CMF literature is yet to be tested or even fully framed. This qualitative paper will critically examine the CMF framework and will engage in discussions aiming to connect the CMF with theories of capitalism in a wider context to bring a holistic approach for analyzing contemporary financial capitalism.Keywords: critical macro-finance, capitalism, financial system, comparative political economy
Procedia PDF Downloads 18615661 Unusual Presentation of Colorectal Cancer within Inguinal Hernia: A Systemic Review of Reported Cases
Authors: Sena Park
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Background: The concurrent presentation with colorectal cancer in the inguinal hernia has been extremely rare. Due to its rarity, its presentation may lead to diagnostic and therapeutic dilemmas. We aim to review all the reported cases on colorectal cancer incarcerated in the inguinal hernia in the last 20 years, and discuss the operative approaches. Methods: We identified all case reports on colorectal cancer within inguinal hernia using PUBMED (2002-2022) and MEDLINE (2002-2022). The search strategy included the following keywords: colorectal cancer (title/abstract) AND inguinal hernia (title/abstract) OR incarceration (title/abstract). The search did not include letters, book chapters, systemic reviews, meta-analysis and editorials. Results: In the last 20 years, a total of 19 cases on colorectal cancer within the inguinal hernia were identified. The age of the patients ranged between 48 and 89. Majority of the patients were male (95%). Most commonly involved part of the large intestine was sigmoid colon (79%). Of all the cases, 79 percent of patients received open procedure and 21 percent had laparoscopic procedure. Discussion: Inguinal hernias are common with an incidence of approximately 1.7 percent. Colorectal cancer is the one of the leading causes of cancer-related mortality worldwide. However, their concurrent presentation has been extremely rare. In the last 20 years, 19 cases on concurrent presentation of colorectal cancer and inguinal hernia have been reported. Most patients who had open procedures had two incisions of groin incision and a midline laparotomy. There were 4 cases where the oncological resection was performed laparoscopically. The advantages of laparoscopic resection include reduced blood lost, reduced post-operative pain, reduced length of hospital stay and similar number of lymph nodes taken. From the review of the cases in the last 20 years, both open and laparoscopic approaches seemed to be safe and achieve adequate oncological resections. Conclusion: This is a brief overview of reported cases of colorectal cancer presenting with inguinal hernia concurrently. Due to its rarity, there are no current guidelines on operative approach in clinical practice. The experience in the last 20 years supports both open and laparoscopic approach.Keywords: colorectal cancer, inguinal hernia, incarceration, operative approach
Procedia PDF Downloads 10115660 The Gold Standard Treatment Plan for Vitiligo: A Review on Conventional and Updated Treatment Methods
Authors: Kritin K. Verma, Brian L. Ransdell
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White patches are a symptom of vitiligo, a chronic autoimmune dermatological condition that causes a loss of pigmentation in the skin. Vitiligo can cause issues of self-esteem and quality of life while also progressing the development of other autoimmune diseases. Current treatments in allopathy and homeopathy exist; some treatments have been found to be toxic, whereas others have been helpful. Allopathy has seemed to offer several treatment plans, such as phototherapy, skin lightening preparations, immunosuppressive drugs, combined modality therapy, and steroid medications to improve vitiligo. This presentation will review the FDA-approved topical cream, Opzelura, a JAK inhibitor, and its effects on limiting vitiligo progression. Meanwhile, other non-conventional methods, such as Arsenic Sulphuratum Flavum used in homeopathy, will be debunked based on current literature. Most treatments still serve to arrest progression and induce skin repigmentation. Treatment plans may differ between patients due to depigmentation location on the skin. Since there is no gold standard plan for treating patients with vitiligo, the oral presentation will review all topical and systemic pharmacological therapies that fight the depigmentation of the skin and categorize their validity from a systematic review of the literature. Since treatment plans are limited in nature, all treatment methods will be mentioned and an attempt will be made to make a golden standard treatment process for these patients.Keywords: vitiligo, phototherapy, immunosuppressive drugs, skin lightening preparations, combined modality therapy, arsenic sulphuratum flavum, homeopathy, allopathy, golden standard, Opzelura
Procedia PDF Downloads 8615659 Cryptography Based Authentication Methods
Authors: Mohammad A. Alia, Abdelfatah Aref Tamimi, Omaima N. A. Al-Allaf
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This paper reviews a comparison study on the most common used authentication methods. Some of these methods are actually based on cryptography. In this study, we show the main cryptographic services. Also, this study presents a specific discussion about authentication service, since the authentication service is classified into several categorizes according to their methods. However, this study gives more about the real life example for each of the authentication methods. It talks about the simplest authentication methods as well about the available biometric authentication methods such as voice, iris, fingerprint, and face authentication.Keywords: information security, cryptography, system access control, authentication, network security
Procedia PDF Downloads 47015658 Urinary Neutrophil Gelatinase Associated Lipocalin as Diagnostic Biomarkers for Lupus Nephritis
Authors: Lorena GóMez Escorcia, Gustavo Aroca MartíNez, Jose Luiz Villarreal, Elkin Navarro Quiroz
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Lupus nephritis (LN) is a high-cost disease, occurring in about half of patients with Systemic Lupus Erythematosus (SLE). Renal biopsy constitutes the only protocol that, to date, allows a correct diagnosis of the level of renal involvement in these patients. However, this procedure can have various adverse effects such as kidney bleeding, muscle bleeding, infection, pain, among others. Therefore, the development of new diagnostic alternatives is required. The neutrophil gelatinase-associated lipocalin (NGAL) has been emerging as a novel biomarker of acute kidney injury. The aim of this study was to assess urinary NGAL levels as a marker for disease activity in patients with lupus nephritis. For this work included 50 systemic lupus erythematosus (SLE) patients, 50 with active lupus nephritis (LN), and 50 without autoimmune and renal disease as controls. TNGAL in urine samples was measured by enzyme-linked immunosorbent assay (ELISA). The results revealed that patients with kidney damage had an elevated urinary NGAL as compared to patients with lupus without kidney damage and controls (p <0.005), and the mean of uNGAL was (28.72 ± 4.53), (19.51 ± 4.72), (8.91 ± 3.37) respectively. Measurement of urinary NGAL levels showed a very good diagnostic performance for discriminating patients with Lupus nephritis from SLE without renal damage and of control individuals.Keywords: lupus nephritis, biomarker, NGAL, urine samples
Procedia PDF Downloads 20715657 Half Dose Tissue Plasminogen Activator for Intermediate-Risk Pulmonary Embolism
Authors: Macie Matta, Ahmad Jabri, Stephanie Jackson
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Introduction: In the absence of hypotension, pulmonary embolism (PE) causing right ventricular dysfunction or strain, whether confirmed by imaging or cardiac biomarkers, is deemed to be an intermediate-risk category. Urgent treatment of intermediate-risk PE can prevent progression to hemodynamic instability and death. Management options include thrombolysis, thrombectomy, or systemic anticoagulation. We aim to evaluate the short-term outcomes of a half-dose tissue plasminogen activator (tPA) for the management of intermediate-risk PE. Methods: We retrospectively identified adult patients diagnosed with intermediate-risk PE between the years 2000 and 2021. Demographic data, lab values, imaging, treatment choice, and outcomes were all obtained through chart review. Primary outcomes measured include major bleeding events and in-hospital mortality. Patients on standard systemic anticoagulation without receiving thrombolysis or thrombectomy served as controls. Patient data were analyzed using SAS®️ Software (version 9.4; Cary, NC) to compare individuals that received half-dose tPA with controls, and statistical significance was set at a p-value of 0.05. Results: We included 57 patients in our final analysis, with 19 receiving tPA. Patient characteristics and comorbidities were comparable between both groups. There was a significant difference between PE location, presence of acute deep vein thrombosis, and peak troponin level between both groups. The thrombolytic cohort was more likely to demonstrate a 60/60 sign and thrombus in transit finding on echocardiography than controls. The thrombolytic group was more likely to have major bleeding (17% vs 7.9%, p= 0.4) and in-hospital mortality (5.3% vs 0%, p=0.3); however, this was not statistically significant. Patients who received half-dose tPA had non-significantly higher rates of major bleeding and in-hospital mortality. Larger scale, randomized control trials are needed to establish the benefit and safety of thrombolytics in patients with intermediate-risk PE.Keywords: pulmonary embolism, half dose thrombolysis, tissue plasminogen activator, cardiac biomarkers, echocardiographic findings, major bleeding event
Procedia PDF Downloads 7515656 Multimodal Ophthalmologic Evaluation Can Detect Retinal Injuries in Asymptomatic Patients With Primary Antiphospholipid Syndrome
Authors: Taurino S. R. Neto, Epitácio D. S. Neto, Flávio Signorelli, Gustavo G. M. Balbi, Alex H. Higashi, Mário Luiz R. Monteiro, Eloisa Bonfá, Danieli C. O. Andrade, Leandro C. Zacharias
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Purpose: To perform a multimodal evaluation, including the use of Optical Coherence Angiotomography (OCTA), in patients with primary antiphospholipid syndrome (PAPS) without ocular complaints and to compare them with healthy individuals. Methods: A complete structural and functional ophthalmological evaluation using OCTA and microperimetry (MP) exam in patients with PAPS, followed at a tertiary rheumatology outpatient clinic, was performed. All ophthalmologic manifestations were recorded and then statistical analysis was performed for comparative purposes; p <0.05 was considered statistically significant. Results: 104 eyes of 52 subjects (26 patients with PAPS without ocular complaints and 26 healthy individuals) were included. Among PAPS patients, 21 were female (80.8%) and 21 (80.8%) were Caucasians. Thrombotic PAPS was the main clinical criteria manifestation (100%); 65.4% had venous and 34.6% had arterial thrombosis. Obstetrical criteria were present in 34.6% of all thrombotic PAPS patients. Lupus anticoagulant was present in all patients. 19.2% of PAPS patients presented ophthalmologic findings against none of the healthy individuals. The most common retinal change was paracentral acute middle maculopathy (PAMM) (3 patients, 5 eyes), followed by drusen-like deposits (1 patient, 2 eyes) and pachychoroid pigment epitheliopathy (1 patient, 1 eye). Systemic hypertension and hyperlipidaemia were present in 100% of the PAPS patients with PAMM, while only six patients (26.1%) with PAPS without PAMM presented these two risk factors together. In the quantitative OCTA evaluation, we found significant differences between PAPS patients and controls in both the superficial vascular complex (SVC) and deep vascular complex (DVC) in the high-speed protocol, as well as in the SVC in the high-resolution protocol. In the analysis of the foveal avascular zone (FAZ) parameters, the PAPS group had a larger area of FAZ in the DVC using the high-speed method compared to the control group (p=0.047). In the quantitative analysis of the MP, the PAPS group had lower central (p=0.041) and global (p<0.001) retinal sensitivity compared to the control group, as well as in the sector analysis, with the exception of the inferior sector. In the quantitative evaluation of fixation stability, there was a trend towards worse stability in the PAPS subgroup with PAMM in both studied methods. Conclusions: PAMM was observed in 11.5% of PAPS patients with no previous ocular complaints. Systemic hypertension concomitant with hyperlipidemia was the most commonly associated risk factor for PAMM in patients with PAPS. PAPS patients present lower vascular density and retinal sensitivity compared to the control group, even in patients without PAMM.Keywords: antiphospholipid syndrome, optical coherence angio tomography, optical coherence tomography, retina
Procedia PDF Downloads 8015655 Rejuvenation of Peanut Seedling from Collar Rot Disease by Azotobacter sp. RA2
Authors: Ravi R. Patel, Vasudev R. Thakkar
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Use of plant growth-promoting rhizobacteria (PGPR) to increase the production and decrees disease occurrence is a recent method in agriculture. An RA2 rhizospheric culture was isolated from peanut rhizosphere from Junagadh region of Gujarat, India and showed different direct and indirect plant growth promoting activity like indole acetic acid, gibberellic acid, siderophore, hydrogen cyanide, Ammonia and (1-Aminocyclopropane-1-Carboxylate) deaminase production, N2 fixation, phosphate and potassium solubilization in vitro. RA2 was able to protect peanut germinating seedling from A. niger infection and reduce collar rot disease incidence 60-35% to 72-41% and increase germination percentage from 70-82% to 75-97% in two varieties GG20 and GG2 of peanut. RA2 was found to induce resistance in A. hypogaea L. seedlings via induction of different defense-related enzymes like phenylalanine ammonia lyase, peroxidase, polyphenol oxidase, lipoxygenase and pathogenesis related protein like chitinase, ß – 1,3- glucanase. Jasmonic acid one of the major signaling molecules of inducing systemic resistance was also found to induced due to RA2 treatments. RA2 bacterium was also promoting peanut growth and reduce A. niger infection in pot studies. 16S rDNA sequence of RA2 showed 99 % homology to Azotobacter species.Keywords: plant growth promoting rhizobacteria, peanut, aspergillus niger, induce systemic resistance
Procedia PDF Downloads 24215654 Effect of Resistance Training on BDNF and Inflammatory Markers in Healthy Older Adults
Authors: Obinna Afamefuna Echi
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Background: The global increase in the elderly population is anticipated to reach significant levels by 2050, presenting extensive economic, social, and healthcare challenges. Age-related cognitive decline, alterations in brain anatomy, and systemic inflammation are profound concerns that diminish the quality of life and increase susceptibility to diseases like Alzheimer's and cardiovascular diseases. Resistance training is presently studied for its potential neuroprotective and anti-inflammatory benefits in older adults. Objectives: This study aimed to explore the effects of different resistance training modalities on neurotrophic factors, inflammatory markers, and cognitive functions in the elderly. Methods: A controlled trial was conducted with 60 male participants aged 60-75, assigned to either 12 weeks of high-intensity blood flow restriction training (BFRT), muscle damaging resistance training (MDRT), or a non-exercising control group. Cognitive function, neurotrophic factors such as BDNF, and inflammatory markers including IL-6 and TNF were measured before and after the intervention period. Setting: Participants were recruited from Kaunas, Lithuania, with sessions facilitated at the Lithuanian Sports University and health assessments conducted at the Lithuanian University of Health Sciences. Results: Preliminary data suggested did not show significant improvements in BDNF levels and cognitive functions in the BFRT and MDRT groups compared to controls. However, there was a notable reduction in inflammatory markers, indicating potential health benefits beyond cognitive enhancement. Conclusion: The incorporation of resistance training can be a strategic intervention to mitigate age-associated cognitive decline and systemic inflammation, thereby enhancing overall health and quality of life in older adults. The results advocate for wider adoption and further study of resistance training as a preventive measure in ageing populations. Funding: The Lithuanian Sports University, the Research Council of Lithuania and the Lithuanian University of Health Sciences.Keywords: ageing, resistance training, BDNF, cognitive function
Procedia PDF Downloads 4615653 Logic of Appearance vs Explanatory Logic: A Systemic Functional Linguistics Approach to the Evolution of Communicative Strategies in the European Union Institutional Discourse
Authors: Antonio Piga
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The issue of European cultural identity has become a prominent topic of discussion among political actors in the wake of the unsuccessful referenda held in France and the Netherlands in May and June 2006. The „period of reflection‟ announced by the European Council at the conclusion of June 2006 has provided an opportunity for the implementation of several initiatives and programmes designed to „bridge the gap‟ between the EU institutions and its citizens. Specific programmes were designed with the objective of enhancing the European Commission‟s external communication of its activities. Subsequently, further plans for democracy, debate, and dialogue were devised with the objective of fostering open and extensive discourse between EU institutions and citizens. Further documentation on communication policy emphasised the necessity of developing linguistic techniques to re-engage disenchanted or uninformed citizens with the European project. It was observed that the European Union is perceived as a „faceless‟ entity, which is attributed to the absence of a distinct public identity vis-à-vis its institutions. This contribution presents an analysis of a collection of informative publications regarding the European Union, entitled “Europe on the Move”. This collection of booklets provides comprehensive information about the European Union, including its historical origins, core values, and historical development, as well as its achievements, strategic objectives, policies, and operational procedures. The theoretical framework adopted for the longitudinal linguistic analysis of EU discourse is that of Systemic Functional Linguistics (SFL). In more detail, this study considers two basic systems of relations between clauses: firstly, the degree of interdependency (or taxis) and secondly, the logico-semantic relation of expansion. The former refers to the structural markers of grammatical relations between clauses within sentences, namely paratactic, hypotactic and embedded relations. The latter pertains to various logicosemantic relationships existing between the primary and secondary members of the clause nexus. These relationships include how the secondary clause expands the primary clause, which may be achieved by (a) elaborating it, (b) extending it or (c) enhancing it. This study examines the impact of the European Commission‟s post-referendum communication methods on the portrayal of Europe, its role in facilitating the EU institutional process, and its articulation of a specific EU identity linked to distinct values. The research reveals that the language employed by the EU is evidently grounded in an explanatory logic, elucidating the rationale behind their institutionalised acts. Nevertheless, the minimal use of hypotaxis in the post-referendum booklets, coupled with the inconsistent yet increasing ratio of parataxis to hypotaxis, may suggest a potential shift towards a logic of appearance, characterised by a predominant reliance on coordination and additive, and elaborative logico-semantic relations.Keywords: systemic functional linguistics, logic of appearance, explanatory logic, interdependency, logico-semantic relation
Procedia PDF Downloads 615652 Induced Systemic Resistance in Tomato Plants against Fusarium Wilt Disease Using Biotic Inducers
Authors: Mostafa A. Amer, I. A. El-Samra, I. I. Abou-ElSeoud, S. M. El-Abd, N. K. Shawertamimi
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Tomato Fusarium wilt disease caused by Fusarium oxysporum f. sp. Lycopercisi (FOL) is considered one of the most destructive diseases in Egypt. Effect of some biotic inducers such as Bacillus megaterium var. phosphaticum, Glomus intraradices and Glomus macrocarpum at seven different mixed treatments, was tested for their ability to induce resistance in tomato plants against the disease. According to pathogenicity tests, all the tested isolates of FOL showed wilt symptoms on both of the tested cultivars; however, they considerably varied in percentages of disease incidence (DI) and disease severity (DS). Castle Rock was more susceptible than Peto 86, which was relatively resistant. Pretreatment of both cultivars, under greenhouse conditions, with the tested biotic inducers alone or in combination with each other's, significantly increased the induction of chitinase, β-1,3-glucanase, peroxidase, and polyphenoloxidase and reduced disease incidence and severity, compared with untreated noninoculated (C1) and untreated inoculated (C2) controls. Application of a combination of BMP, with GI and GM was the most effective in increasing the induction rated of the tested enzymes, compared with the other treatments. Induction of enzymes in most of the tested bioinducers treatments gradually increased, attaining maximum values after 48 or/and 72 hrs after challenging with FOL, then gradually declined. GI was the least effective bioinducer.Keywords: F. oxysporum f. sp. lycopersici, defense enzymes, induced systemic resistance, ISR, B. megaterium var. phosphaticum, G. macrocarpum, G. intraradices
Procedia PDF Downloads 40515651 Automatic Tuning for a Systemic Model of Banking Originated Losses (SYMBOL) Tool on Multicore
Authors: Ronal Muresano, Andrea Pagano
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Nowadays, the mathematical/statistical applications are developed with more complexity and accuracy. However, these precisions and complexities have brought as result that applications need more computational power in order to be executed faster. In this sense, the multicore environments are playing an important role to improve and to optimize the execution time of these applications. These environments allow us the inclusion of more parallelism inside the node. However, to take advantage of this parallelism is not an easy task, because we have to deal with some problems such as: cores communications, data locality, memory sizes (cache and RAM), synchronizations, data dependencies on the model, etc. These issues are becoming more important when we wish to improve the application’s performance and scalability. Hence, this paper describes an optimization method developed for Systemic Model of Banking Originated Losses (SYMBOL) tool developed by the European Commission, which is based on analyzing the application's weakness in order to exploit the advantages of the multicore. All these improvements are done in an automatic and transparent manner with the aim of improving the performance metrics of our tool. Finally, experimental evaluations show the effectiveness of our new optimized version, in which we have achieved a considerable improvement on the execution time. The time has been reduced around 96% for the best case tested, between the original serial version and the automatic parallel version.Keywords: algorithm optimization, bank failures, OpenMP, parallel techniques, statistical tool
Procedia PDF Downloads 36915650 Analyzing the Impact of Global Financial Crisis on Interconnectedness of Asian Stock Markets Using Network Science
Authors: Jitendra Aswani
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In the first section of this study, impact of Global Financial Crisis (GFC) on the synchronization of fourteen Asian Stock Markets (ASM’s) of countries like Hong Kong, India, Thailand, Singapore, Taiwan, Pakistan, Bangladesh, South Korea, Malaysia, Indonesia, Japan, China, Philippines and Sri Lanka, has been analysed using the network science and its metrics like degree of node, clustering coefficient and network density. Then in the second section of this study by introducing the US stock market in existing network and developing a Minimum Spanning Tree (MST) spread of crisis from the US stock market to Asian Stock Markets (ASM) has been explained. Data used for this study is adjusted the closing price of these indices from 6th January, 2000 to 15th September, 2013 which further divided into three sub-periods: Pre, during and post-crisis. Using network analysis, it is found that Asian stock markets become more interdependent during the crisis than pre and post crisis, and also Hong Kong, India, South Korea and Japan are systemic important stock markets in the Asian region. Therefore, failure or shock to any of these systemic important stock markets can cause contagion to another stock market of this region. This study is useful for global investors’ in portfolio management especially during the crisis period and also for policy makers in formulating the financial regulation norms by knowing the connections between the stock markets and how the system of these stock markets changes in crisis period and after that.Keywords: global financial crisis, Asian stock markets, network science, Kruskal algorithm
Procedia PDF Downloads 42415649 Development of Cationic Gelatin Nanoparticles as an Antigen-Carrier for Mucosal Immunization
Authors: Ping-Lun Jiang, Hung-Jun Lin, Shen-Fu Lin, Mei-Yin Chien, Ting-Wei Li, Chun-Han Lin, Der-Zen Liu
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Mucosal vaccine induces both mucosal (secretory IgA) and systemic immune responses and it is considered an ideal vaccination strategy for prevention of infectious diseases. One important point to be considered in mucosal vaccination is effective antigen delivery system which can manage effective delivery of antigen to antigen-presenting cells (APCs) of mucosal. In the present study, cationic gelatin nanoparticles were prepared as ideal carriers for more efficient antigen delivery. The average diameter of cationic gelatin nanoparticle was approximate 190 nm, and the zeta potential was about +45 mV, then ovalbumin (OVA) was physically absorbed onto cationic gelatin nanoparticle. The OVA absorption rate was near 95% the zeta potential was about +20 mV. We show that cationic gelatin nanoparticle effectively facilitated antigen uptake by mice bone marrow-derived dendritic cells (mBMDCs) and RAW264.7 cells and induced higher levels of pro-inflammatory cytokines. C57BL/6 mice twice immunized intranasally with OVA-absorbed cationic gelatin nanoparticle induced high levels of OVA-specific IgG in the serum and IgA in their in the nasal and lung wash fluid. These results indicate that nasal administration of cationic gelatin nanoparticles induced both mucosal and systemic immune responses and cationic gelatin nanoparticles might be a potential antigen delivery carrier for further clinical applications.Keywords: antigen delivery, antigen-presenting cells, gelatin nanoparticle, mucosal vaccine
Procedia PDF Downloads 35915648 Gallbladder Amyloidosis Causing Gangrenous Cholecystitis: A Case Report
Authors: Christopher Leung, Guillermo Becerril-Martinez
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Amyloidosis is a rare systemic disease where abnormal proteins invade various organs and impede their function. Occasionally, they can manifest in a solidary organ such as the heart, lung, and nervous systems; rarely do they manifest in the gallbladder. Diagnosis often requires biopsy of the affected area and histopathology shows deposition of abnormally folded globular proteins called amyloid proteins. This case presents a 69-year-old male with a 3-month history of RUQ pain, diarrhea and non-specific symptoms of tiredness, etc. On imaging, both his US and CT abdomen showed gallbladder wall thickening and pericholecystic fluid, which may represent acute cholecystitis with hypodense lesions around the gallbladder, possibly representing liver abscesses. Given his symptoms of abdominal pain and imaging findings, this gentleman eventually had a laparoscopic cholecystectomy showing a gangrenous gallbladder with a mass on the liver bed. On histopathology, it showed amorphous hyaline eosinophilic material, which Congo-stained confirmed amyloidosis. Amyloidosis explained his non-specific symptoms, he avoided further biopsy, and he was commenced immediately on Lenalidomide. Involvement of the gallbladder is extremely rare, with less than 30 cases around the world. Half of the cases are reported as primary amyloidosis. This case adds to the current literature regarding primary gallbladder amyloidosis. Importantly, this case highlights how laparoscopic cholecystectomy can help with the diagnosis of gallbladder amyloidosis.Keywords: amyloidosis, cholecystitis, gangrenous cholecystitis, gallbladder, systemic amyloidosis
Procedia PDF Downloads 20715647 Procalcitonin and Other Biomarkers in Sepsis Patients: A Prospective Study
Authors: Neda Valizadeh, Soudabeh Shafiee Ardestani, Arvin Najafi
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Objectives: The aim of this study is to evaluate the association of mid-regional pro-atrial natriuretic peptide (MRproANP), procalcitonin (PCT), proendothelin-1 (proET-1) levels with sepsis severity in Emergency ward patients. Materials and Methods: We assessed the predictive value of MRproANP, PCT, copeptin, and proET-1 in early sepsis among patients referring to the emergency ward with a suspected sepsis. Results-132 patients were enrolled in this study. 45 (34%) patients had a final diagnosis of sepsis. A higher percentage of patients with definite sepsis had systemic inflammatory response syndrome (SIRS) criteria at initial visit in comparison with no-sepsis patients (P<0.05) and were admitted to the hospital (P<0.05). PCT levels were higher in sepsis patients [P<0.05]. There was no significant differences for MRproANP or proET-1 in sepsis patients (P=0.47). Conclusion: A combination of SIRS criteria and PCT levels is beneficial for the early sepsis diagnosis in emergency ward patients with a suspicious infection disease.Keywords: emergency, prolactin, sepsis, biomarkers
Procedia PDF Downloads 43815646 Hypertension and Its Association with Oral Health Status in Adults: A Pilot Study in Padusunan Adults Community
Authors: Murniwati, Nurul Khairiyah, Putri Ovieza Maizar
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The association between general and oral health is clearly important, particularly in adults with medical conditions. Many of the medical systemic conditions are either caused or aggravated by poor oral hygiene and vice versa. Hypertension is one of common medical systemic problem which has been a public health concern worldwide due to its known consequences. Those consequences must be related to oral health status as well, whether it may cause or worsen the oral health conditions. The objective of this study was to find out the association between hypertension and oral health status in adults. This study was an analytical observational study by using cross-sectional method. A total of 42 adults both male and female in Padusunan Village, Pariaman, West Sumatra, Indonesia were selected as subjects by using purposive sampling. Manual sphygmomanometer was used to measure blood pressure and dental examination was performed to calculate the decayed, missing, and filled teeth (DMFT) scores in order to represent oral health status. The data obtained was analyzed statistically using One Way ANOVA to determine the association between hypertensive adults and their oral health status. The result showed that majority age of the subjects was ranging from 51-70 years (40.5%). Based on blood pressure examination, 57.1% of subjects were classified to prehypertension. Overall, the mean of DMFT score calculated in normal, prehypertension and hypertension group was not considered statistically significant. There was no significant association (p>0.05) between hypertension and oral health status in adults.Keywords: blood pressure, hypertension, DMFT, oral health status
Procedia PDF Downloads 32715645 Moving beyond the Gender Pay Gap: An Investigation of Pension Gender Inequalities across European Counties
Authors: Enva Doda
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Recent statistical analyses within the European Union (EU) underscore the enduring significance of the Gender Pay Gap in amplifying the Gender Pension Gap, a phenomenon resisting proportional reduction over time. This study meticulously calculates the Pension Gap, scrutinizing contributing variables within diverse pension systems. Furthermore, it investigates whether the "unexplained" segment of the Gender Gap correlates with political institutions, economic systems, historical events, or discrimination, utilizing quantitative methods and the Blinder-Oaxaca Decomposition Method to pinpoint potential discriminatory factors. The descriptive analysis reveals a conspicuous Gender Pension Gap across European nations, displaying notable variation. While an overall reduction in the Gender Gap is observed, the degree of improvement varies among countries. Subsequent analyses will delve into the specific reasons or variables influencing distinct Gender Gap percentages, forming the basis for nuanced policy recommendations. This comprehensive research enriches the ongoing discourse on gender equality and economic equity. By focusing on the root causes of the Pension Gap, the study has the potential to instigate policy adjustments, urging policymakers to reassess systemic structures and contribute to informed decision-making. Emphasizing gender equality as essential for a flourishing and resilient economy, the research aspires to drive positive change on academic and policy fronts.Keywords: blinder Oaxaca decomposition method, discrimination, gender pension gap, quantitative methods, unexplained gender gap
Procedia PDF Downloads 4215644 Evaluation of Systemic Immune-Inflammation Index in Obese Children
Authors: Mustafa M. Donma, Orkide Donma
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A growing list of cancers might be influenced by obesity. Obesity is associated with an increased risk for the occurrence and development of some cancers. Inflammation can lead to cancer. It is one of the characteristic features of cancer and plays a critical role in cancer development. C-reactive protein (CRP) is under evaluation related to the new and simple prognostic factors in patients with metastatic renal cell cancer. Obesity can predict and promote systemic inflammation in healthy adults. BMI is correlated with hs-CRP. In this study, SII index and CRP values were evaluated in children with normal BMI and those within the range of different obesity grades to detect the tendency towards cancer in pediatric obesity. A total of one hundred and ninety-four children; thirty-five children with normal BMI, twenty overweight (OW), forty-seven obese (OB) and ninety-two morbid obese (MO) participated in the study. Age- and sex-matched groups were constituted using BMI-for age percentiles. Informed consent was obtained. Ethical Committee approval was taken. Weight, height, waist circumference (C), hip C, head C and neck C of the children were measured. The complete blood count test was performed. C-reactive protein analysis was performed. Statistical analyses were performed using SPSS. The degree for statistical significance was p≤0.05. SII index values were progressively increasing starting from normal weight (NW) to MO children. There is a statistically significant difference between NW and OB as well as MO children. No significant difference was observed between NW and OW children, however, a correlation was observed between NW and OW children. MO constitutes the only group, which exhibited a statistically significant correlation between SII index and CRP. Obesity-related bladder, kidney, cervical, liver, colorectal, endometrial cancers are still being investigated. Obesity, characterized as a chronic low-grade inflammation, is a crucial risk factor for colon cancer. Elevated childhood BMI values may be indicative of processes leading to cancer, initiated early in life. Prevention of childhood adiposity may decrease the cancer incidence in adults. To authors’ best knowledge, this study is the first to introduce SII index values during obesity of varying degrees of severity. It is suggested that this index seems to affect all stages of obesity with an increasing tendency and may point out the concomitant status of obesity and cancer starting from very early periods of life.Keywords: children, C-reactive protein, systemic immune-inflammation index, obesity
Procedia PDF Downloads 177