Search results for: early development phase

Authors: Olga Blasco-Blasco, Vicente Liern

Abstract:

The development of tourism since the mid-20th century has raised problems of overcrowding, indiscriminate construction in seaside areas and gentrification. Increasingly, the World Tourism Organisation and public institutions are promoting policies that encourage sustainability. From the perspective of sustainability, three types of tourism can be established: traditional tourism, sustainable tourism and sustainable impact tourism. Measuring sustainability is complex due to its multiple dimensions of different relative importance and diversity in nature. In order to try to answer this problem and to identify the benefits of applying policies that promote sustainable tourism, a decision-making analysis will be carried out through the application of a multicriteria analysis method. The proposal is applied to hotel reservations and to the evaluation and management of tourism sustainability in the Spanish Autonomous Communities.

Keywords: sustainable tourism, multicriteria analysis, flexible optimization, composite indicators

Procedia PDF Downloads 295

Authors: T. B. Karu Jayasundara

Abstract:

The Earth’s gravity is not uniform. The satellite imageries of the Earth’s surface from NASA reveal a number of different gravity anomaly regions all over the globe. When the moon rotates around the earth, its gravity has a major physical influence on a number of regions on the earth. This physical change can be seen by the tides. The tides make sea levels high and low in coastal regions. During high tide, the gravitational force of the Moon pulls the Earth’s gravity so that the total gravitational intensity of Earth is reduced; it is further reduced in the low gravity regions of Earth. This reduction in gravity helps keep the suspended particles such as dust in the atmosphere, sand grains in the sea water for longer. Dramatic differences can be seen from the floating dust in the low gravity regions when compared with other regions. The above phenomena can be demonstrated from experiments. The experiments have to be done in high and low gravity regions of the earth during high and low tide, which will assist in comparing the final results. One of the experiments that can be done is by using a water filled cylinder about 80 cm tall, a few particles, which have the same density and same diameter (about 1 mm) and a stop watch. The selected particles were dropped from the surface of the water in the cylinder and the time taken for the particles to reach the bottom of the cylinder was measured using the stop watch. The times of high and low tide charts can be obtained from the regional government authorities. This concept is demonstrated by the particle drop times taken at high and low tides. The result of the experiment shows that the particle settlement time is less in low tide and high in high tide. The experiment for dust particles in air can be collected on filters, which are cellulose ester membranes and using a vacuum pump. The dust on filters can be used to make slides according to the NOHSC method. Counting the dust particles on the slides can be done using a phase contrast microscope. The results show that the concentration of dust is high at high tide and low in low tide. As a result of the high tides, a high concentration of heavy minerals deposit on placer deposits and dust particles retain in the atmosphere for longer in low gravity regions. These conditions are remarkably exhibited in the lowest low gravity region of the earth, mainly in the regions of India, Sri Lanka and in the middle part of the Indian Ocean. The biggest heavy mineral placer deposits are found in coastal regions of India and Sri Lanka and heavy dust particles are found in the atmosphere of India, particularly in the Delhi region.

Keywords: gravity, minerals, tides, moon, costal, atmosphere

Procedia PDF Downloads 115

Authors: X. Li, Y. Liu, H. Wong, B. Pardoen, A. Fabbri, F. McGregor, E. Liu

Abstract:

The target of this paper is to investigate how saturated poroelastic soils subject to freezing temperatures behave and how different boundary conditions can intervene and affect the thermo-hydro-mechanical (THM) responses, based on a particular but classical configuration of a finite homogeneous soil layer studied by Terzaghi. The essential relations on the constitutive behavior of a freezing soil are firstly recalled: ice crystal - liquid water thermodynamic equilibrium, hydromechanical constitutive equations, momentum balance, water mass balance, and the thermal diffusion equation, in general, non-linear case where material parameters are state-dependent. The system of equations is firstly linearized, assuming all material parameters to be constants, particularly the permeability of liquid water, which should depend on the ice content. Two analytical solutions solved by the classic Laplace transform are then developed, accounting for two different sets of boundary conditions. Afterward, the general non-linear equations with state-dependent parameters are solved using a commercial code COMSOL based on finite elements method to obtain numerical results. The validity of this numerical modeling is partially verified using the analytical solution in the limiting case of state-independent parameters. Comparison between the results given by the linearized analytical solutions and the non-linear numerical model reveals that the above-mentioned linear computation will always underestimate the liquid pore pressure and displacement, whatever the hydraulic boundary conditions are. In the nonlinear model, the faster growth of ice crystals, accompanying the subsequent reduction of permeability of freezing soil layer, makes a longer duration for the depressurization of water liquid and slower settlement in the case where the ground surface is swiftly covered by a thin layer of ice, as well as a bigger global liquid pressure and swelling in the case of the impermeable ground surface. Nonetheless, the analytical solutions based on linearized equations give a correct order-of-magnitude estimate, especially at moderate temperature variations, and remain a useful tool for preliminary design checks.

Keywords: chemical potential, cryosuction, Laplace transform, multiphysics coupling, phase transformation, thermodynamic equilibrium

Procedia PDF Downloads 67

Authors: Ezinne K. Okoro, Takahiko Katoh, Yoko Kawamura, Stanley C. Meribe

Abstract:

HIV infection in children is largely as a result of vertical transmission (mother to child transmission [MTCT]). Thus, elimination of mother to child transmission of HIV/AIDS is critical in eliminating HIV infection in children. In Nigeria, drawbacks such as; limited pediatric screening, limited human capital, insufficient advocacy and poor understanding of ART guidelines, have impacted efforts at combating the disease, even as treatment services are free. Prevention of Mother to Child Transmission (PMTCT) program relies on health workers who not only counsel pregnant women on first contact but can competently provide HIV-positive pregnant women with accurate information about the PMTCT program such as feeding techniques and drug adherence. In developing regions like Nigeria where health care delivery faces a lot of drawbacks, it becomes paramount to address these issues of poor PMTCT coverage by conducting a baseline assessment of the knowledge, practices and perceptions related to HIV prevention amongst healthcare workers in Nigeria. A descriptive cross-sectional study was conducted amongst 250 health workers currently employed in health facilities in Abuja, Nigeria where PMTCT services were offered with the capacity to carry out early infant diagnosis testing (EID). Data was collected using a self-administered, pretested, structured questionnaire. This study showed that the knowledge of PMTCT of HIV was poor (30%) among healthcare workers who offer this service day-to-day to pregnant women. When PMTCT practices were analyzed in keeping with National PMTCT guidelines, over 61% of the respondents reported observing standard practices and the majority (58%) had good attitudes towards caring for patients with HIV/AIDS. Although 61% of the respondents reported being satisfied with the quality of service being rendered, 63% reported not being satisfied with their level of knowledge. Predictors of good knowledge were job designation and level of educational attainment. Health workers who were more satisfied with their working conditions and those who had worked for a longer time in the PMTCT service were more likely to observe standard PMTCT practices. With over 62% of the healthcare workers suggesting that more training would improve the quality of service being rendered, this is a strong pointer to stakeholders to consider a ‘healthcare worker-oriented approach’ when planning and conducting PMTCT training for healthcare workers. This in turn will increase pediatric ARV coverage, the knowledge and effectiveness of the healthcare workers in carrying out appropriate PMTCT interventions and culminating in the reduction/elimination of HIV transmission to newborns.

Keywords: attitudes, HIV/AIDS, healthcare workers, knowledge, mother to child transmission, Nigeria, perceptions

Procedia PDF Downloads 190

Authors: Evgeni Baratashvili, Nino Pailodze, Ana Bolkvadze, Giorgi Sulashvili

Abstract:

At the present stage in our country intensifies cooperation with different business cultures, actively developing the process of implementation of Georgia in the global business system that requires us to develop a specific concept, including in the field of management. With the entry of Georgia into the international community, exchange of experience will only intensify. It is clear that the achievement of goals such as the doubling of the National Product increase the competitiveness of Georgian enterprises can’t be recorded without foreign management experience. On the other hand, knowledge of the areas of comparative management can be used in the process of choosing the path of socio-economic development of Georgia.

Keywords: business cultures, comparative management, corporate culture, Georgian business, Anglo-Saxon model, Georgian civilization, anti-capitalist mentality, culture management

Procedia PDF Downloads 459

Authors: Ida Bagus Made Putra Jandhana, Teuku Yuri M. Zagloel, Rahmat Nurchayo

Abstract:

Having several crises that affect industrial sector performance in the past decades, decision makers should utilize measurement application that enables them to measure industrial resiliency more precisely. It provides not only a framework for the development of resilience measurement application, but also several theories for the concept building blocks, such as performance measurement management, and resilience engineering in real world environment. This research is a continuation of previously published paper on performance measurement in the industrial sector. Finally, this paper contributes an alternative performance measurement method in industrial sector based on resilience concept. Moreover, this research demonstrates how applicable the concept of resilience engineering is and its method of measurement.

Keywords: industrial, measurement, resilience, sector

Procedia PDF Downloads 261

Authors: Tauqir A. Moughal, Fusheng Yu, Abeer Mazher

Abstract:

Land-cover and land-use change information are important because of their practical uses in various applications, including deforestation, damage assessment, disasters monitoring, urban expansion, planning, and land management. Therefore, developing change detection methods for remote sensing images is an important ongoing research agenda. However, detection of change through optical remote sensing images is not a trivial task due to many factors including the vagueness between the boundaries of changed and unchanged regions and spatial dependence of the pixels to its neighborhood. In this paper, we propose a binary change detection technique for bi-temporal optical remote sensing images. As in most of the optical remote sensing images, the transition between the two clusters (change and no change) is overlapping and the existing methods are incapable of providing the accurate cluster boundaries. In this regard, a methodology has been proposed which uses the fuzzy c-means clustering to tackle the problem of vagueness in the changed and unchanged class by formulating the soft boundaries between them. Furthermore, in order to exploit the neighborhood information of the pixels, the input patterns are generated corresponding to each pixel from bi-temporal images using 3×3, 5×5 and 7×7 window. The between images and within image spatial dependence of the pixels to its neighborhood is quantified by using Pearson product moment correlation and Moran’s I statistics, respectively. The proposed technique consists of two phases. At first, between images and within image spatial correlation is calculated to utilize the information that the pixels at different locations may not be independent. Second, fuzzy c-means technique is used to produce two clusters from input feature by not only taking care of vagueness between the changed and unchanged class but also by exploiting the spatial correlation of the pixels. To show the effectiveness of the proposed technique, experiments are conducted on multispectral and bi-temporal remote sensing images. A subset (2100×1212 pixels) of a pan-sharpened, bi-temporal Landsat 5 thematic mapper optical image of Los Angeles, California, is used in this study which shows a long period of the forest fire continued from July until October 2009. Early forest fire and later forest fire optical remote sensing images were acquired on July 5, 2009 and October 25, 2009, respectively. The proposed technique is used to detect the fire (which causes change on earth’s surface) and compared with the existing K-means clustering technique. Experimental results showed that proposed technique performs better than the already existing technique. The proposed technique can be easily extendable for optical hyperspectral images and is suitable for many practical applications.

Keywords: burned area, change detection, correlation, fuzzy clustering, optical remote sensing

Procedia PDF Downloads 158

Authors: M. Keršič, M. Lužnik, J. Lužnik

Abstract:

Cervical dilatation and membrane herniation before 26th week of gestation poses very high risk for extremely and very premature childbirth. Cerclage with mesh cap (mesh cerclage, MC) can greatly diminish this risk and provide additional positive effects. Between 2005 and 2014, MC has been performed in 9 patients with singleton pregnancies who had prolapsed membranes beyond external cervical/uterine os before 25th week of pregnancy (one in 29th). With patients in general anaesthesia, lithotomy and Trendelenburg position (about 25°) prolapsed membranes were repositioned in the uterine cavity, using tampon soaked in antiseptic solution (Skinsept mucosa). A circular, a type of purse-string suture (main band) with double string Ethilon 1 was applied at about 1 to 1.5 cm from the border of the external uterine os - 6 to 8 stitches were placed, so the whole external uterine os was encircled (modified McDonald). In the next step additional Ethilon 0 sutures were placed around all exposed parts of the main double circular suture and loosely tightened. On those sutures, round tailored (diameter around 6 cm) mesh (Prolene® or Gynemesh* PS) was attached. In all 9 cases, gestation was prolonged on average for 9 weeks and 4 days (67 days). In four cases maturity was achieved. Mesh was removed in 37th–38th week of pregnancy or if spontaneous labour began. In two cases, a caesarean section was performed because of breech presentation. In the first week after birth in 22nd week one new born died because of immaturity (premature birth was threatening in 18th week and then MC was placed). Ten years after first MC, 8 of 9 women with singleton pregnancy and MC performed have 8 healthy children from these pregnancies. Mesh cerclage successfully closed the opened cervical canal or uterine orifice and prevented further membrane herniation and membrane rupture. MC also provides a similar effect as with occluding the external os with suturing but without interrupting the way for excretion of abundant cervical mucus. The mesh also pulls the main circular band outwards and thus lowers the chance of suture cutting through the remaining cervix. MC prolonged gestation very successfully (mean for 9 weeks and 4 days) and thus increased possibility for survival and diminished the risk for complications in very early preterm delivered survivors in cases with cervical dilatation and membrane herniation before 26th week of gestation. Without action possibility to achieve at least 28th or 32nd week of gestation would be poor.

Keywords: cervical insufficiency, mesh cerclage, membrane protrusion, premature birth prevention, physical exam-indicated cerclage, rescue cerclage

Procedia PDF Downloads 179

Authors: Zohre Shahhosseini, Mehdi Pourasghar, AliReza Khalilian, Fariba Salehi

Abstract:

Objective: The prevalence of anxiety during pregnancy, particularly in developing countries, and its adverse effects on mother and baby, can make pregnancy unpleasant for pregnant women. The effect of anxiety during pregnancy on birth outcomes and children can be a justification for screening of anxious pregnant women in periodic pregnancy care and helping them. In this study, researchers have investigated effects and comparison of group counseling (Cognitive therapy) and interactive lectures on anxiety during pregnancy of primiparas. Methods: The population studied in this semi-experimental trail was nulliparous pregnant women with backgrounds in health care centers in Sari city .They were studied during a period of 3 months from early March to end May 2016. Sample size in this study was 91 patients, who were randomly assigned to three groups: group counseling, interactive lecture, and control group. Demographic questionnaire and Speilberger State –Trait Anxiety Inventory (SPAI) was completed for all three groups after obtaining letter of consent and completing the initial checklist. Then interventions included 4 sessions for group counseling and 4 sessions for interactive lecture which were implemented in two sessions a week. 4 weeks after interventions, Speilberger State – Trait Anxiety Inventory (SPAI), completed by both group counseling and interactive lectures groups again. In control group, the second questionnaire was also completed 4 weeks after completing the initial questionnaire. Data analysis was performed using spss software version 18. At first, the Kalmogorov-Smiranov test was carried out and then chi square tests, Independent t-test, paired t-test, ANOVA test, and Dunnett's post hoc test were applied. Results: Findings show that group counseling and interactive lecture with reducing state and trait anxiety in significant level of P=0/000 contribute to reduction of anxiety in nulliparous pregnant mothers. However, in this study, group counseling was more effective than an interactive lecture in reducing participants' anxiety, but this difference was not significant (P≥0/05). Conclusions: According to the results of this study, it is suggested that by screening of psychological - mental problems of pregnant women in periodic care during pregnancy be considered by revised prenatal care plans and creation of counseling and training units at health centers. Besides owing to the fact that both interactive lecture and group counseling method were effective in reducing anxiety, these methods should be used proportionate to situations and facilities.

Keywords: anxiety, group counseling, cognitive therapy, interactive lecture, nulliparous

Procedia PDF Downloads 282

Authors: Jayahar Sivasubramanian

Abstract:

Understanding laminar-turbulent transition process in hyper-sonic boundary layers is crucial for designing viable high speed flight vehicles. The study of transition becomes particularly important in the high speed regime due to the effect of transition on aerodynamic performance and heat transfer. However, even after many years of research, the transition process in hyper-sonic boundary layers is still not understood. This lack of understanding of the physics of the transition process is a major impediment to the development of reliable transition prediction methods. Towards this end, spatial Direct Numerical Simulations are conducted to investigate the instability waves generated by a localized disturbance in a hyper-sonic flat plate boundary layer. In order to model a natural transition scenario, the boundary layer was forced by a short duration (localized) pulse through a hole on the surface of the flat plate. The pulse disturbance developed into a three-dimensional instability wave packet which consisted of a wide range of disturbance frequencies and wave numbers. First, the linear development of the wave packet was studied by forcing the flow with low amplitude (0.001% of the free-stream velocity). The dominant waves within the resulting wave packet were identified as two-dimensional second mode disturbance waves. Hence the wall-pressure disturbance spectrum exhibited a maximum at the span wise mode number k = 0. The spectrum broadened in downstream direction and the lower frequency first mode oblique waves were also identified in the spectrum. However, the peak amplitude remained at k = 0 which shifted to lower frequencies in the downstream direction. In order to investigate the nonlinear transition regime, the flow was forced with a higher amplitude disturbance (5% of the free-stream velocity). The developing wave packet grows linearly at first before reaching the nonlinear regime. The wall pressure disturbance spectrum confirmed that the wave packet developed linearly at first. The response of the flow to the high amplitude pulse disturbance indicated the presence of a fundamental resonance mechanism. Lower amplitude secondary peaks were also identified in the disturbance wave spectrum at approximately half the frequency of the high amplitude frequency band, which would be an indication of a sub-harmonic resonance mechanism. The disturbance spectrum indicates, however, that fundamental resonance is much stronger than sub-harmonic resonance.

Keywords: boundary layer, DNS, hyper sonic flow, instability waves, wave packet

Procedia PDF Downloads 173

Authors: M.R Asghari Bejestani, Gh. R. Mohammad Khani, V.R. Nafisi

Abstract:

Imagined speech recognition is one of the most interesting approaches to BCI development and a lot of works have been done in this area. Many different experiments have been designed and hundreds of combinations of feature extraction methods and classifiers have been examined. Reported classification accuracies range from the chance level to more than 90%. Based on non-stationary nature of brain signals, we have introduced 3 classification modes according to time difference in inter and intra-class samples. The modes can explain the diversity of reported results and predict the range of expected classification accuracies from the brain signal accusation procedure. In this paper, a few samples are illustrated by inspecting results of some previous works.

Keywords: brain computer interface, silent talk, imagined speech, classification, signal processing

Procedia PDF Downloads 135

Authors: Shashi Bala, Neha A. Chugh, Subhash C. Bansal, Mohal L. Garg, Ashwani Koul

Abstract:

Purpose: The present study was designed to evaluate the radioprotective efficacy of Aloe vera from whole body X-ray exposure in rodents. Materials and Methods: For this purpose, after on week’s acclimatization, male balb/c mice procured from Central Animal House, Panjab University, Chandigarh (India), were divided into four groups: Group I mice served as control. Group II mice were orally administrated Aloe vera pulp extract (50 mg/ kg body weight) on alternate days for 30 days. Group III mice were subjected to whole body X-ray irradiation to cumulative dose of 2Gy (0.258Gy twice a day for four days in the last week). Group IV animals were pretreated with Aloe vera pulp extract on alternate days as in Group II and in the last week of the study, they were exposed to X-ray as in Group III. Results: Spleen of X-ray irradiated mice showed histopathological alterations accompanied with enhanced activity of lactate dehydrogenase (LDH) in serum. Elevated levels of reactive oxygen species (ROS), lipid peroxidation (LPO), enhanced activities in Glutathione based enzymes such as Glutathione peroxidase (GSH-Px), Glutathione reductase (GR), Catalase (CAT), Superoxide dismutase (SOD) associated with depletion in reduced Glutathione (GSH) concentration were observed after X-ray exposure in blood plasma and spleen.. Pro-inflammatory cytokines like tumor necrosis factors (TNF-α) and Inteleukin-6 (IL-6) levels were also found to be enhanced in serum of irradiated mice. Irradiation-induced significant elevation in Total leucocyte counts (TLC), neutrophil counts and decline in platelet counts, associated with unaltered levels of red blood cell counts (RBC’s) and haemoglobin (Hb) in various treatment groups. Clastogenic damage and apoptosis was also found to be increase in splenic tissue of X-ray exposed mice as assessed by micronucleus and TUNEL assay. However, X-ray irradiated animals administered with Aloe vera revealed significant improvement in levels of ROS/ LPO, LDH activity, and antioxidant mechanism. Aloe vera pretreated animals exhibited less severe damage, and early recovery in micronucleated cells, hematological parameters, apoptotic cells and inflammatory markers as compared to X-ray exposed mice. Conclusion: These results indicate that the radioprotective potential of Aloe vera against X-ray induced damage. This may be due to its free radical scavenging, antioxidant, anti-apoptotic and anti-inflammatory properties.

Keywords: aloe vera, antioxidant defense system, lactate dehydrogenase (LDH), micronucleus assay, x-ray

Procedia PDF Downloads 181

Authors: A. J. Regan, F. J. Lidgey, M. Betteridge, P. Georgiou, C. Toumazou, K. Hayatleh, J. R. Dibble

Abstract:

Our goal is development of an algorithm capable of predicting the directional trend of the Standard and Poor’s 500 index (S&P 500). Extensive research has been published attempting to predict different financial markets using historical data testing on an in-sample and trend basis, with many authors employing excessively complex mathematical techniques. In reviewing and evaluating these in-sample methodologies, it became evident that this approach was unable to achieve sufficiently reliable prediction performance for commercial exploitation. For these reasons, we moved to an out-of-sample strategy based on linear regression analysis of an extensive set of financial data correlated with historical closing prices of the S&P 500. We are pleased to report a directional trend accuracy of greater than 55% for tomorrow (t+1) in predicting the S&P 500.

Keywords: financial algorithm, GPU, S&P 500, stock market prediction

Procedia PDF Downloads 337

Authors: Maitree Thamma, Witchupong Wiboonjaroen, Thanat Suknuan, Karan Homchat

Abstract:

First order plus dead time (FOPDT) is a high dynamic system. Therefore, the controller must be intelligent. This paper presents the development and implementation of self-tuning Fuzzy-PID controller for controlling the FOPDT system. The water level process used represented FOPDT system and the mathematical model of the system was approximated by using System Identification toolbox in Matlab. The control programming and Fuzzy-PID algorithm used Matlab/Simulink and run on Microcontroller STM32.

Keywords: real-time control, self-tuning fuzzy-PID, FOPDT system, the water lever process

Procedia PDF Downloads 272

Authors: P. Cavlan, B. Kırmızıgil

Abstract:

Introduction: Each exercise in suspension exercises offer the use of gravity and body weight; and is thought to develop the equilibrium, flexibility and body stability necessary for daily life activities and sports, in addition to creating the correct functional force. Suspension exercises based on body weight focus the human body as an integrated system. Total Resistance Exercises (TRX) suspension training that physiotherapists, athletic health clinics, exercise centers of hospitals and chiropractic clinics now use for rehabilitation purposes. The purpose of this study is to investigate and compare the effects of TRX suspension exercises on physical performance in healthy individuals. Method: Healthy subjects divided into two groups; the study group and the control group with 40 individuals for each, between ages 20 to 45 with similar gender distributions. Study group had 2 sessions of suspension exercises per week for 8 weeks and control group had no exercises during this period. All the participants were given explosive strength, flexibility, strength and endurance tests before and after the 8 week period. The tests used for evaluation were respectively; standing long jump test and single leg (left and right) long jump tests, sit and reach test, sit up and back extension tests. Results: In the study group a statistically significant difference was found between prior- and final-tests in all evaluations, including explosive strength, flexibility, core strength and endurance of the group performing TRX exercises. These values were higher than the control groups’ values. The final test results were found to be statistically different between the study and control groups. Study group showed development in all values. Conclusions: In this study, which was conducted with the aim of investigating and comparing the effects of TRX suspension exercises on physical performance, the results of the prior-tests of both groups were similar. There was no significant difference between the prior and the final values in the control group. It was observed that in the study group, explosive strength, flexibility, strength, and endurance development was achieved after 8 weeks. According to these results, it was shown that TRX suspension exercise program improved explosive strength, flexibility, especially core strength and endurance; therefore the physical performance. Based on the results of our study, it was determined that the physical performance, an indispensable requirement of our life, was developed by the TRX suspension system. We concluded that TRX suspension exercises can be used to improve the explosive strength and flexibility in healthy individuals, as well as developing the muscle strength and endurance of the core region. The specific investigations could be done in this area so that programs that emphasize the TRX's physical performance features could be created.

Keywords: core strength, endurance, explosive strength, flexibility, physical performance, suspension exercises

Procedia PDF Downloads 153

Authors: Adeniyi Samuel Adekoya

Abstract:

The study assessed the independent effects of age and energy expenditure on the risks of obesity among adults (20-64 years). A cross-sectional study with changes in age, changes in work and leisure-time, and physical activities information played roles, with cut-off for energy expenditure and BMI in rural and urban localities. Physical activity information determined the energy expenditure, while the BMI determined the risk of obesity among the subjects. Statistically, age has a strong and direct association with obesity in both rural and urban settings, while energy expenditure was inverse in its association. Findings from the this study showed that in developing societies, age tends to be a risk factor for obesity, whereas energy expenditure is to be protective. Level of education and economic development are also relevant modifiers of the influences exerted by these variables.

Keywords: age, energy expenditure, BMI, rural/urban

Procedia PDF Downloads 407

Authors: T. Ferreira, A. Kulkarni, C. Bretscher, K. Richter, M. Ehrlich, A. Marchini

Abstract:

H-1 protoparvovirus (H-1PV) is a virus with inherent oncolytic and oncosuppressive activities while remaining non-pathogenic in humans. H-1PV was the first oncolytic parvovirus to undergo clinical testing. Results from trials in patients with glioblastoma or pancreatic carcinoma showed an excellent safety profile and first signs of efficacy. H-1PV infection is vastly dependent on cellular factors, from cell attachment and entry to viral replication and egress. Hence, we believe that the characterisation of the parvovirus life cycle would ultimately help further improve H-1PV clinical outcome. In the present study, we explored the entry pathway of H-1PV in cervical HeLa and glioma NCH125 cancer cell lines. Electron and confocal microscopy showed viral particles associated with clathrin-coated pits and vesicles, providing the first evidence that H-1PV cell entry occurs through clathrin-mediated endocytosis. Accordingly, we observed that by blocking clathrin-mediated endocytosis with hypertonic sucrose, chlorpromazine, or pitstop 2, H-1PV transduction was markedly decreased. Accordingly, siRNA-mediated knockdown of AP2M1, which retains a crucial role in clathrin-mediated endocytosis, verified the reliance of H-1PV on this route to enter HeLa and NCH125 cancer cells. By contrast, we found no evidence of viral entry through caveolae-mediated endocytosis. Indeed, pre-treatment of cells with nystatin or methyl-β-cyclodextrin, both inhibitors of caveolae-mediated endocytosis, did not affect viral transduction levels. Unexpectedly, siRNA-mediated knockdown of caveolin-1, the main driver of caveolae-mediated endocytosis, increased H-1PV transduction, suggesting caveolin-1 is a negative modulator of H-1PV infection. We also show that H-1PV entry is dependent on dynamin, a protein responsible for mediating the scission of vesicle neck and promoting further internalisation. Furthermore, since dynamin inhibition almost completely abolished H-1PV infection, makes it unlikely that H-1PV uses macropinocytosis as an alternative pathway to enter cells. After viral internalisation, H-1PV passes through early to late endosomes as observed by confocal microscopy. Inside these endocytic compartments, the acidic environment proved to be crucial for a productive infection. Inhibition of acidification of pH dramatically reduced H-1PV transduction. Besides, a fraction of H-1PV particles was observed inside LAMP1-positive lysosomes, most likely following a non-infectious route. To the author's best knowledge, this is the first study to characterise the cell entry pathways of H-1PV. Along these lines, this work will further contribute to understand H-1PV oncolytic properties as well as to improve its clinical potential in cancer virotherapy.

Keywords: clathrin-mediated endocytosis, H-1 parvovirus, oncolytic virus, virus entry

Procedia PDF Downloads 136

Authors: Aigerim Uyzbayeva, Valeriya Tyo, Nurlan Ibrayev

Abstract:

Kazakhstan is currently one of the dynamically developing states in its region. The stable growth in all sectors of the economy leads to a corresponding increase in energy consumption. Thus, country consumes a significant amount of energy due to the high level of industralisation and the presence of energy-intensive manufacturing such as mining and metallurgy which in turn leads to low energy efficiency. With allowance for this the Government has set several priorities to adopt a transition of Republic of Kazakhstan to a “green economy”. This article provides an overview of Kazakhstan’s energy efficiency situation in for the period of 1991-2014. First, the dynamics of production and consumption of conventional energy resources are given. Second, the potential of renewable energy sources is summarised, followed by the description of GHG emissions trends in the country. Third, Kazakhstan’ national initiatives, policies and locally implemented projects in the field of energy efficiency are described.

Keywords: energy efficiency in Kazakhstan, greenhouse gases, renewable energy, sustainable development

Procedia PDF Downloads 566

Authors: Łukasz Ambroziak

Abstract:

Although the impact of the production fragmentation on trade flows has been examined many times since the 1990s, the research was not comprehensive because of the limitations in traditional trade statistics. Early 2010s the complex databases containing world input-output tables (or indicators calculated on their basis) has made available. It increased the possibilities of examining the production sharing in the world. The trade statistic in value-added terms enables us better to estimate trade changes resulted from the internationalisation and globalisation as well as benefits of the countries from international trade. In the literature, there are many research studies on this topic. Unfortunately, trade in value added of the Central and Eastern European Countries (CEECs) has been so far insufficiently studied. Thus, the aim of the paper is to present changes in value added trade of the CEECs (Bulgaria, the Czech Republic, Estonia, Hungary, Latvia, Lithuania, Poland, Romania, Slovakia and Slovenia) in the period of 1995-2011. The concept 'trade in value added' or 'value added trade' is defined as the value added of a country which is directly and indirectly embodied in final consumption of another country. The typical question would be: 'How much value added is created in a country due to final consumption in the other countries?' The data will be downloaded from the World Input-Output Database (WIOD). The structure of this paper is as follows. First, theoretical and methodological aspects related to the application of the input-output tables in the trade analysis will be studied. Second, a brief survey of the empirical literature on this topic will be presented. Third, changes in exports and imports in value added of the CEECs will be analysed. A special attention will be paid to the differences in bilateral trade balances using traditional trade statistics (in gross terms) on one side, and value added statistics on the other. Next, in order to identify factors influencing value added exports and value added imports of the CEECs the generalised gravity model, based on panel data, will be used. The dependent variables will be value added exports and imports. The independent variables will be, among others, the level of GDP of trading partners, the level of GDP per capita of trading partners, the differences in GDP per capita, the level of the FDI inward stock, the geographical distance, the existence (or non-existence) of common border, the membership (or not) in preferential trade agreements or in the EU. For comparison, an estimation will also be made based on exports and imports in gross terms. The initial research results show that the gravity model better explained determinants of trade in value added than gross trade (R2 in the former is higher). The independent variables had the same direction of impact both on value added exports/imports and gross exports/imports. Only value of coefficients differs. The most difference concerned geographical distance. It had smaller impact on trade in value added than gross trade.

Keywords: central and eastern European countries, gravity model, input-output tables, trade in value added

Procedia PDF Downloads 229

Authors: E. V. Fakhrutdinova, Y. S. Kolesnikova, E. A. Karasik, V. M. Zagidullina

Abstract:

Poverty as the social and economic phenomenon exists in any society and represents a many-sided problem. In this sense it is universal and for many centuries serves as a research objects for scientists. Special attention to a problem of poverty in Russia is caused, first of all, by the critical growth of inequality and by scales of expansion of poverty, considerable decrease in the level and quality of life of the population, decrease in availability of education during the period of reforming. The expansion of poverty on the working members of society, youth, which has to provide reproduction of the population is alarming. As poverty is the reason of weakening of national security of the country, degradation of the population, decline in the quality of the human capital, complication of a demographic situation, strengthening of social contradictions in society, so far as the reduction of poverty, so, the increase in production. Poverty: the characteristic of an economic situation of the individual or social group at which they can't satisfy certain minimum requirements necessary for life, preservations of working capacity and reproduction. Poverty became one of the critical factors expelling people from the system of the institutional interactions reducing social space in which their relations were building breaking their social identity. Complication of the problem of poverty in modern society happened due to penetration of the related relations into many spheres of life. It is known that negative consequences of poverty display not only at the personal level of the poor person, but also at the level of interpersonal social interactions, decline in the quality and level of development of the human capital, and also at social and economic system in general. We conducted a research on the influence of education on the change of poverty level of the population. We consider education as a resource for an increase of the income and social mobility. Dependence of the income of the population on the level of education, availability of education (level of education and quality of education) on the level of income of families is found. Differentiation of quality and number of educational services for children depending on the level of the income of families is revealed. Influence of a factor of poverty on the availability of education is also studied. We consider expenses on education as the limiter of access to education. We consider education as a factor of fixation and aggravation of a property inequality. In the solution of problems of poverty the defining condition is the state regulation of social and economic development by means of creation of the effective institutional environment. The state has to develop measures for an increase of availability of various services to all categories of citizens, in particular services of health care and education, especially for poor citizens enters. The special attention regarding an increase of availability of education services has to be paid to creation of system of social elevators.

Keywords: poverty, education, human capital, quality of life

Procedia PDF Downloads 313

Authors: Helen Nelly Naiga, Jane Frances Zalwango, Saudah N. Kizito, Brian Agaba, Brenda N Simbwa, Maria Goretti Zalwango, Richard Migisha, Benon Kwesiga, Daniel Kadobera, Alex Ario Riolexus, Sarah Paige, Julie R. Harris

Abstract:

Background: Traditional community beliefs and practices can facilitate the spread of Ebola virus during outbreaks. On September 20, 2022, Uganda declared a Sudan Virus Disease (SVD) outbreak after a case was confirmed in Mubende District. During September–November 2022, the outbreak spread to eight additional districts. We investigated the role of community beliefs and practices in the spread of SUDV in Uganda in 2022. Methods: A qualitative study was conducted in Mubende, Kassanda, and Kyegegwa districts in February 2023. We conducted nine focus group discussions (FGDs) and six key informant interviews (KIIs). FGDs included SVD survivors, household members of SVD patients, traditional healers, religious leaders, and community leaders. Key informants included community, political, and religious leaders, traditional healers, and health workers. We asked about community beliefs and practices to understand if and how they contributed to the spread of SUDV. Interviews were recorded, translated, transcribed, and analyzed thematically. Results: Frequently-reported themes included beliefs that the community deaths, later found to be due to SVD, were the result of witchcraft or poisoning. Key informants reported that SVD patients frequently first consulted traditional healers or spiritual leaders before seeking formal healthcare, and noted that traditional healers treated patients with signs and symptoms of SVD without protective measures. Additional themes included religious leaders conducting laying-on-of-hands prayers for SVD patients and symptomatic contacts, SVD patients and their symptomatic contacts hiding in friends’ homes, and exhumation of SVD patients originally buried in safe and dignified burials, to enable traditional burials. Conclusion: Multiple community beliefs and practices likely promoted SVD outbreak spread during the 2022 outbreak in Uganda. Engaging traditional and spiritual healers early during similar outbreaks through risk communication and community engagement efforts could facilitate outbreak control. Targeted community messaging, including clear biological explanations for clusters of deaths and information on the dangers of exhuming bodies of SVD patients, could similarly facilitate improved control in future outbreaks in Uganda.

Keywords: Ebola, Sudan virus, outbreak, beliefs, traditional

Procedia PDF Downloads 48

Authors: Desiree Llaguno Cerezo, Elizabeth Valdes-Miranda Fernandez

Abstract:

Women have a critical role in sustaining the economy and in the development of trade. However, such a role has long been invisible due to orthodox conceptions that have ignored the gender variable in commercial analyses. Today, it is generally accepted that neither the economy nor business are gender-neutral and that the performance of these activities often impact negatively the lives of women. Women’s participation in trade, on equal terms as men, in any of the various possible roles -producer, wage earner, consumer, merchant, taxpayer- will not only favour the lives of women but also the performance of the economies in which they participate. Transparency, as a principle of the multilateral trading system, can play a significant role as a strategy for the empowerment of women.

Keywords: trade, human rights, gender equality, transparency, WTO, women workers, women's economic empowerment

Procedia PDF Downloads 141

Authors: Virany Diana, Martono Tri Utomo, Risa Etika

Abstract:

Background: Shock is one severe condition that can be a major cause of morbidity and mortality in the Neonatal Intensive Care Unit. Preterm infants are very susceptible to shock caused by many complications such as asphyxia, patent ductus arteriosus, intra ventricle haemorrhage, necrotizing enterocolitis, persistent pulmonal hypertension of the newborn, and septicaemia. Limited hemodynamic monitoring for early detection of shock causes delayed intervention and comprises the outcomes. Clinical parameters still used in neonatal shock detection, such as Capillary Refill Time, heart rate, cold extremity, and urine production. Blood pressure is most frequently used to evaluate preterm's circulation, but hypotension indicates uncompensated shock. Near-infrared spectroscopy (NIRS) is known as a noninvasive tool for monitoring and detecting the state of inadequate tissue perfusion. Muscle oxygen saturation shows decreased cardiac output earlier than systemic parameters of tissue oxygenation when cerebral regional oxygen saturation is still stabilized by autoregulation. However, to our best knowledge, until now, no study has analyzed the decrease of muscle oxygen regional saturation (mRSO₂) and the ratio of muscle and cerebral oxygen regional saturation (mRSO₂/cRSO₂) by NIRS in preterm with shock. Purpose: The purpose of this study is to analyze the decrease of mRSO₂ and ratio of muscle to cerebral oxygen regional saturation (mRSO₂/cRSO₂) by NIRS in preterm with shock. Patients and Methods: This cross-sectional study was conducted on preterm infants with 28-34 weeks gestational age, admitted to the NICU of Dr. Soetomo Hospital from November to January 2022. Patients were classified into two groups: shock and non-shock. The diagnosis of shock is based on clinical criteria (tachycardia, prolonged CRT, cold extremity, decreased urine production, and MAP Blood Pressure less than GA in weeks). Measurement of mRSO₂ and cRSO₂ by NIRS was performed by the doctor in charge when the patient came to NICU. Results: We enrolled 40 preterm infants. The initial conventional hemodynamic parameter as the basic diagnosis of shock showed significant differences in all variables. Preterm with shock had higher mean HR (186.45±1.5), lower MAP (29.8±2.1), and lower SBP (45.1±4.28) than non-shock children, and most had a prolonged CRT. The patients’ outcome was not a significant difference between shock and non-shock patients. The mean mRSO₂ in the shock and non-shock groups were 33,65 ± 11,32 vs. 69,15 ± 3,96 (p=0.001), and the mean ratio mRSO₂/cRSO₂ 0,45 ± 0,12 vs. 0,84 ± 0,43 (p=0,001), were significantly different. The mean cRSO₂ in the shock and non-shock groups were 71,60 ± 4,90 vs. 81,85 ± 7,85 (p 0.082), not significantly different. Conclusion: The decrease of mRSO₂ and ratio of mRSO₂/cRSO₂ can differentiate between shock and non-shock in the preterm infant when cRSO₂ is still normal.

Keywords: preterm infant, regional muscle oxygen saturation, regional cerebral oxygen saturation, NIRS, shock

Procedia PDF Downloads 75

Authors: Y. H. Chen, P. Y. Chiang, T. Sugiarto, I. Karsuna, Y. J. Lin, C. C. Chang, W. C. Hsu

Abstract:

Task-specific training with intense practice of functional tasks has been emphasized for the approaches in motor rehabilitation in patients with hemiplegic strokes. Although reciprocal actions which may increase demands on motor control during seated stepping exercise, motor control is not explicitly trained with emphasis and instruction focused on traditional strengthening. Apart from cycling and treadmill, various forms of seated exerciser are becoming available for the lower extremity exercise. The benefit of seated exerciser has been focused on the effect on the cardiopulmonary system. Thus, the aim of current study is to investigate the effect of seated distance on muscle activation during seated strengthening in patients with stroke with extensor synergy pattern in the lower extremities. Electrodes were placed on the surface of lower limbs muscles, including rectus femoris (RF), vastus lateralis (VL), biceps femoris (BF) and gastrocnemius (GT) of both sides. Maximal voluntary contraction (MVC) of the muscles were obtained to normalize the EMG amplitude obtained during dynamic trials with analog raw data digitized with a sampling frequency of 2000 Hz, fully rectified and the linear enveloped. Movement cycle was separated into two phases by pushing (PP) and Return (RP). Integral EMG (iEMG) is then used to quantify level of activation during each of the phases. Subjects performed strengthening with moderate resistance with speed of 60 rpm in two different distances (D1, short) and (D2, long). The results showed greater iEMG in RF and smaller iEMG in VL and BF with obvious increase range of motion of hip flexion in D1 condition. On the contrary, no significant involvement of RF while greater level of muscular activation in VL and BF during RP was found during PP in D2 condition. In addition, greater hip internal rotation was observed in D2 condition. In patients with stroke with abnormal tone revealed by extensor synergy in the lower extremities, shorter seated distance is suggested to facilitate hip flexor muscle activation while avoid inducing hyper extensor tone which may prevent a smooth repetitive motion. Repetitive muscular contraction exercise of hip flexor may be helpful for further gait training as it may assist hip flexion during swing phase of the walking.

Keywords: seated strengthening, patients with stroke, electromyography, synergy pattern

Procedia PDF Downloads 199

Authors: Tomas Seidl

Abstract:

'Enjoy the Czech traditions with all sences!' is the main communication headline of one of the major current marketing project representing the intangible cultural heritage of the Czech Republic to its visitors. The project CZ.1.06/4.1.00/12.08915 and CZ.1.06/4.1.00/12.08916 which is solved in the period 2013-2015 is co-financed form the EU financial sources from the Integrated Operational Programme. The primary goal of the project was to analyze the dislocation and potential of the intangible cultural heritage in the Czech Republic. Further goal was to prepare a useful regionalization. An as solution based on the outcomes the creative and media strategy was created and prepared. The processor – CzechTourism expect the following web and mobile application development and successful marketing campaign in 2015.

Keywords: traditions, intangible cultural heritage, Czech Republic, CzechTourism, digital performance

Procedia PDF Downloads 353

Authors: M. Osipova

Abstract:

Thanks to informational technologies development every sphere of economics is becoming more and more data-centralized as people are generating huge datasets containing information on any aspect of their life. Applying research of such data to human resources management allows getting scarce statistics on labor market state including salary expectations and potential employees’ typical career behavior, and this information can become a reliable basis for management decisions. The following article presents results of career behavior research based on freely accessible resume data. Information used for study is much wider than one usually uses in human resources surveys. That is why there is enough data for statistically significant results even for subgroups analysis.

Keywords: human resources management, salary expectations, statistics, turnover

Procedia PDF Downloads 333

Authors: Oscar F. Toro, Alexia Pardo Figueroa, Brigitte M. Larico

Abstract:

The development of new processes in the textile industry entails designing methodologies to select adequate supplies that fit these new processes requirements. This paper presents a methodology to select chemicals that fulfill a new process technical specifications. The proposed methodology involves three major phases: (1) Data collection of chemical products, (2) Qualitative pre-selection and (3) Laboratory tests. We have applied this methodology to the selection of a binder which will form a protective film above the textile fibers and bond them. Our findings were that, there exist five possible products that can be used in our new process: Arkofil, Elvanol, Size plus A, Size plus AC and Starch. This new methodology has both qualitative and experimental variables, and can be used to select supplies for new textile processes.

Keywords: binder, chemical products, selection methodology, textile supplies, textile fiber

Procedia PDF Downloads 278

Authors: Gabriel I. Oke, Faremi O. Ayodeji

Abstract:

Background: Access to youth Friendly Health Corners is vital for ensuring sexual reproductive health and total well being of young Adults since human sexuality has been widely misunderstood. Meanwhile, behavior of young people towards it remains at variance with the alarm. This study attempt to access the impact of youth corners also called Adolescent Friendly Health Corners on manifestation of human sexual behavior among Nigerian adolescent and young adults. Description: Hundred young adults and adolescents of both sex between the Age range of 12-25years were randomly selected from 5 secondary schools and 3 prominent universities in Southwestern Nigeria and focal group discussions (FGD) were conducted among them. Fifty secondary and primary health facilities were visited between February and June 2017 to conduct interviews for health workers and to ascertain the presence or absence of youth corners. Results: 95% of the health facilities visited lack Youth Corners section neither are they willing to make provision for it due to lack of workmanship and sponsorship. However, 5% with Youth corners does not have well-trained Counselors or a Health Educator but health professionals from nursing profession. 90% of the respondents of which 16-17 years of Age is the mean age had their first sexual exposure with no use of protection even before been introduced to what Sexuality is all about. Virtually, none of the respondents had ever visited a Youth Corner before or heard the term before. 86% have heard about the term STI before of which 60% are using protection, 10% care less about any information attached to the term STI, 4% have not heard of the term STI before even when translated to their local dialect. 20% are abstaining as at the time the study was conducted and they attribute their sexual decision to religion and parental influence. Of the age group 20-25, 45% claimed they have had symptoms of one STI or the other and 40% claimed they have been tested positive for an STI before of which 12% have positive HIV status. Promiscuous behaviors were found among them before they reach the age 16years with pornography ranking the highest, followed by masturbation. Respondents blame this on peer pressure, the lack of Youth Friendly Centers in their locality and lack of proper Sexual Orientation on time. About half of the respondents make use of contraceptives while others have varying views. We found out that inability to access Youth Friendly Centers amongst the respondents might be one of the singular reasons of their early experimentation of their sex life and lack of healthy sexual lifestyle. (95% CI, P=0.922) Conclusion: The study reveals that a connection between youth Friendly Centers and Prevention of Sexually Transmitted Diseases, therefore more sustainable Friendly Youth Corners with well-trained educators are needed in various Health facilities to checkmate the numerous risks of Young People along the path of adulthood.

Keywords: adolescents, sexually transmitted infections, reproductive health, youth corners

Procedia PDF Downloads 215

Authors: Masoud Sakhinia, Sajjad Ahmad

Abstract:

Introduction: Though knowledge of the compositional makeup and structure of the limbal niche has progressed exponentially during the past decade, much is yet to be understood. Identifying the precise profile and role of the stromal makeup which spans the ocular surface may inform researchers of the most optimum conditions needed to effectively expand LESCs in vitro, whilst preserving their differentiation status and phenotype. Limbal fibroblasts, as opposed to corneal fibroblasts are thought to form an important component of the microenvironment where LESCs reside. Methods: The corneal stroma was tissue engineered in vitro using both limbal and corneal fibroblasts embedded within a tissue engineered 3D collagen matrix. The effect of these two different fibroblasts on LESCs and hTCEpi corneal epithelial cell line were then subsequently determined using phase contrast microscopy, histolological analysis and PCR for specific stem cell markers. The study aimed to develop an in vitro model which could be used to determine whether limbal, as opposed to corneal fibroblasts, maintained the stem cell phenotype of LESCs and hTCEpi cell line. Results: Tissue culture analysis was inconclusive and required further quantitative analysis for remarks on cell proliferation within the varying stroma. Histological analysis of the tissue-engineered cornea showed a comparable structure to that of the human cornea, though with limited epithelial stratification. PCR results for epithelial cell markers of cells cultured on limbal fibroblasts showed reduced expression of CK3, a negative marker for LESC’s, whilst also exhibiting a relatively low expression level of P63, a marker for undifferentiated LESCs. Conclusion: We have shown the potential for the construction of a tissue engineered human cornea using a 3D collagen matrix and described some preliminary results in the analysis of the effects of varying stroma consisting of limbal and corneal fibroblasts, respectively, on the proliferation of stem cell phenotype of primary LESCs and hTCEpi corneal epithelial cells. Although no definitive marker exists to conclusively illustrate the presence of LESCs, the combination of positive and negative stem cell markers in our study were inconclusive. Though it is less traslational to the human corneal model, the use of conditioned medium from that of limbal and corneal fibroblasts may provide a more simple avenue. Moreover, combinations of extracellular matrices could be used as a surrogate in these culture models.

Keywords: cornea, Limbal Stem Cells, tissue engineering, PCR

Procedia PDF Downloads 264

Authors: Faris Alkhalil, Rana Bitar, Amer Azaz, Hisham Natour, Noora Almeraikhi, Mohamad Miqdady

Abstract:

Background: Children with liver transplantation are achieving very good survival and so there is now a need to concentrate on achieving good health in these patients and preventing disease. Immunosuppressive medications have side effects that need to be monitored and if possible avoided. Glucocorticoids and calcineurin inhibitors are detrimental to bone and mineral homeostasis in addition steroids can also affect linear growth. Steroid sparing regimes in renal transplant children has shown to improve children’s height. Aim: We aim to review the growth and bone health of children post liver transplant by measuring bone mineral density (BMD) using dual energy X-ray absorptiometry (DEXA) scan and assessing if there is a clear link between poor growth and impaired bone health and use of long term steroids. Subjects and Methods: This is a single centre retrospective Cohort study, we reviewed the medical notes of children (0-16 years) who underwent a liver transplantation between November 2000 to November 2016 and currently being followed at our centre. Results: 39 patients were identified (25 males and 14 females), the median transplant age was 2 years (range 9 months - 16 years), and the median follow up was 6 years. Four patients received a combined transplant, 2 kidney and liver transplant and 2 received a liver and small bowel transplant. The indications for transplant included, Biliary Atresia (31%), Acute Liver failure (18%), Progressive Familial Intrahepatic Cholestasis (15%), transplantable metabolic disease (10%), TPN related liver disease (8%), Primary Hyperoxaluria (5%), Hepatocellular carcinoma (3%) and other causes (10%). 36 patients (95%) were on a calcineurin inhibitor (34 patients were on Tacrolimus and 2 on Cyclosporin). The other three patients were on Sirolimus. Low dose long-term steroids was used in 21% of the patients. A considerable proportion of the patients had poor growth. 15% were below the 3rd centile for weight for age and 21% were below the 3rd centile for height for age. Most of our patients with poor growth were not on long term steroids. 49% of patients had a DEXA scan post transplantation. 21% of these children had low bone mineral density, one patient had met osteoporosis criteria with a vertebral fracture. Most of our patients with impaired bone health were not on long term steroids. 20% of the patients who did not undergo a DEXA scan developed long bone fractures and 50% of them were on long term steroid use which may suggest impaired bone health in these patients. Summary and Conclusion: The incidence of impaired bone health, although studied in limited number of patients; was high. Early recognition and treatment should be instituted to avoid fractures and improve bone health. Many of the patients were below the 3rd centile for weight and height however there was no clear relationship between steroid use and impaired bone health, reduced weight and reduced linear height.

Keywords: bone, growth, pediatric, liver, transplantation

Procedia PDF Downloads 267