Search results for: significant changes
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 16815

Search results for: significant changes

15555 Dietary Patterns and Hearing Loss in Older People

Authors: N. E. Gallagher, C. E. Neville, N. Lyner, J. Yarnell, C. C. Patterson, J. E. Gallacher, Y. Ben-Shlomo, A. Fehily, J. V. Woodside

Abstract:

Hearing loss is highly prevalent in older people and can reduce quality of life substantially. Emerging research suggests that potentially modifiable risk factors, including risk factors previously related to cardiovascular disease risk, may be associated with a decreased or increased incidence of hearing loss. This has prompted investigation into the possibility that certain nutrients, foods or dietary patterns may also be associated with incidence of hearing loss. The aim of this study was to determine any associations between dietary patterns and hearing loss in men enrolled in the Caerphilly study. The Caerphilly prospective cohort study began in 1979-1983 with recruitment of 2512 men aged 45-59 years. Dietary data was collected using a self-administered, semi-quantitative, 56-item food frequency questionnaire (FFQ) at baseline (1979-1983), and 7-day weighed food intake (WI) in a 30% sub-sample, while pure-tone unaided audiometric threshold was assessed at 0.5, 1, 2 and 4 kHz, between 1984 and 1988. Principal components analysis (PCA) was carried out to determine a posteriori dietary patterns and multivariate linear and logistic regression models were used to examine associations with hearing level (pure tone average (PTA) of frequencies 0.5, 1, 2 and 4 kHz in decibels (dB)) for linear regression and with hearing loss (PTA>25dB) for logistic regression. Three dietary patterns were determined using PCA on the FFQ data- Traditional, Healthy, High sugar/Alcohol avoider. After adjustment for potential confounding factors, both linear and logistic regression analyses showed a significant and inverse association between the Healthy pattern and hearing loss (P<0.001) and linear regression analysis showed a significant association between the High sugar/Alcohol avoider pattern and hearing loss (P=0.04). Three similar dietary patterns were determined using PCA on the WI data- Traditional, Healthy, High sugar/Alcohol avoider. After adjustment for potential confounding factors, logistic regression analyses showed a significant and inverse association between the Healthy pattern and hearing loss (P=0.02) and a significant association between the Traditional pattern and hearing loss (P=0.04). A Healthy dietary pattern was found to be significantly inversely associated with hearing loss in middle-aged men in the Caerphilly study. Furthermore, a High sugar/Alcohol avoider pattern (FFQ) and a Traditional pattern (WI) were associated with poorer hearing levels. Consequently, the role of dietary factors in hearing loss remains to be fully established and warrants further investigation.

Keywords: ageing, diet, dietary patterns, hearing loss

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15554 Associations between Polymorphism of Growth Hormone Gene on Milk Production, Fat and Protein Content in Friesian Holstein Cattle

Authors: Tety Hartatik, Dian Kurniawati, Adiarto

Abstract:

The aim of the research was to determine the associations between polymorphism of the bovine growth hormone (GH) gene (Leu/Val, L/V) and milk production of Friesian Holstein Cattle. A total of 62 cows which consist of two Friesian Holstein groups (cattle from New Zealand are 19 heads and cattle from Australia are 43 heads). We perform the PCR and RFLP method for analyzing the genotype of the target gene GH 211 bp in the part of intron 4 and exon 5 of GH gene. The frequencies of genotypes LL were higher than genotype LV. The number of genotype LL in New Zealand and Australia groups are 84% and 79%, respectively. The number of genotype LV in New Zealand and Australia groups are 16% and 21%, respectively. The association between Leu/Val polymorphism on milk production, fat and protein content in both groups does not show the significant effect. However base on the groups (cows from New Zealand compare with those from Australia) show the significant effect on fat and protein content.

Keywords: Friesian Holstein, fat content, growth hormone gene, milk production, PCR-RLFP, protein content

Procedia PDF Downloads 658
15553 Exercise Intensity Increasing Appetite, Energy, Intake Energy Expenditure, and Fat Oxidation in Sedentary Overweight Individuals

Authors: Ghalia Shamlan, M. Denise Robertson, Adam Collins

Abstract:

Appetite control (i.e. control of energy intake) is important for weight maintenance. Exercise contributes to the most variable component of energy expenditure (EE) but its impact is beyond the energy cost of exercise including physiological, behavioural, and appetite effects. Exercise is known to acutely influence effect appetite but evidence as to the independent effect of intensity is lacking. This study investigated the role of exercise intensity on appetite, energy intake (EI), appetite related hormone, fat utilisation and subjective measures of appetite. One hour after a standardised breakfast, 10 sedentary overweight volunteers. Subjects undertook either 8 repeated 60 second bouts of cycling at 95% VO2max (high intensity) or 30 minutes of continuous cycling, at a fixed cadence, equivalent to 50% of the participant’s VO2max (low intensity) in a randomised crossover design. Glucose, NEFA, glucagon-like peptide-1 (GLP-1) were measured fasted, postprandial, and pre and post-exercise. Satiety was assessed subjectively throughout the study using visual analogue scales (VAS). Ad libitum intake of a pasta meal was measured at the end (3-h post-breakfast). Interestingly, there was not significant difference in EE fat oxidation between HI and LI post-exercise. Also, no significant effect of high intensity (HI) was observed on the ad libitum meal, 24h and 48h EI post-exercise. However the mean 24h EI was 3000 KJ lower following HI than low intensity (LI). Despite, no significant differences in hunger score, glucose, NEFA and GLP-1 between both intensities were observed. However, NEFA and GLP-1 plasma level were higher until 30 min post LI. In conclusion, the similarity of EE and oxidation outcomes could give overweight individuals an option to choose between intensities. However, HI could help to reduce EI. There are mechanisms and consequences of exercise in short and long-term appetite control; however, these mechanisms warrant further explanation. These results support the need for future research in to the role of in regulation energy balance, especially for obese people.

Keywords: appetite, exercise, food intake, energy expenditure

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15552 Proposal of Methodology Based on Technical Characterization and Quantitative Contrast of Co₂ Emissions for the Migration to Electric Mobility of the Vehicle Fleet: Case Study of Electric Companies in Ecuador

Authors: Rodrigo I. Ullauri, Santiago E. Tinajero, Omar O. Ramos, Paola R. Quintana

Abstract:

The increase of CO₂ emissions in the atmosphere and its impact on climate change is a global concern. The transportation sector is a significant consumer of fossil fuels and contributes significantly to greenhouse gas emissions. The current challenge is to find ways to reduce the use of fossil fuels in transportation. In Ecuador, where 92% of electricity is generated from clean sources, the concept of e-mobility is considered an attractive alternative to address the challenge of sustainable mobility. The proposal is to migrate from combustion-powered vehicles to electric vehicles in the electric companies of Ecuador, using a methodology to standardize criteria, determine specific requirements, contrast technical characteristics, and estimate emission reductions. The results showed that there are three categories of vehicles that have electric counterparts suitable for performing activities under certain operation parameters inherent to current technology limitations but with a significant contribution to the reduction of annual CO₂ emissions.

Keywords: climate change, electro mobility, energy, sustainable transportation

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15551 Pathological Disparities in Patients Diagnosed with Prostate Imaging Reporting and Data System 3 Lesions: A Retrospective Study in a High-Volume Academic Center

Authors: M. Reza Roshandel, Tannaz Aghaei Badr, Batoul Khoundabi, Sara C. Lewis, Soroush Rais-Bahrami, John Sfakianos, Reza Mehrazin, Ash K. Tewari

Abstract:

Introduction: Prostate biopsy is the most reliable diagnostic method for choosing the appropriate management of prostate cancer. However, discrepancies between Gleason grade groups (GG) of different biopsies remain a significant concern. This study aims to assess the association of the radiological factors with GG discrepancies in patients with index Prostate Imaging Reporting and Data System (PI-RADS) 3 lesions, using radical prostatectomy (RP) specimens as the most accurate and informative pathology. Methods: This single-institutional retrospective study was performed on a total of 2289 consecutive prostate cancer patients with combined targeted and systematic prostate biopsy followed by radical prostatectomy (RP). The database was explored for patients with the index PI-RADS 3 lesions version 2 and 2.1. Cancers with PI-RADS 4 or 5 scoring were excluded from the study. Patient characteristics and radiologic features were analyzed by multivariable logistic regression. Number-density of lesions was defined as the number of lesions per prostatic volume. Results: Of the 151 prostate cancer cases with PI-RADS 3 index lesions, 27% and 17% had upgrades and downgrades at RP, respectively. Analysis of grade changes showed no significant associations between discrepancies and the number or the number density of PI-RADS 3 lesions. Moreover, the study showed no significant association of the GG changes with race, age, location of the lesions, or prostate volume. Conclusions: This study demonstrated that in PI-RADS 3 cancerous nodules, the chance of the pathology changes in the final pathology of RP specimens was low. Furthermore, having multiple PI-RADS 3 nodules did not change the conclusion, as the possibility of grade changes in patients with multiple nodules was similar to those with solitary lesions.

Keywords: prostate, adenocarcinoma, multiparametric MRI, Gleason score, robot-assisted surgery

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15550 Bone Marrow ARA, EPA, and DHA Fatty Acids are Correlated with Femur Minerals Content and Enzyme of Bone Formation in Growing Rabbits

Authors: Al-Nouri Doha Mostfa, Al-Khalifa Abdulrahman Salih

Abstract:

The effects of long-term supplementation with different dietary omega-6/omega-3 (ω-6/ω-3) polyunsaturated fatty acid (PUFAs) ratios on the bone marrow fatty acids level, plasma biomarkers of bone metabolism, and minerals content in bone were evaluated in rabbits. Weanling male and female New Zealand white rabbits were randomly assigned to five groups and fed ad libitum for 100 days on diets containing 70 g/kg different dietary oils which providing the following ω-6/ω-3 ratios: soy bean oil (SBO control, 8.68), sesame oil (SO, 21.75), fish oil (FO, 0.39), DHA algae oil (DHA, 0.63), and DHA and ARA algae oils (DHA/ARA, 0.68). The bone marrow arachidonic (ARA), eicosapentaenoic (EPA), and docosahexaenoic (DHA) fatty acid levels were significantly influenced by and reflected the dietary ω-6/ω-3 ratios fed to rabbits. Rabbits fed on the FO diet maintained a lower ω-6/ω-3 ratio and a higher EPA and DHA levels, those fed on the DHA/ARA diet maintained a lower ω-6/ω-3 ratio and a higher ARA level, while those fed on the SO diet maintained a higher ω-6/ω-3 ratio and a lower ARA level. Plasma alkaline phosphatase (ALP) activity was significantly higher in male and female rabbits fed the DHA/ARA diet compared with those fed the control, SO, FO, or DHA diets. There was a significant main effect of dietary treatment on femur calcium (Ca), phosphorous (P), magnesium (Mg), and zinc (Zn) contents in both genders. This study confirmed that different dietary oil sources with varying ω-6/ω-3 ratios significantly altered the fatty acids level of bone marrow. In addition, the significant elevation in minerals content and the maintenance of optimal Ca/P ratio in bone of DHA/ARA and DHA fed groups beside the significant elevation in ALP activity in the DHA/ARA fed group proved that marine algae oils may be promising dietary sources for promoting bone mineralization and formation, thus improving bone mass during the growth stage.

Keywords: arachidonic (ARA), docosahexaenoic (DHA), eicosapentaenoic (EPA), growing rabbits

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15549 Compare the Effectiveness of Web Based and Blended Learning on Paediatric Basic Life Support

Authors: Maria Janet, Anita David, P. Vijayasamundeeswarimaria

Abstract:

Introduction: The main purpose of this study is to compare the effectiveness of web-based and blended learning on Paediatric Basic Life Support on competency among undergraduate nursing students in selected nursing colleges in Chennai. Materials and methods: A descriptive pre-test and post-test study design were used for this study. Samples of 100 Fourth year B.Sc., nursing students at Sri Ramachandra Faculty of Nursing SRIHER, Chennai, 100 Fourth year B.Sc., nursing students at Apollo College of Nursing, Chennai, were selected by purposive sampling technique. The instrument used for data collection was Knowledge Questionnaire on Paediatric Basic Life Support (PBLS). It consists of 29 questions on the general expansion of Basic Life Support and Cardiopulmonary Resuscitation, Prerequisites of Basic Life Support, and Knowledge on Paediatric Basic Life Support in which each question has four multiple choices answers, each right answer carrying one mark and no negative scoring. This questionnaire was formed with reference to AHA 2020 (American Heart Association) revised guidelines. Results: After the post-test, in the web-based learning group, 58.8% of the students had an inadequate level of objective performance score, while 41.1% of them had an adequate level of objective performance score. In the blended learning group, 26.5% of the students had an inadequate level of an objective performance score, and 73.4% of the students had an adequate level of an objective performance score. There was an association between the post-test level of knowledge and the demographic variables of undergraduate nursing students undergoing blended learning. The age was significant at a p-value of 0.01, and the performance of BLS before was significant at a p-value of 0.05. The results show that there was a significant positive correlation between knowledge and objective performance score of undergraduate nursing students undergoing web-based learning on paediatric basic life support.

Keywords: basic life support, paediatric basic life support, web-based learning, blended learning

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15548 Research on Executive Compensation Incentives and Internal Control: Evidence from China

Authors: Yinjie Han

Abstract:

This paper examines the impact of executive compensation incentives on internal control effectiveness and further analyzes the moderating role of digital transformation in this relationship. Through empirical analysis of relevant data of A-share listed companies in Shanghai and Shenzhen from 2012 to 2022, the results of the study show that there is a significant positive relationship between executive compensation incentives and internal control quality. Digital transformation plays an important moderating role in this relationship. Specifically, executive compensation incentives directly enhance the effectiveness of internal control by increasing executives' motivation and responsibility. At the same time, digital transformation further strengthens the positive impact of executive compensation incentives on the quality of internal controls by increasing information transparency and management efficiency. In addition, the study finds that the impact of executive compensation incentives on internal control quality is more significant in firms with higher levels of digital transformation. This study provides theoretical and practical guidance for enterprises to design and implement effective executive compensation incentives, promote digital transformation, and improve internal control quality.

Keywords: executive compensation incentives, internal control, digital transformation, corporate governance

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15547 Effects of Benzo(k)Fluoranthene, a Polycyclic Aromatic Hydrocarbon, on DNA Damage and Oxidative Stress in Marine Gastropod Morula Granulata

Authors: Jacky Bhagat, Baban S Ingole

Abstract:

In this study, in vivo experiments were carried out to investigate the effects of a toxic polycyclic aromatic hydrocarbon (PAH), benzo(k)fluoranthene (B[k]F), on marine gastropod, Morula granulata collected from Goa, west coast of India. Snails were exposed to different concentrations of B(k)F (1, 10, 25 and 50 µg/L) for 96 h. The genotoxic effects were evaluated by measuring DNA strand breaks using alkaline comet assay and oxidative stress were measured with the help of battery of biomarkers such as superoxide dismutase (SOD) catalase (CAT), glutathione-s-transferase (GST), and lipid peroxidation (LPO). Concentration-dependent increase in percentage tail DNA (TDNA) was observed in snails exposed to B(k)F. Exposure concentrations above 1 µg/L of B(k)F, showed significant increase in SOD activity and LPO value in snails. After 96 h, SOD activity were found to be doubled for 50 µg/L of B(k)F with reference to control. Significant increase in CAT and GST activity was observed at all exposure conditions at the end of the exposure time. Our study showed that B(k)F induces oxidative stress in snails which further lead to genotoxic damage.

Keywords: benzo(k)fluoranthene, comet assay, gastropod, oxidative stress

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15546 Effects of External and Internal Focus of Attention in Motor Learning of Children with Cerebral Palsy

Authors: Morteza Pourazar, Fatemeh Mirakhori, Fazlolah Bagherzadeh, Rasool Hemayattalab

Abstract:

The purpose of study was to examine the effects of external and internal focus of attention in the motor learning of children with cerebral palsy. The study involved 30 boys (7 to 12 years old) with CP type 1 who practiced throwing beanbags. The participants were randomly assigned to the internal focus, external focus, and control groups, and performed six blocks of 10-trial with attentional focus reminders during a practice phase and no reminders during retention and transfer tests. Analysis of variance (ANOVA) with repeated measures on the last factor was used. The results show that significant main effects were found for time and group. However, the interaction of time and group was not significant. Retention scores were significantly higher for the external focus group. The external focus group performed better than other groups; however, the internal focus and control groups’ performance did not differ. The study concluded that motor skills in Spastic Hemiparetic Cerebral Palsy (SHCP) children could be enhanced by external attention.

Keywords: cerebral palsy, external attention, internal attention, throwing task

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15545 Shear Enhanced Flotation Technology Applied to Treat Winery Wastewater

Authors: Bernard Bladergroen, David Vlotman, Bradley Cerff

Abstract:

The agricultural sector is one which requires and consumes large amounts of water globally. Commercial wine production, in particular, uses extensive volumes of fresh water and generates significant volumes of wastewater through various processes. The wastewater produced by wineries typically exhibits elevated levels of chemical oxygen demand (COD), total suspended solids (TSS), total dissolved solids (TDS), acidic pH and varying salinity and nutrient contents. This study investigates the performance of a shear-enhanced flotation separation (SEFS) pilot plant as a primary treatment stage during winery wastewater processing by modifying a conventional Dissolved Air Flotation (DAF) system. The SEFS pilot plant achieved a 99% reduction in both turbidity and TSS in comparison to the 97% achieved with the conventional DAF system. The COD was reduced by 66% and 51% for the SEFS and DAF systems, respectively. SEFS shows the advantages of hydrodynamic shear to enhance the coagulation and subsequent flocculation processes with a significant reduction of coagulant and flocculant (36% and 31%, respectively).

Keywords: shear enhanced flotation, suspended solids, primary wastewater treatment, zeta potential

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15544 Factors Affecting Students' Performance in the Examination

Authors: Amylyn F. Labasano

Abstract:

A significant number of empirical studies are carried out to investigate factors affecting college students’ performance in the academic examination. With a wide-array of literature-and studies-supported findings, this study is limited only on the students’ probability of passing periodical exams which is associated with students’ gender, absences in the class, use of reference book, and hours of study. Binary logistic regression was the technique used in the analysis. The research is based on the students’ record and data collected through survey. The result reveals that gender, use of reference book and hours of study are significant predictors of passing an examination while students’ absenteeism is an insignificant predictor. Females have 45% likelihood of passing the exam than their male classmates. Students who use and read their reference book are 38 times more likely pass the exam than those who do not use and read their reference book. Those who spent more than 3 hours in studying are four (4) times more likely pass the exam than those who spent only 3 hours or less in studying.

Keywords: absences, binary logistic regression, gender, hours of study prediction-causation method, periodical exams, random sampling, reference book

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15543 Genetic Screening of Sahiwal Bulls for Higher Fertility

Authors: Atul C. Mahajan, A. K. Chakravarty, V. Jamuna, C. S. Patil, Neeraj Kashyap, Bharti Deshmukh, Vijay Kumar

Abstract:

The selection of Sahiwal bulls on the basis of dams best lactation milk yield under breeding programme in herd of the country neglecting fertility traits leads to deterioration in their performances and economy. The goal of this study was to explore polymorphism of CRISP2 gene and their association with semen traits (Post Thaw Motility, Hypo-osmotic Swelling Test, Acrosome Integrity, DNA Fragmentation and capacitation status), scrotal circumference, expected predicted difference (EPD) for milk yield and fertility. Sahiwal bulls included in present study were 60 bulls used in breeding programme as well as 50 young bulls yet to be included in breeding programme. All the Sahiwal bulls were found to be polymorphic for CRISP2 gene (AA, AG and GG) present within exon 7 to the position 589 of CRISP2 mRNA by using PCR-SSCP and Sequencing. Semen analysis were done on 60 breeding bulls frozen semen doses pertaining to four season (winter, summer, rainy and autumn). The scrotal circumference was measured from existing Sahiwal breeding bulls in the herd (n=47). The effect of non-genetic factors on reproduction traits were studied by least-squares technique and the significant difference of means between subclasses of season, period, parity and age group were tested. The data were adjusted for the significant non-genetic factors to remove the differential environmental effects. The adjusted data were used to generate traits like Waiting Period (WP), Pregnancy Rate (PR), Expected Predicted Difference (EPD) of fertility, respectively. Genetic and phenotypic parameters of reproduction traits were estimated. The overall least-squares means of Age at First Calving (AFC), Service Period (SP) and WP were estimated as 36.69 ± 0.18 months, 120.47 ± 8.98 days and 79.78 ± 3.09 days respectively. Season and period of birth had significant effect (p < 0.01) on AFC. AFC was highest during autumn season of birth followed by summer, winter and rainy. Season and period of calving had significant effect (p < 0.01) on SP and WP of sahiwal cows. The WP for Sahiwal cows was standardized based on four developed predicted model for pregnancy rate 42, 63, 84 and 105 days using all lactation records. The WP for Sahiwal cows were standardized as 42 days. A selection criterion was developed for Sahiwal breeding bulls and young Sahiwal bulls on the basis of EPD of fertility. The genotype has significant effect on expected predicted difference of fertility and some semen parameters like post thaw motility and HOST. AA Genotype of CRISP2 gene revealed better EPD for fertility than EPD of milk yield. AA genotype of CRISP2 gene has higher scrotal circumference than other genotype. For young Sahiwal bulls only AA genotypes were present with similar patterns. So on the basis of association of genotype with seminal traits, EPD of milk yield and EPD for fertility status, AA and AG genotype of CRISP2 gene was better for higher fertility in Sahiwal bulls.

Keywords: expected predicted difference, fertility, sahiwal, waiting period

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15542 Gender Difference and Conflict Management Strategy Preference among Managers in Public Organizations in South-Western Nigeria

Authors: D. I. Akintayo, C. O. Aje

Abstract:

This study investigated the moderating influence of gender difference and conflict resolution strategy preference on managers` efficiency in managing industrial conflict in work organizations in South-Western Nigeria. This was for the purpose of ascertaining the relevance of gender difference and conflict resolution strategy preference to managerial efficiency towards ensuring sustainable industrial peace and harmonious labour-management relations at workplaces in Nigeria. Descriptive ex-post-facto research design was adopted for the study. A total of 185 respondents were selected for the study using purposive stratified sampling technique. A set of questionnaire titled ‘Rahim Organizational Conflict Inventory’ (ROCI) and Managerial Conflict Efficiency Scale (MCES) were adopted for the study. The three generated hypotheses were tested using Pearson Product Moment Correlation and t-test statistical methods. The findings of the study revealed that: A significant relationship exists between gender difference and conflict management preference of the managers(r = 0.644; P < 0.05). I t was also found that there was no significant difference between male and female managers’ conflict management strategy preference (t (181) = 11.08; P > 0.05).The finding reveals that there is no significant difference between female and male managers’ conflict management efficiency on the basis of conflict management preference of the managers (t (181) = 10.23; P > 0.05). Based on the findings of the study, it is recommended that collective bargaining strategy should be encouraged as conflict resolution strategy in order to guarantee effective management of industrial conflict and harmonious labour-management relations. Also, both male and female managers should be empowered to be appointed to managerial positions and should avoid the use of coercion, competition, aggressiveness and pro-task in the course of managing industrial conflict. Rather, persuasion, compromising, relational, lobbying and participatory approaches should be employed during collective bargaining process in order to foster effective management of conflict at workplaces.

Keywords: conflict management, gender difference, managerial studies, public organization and managers, strategy preference

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15541 Urinary Schistosomiasis among Pre-School and School Aged Children in Two Peri-Urban Communities in Southwest Nigeria

Authors: Isiaka Akinwale, Tolulope Babatunde, Oladepo Sowemimo

Abstract:

A cross-sectional study was conducted between March and April, 2016 among pre-school and school-aged children in two peri-urban communities in Osun State, Southwest Nigeria. Urine samples were collected from the pre-school and school-aged children, tested for microhaematuria using reagent strips, processed and examined for Schistosoma haematobium ova. Out of 274 pupils examined, 132 (48.2%) had infection, with no statistically significant difference (P > 0.05) in infection between male (48.6%) and female pupils (47.6%). The prevalence of infection increases significantly with age (P < 0.05), with the peak (93.3%) of infection recorded in pupils aged 15 to 16 years and the lowest infection (10.0%) in pupils aged 3 to 4 years. There was no statistically significant association (P > 0.05) between intensity in male pupils (156.0 ± 34.5/10 ml) and female pupils (141.7 ± 29.5/10 ml). The prevalence of pupils with microhaematuria was 65.0% and it increased significantly with age (P < 0.001). The conclusion drawn from the study is that to reduce the transmission of S. haematobium in endemic communities, health education and provision of potable water are advocated.

Keywords: Schistosoma haematobium, microhaeamturia, prevalence, urinary schistosomiasis, school aged children, Nigeria

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15540 Intelligent Tooling Embedded Sensors for Monitoring the Wear of Cutting Tools in Turning Applications

Authors: Hatim Laalej, Jon Stammers

Abstract:

In machining, monitoring of tool wear is essential for achieving the desired dimensional accuracy and surface finish of a machined workpiece. Currently, the task of monitoring the wear on the cutting tool is carried out by the operator who performs manual inspections of the cutting tool, causing undesirable stoppages of machine tools and consequently resulting in costs incurred from loss of productivity. The cutting tool consumable costs may also be higher than necessary when tools are changed before the end of their useful life. Furthermore, damage can be caused to the workpiece when tools are not changed soon enough leading to a significant increase in the costs of manufacturing. The present study is concerned with the development of break sensor printed on the flank surface of poly-crystalline diamond (PCD) cutting to perform on-line condition monitoring of the cutting tool used to machine Titanium Ti-6al-4v bar. The results clearly show that there is a strong correlation between the break sensor measurements and the amount of wear in the cutting tool. These findings are significant in that they help the user/operator of the machine tool to determine the condition of the cutting tool without the need of performing manual inspection, thereby reducing the manufacturing costs such as the machine down time.

Keywords: machining, manufacturing, tool wear, signal processing

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15539 Domestic Remittances, Household Enterprises, and Household Well-being in Ghana

Authors: Abdul-Majeed Imoro

Abstract:

This paper investigates the interactive effect of domestic remittances and household enterprises on household well-being in Ghana. The study employs data drawn from the seventh wave of the Ghana Living Standard Survey (GLSS 7) comprising 14,009 households located in 1,000 enumeration areas for the 2016/2017 period. This study employs the Ordinary Least Square (OLS) regression technique in estimating the interactive effect of domestic remittances and household enterprises on household well-being. The Linear Probability Model (LPM) is used to estimate the impact of domestic remittances on household enterprises. A Two-Stage Least Square (2SLS) model is employed to solve endogeneity issues between the dependent variable and the explanatory variable. This study reveals the following findings: domestic remittances improve household well-being significantly. Also, there is a significant negative impact of domestic remittances on household enterprises. This implies that households that receive domestic remittances are less likely to engage in household enterprises. Finally, the 2SLS results show a significant and positive impact of the interaction between domestic remittances and household enterprises on household well-being. This study provides empirical evidence of why policymakers need to encourage households that receive domestic remittances to diversify their income sources and invest in other income-generating activities such as household enterprises.

Keywords: domestic remittances, household enterprises, household well-being, Ghana

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15538 Factors Influencing the Use Intention of Unmanned Retail Stores

Authors: Yen-Ting Chiu, Chia-Ying Lin, Pei-Hsuan Ho

Abstract:

New technologies can help solve the problem of labor shortage and the decline of birthrate. Technologies can improve human’s life and reduce the burden on the staff and bring convenience to people. That’s why unmanned retail store X-Store was established in Taiwan to create more valuable services and shopping experiences based on smart retailing. The purpose of this study is to examine the impact of unmanned stores, X-Store, on customers’ behavioral intentions. It uses the Unified theory of acceptance and use of technology (UTAUT) model as a basis and adds a perceived value factor to explain customer willingness to use the X-Store. In addition, the study further divided the sample into gender and age groups to compare behavioral differences between different groups. The study collected 214 valid questionnaires through online questionnaires. Using SPSS as a statistical analysis tool, the results of the study show that effort expectancy, social influence, facilitating conditions, and perceived value have a significant impact on behavioral intention to use X-Store. However, performance expectancy is not significant. This research concludes with managerial implications and suggestions for retail practitioners.

Keywords: perceived value, smart retailing, unmanned store, UTAUT, X-Store

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15537 Territories' Challenges and Opportunities to Promote Circular Economy in the Building Sector

Authors: R. Tirado, G. Habert, A. Mailhac, S. Laurenceau

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The rapid development of cities implies significant material inflows and outflows. The construction sector is one of the main consumers of raw materials and producers of waste. The waste from the building sector, for its quantity and potential for recovery, constitutes significant deposits requiring major efforts, by combining different actors, to achieve the circular economy's objectives. It is necessary to understand and know the current construction actors' knowledge of stocks, urban metabolism, deposits, and recovery practices in this context. This article aims to explore the role of local governments in planning strategies by facilitating a circular economy. In particular, the principal opportunities and challenges of communities for applying the principles of the circular economy in the building sector will be identified. The approach used for the study was to conduct semi-structured interviews with those responsible for circular economy projects within local administrations of some communities in France. The results show territories' involvement in the inclusion and application of the principles of the circular economy in the building sector. The main challenges encountered are numerous, hence the importance of having identified and described them so that the different actors can work to meet them.

Keywords: building stock, circular economy, interview, local authorities

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15536 Cytotoxicity of a Short Chain Fatty Acid Histone Deactylase Inhibitor on HCT116 Human Colorectal Carcinoma Cell Line

Authors: N. A. Kazemi Sefat, M. M. Mohammadi, J. Hadjati, S. Talebi, M. Ajami, H. Daneshvar

Abstract:

Colorectal cancer metastases result in a significant number of cancer related deaths. Histone deacetylase (HDAC) inhibitors induce growth arrest and apoptosis in a variety of human cancer cells. Sodium butyrate (SB) is a short chain fatty acid, belongs to HDAC inhibitors which is released in the colonic lumen as a consequence of fiber fermentation. In this study, we are about to assess the effect of sodium butyrate on HCT116 human colorectal carcinoma cell line. The viability of cells was measured by microscopic morphologic study and MTT assay. After 48 hours, treatments more than 10 mM lead to cell injury in HCT116 by increasing cell granulation and decreasing cell adhesion (p>0.05). After 72 hours, treatments at 10 mM and more lead to significant cell injury (p<0.05). Our results may suggest that the gene expression which is contributed in cell proliferation and apoptosis has been changed under pressure of HDAC inhibition.

Keywords: colorectal cancer, sodium butyrate, cytotoxicity, MTT

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15535 The Impact of Psychopathology Course on Students' Attitudes towards Mental Illness

Authors: Lorato Itumeleng Kenosi

Abstract:

Background: Negative attitudes towards the mentally ill are widespread and a course for concern as they have a detrimental impact on individuals affected by mental illness. A possible avenue for changing attitudes towards mental illness is through mental health literacy. In a college or university setting, an abnormal psychology course may be introduced in an attempt to change student’s attitudes towards the mentally ill. Objective: To determine if and how students’ attitudes towards the mentally ill change as a result of taking a course in abnormal psychology. Methods: Twenty nine (29) students were recruited from an abnormal psychology class at the University of Botswana. Attitude Scale for Mental Illness (ASMI) questionnaire was administered to participants at the beginning and end of the semester. SPSS was employed to analyze data. Pooled means were used to determine whether the student’s attitudes towards mental illness were negative or positive. A mean of 2.5 translated to negative attitude for both total attitude and attitudes in different domains of the scale. Paired sample t-test was then used to assess whether any changes noted in attitudes were statistically significant or not. Statistical significance was assumed at p < 0.05. Results: Students’ general attitude towards mental illness remained positive although the pooled mean value increased from 2.08 to 2.24. The change was not statistically significant. In relation to different sub scales, the values of the pooled means for all the sub scales showed an increase although the changes were not statistically significant except for the Stereotyping sub scale (p = 0.031). The stereotyping domain reflected a statistically significant change in student’s attitude from positive attitude to negative (X² = 2.06 to X² = 2.55). For the pessimistic prediction domain, students consistently showed a negative attitude (X² = 3.34 to X² = 3.55). The other 4 domains indicated that students had positive attitude toward mentally ill throughout. Discussion: Abnormal psychology students have a positive attitude towards the mentally ill generally. This could be attributed to the fact that all students in the abnormal psychology course are majoring in psychology and research has shown that interest in psychology can affect one’s attitude towards mental illness. The students continuously held the view that people with mental illness are unlikely to improve as evidenced by a high score for Pessimistic prediction domain for both pre and post-test. Students initially had no stereotyping attitude towards the mentally ill, but at the end of the course, they were of the opinion that people with mental illness can be defined in a certain behavioural pattern and mental ability. This results could be an indication that students have learnt well how to differentiate abnormal from normal behaviour not necessarily that students had developed a negative attitude. Conclusion: A course in abnormal psychology does have an impact on the students’ attitudes towards the mentally ill. The impact does not solely depend on knowledge of mental illness but also on several other factors such as contact with the mentally ill, interest in psychology, and teaching methods. However, it should be noted that sometimes improved knowledge in mental illness can be misunderstood for a negative attitude. For example, stereotyping attitudes may be a reflection of the ability to differentiate between abnormal and normal behaviour.

Keywords: attitudes, mental illness, psychopathology, students

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15534 Enhanced Physiological Response of Blood Pressure and Improved Performance in Successive Divided Attention Test Seen with Classical Instrumental Background Music Compared to Controls

Authors: Shantala Herlekar

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Introduction: Entrainment effect of music on cardiovascular parameters is well established. Music is being used in the background by medical students while studying. However, does it really help them relax faster and concentrate better? Objectives: This study was done to compare the effects of classical instrumental background music versus no music on blood pressure response over time and on successively performed divided attention test in Indian and Malaysian 1st-year medical students. Method: 60 Indian and 60 Malaysian first year medical students, with an equal number of girls and boys were randomized into two groups i.e music group and control group thus creating four subgroups. Three different forms of Symbol Digit Modality Test (to test concentration ability) were used as a pre-test, during music/control session and post-test. It was assessed using total, correct and error score. Simultaneously, multiple Blood Pressure recordings were taken as pre-test, during 1, 5, 15, 25 minutes during music/control (+SDMT) and post-test. The music group performed the test with classical instrumental background music while the control group performed it in silence. Results were analyzed using students paired t test. p value < 0.05 was taken as statistically significant. A drop in BP recording was indicative of relaxed state and a rise in BP with task performance was indicative of increased arousal. Results: In Symbol Digit Modality Test (SDMT) test, Music group showed significant better results for correct (p = 0.02) and total (p = 0.029) scores during post-test while errors reduced (p = 0.002). Indian music group showed decline in post-test error scores (p = 0.002). Malaysian music group performed significantly better in all categories. Blood pressure response was similar in music and control group with following variations, a drop in BP at 5minutes, being significant in music group (p < 0.001), a steep rise in values till 15minutes (corresponding to SDMT test) also being significant only in music group (p < 0.001) and the Systolic BP readings in controls during post-test were at lower levels compared to music group. On comparing the subgroups, not much difference was noticed in recordings of Indian student’s subgroups while all the paired-t test values in the Malaysian music group were significant. Conclusion: These recordings indicate an increased relaxed state with classical instrumental music and an increased arousal while performing a concentration task. Music used in our study was beneficial to students irrespective of their nationality and preference of music type. It can act as an “active coping” strategy and alleviate stress within a very short period of time, in our study within a span of 5minutes. When used in the background, during task performance, can increase arousal which helps the students perform better. Implications: Music can be used between lectures for a short time to relax the students and help them concentrate better for the subsequent classes, especially for late afternoon sessions.

Keywords: blood pressure, classical instrumental background music, ethnicity, symbol digit modality test

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15533 Effects of Oral Resveratrol Supplementation on Inflammation and Quality of Life in Patients with Ulcerative Colitis

Authors: M. Samsami, A. Hekmatdoost, N. Ebrahimi Daryani, P. Rezanejad Asl

Abstract:

Ulcerative colitis (UC) is an inflammatory bowel disease in which immune and inflammatory factors are thought to be effective in this disease. Resveratrol is an antioxidant and anti-inflammatory compound. This study determined the effects of resveratrol compound on inflammatory factors in patients with ulcerative colitis. This study was a double-blind randomized clinical trial conducted on 50 patients with UC. Subjects received one capsule daily for 6 wk of either resveratrol (500 mg) or a placebo. Inflammatory factors, anthropometric measures, and IBDQ-9 (Inflammatory Bowel Disease Questionnaire-9) scores were assessed at baseline and at the end of the study. STATA12 software was used for data analysis. No significant differences were found in the background variables between the two groups at baseline. The results indicated that resveratrol supplementation for 6 week significantly decreased plasma levels of TNF-a and hs-CRP and the activity of NF-κB over the placebo group (p<0.001). Significant differences remained after adjustment for vitamin C (p<0.0001). The IBDQ-9 scores increased significantly in the resveratrol group over the placebo group (p<0.001). The findings of this study showed that resveratrol supplementation can be useful in patients with ulcerative colitis.

Keywords: IBD, inflammation, resveratrol, ulcerative colitis

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15532 Correlation between the Levels of Some Inflammatory Cytokines/Haematological Parameters and Khorana Scores of Newly Diagnosed Ambulatory Cancer Patients

Authors: Angela O. Ugwu, Sunday Ocheni

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Background: Cancer-associated thrombosis (CAT) is a cause of morbidity and mortality among cancer patients. Several risk factors for developing venous thromboembolism (VTE) also coexist with cancer patients, such as chemotherapy and immobilization, thus contributing to the higher risk of VTE in cancer patients when compared to non-cancer patients. This study aimed to determine if there is any correlation between levels of some inflammatory cytokines/haematological parameters and Khorana scores of newly diagnosed chemotherapy naïve ambulatory cancer patients (CNACP). Methods: This was a cross-sectional analytical study carried out from June 2021 to May 2022. Eligible newly diagnosed cancer patients 18 years and above (case group) were enrolled consecutively from the adult Oncology Clinics of the University of Nigeria Teaching Hospital, Ituku/Ozalla (UNTH). The control group was blood donors at UNTH Ituku/Ozalla, Enugu blood bank, and healthy members of the Medical and Dental Consultants Association of Nigeria (MDCAN), UNTH Chapter. Blood samples collected from the participants were assayed for IL-6, TNF-Alpha, and haematological parameters such as haemoglobin, white blood cell count (WBC), and platelet count. Data were entered into an Excel worksheet and were then analyzed using Statistical Package for Social Sciences (SPSS) computer software version 21.0 for windows. A P value of < 0.05 was considered statistically significant. Results: A total of 200 participants (100 cases and 100 controls) were included in the study. The overall mean age of the participants was 47.42 ±15.1 (range 20-76). The sociodemographic characteristics of the two groups, including age, sex, educational level, body mass index (BMI), and occupation, were similar (P > 0.05). Following One Way ANOVA, there were significant differences between the mean levels of interleukin-6 (IL-6) (p = 0.036) and tumor necrotic factor-α (TNF-α) (p = 0.001) in the three Khorana score groups of the case group. Pearson’s correlation analysis showed a significant positive correlation between the Khorana scores and IL-6 (r=0.28, p = 0.031), TNF-α (r= 0.254, p= 0.011), and PLR (r= 0.240, p=0.016). The mean serum levels of IL-6 were significantly higher in CNACP than in the healthy controls [8.98 (8-12) pg/ml vs. 8.43 (2-10) pg/ml, P=0.0005]. There were also significant differences in the mean levels of the haemoglobin (Hb) level (P < 0.001)); white blood cell (WBC) count ((P < 0.001), and platelet (PL) count (P = 0.005) between the two groups of participants. Conclusion: There is a significant positive correlation between the serum levels of IL-6, TNF-α, and PLR and the Khorana scores of CNACP. The mean serum levels of IL-6, TNF-α, PLR, WBC, and PL count were significantly higher in CNACP than in the healthy controls. Ambulatory cancer patients with high-risk Khorana scores may benefit from anti-inflammatory drugs because of the positive correlation with inflammatory cytokines. Recommendations: Ambulatory cancer patients with 2 Khorana scores may benefit from thromboprophylaxis since they have higher Khorana scores. A multicenter study with a heterogeneous population and larger sample size is recommended in the future to further elucidate the relationship between IL-6, TNF-α, PLR, and the Khorana scores among cancer patients in the Nigerian population.

Keywords: thromboprophylaxis, cancer, Khorana scores, inflammatory cytokines, haematological parameters

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15531 Intrastromal Donor Limbal Segments Implantation as a Surgical Treatment of Progressive Keratoconus: Clinical and Functional Results

Authors: Mikhail Panes, Sergei Pozniak, Nikolai Pozniak

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Purpose: To evaluate the effectiveness of intrastromal donor limbal segments implantation for treatment of progressive keratoconus considering on main characteristics of corneal endothelial cells. Setting: Outpatient ophthalmic clinic. Methods: Twenty patients (20 eyes) with progressive keratoconus II-III of Amsler classification were recruited. The worst eye was treated with the transplantation of donor limbal segments in the recipient corneal stroma, while the fellow eye was left untreated as a control of functional and morphological changes. Furthermore, twenty patients (20 eyes) without progressive keratoconus was used as a control of corneal endothelial cells changes. All patients underwent a complete ocular examination including uncorrected and corrected distance visual acuity (UDVA, CDVA), slit lamp examination fundus examination, corneal topography and pachymetry, auto-keratometry, Anterior Segment Optical Coherence Tomography and Corneal Endothelial Specular Microscopy. Results: After two years, statistically significant improvement in the UDVA and CDVA (on the average on two lines for UDVA and three-four lines for CDVA) were noted. Besides corneal astigmatism decreased from 5.82 ± 2.64 to 1.92 ± 1.4 D. Moreover there were no statistically significant differences in the changes of mean spherical equivalent, keratometry and pachymetry indicators. It should be noted that after two years there were no significant differences in the changes of the number and form of corneal endothelial cells. It can be regarded as a process stabilization. In untreated control eyes, there was a general trend towards worsening of UDVA, CDVA and corneal thickness, while corneal astigmatism was increased. Conclusion: Intrastromal donor segments implantation is a safe technique for keratoconus treatment. Intrastromal donor segments implantation is an efficient procedure to stabilize and improve progressive keratoconus.

Keywords: corneal endothelial cells, intrastromal donor limbal segments, progressive keratoconus, surgical treatment of keratoconus

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15530 The Importance of Functioning and Disability Status Follow-Up in People with Multiple Sclerosis

Authors: Sanela Slavkovic, Congor Nad, Spela Golubovic

Abstract:

Background: The diagnosis of multiple sclerosis (MS) is a major life challenge and has repercussions on all aspects of the daily functioning of those attained by it – personal activities, social participation, and quality of life. Regular follow-up of only the neurological status is not informative enough so that it could provide data on the sort of support and rehabilitation that is required. Objective: The aim of this study was to establish the current level of functioning of persons attained by MS and the factors that influence it. Methods: The study was conducted in Serbia, on a sample of 108 persons with relapse-remitting form of MS, aged 20 to 53 (mean 39.86 years; SD 8.20 years). All participants were fully ambulatory. Methods applied in the study include Expanded Disability Status Scale-EDSS and World Health Organization Disability Assessment Schedule, WHODAS 2.0 (36-item version, self-administered). Results: Participants were found to experience the most problems in the domains of Participation, Mobility, Life activities and Cognition. The least difficulties were found in the domain of Self-care. Symptom duration was the only control variable with a significant partial contribution to the prediction of the WHODAS scale score (β=0.30, p < 0.05). The total EDSS score correlated with the total WHODAS 2.0 score (r=0.34, p=0.00). Statistically significant differences in the domain of EDSS 0-5.5 were found within categories (0-1.5; 2-3.5; 4-5.5). The more pronounced a participant’s EDSS score was, although not indicative of large changes in the neurological status, the more apparent the changes in the functional domain, i.e. in all areas covered by WHODAS 2.0. Pyramidal (β=0.34, p < 0.05) and Bowel and bladder (β=0.24, p < 0.05) functional systems were found to have a significant partial contribution to the prediction of the WHODAS score. Conclusion: Measuring functioning and disability is important in the follow-up of persons suffering from MS in order to plan rehabilitation and define areas in which additional support is needed.

Keywords: disability, functionality, multiple sclerosis, rehabilitation

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15529 Comparison and Improvement of the Existing Cone Penetration Test Results: Shear Wave Velocity Correlations for Hungarian Soils

Authors: Ákos Wolf, Richard P. Ray

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Due to the introduction of Eurocode 8, the structural design for seismic and dynamic effects has become more significant in Hungary. This has emphasized the need for more effort to describe the behavior of structures under these conditions. Soil conditions have a significant effect on the response of structures by modifying the stiffness and damping of the soil-structural system and by modifying the seismic action as it reaches the ground surface. Shear modulus (G) and shear wave velocity (vs), which are often measured in the field, are the fundamental dynamic soil properties for foundation vibration problems, liquefaction potential and earthquake site response analysis. There are several laboratory and in-situ measurement techniques to evaluate dynamic soil properties, but unfortunately, they are often too expensive for general design practice. However, a significant number of correlations have been proposed to determine shear wave velocity or shear modulus from Cone Penetration Tests (CPT), which are used more and more in geotechnical design practice in Hungary. This allows the designer to analyze and compare CPT and seismic test result in order to select the best correlation equations for Hungarian soils and to improve the recommendations for the Hungarian geologic conditions. Based on a literature review, as well as research experience in Hungary, the influence of various parameters on the accuracy of results will be shown. This study can serve as a basis for selecting and modifying correlation equations for Hungarian soils. Test data are taken from seven locations in Hungary with similar geologic conditions. The shear wave velocity values were measured by seismic CPT. Several factors are analyzed including soil type, behavior index, measurement depth, geologic age etc. for their effect on the accuracy of predictions. The final results show an improved prediction method for Hungarian soils

Keywords: CPT correlation, dynamic soil properties, seismic CPT, shear wave velocity

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15528 Effect of Rolling Parameters on Thin Strip Profile in Cold Rolling

Authors: H. B. Tibar, Z. Y. Jiang

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In this study, the influence of rolling process parameters such as the work roll cross angle and work roll shifting value on the strip shape and profile of aluminum have been investigated under dry conditions at a speed ratio of 1.3 using Hille 100 experimental mill. The strip profile was found to improve significantly with increase in work roll cross angle from 0o to 1o, with an associated decrease in rolling force. The effect of roll shifting (from 0 to 8mm) was not as significant as the roll cross angle. However, an increase in work roll shifting value achieved a similar decrease in rolling force as that of work roll cross angle. The effect of work roll shifting was also found to be maximum at an optimum roll speed of 0.0986 m/s for the desired thickness. Of all these parameters, the most significant effect of the strip shape profile was observed with variation of work roll cross angle. However, the rolling force can be a significantly reduced by either increasing the the work roll cross angle or work roll shifting.

Keywords: rolling speed ratio, strip shape, work roll cross angle, work roll shifting

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15527 Effect of Oxidative Stress from Smoking on Erythrocyte Phosphatidylserine Externalization

Authors: Ratchaneewan Maneemaroj, Paveena Noisuwan, Chonlada Lakhonphon

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The smoking is one of the major risk factors in Non-Communicable Disease. Free radicals from cigarette smoke can cause oxidative stress. The oxidative insults can lead to red blood cell (RBC) senescence and are involved in the clearance of red blood cells. The objective of the present study is to assess the association between smoke, oxidative stress evaluated with serum Malondialdehyde (MDA) level and phosphatidylserine (PS) externalization (biomarker of RBC senescence) evaluated with annexin V binding. A total of sixty-four male volunteers aged 25-60 years old were recruited in this study. MDA was measured by colorimetric method. Annexin V binding was detected by flow cytometry. Our results show that there was a significant increase in MDA levels in cigarette smokers as compared to non-smokers (p < 0.001). However, there was no significant different between annexin V binding (% gate) in cigarette smokers and non-smokers (p = 0.978). These results provide evidence of free radical from smoking is associated with oxidative damage to erythrocytes. However, our results suggest that PS externalization is unlikely to have a role in RBC senescence pathway of stressed erythrocytes from cigarette smoke. The other biomarker of RBC senescence should be determined on cigarette smoker erythrocytes.

Keywords: malondialdehyde, phosphatidylserine, RBC senescence, annexin V

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15526 Effect of Fenugreek Seed with Aerobic Exercise Training on Insulin Resistance in Women with Type 2 Diabetes

Authors: M. Nasiri

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Aim: Considering the hypoglisimic ad hipolipidimic effect of the fenugreek seed and aerobic exercise training, this study was conducted to evaluate the effect of fenugreek and aerobic exercise training on insulin resistance in women with type 2 diabetes. Methodology: 32 patients with type II diabetes were selected and randomly divided into four groups: control, fenugreek, training and fenugreek - training. Fenugreek groups used 10 grams of fenugreek seeds daily for eight weeks on two occasions before noon and evening meal. Training of groups is also performed a regular program of aerobic exercise 65-55% of maximum heart rate (4 days per week).Two days before and after the training period, blood samples were taken from their brachial veins in a fasting state (12 hours prior to the test) in a sitting position. The data was analyzed used of t-independent and ANOVA at a significance level of α < 0.05. Results: Intra-group changes in all experimental groups showed that significant decrease insulin resistance, and the difference between groups showed significant difference between the groups of fenugreek - training than other groups there. Conclusions: According to the research findings to fenugreek combined with aerobic exercise more beneficial effect on the inhibition of insulin resistance in women with diabetes are recommended to them.

Keywords: fenugreek, training, insulin resistance, diabetes

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