Search results for: motility analysis of human spermatozoa
19651 Building Collapse: Factors and Resisting Mechanisms: A Review of Case Studies
Authors: Genevieve D. Fernandes, Nisha P. Naik
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All through the ages in all human civilizations, men have been engaged in construction activity, not only to build their dwellings and house their activities, but also roads, bridges to facilitate means of transport, and communication etc. The main concern in this activity was to ensure safety and reduce the collapse of the buildings and other structures. But even after taking all precautions, it is impossible to guarantee safety and collapse because of several unforeseen reasons like faulty constructions, design errors, overloading, soil liquefaction, gas explosion, material degradation, terrorist attacks and economic factors also contributing to the collapse. It is also uneconomical to design the structure for unforeseen events unless they have a reasonable chance of occurrence. In order to ensure safety and prevent collapse, many guidelines have been framed by local bodies and government authorities in many countries like the United States Department of Defence (DOD), United States General Service Administration (GSA) and Euro-Codes in European Nations. Some other practices are followed to incorporate redundancies in the structure like detailing, ductile designs, tying of elements at particular locations, and provision of hinges and interconnections. It is also to be admitted that a full-proof safe design structure for accidental events cannot be prepared and implemented as it is uneconomical and the chances of such occurrences are less. This paper reviews past case studies of the collapse of structures with the aim of developing an understanding of the collapse mechanism. This study will definitely help to bring about a detailed improvement in the design to maximise the quality of the construction at a minimal cost.Keywords: unforeseen factors, progressive collapse, collapse resisting mechanisms, column removal scenario
Procedia PDF Downloads 12719650 Towards a Methodology for the Assessment of Neighbourhood Design for Happiness
Authors: Tina Pujara
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Urban and regional research in the new emerging inter-disciplinary field of happiness is seemingly limited. However, it is progressively being recognized that there is enormous potential for social and behavioral scientists to add a spatial dimension to it. In fact, the happiness of communities can be notably influenced by the design and maintenance of the neighborhoods they inhabit. The probable key reasons being that places can facilitate human social connections and relationships. While it is increasingly being acknowledged that some neighborhood designs appear better suited for social connectedness than others, the plausible reasons for places to deter these characteristics and perhaps their influence on happiness are outwardly unknown. In addition, an explicit step wise methodology to assess neighborhood designs for happiness (of their communities) is not known to exist. This paper is an attempt towards developing such a methodological framework. The paper presents the development of a methodological framework for assessing neighborhood designs for happiness, with a particular focus on the outdoor shared spaces in neighborhoods. The developed methodological framework of investigation follows a mixed method approach and draws upon four different sources of information. The framework proposes an empirical examination of the contribution of neighborhood factors, particularly outdoor shared spaces, to individual happiness. One of the main tools proposed for this empirical examination is Jan Gehl’s Public Space Public Life (PSPL) Survey. The developed framework, as presented in the paper, is a contribution towards the development of a consolidated methodology for assessing neighborhood designs for happiness, which can further serve as a unique tool to inform urban designers, architects and other decision makers.Keywords: happiness, methodology, neighbourhood design, outdoor shared spaces
Procedia PDF Downloads 15919649 The Connection between Required Safe Egress Time and Occupant Fire Safety Training
Authors: Christina Knorr
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Analysis of the evacuation of occupants of a building plays a significant role in Fire Safety Engineering. One of the tools used for the analysis is the concept of the Required Safe Egress Time (RSET). It is generally accepted that RSET is measured from the time the fire ignites until the time that all occupants have evacuated to a safe location. Instructions on how RSET is determined can be found in both the International Fire Engineering Guidelines and, more recently, in the Australian Fire Engineering Guidelines. The guidelines also specify measures that could be applied to reduce the RSET and hence improve the performance of fire-safety measures of a building. Further, it is suggested that the delay period can be reduced through “training programs.” This study examined the overall level of fire-safety awareness among occupants of residential apartment buildings in Australia and investigated the possible effects of fire-safety training on the delay period and, hence, the RSET. A questionnaire, interviews, and an experiment were conducted to collect data about people’s fire-safety knowledge, people’s behaviour and nature, and the duration of activities people are likely to undertake in the event of a fire. The study led to an investigation into the delay and response time approximations and the development of a new equation to incorporate the impact of training into the RSET calculations for the general use of the fire engineering community. Regardless of the RSET, it can be concluded that fire-safety education and training for residents of apartment buildings have a direct impact on improving their behaviour and firefighting equipment usage in a fire incident.Keywords: fire safety engineering, fire safety training, occupant evacuation behaviour, required safe egress time
Procedia PDF Downloads 2819648 Design and Analysis of a Lightweight Fire-Resistant Door
Authors: Zainab Fadil, Mouath Alawadhi, Abdullah Alhusainan, Fahad Alqadiri, Abdulaziz Alqadiri
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This study investigates how lightweight a fire resistance door will perform with under types of insulation materials. Data is initially collected from various websites, scientific books and research papers. Results show that different layers of insulation in a single door can perform better than one insulator. Furthermore, insulation materials that are lightweight, high strength and low thermal conductivity are the most preferred for fire-rated doors. Whereas heavy weight, low strength, and high thermal conductivity are least preferred for fire-resistance doors. Fire-rated doors specifications, theoretical test methodology, structural analysis, and comparison between five different models with diverse layers insulations are presented. Five different door models are being investigated with different insulation materials and arrangements. Model 1 contains an air gap between door layers. Model 2 includes phenolic foam, mild steel and polyurethane. Model 3 includes phenolic foam and glass wool. Model 4 includes polyurethane and glass wool. Model 5 includes only rock wool between the door layers. It is noticed that model 5 is the most efficient model and its design is simple compared to other models. For this model, numerical calculations are performed to check its efficiency and the results are compared to data from experiments for validation. Good agreement was noticed.Keywords: fire resistance, insulation, strength, thermal conductivity, lightweight, layers
Procedia PDF Downloads 8119647 Development of Automatic Laser Scanning Measurement Instrument
Authors: Chien-Hung Liu, Yu-Fen Chen
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This study used triangular laser probe and three-axial direction mobile platform for surface measurement, programmed it and applied it to real-time analytic statistics of different measured data. This structure was used to design a system integration program: using triangular laser probe for scattering or reflection non-contact measurement, transferring the captured signals to the computer through RS-232, and using RS-485 to control the three-axis platform for a wide range of measurement. The data captured by the laser probe are formed into a 3D surface. This study constructed an optical measurement application program in the concept of visual programming language. First, the signals are transmitted to the computer through RS-232/RS-485, and then the signals are stored and recorded in graphic interface timely. This programming concept analyzes various messages, and makes proper presentation graphs and data processing to provide the users with friendly graphic interfaces and data processing state monitoring, and identifies whether the present data are normal in graphic concept. The major functions of the measurement system developed by this study are thickness measurement, SPC, surface smoothness analysis, and analytical calculation of trend line. A result report can be made and printed promptly. This study measured different heights and surfaces successfully, performed on-line data analysis and processing effectively, and developed a man-machine interface for users to operate.Keywords: laser probe, non-contact measurement, triangulation measurement principle, statistical process control, labVIEW
Procedia PDF Downloads 35919646 Comparison of Microleakage of Composite Restorations Using Fifth and Seventh Generation of Bonding Agents
Authors: Karina Nabilla, Dedi Sumantri, Nurul T. Rizal, Siti H. Yavitha
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Background: Composite resin is the most frequently used material for restoring teeth, but still failure cases are seen which leading to microleakage. Microleakage might be attributed to various factors, one of them is bonding agent. Various generations of bonding agents have been introduced to overcome the microleakage. The aim of this study was to evaluate the microleakage of composite restorations using the fifth and seventh bonding agent. Methods: Class I cavities (3X2X2 mm) were prepared on the occlusal surfaces of 32 human upper premolars. Teeth were classified into two groups according to the type of bonding agent used (n =16). Group I: Fifth Generation of Bonding Agent-Adper Single Bond2. Group II: Seventh Generation of Bonding Agent-Single Bond Universal. All cavities were restored with Filtek Z250 XT composite resin, stored in sterile aquades water at 370C for 24 h. The root apices were sealed with sticky wax, and all the surfaces, except for 2 mm from the margins, were coated with nail varnish. The teeth were immersed in a 1% methylene blue dye solution for 24 h, and then rinsed in running water, blot-dried and sectioned longitudinally through the center of restorations from the buccal to palatal surface. The sections were blindly assessed for microleakage of dye penetration by using a stereomicroscope. Dye penetration along margin was measured in µm then calculated into the percentage and classified into scoring system 1 to 3. Data were collected and statistically analyzed by Chi-Square test. Result: There was no significant difference (p > 0,05) between two groups. Conclusion: Fifth generation of bonding agent revealed less leakage compared to the seventh generation even statistically there was no significant difference.Keywords: composite restoration, fifth generation of bonding agent, microleakage, seventh generation of bonding agent
Procedia PDF Downloads 26619645 Contemporary Art of Healing: New Generation of Shamanism Ritual
Authors: Yeaeun Jang
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Shamanism, in general, has been steadily reinterpreted as research and art from cult, superstition, mysticism, and historical perspectives. Shamanism has existed throughout the five-thousand-year-old history of Korea, and it still actively is ongoing. It is interesting to observe how this tradition has had a profound impact on its current high-technology society. Many still ask Shamans for pieces of advice rituals for their problems to be solved. Historically, Korean shamanism has a strong connection and many similarities with Mongolian and Eastern Siberian Shamanism. 'God' is 'Nature'. 'Shaman' is a 'Mediator of communication chosen by God' and is a divine being who has entered the mysterious realm by challenging human limitations through harsh training. A shaman in ancient society used to be a leader of a group and entertainer who played various roles; king, counsellor, doctor, singer, dancer, painter, and performer. This artistic research focuses on the Shaman role as an artist with multiple mediums and reconstructing their ancient ritual into multimedia performing art that attempts to deal with traumatic memories in one’s life. This fusion style of contemporary ritual is mainly inspired by ‘Gut(굿)’, Korean Shamanism ritual. This comprehensive art needs several important elements; a shaman, a client, musicians, helpers, and the audience. It is a feast to gather people in a big circle. Nowadays, art has been divided into separate fields and developed, but before, there existed art of Synesthesia, whose boundaries were unclear that were not determined through which medium to express that abstract ideas. Multiple disciplines coexist and harmonise with each other. Studying shamanism ritual as an ancient form of performing art can create a warm, spiritual feast for everyone and remind us about ‘togetherness’.Keywords: healing, multimedia art, performance art, shamanism, spirituality
Procedia PDF Downloads 9419644 Size Effect on Shear Strength of Slender Reinforced Concrete Beams
Authors: Subhan Ahmad, Pradeep Bhargava, Ajay Chourasia
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Shear failure in reinforced concrete beams without shear reinforcement leads to loss of property and life since a very little or no warning occurs before failure as in case of flexural failure. Shear strength of reinforced concrete beams decreases as its depth increases. This phenomenon is generally called as the size effect. In this paper, a comparative analysis is performed to estimate the performance of shear strength models in capturing the size effect of reinforced concrete beams made with conventional concrete, self-compacting concrete, and recycled aggregate concrete. Four shear strength models that account for the size effect in shear are selected from the literature and applied on the datasets of slender reinforced concrete beams. Beams prepared with conventional concrete, self-compacting concrete, and recycled aggregate concrete are considered for the analysis. Results showed that all the four models captured the size effect in shear effectively and produced conservative estimates of the shear strength for beams made with normal strength conventional concrete. These models yielded unconservative estimates for high strength conventional concrete beams with larger effective depths ( > 450 mm). Model of Bazant and Kim (1984) captured the size effect precisely and produced conservative estimates of shear strength of self-compacting concrete beams at all the effective depths. Also, shear strength models considered in this study produced unconservative estimates of shear strength for recycled aggregate concrete beams at all effective depths.Keywords: reinforced concrete beams; shear strength; prediction models; size effect
Procedia PDF Downloads 15319643 Computational Fluid Dynamics Analysis of Sit-Ski Aerodynamics in Crosswind Conditions
Authors: Lev Chernyshev, Ekaterina Lieshout, Natalia Kabaliuk
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Sit-skis enable individuals with limited lower limb or core movement to ski unassisted confidently. The rise in popularity of the Winter Paralympics has seen an influx of engineering innovation, especially for the Downhill and Super-Giant Slalom events, where the athletes achieve speeds as high as 160km/h. The growth in the sport has inspired recent research into sit-ski aerodynamics. Crosswinds are expected in mountain climates and, therefore, can greatly impact a skier's maneuverability and aerodynamics. This research investigates the impact of crosswinds on the drag force of a Paralympic sit-ski using Computational Fluid Dynamics (CFD). A Paralympic sit-ski with a model of a skier, a leg cover, a bucket seat, and a simplified suspension system was used for CFD analysis in ANSYS Fluent. The hybrid initialisation tool and the SST k–ω turbulence model were used with two tetrahedral mesh bodies of influence. The crosswinds (10, 30, and 50 km/h) acting perpendicular to the sit-ski's direction of travel were simulated, corresponding to the straight-line skiing speeds of 60, 80, and 100km/h. Following the initialisation, 150 iterations for both first and second order steady-state solvers were used, before switching to a transient solver with a computational time of 1.5s and a time step of 0.02s, to allow the solution to converge. CFD results were validated against wind tunnel data. The results suggested that for all crosswind and sit-ski speeds, on average, 64% of the total drag on the ski was due to the athlete's torso. The suspension was associated with the second largest overall sit-ski drag force contribution, averaging at 27%, followed by the leg cover at 10%. While the seat contributed a negligible 0.5% of the total drag force, averaging at 1.2N across the conditions studied. The effect of the crosswind increased the total drag force across all skiing speed studies, with the drag on the athlete's torso and suspension being the most sensitive to the changes in the crosswind magnitude. The effect of the crosswind on the ski drag reduced as the simulated skiing speed increased: for skiing at 60km/h, the drag force on the torso increased by 154% with the increase of the crosswind from 10km/h to 50km/h; whereas, at 100km/h the corresponding drag force increase was halved (75%). The analysis of the flow and pressure field characteristics for a sit-ski in crosswind conditions indicated the flow separation localisation and wake size correlated with the magnitude and directionality of the crosswind relative to straight-line skiing. The findings can inform aerodynamic improvements in sit-ski design and increase skiers' medalling chances.Keywords: sit-ski, aerodynamics, CFD, crosswind effects
Procedia PDF Downloads 6219642 Perception Study on the Environmental Ramifications of Inadequate Drainage Systems in Jere Local Government Area, Borno State, Nigeria
Authors: Mohammed Bukar Maina, Mohammed Alhaji Bukar
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Flooding is a significant threat to human lives, particularly in low- and middle-income nations. This study focuses on the environmental implications of inadequate drainage systems in the Jere Local Government Area of Borno State, Nigeria. By examining community awareness, understanding, and perceived impacts of the absence of drainage systems, as well as exploring potential solutions, this research aims to address the existing knowledge gap. The study focuses on the Fori and 202/303 Quarters, chosen for their lack of drainage infrastructure and environmental challenges. Primary data was collected through questionnaires and observations supplemented by secondary sources. The findings highlight the need for increased awareness of drainage systems and the consequences of inadequate infrastructure. The community faces challenges like flooding, water-logging, contamination of drinking water, waterborne diseases, and property damage, necessitating the implementation of proper drainage systems. Recommendations include prioritizing new drainage systems, awareness campaigns, community participation, involvement of local government and leaders, and regular maintenance. Long-term planning is crucial for integrating drainage infrastructure into future development. Implementing these recommendations will establish sustainable and resilient drainage systems, mitigating environmental hazards. This research provides valuable insights for policymakers, stakeholders, and communities in addressing insufficient drainage systems and safeguarding the community's well-being.Keywords: environment, drainage systems, flooding, lack
Procedia PDF Downloads 019641 Demographic Determinants of Spatial Patterns of Urban Crime
Authors: Natalia Sypion-Dutkowska
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Abstract — The main research objective of the paper is to discover the relationship between the age groups of residents and crime in particular districts of a large city. The basic analytical tool is specific crime rates, calculated not in relation to the total population, but for age groups in a different social situation - property, housing, work, and representing different generations with different behavior patterns. They are the communities from which criminals and victims of crimes come. The analysis of literature and national police reports gives rise to hypotheses about the ability of a given age group to generate crime as a source of offenders and as a group of victims. These specific indicators are spatially differentiated, which makes it possible to detect socio-demographic determinants of spatial patterns of urban crime. A multi-feature classification of districts was also carried out, in which specific crime rates are the diagnostic features. In this way, areas with a similar structure of socio-demographic determinants of spatial patterns on urban crime were designated. The case study is the city of Szczecin in Poland. It has about 400,000 inhabitants and its area is about 300 sq km. Szczecin is located in the immediate vicinity of Germany and is the economic, academic and cultural capital of the region. It also has a seaport and an airport. Moreover, according to ESPON 2007, Szczecin is the Transnational and National Functional Urban Area. Szczecin is divided into 37 districts - auxiliary administrative units of the municipal government. The population of each of them in 2015-17 was divided into 8 age groups: babes (0-2 yrs.), children (3-11 yrs.), teens (12-17 yrs.), younger adults (18-30 yrs.), middle-age adults (31-45 yrs.), older adults (46-65 yrs.), early older (66-80) and late older (from 81 yrs.). The crimes reported in 2015-17 in each of the districts were divided into 10 groups: fights and beatings, other theft, car theft, robbery offenses, burglary into an apartment, break-in into a commercial facility, car break-in, break-in into other facilities, drug offenses, property damage. In total, 80 specific crime rates have been calculated for each of the districts. The analysis was carried out on an intra-city scale, this is a novel approach as this type of analysis is usually carried out at the national or regional level. Another innovative research approach is the use of specific crime rates in relation to age groups instead of standard crime rates. Acknowledgments: This research was funded by the National Science Centre, Poland, registration number 2019/35/D/HS4/02942.Keywords: age groups, determinants of crime, spatial crime pattern, urban crime
Procedia PDF Downloads 16619640 Combined Treatment of PARP-1 Inhibitor and Carbon Ion or Gamma Exposure Reduces the Metastatic Potential in Cultured Human Cells
Authors: Priyanka Chowdhury, Asitikantha Sarma, Utpal Ghosh
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Hadron therapy using high Linear Energy Transfer (LET) ion beam is producing promising clinical results worldwide. The major advantages are its ability to kill radio-resistant tumor and its anti-metastatic activity. Poly(ADP-ribose) polymerase-1 (PARP-1) inhibitors have been widely used as radiosensitizer, but its role in metastasis is unknown. The purpose of our study was to investigate the effect of PARP-1 depletion in combination with either Carbon Ion Beam (CIB) or gamma irradiation on metastatic potential of cultured cancerous cells. A549 cells were irradiated with CIB (0-4Gy) or gamma (0, 2, 4, 6 and 10 Gy) with and without PARP-1 inhibition. The metastatic potential of the cells was determined by cell migratory assay, expression, and activity of MMP-2 and MMP-9, expression of Cadherin, Fibronectin, and Vimentin. CIB exposure reduced migratory property and activity of MMP-2 and MMP-9 significantly. CIB with PARP-1 inhibition reduced cell migration and Matrix Metalloproteinase (MMPs) activity in a synergistic manner. Expression of MMPs was also down-regulated in CIB and combined treatment. On the contrary, MMP- 2 and MMP-9 activity was significantly increased in gamma irradiated cells but decreased upon combined treatment of gamma and PARP-1 inhibitor. MMPs expression and migration was reduced when gamma irradiation was combined with PARP-1 inhibition. Thus, our study clearly demonstrates that PARP-1 inhibition in combination with either high or low LET can significantly suppress metastatic potential in cancer cells and thereby can be a promising tool in controlling metastatic cancers.Keywords: high LET, low LET, matrix metalloproteinase (MMP), PARP-1
Procedia PDF Downloads 20819639 Design and Preliminary Evaluation of Benzoxazolone-Based Agents for Targeting Mitochondrial-Located Translocator Protein
Authors: Nidhi Chadha, A. K. Tiwari, Marilyn D. Milton, Anil K. Mishra
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Translocator protein (18 kDa) TSPO is highly expressed during microglia activation in neuroinflammation. Although a number of PET ligands have been developed for the visualization of activated microglia, one of the advantageous approaches is to develop potential optical imaging (OI) probe. Our study involves computational screening, synthesis and evaluation of TSPO ligand through various imaging modalities namely PET/SPECT/Optical. The initial computational screening involves pharmacophore modeling from the library designing having oxo-benzooxazol-3-yl-N-phenyl-acetamide groups and synthesis for visualization of efficacy of these compounds as multimodal imaging probes. Structure modeling of monomer, Ala147Thr mutated, parallel and anti-parallel TSPO dimers was performed and docking analysis was performed for distinct binding sites. Computational analysis showed pattern of variable binding profile of known diagnostic ligands and NBMP via interactions with conserved residues along with TSPO’s natural polymorphism of Ala147→Thr, which showed alteration in the binding affinity due to considerable changes in tertiary structure. Preliminary in vitro binding studies shows binding affinity in the range of 1-5 nm and selectivity was also certified by blocking studies. In summary, this skeleton was found to be potential probe for TSPO imaging due to ease in synthesis, appropriate lipophilicity and reach to specific region of brain.Keywords: TSPO, molecular modeling, imaging, docking
Procedia PDF Downloads 45219638 An Integrated Approach for Risk Management of Transportation of HAZMAT: Use of Quality Function Deployment and Risk Assessment
Authors: Guldana Zhigerbayeva, Ming Yang
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Transportation of hazardous materials (HAZMAT) is inevitable in the process industries. The statistics show a significant number of accidents has occurred during the transportation of HAZMAT. This makes risk management of HAZMAT transportation an important topic. The tree-based methods including fault-trees, event-trees and cause-consequence analysis, and Bayesian network, have been applied to risk management of HAZMAT transportation. However, there is limited work on the development of a systematic approach. The existing approaches fail to build up the linkages between the regulatory requirements and the safety measures development. The analysis of historical data from the past accidents’ report databases would limit our focus on the specific incidents and their specific causes. Thus, we may overlook some essential elements in risk management, including regulatory compliance, field expert opinions, and suggestions. A systematic approach is needed to translate the regulatory requirements of HAZMAT transportation into specified safety measures (both technical and administrative) to support the risk management process. This study aims to first adapt the House of Quality (HoQ) to House of Safety (HoS) and proposes a new approach- Safety Function Deployment (SFD). The results of SFD will be used in a multi-criteria decision-support system to develop find an optimal route for HazMats transportation. The proposed approach will be demonstrated through a hypothetical transportation case in Kazakhstan.Keywords: hazardous materials, risk assessment, risk management, quality function deployment
Procedia PDF Downloads 13619637 Performance Based Design of Masonry Infilled Reinforced Concrete Frames for Near-Field Earthquakes Using Energy Methods
Authors: Alok Madan, Arshad K. Hashmi
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Performance based design (PBD) is an iterative exercise in which a preliminary trial design of the building structure is selected and if the selected trial design of the building structure does not conform to the desired performance objective, the trial design is revised. In this context, development of a fundamental approach for performance based seismic design of masonry infilled frames with minimum number of trials is an important objective. The paper presents a plastic design procedure based on the energy balance concept for PBD of multi-story multi-bay masonry infilled reinforced concrete (R/C) frames subjected to near-field earthquakes. The proposed energy based plastic design procedure was implemented for trial performance based seismic design of representative masonry infilled reinforced concrete frames with various practically relevant distributions of masonry infill panels over the frame elevation. Non-linear dynamic analyses of the trial PBD of masonry infilled R/C frames was performed under the action of near-field earthquake ground motions. The results of non-linear dynamic analyses demonstrate that the proposed energy method is effective for performance based design of masonry infilled R/C frames under near-field as well as far-field earthquakes.Keywords: masonry infilled frame, energy methods, near-fault ground motions, pushover analysis, nonlinear dynamic analysis, seismic demand
Procedia PDF Downloads 28519636 Key Challenges Facing the Management of Archaeological and Tourism Sites in Jordan
Authors: Muna Slehat
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Jordan is endowed with over 14,500 productive archaeological sites and also a wealth of heritage sites that need to be protected from the pressing threat of destruction and damage. Archaeological sites in Jordan face significant threats, including insensitive development, urbanization, pollution, tourism, and vandalism, therefore an effective management plan is a key element, not only for the conservation of this heritage, but also to address issues such as tourism and sustainable development. This study highlights the obstacles that confront the management of the archaeological and tourism sites in Jordan, prior to and after the launch of the Strategies for Management of Jordan’s Archaeological Heritage by the Department of Antiquities (DoA) 2007-2010 and 2014-2018, as well as the establishment of the Directorate of the Management of Archaeological Sites in 2010, and instructions for the proper use of tourism sites, 2014, by the Ministry of Tourism and Antiquities (MoTA). The study has revealed that the management of the archaeological and tourism sites under the pretext of improvement of services for tourists and visitors to Jordan would allow access to so-called polarization tourism and facilitate tourism development that would be sustainable economically and provide attractive returns. The data required have been collected through conducting interviews with 18 specialists. The main findings of the study are that management is new in Jordan, and has become a vital and dynamic force in Jordan after 2000 but that there have also been many mistakes, with sustainability of the sites being ignored and a lack of awareness among local communities surrounding these sites. Management of the sites has also suffered from a lack of organizational vision, with no instructions for practical application and no legislative provisions which cater for the efficient management of the sites. All of this needs to be amended to remove gaps, overlaps and ambiguities, so that the authorities responsible for the rehabilitation and promotion, development and management of these sites can overcome the problems, such as lack of human resources (specialists) and financial resources.Keywords: Jordan, management, archaeological sites, tourism, challenges
Procedia PDF Downloads 30019635 Human Immune Response to Surgery: The Surrogate Prediction of Postoperative Outcomes
Authors: Husham Bayazed
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Immune responses following surgical trauma play a pivotal role in predicting postoperative outcomes from healing and recovery to postoperative complications. Postoperative complications, including infections and protracted recovery, occur in a significant number of about 300 million surgeries performed annually worldwide. Complications cause personal suffering along with a significant economic burden on the healthcare system in any community. The accurate prediction of postoperative complications and patient-targeted interventions for their prevention remain major clinical provocations. Recent Findings: Recent studies are focusing on immune dysregulation mechanisms that occur in response to surgical trauma as a key determinant of postoperative complications. Antecedent studies mainly were plunging into the detection of inflammatory plasma markers, which facilitate in providing important clues regarding their pathogenesis. However, recent Single-cell technologies, such as mass cytometry or single-cell RNA sequencing, have markedly enhanced our ability to understand the immunological basis of postoperative immunological trauma complications and to identify their prognostic biological signatures. Summary: The advent of proteomic technologies has significantly advanced our ability to predict the risk of postoperative complications. Multiomic modeling of patients' immune states holds promise for the discovery of preoperative predictive biomarkers and providing patients and surgeons with information to improve surgical outcomes. However, more studies are required to accurately predict the risk of postoperative complications in individual patients.Keywords: immune dysregulation, postoperative complications, surgical trauma, flow cytometry
Procedia PDF Downloads 7819634 Extra Skeletal Manifestations of Histocytosis in Pediatrics
Authors: Ayda Youssef, Mohammed Ali Khalaf, Tarek Rafaat
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Background: Langerhans cell histiocytosis (LCH) is a rare multi-systemic disease that shows an abnormal proliferation of these kinds of cells associated with a granular infiltration that affects different structures of the human body, including the lung, liver, spleen, lymph nodes, brain, mucocutaneous, soft tissue (head and neck), and salivary glands. Evaluation of the extent of disease is one of the major predictors of patient outcome. Objectives: To recognize the pathogenesis of Langerhans cell histiocytosis (LCH), describe the radiologic criteria that are suggestive of LCH in different organs rather than the bones and to illustrate the appropriate differential diagnoses for LCH in each of the common extra-osseous sites. Material and methods: A retrospective study was done on 150 biopsy-proven LCH patients from 2007 to 2012. All patients underwent imaging studies, mostly US, CT, and MRI. These patients were reviewed to assess the extra-skeletal manifestations of LCH. Results: In 150 patients with biopsy-proven LCH, There were 33 patients with liver affection, 5 patients with splenic lesions, 55 patients with enlarged lymph nodes, 9 patient with CNS disease and 11 patients with lung involvement. Conclusions: Because of the frequent LCH children and evaluation of the extent of disease is one of the major predictors of patient outcome. Radiologist need to be familiar with its presentation in different organs and regions of body outside the commonest site of affection (bones). A high-index suspicion should be raised a biopsy is recommended in the presence of radiological suspicion. Chemotherapy is the preferred therapeutic modality.Keywords: langerhans cell histiocytosis, extra-skeletal, pediatrics, radiology
Procedia PDF Downloads 43219633 Investigation of Nutritional Values, Sensorial, Flesh Productivity of Parapenaus longirostris between Populations in the Sea of Marmara and in the Northern Aegean Sea
Authors: Onur Gönülal, Zafer Ceylan, Gülgün F. Unal Sengor
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The differences of Parapenaus longirostris caught from The North Aegean Sea and the Marmara Sea on proximate composition, sensorial analysis (for raw and cooked samples), flesh productivity of the samples were investigated. The moisture, protein, lipid, ash, carbohydrate, energy contents of shrimp caught from The North Aegean Sea were 74.92 ± 0.1, 20.32 ± 0.16, 2.55 ± 0.1, 2.13 ± 0.08, 0.08, 110.1 kcal/100g, respectively. The moisture, protein, lipid, ash, carbohydrate, energy contents of shrimp caught from Marmara Sea were 76.9 ± 0.02, 19.06 ± 0.03, 2.22 ± 0.08, 1.51 ± 0.04, 0.33, 102.77 kcal/100g, respectively. The protein, lipid, ash and energy values of the Northern Aegean Sea shrimp were higher than The Marmara Sea shrimp. On the other hand, The moisture, carbohydrate values of the Northern Aegean Sea shrimp were lower than the other one. Sensorial analysis was done for raw and cooked samples. Among all properties for raw samples, flesh color, shrimp connective tissue, shrimp body parameters were found different each other according to the result of the panel. According to the result of the cooked shrimp samples among all properties, cooked odour, flavours, texture were found to be different from each other, as well. Especially, flavours and textural properties of cooked shrimps of the Northern Aegean Sea were higher than the Marmara Sea shrimp. Flesh productivity of Northern Aegean Sea shrimp was found as 46.42 %, while that of the Marmara Sea shrimp was found as 47.74 %.Keywords: shrimp, biological differences, proximate value, sensory, Parapenaus longirostris, flesh productivity
Procedia PDF Downloads 27519632 A Geogpraphic Overview about Offshore Energy Cleantech in Portugal
Authors: Ana Pego
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Environmental technologies were developed for decades. Clean technologies emerged a few years ago. In these perspectives, the use of cleantech technologies has become very important due the fact of new era of environmental feats. As such, the market itself has become more competitive, more collaborative towards a better use of clean technologies. This paper shows the importance of clean technologies in offshore energy sector in Portuguese market, its localization and its impact on economy. Clean technologies are directly related with renewable cluster and concomitant with economic and social resource optimization criteria, geographic aspects, climate change and soil features. Cleantech is related with regional development, socio-technical transitions in organisations. There are an economical and social combinations which allow specialisation of regions in activities, higher employment, reduce of energy costs, local knowledge spillover and, business collaboration and competitiveness. The methodology used will be quantitative (IO matrix for Portugal 2013) and qualitative (questionnaires to stakeholders). The mix of both methodologies will confirm whether the use of technologies will allow a positive impact on economic and social variables used on this model. It is expected a positive impact on Portuguese economy both in investment and employment taking in account the localization of offshore renewable activities. This means that the importance of offshore renewable investment in Portugal has a few points which should be pointed out: the increase of specialised employment, localization of specific activities in territory, and increase of value added in certain regions. The conclusion will allow researchers and organisation to compare the Portuguese model to other European regions in order to a better use of natural and human resources.Keywords: cleantech, economic impact, localisation, territory dynamics
Procedia PDF Downloads 22319631 River Analysis System Model for Proposed Weirs at Downstream of Large Dam, Thailand
Authors: S. Chuenchooklin
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This research was conducted in the Lower Ping River Basin downstream of the Bhumibol Dam and the Lower Wang River Basin in Tak Province, Thailand. Most of the tributary streams of the Ping can be considered as ungauged catchments. There are 10- pumping station installation at both river banks of the Ping in Tak Province. Recently, most of them could not fully operate due to the water amount in the river below the level that would be pumping, even though included water from the natural river and released flow from the Bhumibol Dam. The aim of this research was to increase the performance of those pumping stations using weir projects in the Ping. Therefore, the river analysis system model (HEC-RAS) was applied to study the hydraulic behavior of water surface profiles in the Ping River with both cases of existing conditions and proposed weirs during the violent flood in 2011 and severe drought in 2013. Moreover, the hydrologic modeling system (HMS) was applied to simulate lateral streamflow hydrograph from ungauged catchments of the Ping. The results of HEC-RAS model calibration with existing conditions in 2011 showed best trial roughness coefficient for the main channel of 0.026. The simulated water surface levels fitted to observation data with R2 of 0.8175. The model was applied to 3 proposed cascade weirs with 2.35 m in height and found surcharge water level only 0.27 m higher than the existing condition in 2011. Moreover, those weirs could maintain river water levels and increase of those pumping performances during less river flow in 2013.Keywords: HEC-RAS, HMS, pumping stations, cascade weirs
Procedia PDF Downloads 38519630 The Effect of Non-Surgical Periodontal Therapy on Metabolic Control in Children
Authors: Areej Al-Khabbaz, Swapna Goerge, Majedah Abdul-Rasoul
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Introduction: The most prevalent periodontal disease among children is gingivitis, and it usually becomes more severe in adolescence. A number of intervention studies suggested that resolution of periodontal inflammation can improve metabolic control in patients diagnosed with diabetes mellitus. Aim: to assess the effect of non-surgical periodontal therapy on glycemic control of children diagnosed with diabetes mellitus. Method: Twenty-eight children diagnosed with diabetes mellitus were recruited with established diagnosis diabetes for at least 1 year. Informed consent and child assent form were obtained from children and parents prior to enrolment. The dental examination for the participants was performed on the same week directly following their annual medical assessment. All patients had their glycosylated hemoglobin (HbA1c%) test one week prior to their annual medical and dental visit and 3 months following non-surgical periodontal therapy. All patients received a comprehensive periodontal examination The periodontal assessment included clinical attachment loss, bleeding on probing, plaque score, plaque index and gingival index. All patients were referred for non-surgical periodontal therapy, which included oral hygiene instruction and motivation followed by supra-gingival and subg-ingival scaling using ultrasonic and hand instruments. Statistical Analysis: Data were entered and analyzed using the Statistical Package for Social Science software (SPSS, Chicago, USA), version 18. Statistical analysis of clinical findings was performed to detect differences between the two groups in term of periodontal findings and HbA1c%. Binary logistic regression analysis was performed in order to examine which factors were significant in multivariate analysis after adjusting for confounding between effects. The regression model used the dependent variable ‘Improved glycemic control’, and the independent variables entered in the model were plaque index, gingival index, bleeding %, plaque Statistical significance was set at p < 0.05. Result: A total of 28 children. The mean age of the participants was 13.3±1.92 years. The study participants were divided into two groups; Compliant group (received dental scaling) and non-complaints group (received oral hygiene instructions only). No statistical difference was found between compliant and non-compliant group in age, gender distribution, oral hygiene practice and the level of diabetes control. There was a significant difference between compliant and non-compliant group in term of improvement of HBa1c before and after periodontal therapy. Mean gingival index was the only significant variable associated with improved glycemic control level. In conclusion, this study has demonstrated that non-surgical mechanical periodontal therapy can improve HbA1c% control. The result of this study confirmed that children with diabetes mellitus who are compliant to dental care and have routine professional scaling may have better metabolic control compared to diabetic children who are erratic with dental care.Keywords: children, diabetes, metabolic control, periodontal therapy
Procedia PDF Downloads 15319629 Eight-Week Exercise for Women: Impact on Anomalies in Width Depth and Environmental Dimension
Authors: Yalcin Kaya, Fatma Arslan, Ahmet Selim Kaya
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This study aimed to determine the undesirable hypertrophic anomalies in the body of females and to investigate how they can be affected by the exercise program according to the applied 8 week individual conditions. The research was carried out on 35 women who did not have any regular previous sports practice and had an approximate age of 30 ± 5.0 at the gymnasium because of their asymmetric structure and weight gain of the body. Measurements of width, depth, and periphery were taken from the participants' body, and the exercise protocol was applied for 8 weeks according to the individual measurements in accordance with the obtained measurements. After 8 weeks, the same measurements were applied again. Measurements were made by using ruler and paper tape. The findings were evaluated and differences were analyzed by paired sample t test. According to the findings obtained, ulnae distal proiecturas width averages were 44.77 ± 3.65 and 43.52 ± 3.47 pre- and post-exercise respectively. Bithorachanteric width averages were 29.3 ± 3.12 before exercise and 26.67 ± 3.27 after exercise. Average abdominal widths were observed as 18.64 ± 4.14 (before exercise) and 18.01 ± 6.27 (after exercise). The distances between the malleolus were measured as 16.98 ± 1.62 (before exercise) and 16.70 ± 1.64 (after exercise). The results were statistically significant (p < 0.05). The mean of pre-exercise Externus abdominis circumference was 93.97 ± 8.91, and the mean of post-exercise mean was 90.82 ± 8.24. The results are statistically significant (p < 0.05). In conclusion, findings of the study show that inactivity, daily uncontrolled activities or erroneous postural postures, malnutrition cause some anomalies in the human body. However, with consciously standardized and regular exercises, these abnormalities are reduced by an eight-week exercise protocol in parallel with the expulsion of excess kilos and can be removed when working much longer and fitter, it is proposed to be healthier and more beautiful in appearance.Keywords: women, body, circumference-width and depth measurements, hypertrophy, exercise
Procedia PDF Downloads 37719628 Scenarios of Digitalization and Energy Efficiency in the Building Sector in Brazil: 2050 Horizon
Authors: Maria Fatima Almeida, Rodrigo Calili, George Soares, João Krause, Myrthes Marcele Dos Santos, Anna Carolina Suzano E. Silva, Marcos Alexandre Da
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In Brazil, the building sector accounts for 1/6 of energy consumption and 50% of electricity consumption. A complex sector with several driving actors plays an essential role in the country's economy. Currently, the digitalization readiness in this sector is still low, mainly due to the high investment costs and the difficulty of estimating the benefits of digital technologies in buildings. Nevertheless, the potential contribution of digitalization for increasing energy efficiency in the building sector in Brazil has been pointed out as relevant in the political and sectoral contexts, both in the medium and long-term horizons. To contribute to the debate on the possible evolving trajectories of digitalization in the building sector in Brazil and to subsidize the formulation or revision of current public policies and managerial decisions, three future scenarios were created to anticipate the potential energy efficiency in the building sector in Brazil due to digitalization by 2050. This work aims to present these scenarios as a basis to foresight the potential energy efficiency in this sector, according to different digitalization paces - slow, moderate, or fast in the 2050 horizon. A methodological approach was proposed to create alternative prospective scenarios, combining the Global Business Network (GBN) and the Laboratory for Investigation in Prospective Strategy and Organisation (LIPSOR) methods. This approach consists of seven steps: (i) definition of the question to be foresighted and time horizon to be considered (2050); (ii) definition and classification of a set of key variables, using the prospective structural analysis; (iii) identification of the main actors with an active role in the digital and energy spheres; (iv) characterization of the current situation (2021) and identification of main uncertainties that were considered critical in the development of alternative future scenarios; (v) scanning possible futures using morphological analysis; (vi) selection and description of the most likely scenarios; (vii) foresighting the potential energy efficiency in each of the three scenarios, namely slow digitalization; moderate digitalization, and fast digitalization. Each scenario begins with a core logic and then encompasses potentially related elements, including potential energy efficiency. Then, the first scenario refers to digitalization at a slow pace, with induction by the government limited to public buildings. In the second scenario, digitalization is implemented at a moderate pace, induced by the government in public, commercial, and service buildings, through regulation integrating digitalization and energy efficiency mechanisms. Finally, in the third scenario, digitalization in the building sector is implemented at a fast pace in the country and is strongly induced by the government, but with broad participation of private investments and accelerated adoption of digital technologies. As a result of the slow pace of digitalization in the sector, the potential for energy efficiency stands at levels below 10% of the total of 161TWh by 2050. In the moderate digitalization scenario, the potential reaches 20 to 30% of the total 161TWh by 2050. Furthermore, in the rapid digitalization scenario, it will reach 30 to 40% of the total 161TWh by 2050.Keywords: building digitalization, energy efficiency, scenario building, prospective structural analysis, morphological analysis
Procedia PDF Downloads 10619627 Structural Insights into the Bypass of the Major Deaminated Purines by Translesion Synthesis DNA Polymerase
Authors: Hunmin Jung, Michael Hawkins, Seongmin Lee
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The exocyclic amines of nucleobases can undergo deamination by various DNA damaging agents such as reactive oxygen species, nitric oxide, and water. The deamination of guanine and adenine generates the promutagenic xanthine and hypoxanthine, respectively. The exocyclic amines of bases in DNA are hydrogen bond donors, while the carbonyl moiety generated by the base deamination acts as hydrogen bond acceptors, which can alter base pairing properties of the purines. Xanthine is known to base pair with both cytosine and thymine, while hypoxanthine predominantly pairs with cytosine to promote A to G mutations. Despite the known promutagenicity of the major deaminated purines, structures of DNA polymerase bypassing these lesions have not been reported. To gain insights into the deaminated-induced mutagenesis, we solved crystal structures of human DNA polymerase η (polη) catalyzing across xanthine and hypoxanthine. In the catalytic site of polη, the deaminated guanine (i.e., xanthine) forms three Watson-Crick-like hydrogen bonds with an incoming dCTP, indicating the O2-enol tautomer of xanthine involves in the base pairing. The formation of the enol tautomer appears to be promoted by the minor groove contact by Gln38 of polη. When hypoxanthine is at the templating position, the deaminated adenine uses its O6-keto tautomer to form two Watson-Crick hydrogen bonds with an incoming dCTP, providing the structural basis for the high promutagenicity of hypoxanthine.Keywords: DNA damage, DNA polymerase, deamination, mutagenesis, tautomerization, translesion synthesis
Procedia PDF Downloads 12719626 Comparative Study of the Abundance of Winter Nests of the Pine Processionary Caterpillar in Different Forests of Pinus Halepensis, pinus Pinaster, Pinus Pinea and Cedrus Atlantica, in Algeria
Authors: Boudjahem Ibtissem, Aouati Amel
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Thaumetopoea pityocampa is one of the major insect pests of pine forests in Algeria, the Mediterranean region, and central Europe. This pest is responsible for several natural and human damages these last years. The caterpillar can feed itself during the larval stage on several species of pine or cedar. The forests attack by the insect can reduce their resistance against other forest enemies, fires, or drought conditions. In this case, the tree becomes more vulnerable to other pests. To understand the eating behavior of the insect in its ecological conditions, and its nutritional preference, we realized a study of the abundance of winter nests of the pine processionary caterpillar in four different forests: Pinus halepensis; Pinus pinaster; Pinus pinea, and Cedrus atlantica. A count of the sites affected by the processionary caterpillar was carried out on a hundred trees from the forests in different regions in Algeria; Alkala region, Mila region, Annaba region, and Blida region; the total rate and average abundance are calculated for each forest. Ecological parameters are also estimated for each infestation. The results indicated a higher rate of infestation in Pinus halepensis trees (85%) followed by Cedrus atlantica (66%) and Pinus pinaster (50%) trees. The Pinus pinea forest is the least attacked region by the pine processionary caterpillar (23%). The abundance of the pine processionary caterpillar can be influenced by the height of the trees, the climate of the region, the age of the forest but also the quality of needles.Keywords: Thaumetopoea pityocampa, Pinus halepensis, needles, winter nests
Procedia PDF Downloads 14419625 Environmental Consequences of Metal Concentrations in Stream Sediments of Atoyac River Basin, Central Mexico: Natural and Industrial Influences
Authors: V. C. Shruti, P. F. Rodríguez-Espinosa, D. C. Escobedo-Urías, Estefanía Martinez Tavera, M. P. Jonathan
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Atoyac River, a major south-central river flowing through the states of Puebla and Tlaxcala in Mexico is significantly impacted by the natural volcanic inputs in addition with wastewater discharges from urban, agriculture and industrial zones. In the present study, core samples were collected from R. Atoyac and analyzed for sediment granularity, major (Al, Fe, Ca, Mg, K, P and S) and trace elemental concentrations (Ba, Cr, Cd, Mn, Pb, Sr, V, Zn, Zr). The textural studies reveal that the sediments are mostly sand sized particles exceeding 99% and with very few to no presence of mud fractions. It is observed that most of the metals like (avg: all values in μg g-1) Ca (35,528), Mg (10,789), K (7453), S (1394), Ba (203), Cr (30), Cd (4), Pb (11), Sr (435), Zn (76) and Zr (88) are enriched throughout the sediments mainly sourced from volcanic inputs, source rock composition of Atoyac River basin and industrial influences from the Puebla city region. Contamination indices, such as anthropogenic factor (AF), enrichment factor (EF) and geoaccumulation index (Igeo), were used to investigate the level of contamination and toxicity as well as quantitatively assess the influences of human activities on metal concentrations. The AF values (>1) for Ba, Ca, Mg, Na, K, P and S suggested volcanic inputs from the study region, where as Cd and Zn are attributed to the impacts of industrial inputs in this zone. The EF and Igeo values revealed an extreme enrichment of S and Cd. The ecological risks were evaluated using potential ecological risk index (RI) and the results indicate that the metals Cd and V pose a major hazard for the biological community.Keywords: Atoyac River, contamination indices, metal concentrations, Mexico, textural studies
Procedia PDF Downloads 28819624 Markowitz and Implementation of a Multi-Objective Evolutionary Technique Applied to the Colombia Stock Exchange (2009-2015)
Authors: Feijoo E. Colomine Duran, Carlos E. Peñaloza Corredor
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There modeling component selection financial investment (Portfolio) a variety of problems that can be addressed with optimization techniques under evolutionary schemes. For his feature, the problem of selection of investment components of a dichotomous relationship between two elements that are opposed: The Portfolio Performance and Risk presented by choosing it. This relationship was modeled by Markowitz through a media problem (Performance) - variance (risk), ie must Maximize Performance and Minimize Risk. This research included the study and implementation of multi-objective evolutionary techniques to solve these problems, taking as experimental framework financial market equities Colombia Stock Exchange between 2009-2015. Comparisons three multiobjective evolutionary algorithms, namely the Nondominated Sorting Genetic Algorithm II (NSGA-II), the Strength Pareto Evolutionary Algorithm 2 (SPEA2) and Indicator-Based Selection in Multiobjective Search (IBEA) were performed using two measures well known performance: The Hypervolume indicator and R_2 indicator, also it became a nonparametric statistical analysis and the Wilcoxon rank-sum test. The comparative analysis also includes an evaluation of the financial efficiency of the investment portfolio chosen by the implementation of various algorithms through the Sharpe ratio. It is shown that the portfolio provided by the implementation of the algorithms mentioned above is very well located between the different stock indices provided by the Colombia Stock Exchange.Keywords: finance, optimization, portfolio, Markowitz, evolutionary algorithms
Procedia PDF Downloads 29019623 Exploring Spin Reorientation Transition and Berry Curvature Driven Anomalous Hall Effect in Quasi-2D vdW Ferromagnet Fe4GeTe2
Authors: Satyabrata Bera, Mintu Mondal
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Two-dimensional (2D) ferromagnetic materials have garnered significant attention due to their potential to host intriguing scientific phenomena such as the anomalous Hall effect, anomalous Nernst effect, and high transport spin polarization. This study focuses on the investigation of air-stable van der Waals(vdW) ferromagnets, FeGeTe₂ (FₙGT with n = 3, 4, and 5). Particular emphasis is placed on the Fe4GeTe2 (F4GT) compound, which exhibits a complex and fascinating magnetic behavior characterized by two distinct transitions: (i) paramagnetic (PM) to ferromagnetic (FM) around T C ∼ 270 K, and (ii) another spins reorientation transition (SRT) at T SRT ∼ 100 K . Scaling analysis of magnetocaloric effect confirms the second-order character of the ferromagnetic transition, while the same analysis at T SRT suggests that SRT is first-order phase transition. Moreover, the F4GT exhibits a large anomalous Hall conductivity (AHC), ∼ 490 S/cm at 2 K . The near-quadratic behavior of the anomalous Hall resistivity with the longitudinal resistivity suggests that a dominant AHC contribution arises from an intrinsic Berry curvature (BC) mechanism. Electronic structure calculations reveal a significant BC resulting from SOC-induced gapped nodal lines around the Fermi level, thereby giving rise to large AHC. Additionally, we reported exceptionally large anomalous Hall angle (≃ 10.6%) and Hall factor (≃ 0.22 V −1 ) values, the largest observed within this vdW family. The findings presented here, provide valuable insights into the fascinating magnetic and transport properties of 2D ferromagnetic materials, in particular, FₙGT family.Keywords: 2D vdW ferromagnet, spin reorientation transition, anomalous hall effect, berry curvature
Procedia PDF Downloads 7919622 The Risk of Hyperglycemia Associated with Use of Dolutegravir among Adults Living with HIV in Kampala, Uganda: A Case Control Study
Authors: Daphine Namara, Jeremy I. Schwartz, Andrew K. Tusubira, Willi McFarland, Caroline Birungi, Fred C. Semitala, Martin Muddu
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Emerging evidence suggests a possible association between hyperglycemia and dolutegravir (DTG), a preferred first-line antiretroviral agent in sub-Saharan Africa (SSA). There is a need for rigorous studies to validate this association in the face of increasing DTG use and the burden of non-communicable diseases among people living with HIV (PLHIV). We conducted a case-control study to assess the risk of hyperglycemia associated with the use of DTG among PLHIV attending Mulago ISS Clinic in Kampala. Cases had hyperglycemia, while controls had no hyperglycemia, as confirmed by fasting plasma glucose and oral glucose tolerance tests. Demographic, laboratory, and clinical data were collected using interviewer-administered questionnaires and medical record abstraction. The analysis compared cases and controls on DTG use prior to diagnosis of hyperglycemia while controlling for potential confounders using multivariable logistic regression. We included 204 cases and 231 controls. In multivariable analysis, patients with prior DTG use had seven times greater odds of subsequent diagnosis of hyperglycemia compared to those who had non-DTG-based regimens (adjusted odds ratio [aOR] 7.01, 95% CI 1.96-25.09). The odds of hyperglycemia also increased with age (56 years and above vs. 18-35, aOR 12.38, 95% CI 3.79-40.50) and hypertension (aOR 5.78, 95% CI 2.53-13.21). Our study demonstrates a strong association between prior DTG exposure and subsequent diagnosis of hyperglycemia. Given the benefits of DTG, wide-scale use, and the growing burden of diabetes mellitus (DM) in SSA, there is a need for systematic screening for hyperglycemia and consideration of alternate regimens for those at risk for DM.Keywords: HIV, hyperglycemia, doluteravir, diabetes
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