Search results for: motherhood studies
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 11381

Search results for: motherhood studies

10061 The Importance of Downstream Supply Chain in Supply Chain Risk Management: Multi-Objective Optimization

Authors: Zohreh Khojasteh-Ghamari, Takashi Irohara

Abstract:

One of the efficient ways in supply chain risk management is avoiding the interruption in Supply Chain (SC) before it occurs. Although the majority of the organizations focus on their first-tier suppliers to avoid risk in the SC, studies show that in only 60 percent of the disruption cases the reason is first tier suppliers. In the 40 percent of the SC disruptions, the reason is downstream SC, which is the second tier and lower. Due to the increasing complexity and interrelation of modern supply chains, the SC elements have become difficult to trace. Moreover, studies show that there is a vital need to better understand the integration of risk and visibility, especially in the context of multiple objectives. In this study, we propose a multi-objective programming model to avoid disruption in SC. The objective of this study is evaluating the effect of downstream SCV on managing supply chain risk. We propose a multi-objective mathematical programming model with the objective functions of minimizing the total cost and maximizing the downstream supply chain visibility (SCV). The decision variable is supplier selection. We assume there are several manufacturers and several candidate suppliers. For each manufacturer, our model proposes the best suppliers with the lowest cost and maximum visibility in downstream supply chain. We examine the applicability of the model by numerical examples. We also define several scenarios for datasets and observe the tendency. The results show that minimum visibility in downstream SC is needed to have a safe SC network.

Keywords: downstream supply chain, optimization, supply chain risk, supply chain visibility

Procedia PDF Downloads 244
10060 Motivation and Constraints of Athletes’ Migration: Foreign Players in Korean Volleyball League (V-League)

Authors: Young Ik Suh, Sanghak Lee, Tywan G. Martin

Abstract:

An increasing number of athletes, across all sports, are moving from their home countries to play in foreign countries. The migration of athletes, coaches, managers, and administrators within and between nations is an important aspect of the social and cultural changes taking place in modern, global sports. It is especially important to understand the context of these migrations as they are critical factors in the successful development of sports policies. In previous decades, efforts have been made to understand the motives of migrating athletes from a variety of sports, including rugby, cricket, baseball, and soccer. These studies focused on the athletes’ motivations, experiences as migrants, and recruit process. However, few studies have been conducted in order to understand athletes’ constraints of migration. The concept of constraints in leisure studies refers to the barriers that exist between an individual’s desire for participation and an individual’s real participation. The study of constraints is not a new topic in the fields of sports and recreation. In addition to understanding the motives that drive athletes to work or play in foreign countries, it is also important to recognize that negative dimensions exist that stop some athletes from migrating. Furthermore, little research has explored what makes athletes consider playing in small and unknown volleyball markets, such as the Korean Volleyball League (V-League). The V-League is a professional men’s and women’s volleyball league, started in 2005. It consists of seven men’s clubs, and six women’s clubs and each team has one foreign player. In addition, several limitations are placed on the foreign players, such as on height, position, and salary to play in the V-League. Thus, the main focus of the present research is to understand why foreign athletes (e.g., European, American, Brazil, etc.) are attracted to the V-League, which has a smaller market compared to its neighbors (i.e., China, Japan, and The Philippines). In addition, the current study seeks to identify the negative factors that prevent athletes from playing in the V-League. The participants for this study will be foreign volleyball players participating in the V-League. The investigators will provide a brief introduction to this study and inform the potential participants that they can choose whether to participate in this study. In terms of theoretical saturation, at least 12 participants are generally an adequate number to reach saturation, if they belong to a relatively homogenous group based on culture and ethnicity. This study utilizes a qualitative approach in order to understand the migration experiences foreign volleyball athletes playing in the V-League. The proposed study represents ongoing research to support work conducted by the investigators to understand the possible motivations and constraints for foreign volleyball players playing in the V-League. In addition, significant contributions to scholarship in the field of sports, psychology, and coaching studies will be an outcome of this study along with additions to the body of knowledge in several disciplines, including psychology, sociology, and social work.

Keywords: athletes’ migration, motivation, constraints, volleyball

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10059 Mycotoxin Bioavailability in Sparus Aurata Muscle After Human Digestion and Intestinal Transport (Caco-2/HT-29 Cells) Simulation

Authors: Cheila Pereira, Sara C. Cunha, Miguel A. Faria, José O. Fernandes

Abstract:

The increasing world population brings several concerns, one of which is food security and sustainability. To meet this challenge, aquaculture, the farming of aquatic animals and plants, including fish, mollusks, bivalves, and algae, has experienced sustained growth and development in recent years. Recent advances in this industry have focused on reducing its economic and environmental costs, for example, the substitution of protein sources in fish feed. Plant-based proteins are now a common approach, and while it is a greener alternative to animal-based proteins, there are some disadvantages, such as their putative content and intoxicants such as mycotoxins. These are naturally occurring plant contaminants, and their exposure in fish can cause health problems, stunted growth or even death, resulting in economic losses for the producers and health concerns for the consumers. Different works have demonstrated the presence of both AFB1 (aflatoxin B1) and ENNB1 (enniatin B1) in fish feed and their capacity to be absorbed and bioaccumulate in the fish organism after digestion, further reaching humans through fish ingestion. The aim of this work was to evaluate the bioaccessibility of both mycotoxins in samples of Sparus aurata muscle using a static digestion model based on the INFOGEST protocol. The samples were subjected to different cooking procedures – raw, grilled and fried – and different seasonings – none, thyme and ginger – in order to evaluate their potential reduction effect on mycotoxins bioaccessibility, followed by the evaluation of the intestinal transport of both compounds with an in vitro cell model composed of Caco-2/HT-29 co-culture monolayers, simulating the human intestinal epithelium. The bioaccessible fractions obtained in the digestion studies were used in the transport studies for a more realistic approach to bioavailability evaluation. Results demonstrated the effect of the use of different cooking procedures and seasoning on the toxin's bioavailability. Sparus aurata was chosen in this study for its large production in aquaculture and high consumption in Europe. Also, with the continued evolution of fish farming practices and more common usage of novel feed ingredients based on plants, there is a growing concern about less studied contaminants in aquaculture and their consequences for human health. In pair with greener advances in this industry, there is a convergence towards alternative research methods, such as in vitro applications. In the case of bioavailability studies, both in vitro digestion protocols and intestinal transport assessment are excellent alternatives to in vivo studies. These methods provide fast, reliable and comparable results without ethical restraints.

Keywords: AFB1, aquaculture, bioaccessibility, ENNB1, intestinal transport.

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10058 A Comparative Analysis of the Role, Representations and Architectural Identity of Public Space in Medieval and Contemporary Cairo

Authors: Muhammad Feteha

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The socio-political Middle East scene has radically changed over the last decade, and one major contributor to this change was the Egyptian revolution of 2011. The massive impact of this revolution that originally started as a small protest in the Tahrir square has attracted more scholars to study the public space in Egypt, where it has become a necessity in order to understand and improve the socio-political conditions. The status of public space in Egypt has been deteriorating due to many reasons, including privatization and neglect. This paper studies one of the major problems of the contemporary public space in Cairo, which is the lack of identity. This takes place through a comparative analysis between selected case studies from both medieval and contemporary Cairo. The theoretical framework upon which the analysis is based views public space as a ‘container of social action’ and a ‘product of spatial practice’. Through the ‘deciphering of space’, differences in the socio-political role, symbolism, and identity of public spaces between both eras are shown. The paper aims to extract some lessons from public space in medieval Cairo, which was truly the ‘centerpiece of the public realm’ and a ‘fundamental expressions’ of the unique trans-dynastic architectural identity of Cairo. In addition, it suggests some strategies to revive the Cairene identity of public space instead of constructing new ones to be only ‘utilitarian spaces used for circulation’ and lack any identity.

Keywords: architectural identity, Cairene public space, Islamic architectural history, production of space

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10057 Efficacy of Cognitive Rehabilitation Therapy on Poststroke Depression among Survivors of Stroke; A Systematic Review

Authors: Zahra Hassani

Abstract:

Background and Purpose: Poststroke depression (PSD) is one of the complications of a stroke that reduces the patient's chance of recovery, becomes irritable, and changes personality. Cognitive rehabilitation is one of the non-pharmacological methods that improve deficits such as attention, memory, and symptoms of depression. Therefore, the purpose of the present study is to evaluate the Efficacy of Cognitive Rehabilitation Therapy on Poststroke Depression among Survivors of stroke. Method: In this study, a systematic review of the databases Google Scholar, PubMed, Science Direct, Elsevier between the years 2015 and 2019 with the keywords cognitive rehabilitation therapy, post-stroke, depression Search is done. In this process, studies that examined the Efficacy of Cognitive Rehabilitation Therapy on Poststroke Depression among Survivors of stroke were included in the study. Results: Inclusion criteria were full-text availability, interventional study, and non-review articles. There was a significant difference between the articles in terms of the indices studied, sample number, method of implementation, and so on. A review of studies have shown that cognitive rehabilitation therapy has a significant role in reducing the symptoms of post-stroke depression. The use of these interventions is also effective in improving problem-solving skills, improving memory, and improving attention and concentration. Conclusion: This study emphasizes on the development of efficient and flexible adaptive skills through cognitive processes and its effect on reducing depression in patients after stroke.

Keywords: cognitive therapy, depression, stroke, rehabilitation

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10056 International Retirement Migration of Westerners to Thailand: Well-Being and Future Migration Plans

Authors: Kanokwan Tangchitnusorn, Patcharawalai Wongboonsin

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Following the ‘Golden Age of Welfare’ which enabled post-war prosperity to European citizens in 1950s, the world has witnessed the increasing mobility across borders of older citizens of First World countries. Then, in 1990s, the international retirement migration (IRM) of older persons has become a prominent trend, in which, it requires the integration of several fields of knowledge to explain, i.e. migration studies, tourism studies, as well as, social gerontology. However, while the studies of the IRM to developed destinations in Europe (e.g. Spain, Malta, Portugal, Italy), and the IRM to developing countries like Mexico, Panama, and Morocco have been largely studied in recent decades due to their massive migration volume, the study of the IRM to remoter destinations has been far more relatively sparse and incomplete. Developing countries in Southeast Asia have noticed the increasing number of retired expats, particularly to Thailand, where the number of foreigners applying for retirement visa increased from 10,709 in 2005 to 60,046 in 2014. Additionally, it was evident that the majority of Thailand’s retirement visa applicants were Westerners, i.e. citizens of the United Kingdom, the United States, Germany, and the Nordic countries, respectively. As such trend just becoming popular in Thailand in recent decades, little is known about the IRM populations, their well-being, and their future migration plans. This study aimed to examine the subjective wellbeing or the self-evaluations of own well-being among Western retirees in Thailand, as well as, their future migration plans as whether they planned to stay here for life or otherwise. The author employed a mixed method to obtain both quantitative and qualitative data during October 2015 – May 2016, including 330 self-administered questionnaires (246 online and 84 hard-copied responses), and 21 in-depth interviews of the Western residents in Nan (2), Pattaya (4), and Chiang Mai (15). As derived from the integration of previous subjective well-being measurements (i.e. Personal Wellbeing Index (PWI), Global AgeWatch Index, and OECD guideline on measuring subjective wellbeing), this study would measure the subjective well-being of Western retirees in Thailand in 7 dimensions, including standard of living, health status, personal relationships, social connections, environmental quality, personal security and local infrastructure.

Keywords: international retirement migration, ageing, mobility, wellbeing, Western, Thailand

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10055 Topical Negative Pressure for Autologous Fat Grafting in Breast Augmentation

Authors: Mohamed Eftal Bin Mohamed Ebrahim, Alexander Varey

Abstract:

Aim: Topical negative pressure has been shown to enhance angiogenesis during wound healing, both for open and closed wounds. Since angiogenesis is a key requirement for successful fat grafting, there may be a role for topical negative pressure as a means of enhancing the take rate during autologous fat grafting to breasts. Here we present a systematic review of the literature on this topic. Methods: Ovid and Embase were utilized, with searches ranging between 1960 – 2019. Terms (“Liposculpting” OR “Fat grafting” OR “Lipofilling” OR “Lipograft” OR “Fat transfer”) AND (“Negative Pressure” OR “Brava” OR “Kiwi”) AND (“Breast”) were merged as keywords. Inclusion criteria were females, autologous fat graft to breast with topical negative pressure prior to the procedure. Studies were excluded if there was no primary endpoint or non-original article. Results: Upon reviewing 219 articles, 2 met inclusion criteria. A total of 565 and 46 breasts in each article were treated respectively using the negative pressure device BRAVA®, with each cohort having different pre-and post-operative pressure settings. Khouri et al. cohort had higher graft survival (79%) compared to Del Vecchio et al. cohort (64%); however, the latter had fewer complications compared to Khouri’s cohort, e.g., fat necrosis, pneumothorax and infection. Conclusion: There is limited evidence regarding the use of topical negative pressure for fat grafting to the breasts. However, in the two studies published, the reported rates of success are high, suggesting there may be a benefit. Consequently, a randomized controlled trial on this area is required.

Keywords: fat grafting, lipograft, negative pressure, breast, breast augmentation, brava

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10054 Environmental Impact Assessment of Conventional Tyre Manufacturing Process

Authors: G. S. Dangayach, Gaurav Gaurav, Alok Bihari Singh

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The popularity of vehicles in both industrialized and developing economies led to a rise in the production of tyres. People have become increasingly concerned about the tyre industry's possible environmental impact in the last two decades. The life cycle assessment (LCA) methodology was used to assess the environmental impacts of industrial tyres throughout their life cycle, which included four stages: manufacture, transportation, consumption, and end-of-life. The majority of prior studies focused on tyre recycling and disposal. Only a few studies have been conducted on the environmental impact of tyre production process. LCA methodology was employed to determine the environmental impact of tyre manufacture process (gate to gate) at an Indian firm. Comparative analysis was also conducted to identify the environmental hotspots in various stages of tire manufacturing. This study is limited to gate-to-gate analysis of manufacturing processes with the functional unit of a single tyre weighing 50 kg. GaBi software was used to do both qualitative and quantitative analysis. Different environmental impact indicators are measured in terms of CO2, SO2, NOx, GWP (global warming potential), AP (acidification potential), EP (eutrophication potential), POCP (photochemical oxidant formation potential), and HTP (toxic human potential). The results demonstrate that the major contributor to environmental pollution is electricity. The Banbury process has a very high negative environmental impact, which causes respiratory problems to workers and operators.

Keywords: life cycle assessment (LCA), environmental impact indicators, tyre manufacturing process, environmental impact assessment

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10053 Optical and Luminescence Studies on Dy³+ Singly Doped and Dy³+/Ce³+ Co-doped Alumina Borosilicate Glasses for Photonics Device Application

Authors: M. Monisha, Sudha D. Kamath

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We investigate the optical and photoluminescence properties from Dy³+ singly doped and Dy³+ co-doped with Ce³+alumino borosilicate glasses prepared using high temperature melt-quenching technique. The glass composition formula is 25SiO₂-(40-x-y)B2O₃-10Al₂O₃-15NaF-10ZnO-xDy₂O₃ yCe₂O₃ where, x = 0.5 mol% and y = 0, 0.1, and 0.5 mol%. The XRD study reveals the amorphous nature of both singly doped and co-doped glasses. Absorption study on Dy3+ singly doped glass shows nearly twelve absorption peaks arising from the ground level of Dy³+ ions (⁶H₁₅/₂) to various upper levels, and for Dy³+/Ce³+ co-doped glasses, few of the transitions in the visible region are suppressed. The absorption band edge is shifted towards the higher wavelength region on increasing Ce3+concentration. The decrease in indirect energy bandgap and increase in Urbach energy of the prepared glasses is observed due to codoping with Ce3+ ions. The photoluminescence studies on singly doped glass under 350 nm excitation showed three peaks at the blue (482 nm), yellow (575 nm), and red (663 nm) region. For codoped glasses, the emission peak at 403 nm is raised due to the 4d to 5f transition of Ce3+ ions. Lifetime values (ms) of co-doped glass is found to be higher than singly doped glass. Under 350 nm excitation, CIE coordinates of the co-doped glasses moved towards the bright white light region. The correlated color temperature (CCT) values were obtained in the range 4500 – 4700 K. Thus, the prepared glasses can be used for photonics device applications.

Keywords: absorption spectra, borosilicate glasses, Ce³+, Dy³+, photoluminescence

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10052 A Cognitive Behavioural Therapy for Post-Traumatic Stress Disorders

Authors: Ryotaro Ishikawa

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INTRODUCTION: Post-traumatic stress disorder (PTSD) is a psychiatric label for a collection of psychological symptoms following a traumatic event. PTSD is as a result of a traumatic experience such as rape or sexual assault. A victim may have PTSD if she/he has experienced the following symptoms for at least a month: a) Stressor, b) Intrusion symptoms, c) Avoidance, d) Negative alterations in cognitions and mood, e) Alterations in arousal and reactivity. Studies on the cognitive theory of PTSD emphasized the roles of (a) negative appraisals of trauma memories in maintaining the symptomatology of PTSD, and (b) disorganized trauma memories in the development of PTSD. Mental contamination is primarily caused by experiences involving humans (e.g. violators or perpetrators) as opposed to substances (e.g. dirt or bodily fluids). Feelings of mental contamination may evoke following experiences of ill-treatment, sexual assault, domination, degradation, manipulation, betrayal, or humiliation. Some studies have demonstrated that traumatic thoughts related to sexual assault are particularly strong predictors of mental contamination. Treatment protocols based on cognitive-behavioral therapy appear to be beneficial in reducing the severity of PTSD and mental contamination. Studies on the cognitive theory of PTSD emphasized the roles of (A) negative appraisals of trauma memories in maintaining the symptomatology of PTSD, and (B) disorganized trauma memories in the development of PTSD. We will demonstrate a feasibility study of individual CBT for PTSD and mental contamination in Japanese clinical settings. METHOD: The single-arm trial is a group setting CBT intervention. The primary outcome is the self-rated Posttraumatic Stress Diagnostic Scale, with secondary measurements of depressive severity and mental pollution questionnaire. Assessments are conducted at baseline, after a waiting period before CBT, during CBT, and after CBT. RESULTS: Participants are eligible for the study and complete the outcome measures at all assessment points. In our hypothesis, receiving CBT would lead to improvements in primary and secondary PTSD severity. CONCLUSION: We will demonstrate a feasibility study of individual CBT for PTSD and mental contamination in Japanese clinical settings. Our treatment would achieve favorable treatment outcomes for PTSD with mental contamination in Japanese clinical settings.

Keywords: CBT, cognitive theory, PTSD, mental pollution

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10051 Nurses' Knowledge and Attitudes toward the Use of Physical Restraints

Authors: Fatema Salman, Ridha Hammam, Fatima Khairallah, Fatima Aradi, Nafeesa Abdulla, Mohammed Alsafar

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Purpose: This study aims at measuring the extent of nurses’ knowledge and attitudes toward the use of physical restraints in different hospital wards at Salmaniya Medical Complex (SMC). Background: The habitual use of physical restraint is a widespread practice among nurses working in the clinical settings. Restraints inflict many deleterious consequences on patients physically and psychologically which in turn increases their morbidity and mortality risk and jeopardizes care quality. Nurses’ knowledge and attitudes toward physical restraints are crucial determinants of the persistence of this practice. Literature review: the evidence of lack of knowledge among nurses regarding the use of physical restraints is overwhelming in various clinical settings, especially in two main areas which are the negative consequences and the available alternatives to physical restraints. Studies explored nurses’ attitudes toward physical restraints yielded inconsistent findings. Equally comparable, some studies found that nurses hold positive attitudes toward the use of physical restraints while some others reported just the opposite. Methods: Self-administered knowledge and attitudes scales to 106 nurses working in the SMC. Findings: nurses hold the moderate level of knowledge about restraints (M=58%) with weak negative attitudes (M = -20%) toward using it. Significant moderately-strong negative correlation (r= -0.57, r2= 0.32, p= 0.000) was uncovered between nurses knowledge and their attitudes which provided an empirical explanation of this phenomenon (use of physical restraints). Recommendations: Induction of awareness program that especially focuses on the negative consequences and encourages the use of alternatives is an evident need. This effort necessarily should be adjoined with policy and procedure adjustments.

Keywords: attitudes, knowledge, nurses, restraints

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10050 Depressant Effects of 2-PMPA through Reduction of p-CREB (Ser133) and mGluR5 Level in Prefrontal Cortex of C57BL/6 Mice

Authors: Sang-Sun Yoon, Yea-Hyun Leem, Sangmee Ahn Jo

Abstract:

The N-acetylated-alpha-linked-acidic (NAAG) peptidase inhibitor 2-phosphonomethyl pentanedioic acid (2-PMPA) has demonstrated to be neuroprotective against glutamate-mediated neuron degeneration and neurological disorders such as ischemia. Several studies have demonstrated impaired psychiatric function by altered glutamate carboxypeptidase II expression, although 2-PMPA has not yet been studied. Thus, we investigated effect of 2-PMPA on depressive-like phenotype using C57BL/6 mice. Treatment of 2-PMPA (10 mg/kg for 6 days/daily, ip injection) on C57BL/6 naïve mice showed depressive-like symptoms such as decreased social preference, but did not affect the immobility measured by tail suspension test. Reduction of phosphorylated cAMP-responsive element binding (p-CREB) known as a representative marker of depressive-like behavior was observed in layer 1 and piriform cortex subregions of the prefrontal cortex of 2-PMPA-treated mice. The immunoreactivity of metabotropic glutamate receptors 5 (mGluR5) that mediate phosphorylation of CREB was also decreased in layer 1 and piriform cortex subregions of the prefrontal cortex of 2-PMPA injected mice. Thus, our results suggest that dysregulation of the GCPII or NAAG by 2-PMPA treatment is likely to be associated with pathogenesis of depression and further studies are needed to understand whether the reduced NAAG level or enhanced glutamate level in the brain is involved in this response.

Keywords: depression, GCPII, 2-PMPA, p-CREB, mGluR5

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10049 Coffee Consumption Has No Acute Effects on Glucose Metabolism in Healthy Men: A Randomized Crossover Clinical Trial

Authors: Caio E. G. Reis, Sara Wassell, Adriana L. Porto, Angélica A. Amato, Leslie J. C. Bluck, Teresa H. M. da Costa

Abstract:

Background: Multiple epidemiologic studies have consistently reported association between increased coffee consumption and a lowered risk of Type 2 Diabetes Mellitus. However, the mechanisms behind this finding have not been fully elucidated. Objective: We investigate the effect of coffee (caffeinated and decaffeinated) on glucose effectiveness and insulin sensitivity using the stable isotope minimal model protocol with oral glucose administration in healthy men. Design: Fifteen healthy men underwent 5 arms randomized crossover single-blinding (researchers) clinical trial. They consumed decaffeinated coffee, caffeinated coffee (with and without sugar), and controls – water (with and without sugar) followed 1 hour by an oral glucose tolerance test (75 g of available carbohydrate) with intravenous labeled dosing interpreted by the two compartment minimal model (225 minutes). One-way ANOVA with Bonferroni adjustment were used to compare the effects of the tested beverages on glucose metabolism parameters. Results: Decaffeinated coffee resulted in 29% and 85% higher insulin sensitivity compared with caffeinated coffee and water, respectively, and the caffeinated coffee showed 15% and 60% higher glucose effectiveness compared with decaffeinated coffee and water, respectively. However, these differences were not significant (p > 0.10). In overall analyze (0 – 225 min) there were no significant differences on glucose effectiveness, insulin sensitivity, and glucose and insulin area under the curve between the groups. The beneficial effects of coffee did not seem to act in the short-term (hours) on glucose metabolism parameters mainly on insulin sensitivity indices. The benefits of coffee consumption occur in the long-term (years) as has been shown in the reduction of Type 2 Diabetes Mellitus risk in epidemiological studies. The clinical relevance of the present findings is that there is no need to avoid coffee as the drink choice for healthy people. Conclusions: The findings of this study demonstrate that the consumption of caffeinated and decaffeinated coffee with or without sugar has no acute effects on glucose metabolism in healthy men. Further researches, including long-term interventional studies, are needed to fully elucidate the mechanisms behind the coffee effects on reduced risk for Type 2 Diabetes Mellitus.

Keywords: coffee, diabetes mellitus type 2, glucose, insulin

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10048 Impact of Primary Care Telemedicine Consultations On Health Care Resource Utilisation: A Systematic Review

Authors: Anastasia Constantinou, Stephen Morris

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Background: The adoption of synchronous and asynchronous telemedicine modalities for primary care consultations has exponentially increased since the COVID-19 pandemic. However, there is limited understanding of how virtual consultations influence healthcare resource utilization and other quality measures including safety, timeliness, efficiency, patient and provider satisfaction, cost-effectiveness and environmental impact. Aim: Quantify the rate of follow-up visits, emergency department visits, hospitalizations, request for investigations and prescriptions and comment on the effect on different quality measures associated with different telemedicine modalities used for primary care services and primary care referrals to secondary care Design and setting: Systematic review in primary care Methods: A systematic search was carried out across three databases (Medline, PubMed and Scopus) between August and November 2023, using terms related to telemedicine, general practice, electronic referrals, follow-up, use and efficiency and supported by citation searching. This was followed by screening according to pre-defined criteria, data extraction and critical appraisal. Narrative synthesis and metanalysis of quantitative data was used to summarize findings. Results: The search identified 2230 studies; 50 studies are included in this review. There was a prevalence of asynchronous modalities in both primary care services (68%) and referrals from primary care to secondary care (83%), and most of the study participants were females (63.3%), with mean age of 48.2. The average follow-up for virtual consultations in primary care was 28.4% (eVisits: 36.8%, secure messages 18.7%, videoconference 23.5%) with no significant difference between them or F2F consultations. There was an average annual reduction of primary care visits by 0.09/patient, an increase in telephone visits by 0.20/patient, an increase in ED encounters by 0.011/patient, an increase in hospitalizations by 0.02/patient and an increase in out of hours visits by 0.019/patient. Laboratory testing was requested on average for 10.9% of telemedicine patients, imaging or procedures for 5.6% and prescriptions for 58.7% of patients. When looking at referrals to secondary care, on average 36.7% of virtual referrals required follow-up visit, with the average rate of follow-up for electronic referrals being higher than for videoconferencing (39.2% vs 23%, p=0.167). Technical failures were reported on average for 1.4% of virtual consultations to primary care. When using carbon footprint estimates, we calculate that the use of telemedicine in primary care services can potentially provide a net decrease in carbon footprint by 0.592kgCO2/patient/year. When follow-up rates are taken into account, we estimate that virtual consultations reduce carbon footprint for primary care services by 2.3 times, and for secondary care referrals by 2.2 times. No major concerns regarding quality of care, or patient satisfaction were identified. 5/7 studies that addressed cost-effectiveness, reported increased savings. Conclusions: Telemedicine provides quality, cost-effective, and environmentally sustainable care for patients in primary care with inconclusive evidence regarding the rates of subsequent healthcare utilization. The evidence is limited by heterogeneous, small-scale studies and lack of prospective comparative studies. Further research to identify the most appropriate telemedicine modality for different patient populations, clinical presentations, service provision (e.g. used to follow-up patients instead of initial diagnosis) as well as further education for patients and providers alike on how to make best use of this service is expected to improve outcomes and influence practice.

Keywords: telemedicine, healthcare utilisation, digital interventions, environmental impact, sustainable healthcare

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10047 Economic Value Added of Green Marketing for Urban Commerical Center

Authors: Kuo-Wei Hsu, Yen-Ting, Wu

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Recently, green marketing issues have emerged as the developing direction for local governments and social enterprises. At the same time, many social enterprises have considered how to effectively create a low-carbon and sustainable environment. Local government has a role to play in promoting low-carbon life styles and creating a green sustainable environment within this green marketing trend. Therefore, urban commercial centers have implemented relevant plans such as: Green Store, Green Action Shops, Green Restaurants and Green Hotels. The purpose of these plans to select the commercial center organizations have potential energy saving demonstration and environmental greenification. These organizations are willing to provide assistance counseling and become a green demonstration district, thereby promoting the major shopping district to take the initiative to enhance its green competitiveness. Finally, they create a new landscape for the commercial center. Studies on green marketing in commercial centers are seen as less attractive and only a few studies for commercial centers have focused on green marketing strategies. There is no empirical evidence for how commercial center managers evaluate a commercial center green marketing strategy. This research investigated the major commercial centers in Taichung City and found green marketing helps to enhance the connection between the urban commercial center value and society value, shape corporate image with social responsibility and create brand value, and therefore impact the increase of economic value.

Keywords: economic value added, green marketing, sustainable environment, urban commercial center.

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10046 Potential Role of Arbuscular Mycorrhizal (AM) Fungi in CO₂-Sequestration During Bipartite Interaction with Host Plant Oryza Sativa

Authors: Sadhana Shukla, Pushplata Singh, Nidhi Didwania

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Arbuscular mycorrhizal (AM) fungi are a highly advantageous and versatile group of fungi that significantly contribute to the formation of soil organic matter by creating a demand for plant carbon (C) and distributing it through below-ground hyphal biomass, regardless of their substantial contribution in enhancing net primary productivity and accumulating additional photosynthetic fixed C in the soil. The genetic role of AM fungi in carbon cycling is largely unexplored. In our study, we propose that AM fungi significantly interact with the soil, particularly: the provision of photosynthates by plants. We have studied the expression of AM fungi genes involved in CO₂ sequestration during host-plant interaction was investigated by qPCR studies. We selected Rhizophagus proliferus (AM fungi) and Oryza sativa (Rice) (inoculated with or without 200ppg AMF inoculums per plant) and investigated the effect of AM fungi on soil organic carbon (SOC) and rice growth under field conditions. Results thus provided faster SOC turnover, 35% increased nutrient uptake in plants and pronounced hyphal biomass of AM fungi which enhanced soil carbon storage by 15% in comparison to uninoculated plants. This study will offer a foundation for delving into various carbon-soil studies while also advancing our comprehension of the relationship between AM fungi and the sustainability of agricultural ecosystems.

Keywords: arbuscular mycorrhizal (AM) fungi, carbon sequestration, gene expression, soil health, plant development.

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10045 Aerodynamic Design Optimization of High-Speed Hatchback Cars for Lucrative Commercial Applications

Authors: A. Aravind, M. Vetrivel, P. Abhimanyu, C. A. Akaash Emmanuel Raj, K. Sundararaj, V. R. S. Kumar

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The choice of high-speed, low budget hatchback car with diversified options is increasing for meeting the new generation buyers trend. This paper is aimed to augment the current speed of the hatchback cars through the aerodynamic drag reduction technique. The inverted airfoils are facilitated at the bottom of the car for generating the downward force for negating the lift while increasing the current speed range for achieving a better road performance. The numerical simulations have been carried out using a 2D steady pressure-based    k-ɛ realizable model with enhanced wall treatment. In our numerical studies, Reynolds-averaged Navier-Stokes model and its code of solution are used. The code is calibrated and validated using the exact solution of the 2D boundary layer displacement thickness at the Sanal flow choking condition for adiabatic flows. We observed through the parametric analytical studies that the inverted airfoil integrated with the bottom surface at various predesigned locations of Hatchback cars can improve its overall aerodynamic efficiency through drag reduction, which obviously decreases the fuel consumption significantly and ensure an optimum road performance lucratively with maximum permissible speed within the framework of the manufactures constraints.

Keywords: aerodynamics of commercial cars, downward force, hatchback car, inverted airfoil

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10044 Evaluation of ROS Mediated Apoptosis Induced by Tuber Extract of Dioscorea Bulbifera on Human Breast Adenocarcinoma

Authors: Debasmita Dubey, Rajesh Kumar Meher, Smruti Pragya Samal, Pradeep Kumar Naik

Abstract:

Background: To determine antioxidant properties and anticancer activity by ROS and mitochondrial transmembrane potential mediated apoptosis against MCF7, MDA-MB-231, cell line. Methods: Leaf sample was extracted using methanol by microwave digestion technique. The antioxidant properties of the methanolic extract were determined by a DPPH scavenging assay. In vitro anticancer activity, mitochondrial transmembrane potential, apoptosis activity and DNA fragmentation study, as well as intracellular ROS activity of most potential leaf extract, were also determined by using the MDA-MB-231cell line. In vivo animal toxicity study was carried out using mice model. Results: Methanolic leaf extract has shown the highest antioxidant, as well as anticancer activity, is based on the assay conducted. For the identification of active phytochemicals from methanolic extract, High-resolution mass spectroscopy-LCMS was used. In vitro cytotoxicity study against MCF-7 and MDA-MB-231 cell line and IC 50 value was found to be 37.5µg/ml. From histopathological studies, no toxicity in liver and kidney tissue was identified. Conclusion: This plant tuber can be used as a regular diet to reduce the chance of breast cancer. Further, more studies should be conducted to isolate and identify the responsible compound.

Keywords: human breast adenocarcinoma, ROS, mitochondrial transmembrane, apoptosis

Procedia PDF Downloads 118
10043 Smart Growth Through Innovation Programs: Challenges and Opportunities

Authors: Hanadi Mubarak Al-Mubaraki, Michael Busler

Abstract:

Innovation is the powerful tools for economic growth and diversification, which lead to smart growth. The objective of this paper is to identify the opportunities and challenges of innovation programs discuss and analyse the implementation of the innovation program in the United States (US) and United Kingdom (UK). To achieve the objectives, the research used a mixed methods approach, quantitative (survey), and qualitative (multi-case study) to examine innovation best practices in developed countries. In addition, the selection of 4 interview case studies of innovation organisations based on the best practices and successful implementation worldwide. The research findings indicated the two challenges such as 1) innovation required business ecosystem support to deliver innovation outcomes such as new product and new services, and 2) foster the climate of innovation &entrepreneurship for economic growth and diversification. Although the two opportunities such as 1) sustainability of the innovation events which lead smart growth, and 2) establish the for fostering the artificial intelligence hub entrepreneurship networking at multi-levels. The research adds value to academicians and practitioners such as government, funded organizations, institutions, and policymakers. The authors aim to conduct future research a comparative study of innovation case studies between developed and developing countries for policy implications worldwide. The Originality of This study contributes to current literature about the innovation best practice in developed and developing countries.

Keywords: economic development, technology transfer, entrepreneurship, innovation program

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10042 Water-Bentonite Interaction of Green Pellets through Micro-Structural Analysis

Authors: Satyananda Patra, Venugopal Rayasam

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The quality of pellets produced is affected by quality and type of green pellets, amount of addition of binders and fluxing agents along with the provided firing conditions. The green pellet quality depends upon chemistry, mineralogy and granulometry of fines used for pellet making, the feed size, its moisture content and porosity. During firing of green pellets, ingredients present within reacts to form different phases and microstructure. So in turn, physical and metallurgical properties of pellets are influenced by amount and type of binder and flux addition, induration time and temperature. During iron making process, the metallurgical properties of fired pellets are decided by the type and amount of these phases and their chemistry. Green pelletizing and induration studies have been already carried out with magnetite and hematite ore fines but for Indian iron ores of high alumina content showing different pelletizing characters, these studies cannot be directly interpreted. The main objective of proposed research work is to understand the green pelletizing process and determine the water bentonite interaction at different levels. Swelling behavior of bentonite and microstructure of the green pellet are investigated. Conversion of iron ore fines into pellets, the key raw material and process variables that influence the pellet quality needs to be identified and a correlation should be established between them.

Keywords: iron ore, pelletization, binders, green pellets, microstructure

Procedia PDF Downloads 314
10041 Locus of Control and Sense of Happiness: A Mediating Role of Self-Esteem

Authors: Ivanna Shubina

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Background/Objectives and Goals: Recent interest in positive psychology is reflected in a plenty of studies conducted on its basic constructs (e.g. self-esteem and happiness) in interrelation with personality features, social rules, business and technology development. The purpose of this study is to investigate the mediating role of self-esteem, exploring the relationships between self-esteem and happiness, self-esteem and locus of control (LOC). It hypothesizes that self-esteem may be interpreted as a predictor of happiness and mediator in the locus of control establishment. A plenty of various empirical studies results have been analyzed in order to collect data for this theoretical study, and some of the analysed results can be considered as arguable or incoherent. However, the majority of results indicate a strong relationship between three considered concepts: self-esteem, happiness, the locus of control. Methods: In particular, this study addresses the following broad research questions: i) Is self-esteem just an index of global happiness? ii) May happiness be possible or realizable without a healthy self-confidence and self-acceptance? iii) To what extent does self-esteem influence on the level of happiness? iv) Is high self-esteem a sufficient condition for happiness? v) Is self-esteem is a strong predictor of internal locus of control maintenance? vi) Is high self-esteem related to internal LOC, while low self-esteem to external LOC? In order to find the answers for listed questions, 60 reliable sources have been analyzed, results of what are discussed more detailed below. Expected Results/Conclusion/Contribution:It is recognized that the relationship between self-esteem, happiness, locus of control is complex: internal LOC is contributing to happiness, but it is not directly related to it; self-esteem is a powerful and important psychological factor in mental health and well-being; the feelings of being worthy and empowered are associated with significant achievements and high self-esteem; strong and appropriate self-esteem (when the discrepancy between “ideal” and “real” self is balanced) is correlated with more internal LOC (when the individual tends to believe that personal achievements depend on possessed features, vigor, and persistence). Despite the special attention paid to happiness, the locus of control and self-esteem, independently, theoretical and empirical equivocations within each literature foreclose many obvious predictions about the nature of their empirical distinction. In terms of theoretical framework, no model has achieved consensus as an ultimate theoretical background for any of the mentioned constructs. To be able to clarify the relationship between self-esteem, happiness, and locus of control more interdisciplinary studies have to take place in order to get data on heterogeneous samples, provided from various countries, cultures, and social groups.

Keywords: happiness, locus of control, self-esteem, mediation

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10040 The Use of Robots for Children and Young People on the Autism Spectrum: A Systematic Review

Authors: Athanasia Kouroupa

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Existing research highlights the effect of employing robots in sessions with children and young people on the autism spectrum to develop and practice skills important to independent and functional living. The systematic review aimed to explore the way robots has been used with children and young people on the autism spectrum and the effect of using robots as a therapeutic interface. An electronic bibliographic database search using a combination of expressions was conducted. Data were extracted in relation to robot types, session characteristics, and outcomes and analysed using narrative synthesis. Forty studies were selected in the review. Humanoid robots were predominantly used to practice a range of social and communication skills. On average, children and young people on the autism spectrum had five sessions, twice a week, for approximately half an hour. Having sessions with a robot was commonly equal to or more effective than 'traditional' interventions delivered by a human therapist or having no therapy. The review reported encouraging outcomes to practice and develop a range of skills with children and young people on the autism spectrum. These findings suggest that some form of intervention is favourable over no intervention. However, there is little evidence for the relative effectiveness of the robot-based intervention as an innovative alternative option. Many of the studies had methodological weaknesses that make them vulnerable to bias. There is a need for further research that adheres to strict scientific methods making direct comparisons between different treatment options.

Keywords: autism, children, robots, outcomes

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10039 Road Traffic Accidents Analysis in Mexico City through Crowdsourcing Data and Data Mining Techniques

Authors: Gabriela V. Angeles Perez, Jose Castillejos Lopez, Araceli L. Reyes Cabello, Emilio Bravo Grajales, Adriana Perez Espinosa, Jose L. Quiroz Fabian

Abstract:

Road traffic accidents are among the principal causes of traffic congestion, causing human losses, damages to health and the environment, economic losses and material damages. Studies about traditional road traffic accidents in urban zones represents very high inversion of time and money, additionally, the result are not current. However, nowadays in many countries, the crowdsourced GPS based traffic and navigation apps have emerged as an important source of information to low cost to studies of road traffic accidents and urban congestion caused by them. In this article we identified the zones, roads and specific time in the CDMX in which the largest number of road traffic accidents are concentrated during 2016. We built a database compiling information obtained from the social network known as Waze. The methodology employed was Discovery of knowledge in the database (KDD) for the discovery of patterns in the accidents reports. Furthermore, using data mining techniques with the help of Weka. The selected algorithms was the Maximization of Expectations (EM) to obtain the number ideal of clusters for the data and k-means as a grouping method. Finally, the results were visualized with the Geographic Information System QGIS.

Keywords: data mining, k-means, road traffic accidents, Waze, Weka

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10038 The Relationship between Wasting and Stunting in Young Children: A Systematic Review

Authors: Susan Thurstans, Natalie Sessions, Carmel Dolan, Kate Sadler, Bernardette Cichon, Shelia Isanaka, Dominique Roberfroid, Heather Stobagh, Patrick Webb, Tanya Khara

Abstract:

For many years, wasting and stunting have been viewed as separate conditions without clear evidence supporting this distinction. In 2014, the Emergency Nutrition Network (ENN) examined the relationship between wasting and stunting and published a report highlighting the evidence for linkages between the two forms of undernutrition. This systematic review aimed to update the evidence generated since this 2014 report to better understand the implications for improving child nutrition, health and survival. Following PRISMA guidelines, this review was conducted using search terms to describe the relationship between wasting and stunting. Studies related to children under five from low- and middle-income countries that assessed both ponderal growth/wasting and linear growth/stunting, as well as the association between the two, were included. Risk of bias was assessed in all included studies using SIGN checklists. 45 studies met the inclusion criteria- 39 peer reviewed studies, 1 manual chapter, 3 pre-print publications and 2 published reports. The review found that there is a strong association between the two conditions whereby episodes of wasting contribute to stunting and, to a lesser extent, stunting leads to wasting. Possible interconnected physiological processes and common risk factors drive an accumulation of vulnerabilities. Peak incidence of both wasting and stunting was found to be between birth and three months. A significant proportion of children experience concurrent wasting and stunting- Country level data suggests that up to 8% of children under 5 may be both wasted and stunted at the same time, global estimates translate to around 16 million children. Children with concurrent wasting and stunting have an elevated risk of mortality when compared to children with one deficit alone. These children should therefore be considered a high-risk group in the targeting of treatment. Wasting, stunting and concurrent wasting and stunting appear to be more prevalent in boys than girls and it appears that concurrent wasting and stunting peaks between 12- 30 months of age with younger children being the most affected. Seasonal patterns in prevalence of both wasting and stunting are seen in longitudinal and cross sectional data and in particular season of birth has been shown to have an impact on a child’s subsequent experience of wasting and stunting. Evidence suggests that the use of mid-upper-arm circumference combined with weight-for-age Z-score might effectively identify children most at risk of near-term mortality, including those concurrently wasted and stunted. Wasting and stunting frequently occur in the same child, either simultaneously or at different moments through their life course. Evidence suggests there is a process of accumulation of nutritional deficits and therefore risk over the life course of a child demonstrates the need for a more integrated approach to prevention and treatment strategies to interrupt this process. To achieve this, undernutrition policies, programmes, financing and research must become more unified.

Keywords: Concurrent wasting and stunting, Review, Risk factors, Undernutrition

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10037 The Impact of Innovation Best Practices in Economic Development

Authors: Hanadi Mubarak AL-Mubaraki, Michael Busler

Abstract:

Innovation is the process of making changes, differences, and novelties in the products and services, adding values and business practices to create economic and social benefit. The purpose of this paper is to identify the strengths and weaknesses of innovation programs in developed and developing countries. We used a mixed-methods approach, quantitative as survey and qualitative as a multi-case study to examine innovation best practices in developed and developing countries. In addition, four case studies of innovation organisations based on the best practices and successful implementation in the developed and developing countries are selected for examination. The research findings provide guidance, suggestions, and recommendations for future implementation in developed and developing countries for practitioners such as policy makers, governments, funded organizations, and strategic institutions. In conclusion, innovation programs are vital tools for economic growth, knowledge, and technology transfer based on the several indicators such as creativity, entrepreneurship, role of government, role of university, strategic focus, new products, survival rate, job creation, start-up companies, and number of patents. The authors aim to conduct future research which will include a comparative study of innovation case studies between developed and developing countries for policy implications worldwide. The originality of this study makes a contribution to the current literature about the innovation best practice in developed and developing countries.

Keywords: economic development, entrepreneurship, innovation program, developed countries

Procedia PDF Downloads 376
10036 The Burmese Exodus of 1942: Towards Evolving Policy Protocols for a Refugee Archive

Authors: Vinod Balakrishnan, Chrisalice Ela Joseph

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The Burmese Exodus of 1942, which left more than 4 lakh as refugees and thousands dead, is one of the worst forced migrations in recorded history. Adding to the woes of the refugees is the lack of credible documentation of their lived experiences, trauma, and stories and their erasure from recorded history. Media reports, national records, and mainstream narratives that have registered the exodus provide sanitized versions which have reduced the refugees to a nameless, faceless mass of travelers and obliterated their lived experiences, trauma, and sufferings. This attitudinal problem compels the need to stem the insensitivity that accompanies institutional memory by making a case for a more humanistically evolved policy that puts in place protocols for the way the humanities would voice the concern for the refugee. A definite step in this direction and a far more relevant project in our times is the need to build a comprehensive refugee archive that can be a repository of the refugee experiences and perspectives. The paper draws on Hannah Arendt’s position on the Jewish refugee crisis, Agamben’s work on statelessness and citizenship, Foucault’s notion of governmentality and biopolitics, Edward Said’s concepts on Exile, Fanon’s work on the dispossessed, Derrida’s work on ‘the foreigner and hospitality’ in order to conceptualize the refugee condition which will form the theoretical framework for the paper. It also refers to the existing scholarship in the field of refugee studies such as Roger Zetter’s work on the ‘refugee label’, Philip Marfleet’s work on ‘refugees and history’, Lisa Malkki’s research on the anthropological discourse of the refugee and refugee studies. The paper is also informed by the work that has been done by the international organizations to address the refugee crisis. The emphasis is on building a strong argument for the establishment of the refugee archive that finds but a passing and a none too convincing reference in refugee studies in order to enable a multi-dimensional understanding of the refugee crisis. Some of the old questions cannot be dismissed as outdated as the continuing travails of the refugees in different parts of the world only remind us that they are still, largely, unanswered. The questions are -What is the nature of a Refugee Archive? How is it different from the existing historical and political archives? What are the implications of the refugee archive? What is its contribution to refugee studies? The paper draws on Diana Taylor’s concept of the archive and the repertoire to theorize the refugee archive as a repository that has the documentary function of the ‘archive’ and the ‘agency’ function of the repertoire. It then reads Ayya’s Accounts- a memoir by Anand Pandian -in the light of Hannah Arendt’s concepts of the ‘refugee as vanguard’ and ‘story telling as political action’- to illustrate how the memoir contributes to the refugee archive that provides the refugee a place and agency in history. The paper argues for a refugee archive that has implications for the formulation of inclusive refugee policies.

Keywords: Ayya’s Accounts, Burmese Exodus, policy protocol, refugee archive

Procedia PDF Downloads 140
10035 Strategic Analysis of Hospitality Marketing Driven by Culture in Historical City: Comparable Case Studies in Tainan City

Authors: Tsung-Han Lin, Chia-Han Yang

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Recently, it’s obvious that many hotels not only provide customized service, but offer local culture to give customers different experiences. Luxury decoration and fancy equipment are not enough anymore. Customers expect that hotels not just as an accommodation, but connecting to their trips. Therefore, culture becomes significant when developing marketing strategy for hotels. Tainan, located in south of Taiwan, is the city full of culture that some hospitality industries promote their hotels exactly base on culture. Historic Tainan (台南; táinán), is a city of ancient monuments, delicious food and, above all, temples: there are more gods worshipped and more festivals and rituals observed in Tainan than in any other place in Taiwan. The oldest and most absorbing parts of Tainan are historic Anping, on the west side of town by the sea, and the cultural zones in the heart of the old city; the latter were created specifically to make things easier for visitors, with city information, signs and maps tailored to each zone and well-marked in English. The Chihkan, Dong-an Fang, Five Canals and Confucius Temple cultural zones contain the richest concentration of sights – reckon on spending at least two days to do them justice. As a result, the study aims to analyze the significance of culture on marketing strategies and C and H two hotels in Tainan city as case studies conducting the comparison of cultural marketing and experience marketing to provide a framework for hotels to develop their marketing strategies.

Keywords: cultural marketing, hospitality, historical city, Tainan city

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10034 Factors Associated with Ketamine Use in Pancreatic Cancer Patient in a Single Hospice Center

Authors: Kyung Min Kwom, Young Joo Lee

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Purpose: Up to 90% of pancreatic cancer patient suffer from neuropathic pain. In palliative care setting, pain control in a pancreatic cancer patient is one of the major goals. Ketamine is a NMDA receptor antagonist effective in neuropathic pain. Also, there have been studies about opioid sparing effect of ketamine. This study was held in palliative care unit among pancreatic cancer patients to find out the factors related to ketamine use and the opioid sparing effect. Methods: Medical records of pancreatic cancer patients admitted to St. Mary’s hospital palliative care unit from 2013.1 to 2014.12 were reviewed. Patients were divided into two categories according to ketamine use. Also, opioid use before and after ketamine use was compared in ketamine group. Results: Compared to non ketamine use group, patients in ketamine group required a higher dose of opioid. Total opioid dose, daily opioid dose, number of daily rescue medication, daily average rescue dose were statistically significantly higher in ketamine group. Opioid requirement was increased after ketamine administration. Conclusion: In this study, ketamine group required more opioid. Ketamine is frequently considered in patients with severe pain, requiring high amount of opioid. Also, ketamine did not have an opioid sparing effect. Future studies about palliative use of ketamine in a larger number of patients are required.

Keywords: ketamine, opioid sparing, palliative care, pancreatic cancer

Procedia PDF Downloads 234
10033 Association between Polygenic Risk of Alzheimer's Dementia, Brain MRI and Cognition in UK Biobank

Authors: Rachana Tank, Donald. M. Lyall, Kristin Flegal, Joey Ward, Jonathan Cavanagh

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Alzheimer’s research UK estimates by 2050, 2 million individuals will be living with Late Onset Alzheimer’s disease (LOAD). However, individuals experience considerable cognitive deficits and brain pathology over decades before reaching clinically diagnosable LOAD and studies have utilised gene candidate studies such as genome wide association studies (GWAS) and polygenic risk (PGR) scores to identify high risk individuals and potential pathways. This investigation aims to determine whether high genetic risk of LOAD is associated with worse brain MRI and cognitive performance in healthy older adults within the UK Biobank cohort. Previous studies investigating associations of PGR for LOAD and measures of MRI or cognitive functioning have focused on specific aspects of hippocampal structure, in relatively small sample sizes and with poor ‘controlling’ for confounders such as smoking. Both the sample size of this study and the discovery GWAS sample are bigger than previous studies to our knowledge. Genetic interaction between loci showing largest effects in GWAS have not been extensively studied and it is known that APOE e4 poses the largest genetic risk of LOAD with potential gene-gene and gene-environment interactions of e4, for this reason we  also analyse genetic interactions of PGR with the APOE e4 genotype. High genetic loading based on a polygenic risk score of 21 SNPs for LOAD is associated with worse brain MRI and cognitive outcomes in healthy individuals within the UK Biobank cohort. Summary statistics from Kunkle et al., GWAS meta-analyses (case: n=30,344, control: n=52,427) will be used to create polygenic risk scores based on 21 SNPs and analyses will be carried out in N=37,000 participants in the UK Biobank. This will be the largest study to date investigating PGR of LOAD in relation to MRI. MRI outcome measures include WM tracts, structural volumes. Cognitive function measures include reaction time, pairs matching, trail making, digit symbol substitution and prospective memory. Interaction of the APOE e4 alleles and PGR will be analysed by including APOE status as an interaction term coded as either 0, 1 or 2 e4 alleles. Models will be adjusted partially for adjusted for age, BMI, sex, genotyping chip, smoking, depression and social deprivation. Preliminary results suggest PGR score for LOAD is associated with decreased hippocampal volumes including hippocampal body (standardised beta = -0.04, P = 0.022) and tail (standardised beta = -0.037, P = 0.030), but not with hippocampal head. There were also associations of genetic risk with decreased cognitive performance including fluid intelligence (standardised beta = -0.08, P<0.01) and reaction time (standardised beta = 2.04, P<0.01). No genetic interactions were found between APOE e4 dose and PGR score for MRI or cognitive measures. The generalisability of these results is limited by selection bias within the UK Biobank as participants are less likely to be obese, smoke, be socioeconomically deprived and have fewer self-reported health conditions when compared to the general population. Lack of a unified approach or standardised method for calculating genetic risk scores may also be a limitation of these analyses. Further discussion and results are pending.

Keywords: Alzheimer's dementia, cognition, polygenic risk, MRI

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10032 Climatic and Environmental Factors Affecting Human Comfort Evaluation: Case Study of Shiraz Iran

Authors: Hamid Yazdani, Fatemeh Abbasi

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Understanding the natural potentials, as the basis for the prevailing context of human activities, environmental planning, and land-use form shows. In this regard, regional characteristics and spatial distribution of the dominant elements in shaping human behavior and environment play a role Knndhayy. As far as today's studies of human Byvklymay basis for urban planning, settlement, architecture, Tourism and so on. In this study, comfort or lack of comfort in Shiraz in Horn of models and indices based on eco-Baker, Trjvng, were examined and the best time to do-using 39 years of data (TCI) stress, and the effective temperature Environmental activities and tourism in the city was established. The results showed that the worth parameters used, the ability to detect Terms of comfort and discomfort are Shiraz, despite minor differences, relatively homogenous aspects of the city provide a comfortable climate. Studies showed that having diversity in the worth of Shiraz during the year, the situation is heating up much coolness; during winter and summer Find out eco comfort zone and during the transition from cold to warm in spring and autumn (April) and warm to cold (November) climate Iran is close to human comfort. Totally, unique human comfort conditions in spring, the best season for environmental activities Tourism in Shiraz.

Keywords: BIO comfort Klymayy, Trjvng, baker, effective temperature, stress and (TCI)

Procedia PDF Downloads 348