Search results for: chronic covid syndrome

Authors: Angeliki Gkiouzeli, Christine Rotonda, Elise Eby, Claire Touchet, Marie-Jo Brennstuhl, Cyril Tarquinio

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Resilience is a psychological concept of possible relevance to the development and maintenance of chronic pain (CP). It refers to the ability of individuals to maintain reasonably healthy levels of physical and psychological functioning when exposed to an isolated and potentially highly disruptive event. Extensive research in recent years has supported the importance of this concept in the CP literature. Increased levels of resilience were associated with lower levels of perceived pain intensity and better mental health outcomes in adults with persistent pain. The ongoing project seeks to include the concept of pain-specific resilience in the French literature in order to provide more appropriate measures for assessing and understanding the complexities of CP in the near future. To the best of our knowledge, there is currently no validated version of the pain-specific resilience measure, the Pain Resilience scale (PRS), for French-speaking populations. Therefore, the present work aims to address this gap, firstly by performing a linguistic and cultural translation of the scale into French and secondly by studying the internal validity and reliability of the PRS for French CP populations. The forward-translation-back translation methodology was used to achieve as perfect a cultural and linguistic translation as possible according to the recommendations of the COSMIN (Consensus-based Standards for the selection of health Measurement Instruments) group, and an online survey is currently conducted among a representative sample of the French population suffering from CP. To date, the survey has involved one hundred respondents, with a total target of around three hundred participants at its completion. We further seek to study the metric properties of the French version of the PRS, ''L’Echelle de Résilience à la Douleur spécifique pour les Douleurs Chroniques'' (ERD-DC), in French patients suffering from CP, assessing the level of pain resilience in the context of CP. Finally, we will explore the relationship between the level of pain resilience in the context of CP and other variables of interest commonly assessed in pain research and treatment (i.e., general resilience, self-efficacy, pain catastrophising, and quality of life). This study will provide an overview of the methodology used to address our research objectives. We will also present for the first time the main findings and further discuss the validity of the scale in the field of CP research and pain management. We hope that this tool will provide a better understanding of how CP-specific resilience processes can influence the development and maintenance of this disease. This could ultimately result in better treatment strategies specifically tailored to individual needs, thus leading to reduced healthcare costs and improved patient well-being.

Keywords: chronic pain, pain measure, pain resilience, questionnaire adaptation

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Authors: Satria B. Mahathma, Asri Hendrawati

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Background: Diabetes mellitus (DM) is a metabolic disorder syndrome characterized by chronic hyperglycemia. The number of people with diabetes rose from 108 million in 1980 to 422 million in 2014. In general, almost 90% of the prevalence of DM is type 2 DM which marked by insulin resistance and decreased receptor sensitivity. Aside from conventional antidiabetic therapy, the utilization of medicinal plants as alternative medicine has beneficial effects in diabetic patients. Flavonoid contents in radish leaves such as quercetin, pelargonidin, and kaempferol are thought to have antidiabetic activity on decreasing blood glucose levels by tricyclic nucleotide modulation of pancreatic beta cells and ameliorating insulin resistance. This study aimed to determine the effect of variant concentration of radish leaves ethanol extract on blood glucose levels in diabetic rats. Method: This study used pretest-posttest control group design by using 16 male Wistar rats which were induced type-2 diabetic by streptozotocin 60 mg/kg BW-nicotinamide 120 mg/kg BW intraperitoneally. Rats who had developed type-2 DM later divided randomly into 4 groups; negative control received placebo, positive control received glibenclamide 5 mg/kg BW/day, rats intervention I and intervention II received 100% and 50% of radish leaves ethanol extract, respectively. Treatments were administered orally for four weeks. The blood glucose levels were measured using the Enzymatic Colorimetric Test “GOD-PAP”. Data were analyzed by the dependent t-test for pretest-posttest intervention difference and one-way ANOVA followed by post hoc test to determine the significant difference of each treatment to obtain the significant data. Result: The result revealed that intervention group had lower blood glucose levels mean than control group which the lowest was intervention II group (negative control: 540,9 ± 191,7 mg/dl, positive control: 494, 97 ± 64,91 mg/dl, intervention I: 301,92 ± 165,70 mg/dl, and intervention II group: 276,1 ± 139,02 mg/dl. Intervention II group had the highest antidiabetic activity, followed by the intervention I group with the amount of decrease in blood glucose levels were -151,85 ± 77,43 mg/dl and -11,08 ± 186,62 mg/dl, however negative and positive control group didn’t have antidiabetic activity. The dependent t-test result showed there is a significant difference in decreasing blood glucose levels in the intervention II pretest-posttest intervention (p=0,03) while the other group didn’t. Data analyzed by one-way ANOVA also revealed the intervention II group significantly declined blood glucose levels compared to the negative and positive control group (p = 0,033 and p=0,032, respectively). Conclusion: There is a significant effect of radish leaves ethanol extract on blood glucose levels in streptozotocin-nicotinamide-induced diabetic rats with the optimal therapeutic effect at a concentration of 50%.

Keywords: blood glucose levels, medicinal plant, radish leaves, type-2 diabetes mellitus

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Authors: David Cobham

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In higher education, a great degree of importance is placed on the internationalization of the student experience. This is seen as a valuable contributor to elements such as building confidence, broadening knowledge, creating networks and connections, and enhancing employability for current students who will become the next generation of managers in technology and business. The COVID-19 pandemic has affected all areas of people’s lives. The limitations of travel coupled with the fears and concerns generated by the health risks have dramatically reduced the opportunity for students to engage with this agenda. Institutions of higher education have been required to rethink fundamental aspects of their business model from recruitment and enrolment through learning approaches, assessment methods, and the pathway to employment. This paper presents a case study which focuses on student mobility and how the physical experience of being in another country, either to study, to work, to volunteer or to gain cultural and social enhancement, has of necessity been replaced by alternative approaches. It considers trans-national education as an alternative to physical study overseas, virtual mobility and internships as an alternative to international work experience, and adopting collaborative online projects as an alternative to in-person encounters. The paper concludes that although these elements have been adopted to address the current situation, the lessons learned and the feedback gained suggests that they have contributed successfully in new and sometimes unexpected ways and that they will persist beyond the present to become part of the 'new normal' for the future. That being the case, senior leaders of institutions of higher education will be required to revisit their international plans and to rewrite their international strategies to take account of and build upon these changes.

Keywords: higher education management, internationalization, transnational education, virtual mobility

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Authors: Pamela E. Mukaire

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Anemia and chronic energy deficiency are significant manifestations of poor nutritional health. Anaemia and nutritional status screening are practical ways for assessing the prevalence of iron deficiency anemia in the food insecure populations with large groups of childbearing women and children. The objective of the study was to assess anemia prevalence and other clinical manifestations of malnutrition among pairs of mothers and young children in rural Uganda. This community cross-sectional study used consecutive sampling to select 214 mothers and 214 children for the study. Data was generated using structured questionnaire, anthropometric measurements and on site analysis for anemia. Bivariable and multivariable analyses were used to assess the effect of different factors on anaemia. Of the 214 mothers, 54.2% were 25-34 years of age, 76.7% unmarried, 63% low income, and 55% had more than four children. Of the 214 children, 57% were female, 50% between 1 to 3 years of age and 35% under one year, and. Overall, 38% of the households had more 4 children under the age of 12. The prevalence of anemia was 48% for mothers and 72% for children; 20.6% of mothers had moderate to severe chronic energy deficiency, 39% had moderately-severe anaemia (10 to 7.1 g/dL). Among children, 53% had moderately-severe anaemia, and 18.2% had severe anaemia. Parity X2 =20, p < .037, number of children under 12 years living in a household X2 =10, p < .015, and child’s gender X2 =6.5, p < .038, had a significant relationship with maternal anaemia. There was a significant relationship between household income X2 =10, p < .005, marital status X2 =9, p < .011, owing a piece of land X2 =18, p < .000, owing home X2 =7, p < .036, and anaemia in children. The prevalence of anemia was high in both mothers and children. Income, marital status, owing a piece of land, owing home, number of children under age 12 in a household were associated with anaemia. Hence, efforts should be made for early diagnosis and management of anaemia deficiencies with special emphasis on those households with large number of children under age 12.

Keywords: anemia, maternal-child, nutrition, rural population

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Authors: Caroline F. Moeser

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The skin-gut axis defines the relationship between the intestinal microbiota and the development of pathological skin diseases. Low diversity within the gut can predispose to the development of allergic skin conditions, and a greater diversity of the gastrointestinal microflora has been associated with a reduction of skin flares in people with atopic dermatitis. Manipulation of the gut microflora has been used as a treatment option for several conditions in people, but there is limited data available on the use of faecal transplantation as a preventative measure in either people or dogs. Six, 4-month-old pups from a litter of ten were presented for diarrhea and/or signs of skin disease (chronic scratching, otitis externa). Of these pups, two were given probiotics with a resultant resolution of diarrhea. The other four pups were given faecal transplantation, either as a sole treatment or in combination with other treatments. Follow-up on the litter of ten pups was performed at 18 months of age. At this stage, the four pups that had received faecal transplantation had resolved all clinical signs and had no recurrence of either skin or gastrointestinal symptoms. Of the remaining six pups from the litter, all had developed at least one episode of Malassezia otitis externa within the period of 5 months to 18 months of age. Two pups had developed two Malassezia otitis infections, and one had developed three Malassezia otitis infections during this period. Favrot’s criteria for the diagnosis of canine atopic dermatitis include chronic or recurrent Malassezia infections by the age of three years. Early results from this litter predict a reduction in the development of canine atopic disease in dogs given faecal microbial transplantation. Follow-up studies at three years of age and within a larger population of dogs can enhance understanding of the impact of early faecal transplantation in the prevention of canine atopic dermatitis.

Keywords: canine atopic dermatitis, faecal microbial transplant, skin-gut axis, otitis

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Authors: K. S. Suganya, R. Nedunchezhian

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In recent years, blockchain technology has been found to be the most significant discovery in this digital era, after the discovery of the Internet and Cloud Computing. Blockchain is a simple, distributed public ledger that contains all the user’s transaction details in a block. The global copy of the block is then shared among all its peer-peer network users after validation by the Blockchain miners. Once a block is validated and accepted, it cannot be altered by any users making it a trust-free transaction. It also resolves the problem of double-spending by using traditional cryptographic methods. Since the advent of bitcoin, blockchain has been the backbone for all its transactions. But in recent years, it has found its roots and uses in many fields like Smart Contracts, Smart City management, healthcare, etc. Identity management against digital identity theft has become a major concern among financial and other organizations. To solve this digital identity theft, blockchain technology can be employed with existing identity management systems, which maintain a distributed public ledger containing details of an individual’s identity containing information such as Digital birth certificates, Citizenship number, Bank details, voter details, driving license in the form of blocks verified on the blockchain becomes time-stamped, unforgeable and publicly visible for any legitimate users. The main challenge in using blockchain technology to prevent digital identity theft is ensuring the pseudo-anonymity and privacy of the users. This survey paper will exert to study the blockchain concepts, consensus protocols, and various blockchain-based Digital Identity Management systems with their research scope. This paper also discusses the role of Blockchain in COVID-19 pandemic management by self-sovereign identity and supply chain management.

Keywords: blockchain, consensus protocols, bitcoin, identity theft, digital identity management, pandemic, COVID-19, self-sovereign identity

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Authors: Williams A. Adu, Cynthia A. Danquah, Paul P. S. Ossei, Selase Ativui, Michael Ofori, James Asenso, George Owusu

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Background Silicosis is an occupational disease of the lung that is caused by chronic exposure to silica dust. There is a higher frequency of co-existence of silicosis with tuberculosis (TB), ultimately resulting in lung fibrosis and respiratory failure. Chronic intake of synthetic drugs has resulted in undesirable side effects. Diosgenin is a steroidal saponin that has been shown to exert a therapeutic effect on lung injury. Therefore, we investigated the ability of diosgenin to reduce the susceptibility of silica-induced TB in rats. Method Silicosis was induced by intratracheal instillation of 50 mg/kg crystalline silica in Sprague Dawley rats. Different doses of diosgenin (1, 10, and 100 mg/kg), Mycobacterium smegmatis and saline were administered for 30 days. Afterwards, 5 of the rats from each group were sacrificed, and the 5 remaining rats in each group, except the control, received Mycobacterium smegmatis. Treatment of diosgenin continued until the 50th day, and the rats were sacrificed at the end of the experiment. The result was analysed using a one-way analysis of variance (ANOVA) with a Graph-pad prism Result At a half-maximal inhibition concentration of 48.27 µM, diosgenin inhibited the growth of Mycobacterium smegmatis. There was a marked decline in the levels of immune cell infiltration and cytokines production. Lactate dehydrogenase and total protein levels were significantly reduced compared to control. There was an increase in the survival rate of the treatment group compared to the control. Conclusion Diosgenin ameliorated silica-induced pulmonary tuberculosis by declining the levels of inflammatory and pro-inflammatory cytokines and, in effect, significantly reduced the susceptibility of rats to pulmonary TB.

Keywords: silicosis, tuberculosis, diosgenin, fibrosis, crystalline silica

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Authors: Ali Alshahrani, Adel Almaai, Saad Garni

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Aim of the study: To explore duration and determinants of consultation time at a family medicine center. Methodology: This study was conducted at the Family Medicine Center in Ahad Rafidah City, at the southwestern part of Saudi Arabia. It was conducted on the working days of March 2013. Trained nurses helped in filling in the checklist. A total of 459 patients were included. A checklist was designed and used in this study. It included patient’s age, sex, diagnosis, type of visit, referral and its type, psychological problems and additional work-up. In addition, number of daily bookings, physician`s experience and consultation time. Results: More than half of patients (58.39%) had less than 10 minutes’ consultation (Mean+SD: 12.73+9.22 minutes). Patients treated by physicians with shortest experience (i.e., ≤5 years) had the longest consultation time while those who were treated with physicians with the longest experience (i.e., > 10 years) had the shortest consultation time (13.94±10.99 versus 10.79±7.28, p=0.011). Regarding patients’ diagnosis, those with chronic diseases had the longest consultation time (p<0.001). Patients who did not need referral had significantly shorter consultation time compared with those who had routine or urgent referral (11.91±8.42,14.60±9.03 and 22.42±14.81 minutes, respectively, p<0.001). Patients with associated psychological problems needed significantly longer consultation time than those without associated psychological problems (20.06±13.32 versus 12.45±8.93, p<0.001). Conclusions: The average length of consultation time at Ahad Rafidah Family Medicine Center is approximately 13 minutes. Less-experienced physicians tend to spend longer consultation times with patients. Referred patients, those with psychological problems, those with chronic diseases tend to have longer consultation time. Recommendations: Family physicians should be encouraged to keep their optimal consultation time. Booking an adequate number of patients per shift would allow the family physician to provide enough consultation time for each patient.

Keywords: consultation, quality, medicine, clinics

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Authors: Almutazballlah Bassam Qablan, Jihan M. Muhaidat, bana Abu Rajab

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Background: Acne vulgaris is considered one of the most common skin conditions encountered by dermatologists. It is a chronic inflammation affecting the pilosebaceous unit. Although acne vulgaris is not fatal, it leads to permanent scarring and disfigurement, and even without scarring, it has a huge effect on patients, causing negative health outcomes. Acne vulgaris patients experience psychological, and emotional ramifications as those with chronic health problems; they feel depressed, angry, anxious, and confused. Although acne is a popular disease, many thoughts and myths are still discussed about its origins and triggering factors. These myths can make you feel guilt as if you were somehow responsible for your acne. In this case control study, we want to define the relationship between two modifiable risk factors ;BMI and smoking, with acne vulgaris. Methods: A case-control study was conducted at King Abdullah University Hospital in Ramtha, Jordan in 2019/2020. A total number of 325 participants between 14 and 33 years of age were interviewed by the authors; including 163 acne vulgaris cases and 162 controls without acne vulgaris. Anthropometric measures and smoking for Acne patients and control participants were the independent variables used to assess acne. Univariate and multivariate analysis were used to compare the characteristics of people who reported acne with those with no acne. The collected data analyzed by using the Statistical Package for Social Sciences (SPSS). Results: Cigarette smoking was highly associated with controls; odds ratio 0.4 (95% CI: 0.2–0.9) , P-value = 0.018. BMI and waterpipe smoking were statistically insignificant with acne in the multivariate analysis. Conclusion: We found that cigarette smoking was protective against Acne. There was a statistically insignificant relation between BMI, waterpipe smoking and the development of Acne Vulgaris.

Keywords: acne, adolescents, BMI, smoking, case-control, risk factors

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Authors: Matthew John F. Sino Cruz, Sarah Jane M. Ferrer, Janice C. Francisco

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COVID-19 pandemic has affected more than 114 countries all over the world since it was considered a global health concern in 2020. Different sectors, including education, have shifted to remote/distant setups to follow the guidelines set to prevent the spread of the disease. One of the higher education institutes which shifted to remote setup is the Pangasinan State University (PSU). In order to continue providing quality instructions to the students, PSU designed Flexible Learning Model to still provide services to its stakeholders amidst the pandemic. The model covers the redesigning of delivering instructions in remote setup and the technology needed to support these adjustments. The primary goal of this study is to determine the insights of the PSU – Bayambang students towards the remote setup implemented during the pandemic and how they perceived the initiatives employed in relation to their experiences in flexible learning. In this study, the topic modelling approach was implemented using Latent Dirichlet Allocation. The dataset used in the study. The results show that the most common concern of the students includes time and resource management, poor internet connection issues, and difficulty coping with the flexible learning modality. Furthermore, the findings of the study can be used as one of the bases for the administration to review and improve the policies and initiatives implemented during the pandemic in relation to remote service delivery. In addition, further studies can be conducted to determine the overall sentiment of the other stakeholders in the policies implemented at the University.

Keywords: COVID-19, topic modelling, students’ sentiment, flexible learning, Latent Dirichlet allocation

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Authors: Zahra Khazaeipour, Ehsan Ahmadipour, Vafa Rahimi-Movaghar, Fereshteh Ahmadipour

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Research Objectives: Chronic pain is one of the common problems associated with spinal cord injuries (SCI), which causes many complications. Therefore, this study intended to evaluate the relationship between pain and demographic, injury characteristics, socio-economic and social support in individuals with spinal cord Injury in Iran. Design: Descriptive cross-sectional study. Setting: Brain and Spinal Cord Injury Research Center (BASIR), Tehran University of Medical Sciences, Tehran, Iran, between 2012 and 2013. Participants: The participants were 140 individuals with SCI, 101 (72%) men and 39 (28%) women, with mean age of 29.4 ±7.9 years. Main Outcome Measure: The Persian version of the Brief Pain Inventory (BPI) was used to measure the pain, and the Multidimensional Scale of Perceived Social Support (MSPSS) was used to measure social support. Results: About 50.7% complained about having pain, which 79.3% had bilateral pain. The most common locations of pain were lower limbs and back. The most quality of pain was described as aching (41.4%), and tingling (32.9%). Patients with a medium level of education had the least pain compared to high and low level of education. SCI individuals with good economic situation reported higher frequency of having pain. There was no significant relationship between pain and social support. There was positive correlation between pain and impairment of mood, normal work, relations with other people and lack of sleep (P < 0.001). Conclusion: These findings revealed the importance of socioeconomic factors such as economic situation and educational level in understanding chronic pain in people with SCI and provide further support for the bio-psychosocial model. Hence, multidisciplinary evaluations and treatment strategies are advocated, including biomedical, psychological, and psycho-social interventions.

Keywords: pain, social support, socio-economic indicators, spinal cord injury

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Authors: Yang Liandong

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The rapid development of cities has triggered a series of urban health problems. Residents' daily lives have generally changed to long-term unhealthy work and rest, and the prevalence of chronic diseases in the population is on the rise. Promoting physical activity is an effective way to enhance the population's health and reduce the risk of various chronic diseases. As the most basic unit of the city, the community is the living space where residents use the highest frequency of daily activities and also the best space carrier for people to carry out all kinds of physical activities, and its planning research is of great significance for promoting physical activities. Under special conditions, the old communities in mountainous cities present compact and three-dimensional spatial characteristics, and there are problems such as disordered spatial organization, scattered distribution, and low utilization rates. This paper selects four communities in Daxigou Street, Yuzhong District, Chongqing as the research object, analyzes the current situation of the research cases through literature combing and field investigation and interviews, and puts forward the planning strategies for promoting physical activity in old communities in mountain cities from four aspects: building a convenient and smooth public space system, creating a diversified and shared activity space, creating a beautiful and healing community landscape, and providing convenient and perfect supporting facilities, to provide a certain reference for the healthy development of old communities in mountain cities.

Keywords: physical activity, community planning, old communities in mountain cities, public space optimization, spatial fairness

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Authors: Claire Norman-Maillet

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Insider fraud is a major financial crime threat whereby an employee defrauds (or attempts to defraud) their current, prospective, or past employer. ‘Employee’ covers anyone employed by the company, including Board members and part-time staff. Insider fraud can take many forms, including an employee working alone or in collusion with others. Insider fraud has been on the rise since the Coronavirus pandemic and shows no signs of slowing. The objective of the research is to better understand how FinTechs are impacted by insider fraud and, therefore, how to stop it. This research will make an original contribution to the financial crime field, given the timing of this research being intertwined with the cost-of-living crisis in the UK and the global Coronavirus pandemic. This research focuses on insider fraud within FinTechs specifically, as they are arguably a modern phenomenon in the financial institutions space and have cutting-edge technology at their disposal. To achieve the research objective, the researcher held semi-structured interviews with over 20 individuals who deal with insider fraud perpetration in a practitioner, recruitment, or advisory capacity. The interviews were subsequently transcribed and analysed thematically. Main findings in the research suggest that FinTechs are arguably in the best position to combat insider fraud, given their focus on using recent technologies, as this can be used to combat the threat. However, insider fraud has been ignored owing to the denial of accepting the possibility that colleagues would defraud their employer, as well as the idea that external fraud is the most important threat. The research concludes that, whilst the technology is understandably prioritised by FinTechs for providing an agreeable customer experience, insider fraud needs to be given a platform upon which to be recognised as a significant threat to any company. Moreover, insider fraud needs to be given the same level of weighting and attention by Executive Committees and Boards as the customer experience.

Keywords: insider fraud, occupational fraud, COVID-19, COVID, Coronavirus, pandemic, internal fraud, financial crime, economic crime

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Authors: Maria Lopez-Ibarra, Ana Velazquez-Wong, Lucelli Yañez-Gutierrez, Maria Araujo-Solis, Fabio Salamanca-Gomez, Alfonso Mendez-Tenorio, Haydeé Rosas-Vargas

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Congenital heart diseases (CHD) are the most common congenital abnormalities. These conditions can occur as both an element of distinct chromosomal malformation syndromes or as non-syndromic forms. Their etiology is not fully understood. Genetic variants such copy number variants have been associated with CHD. The aim of our study was to analyze these genomic variants in peripheral blood from Mexican children diagnosed with non-syndromic CHD. We included 16 children with atrial and ventricular septal defects and 5 healthy subjects without heart malformations as controls. To exclude the most common heart disease-associated syndrome alteration, we performed a fluorescence in situ hybridization test to identify the 22q11.2, responsible for congenital heart abnormalities associated with Di-George Syndrome. Then, a microarray based comparative genomic hybridization was used to identify global copy number variants. The identification of copy number variants resulted from the comparison and analysis between our results and data from main genetic variation databases. We identified copy number variants gain in three chromosomes regions from pediatric patients, 4q13.2 (31.25%), 9q34.3 (25%) and 20q13.33 (50%), where several genes associated with cellular, biosynthetic, and metabolic processes are located, UGT2B15, UGT2B17, SNAPC4, SDCCAG3, PMPCA, INPP6E, C9orf163, NOTCH1, C20orf166, and SLCO4A1. In addition, after a hierarchical cluster analysis based on the fluorescence intensity ratios from the comparative genomic hybridization, two congenital heart disease groups were generated corresponding to children with atrial or ventricular septal defects. Further analysis with a larger sample size is needed to corroborate these copy number variants as possible biomarkers to differentiate between heart abnormalities. Interestingly, the 20q13.33 gain was present in 50% of children with these CHD which could suggest that alterations in both coding and non-coding elements within this chromosomal region may play an important role in distinct heart conditions.

Keywords: aCGH, bioinformatics, congenital heart diseases, copy number variants, fluorescence in situ hybridization

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Authors: O. J. Olaniran, P. E. D. Love, D. J. Edwards, O. Olatunji, J. Matthews

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Cost overruns are a persistent problem in oil and gas megaprojects. Whilst the extant literature is filled with studies on incidents and causes of cost overruns, underlying theories to explain their emergence in oil and gas megaprojects are few. Yet, a way to contain the syndrome of cost overruns is to understand the bases of ‘how and why’ they occur. Such knowledge will also help to develop pragmatic techniques for better overall management of oil and gas megaprojects. The aim of this paper is to explain the development of cost overruns in hydrocarbon megaprojects through the perspective of chaos theory. The underlying principles of chaos theory and its implications for cost overruns are examined and practical recommendations proposed. In addition, directions for future research in this fertile area provided.

Keywords: chaos theory, oil and gas, cost overruns, megaprojects

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Authors: Mahesh Mitra

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Introduction and Purpose: Patellofemoral Pain Syndrome [PFPS] is characterized by pain or discomfort seemingly originating from the contact of posterior surface of Patella with Femur. Given the multifactorial causes and high prevalence there is a need of proper management technique. Also a more comprehensive and best possible Physiotherapy treatment approach has to be devised to enhance the performance of the individual with PFPS. Purpose of the study was to: - Prevalence of PFPS in various sports - To determine if there exists any relationship between the Body Mass Index[BMI] and Pain Intensity in the person playing a sport. - To evaluate the effect of conventional Physiotherapy program, Mobilization and Taping with Proprioceptive training on PFPS. Hypothesis 1. Prevalence is not the same with different sporting activities 2. There is a relationship between BMI and Pain intensity. 3. There is no significant difference in the improvement with the different treatment approaches. Methodology: A sample of 200 sports men were tested for the prevalence of PFPS and their anthropometric measurements were obtained to check for the correlation between BMI vs Pain intensity. Out of which 80 diagnosed cases of PFPS were allotted into three treatment groups and evaluated for Pain at rest and at activity and KUJALA scale. Group I were treated with conventional Physiotherapy that included TENS application and Exercises, Group II were treated with compression mobilization along with exercises, Group III were treated with Taping and Proprioceptive exercises. The variables Pain on rest, activity and KUJALA score were measured initially, at 1 week and at the end of 2 weeks after respective treatment. Data Analysis - Prevalence percentage of PFPS in each sport - Pearsons Correlation coefficient to find the relationship between BMI and Pain during activity. - Repeated measures analysis of variance [ANOVA] to find out the significance during Pre, Mid and Post-test difference among - Newman Kuel Post hoc Test - ANCOVA for the difference amongst group I, II and III. Results and conclusion It was concluded that PFPS was more prevalent in volley ball players [80%] followed by football and basketball [66%] players, then in hand ball and cricket players [46.6%] and 40% in tennis players. There was no relationship between BMI of the individual and Pain intensity. All the three treatment approaches were effective whereas mobilization and taping were more effective than Conventional Physiotherapy program.

Keywords: PFPS, KUJALA score, mobilization, proprioceptive training

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Authors: Murtadha Kareem, Oliver Faust

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Wearable biosensor systems can be designed and developed for health monitoring. There is much interest in both scientific and industrial communities established since 2007. Fundamentally, the cost of healthcare has increased dramatically and the world population is aging. That creates the need to harvest technological improvements with small bio-sensing devices, wireless-communication, microelectronics and smart textiles, that leads to non-stop developments of wearable sensor based systems. There has been a significant demand to monitor patient's health status while the patient leaves the hospital in his/her personal environment. To address this need, there are numerous system prototypes which has been launched in the medical market recently, the aim of that is to provide real time information feedback about patient's health status, either to the patient himself/herself or direct to the supervising medical centre station, while being capable to give a notification for the patient in case of possible imminent health threatening conditions. Furthermore, wearable health monitoring systems comprise new techniques to address the problem of managing and monitoring chronic heart diseases for elderly people. Wearable sensor systems for health monitoring include various types of miniature sensors, either wearable or implantable. To be specific, our proposed system able to measure essential physiological parameter, such as heart rate signal which could be transmitted through Bluetooth to the cloud server in order to store, process, analysis and visualise the data acquisition. The acquired measurements are connected through internet of things to a central node, for instance an android smart phone or tablet used for visualising the collected information on application or transmit it to a medical centre.

Keywords: Wearable sensor, Heart rate, Internet of things, Chronic heart disease

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Authors: Hongyun Li, Zhibin Jiang

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The travel of passengers in the urban rail transit network is influenced by changes in network structure and operational status, and the response of individual travel preferences to these changes also varies. Firstly, the influence of the suspension of urban rail transit line sections on passenger travel along the line is analyzed. Secondly, passenger travel trajectories containing multi-dimensional semantics are described based on network UD data. Next, passenger panel data based on spatio-temporal sequences is constructed to achieve frequent passenger clustering. Then, the Graph Convolutional Network (GCN) is used to model and identify the changes in travel modes of different types of frequent passengers. Finally, taking Shanghai Metro Line 11 as an example, the travel behavior patterns of frequent passengers after the Huaqiao section shutdown during the COVID-19 epidemic are analyzed. The results showed that after the section shutdown, most passengers would transfer to the nearest Anting station for boarding, while some passengers would transfer to other stations for boarding or cancel their travels directly. Among the passengers who transferred to Anting station for boarding, most of passengers maintained the original normalized travel mode, a small number of passengers waited for a few days before transferring to Anting station for boarding, and only a few number of passengers stopped traveling at Anting station or transferred to other stations after a few days of boarding on Anting station. The results can provide a basis for understanding urban rail transit passenger travel patterns and improving the accuracy of passenger flow prediction in abnormal operation scenarios.

Keywords: urban rail transit, section shutdown, frequent passenger, travel behavior pattern

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Authors: Kandi Sridhar, Charles Albert Linton

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Grapes are excellent sources of bioactive compounds, which have been suggested to be responsible for lowering the risk of chronic diseases. Fresh and freeze-dried extracts of Kyoho and Jubilee, commercial grape varieties available in Taiwan and attractive for their quality berries, were investigated for their total phenolics and total flavonoids contents and related dose-dependent antioxidants properties using various in vitro assays. The efficiency of the extraction yield ranged from 7.10 % to 25.53 % (w/w), depending on solvent used. Fresh samples of Kyoho and Jubilee exhibited total polyphenolic contents (351.56 ± 23.08 and 328.67 ± 16.54 µg GAE/mL, respectively), whereas Kyoho freeze-dried methanol: water extracts contains the good levels of total flavonoids (4767.82 ± 22.20 µg QE/mL). Kyoho and Jubilee freeze-dried extracts exhibited the highest total flavonoid contents. There was a weak correlation between total phenolic and flavonoid assays (r= -0.05, R2 = 0.02, p > 0.05). Kyoho fresh and freeze-dried samples showed the DPPH (11.51 – 77.82 %), superoxide scavenging activity (33.61 – 81.95 %), and total antioxidant inhibition (92.01 – 99.28 %), respectively. Total flavonoids were statistically correlated with EC50 DPPH scavenging radicals (r =0.91, p < 0.01), EC50 nitric oxide (r = 0.25, p > 0.05), and EC50 lipid peroxidation radicals (r = 0.38, p > 0.05). These results suggested that the two commercial grape cultivars in Taiwan could be used as a good source of natural antioxidants. Thus, consumption of grapes as a source antioxidant might lower the risk of chronic diseases. Moreover, future studies will investigate and develop phenolic acid profile for the cultivars in Taiwan.

Keywords: antioxidants, EC50 radical scavenging activity, grape cultivars, total phenolics

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Authors: Amjad Alsulami, Farah Albishri, Kholod Alzubidi, Lama Almehemadi, Salma Elhag

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Food allergy is a common and rising problem among children. Many students have their first allergic reaction at school, one of these is anaphylaxis, which can be fatal. This study discovered that several schools' processes lacked safety regulations and information on how to handle allergy issues and chronic diseases like diabetes where students were not supervised or monitored during the cafeteria purchasing process. There is no obvious prevention or effort in academic institutions when purchasing food containing allergens or negatively impacting the health status of students who suffer from chronic diseases. Students must always be stable to reflect positively on their educational development process. To address this issue, this paper uses a business reengineering process to propose the automation of the whole food-purchasing process, which will aid in detecting and avoiding allergic occurrences and preventing any side effects from eating foods that are conflicting with students' health. This may be achieved by designing a smart card with an embedded QR code that reveals which foods cause an allergic reaction in a student. A survey was distributed to determine and examine how the cafeteria will handle allergic children and whether any management or policy is applied in the school. Also, the survey findings indicate that the integration of QR technology into the food purchasing process would improve health condition detection. The suggested system would be beneficial to all parties, the family agreed, as they would ensure that their children didn't eat foods that were bad for their health. Moreover, by analyzing and simulating the as-is process and the suggested process the results demonstrate that there is an improvement in quality and time.

Keywords: QR code, smart card, food allergies, business process reengineering, health condition detection

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Authors: Mohamed Abo El Nasr, Mohamed Shoeib, Abdelhamid Abdelkhalik, Amro Serag

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Background: Early assessment of severity of chest trauma, either blunt or penetrating is of critical importance in prediction of patient outcome. Different trauma scoring systems are widely available and are based on anatomical or physiological parameters to expect patient morbidity or mortality. Up till now, there is no ideal, universally accepted trauma score that could be applied in all trauma centers and is suitable for assessment of severity of chest trauma patients. Aim: Our aim was to compare various trauma scoring systems regarding their predictability of morbidity and mortality in chest trauma patients. Patients and Methods: This study was a prospective study including 400 patients with chest trauma who were managed at Tanta University Emergency Hospital, Egypt during a period of 2 years (March 2014 until March 2016). The patients were divided into 2 groups according to the mode of trauma: blunt or penetrating. The collected data included age, sex, hemodynamic status on admission, intrathoracic injuries, and associated extra-thoracic injuries. The patients outcome including mortality, need of thoracotomy, need for ICU admission, need for mechanical ventilation, length of hospital stay and the development of acute respiratory distress syndrome were also recorded. The relevant data were used to calculate the following trauma scores: 1. Anatomical scores including abbreviated injury scale (AIS), Injury severity score (ISS), New injury severity score (NISS) and Chest wall injury scale (CWIS). 2. Physiological scores including revised trauma score (RTS), Acute physiology and chronic health evaluation II (APACHE II) score. 3. Combined score including Trauma and injury severity score (TRISS ) and 4. Chest-Specific score Thoracic trauma severity score (TTSS). All these scores were analyzed statistically to detect their sensitivity, specificity and compared regarding their predictive power of mortality and morbidity in blunt and penetrating chest trauma patients. Results: The incidence of mortality was 3.75% (15/400). Eleven patients (11/230) died in blunt chest trauma group, while (4/170) patients died in penetrating trauma group. The mortality rate increased more than three folds to reach 13% (13/100) in patients with severe chest trauma (ISS of >16). The physiological scores APACHE II and RTS had the highest predictive value for mortality in both blunt and penetrating chest injuries. The physiological score APACHE II followed by the combined score TRISS were more predictive for intensive care admission in penetrating injuries while RTS was more predictive in blunt trauma. Also, RTS had a higher predictive value for expectation of need for mechanical ventilation followed by the combined score TRISS. APACHE II score was more predictive for the need of thoracotomy in penetrating injuries and the Chest-Specific score TTSS was higher in blunt injuries. The anatomical score ISS and TTSS score were more predictive for prolonged hospital stay in penetrating and blunt injuries respectively. Conclusion: Trauma scores including physiological parameters have a higher predictive power for mortality in both blunt and penetrating chest trauma. They are more suitable for assessment of injury severity and prediction of patients outcome.

Keywords: chest trauma, trauma scores, blunt injuries, penetrating injuries

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Authors: Farshad Ghodoosi

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This article analyzes the effect of supervening events in contracts. Contracts serve an important function: allocation of risks. In spite of its importance, the case law and the doctrine are messy and inconsistent. This article provides a fresh look at excuse doctrines (i.e., force majeure, impracticability, impossibility, and frustration) with a focus on force majeure clauses. The article makes the following contributions: First, it furnishes a new conceptual and theoretical framework of excuse doctrines. By distilling the decisions, it shows that excuse doctrines rests on the triangle of control, foreseeability, and contract language. Second, it analyzes force majeure clauses used by S&P 500 companies to understand the stickiness and similarity of such clauses and the events they cover. Third, using computational and statistical tools, it analyzes US cases since 1810 in order to assess the weight given to the triangle of control, foreseeability, and contract language. It shows that the control factor plays an important role in force majeure analysis, while the contractual interpretation is the least important factor. The Article concludes that it is the standard for control -whether the supervening event is beyond the control of the party- that determines the outcome of cases in the force majeure context and not necessarily the contractual language. This article has important implications on COVID-19-related contractual cases. Unlike the prevailing narrative that it is the language of the force majeure clause that’s determinative, this article shows that the primarily focus of the inquiry will be on whether the effects of COVID-19 have been beyond the control of the promisee. Normatively, the Article suggests that the trifactor of control, foreseeability, and contractual language are not effective for allocation of legal risks in times of crises. It puts forward a novel approach to force majeure clauses whereby that the courts should instead focus on the degree to which parties have relied on (expected) performance, in particular during the time of crisis.

Keywords: contractual risks, force majeure clauses, foreseeability, control, contractual language, computational analysis

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Authors: Surbhi Kaura, Sachin Kandhari, Shahiduz Zafar

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Chronic stroke, characterized by persistent motor deficits, often necessitates comprehensive rehabilitation interventions to improve functional outcomes and mitigate long-term dependency. Luna neurorobotic devices, integrated with EMG feedback systems, provide an innovative platform for facilitating neuroplasticity and functional improvement in stroke survivors. This retrospective study aims to investigate the impact of EMG-based Luna neurorobotic interventions on the strengthening of the affected side in chronic stroke patients. In rehabilitation, active patient participation significantly activates the sensorimotor network during motor control, unlike passive movement. Stroke is a debilitating condition that, when not effectively treated, can result in significant deficits and lifelong dependency. Common issues like neglecting the use of limbs can lead to weakness in chronic stroke cases. In rehabilitation, active patient participation significantly activates the sensorimotor network during motor control, unlike passive movement. This study aims to assess how electromyographic triggering (EMG-triggered) robotic treatments affect walking, ankle muscle force after an ischemic stroke, and the coactivation of agonist and antagonist muscles, which contributes to neuroplasticity with the assistance of biofeedback using robotics. Methods: The study utilized robotic techniques based on electromyography (EMG) for daily rehabilitation in long-term stroke patients, offering feedback and monitoring progress. Each patient received one session per day for two weeks, with the intervention group undergoing 45 minutes of robot-assisted training and exercise at the hospital, while the control group performed exercises at home. Eight participants with impaired motor function and gait after stroke were involved in the study. EMG-based biofeedback exercises were administered through the LUNA neuro-robotic machine, progressing from trigger and release mode to trigger and hold, and later transitioning to dynamic mode. Assessments were conducted at baseline and after two weeks, including the Timed Up and Go (TUG) test, a 10-meter walk test (10m), Berg Balance Scale (BBG), and gait parameters like cadence, step length, upper limb strength measured by EMG threshold in microvolts, and force in Newton meters. Results: The study utilized a scale to assess motor strength and balance, illustrating the benefits of EMG-biofeedback following LUNA robotic therapy. In the analysis of the left hemiparetic group, an increase in strength post-rehabilitation was observed. The pre-TUG mean value was 72.4, which decreased to 42.4 ± 0.03880133 seconds post-rehabilitation, with a significant difference indicated by a p-value below 0.05, reflecting a reduced task completion time. Similarly, in the force-based task, the pre-knee dynamic force in Newton meters was 18.2NM, which increased to 31.26NM during knee extension post-rehabilitation. The post-student t-test showed a p-value of 0.026, signifying a significant difference. This indicated an increase in the strength of knee extensor muscles after LUNA robotic rehabilitation. Lastly, at baseline, the EMG value for ankle dorsiflexion was 5.11 (µV), which increased to 43.4 ± 0.06 µV post-rehabilitation, signifying an increase in the threshold and the patient's ability to generate more motor units during left ankle dorsiflexion. Conclusion: This study aimed to evaluate the impact of EMG and dynamic force-based rehabilitation devices on walking and strength of the affected side in chronic stroke patients without nominal data comparisons among stroke patients. Additionally, it provides insights into the inclusion of EMG-triggered neurorehabilitation robots in the daily rehabilitation of patients.

Keywords: neurorehabilitation, robotic therapy, stroke, strength, paralysis

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Authors: Lize Tibiriçá, Ronnie Lee, Samantha Behbahani

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Fibromyalgia (FM) is a musculoskeletal disorder affecting men and women of different ages and cultures. The cause of this disorder is unknown; however, studies suggest an etiology that involves biological and psychosocial factors. Few studies have shown that a personality type such as neuroticism is associated with chronic pain conditions. Past research has explored whether patients with FM present with a specific personality trait. However, studies have used different methods (i.e. Minnesota Multiphasic Personality Inventory (MMPI), Sociotropy and Autonomy Scale (SAS) and Dysfunctional Attitude Scale (DAS), Tridimensional Personality Questionnaire or Temperament and Character Inventory (TCI), Karolinska scale of personality, Big Five Inventory or NEO Personality Inventory) to explore the connection between FM and a personality type. They have identified personality types that present similar characteristics but vary in the name (i.e. high harm avoidance and low novelty seeking, psychasthenia/muscular tension/somatic anxiety, neuroticism). Although Zuckerman-Kuhlman Personality Questionnaire and the Big Five Inventory differ in terms of content and structure, both of them identify neuroticism as the personality type of FM patients, and the former also identifies these patients as having a low sociability personality trait. Previous research also shows a trend of sociotropic personality style with FM patients that also suffer from Major Depressive Disorder. Participants in these studies were, for the most part, adult female and researchers have recognized that as a limitation and whether their findings can be generalized to men and younger patients with FM. Furthermore, most studies reviewed were conducted in Europe (i.e. Spain) and had a cross-sectional design. Future research should replicate past studies in different countries and consider conducting a longitudinal study. Although it is suspected that FM course is modulated by FM patients’ personality, it is not known whether individuals with similar personalities will develop FM. This review sought to explain the differences and similarities between the personality types identified. Limitations in the studies reviewed were addressed, and considerations for future research and treatment were discussed.

Keywords: chronic pain, fibromyalgia, neuroticism, personality type

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Authors: Mohammad K. Parvez, Mohammed S. Al-Dosari

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Hepatitis E virus (HEV) is an emerging RNA virus that causes acute and chronic liver disease with a global mortality rate of about 2%. Despite milestone developments in understanding of HEV biology, there is still lack of a robust culture system or animal model. Therefore, in a novel approach, two recombinant-baculoviruses (vBac-ORF2 and vBac-ORF3) that could overexpress HEV ORF2 (structural/capsid) and ORF3 (nonstructural/regulatory) proteins, respectively were constructed. The established HEV-SAR55 (genotype 1) replicon that contained GFP gene, in place of ORF2/ORF3 sequences was in vitro transcribed, and GFP production in RNA transfected S10-3 cells was scored by FACS. Enhanced infectivity, if any, of nascent virions produced by exogenously-supplied ORF2 and viral RNA by co-expression of ORF3 was tested on naïve HepG2 cells. Co-transduction with vBac-ORF2/vBac-ORF3 (108 pfu/microL) produced high amounts of native ORF2/ORF3 in approximately 60% of S10-3 cells, determined by immunofluorescence microscopy and Western analysis. FACS analysis showed about 9% GFP positivity of S10-3 cells on day6 post-transfection (i.e, day5 post-transduction). Further, FACS scoring indicated that lysates from S10-3 cultures receiving the RNA plus vBac-ORF2 were capable of producing HEV particles with about 4% infectivity in HepG2 cells. However, lysates of cultures co-transduced with vBac-ORF3, were found to further enhance virion infectivity by approximately 17%. This supported a previously proposed role of ORF3 as a minor-structural protein in HEV virion assembly and infectivity. In conclusion, the present model for efficient genomic RNA packaging and production of infectious virions could be a valuable tool to study various aspects of HEV molecular biology, in vitro.

Keywords: chronic liver disease, hepatitis E virus, ORF2, ORF3, replicon

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Authors: Cassey Younghans

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Background: Current health care trends demonstrate that there is an increasing number of patients being hospitalized with complex comorbidities. These complex needs require advanced therapies, and treatment goals often focus on doing everything possible to prolong life rather than focusing on the individual patient’s quality of life which is the goal of palliative care efforts. Patients benefit from palliative care in the early stages of the illness rather than after the disease progressed or the state of acuity has advanced. The clinical problem identified was that palliative care was not being implemented early enough in the disease process with patients who had complex medical conditions and who would benefit from the philosophy and skills of palliative care professionals. Purpose: The purpose of this quality improvement study was to increase the number of palliative care screenings and consults completed on adults after being admitted to one Non-ICU and Non-COVID hospital unit. Methods: A retrospective chart review assessing for possible missed opportunities to introduce palliation was performed for patients with six primary diagnoses, including heart failure, liver failure, end stage renal disease, chronic obstructive pulmonary disease, cerebrovascular accident, and cancer in a population of adults over the ago of 19 on one medical-surgical unit over a three-month period prior to the intervention. An educational session with the nurses on the benefits of palliative care was conducted by the researcher, and a screening tool was implemented. The expected outcome was to have an increase in early palliative care consultation with patients with complex comorbid conditions and a decrease in missed opportunities for the implementation of palliative care. Another retrospective chart review was completed following completion of the three month piloting of the tool. Results: During the retrospective chart review, 46 patients were admitted to the medical-surgical floor with the primary diagnoses identified in the inclusion criteria. Six patients had palliative care consults completed during that time. Twenty-two palliative care screening tools were completed during the intervention period. Of those, 15 of the patients scored a 7 or higher, suggesting that a palliative care consultation was warranted. The final retrospective chart review identified that 4 palliative consults were implemented during that time of the 31 patients who were admitted over the three month time frame. Conclusion: Educating nurses and implementing a palliative care screening upon admission can be of great value in providing early identification of patients who might benefit from palliative care. Recommendations – It is recommended that this screening tool should be used to help identify the patents of whom would benefit from a palliative care consult, and nurses would be able to initiated a palliative care consultation themselves.

Keywords: palliative care, screening, early, palliative care consult

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Authors: Franck Acho

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This is a chronic metabolic disorder which is a fast-growing global problem with a huge social, health, and economic consequences. It is estimated that in 2010 there were globally 285 million people (approximately 6.4% of the adult population) suffering from this disease. This number is estimated to increase to 430 million in the absence of better control or cure. An ageing population and obesity are two main reasons for the increase. Diabetes mellitus is a chronic heterogeneous metabolic disorder with a complex pathogenesis. It is characterized by elevated blood glucose levels or hyperglycemia, which results from abnormalities in either insulin secretion or insulin action or both. Hyperglycemia manifests in various forms with a varied presentation and results in carbohydrate, fat, and protein metabolic dysfunctions. Long-term hyperglycemia often leads to various microvascular and macrovascular diabetic complications, which are mainly responsible for diabetes-associated morbidity and mortality. Hyperglycemia serves as the primary biomarker for the diagnosis of diabetes as well. Furthermore, it has been shown that almost 50% of the putative diabetics are not diagnosed until 10 years after onset of the disease, hence the real prevalence of global diabetes must be astronomically high. This study was conducted in a locality to access the level of knowledge, awareness and risk factors associated with people leaving with diabetes mellitus. A month before the screening was to be conducted, a health screening in some selected churches and on the local community radio as well as on relevant WhatsApp groups were advertised. A general health talk was delivered by the head of the screening unit to all attendees who were all educated on the procedure to be carried out with benefits and any possible discomforts after which the attendee’s consent was obtained. Evaluation of the participants for any leads to the diabetes selected for the screening was done by taking adequate history and physical examinations such as excessive thirst, increased urination, tiredness, hunger, unexplained weight loss, feeling irritable or having other mood changes, having blurry vision, having slow-healing sores, getting a lot of infections, such as gum, skin and vaginal infections. Out of the 94 participants the finding show that 78 were females and 16 were males, 70.21% of participants with diabetes were between the ages of 60-69yrs.The study found that only 10.63% of respondents declared a good level of knowledge of diabetes. Out of 3 symptoms of diabetes analyzed in this study, high blood sugar (58.5%) and chronic fatigue (36.17%) were the most recognized. Out of 4 diabetes risk factors analyzed in this study, obesity (21.27%) and unhealthy diet (60.63%) were the most recognized diabetes risk factors, while only 10.6% of respondents indicated tobacco use. The diabetic foot was the most recognized diabetes complication (50.57%), but some the participants indicated vision problems (30.8%),or cardiovascular diseases (20.21%) as diabetes complications.

Keywords: diabetes mellitus, non comunicable disease, general health talk, hyperglycemia

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Authors: Shiamaa Eltantawy, Gihan Sobhy, Alif Alaam

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Wilson disease, or hepatolenticular degeneration, is an autosomal recessive disease that results in excess copper buildup in the body. It primarily affects the liver and basal ganglia of the brain, but it can affect other organ systems. Musculoskeletal abnormalities, including premature osteoarthritis, skeletal deformity, and pathological bone fractures, can occasionally be found in WD patients with a hepatic or neurologic type. The aim was to assess the prevalence of osteoporosis and osteopenia in Wilson’s disease patients. This case-control study was conducted on ninety children recruited from the inpatient ward and outpatient clinic of the Paediatric Hepatology, Gastroenterology, and Nutrition department of the National Liver Institute at Menofia University, aged from 1 to 18 years. Males were 49, and females were 41. Children were divided into three groups: (Group I) consisted of thirty patients with WD; (Group II) consisted of thirty patients with chronic liver disease other than WD; (Group III) consisted of thirty age- and sex-matched healthy The exclusion criteria were patients with hyperparathyroidism, hyperthyroidism, renal failure, Cushing's syndrome, and patients on certain drugs such as chemotherapy, anticonvulsants, or steroids. All patients were subjected to the following: 1- Full history-taking and clinical examination. 2-Laboratory investigations: (FBC,ALT,AST,serum albumin, total protein, total serum bilirubin,direct bilirubin,alkaline phosphatase, prothrombin time, serum critine,parathyroid hormone, serum calcium, serum phosphrus). 3-Bone mineral density (BMD, gm/cm2) values were measured by dual-energy X-ray absorptiometry (DEXA). The results revealed that there was a highly statistically significant difference between the three groups regarding the DEXA scan, and there was no statistically significant difference between groups I and II, but the WD group had the lowest bone mineral density. The WD group had a large number of cases of osteopenia and osteoporosis, but there was no statistically significant difference with the group II mean, while a high statistically significant difference was found when compared to group III. In the WD group, there were 20 patients with osteopenia, 4 patients with osteoporosis, and 6 patients who were normal. The percentages were 66.7%, 13.3%, and 20%, respectively. Therefore, the largest number of cases in the WD group had osteopenia. There was no statistically significant difference found between WD patients on different treatment regimens regarding DEXA scan results (Z-Score). There was no statistically significant difference found between patients in the WD group (normal, osteopenic, or osteoporotic) regarding phosphorus (mg/dL), but there was a highly statistically significant difference found between them regarding ionised Ca (mmol/L). Therefore, there was a decrease in bone mineral density when the Ca level was decreased. In summary, Wilson disease is associated with bone demineralization. The largest number of cases in the WD group in our study had osteopenia (66.7%). Different treatment regimens (zinc monotherapy, Artamin, and zinc) as well as different laboratory parameters have no effect on bone mineralization in WD cases. Decreased ionised Ca is associated with low BMD in WD patients. Children with WD should be investigated for BMD.

Keywords: wilson disease, Bone mineral density, liver disease, osteoporosis

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Authors: Sally A. El Awdan

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Objective and Design: The purpose of this study was to evaluate the anti inflammatory, anti-arthritic and analgesic effects of antidepressants. Methods: Carrageenan model was used to assess effect on acute inflammation. Paw volume were measured at 1, 2, 3 and 4th hour post challenge. Anti-nociceptive effect was evaluated by hot plate method. Chronic inflammation was developed using Complete Freund's Adjuvant (CFA). The animals were injected with Freund’s adjuvant in sub-plantar tissue of the right posterior paw. Paw volume, ankle flexion scores, adjuvant-induced hyperalgesia and serum cytokine levels were assessed. Results: Results obtained demonstrate that mirtazapine, venalfaxine and escitalopram significantly and dose-dependently inhibited carrageenan-induced rat paw oedema. Mirtazapine, venalfaxine and escitalopram increased the reaction time of rats in hot plate test. We observed an increase in paw volume, ankle flexion scores, thermal hyperalgesia, serum levels of interleukin-1β, PGE2 and TNF-α, induced by intraplantar CFA injection. Regular treatment up to 28 days of adjuvant-induced arthritic rats with mirtazapine, venalfaxine and escitalopram showed anti anti-inflammatory and analgesic activities by suppressing the paw volume, recovering the paw withdrawal latency, and by inhibiting the ankle flexion scores in CFA-induced rats. In addition significant reduction in serum levels of interleukin-1β, PGE2 and TNF-α level in arthritic rats was reduced by treatment with drugs. Conclusion: These results suggest that antidepressants have significant anti-inflammatory and anti-nociceptive effects in acute and chronic models in rats, which may be associated with the reduction of interleukin-1β, PGE2 and TNF-α levels.

Keywords: antidepressants, carrageenan, anti-nociceptive, Complete Freund's Adjuvant

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Authors: Yidan Xu, Pim Martens, Thomas Krafft

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Marine fishing, an energy-intensive activity, directly emits greenhouse gases through fuel combustion, making it a significant contributor to oceanic greenhouse gas (GHG) emissions and worsening climate change. China is the world’s second-largest economy and the top emitter of GHG emissions, and it carries a significant energy conservation and emission reduction burden. However, the increasing GHG emissions from marine fishing is an easily overlooked but essential issue in China. This study offers a diverse perspective by integrating the concepts of total carbon emissions, carbon intensity, and per capita carbon emissions as indicators into calculation and discussion. To better understand the GHG emissions-Gross marine fishery product (GFP) relationship and influencing factors in Chinese marine fishing, the relationship between GHG emissions and economic development in marine fishing, a comprehensive framework is developed by combining the environmental Kuznets curve, the Tapio elasticity index, and the decomposition model. Results indicated that (1) The GHG emissions increased from 16.479 to 18.601 million tons in 2001-2020, in which trawlers and gillnetter are the main source in fishing operation. (2) Total carbon emissions (TC) and CI presented the same decline as GHG emissions, while per capita carbon emissions (PC) displayed an uptrend. (32) GHG emissions and gross marine fishery product (GFP) presented an inverted U-shaped relationship in China; the turning point came in the 13th Five-year Plan period (2016-2020). (43) Most provinces strongly decoupled GFP and CI. Still, PC and TC need more effort to decouple. (54) GHG emissions promoted by an industry structure driven, though carbon intensity and industry scale aid in GHG emissions reduced. (5) Compare with TC and PC, CI has been relatively affected by COVID-19 in 2020. The rise in fish and seafood prices during COVID-19 has boosted the GFP.

Keywords: marine fishing economy, greenhouse gas emission, fishery management, green development

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