Search results for: higher education policies

Authors: Mohammed Amin, Debra Kerr, Yacoba Atiase, Andrea Driscoll

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Background: Physical activity (PA) is a major component of diabetes self-care management; although this is often stressed to patients, many adults with Type 2 Diabetes Mellitus (T2DM)lead sedentary lifestyles, and barriers exist for uptake of PA. Aim: To explore opinions of healthcare professionals about barriers to PA for adults with T2DM in Ghana. Methods: This qualitative descriptive study included 13healthcare professionals (3 Physiotherapists, 3 exercise physiologists, 3 nurses, and 4 physicians) who provide care to individuals with T2DM in Ghana. Data was collected by semi-structured interviews. The social cognitive theory guided the design of the interview schedule. Data was analysed using thematic analysis. Results: Four main themeswere identified: 1) Individual-related factors, 2) Interpersonal factors, 3) Environment-related factors, and 4) Health system-related factors. Fear of injury, existing co-morbidities, and lack of time make it difficult for people with T2DM to engage in PA. Lack of family support, fear of social ridicule, and cultural beliefs prevent uptake of PA. Poorly designed community spaces, including safe walkways and lack of exercise facilities, inhibit PA participation. Few physical therapists and physical therapy centres exist to support PA participation among people with T2DM. Some nurses and doctors lack adequate knowledge to deliver proper PA education to clients, thereby making clients lack the needed support. Conclusion: Adults with T2DM may be restricted from partaking in PA arising from personal and external factors. This study has identified that barriers to exercise need consideration when designing PA programs that aim to improve health outcomes for people with T2DM in Ghana.

Keywords: type 2 diabetes, physical activity, exercise, ghana, qualitative, barriers

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Authors: H. Taylan Selamlar, I. Yavuz, G. Yapar

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It is difficult to make predictions especially about the future and making accurate predictions is not always easy. However, better predictions remain the foundation of all science therefore the development of accurate, robust and reliable forecasting methods is very important. Numerous number of forecasting methods have been proposed and studied in the literature. There are still two dominant major forecasting methods: Box-Jenkins ARIMA and Exponential Smoothing (ES), and still new methods are derived or inspired from them. After more than 50 years of widespread use, exponential smoothing is still one of the most practically relevant forecasting methods available due to their simplicity, robustness and accuracy as automatic forecasting procedures especially in the famous M-Competitions. Despite its success and widespread use in many areas, ES models have some shortcomings that negatively affect the accuracy of forecasts. Therefore, a new forecasting method in this study will be proposed to cope with these shortcomings and it will be called ATA method. This new method is obtained from traditional ES models by modifying the smoothing parameters therefore both methods have similar structural forms and ATA can be easily adapted to all of the individual ES models however ATA has many advantages due to its innovative new weighting scheme. In this paper, the focus is on modeling the trend component and handling seasonality patterns by utilizing classical decomposition. Therefore, ATA method is expanded to higher order ES methods for additive, multiplicative, additive damped and multiplicative damped trend components. The proposed models are called ATA trended models and their predictive performances are compared to their counter ES models on the M3 competition data set since it is still the most recent and comprehensive time-series data collection available. It is shown that the models outperform their counters on almost all settings and when a model selection is carried out amongst these trended models ATA outperforms all of the competitors in the M3- competition for both short term and long term forecasting horizons when the models’ forecasting accuracies are compared based on popular error metrics.

Keywords: accuracy, exponential smoothing, forecasting, initial value

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Authors: Napasri Suwanajote

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The purposes of this research were to analyse and evaluate successful factors in OTOP production process for the developing of learning centre on OTOP production process based on Sufficiency Economic Philosophy for sustainable life quality. The research has been designed as a qualitative study to gather information from 30 OTOP producers in Bangkontee District, Samudsongkram Province. They were all interviewed on 3 main parts. Part 1 was about the production process including 1) production 2) product development 3) the community strength 4) marketing possibility and 5) product quality. Part 2 evaluated appropriate successful factors including 1) the analysis of the successful factors 2) evaluate the strategy based on Sufficiency Economic Philosophy and 3) the model of learning centre on OTOP production process based on Sufficiency Economic Philosophy for sustainable life quality. The results showed that the production did not affect the environment with potential in continuing standard quality production. They used the raw materials in the country. On the aspect of product and community strength in the past 1 year, it was found that there was no appropriate packaging showing product identity according to global market standard. They needed the training on packaging especially for food and drink products. On the aspect of product quality and product specification, it was found that the products were certified by the local OTOP standard. There should be a responsible organization to help the uncertified producers pass the standard. However, there was a problem on food contamination which was hazardous to the consumers. The producers should cooperate with the government sector or educational institutes involving with food processing to reach FDA standard. The results from small group discussion showed that the community expected high education and better standard living. Some problems reported by the community included informal debt and drugs in the community. There were 8 steps in developing the model of learning centre on OTOP production process based on Sufficiency Economic Philosophy for sustainable life quality.

Keywords: production process, OTOP, sufficiency economic philosophy, marketing management

Procedia PDF Downloads 220

Authors: Sarinra Thongmee, Adithep Mingsuan, Chanyapak Polkhet, Supattra Wongsuk, Krittaphon Prakobsaeng

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The purposes of this research and development was to develop and evaluation of clinical nursing practice guideline (CNPG) for the prevention of infection during intubation in patient withsuspected or confirmedCOVID-19 patient. This study was developed by using the evidence based practice model of Soukup (2000) as a conceptual framework. The study consisted of 4 steps: 1) situational analysis of intubation service in patients with confirmed COVID-19, 2) development the CNPG, 3) apply the NPG to trial, and 4) evaluation of the NPG. Thesample consisted of 52 nurse anesthetists and 25 infected or suspected COVID-19 patients. The research instrument consisted of 1) CNPG, 2) the nurses anesthetist opinion questionnaire to the guideline, 3) the evaluation practice form, and 4) the nurse anesthetist knowledge test on nursing care of patients infected with COVID-19. Data were analyzed by using descriptive statistics, and Wilcoxon matched-pairs signed rank test. The results found that this developed NPG consists of 4 sections: 1) NPG for Preventing Airborne Infection Prevention2) preparation of anesthetic and intubation equipments 3) roles and duties of the intubation team 4) guidelines for intubation in suspected or confirmed COVID-19patients. The result found that 1) provider: using NPG in providers revealed that nurse anesthetist had higher mean of knowledge scores than before using NPG statistically significant at the 0.05 level (p<0.01) and able to follow the NPG 100% in all activities. The anesthetic team was not infected with COVID-19from intubation outside operating room.2) Client: the patient was safe, no complications from intubation. Summary CNPG to prevent infection in intubation of suspected or confirmedCOVID-19 patient was appropriate and applicable to practice.

Keywords: nursing practice guideline, prevention of infection, endotracheal intubation, COVID-19

Procedia PDF Downloads 129

Authors: Jaehong Yu, Seoung Bum Kim

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Clustering analysis can facilitate the extraction of intrinsic patterns in a dataset and reveal its natural groupings without requiring class information. For effective clustering analysis in high dimensional datasets, unsupervised dimensionality reduction is an important task. Unsupervised dimensionality reduction can generally be achieved by feature extraction or feature selection. In many situations, feature selection methods are more appropriate than feature extraction methods because of their clear interpretation with respect to the original features. The unsupervised feature selection can be categorized as feature subset selection and feature ranking method, and we focused on unsupervised feature ranking methods which evaluate the features based on their importance scores. Recently, several unsupervised feature ranking methods were developed based on ensemble approaches to achieve their higher accuracy and stability. However, most of the ensemble-based feature ranking methods require the true number of clusters. Furthermore, these algorithms evaluate the feature importance depending on the ensemble clustering solution, and they produce undesirable evaluation results if the clustering solutions are inaccurate. To address these limitations, we proposed an ensemble-based feature ranking method with random subspace and multiple-k ensemble (FRRM). The proposed FRRM algorithm evaluates the importance of each feature with the random subspace ensemble, and all evaluation results are combined with the ensemble importance scores. Moreover, FRRM does not require the determination of the true number of clusters in advance through the use of the multiple-k ensemble idea. Experiments on various benchmark datasets were conducted to examine the properties of the proposed FRRM algorithm and to compare its performance with that of existing feature ranking methods. The experimental results demonstrated that the proposed FRRM outperformed the competitors.

Keywords: clustering analysis, multiple-k ensemble, random subspace-based feature evaluation, unsupervised feature ranking

Procedia PDF Downloads 319

Authors: Milad Mirzaei Aminiyan, Abdolreza Akhgar, Farzad Mirzaei Aminiyan

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Water quality is the critical factor that influence on human health and quantity and quality of grain production in semi-humid and semi-arid area. Pistachio is a main crop that accounts for a considerable portion of Iranian agricultural exports. Give that pistachio tree is a tolerant type of tree to saline and alkaline soil and water conditions, but groundwater and irrigation water quality play important roles in main production this crop. For this purpose, 94 well water samples were taken from 25 wells and samples were analyzed. The results showed give that region’s geological, climatic characteristics, statistical analysis, and based on dominant cations and anions in well water samples (piper diagram); four main types of water were found: Na-Cl, K-Cl, Na-SO4, and K-SO4. It seems that most wells in terms of water quality (salinity and alkalinity) and based on Wilcox diagram have critical status. The analysis suggested that more than eighty-seven percentage of the well water samples have high values of EC that these values are higher than into critical limit EC value for irrigation water, which may be due to the sandy soils in this area. Most groundwater were relatively unsuitable for irrigation but it could be used by application of correct management such as removing and reducing the ion concentrations of Cl‾, SO42‾, Na+ and total hardness in groundwater and also the concentrated deep groundwater was required treatment to reduce the salinity and sodium hazard. Given that irrigation water quality in this area was relatively unsuitable for most agriculture production but pistachio tree was adapted to this area conditions. The integrated management of groundwater for irrigation is the way to solve water quality issues not only in Rafsanjan area, but also in other arid and semi-arid areas.

Keywords: groundwater quality, irrigation water quality, salinity, alkalinity, Rafsanjan plain, pistachio

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Authors: Samaneh Pouyanfar, Michael Oliff

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The industry of home appliances may beone of theindustries which has the highest competition, and actually what can guarantee the survival of this industry is discovering the superior services. A trend to provide quality products and services plays an important role in this industry because discovering the services is counted as a vital affair for Manufacturing Organizations’ survival and profitability. Given the importance of the topic, this paper attempts to investigate the relative priority of the factors influencing the customer satisfaction in gaining the competitive advantage in Pars-Khazar Company. In sum, 96 executives of Pars-Khazar Company where investigated in a census. For this purpose, after reviewing the research literature and performing deep interviews between pundits and experts active in the industry, the research questionnaire was made based on variables affecting customer satisfaction and components determining business competitive advantage. Determining the content validity took place by judgement of the experts. The reliability of each structure was measured based on Cronbach’s alpha coefficient. Since the value of Cronbach's alpha was higher than 0.7 for each structure, internal consistency of statements was high and the reliability of the questionnaire was acceptable. The data analysis was also done with Kulmgrf-asmyrnf test and Friedman test using SPSS software. The results showed that in dimension of factors affecting customer satisfaction, the History of trade name (brand), Familiarity with the product brand, Brand reputation and Safety have the highest value of priority respectively, and the variable of firm growth has the highest value of priority among the components determining the performance of competitive advantage.

Keywords: customer satisfaction, competitive advantage, brand history, safety, growth

Procedia PDF Downloads 214

Authors: Rumesh Liyanage, S. B. Nawaratne, K. K. D. S. Ranaweera, Indira Wickramasinghe, K. G. S. C. Katukurunda

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Study it was attempted to identify an effect of food habits and publics’ attitudes on micro-sleepiness and preventive measures to develop a food product to combat. Statistical data pertaining to road accidents were collected from, Sri Lanka Police Traffic Division and a pre-tested questionnaire was used to collect data from 250 respondents. They were selected representing drivers (especially highway drivers), private and public sector workers (shift based) and cramming students (university and school). Questionnaires were directed to fill independently and personally and collected data were analyzed statistically. Results revealed that 76.84, 96.39 and 80.93% out of total respondents consumed rice for all three meals which lead to ingesting higher glycemic meals. Taking two hyper glycemic meals before 14.00h was identified as a cause of micro-sleepiness within these respondents. Peak level of road accidents were observed at 14.00 - 20.00h (38.2%)and intensity of micro-sleepiness falls at the same time period (37.36%) while 14.00 to 16.00h was the peak time, 16.00 to 18.00h was the least; again 18.00 to 20.00h it reappears slightly. Even though respondents of the survey expressed that peak hours of micro- sleepiness is 14.00-16.00h, according to police reports, peak hours fall in between 18.00-20.00h. Out of the interviewees, 69.27% strongly wanted to avoid micro-sleepiness and intend to spend LKR 10-20 on a commercial product to combat micro sleepiness. As age-old practices to suppress micro-sleepiness are time taken, modern day respondents (51.64%) like to have a quick solution through a drink. Therefore, food habits of morning and noon may cause for micro- sleepiness while dinner may cause for both, natural and micro-sleepiness due to the heavy glycemic load of food. According to the study micro-sleepiness, can be categorized into three zones such as low-risk zone (08.00-10.00h and 18.00-20.00h), manageable zone (10.00-12.00h), and high- risk zone (14.00-16.00h).

Keywords: food habits, glycemic load, micro-sleepiness, road accidents

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Authors: Ziqu Ouyang, Kun Su

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A novel efficient and clean coal combustion system, namely the purification-combustion system, was designed by the Institute of Engineering Thermal Physics, Chinese Academy of Science, in 2022. Among them, the purification system was composed of a mesothermal activating unit and a hyperthermal reductive unit, and the combustion system was composed of a mild combustion system. In the purification-combustion system, the deep in-situ removal of coal-N could be realized by matching the temperature and atmosphere in each unit, and thus the NOx emission was controlled effectively. To acquire the methods for realizing the efficient and clean coal combustion, this study investigated the effect of the activating temperature (including 822 °C, 858 °C, 933 °C, 991 °C), which was the key factor affecting the system operation, on combustion and NOx emission characteristics of pulverized coal in a 30 kW purification-combustion test bench. The research result turned out that the activating temperature affected the combustion and NOx emission characteristics significantly. As the activating temperature increased, the temperature increased first and then decreased in the mild combustion unit, and the temperature change in the lower part was much higher than that in the upper part. Moreover, the main combustion region was always located at the top of the unit under different activating temperatures, and the combustion intensity along the unit was weakened gradually. Increasing the activating temperature excessively could destroy the reductive atmosphere early in the upper part of the unit, which wasn’t conducive to the full removal of coal-N in the reductive coal char. As the activating temperature increased, the combustion efficiency increased first and then decreased, while the NOx emission decreased first and then increased, illustrating that increasing the activating temperature properly promoted the efficient and clean coal combustion, but there was a limit to its growth. In this study, the optimal activating temperature was 858 °C. Hence, this research illustrated that increasing the activating temperature properly could realize the mutual matching of improving the combustion efficiency and reducing the NOx emission, and thus guaranteed the clean and efficient coal combustion well.

Keywords: activating temperature, combustion characteristics, nox emission, purification-combustion system

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Authors: Ana Maria Reis D'Azevedo Breda, Catarina Maria Neto da Cruz

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The Japanese art of origami provides a rich context for designing exploratory mathematical activities for children and young people. By folding a simple sheet of paper, fascinating and surprising planar and spatial configurations emerge. Equally surprising is the unfolding process, which also produces striking patterns. The procedure of folding, unfolding, and folding again allows the exploration of interesting geometric patterns. When adequately and systematically done, we may deduce some of the mathematical rules ruling origami. As the child/youth folds the sheet of paper repeatedly, he can physically observe how the forms he obtains are transformed and how they relate to the pattern of the corresponding unfolding, creating space for the understanding/discovery of mathematical principles regulating the folding-unfolding process. As part of a 2023 Summer Academy organized by a Portuguese university, a session entitled “Folding, Thinking and Generalizing” took place. Twenty-three students attended the session, all enrolled in the 2nd cycle of Portuguese Basic Education and aged between 10 and 12 years old. The main focus of this session was to foster the development of critical cognitive and socio-emotional skills among these young learners using origami. These skills included creativity, critical analysis, mathematical reasoning, collaboration, and communication. Employing a qualitative, descriptive, and interpretative analysis of data collected during the session through field notes and students’ written productions, our findings reveal that structured origami-based activities not only promote student engagement with mathematical concepts in a playful and interactive but also facilitate the development of socio-emotional skills, which include collaboration and effective communication between participants. This research highlights the value of integrating origami into educational practices, highlighting its role in supporting comprehensive cognitive and emotional learning experiences.

Keywords: skills, origami rules, active learning, hands-on activities

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Authors: Haris Karnezi, Kevin Tierney

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Cognitive Behaviour Drama is a research-based intervention model that brought together the science of psychology with the art form of drama to create an unobtrusive and exciting approach that would provide children on the higher end of the autism spectrum the motivation to explore the rules of social interaction and develop competencies associated with communicative success. The method involves engaging the participants in exciting fictional scenarios and encouraging them to seek various solutions on a number of problems that will lead them to an understanding of causal relationships and how a different course of action may lead to a different outcome. The sessions are structured to offer opportunities to the participants to practice target behaviours and understand the functions they serve. The study involved six separate interventions and employed both single case and group designs. Overall 8 children aged between 6 to 13 years, diagnosed with ASD participated in the study. Outcomes were measured using theory of mind tests, executive functioning tests, behavioural observations, pre and post intervention standardised social competence questionnaires for parents and teachers. Collectively, the results indicated positive changes in the self esteem and behaviour of all eight participants. In particular, improvements in the ability to solve theory of mind tasks were noted in the younger group; and qualitative improvements in social communication, in terms of verbal (content) and non verbal expression (body posture, vocal expression, fluency, eye contact, reduction of ritualistic mannerisms) were noted in the older group. The need for reliable impact measures to assess the effectiveness of the model in generating global changes in the participants’ behaviour outside the therapeutic context was identified.

Keywords: autism, drama, intervention, social skills

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Authors: Tai Mei Kin, Omar Abdull Kareem

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In light of globalization, educational reform has become a top priority for many countries. However, the task of leading change effectively requires a multidimensional set of competencies. Over the past two decades, technical competencies of principal change leadership have been extensively analysed and discussed. Comparatively, little research has been conducted in Malaysian education context on non-technical competencies or popularly known as emotional intelligence, which is equally crucial for the success of change. This article provides a validation of the Principal Change Leadership Non-Technical Competencies (PCLnTC) Scale, a tool that practitioners can easily use to assess school principals’ level of change leadership non-technical competencies that facilitate change and maximize change effectiveness. The overall coherence of the PCLnTC model was constructed by incorporating three theories: a)the change leadership theory whereby leading change is the fundamental role of a leader; b)competency theory in which leadership can be taught and learned; and c)the concept of emotional intelligence whereby it can be developed, fostered and taught. An exploratory factor analysis (EFA) was used to determine the underlying factor structure of PCLnTC model. Before conducting EFA, five important pilot test approaches were conducted to ensure the validity and reliability of the instrument: a)reviewed by academic colleagues; b)verification and comments from panel; c)evaluation on questionnaire format, syntax, design, and completion time; d)evaluation of item clarity; and e)assessment of internal consistency reliability. A total of 335 teachers from 12 High Performing Secondary School in Malaysia completed the survey. The PCLnTCS with six points Liker-type scale were subjected to Principal Components Analysis. The analysis yielded a three-factor solution namely, a)Interpersonal Sensitivity; b)Flexibility; and c)Motivation, explaining a total 74.326 per cent of the variance. Based on the results, implications for instrument revisions are discussed and specifications for future confirmatory factor analysis are delineated.

Keywords: exploratory factor analysis, principal change leadership non-technical competencies (PCLnTC), interpersonal sensitivity, flexibility, motivation

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Authors: Shannon Hearney, Jeffrey Hoch

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Pancreatic cancer is a notoriously costly and deadly form of cancer. Many types of treatment centers exist for patients to seek care from, including high-volume centers which have shown promise to provide the highest quality of care. While it may be true that this type of center provides the best care it is unclear if that care is cost-effective. Studies in the US have confirmed that high-volume hospitals do provide higher quality of care but have shown inconsistencies in the cost-effectiveness of that care. Other studies, like those from Finland have shown that high-volume centers had lower mortality and lower costs than low-volume centers. This paper thus seeks to review the current scientific literature to better understand if high-volume centers are cost-effective in delivering care in both a European setting and in the US. A review of major reference databases such as Medline, Embase and PubMed will be conducted for cost-effectiveness studies on the surgical treatment of pancreatic cancer at high-volume centers. Possible MeSH terms to be included, but not limited to, are: “pancreatic cancer”, “cost analysis”, “cost-effectiveness”, “economic evaluation”, “pancreatic neoplasms”, “surgical”, and “high-volume”. Studies must also have been available in the English language. This review will encompass European scientific literature, as well as those in the US. Based on our preliminary findings, we anticipate high-volume hospitals to provide better care at greater costs. We anticipate that high-volume hospitals may be cost-effective in different contexts depending on the national structure of a healthcare system. Countries with more centralized and socialized healthcare may yield results that are more cost-effective. High-volume centers may differ in their cost-effectiveness of the surgical care of pancreatic cancer internationally especially when comparing those in the United States to others throughout Europe.

Keywords: cost-effectiveness analysis, economic evaluation, pancreatic cancer, scientific literature review

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Authors: Sujit Kumar Sinha, Madan Lal Regar

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Sewing thread plays an important role in the transformation of a two-dimensional fabric into a three-dimensional garment. The interaction of the sewing thread with the fabric at the seam not only influences the appearance of a garment but also its performance. Careful selection of sewing thread and associated parameters can only help in improvement. Over the years, ring spinning has been dominating the yarn market. In the pursuit of improvement to challenge its dominance alternative technology has also been developed. But no real challenge has been posed by the any of the developed spinning systems. Eli-Twist spinning system can be a new method of yarn manufacture to provide a product with improved mechanical and physical properties with respect to the conventional ring spun yarn. The system, patented by Suessen has gained considerable attention in the recent times. The process of produces a two-ply compact yarn with improved fiber utilization. It produces a novel structure combining all advantages of condensing and doubling. In the present study, sewing threads of three different counts each from cotton, polyester and polyester/cotton (50/50) blend were produced on a ring and Eli-Twist systems. A twist multiplier of 4.2 was used to produce all the yarns. A comparison of hairiness, tensile strength and coefficient of friction with conventional ring yarn was made. Eli-Twist yarn has shown better frictional characteristics, better tensile strength and less hairiness. The performance of the Eli-Twist sewing thread has also been found to be better than the conventional 2-ply sewing thread. The performance was estimated through seam strength, seam elongation and seam efficiency of sewn fabric. Eli-Twist sewing thread has shown less friction, less hairiness, and higher tensile strength. Eli-Twist sewing thread resulted in better seam characteristics in comparison to conventional 2-ply sewing thread.

Keywords: ring spun yarn, Eli-Twist yarn, sewing thread, seam strength, seam elongation, seam efficiency

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Authors: Abdullah Kaymakci, Daniel M. Madyira, Ntokozo Nkwanyana

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The effect of metal transfer modes on mechanical properties of welded 3CR12 stainless steel were investigated. This was achieved by butt welding 10 mm thick plates of 3CR12 in different positions while varying the welding positions for different metal transfer modes. The ASME IX: 2010 (Welding and Brazing Qualifications) code was used as a basis for welding variables. The material and the thickness of the base metal were kept constant together with the filler metal, shielding gas and joint types. The effect of the metal transfer modes on the microstructure and the mechanical properties of the 3CR12 steel was then investigated as it was hypothesized that the change in welding positions will affect the transfer modes partly due to the effect of gravity. The microscopic examination revealed that the substrate was characterized by dual phase microstructure, that is, alpha phase and beta phase grain structures. Using the spectroscopic examination results and the ferritic factor calculation had shown that the microstructure was expected to be ferritic-martensitic during air cooling process. The tested tensile strength and Charpy impact energy were measured to be 498 MPa and 102 J which were in line with mechanical properties given in the material certificate. The heat input in the material was observed to be greater than 1 kJ/mm which is the limiting factor for grain growth during the welding process. Grain growths were observed in the heat affected zone of the welded materials. Ferritic-martensitic microstructure was observed in the microstructure during the microscopic examination. The grain growth altered the mechanical properties of the test material. Globular down hand had higher mechanical properties than spray down hand. Globular vertical up had better mechanical properties than globular vertical down.

Keywords: welding, metal transfer modes, stainless steel, microstructure, hardness, tensile strength

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Authors: Ramūnas Antanaitis, Robertas Stoškus, Mindaugas Televičius

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The objective is to identify changes in the quantity of milk and the pH and the temperature of rumen content after omentopexia. The research was performed in a dairy farm with 550 cows on December 2014 – January 2015. The sample consisted of 10 cows. Left-sided displacement of the abomasums was diagnosed in 5 of them, which was treated by lateral omentopexia according to Dirksen; the rest 5 were used for control. Additional treatment was not applied. A special bolus for measuring pH and temperature was administered to the rumen of healthy cows and cows after the operation. The quantity of milk was registered with the help of herd management program Westfalia DP C21. All data were recorded ones a week in the period of four weeks. Statistically reliable difference in the quantity of milk (p<0.05) between the research groups was observed during the entire research. The major difference was recorded on Week 1 after the treatment (29.18 kg/d); on Week 4, the difference was 13.97 kg/d. During the entire research, rumen pH of Test group was lower than that of the Control group. Statistically reliable difference between the groups was identified on Week 1 (p<0.05). On the period mentioned, the pH of the rumen content of Test group was lower by 0.42 than that of the Control group. On Week 3, the difference increased up to 0.84. On Weeks 1, 2, and 3, statistically reliable (p<0.05) higher temperature was observed in the Test group. Major difference of temperature, 1.81 °C, was recorded on Week 1. On Week 4, the temperature of rumen in the Test group became equal to that of the Control group. After omentopexia treatment, the first four weeks showed the following results: statistically reliable difference in the quantity of milk remains the most obvious in Week 1 after the treatment; cows with left-sided displacement of abomasums were exposed to greater risk of acidosis; they indicated lower pH of rumen content; the first two weeks after omentopexia, rumen content has increased temperature, especially obvious in Week 1.

Keywords: Displacement of the abomasum, omentopexia, acidosis

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Authors: Sahar Rakhshan, Simonetta Geninatti Crich, Diego Alberti, Rachele Stefania

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The combination of imaging and therapeutic agents in the same smart nanoparticle is a promising option to perform a minimally invasive imaging guided therapy. In this study, Low density lipoproteins (LDL), one of the most attractive biodegradable and biocompatible nanoparticles, were used for the simultaneous delivery of Paclitaxel (PTX), a hydrophobic antitumour drug and an amphiphilic contrast agent, Gd-AAZTA-C17, in B16-F10 melanoma cell line. These cells overexpress LDL receptors, as assessed by Flow cytometry analysis. PTX and Gd-AAZTA-C17 loaded LDLs (LDL-PTX-Gd) have been prepared, characterized and their stability was assessed under 72 h incubation at 37 ◦C and compared to LDL loaded with Gd-AAZTA-C17 (LDL-Gd) and LDL-PTX. The cytotoxic effect of LDL-PTX-Gd was evaluated by MTT assay. The anti-tumour drug loaded into LDLs showed a significantly higher toxicity on B16-F10 cells with respect to the commercially available formulation Paclitaxel Kabi (PTX Kabi) used in clinical applications. It was possible to demonstrate a high uptake of LDL-Gd in B16-F10 cells. As a consequence of the high cell uptake, melanoma cells showed significantly high cytotoxic effect when incubated in the presence of PTX (LDL-PTX-Gd). Furthermore, B16-F10 have been used to perform Magnetic Resonance Imaging. By the analysis of the image signal intensity, it was possible to extrapolate the amount of internalized PTX indirectly by the decrease of relaxation times caused by Gd, proportional to its concentration. Finally, the treatment with PTX loaded LDL on B16-F10 tumour bearing mice resulted in a marked reduction of tumour growth compared to the administration of PTX Kabi alone. In conclusion, LDLs are selectively taken-up by tumour cells and can be successfully exploited for the selective delivery of Paclitaxel and imaging agents.

Keywords: low density lipoprotein, melanoma cell lines, MRI, paclitaxel, personalized medicine application, theragnostic System

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Authors: Yahia A. M. AlKhoudary

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This Study presents the outcome of an investigation to evaluate the importance of autonomous learning as a means of motivation. However, very little research done in this field. Thus, the aims of this study are to ascertain the needs of the learners and to investigate their attitudes and motivation towards the mode of learning. Various suggestions made on how to improve learners’ participation in the learning process. A survey conducted on a sample group of 60 Omani College students. Self-report questionnaires and retrospective interviews conducted to find out their material-type preferences in a self-access learning context. Achieving autonomous learning system, which learners is one of the Ministry of Education goals in the Sultanate of Oman. As a result, this study presents the outcome of an investigation to evaluate the students’ performance in English as a Foreign Language (EFL). It focuses on the effect of autonomous learning that encourages students to learn English, a research conducted at Buraimi city, the Sultanate of Oman. The procedure of this investigation based on four dimensions: (1) sixty students are selected and divided into two groups, (2) pre and posttest projects are given to them, and (3) questionnaires are administered to both students who are involved in the experiment and 50 teachers (25 males and 25 females) to collect accurate data, (4) an interview with students and teachers to find out their attitude towards autonomous learning. Analysis of participants’ responses indicated that autonomous learning motivates students to learn English independently and increase the intrinsic rather than extrinsic motivation to improve their English language as a long-life active learning. The findings of this study show that autonomous learning approach is the best remedy to empower the students’ skills and overcome all relevant difficulties. They also show that secondary school teachers can fully rely on this learning approach that encourages language learners to monitor their progress, increase both learners and teachers’ motivation and ameliorate students’ behavior in the classroom. This approach is also an ongoing process, which takes time, patience and support to be lifelong learning.

Keywords: Omani, autonomous learning system, English as a Foreign Language (EFL), learning approach

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Authors: Dyah Larasati, Karishma Alize Huda, Sri Kusumastuti Rahayu, Martin Daniel Siyaranamual

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Indonesia continues to reform its social protection system to provide the needed protection for its citizen. Indonesia Social Protection consisted of social assistance programs (non-contributory/tax-financed) specifically targeted for the poor and at-risk and social security/insurance program (contributory system). The social assistance programs have mostly been implemented since 1998. The national health insurance has been implemented since 2014 and the employment social insurance since 2015. One major reform implemented has been improving the targeting performance of its major social assistance portfolios including (1) Food Assistance for the poor families (Rastra and BPNT/noncash foods assistance); (2) Education Assistance for poor children; (3) Conditional Cash Transfer for poor families (PKH); and (4) Subsidized beneficiaries of National Health Insurance (JKN-PBI) for the poor and at-risk individuals. For the Social Insurance (through BPJS Employment program), several initiatives have been implemented to expand the program contributing members, although it mostly benefits the formal sector workers. However, major gaps still exist especially for the emerging middle-income groups who typically work at the informal sectors. They have yet to get the protection needed to sustain their social and economic growth. Since 2017, TNP2K (the National Team for Poverty Reduction) under the Vice President office has led the social protection discourse as the government understands the need to address vulnerabilities across the lifecycle and prioritize support to the most at-risk population particularly the elderly, young children and people with disabilities. Discussion and advocacy to recommend for more investment is continuing in order for the government to establish a comprehensive social protection system in the near future (2020-2024) that protects children through an inclusive child benefit program; build a system to benefit more working-age adults (including individuals with disabilities) and a three-tier elderly protection as they reach 65 years.

Keywords: poverty reduction, social assistance, social insurance, social protection

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Authors: Kiatnarong Supapanmanee, Ekkarin Phongphinittana, Pongsak Nimdum

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Natural fibers are readily available raw materials that are widely used as composite materials. The most common problem facing many researchers with composites made from this fiber is the adhesion between the natural fiber contact surface and the matrix material. Part of the problem is due to the hydrophilic properties of natural fibers and the hydrophobic properties of the matrix material. Based on the aforementioned problems, this research selected bamboo fiber, which is a strong natural fiber in the research study. The first step was to study the effect of the mechanical properties of the pure bamboo strip by testing the tensile strength of different measurement lengths. The bamboo strip was modified surface with sodium hydroxide (NaOH) at 6wt% concentrations for different soaking periods. After surface modification, the physical and mechanical properties of the pure bamboo strip fibers were studied. The modified and unmodified bamboo strips were molded into a composite material using epoxy as a matrix to compare the mechanical properties and adhesion between the fiber surface and the material with tensile and bending tests. In addition, the results of these tests were compared with the finite element method (FEM). The results showed that the length of the bamboo strip affects the strength of the fibers, with shorter fibers causing higher tensile stress. Effects of surface modification of bamboo strip with NaOH, this chemical eliminates lignin and hemicellulose, resulting in the smaller dimension of the bamboo strip and increased density. From the pretreatment results above, it was found that the treated bamboo strip and composite material had better Ultimate tensile stress and Young's modulus. Moreover, that results in better adhesion between bamboo fiber and matrix material.

Keywords: bamboo fiber, bamboo strip, composite material, bamboo composite, pure bamboo, surface modification, mechanical properties of bamboo, bamboo finite element method

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Authors: N. B. Ikenweiwe, A. A. Alimi, N. A. Bamidele, O. A. Ewumi, K. Fasina, S. O. Otubusin

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A study on the physical, chemical and biological parameters of the lower course of Ogun River, Isheri-Olofin was carried out between January and December 2014 in order to determine the effects of the anthropogenic activities of the Kara abattoir and domestic waste depositions on the quality of the water. Water samples were taken twice each month at three selected stations A, B and C (based on characteristic features or activity levels) along the water course. Samples were analysed using standard methods for chemical and biological parameters the same day in the laboratory while physical parameters were determined in-situ with water parameters kit. Generally, results of Transparency, Dissolved Oxygen, Nitrates, TDS and Alkalinity fall below the permissible limits of WHO and FEPA standards for drinking and fish production. Results of phosphates, lead and cadmium were also low but still within the permissible limit. Only Temperature and pH were within limit. Low plankton community, (phytoplankton, zooplankton), which ranges from 3, 5 to 40, 23 were as a result of low levels of DO, transparency and phosphate. The presence of coliform bacteria of public health importance like Escherichia coli, Proteus vulgaris, Aeromonas sp., Shigella sp, Enterobacter aerogenes as well as gram negative bacteria Proteus morganii are mainly indicators of faecal pollution. Fish and other resources obtained from this water stand the risk of being contaminated with these organisms and man is at the receiving end. The results of the physical, chemical and some biological parameters of Isheri, Ogun River, according to this study showed that the live forms of aquatic and fisheries resources there are dwelling under stress as a result of deposition of bones, horns, faecal components, slurry of suspended solids, fat and blood into the water. Government should therefore establish good monitoring system against illegal waste depositions and create education programmes that will enlighten the community on the social, ecological and economic values of the river.

Keywords: damage, ecosystem, human activities, Isheri ogun river

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Authors: Tuiana A. Aiusheeva, Sergey S. Tamozhnikov, Alexander E. Saprygin, Arina A. Antonenko, Valentina V. Stepanova, Natalia N. Tolstykh, Alexander N. Savostyanov

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Situation of choice is an important condition for the formation of essential character qualities of a child, such as being initiative, responsible, hard-working. We have studied the behavioral and EEG reactions in Russian schoolchildren during recognition of syntactic errors in emotionally colored sentences that describe the choice situation. Twenty healthy children (mean age 9,0±0,3 years, 12 boys, 8 girls) were examined. Forty sentences were selected for the experiment; the half of them contained a syntactic error. The experiment additionally had the hidden condition: 50% of the sentences described the children's own choice and were emotionally colored (positive or negative). The other 50% of the sentences described the forced-choice situation, also with positive or negative coloring. EEG were recorded during execution of error-recognition task. Reaction time and quality of syntactic error detection were chosen as behavioral measures. Event-related spectral perturbation (ERSP) was applied to characterize the oscillatory brain activity of children. There were two time-frequency intervals in EEG reactions: (1) 500-800 ms in the 3-7 Hz frequency range (theta synchronization) and (2) 500-1000 ms in the 8-12 Hz range (alpha desynchronization). We found out that behavioral and brain reactions in child brain during recognition of positive and negative sentences describing forced-choice situation did not have significant differences. Theta synchronization and alpha desynchronization were stronger during recognition of sentences with children's own choice, especially with negative coloring. Also, the quality and execution time of the task were higher for this types of sentences. The results of our study will be useful for improvement of teaching methods and diagnostics of children affective disorders.

Keywords: choice situation, electroencephalogram (EEG), emotionally colored sentences, schoolchildren

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Authors: Wenjiang Deng, Tian Mou, Yudi Pawitan, Trung Nghia Vu

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Estimation of isoform-level gene expression from RNA-seq data depends on simplifying assumptions, such as uniform reads distribution, that are easily violated in real data. Such violations typically lead to biased estimates. Most existing methods provide a bias correction step(s), which is based on biological considerations, such as GC content–and applied in single samples separately. The main problem is that not all biases are known. For example, new technologies such as single-cell RNA-seq (scRNA-seq) may introduce new sources of bias not seen in bulk-cell data. This study introduces a method called XAEM based on a more flexible and robust statistical model. Existing methods are essentially based on a linear model Xβ, where the design matrix X is known and derived based on the simplifying assumptions. In contrast, XAEM considers Xβ as a bilinear model with both X and β unknown. Joint estimation of X and β is made possible by simultaneous analysis of multi-sample RNA-seq data. Compared to existing methods, XAEM automatically performs empirical correction of potentially unknown biases. XAEM implements an alternating expectation-maximization (AEM) algorithm, alternating between estimation of X and β. For speed XAEM utilizes quasi-mapping for read alignment, thus leading to a fast algorithm. Overall XAEM performs favorably compared to other recent advanced methods. For simulated datasets, XAEM obtains higher accuracy for multiple-isoform genes, particularly for paralogs. In a differential-expression analysis of a real scRNA-seq dataset, XAEM achieves substantially greater rediscovery rates in an independent validation set.

Keywords: alternating EM algorithm, bias correction, bilinear model, gene expression, RNA-seq

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Authors: Saha Naseri

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Introduction/Objective: Son preference, a preference for sons over daughters, is a practice deeply-rooted in gender inequality that is widespread in many societies and across different religions and cultures. In this study, we are aiming to study the effects of son preference on fertility outcomes (birth interval and current contraceptive use) in Afghanistan, where have been perceived with high rates of son preference. The objectives of the study are to examine the association between the sex of the previous child and the duration of the subsequent birth interval and to evaluate the effect of son preference on current contraceptive use. Methodology: Afghanistan Demographic and Health Survey (DHS) (2015) was used to study the impact of son preference on fertility outcomes among married women. The data collected from 28,661 on currently-married women, aged between 15 and 49 years who have at least one child, have used to conduct this quantitative study. Outcomes of interest are birth interval and current contraceptive use. Simple and multiple regression analysis have been conducted to assess the effect of son preference on these fertility outcomes. Results: The present study has highlighted that son preference somehow exists among married women in Afghanistan. It is indicated that the sex of the first birth is significantly associated with the succeeding birth interval. Having a female child as the first baby was associated with a shorter average succeeding birth interval by 1.8 months compared to a baby boy (p-value = 0.000). For the second model, the results identified that women who desire for more sons have 7% higher odds to be current contraceptive user compared to those who have no preference (p-value = 0.03). The latter results do not indicate the son preference. However, one limitation for this result was the timeliness of the questions asked since contraceptive use in the current time was asked along with a question on ‘future’ desired sex composition. Moreover, women may have just given birth and want to reach a certain time span of birth interval before planning for another child, even if it was a boy, which might have affected the results. Conclusion: Overall, this study has demonstrated that there is a positive relationship between son preference and one main fertility behaviors, birth interval. The second fertility outcome, current contraceptive use, was not a good indicator to measure son preference. Based on the finding, recommendations will be made for appropriate interventions addressing gender norms and related fertility decisions.

Keywords: Afghanistan, birth interval, contraceptive, son preference

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Authors: Ainur Mukhambetova, Miras Karzhauov, Vyacheslav Ogay

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Introduction: Mesenchymal stem cells (MSCs) have the capacity to be differentiated into several cell lineages and are a promising source for cell therapy and tissue engineering. However, currently most MSCs culturing protocols use media supplemented with fetal bovine serum (FBS), which limits their application in clinic due to the possibility of zoonotic infections, contamination and immunological reactions. Consequently, formulating effective serum free culture medium becomes one of the important problems in contemporary cell biotechnology. Objectives: The aim of this study was to define an optimal serum-free medium for culturing of periosteum derived MSCs. Materials and methods: The MSCs were extracted from human periosteum and transferred to the culture flasks pretreated with CELLstart™. Immunophenotypic characterization, proliferation and in vitro differentiation of cells grown on STEM PRO® MSC SFM were compared to the cells cultured in the standard FBS containing media. Chromosome analysis and flow cytometry were also performed. Results: We have shown that cells were grown on STEM PRO® MSC SFM retained all the morphological, immunophenotypic (CD73, CD90, CD105, vimentin and Stro-1) and cell differentiation characteristics specific to MSCs. Chromosome analysis indicated no anomalies in the chromosome structure. Flow cytometry showed a high expression of cell adhesion molecules CD44 (98,8%), CD90 (97,4%), CD105 (99,1%). In addition, we have shown that cell is grown on STEM PRO® MSC SFM have higher proliferation capacity compared to cell expanded on standard FBS containing the medium. Conclusion: We have shown that STEM PRO® MSC SFM is optimal for culturing periosteum derived human MSCs which subsequently can be safely used in cell therapy.

Keywords: cell technologies, periosteum-derived MSCs, regenerative medicine, serum-free medium

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Authors: Hussein Lujuo Mohamed

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Introduction: Public health has always been influenced by climate and weather. Changes in climate and climate variability, particularly changes in weather extremes affect the environment that provides people with clean air, food, water, shelter, and security. Tanzania is not an exception to the threats of climate change. The health sector is mostly affected due to emergence and proliferation of infectious diseases, thereby affecting health of the population and thus impacting achievement of sustainable development goals. Methodology: A desk review on documented issues pertaining to climate change and health in Tanzania was done using Google search engine. Keywords included climate change, link, health, climate initiatives. In cases where information was not available, documents from Ministry of Health, Vice Presidents Office-Environment, Local Government Authority, Ministry of Water, WHO, research, and training institutions were reviewed. Some of the reviewed documents from these institutions include policy brief papers, fieldwork activity reports, training manuals, and guidelines. Results: Six main climate resilience activities were identified in Tanzania. These were development and implementation of climate resilient water safety plans guidelines both for rural and urban water authorities, capacity building of rural and urban water authorities on implementation of climate-resilient water safety plans, and capacity strengthening of local environmental health practitioners on mainstreaming climate change and health into comprehensive council health plans. Others were vulnerability and adaptation assessment for the health sector, mainstreaming climate change in the National Health Policy, and development of risk communication strategy on climate. In addition information, education, and communication materials on climate change and to create awareness were developed aiming to sensitize and create awareness among communities on climate change issues and its effect on public health. Conclusion: Proper implementation of these interventions will help the country become resilient to many impacts of climate change in the health sector and become a good example for other least developed countries.

Keywords: climate, change, Tanzania, health

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Authors: Wern Lin Yeo, Choo Kim Tan, Sook Ling Lew

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Mathematics anxiety refers to the feeling of anxious when one having difficulties in solving mathematical problem. Mathematics anxiety is the most common type of anxiety among other types of anxiety which occurs among the students. However, level of anxiety among males and females are different. There were few past study were conducted to determine the relationship of anxiety and gender but there were still did not have an exact results. Hence, the purpose of this study is to determine the relationship of anxiety level between male and female undergraduates at a private university in Malaysia. Convenient sampling method used in this study in which the students were selected based on the grouping assigned by the faculty. There were 214 undergraduates who registered the probability courses had participated in this study. Mathematics Anxiety Rating Scale (MARS) was the instrument used in study which used to determine students’ anxiety level towards probability. Reliability and validity of instrument was done before the major study was conducted. In the major study, students were given briefing about the study conducted. Participation of this study were voluntary. Students were given consent form to determine whether they agree to participate in the study. Duration of two weeks were given for students to complete the given online questionnaire. The data collected will be analyzed using Statistical Package for the Social Sciences (SPSS) to determine the level of anxiety. There were three anxiety level, i.e., low, average and high. Students’ anxiety level were determined based on their scores obtained compared with the mean and standard deviation. If the scores obtained were below mean and standard deviation, the anxiety level was low. If the scores were at below and above the mean and between one standard deviation, the anxiety level was average. If the scores were above the mean and greater than one standard deviation, the anxiety level was high. Results showed that both of the gender were having average anxiety level. Males having high frequency of three anxiety level which were low, average and high anxiety level as compared to females. Hence, the mean values obtained for males (M = 3.62) was higher than females (M = 3.42). In order to be significant of anxiety level among the gender, the p-value should be less than .05. The p-value obtained in this study was .117. However, this value was greater than .05. Thus, there was no significant difference of anxiety level among the gender. In other words, there was no relationship of anxiety level with the gender.

Keywords: anxiety level, gender, mathematics anxiety, probability and statistics

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Authors: S. P. Bansal, Mukesh Kumar Sharma, Ankit Prabhakar

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Luhri Hydroelectric Project Stage-I (210 MW) is a run of the river type development with a dam toe surface powerhouse (122m long, 50.50m wide, and 65.50m high) on the right bank of river Satluj in Himachal Pradesh, India. The project is located in the inner lesser Himalaya between Dhauladhar Range in the south and higher Himalaya in the north in the seismically active region. At the project, the location river is confined within narrow V-shaped valleys with little or no flat areas close to the river bed. Nearly 120m high cut slopes behind the powerhouse are proposed from the powerhouse foundation level of 795m to ± 915m to accommodate the surface powerhouse. The stability of 120m high cut slopes is a prime concern for the reason of risk involved. The slopes behind the powerhouse will be excavated in mainly in augen gneiss, fresh to weathered in nature, and biotite rich at places. The foliation joints are favorable and dipping inside the hill. Two valleys dipping steeper joints will be encountered on the slopes, which can cause instability during excavation. Geological exploration plays a vital role in designing and optimization of cut slopes. SWEDGE software has been used to analyze the geometry and stability of surface wedges in cut slopes. The slopes behind powerhouse have been analyzed in three zones for stability analysis by providing a break in the continuity of cut slopes, which shall provide quite substantial relief for slope stabilization measure. Pseudo static analysis has been carried out for the stabilization of wedges. The results indicate that many large wedges are forming, which have a factor of safety less than 1. The stability measures (support system, bench width, slopes) have been planned so that no wedge failure may occur in the future.

Keywords: cut slopes, geotechnical investigations, Himalayan geology, surface powerhouse, wedge failure

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Authors: Suelen C. Lima, André C. de Oliveira, Rosemary A. Roque

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Dengue is fatal arboviruses transmitted by the A. aegypti mosquito to more than 100 countries, for which the WHO estimates that 2.5 million people will be infected by these disease. The widespread of these diseases is due, among other factors, to the resistance that A. aegypti has to several commercial insecticides. On the other hand, natural products based on plants of the genus Piper (Piperaceae) are characterized by their insecticidal activities against mosquitoes. Piper longepetiolatum and Piper brachypetiolatum are species with wide distribution in the State of Amazonas. However, there is no investigation of phytochemical or biological of these plants against mosquitoes such as A. aegypti. The main of this study was to identify the chemical composition of the essential oil (EOs) from P. longepetiolatum and P. brachypetiolatum and to evaluate the biological activity against A. aegypti. The EOs were extracted by hydrodistillation from leaves (200 g) of P. longepetiolatum and P. brachypetiolatum and analyzed by GC-MS and GC-FID. The main compounds β-caryophyllene (99.9% of purity) and E-nerolidol (99.4% of purity) were purchased from Sigma-Aldrich® Brazil. The larvicidal activity of EOs (20 to 100 ppm), β-caryophyllene and E-nerolidol (10 to 50 ppm) was performed according to WHO protocol against A. aegypti larvae. The GC-MS and GC-FID analysis of EOs from P. longepetiolatum and P. brachypetiolatum indicated the majority presence of β-caryophyllene (35.42%) and E-nerolidol (49.79%), respectively. The results showed that all natural products presented larvicidal activity against A. aegypti. In this aspect, the OE from P. brachypetiolatum (LC50 of 15.51 ppm and LC90 of 22.79 ppm) was more active than the OE from P. longepetiolatum (LC50 of 47.17 ppm and LC90 of 69.60 ppm) (p < 0.05). Regarding of main compounds, E-nerolidol (LC50 of 9.50 ppm and LC90 of 23.89 ppm) showed higher larvicidal activity than the β-caryophyllene compound (LC50 of 79.00 ppm and LC90 of 230.91 ppm) (p < 0.05). The larvae treated with these natural products showed tremors and lethargic movements, suggesting that these natural products have neurotoxic action. These observations support studies to investigate the mechanism of action. This is the first record of the chemical composition and larvicidal activity of the EO from P. longepetiolatum and P. brachypetiolatum rich in β-caryophyllene and E-nerolidol against A. aegypti larvae.

Keywords: piperaceae, aedes, sesquiterpenes, biological control

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Authors: Pablo Cid Galache, Laura Zamorano Bonilla

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Mauriac syndrome (MS) is a rare complication of type 1 diabetes mellitus (DM1). It is rela-ted to low insulin concentrations. Therefore is a complication mainly found in developing countries. The main clinical features are hepatomegaly, edema, growth and puberty delay, and the presence of elevated transaminases and serum lipids. The MS incidence is de-creasing due to the new types of insulin and intensive glycemic control. Therefore is a rare diagnosis in Europe nowadays, being described mainly in developing countries or with so-cioeconomic limitations to guarantee an adequate management of diabetes. Edema secondary to fluid retention is a rare complication of insulin treatment, especially in young patients. Its severity is variable and is mainly related to the start of a proper treatment and the improvement in glycemic control after diagnosis or after periods of poor metabolic control. Edema resolves spontaneously without requiring treatment in most cases. The Pediatric Endocrinology Unit of Hospital Motril could diagnose a 14-year-old girl who presented very poor metabolic control during the last 3 years as a consequence of the socioeconomic conditions of the country of origin during the last years. Presents up to 4 admissions for ketoacidosis during the last 12 months. After the family moved to Spain our patient began to be followed up in our Hospital. Initially presented glycated hemoglobin figures of 11%. One week after the start of treatment, the patient was admitted in the emergency room due to the appearance of generalized edema and pain in the limbs. The main laboratory abnormalities include: blood glucose 225mg/dl; HbA1C 10.8% triglycerides 543 mg/dl, total cholesterol 339 mg/dl (LDL 225) GOT 124 U/l, GPT 89U/l. Abdominal ultrasound shows mild hepatomegaly and no signs of ascites were shown. The patient presented a progressive improvement with resolution of the edema and analitical abnormalities during the next two weeks. During admission, the family received diabetes education, achieving adequate glycemic control at discharge. Nowadays the patient has a good glycemic control having glycated hemoglobin levels around 7%.

Keywords: Mauriac, diabetes, complication, developing countries

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