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Authors: Nasiruddin Khan, Nasser M. Al-Daghri, Dara A. Al-Disi, Asim Al-Fadda, Mohamed Al-Seif, Gyanendra Tripathi, A. L. Harte, Philip G. Mcternan

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For the last few decades, the prevalence of type 2 diabetes mellitus (T2DM) in the Kingdom of Saudi Arabia (KSA) is increasing alarmingly high and is unprecedented at 31.6 %. Preventive measures should be taken to curb down the increasing incidence. In this prospective, 3-month study, we aimed to determine whether dietary modification program would confer favorable affects among overweight and obese adult Saudi women with or without T2DM. A total of 92 Saudi women [18 healthy controls, 24 overweight subjects and 50 overweight or obese patients with early onset T2DM were included in this prospective study. Baseline anthropometrics and fasting blood samples were taken at baseline and after 3 months. Fasting blood sugar and lipid profile were measured routinely. A 500 Kcal deficit energy diet less than their daily recommended dietary allowances were prescribed to all participants. After 3 months of follow-up visit, significant improvements were observed in both the overweight and DMT2 group as compared to baseline with decreased mean BMI [Overweight Group 28.54±1.49 versus 27.95±2.25, p<0.05; DMT2 group 35.24±7.67 versus 35.04±8.07, p<0.05] and hip circumference [Overweight group 109.67±5.01 versus 108.07±4.07, p<0.05; DMT2 group 112.3±13.43 versus 109.21±12.71, p<0.01]. Moreover, in the overweight group, baseline HDL-cholesterol was significantly associated with protein intake and inversely associated with carbohydrate intake in controls. In the DMT2 group, carbohydrate intake at baseline was significantly associated with BMI. A 3-month 500kcal/day deficit dietary modification alone is probably effective among adult overweight or obese Saudi females without or with T2DM. Longer prospective studies are to determine whether the dietary intervention alone can reduce progression of T2DM among high-risk adult Arabs.

Keywords: diet, lipid, obesity, T2DM

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Authors: Nino Chikhladze, Tamar Dochviri, Nato Pitskhelauri, Maia Bitskhinashvili

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Population aging is a key social and demographic trend of the 21st century. Falls represent a prevalent geriatric syndrome that poses significant risks to the health and independence of older adults. The World Health Organization notes a lack of comprehensive data on falls in low- and middle-income countries, complicating the creation of effective prevention programs. To the authors’ best knowledge, no such studies have been conducted in Georgia. The aim of the study is to explore the epidemiology of falls in the elderly population. The hospitalization database of the National Center for Disease Control and Public Health of Georgia was used for the retrospective study. Falls-related injuries were identified using ICD-10 classifications using the class XIX (S and T codes) and class XX for the type of injury (V-Y codes). Statistical data analyses were done using SPSS software version 23.0. The total number of fall-related hospitalizations for individuals aged 65 and older from 2015 to 2021 was 29,697. The study revealed that falls accounted for an average of 63% (ranging from 59% to 66%) of all hospitalizations and 68% (ranging from 65% to 70%) of injury-related hospitalizations during this period. The 69% of all patients were women and 31%-men (Chi2=4482.1, p<0.001). The highest rate of hospitalization was in the age groups 80-84 and 75-79. The probability of fall-related hospitalization was significantly higher in women (p<0.001) compared to men in all age groups except 65-69 years. In the target age group of 65 years and older, the probability of hospitalization increased significantly with an increase in age (p<0.001). The study's results can be leveraged to create evidence-based awareness programs, design targeted multi-domain interventions addressing specific risk factors, and enhance the quality of geriatric healthcare services in Georgia.

Keywords: elderly population, falls, geriatric patients, hospitalization, injuries

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Authors: Qing Li, Maiko Kobayashi, Shigeyoshi Kumeda, Hiroko Ochiai, Toshiya Ochiai, Takashi Miura, Takahide Kagawa, Michiko Imai, Toshiaki Otsuka, Tomoyuki Kawada

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In the present study, we investigated the effects of a forest bathing program on cardiovascular and metabolic parameters. Nineteen healthy male subjects (mean age: 51.3 ± 8.8 years) were selected after obtaining informed consent. These subjects took day trips to a forest park named Akasawa Shizen Kyuyourin, Agematsu, Nagano Prefecture (situated in central Japan), and to an urban area of Nagano Prefecture as a control in August 2015. On both trips, they walked 2.6 km for 80 min each in the morning and afternoon on Saturdays. Blood and urine were sampled in the morning before and after each trip. Cardiovascular and metabolic parameters were measured. Blood pressure and pulse rate were measured by an ambulatory automatic blood pressure monitor. The Japanese version of the profile of mood states (POMS) test was conducted before, during and after the trips. Ambient temperature and humidity were monitoring during the trips. The forest bathing program significantly reduced pulse rate, and significantly increased the score for vigor and decreased the scores for depression, fatigue, and confusion in the POMS test. The levels of urinary noradrenaline and dopamine after forest bathing were significantly lower than those after urban area walking, suggesting the relaxing effect of the forest bathing program. The level of adiponectin in serum after the forest bathing program was significantly greater than that after urban area walking. There was no significant difference in blood pressure between forest and urban area trips during the trips.

Keywords: ambient temperature, blood pressure, forest bathing, forest therapy, human health, POMS, pulse rate

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Authors: Parmeet Kaur, Nighat Yaseen Sofi, Shakti Kumar Gupta, Veena Pandey, Rajvaedhan Azad

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Nutritional status and prevailing blood glucose level trends amongst hospitalized patients has been linked to clinical outcome. Therefore, the present study was undertaken to assess hospitalized Diabetic Eye Disease (DED) patients' anthropometric and dietary intake trends. DED patients with type 1 or 2 diabetes > 20 years were enrolled. Actual food intake was determined by weighed food record method. Mifflin St Joer predictive equation multiplied by a combined stress and activity factor of 1.3 was applied to estimate caloric needs. A questionnaire was further administered to obtain reasons of inadequate dietary intake. Results indicated validity of joint analyses of body mass index in combination with waist circumference for clinical risk prediction. Dietary data showed a significant difference (p < 0.0005) between average daily caloric and carbohydrate intake and actual daily caloric and carbohydrate needs. Mean fasting and post-prandial plasma glucose levels were 150.71 ± 72.200 mg/dL and 219.76 ± 97.365 mg/dL, respectively. Improvement in food delivery systems and nutrition educations were indicated for reducing plate waste and to enable better understanding of dietary aspects of diabetes management. A team approach of nurses, physicians and other health care providers is required besides the expertise of dietetics professional. To conclude, findings of the present study will be useful in planning nutritional care process (NCP) for optimizing glucose control as a component of quality medical nutrition therapy (MNT) in hospitalized DED patients.

Keywords: nutritional status, diabetic eye disease, nutrition care process, medical nutrition therapy

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Authors: Daniel Alati

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Recent high-profile terrorist events in Canada, the United Kingdom and Europe – the London Bridge attacks, the terrorist attacks in Nice, France and Barcelona, Spain, the 2014 Ottawa Parliament attacks and the 2017 attacks in Edmonton – have all raised levels of public and academic concern with so-called “lone-wolf” and “radicalized” terrorism. Similarly, several countries outside of the “Western” world have been dealing with radicalization to violent extremism for several years. Many South East Asian countries, including Indonesia, Malaysia, Singapore and the Philippines have all had experience with what might be described as ISIS or extremist-inspired acts of terrorism. Indeed, it appears the greatest strength of groups such as ISIS has been their ability to spread a global message of violent extremism that has led to radicalization in markedly different jurisdictions throughout the world. These markedly different jurisdictions have responded with counter-radicalization strategies that warrant further comparative analysis. This paper utilizes an inter-disciplinary legal methodology. In doing so, it compares legal, political, cultural and historical aspects of the counter-radicalization strategies employed by Canada, the United Kingdom and several South East Asian countries (Indonesia, Malaysia, Singapore and the Philippines). Whilst acknowledging significant legal and political differences between these jurisdictions, the paper engages in these analyses with an eye towards understanding which best practices might be shared between the jurisdictions. In doing so, it presents valuable findings of a comparative nature that are useful to both academic and practitioner audiences in several jurisdictions.

Keywords: Canada, United Kingdom and South East Asia, comparative law and politics, radicalization to violent extremism, terrorism

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Authors: Seetanah Boopen, Padachi Kesseven, R. Juwaheer , R. V. Sannassee, M. L. Lamport

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This study aims primarily at investigating the importance of soft infrastructure in tourism development for the case of an island economy namely Mauritius. The study in the first place assesses the level of perceived and actual satisfaction of the present state of the different types of soft tourism infrastructure and the allied services provided by tourism stakeholders in Mauritius and address the identified gaps. In order to address the study objectives, a rigorous survey analysis among 1741 international tourists at the departure lounge of the Sir Seewoosagur International Airport of Mauritius was carried out. The respondents placed significant emphasis on the different elements of the soft infrastructure dimension, where many of the elements falling under this dimension were rated with a high mean score. In particular the visitors rated communication, both internet and telephone services, and security to be most important. Significant gap has been found in the categories of ‘Health’ and ‘Security’. This indicates that the tourists ascribe high importance to the soft infrastructure dimension. The link between the respondent profile and the key variables which influence the tourist choice of the island as a destination are found to be equally important for most of the international tourists. However, these were deemed to be more critical for tourists travelling with family members. Although the survey instrument attempted to measure any gap between on the one hand, the importance of the infrastructure dimension and on the other hand, the level of satisfaction with the infrastructure dimension, overall the results do not show any statistically significant gap among the different elements of the infrastructural dimension. The study dwells into further analysis by engaging into an econometric framework related to a Probit Model, using the data collected, to gauge the effect of soft infrastructure on tourist intention to repeat or recommend the destination. The results confirm that soft infrastructure is found to be sensible to tourists, although relatively less sensitive as compared to tourism and transport and hotel infrastructure.

Keywords: tourism development, soft infrastructure, Mauritius, hotel infrastructure

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Authors: O. O. Olawusi-Peters, M. O. Adediran, O. A. Ajibare

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Etheria elliptica population is declining due to various human activities on the freshwater habitat. This necessitate the habitat study of the mussel in river Ogbese and Owena reservoir in Ondo state, Nigeria in order to know the status of the organism within the ecosystem. Thirty (30) specimens each from River Ogbese and Owena reservoir were sampled between May and August 2012. The meristic variables such as length, breadth, shell thickness and weight of the mussel were measured. Also, some physico-chemical parameters, flow rate and soil profile of the two rivers were studied. In River Ogbese, the weight, length, breadth and thickness variables obtained were; 49.73g, 8.42cm, 3.78cm and 0.53cm respectively. In Owena reservoir, the values were; 111.17g, 8.80cm, 6.64cm, 0.22cm respectively. The condition factor showed that the samples from Owena reservoir (K = 16.33) were healthier than River Ogbese (K = 8.34). Also, the length-weight relationship indicated isometric growth in both water bodies (Ogbese r2 = 0.68; Owena r2 = 0.66). In River Ogbese, the physico-chemical parameters obtained were; temperature (24.3oC), pH (7.12), TDS (72ppm), DO (3.2mg/l), conductivity (145µ), BOD (0.7mg/l). The mean temperature (24.1oC), pH (7.69), TDS (102ppm), DO (3.1mg/l), conductivity (183µ), BOD (0.8mg/l) were obtained from Owena reservoir. The soil samples values obtained from both water bodies are; River Ogbese –phosphorus; 78.78, calcium; 3.60, magnesium; 1.90 and organic matter; 0.17. Owena reservoir - Phosphorus; 3.34, calcium; 4.40, magnesium; 1.20 and organic matter; 0.66. The river flow rate was 0.22m/s for Owena reservoir and 0.26m/s for river Ogbese. The study revealed that Etheria elliptica in Owena reservoir and Ogbese were in good and healthy conditions despite the various human activities on the water bodies. The water quality parameters obtained were within the preferred requirements of the mussels.

Keywords: Etheria elliptica, mussels, Owena reservoir, River Ogbese

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Authors: Narges Razmjoo, Hamid Sefidari, Michael Strand

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Biomass combustion is a growing technique for heat and power production due to the increasing stringent regulations with CO2 emissions. Grate-fired systems have been regarded as a common and popular combustion technology for burning woody biomass. However, some grate furnaces are not well optimized and may emit significant amount of unwanted compounds such as dust, NOx, CO, and unburned gaseous components. The combustion characteristics inside the fuel bed are of practical interest, as they are directly related to the release of volatiles and affect the stability and the efficiency of the fuel bed combustion. Although numerous studies have been presented on the grate firing of biomass, to the author’s knowledge, none of them have conducted a detailed experimental study within the fuel bed. It is difficult to conduct measurements of temperature and gas species inside the burning bed of the fuel in full-scale boilers. Results from such inside bed measurements can also be applied by the numerical experts for modeling the fuel bed combustion. The current work presents an experimental investigation into the combustion behavior of wet woody biomass (53 %) in a 4 MW reciprocating grate boiler, by focusing on the gas species distribution along the height of the fuel bed. The local concentrations of gases (CO, CO2, CH4, NO, and O2) inside the fuel bed were measured through a glass port situated on the side wall of the furnace. The measurements were carried out at five different heights of the fuel bed, by means of a bent stainless steel probe containing a type-k thermocouple. The sample gas extracted from the fuel bed, through the probe, was filtered and dried and then was analyzed using two infrared spectrometers. Temperatures of about 200-1100 °C were measured close to the grate, indicating that char combustion is occurring at the bottom of the fuel bed and propagates upward. The CO and CO2 concentration varied in the range of 15-35 vol % and 3-16 vol %, respectively, and NO concentration varied between 10-140 ppm. The profile of the gas concentrations distribution along the bed height provided a good overview of the combustion sub-processes in the fuel bed.

Keywords: experimental, fuel bed, grate firing, wood combustion

Procedia PDF Downloads 326

Authors: Abrar Al-Hasan

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Objectives: There is ongoing discourse regarding the potential risks to health professionals' reputations and credibility arising from their personal social media use. However, the specific impacts on professional credibility and the health professional-client relationship remain largely unexplored. This study aims to investigate the type and frequency of the content posted by health professionals on their Instagram accounts and its influence on their credibility and the professional-client relationship. Methodology: In a controlled field study, participants reviewed randomly assigned mock Instagram profiles of health professionals. Mock profiles were constructed according to gender (female/male), social media usage (high/low), and social media richness (high/ low), with richness increasing from posts to stories to reels and personal content type (high /low). Participants then rated the profile owners’ credibility on a visual analog scale. An analysis of variance compared these ratings, and mediation analyses assessed the influence of credibility ratings on participants' willingness to become clients of the mock health professional. Results: Results from 315 participants showed that health professionals with personal Instagram profiles displaying high social media richness were perceived as more credible than those with lower social media richness. Low social media usage is perceived as more credible than high social media usage. Personal content type is perceived as less credible as compared to those with low personal content type. Contributions: These findings provide initial evidence of the impact of health professionals' personal online disclosures on credibility and the health professional-client relationship. Understanding public perceptions of professionalism and credibility is essential for informing e-professionalism guidelines and promoting best practices in social media use among health professionals.

Keywords: credibility, consumer behavior, social media, media richness, healthcare professionals

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Authors: M. Marjaneh, M. Y. Narazah, H. Shahrul

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Array-based gene expression analysis is a powerful tool to profile expression of genes and to generate information on therapeutic effects of new anti-cancer compounds. Anti-apoptotic effect of thymoquinone was studied in MCF7 breast cancer cell line using gene expression profiling with cDNA micro array. The purity and yield of RNA samples were determined using RNeasyPlus Mini kit. The Agilent RNA 6000 Nano LabChip kit evaluated the quantity of the RNA samples. AffinityScript RT oligo-dT promoter primer was used to generate cDNA strands. T7 RNA polymerase was used to convert cDNA to cRNA. The cRNA samples and human universal reference RNA were labelled with Cy-3-CTP and Cy-5-CTP, respectively. Feature Extraction and GeneSpring software analysed the data. The single experiment analysis revealed involvement of 64 pathways with up-regulated genes and 78 pathways with down-regulated genes. The MAPK and p38-MAPK pathways were inhibited due to the up-regulation of PTPRR gene. The inhibition of p38-MAPK suggested up-regulation of TGF-ß pathway. Inhibition of p38 - MAPK caused up-regulation of TP53 and down-regulation of Bcl2 genes indicating involvement of intrinsic apoptotic pathway. Down-regulation of CARD16 gene as an adaptor molecule regulated CASP1 and suggested necrosis-like programmed cell death and involvement of caspase in apoptosis. Furthermore, down-regulation of GPCR, EGF-EGFR signalling pathways suggested reduction of ER. Involvement of AhR pathway which control cytochrome P450 and glucuronidation pathways showed metabolism of Thymoquinone. The findings showed differential expression of several genes in apoptosis pathways with thymoquinone treatment in estrogen receptor-positive breast cancer cells.

Keywords: cDNA microarray, thymoquinone, CARD16, PTPRR, CASP10

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Authors: A. Watson, G. Telford, D. I. Pritchard

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Objective: We investigated the immunomodulatory ability of licorice (Glycyrrhiza glabra). Such activities could have value for the management of common immunological diseases in dogs, such as environmental allergy. This study investigated the potential of a Licorice root extract (LRE) to influence the relative expression of Th-1, Th-2, and Th-17 cytokines in canine peripheral blood mononuclear cells (PBMC). Methods: A LRE was prepared using an alcoholic-aqueous-based solvent method. The extract was tested in three in vitro assays using canine leukocytes to determine its toxicity and immunoregulatory profile. Extract toxicity was assessed using the human T-lymphocyte cell line, Jurkat E6.1. The impact of the extract on the proliferation of concanavalin-activated canine PBMC was also determined. Finally, the extract was assessed for its ability to influence cytokine release in activated PBMC, measuring culture medium concentrations of interleukin-17, interferon gamma, and interleukin-4. One-way ANOVA followed by Dunnett’s post-test was used for statistics using concanavalin positive control as reference (p ≤ 0.05). Results: There was evidence that the LRE had specific immunomodulatory properties, causing significant inhibition of IL4 expression over a non-toxic/non-cytostatic concentration range (p < 0.001). In the same cell incubations, there was no significant impact on IL17 nor IFNg over the same non-toxic/non-cytostatic concentration range. Conclusion: The study provides in vitro evidence that LRE preferentially reduces the expression of a Th-2-type cytokine, IL4. The dog population, as with humans, is prone to conditions associated with a Th-2 bias of the immune system, such as environmental allergy. Based on these results, licorice merits further evaluation as a useful immune modulator for such allergic diseases.

Keywords: cytokine, Glycyrrhiza glabra, peripheral blood mononuclear cells, T-cell activation

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Authors: Inam Ridha, Christine L. Kuryla, Madhuranga Thilakasiri Madugoda Ralalage Don, Norman J. Kleiman, Yunro Chung, Jin Park, Vel Murugan, Joshua LaBaer

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To date, more than 275 million people worldwide have been diagnosed with COVID-19 and the rapid spread of the omicron variant suggests many millions more will soon become infected. Many infections are asymptomatic, while others result in mild to moderate illness. Unfortunately, some infected individuals exhibit more serious symptoms including respiratory distress, thrombosis, cardiovascular disease, multi-organ failure, cognitive difficulties, and, in roughly 2% of cases, death. Studies indicate other coronaviruses can alter the host cell's epigenetic profile and lead to alterations in the immune response. To better understand the mechanism(s) by which SARS-CoV-2 infection causes serious illness, DNA methylation profiles in peripheral blood mononuclear cells (PBMCs) from 90 hospitalized severely ill COVID-19 patients were compared to profiles from uninfected control subjects. Exploratory epigenome-wide DNA methylation analyses were performed using multiplexed methylated DNA immunoprecipitation (MeDIP) followed by pathway enrichment analysis. The findings demonstrated significant DNA methylation changes in infected individuals as compared to uninfected controls. Pathway analysis indicated that apoptosis, cell cycle control, Toll-like receptors (TLR), cytokine interactions, and T cell differentiation were among the most affected metabolic processes. In addition, changes in specific gene methylation were compared to SARS-CoV-2 induced changes in RNA expression using published RNA-seq data from 3 patients with severe COVID-19. These findings demonstrate significant correlations between differentially methylated and differentially expressed genes in a number of critical pathways.

Keywords: COVID19, epigenetics, DNA mathylation, viral infection

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Authors: Zahra Ashraf

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Flax and pumpkin seeds are a rich source of unsaturated fatty acids, antioxidants and fiber, known to have anti-atherogenic properties. Hypercholesterolemia is a state characterized by the elevated level of cholesterol in the blood. This research was designed to study the effect of flax and pumpkin seeds powder mixture on hypercholesterolemia and body weight. Rat’s species were selected as human representative. Thirty male albino rats were divided into three groups: a control group, a CD-chol group (control diet+cholesterol) fed with 1.5% cholesterol and FP-chol group (flaxseed and pumpkin seed powder+ cholesterol) fed with 1.5% cholesterol. Flax and pumpkin seed powder mixed at proportion of (5/1) (omega-3 and omega-6). Blood samples were collected to examine lipid profile and body weight was also measured. Thus the data was subjected to analysis of variance. In CD-chol group, body weight, total cholesterol TC, triacylglycerides TG in plasma, plasma LDL-C, ratio significantly increased with a decrease in plasma HDL (good cholesterol). In FP-chol group lipid parameters and body weights were decreased significantly with an increase in HDL and decrease in LDL (bad cholesterol). The mean values of body weight, total cholesterol, triglycerides, low density lipoprotein and high density lipoproteins in FP-chol group were 240.66±11.35g, 59.60±2.20mg/dl, 50.20±1.79 mg/dl, 36.20±1.62mg/dl, 36.40±2.20 mg/dl, respectively. Flaxseed and pumpkin seeds powder mixture showed reduction in body weight, serum cholesterol, low density lipoprotein and triglycerides. While significant increase was shown in high density lipoproteins when given to hypercholesterolemic rats. Our results suggested that flax and pumpkin seed mixture has hypocholesterolemic effects which were probably mediated by polyunsaturated fatty acids (omega-3 and omega-6) present in seed mixture.

Keywords: hypercolesterolemia, omega 3 and omega 6 fatty acids, cardiovascular diseases

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Authors: Snehalata Tembhurne

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Introduction: A healthy menstrual cycle is a sign of women’s sound health.Various variables may influence the length and regularity of menstrual cycle.Studies have revealed that menstrual cycle abnormalities may be associated with psychological stress,lack of physical exercise, alteration in body composition,endocrine disturbances,higher estrogen levels as seen in obese females.Hence there is an urgent need to find out the relationship between variations in body mass composition(BMI & body fat%) with menstrual abnormalities like primary dysmenorrhoea. Aim: To find out the relationship between body mass composition and primary dysmenorrhea. Objectives: 1.To check whether there is any association between body mass index and primary dysmenorrhoea.2.To check whether there is any association between body fat percentage and primary dysmenorrhoea. NULL HYPOTHESES-There is no relationship between body mass composition and primary dysmenorrhea. Hypothesis: There exists a relationship between body mass composition and primary dysmenorrhea. Materials and Methods: The study was conducted over a period of 6 months with 90 samples selected on random basis. The procedure was explained to the participant and a written consent was taken thereafter. The participant was made to stand on the BODY COMPOSITION SCANNING MONITOR, which scanned the physical profile of the participant (height, weight, BMI, body fat percentage and visceral fat).Thereafter, the candidate was asked about her menstrual irregularities and was asked to grade her level of dysmenorrhoea (if present) using the Verbal Dimensional Dysmenorrhea Scale. Results: Chi square test of association was used to find out the association between body mass composition(body mass index,body fat percentage) and primary dysmenorrhea.The chi-square value for association between body mass index and primary dysmenorrhea was 38.63 p<0.001 which was statistically significant.The chi-square value for the association of body fat % & primary dysmenorrhea was 30.09,p<0.001which was statistically significant. Conclusion: Study shows that there exists a significant relationship between body mass composition and primary dysmenorrhea and as the value of Body mass index and body fat percentages goes on increasing in females, the severity of primary dysmenorrhea also increases.

Keywords: body mass index, body composition screening monitor, primary dysmenorrhea, verbal dimensional dysmenorrhea scale

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Authors: Raj Raghupathy

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Recurrent Spontaneous Miscarriage (RSM) is a common form of pregnancy loss, 50% of which are due to ‘unexplained’ causes. Evidence exists to suggest that RSM may be caused by immunologic factors such as cytokines which are critical molecules of the immune system, with an impressive array of capabilities. An association appears to exist between Th2-type reactivity (mediated by Th2 or anti-inflammatory cytokines) and normal, successful pregnancy, and between unexplained RSM and Th1 cytokine dominance. If pro-inflammatory cytokines are indeed associated with pregnancy loss, the suppression of these cytokines, and thus the ‘redirection’ of maternal reactivity, may help prevent cytokine-mediated pregnancy loss. The objective of this study was to explore the possibility of modulating cytokine production using Dydrogesterone (Duphaston®), an orally-administered progestogen. Peripheral blood mononuclear cells from 34 women with a history of at least 3 unexplained recurrent miscarriages were stimulated in vitro with a mitogen (to elicit cytokine production) in the presence and absence of dydrogesterone. Levels of selected pro- and anti-inflammatory cytokines produced by peripheral blood mononuclear cells were measured after exposure to these progestogens. Dydrogesterone down-regulates the production of pro-inflammatory cytokines and up-regulates the production of anti-inflammatory cytokines. The ratios of Th2 to Th1 cytokines are markedly elevated in the presence of dydrogesterone, indicating a shift from potentially harmful maternal Th1 reactivity to a more pregnancy-conducive Th2 profile. We used a progesterone receptor antagonist to show that this cytokine-modulating effect of dydrogesterone is mediated via the progesterone receptor. Dydrogesterone also induces the production of the Progesterone-Induced Blocking Factor (PIBF); lymphocytes exposed to PIBF produce higher levels of Th2 cytokines, affecting a Th1 → Th2 cytokine shift which could be favourable to the success of pregnancy. We conclude that modulation of maternal cytokine production profiles is possible with dydrogesterone which has the merits that it can be administered orally and that it is safe.

Keywords: cytokines, dydrogesterone, progesterone, recurrent spontaneous miscarriage

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Authors: Londeka Ntuli, Frasia Oosthuizen

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Background: Tenefovir disiproxil fumarate (TDF) is a nephrotoxic drug and has been proven to contribute to renal insufficiency necessitating intensive monitoring and management of adverse effects arising from prolonged exposure to the drug. TDF is one of the preferred first-line drugs used in combination therapy in most regions. There are estimated 300 000 patients being initiated on the Efavirenz/TDF/Emtricitabine first-line regimen annually in South Africa. It is against this background that this study aims to investigate the effects of TDF on renal sufficiency of HIV positive patients. Methodology: A retrospective quantitative study was conducted, analysing clinical charts of HIV positive patient’s older than 18 years of age and on a TDF-containing regimen for more than 1 year. Data were obtained from the analysis of patient files and was transcribed into Microsoft® Excel® spreadsheet. Extracted data were coded, categorised and analysed using STATA®. Results: A total of 275 patient files were included in this study. Renal function started decreasing after 3 months of treatment (with 93.5% patients having a normal EGFR), and kept on decreasing as time progressed with only 39.6% normal renal function at year 4. Additional risk factors for renal insufficiency included age below 25, female gender, and additional medication. Conclusion: It is clear from this study that the use of TDF necessitates intensive monitoring and management of adverse effects arising from prolonged exposure to the drug. The findings from this study generated pertinent information on the safety profile of the drug TDF in a resource-limited setting of a public health institution. The appropriate management is of tremendous importance in the South African context where the majority of HIV positive individuals are on the TDF containing regimen; thus it is beneficial to ascertain the possible level of toxicities these patients may be experiencing.

Keywords: renal insufficiency, tenefovir, HIV, risk factors

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Authors: Eva Tvrdá, Boris Botman, Marek Halenár, Tomáš Slanina, Norbert Lukáč

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In vitro storage and processing of animal semen represents a risk factor to spermatozoa vitality, potentially leading to reduced fertility. A variety of substances isolated from natural sources may exhibit protective or antioxidant properties on the spermatozoon, thus extending the lifespan of stored ejaculates. This study compared the ability of different concentrations of the Salvia officinalis extract on the motility, mitochondrial activity, viability and reactive oxygen species (ROS) production by bovine spermatozoa during different time periods (0, 2, 6 and 24 h) of in vitro culture. Spermatozoa motility was assessed using the Computer-assisted sperm analysis (CASA) system. Cell viability was examined using the metabolic activity MTT assay, the eosin-nigrosin staining technique was used to evaluate the sperm viability and ROS generation was quantified using luminometry. The CASA analysis revealed that the motility in the experimental groups supplemented with 0.5-2 µg/mL Salvia extract was significantly lower in comparison with the control (P<0.05; Time 24 h). At the same time, a long-term exposure of spermatozoa to concentrations ranging between 0.05 µg/mL and 2 µg/mL had a negative impact on the mitochondrial metabolism (P<0.05; Time 24 h). The viability staining revealed that 0.001-1 µg/mL Salvia extract had no effects on bovine male gametes, however 2 µg/mL Salvia had a persisting negative effect on spermatozoa (P<0.05). Furthermore 0.05-2 µg/mL Salvia exhibited an immediate ROS-promoting effect on the sperm culture (P>0.05; Time 0 h and 2 h), which remained significant throughout the entire in vitro culture (P<0.05; Time 24 h). Our results point out to the necessity to examine specific effects the biomolecules present in Salvia officinalis may have individually or collectively on the in vitro sperm vitality and oxidative profile.

Keywords: bulls, CASA, MTT test, reactive oxygen species, sage, Salvia officinalis, spermatozoa

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Authors: Svetlana Bialkova, Marnix van Gisbergen

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Advanced Virtual Reality (VR) technologies offer compelling multisensory and interactive experiences applicable in various fields from education to entertainment. However, serious VR applications within the financial sector are scarce, and managing ‘real’ business services with(in) VR is a challenge inviting further investigation. The current research addresses this challenge, by exploring the key parameters influencing the VR business power and the development of appropriate VR applications in real financial business. We conducted profound investigation of both B2B and B2C needs, and how these could be met. In three studies, we have approached experts from leading international banks (finance to computer specialists), and their (potential) customers. Study 1 included focus group discussions with experts. First, participants could experience different VR devices such as Samsung Gear VR, then a structured discussion was held. The outcomes are analyzed and summarized in a portfolio. Study 2 further used the portfolio analyzer to profile the management of real business services with(in) VR. Again experts participated, where first being introduced with Samsung Gear, then experiencing it and being interviewed. Based on the outcomes, a survey was developed to interview (potential) customers and test ideas created (Study 3). The results suggest that developing proper system architectures to connect people and to connect devices is crucial for building up powerful business with(in) VR. From one side, connecting devices, e.g., pairing mobile Head Mounted Displays for VR with smart-phones and/or wearable technologies would be appropriate way “to have” customers anywhere, anytime with a brand and/or business. Developing VR Apps, providing detailed real time visualization of performance and infrastructure types could enable 3D VR navigation, 3D contents viewing, but also being opportunity for connecting people in collaborative platforms. The outcomes of the current research are summarized in a model which could be applied to unlock the real business power of VR.

Keywords: business power, B2B, B2C, VR applications

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Authors: Ramin Dabirian, Yi Zhang, Ilias Gavrielatos, Ram Mohan, Ovadia Shoham

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Oil-water emulsions can be found in almost every part of the petroleum industry, namely in reservoir rocks, drilling cuttings circulation, production in wells, transportation pipelines, surface facilities and refining process. However, it is necessary for oil production and refinery engineers to resolve the petroleum emulsion problems as well as to eliminate the contaminants in order to meet environmental standards, achieve the desired product quality and to improve equipment reliability and efficiency. A state-of-art Dispersion Characterization Rig (DCR) has been utilized to investigate crude oil-distilled water dispersion separation. Over 80 experimental tests were ran to investigate the flow behavior and stability of the dispersions. The experimental conditions include the effects of water cuts (25%, 50% and 75%), NaCl concentrations (0, 3.5% and 18%), mixture flow velocities (0.89 and 1.71 ft/s), and also orifice place types on the separation rate. The experimental data demonstrate that the water cut can significantly affects the separation time and efficiency. The dispersion with lower water cut takes longer time to separate and have low separation efficiency. The medium and lower water cuts will result in the formation of Mousse emulsion and the phase inversion happens around the medium water cut. The data also confirm that increasing the NaCl concentration in aqueous phase can increase the crude oil water dispersion separation efficiency especially at higher salinities. The separation profile for dispersions with lower salt concentrations has a lower sedimentation rate slope before the inflection point. Dispersions in all tests with higher salt concentrations have a larger sedimenting rate. The presence of NaCl can influence the interfacial tension gradients along the interface and it plays a role in avoiding the Mousse emulsion formation.

Keywords: oil-water dispersion, separation mechanism, phase inversion, emulsion formation

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Authors: Ekaterina Zubkova, Irina Beloglazova, Iurii Stafeev, Konsyantin Dergilev, Yelena Parfyonova, Mikhail Menshikov

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Mesenchymal stromal cells from adipose tissue (MSC) currently are widely used in regenerative medicine to restore the function of damaged tissues, but that is significantly hampered by their heterogeneity. One of the modern approaches to overcoming this obstacle is the polarization of cell subpopulations into a specific phenotype under the influence of cytokines and other factors that activate receptors and signal transmission to cells. We polarized MSC with factors affecting the inflammatory signaling and functional properties of cells, followed by verification of their expression profile and ability to affect the polarization of macrophages. RT-PCR evaluation showed that cells treated with LPS, interleukin-17, tumor necrosis factor α (TNF α), primarily express pro-inflammatory factors and cytokines, and after treatment with polyninosin polycytidic acid and interleukin-4 (IL4) anti-inflammatory factors and some proinflammatory factors. MSC polarized with pro-inflammatory cytokines showed a more robust pro-angiogenic effect in fibrin gel bead 3D angiogenesis assay. Further, we evaluated the possibility of paracrine effects of MSCs on the polarization of intact macrophages. Polarization efficiency was assesed by expression of M1/M2 phenotype markers CD80 and CD206. We showed that conditioned media from MSC preincubated in the presence of IL-4 cause an increase in CD206 expression similar to that observed in M2 macrophages. Conditioned media from MSC polarized in the presence of LPS or TNF-α increased the expression of CD80 antigen in macrophages, similar to that observed in M1 macrophages. In other cases, a pronounced paracrine effect of MSC on the polarization of macrophages was not detected. Thus, our study showed that the polarization of MSC along the pro-inflammatory or anti-inflammatory pathway allows us to obtain cell subpopulations that have a multidirectional modulating effect on the polarization of macrophages. (RFBR grants 20-015-00405 and 18-015-00398.)

Keywords: angiogenesis, cytokines, mesenchymal, polarization, inflammation

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Authors: Erin V. Kelly, Nicola C. Newton, Lexine A. Stapinski, Maree Teesson

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Introduction: There is a lack of targeted prevention programs for reducing bullying and distress among adolescents involved in bullying. The current study aimed to examine the impact of a personality-targeted intervention (Preventure) on bullying (victimization and perpetration) and distress among adolescent victims/bullies with high-risk personality types. Method: A cluster randomized trial (RCT) was conducted in 26 secondary schools (2190 students) in NSW and Victoria, Australia, as part of the Climate Schools and Preventure trial. The schools were randomly allocated to Preventure (13 schools received Preventure, 13 did not). Students were followed up at 4 time points (6, 12, 24 and 36 months post-baseline). Preventure involves two group sessions, based on cognitive behavioral therapy, and tailored to four personality types shown to increase risk of substance misuse and other emotional and behavioural problems, including impulsivity, sensation-seeking, anxiety sensitivity and hopelessness. Students were allocated to the personality-targeted groups based on their scores on the Substance Use Risk Profile Scale. Bullying was measured using an amended version of the Revised Olweus Bully/Victim Scale. Psychological distress was measured using the Kessler Psychological Distress Scale. Results: Among high-risk students classified as victims at baseline, those in Preventure schools reported significantly less victimization and distress over time than those in control schools. Among high-risk students classified as bullies at baseline, those in Preventure schools reported significantly less distress over time than those in control schools (no difference for perpetration). Conclusion: Preventure is a promising intervention for reducing bullying victimization and psychological distress among adolescents involved in bullying.

Keywords: adolescents, bullying, personality, prevention

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Authors: Ning Li, Jiacheng Zhang, Zheng Yang, Sylvia Kang

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Introduction: Polycystic ovary syndrome (PCOS) is a common physiological symptom in women of reproductive age. Women with PCOS may have infrequent or prolonged menstrual periods and excess male hormone (androgen) levels. Mira analyzes the cycle profiles and the luteinizing hormone (LH) changes in urine, closely related to the fertility level of healthy women and PCOS women. From the difference between the two groups, Mira helps to understand the physiological state of PCOS women and their hormonal changes in the menstrual cycle. Methods: In this study, data from 1496 cycles and information from 342 women belonging to two groups (181 PCOS and 161 Healthy) were collected and analyzed. Women test their luteinizing hormone (LH) in urine daily with Mira fertility test wand and Mira analyzer, from the day after the menstruation to the starting day of the next menstruation. All the collected data meets Mira’s user agreement and users’ identification was removed. The cycle length, LH peak, and other cycle information of the PCOS group were compared with the Healthy group. Results: The average cycle length of PCOS women is 41 days and of the Healthy women is 33 days. 91.4% of cycle length is within 40 days for the Healthy group, while it decreases to 71.9% for the PCOS group. This means PCOS women have a longer menstrual cycle and more variation during the cycle. With more variation, the ovulation prediction becomes more difficult for the PCOS group. The deviation between the LH surge day and the predicted ovulation day, calculated by the starting day of the next menstruation minus 14 days, is greater in the PCOS group compared with the Healthy group. Also, 46.96% of PCOS women have an irregular cycle, and only 19.25% of healthy women show an irregular cycle. Conclusion: PCOS women have longer menstrual cycles and more variation during the menstrual cycles. The traditional ovulation prediction is not suitable for PCOS women.

Keywords: menstrual cycle, PCOS, urinary luteinizing hormone, Mira

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Authors: H. Shokouhmand, M. Tajerian

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A numerical investigation of laminar forced convection flows through a square cross section micro heat pipe by applying electrohydrodynamic (EHD) field has been studied. In the present study, pentane is selected as working fluid. Temperature and velocity profiles and heat transfer enhancement in the micro heat pipe by using EHD field at the two-dimensional and single phase fluid flow in steady state regime have been numerically calculated. At this model, only Coulomb force is considered. The study has been carried out for the Reynolds number 10 to 100 and EHD force field up to 8 KV. Coupled, non-linear equations governed on the model (continuity, momentum, and energy equations) have been solved simultaneously by CFD numerical methods. Steady state behavior of affecting parameters, e.g. friction factor, average temperature, Nusselt number and heat transfer enhancement criteria, have been evaluated. It has been observed that by increasing Reynolds number, the effect of EHD force became more significant and for smaller Reynolds numbers the rate of heat transfer enhancement criteria is increased. By obtaining and plotting the mentioned parameters, it has been shown that the EHD field enhances the heat transfer process. The numerical results show that by increasing EHD force field the absolute value of Nusselt number and friction factor increases and average temperature of fluid flow decreases. But the increasing rate of Nusselt number is greater than increasing value of friction factor, which makes applying EHD force field for heat transfer enhancement in micro heat pipes acceptable and applicable. The numerical results of model are in good agreement with the experimental results available in the literature.

Keywords: micro heat pipe, electrohydrodynamic force, Nusselt number, average temperature, friction factor

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Authors: Camilo Andrés Agudelo Vélez, Lina María Martínez Sánchez, Isabel Cristina Ortiz Trujillo, Evert Armando Jiménez Cotes, Natalia Perilla Hernández, María de los Ángeles Rodríguez Gázquez, Daniel Duque Restrepo, Felipe Hernández Restrepo, Dayana Andrea Quintero Moreno, Juan José Builes Gómez, Camilo Ruiz Mejía, Ana Lucia Arango Gómez

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Preeclampsia is a clinical complication during pregnancy with high incidence in Colombia; therefore, it is important to evaluate the influence of external conditions and medical interventions, in order to promote measures that encourage improvements in the quality of life. Objective: Determine clinical and sociodemographic variables in women with preeclampsia. Methods: This cross-sectional study enrolled 50 patients with the diagnosis of preeclampsia, from a private institution in Medellin, during 2015. We used the software SPSS ver.20 for statistical analysis. For the qualitative variables, we calculated the mean and standard deviation, while, for ordinal and nominal levels of quantitative variables, ratios were estimated. Results: The average age was 26.8±5.9 years. The predominant characteristics were socioeconomic stratum 2 (48%), students (55%), mixed race (46%) and middle school as level of education (38%). As for clinical features, 72% of the cases were mild preeclampsia, and 22% were severe forms. The most common clinical manifestations were edema (46%), headache (62%), and proteinuria (55%). As for the Gyneco-obstetric history, 8% reported previous episodes of this disease and it was the first pregnancy for 60% of the patients. Conclusions: Preeclampsia is a frequent condition in young women; on the other hand, headache and edema were the most common reasons for consultation, therefore, doctors need to be aware of these symptoms in pregnant women.

Keywords: pre-eclampsia, hypertension, pregnancy complications, pregnancy, abdominal, edema

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Authors: Mahboubeh Kabiri, Saba Aslani

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Among various approaches used for the treatment of cardiovascular diseases, the occlusion of the small-diameter vascular graft (SDVG) is still an unresolved problem which seeks further research to address them. Though autografts are now the gold standards to be replaced for blocked coronary arteries, they suffer from inadequate quality and quantity. On the other hand, the major problems of the tissue engineered grafts are thrombosis and intimal hyperplasia. Provision of a suitable spatiotemporal release pattern of anticoagulant agents such as heparin and aspirin can be a step forward to overcome such issues . Herein, we fabricated electrospun scaffolds from FDA (Food and Drug Administration) approved poly-L-lactic acid (PLLA) with aspirin loaded into the nanofibers. Also, we surface coated the scaffolds with Amniotic Membrane lysate as a source for natural elastic polymers and a mimic of endothelial basement membrane. The scaffolds were characterized thoroughly structurally and mechanically for their morphology, fiber orientation, tensile strength, hydrophilicity, cytotoxicity, aspirin release and cell attachment support. According to the scanning electron microscopy (SEM) images, the size of fibers ranged from 250 to 500 nm. The scaffolds showed appropriate tensile strength expected for vascular grafts. Cellular attachment, growth, and infiltration were proved using SEM and MTT (3-(4,5-Dimethylthiazol-2-Yl)-2,5-Diphenyltetrazolium Bromide) assay. Drug-loaded scaffolds showed a sustained release profile of aspirin in 7 days. An enhanced cytocompatibility was observed in AM-coated electrospun PLLA fibers compared to uncoated scaffolds. Our results together indicated that AM lysate coated ASA releasing scaffolds have promising potentials for development of a biocompatible SDVG.

Keywords: vascular tissue engineering, vascular grafts, anticoagulant agent, aspirin, amniotic membrane

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Authors: Hatem I. Mokhtar, Randa A. Abd-El-Salam, Ghada M. Hadad

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An improved nano-composite of self-doped polyaniline nanofibers and silica-coated magnetite nanoparticles were prepared and evaluated for suitability to magnetic dispersive micro solid-phase extraction. The work focused on optimization of the composite capacity to extract four fluoroquinolones (FQs) antibiotics, ciprofloxacin, enrofloxacin, danofloxacin, and difloxacin from water and improvement of composite stability towards acid and atmospheric degradation. Self-doped polyaniline nanofibers were prepared by oxidative co-polymerization of aniline with anthranilic acid. Magnetite nanopariticles were prepared by alkaline co-precipitation and coated with silica by silicate hydrolysis on magnetite nanoparticles surface at pH 6.5. The composite was formed by self-assembly by mixing self-doped polyaniline nanofibers with silica-coated magnetite nanoparticles dispersions in ethanol. The composite structure was confirmed by transmission electron microscopy (TEM). Self-doped polyaniline nanofibers and magnetite chemical structures were confirmed by FT-IR while silica coating of the magnetite was confirmed by Energy Dispersion X-ray Spectroscopy (EDS). Improved stability of the composite magnetic component was evidenced by resistance to degrade in 2N HCl solution. The adsorption capacity of self-doped polyaniline nanofibers based composite was higher than previously reported corresponding composite prepared from polyaniline nanofibers instead of self-doped polyaniline nanofibers. Adsorption-pH profile for the studied FQs on the prepared composite revealed that the best pH for adsorption was in range of 6.5 to 7. Best extraction recovery values were obtained at pH 7 using phosphate buffer. The best solvent for FQs desorption was found to be 0.1N HCl in methanol:water (8:2; v/v) mixture. 20 mL of Spiked water sample with studied FQs were preconcentrated using 4.8 mg of composite and resulting extracts were analysed by HPLC-UV method. The prepared composite represented a suitable adsorbent phase for magnetic dispersive micro-solid phase application.

Keywords: fluoroquinolones, magnetic dispersive micro extraction, nano-composite, self-doped polyaniline nanofibers

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Authors: Nataša Šimić, Ljiljana Gregov, Matilda Nikolić, Andrea Tokić, Ana Proroković

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Moral development takes place in six phases which can be divided in a pre-conventional, conventional and post-conventional level. Moral reasoning, as a key concept of moral development theories, involves a process of discernment/inference in doubtful situations. In research to date, education has proved to be a significant predictor of moral reasoning. The aim of this study was to investigate differences in moral reasoning and Kohlberg's phases of moral development between Croatian adolescents with different levels of education. In Study 1 comparisons between the group of secondary school students aged 17-18 (N=192) and the group of university students aged 21-25 (N=383) were made. Study 2 included comparison between university students group (N=69) and non-students group (N=43) aged from 21 to 24 (these two groups did not differ in age). In both studies, the Croatian Test of Moral Reasoning by Proroković was applied. As a measure of moral reasoning, the Index of Moral Reasoning (IMR) was calculated. This measure has some advantages compared to other measures of moral reasoning, and includes individual assessments of deviations from the ‘optimal profile’. Results of the Study 1 did not show differences in the IMR between secondary school students and university students. Both groups gave higher assessments to the arguments that correspond to higher phases of moral development. However, group differences were found for pre-conventional and conventional phases. As expected, secondary school students gave significantly higher assessments to the arguments that correspond to lower phases of moral development. Results of the Study 2 showed that university students, in relation to non-students, have higher IMR. Respecting to phases of moral development, both groups of participants gave higher assessments to the arguments that correspond to the post-conventional phase. Consistent with expectations and previous findings, results of both studies did not confirm gender differences in moral reasoning.

Keywords: education, index of moral reasoning, Kohlberg's theory of moral development, moral reasoning

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Authors: Klary Geisler, Dalit Lev-Arey, Yael Hacohen

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It is a well-known fact that exercise has favorable effects on people's physical health, as well as mental well-being. However, as for as excessive exercise, it may likely elevate negative consequences (e.g., physical injuries, negligence of everyday responsibilities such as work, family life). Lately, there is a growing interest in exercise addiction, sometimes referred to as exercise dependence, which is defined as a craving for physical activity that results in extreme work-out sessions and generates negative physiological and psychological symptoms (e.g., withdrawal symptoms, tolerance, social conflict). Exercise addiction is considered a behavioral addiction, yet it was not included in the latest editions of the diagnostic and statistical manual of mental disorders (DSM-IV), due to lack of significant research. Specifically, there is scarce research on the relationship between exercise addiction and personality dimensions. The purpose of the current research was to examine the relationship between primary exercise addiction symptoms and the big five dimensions, perfectionism (high performance expectations and self-critical performance evaluations) and subjective affect. participants were 152 trainees on a variety of aerobic sports activities (running, cycling, swimming) that were recruited through sports groups and trainers. 88% of participants trained for at least 5 hours per week, 24% of the participants trained above 10 hours per week. To test the predictive ability of the IVs a hierarchical linear regression with forced block entry was performed. It was found that Neuroticism significantly predicted exercise addiction symptoms (20% of the variance, p<0.001), while consciousness was negatively correlated with exercise addiction symptoms (14% of variance p<0.05); both had a unique contribution. Other dimensions of the big five (agreeableness, openness and extraversion) did not have any contribution to the dependent. Moreover, maladaptive perfectionism (self-critical performance evaluations) significantly predicted exercise addiction symptoms as well (10% of the variance P < 0.05). The overall regression model explained 54% of variance.

Keywords: big five, consciousness, excessive exercise, exercise addiction, neuroticism, perfectionism, personality

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Authors: Douglas Arthur, Oluwayemisi Ekor, Ernest Obese, Andrew Kissi Agyei, Elvis Ofori Ameyaw

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bjective: Pain negatively impacts every aspect of health, and patients with pain disorders create enormous demands on healthcare systems globally, costing economies up to $635 billion annually. The study was therefore conducted at the Cape Coast Teaching Hospital (CCTH), the only Tertiary Hospital in the Central Region of Ghana and was designed to assess pain disorders in patients between 18 and 90 years attending Urology Clinic. Methods: The study employed a descriptive cross-sectional design, and 149 subjects (16-24, 25-34, 35-44, 45-54, 55-64, 65-90 years) were conveniently selected. The McGill Pain Questionnaire (MPQ), a multidimensional instrument that assesses several aspects of pain by the use of words (descriptors) that the patient chooses to express his/her pain, was used as the primary instrument for data collection. A patient profile form (PPF) was also designed to document the demographics and history of patients. Results: The prevalence of pain disorders was higher among females compared to males. The univariate and multivariate analysis showed that females were more likely to experience pain while being married correlated with a lower likelihood of pain. Again, the 45-54 age group exhibited the highest prevalence of pain disorders. Results from the MPQ showed that half of the patients experienced pain on a daily basis, 15.91% had experienced pain for 3-6 months and 37% experienced pain for more than one year. Pain intensity was described by 25% of the subjects as excruciating for their worst pain experience, followed by 21% for the distressing experience. The most frequently reported area of pain was the abdominal region (22.72%). The co-administration of NSAIDs and opioid compounds was provided for 17.46% of the patients with chronic pain. Conclusion: The treatment interventions improved the pain and associated symptoms such as nausea, improved daily activities and ability to sleep. However, attention and resources should be devoted to 45-54 age group.

Keywords: pain, opioids, distressing, excruciating

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Authors: Anil Kumar Baral

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The research introduces a ground-breaking approach to waste management, emphasizing innovation, education, and transformation. Using Chandragiri Municipality as a case study, the study advocates a shift from traditional to progressive waste management strategies, contributing an inventive waste framework, sustainability advocacy, and a transformative blueprint. The waste composition analysis highlights Chandragiri's representative profile, leading to a comprehensive plan addressing challenges and recommending a transition to a profitable waste treatment model, supported by relevant statistics. The data-driven approach incorporates the official data of waste Composition from Chandragiri Municipality as secondary data and incorporates the primary data from Chandragiri households, ensuring a nuanced perspective. Discussions on implementation, viability, and environmental preservation underscore the dual benefit of sustainability. The study includes a comparative analysis, monitoring, and evaluation framework, examining international relevance and collaboration, and conducting a social and environmental impact assessment. The results indicate the necessity for creative changes in Chandragiri's waste practices, recommending separate treatment centers in wards level rather than Municipal level, composting machines, and a centralized waste treatment plant. Educational reforms involve revising school curricula and awareness campaigns. The transformation's success hinges on reducing waste size, efficient treatment center operation, and ongoing public literacy. The conclusion summarizes key findings, envisioning a future with sustainable waste management practices deeply embedded in the community fabric.

Keywords: innovate, educate, transform, municipality, method

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