Search results for: death level differences
672 Bone Mineralization in Children with Wilson’s Disease
Authors: Shiamaa Eltantawy, Gihan Sobhy, Alif Alaam
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Wilson disease, or hepatolenticular degeneration, is an autosomal recessive disease that results in excess copper buildup in the body. It primarily affects the liver and basal ganglia of the brain, but it can affect other organ systems. Musculoskeletal abnormalities, including premature osteoarthritis, skeletal deformity, and pathological bone fractures, can occasionally be found in WD patients with a hepatic or neurologic type. The aim was to assess the prevalence of osteoporosis and osteopenia in Wilson’s disease patients. This case-control study was conducted on ninety children recruited from the inpatient ward and outpatient clinic of the Paediatric Hepatology, Gastroenterology, and Nutrition department of the National Liver Institute at Menofia University, aged from 1 to 18 years. Males were 49, and females were 41. Children were divided into three groups: (Group I) consisted of thirty patients with WD; (Group II) consisted of thirty patients with chronic liver disease other than WD; (Group III) consisted of thirty age- and sex-matched healthy The exclusion criteria were patients with hyperparathyroidism, hyperthyroidism, renal failure, Cushing's syndrome, and patients on certain drugs such as chemotherapy, anticonvulsants, or steroids. All patients were subjected to the following: 1- Full history-taking and clinical examination. 2-Laboratory investigations: (FBC,ALT,AST,serum albumin, total protein, total serum bilirubin,direct bilirubin,alkaline phosphatase, prothrombin time, serum critine,parathyroid hormone, serum calcium, serum phosphrus). 3-Bone mineral density (BMD, gm/cm2) values were measured by dual-energy X-ray absorptiometry (DEXA). The results revealed that there was a highly statistically significant difference between the three groups regarding the DEXA scan, and there was no statistically significant difference between groups I and II, but the WD group had the lowest bone mineral density. The WD group had a large number of cases of osteopenia and osteoporosis, but there was no statistically significant difference with the group II mean, while a high statistically significant difference was found when compared to group III. In the WD group, there were 20 patients with osteopenia, 4 patients with osteoporosis, and 6 patients who were normal. The percentages were 66.7%, 13.3%, and 20%, respectively. Therefore, the largest number of cases in the WD group had osteopenia. There was no statistically significant difference found between WD patients on different treatment regimens regarding DEXA scan results (Z-Score). There was no statistically significant difference found between patients in the WD group (normal, osteopenic, or osteoporotic) regarding phosphorus (mg/dL), but there was a highly statistically significant difference found between them regarding ionised Ca (mmol/L). Therefore, there was a decrease in bone mineral density when the Ca level was decreased. In summary, Wilson disease is associated with bone demineralization. The largest number of cases in the WD group in our study had osteopenia (66.7%). Different treatment regimens (zinc monotherapy, Artamin, and zinc) as well as different laboratory parameters have no effect on bone mineralization in WD cases. Decreased ionised Ca is associated with low BMD in WD patients. Children with WD should be investigated for BMD.Keywords: wilson disease, Bone mineral density, liver disease, osteoporosis
Procedia PDF Downloads 47671 Effects of Soil Neutron Irradiation in Soil Carbon Neutron Gamma Analysis
Authors: Aleksandr Kavetskiy, Galina Yakubova, Nikolay Sargsyan, Stephen A. Prior, H. Allen Torbert
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The carbon sequestration question of modern times requires the development of an in-situ method of measuring soil carbon over large landmasses. Traditional chemical analytical methods used to evaluate large land areas require extensive soil sampling prior to processing for laboratory analysis; collectively, this is labor-intensive and time-consuming. An alternative method is to apply nuclear physics analysis, primarily in the form of pulsed fast-thermal neutron-gamma soil carbon analysis. This method is based on measuring the gamma-ray response that appears upon neutron irradiation of soil. Specific gamma lines with energies of 4.438 MeV appearing from neutron irradiation can be attributed to soil carbon nuclei. Based on measuring gamma line intensity, assessments of soil carbon concentration can be made. This method can be done directly in the field using a specially developed pulsed fast-thermal neutron-gamma system (PFTNA system). This system conducts in-situ analysis in a scanning mode coupled with GPS, which provides soil carbon concentration and distribution over large fields. The system has radiation shielding to minimize the dose rate (within radiation safety guidelines) for safe operator usage. Questions concerning the effect of neutron irradiation on soil health will be addressed. Information regarding absorbed neutron and gamma dose received by soil and its distribution with depth will be discussed in this study. This information was generated based on Monte-Carlo simulations (MCNP6.2 code) of neutron and gamma propagation in soil. Received data were used for the analysis of possible induced irradiation effects. The physical, chemical and biological effects of neutron soil irradiation were considered. From a physical aspect, we considered neutron (produced by the PFTNA system) induction of new isotopes and estimated the possibility of increasing the post-irradiation gamma background by comparisons to the natural background. An insignificant increase in gamma background appeared immediately after irradiation but returned to original values after several minutes due to the decay of short-lived new isotopes. From a chemical aspect, possible radiolysis of water (presented in soil) was considered. Based on stimulations of radiolysis of water, we concluded that the gamma dose rate used cannot produce gamma rays of notable rates. Possible effects of neutron irradiation (by the PFTNA system) on soil biota were also assessed experimentally. No notable changes were noted at the taxonomic level, nor was functional soil diversity affected. Our assessment suggested that the use of a PFTNA system with a neutron flux of 1e7 n/s for soil carbon analysis does not notably affect soil properties or soil health.Keywords: carbon sequestration, neutron gamma analysis, radiation effect on soil, Monte-Carlo simulation
Procedia PDF Downloads 127670 Research on Reducing Food Losses by Extending the Date of Minimum Durability on the Example of Cereal Products
Authors: Monika Trzaskowska, Dorota Zielinska, Anna Lepecka, Katarzyna Neffe-Skocinska, Beata Bilska, Marzena Tomaszewska, Danuta Kolozyn-Krajewska
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Microbiological quality and food safety are important food characteristics. Regulation (EU) No 1169/2011 of the European Parliament and of the Council on the provision of food information to consumers introduces the obligation to provide information on the 'use-by' date or the date of minimum durability (DMD). The second term is the date until which the properly stored or transported foodstuff retains its physical, chemical, microbiological and organoleptic properties. The date should be preceded by 'best before'. It is used for durable products, e.g., pasta. In relation to reducing food losses, the question may be asked whether products with the date of minimum durability currently declared retain quality and safety beyond this. The aim of the study was to assess the sensory quality and microbiological safety of selected cereal products, i.e., pasta and millet after DMD. The scope of the study was to determine the markers of microbiological quality, i.e., the total viable count (TVC), the number of bacteria from the Enterobacteriaceae family and the number of yeast and mold (TYMC) on the last day of DMD and after 1 and 3 months of storage. In addition, the presence of Salmonella and Listeria monocytogenes was examined on the last day of DMD. The sensory quality of products was assessed by quantitative descriptive analysis (QDA), the intensity of 14 differentiators and overall quality were defined and determined. In the tested samples of millet and pasta, no pathogenic bacteria Salmonella and Listeria monocytogenes were found. The value of the distinguishing features of selected quality and microbiological safety indicators on the last DMD day was in the range of about 3-1 log cfu/g. This demonstrates the good microbiological quality of the tested food. Comparing the products, a higher number of microorganisms was found in the samples of millet. After 3 months of storage, TVC decreased in millet, while in pasta, it was found to increase in value. In both products, the number of bacteria from the Enterobacretiaceae family decreased. In contrast, the number of TYMCs increased in samples of millet, and in pasta decreased. The intensity of sensory characteristic in the studied period varied. It remained at a similar level or increased. Millet was found to increase the intensity and flavor of 'cooked porridge' 3 months after DMD. Similarly, in the pasta, the smell and taste of 'cooked pasta' was more intense. To sum up, the researched products on the last day of the minimum durability date were characterized by very good microbiological and sensory quality, which was maintained for 3 months after this date. Based on these results, the date of minimum durability of tested products could be extended. The publication was financed on the basis of an agreement with the National Center for Research and Development No. Gospostrateg 1/385753/1/NCBR/2018 for the implementation and financing of the project under the strategic research and development program 'social and economic development of Poland in the conditions of globalizing markets – GOSPOSTRATEG - acronym PROM'.Keywords: date of minimum durability, food losses, food quality and safety, millet, pasta
Procedia PDF Downloads 154669 Perceived Procedural Justice and Organizational Citizenship Behavior: Evidence from a Security Organization
Authors: Noa Nelson, Orit Appel, Rachel Ben-ari
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Organizational Citizenship Behavior (OCB) is voluntary employee behavior that contributes to the organization beyond formal job requirements. It can take different forms, such as helping teammates (OCB toward individuals; hence, OCB-I), or staying after hours to attend a task force (OCB toward the organization; hence, OCB-O). Generally, OCB contributes substantially to organizational climate, goals, productivity, and resilience, so organizations need to understand what encourages it. This is particularly challenging in security organizations. Security work is characterized by high levels of stress and burnout, which is detrimental to OCB, and security organizational design emphasizes formal rules and clear hierarchies, leaving employees with less freedom for voluntary behavior. The current research explored the role of Perceived Procedural Justice (PPJ) in enhancing OCB in a security organization. PPJ refers to how fair decision-making processes are perceived to be. It involves the sense that decision makers are objective, attentive to everyone's interests, respectful in their communications and participatory - allowing individuals a voice in decision processes. Justice perceptions affect motivation, and it was specifically suggested that PPJ creates an attachment to one's organization and personal interest in its success. Accordingly, PPJ had been associated with OCB, but hardly any research tested their association with security organizations. The current research was conducted among prison guards in the Israel Prison Service, to test a correlational and a causal association between PPJ and OCB. It differentiated between perceptions of direct commander procedural justice (CPJ), and perceptions of organization procedural justice (OPJ), hypothesizing that CPJ would relate to OCB-I, while OPJ would relate to OCB-O. In the first study, 336 prison guards (305 male) from 10 different prisons responded to questionnaires measuring their own CPJ, OPJ, OCB-I, and OCB-O. Hierarchical linear regression analyses indicated the significance of commander procedural justice (CPJ): It associated with OCB-I and also associated with OPJ, which, in turn, associated with OCB-O. The second study tested CPJ's causal effects on prison guards' OCB-I and OCB-O; 311 prison guards (275 male) from 14 different prisons read scenarios that described either high or low CPJ, and then evaluated the likelihood of that commander's prison guards performing OCB-I and OCB-O. In this study, CPJ enhanced OCB-O directly. It also contributed to OCB-I, indirectly: CPJ enhanced the motivation for collaboration with the commander, which respondents also evaluated after reading scenarios. Collaboration, in turn, associated with OCB-I. The studies demonstrate that procedural justice, especially commander's PJ, promotes OCB in security work environments. This is important because extraordinary teamwork and motivation are needed to deal with emergency situations and with delicate security challenges. Following the studies, the Israel Prison Service implemented personal procedural justice training for commanders and unit level programs for procedurally just decision processes. From a theoretical perspective, the studies extend the knowledge on PPJ and OCB to security work environments and contribute evidence on PPJ's causal effects. They also call for further research, to understand the mechanisms through which different types of PPJ affect different types of OCB.Keywords: organizational citizenship behavior, perceived procedural justice, prison guards, security organizations
Procedia PDF Downloads 213668 Electroactive Fluorene-Based Polymer Films Obtained by Electropolymerization
Authors: Mariana-Dana Damaceanu
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Electrochemical oxidation is one of the most convenient ways to obtain conjugated polymer films as polypyrrole, polyaniline, polythiophene or polycarbazole. The research in the field has been mainly directed to the study of electrical conduction properties of the materials obtained by electropolymerization, often the main reason being their use as electroconducting electrodes, and very little attention has been paid to the morphological and optical quality of the films electrodeposited on flat surfaces. Electropolymerization of the monomer solution was scarcely used in the past to manufacture polymer-based light-emitting diodes (PLED), most probably due to the difficulty of obtaining defectless polymer films with good mechanical and optical properties, or conductive polymers with well controlled molecular weights. Here we report our attempts in using electrochemical deposition as appropriate method for preparing ultrathin films of fluorene-based polymers for PLED applications. The properties of these films were evaluated in terms of structural morphology, optical properties, and electrochemical conduction. Thus, electropolymerization of 4,4'-(9-fluorenylidene)-dianiline was performed in dichloromethane solution, at a concentration of 10-2 M, using 0.1 M tetrabutylammonium tetrafluoroborate as electrolyte salt. The potential was scanned between 0 and 1.3 V on the one hand, and 0 - 2 V on the other hand, when polymer films with different structures and properties were obtained. Indium tin oxide-coated glass substrate of different size was used as working electrode, platinum wire as counter electrode and calomel electrode as reference. For each potential range 100 cycles were recorded at a scan rate of 100 mV/s. The film obtained in the potential range from 0 to 1.3 V, namely poly(FDA-NH), is visible to the naked eye, being light brown, transparent and fluorescent, and displays an amorphous morphology. Instead, the electrogrowth poly(FDA) film in the potential range of 0 - 2 V is yellowish-brown and opaque, presenting a self-assembled structure in aggregates of irregular shape and size. The polymers structure was identified by FTIR spectroscopy, which shows the presence of broad bands specific to a polymer, the band centered at approx. 3443 cm-1 being ascribed to the secondary amine. The two polymer films display two absorption maxima, at 434-436 nm assigned to π-π* transitions of polymers, and another at 832 and 880 nm assigned to polaron transitions. The fluorescence spectra indicated the presence of emission bands in the blue domain, with two peaks at 422 and 488 nm for poly (FDA-NH), and four narrow peaks at 422, 447, 460 and 484 nm for poly(FDA), peaks originating from fluorene-containing segments of varying degrees of conjugation. Poly(FDA-NH) exhibited two oxidation peaks in the anodic region and the HOMO energy value of 5.41 eV, whereas poly(FDA) showed only one oxidation peak and the HOMO level localized at 5.29 eV. The electrochemical data are discussed in close correlation with the proposed chemical structure of the electrogrowth films. Further research will be carried out to study their use and performance in light-emitting devices.Keywords: electrogrowth polymer films, fluorene, morphology, optical properties
Procedia PDF Downloads 337667 Aspiring to Achieve a Fairer Society
Authors: Bintou Jobe
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Background: The research is focused on the concept of equality, diversity, and inclusion (EDI) and the need to achieve equity by treating individuals according to their circumstances and needs. The research is rooted in the UK Equality Act 2010, which emphasizes the importance of equal opportunities for all individuals regardless of their background and social life. However, inequality persists in society, particularly for those from minority backgrounds who face discrimination. Research Aim: The aim of this research is to promote equality, diversity, and inclusion by encouraging the regeneration of minds and the eradication of stereotypes. The focus is on promoting good Equality, Diversity and Inclusion practices in various settings, including schools, colleges, universities, and workplaces, to create environments where every individual feels a sense of belonging. Methodology: The research utilises a literature review approach to gather information on promoting inclusivity, diversity, and inclusion. Findings: The research highlights the significance of promoting equality, diversity, and inclusion practices to ensure that individuals receive the respect and dignity they deserve. It emphasises the importance of treating individuals based on their unique circumstances and needs rather than relying on stereotypes. The research also emphasises the benefits of diversity and inclusion in enhancing innovation, creativity, and productivity. The theoretical importance of this research is to raise awareness about the importance of regenerating minds, challenging stereotypes, and promoting equality, diversity, and inclusion. The emphasis is on treating individuals based on their circumstances and needs rather than relying on generalizations. Diversity and inclusion are beneficial in different settings, as highlighted by the research. By raising awareness about the importance of mind regeneration, eradicating stereotypes, and promoting equality, diversity, and inclusion, this research makes a significant contribution to the subject area. It emphasizes the necessity of treating individuals based on their unique circumstances instead of relying on generalizations. However, the methodology could be strengthened by incorporating primary research to complement the literature review approach. Data Collection and Analysis Procedures: The research utilised a literature review approach to gather relevant information on promoting inclusivity, diversity, and inclusion. NVivo software application was used to analysed and synthesize the findings to identify themes and support the research aim and objectives. Question Addressed: This research addresses the question of how to promote inclusivity, diversity, and inclusion and reduce the prevalence of stereotypes and prejudice. It explores the need to treat individuals based on their unique circumstances and needs rather than relying on generic assumptions. Encourage individuals to adopt a more inclusive approach. Provide managers with responsibility and training that helps them understand the importance of their roles in shaping the workplace culture. Have an equality, diversity, and inclusion manager from a majority background at the senior level who can speak up for underrepresented groups and flag any issues that need addressing. Conclusion: The research emphasizes the importance of promoting equality, diversity, and inclusion practices to create a fairer society. It highlights the need to challenge stereotypes, treat individuals according to their circumstances and needs, and promote a culture of respect and dignity.Keywords: equality, fairer society, inclusion, diversity
Procedia PDF Downloads 40666 Designing Automated Embedded Assessment to Assess Student Learning in a 3D Educational Video Game
Authors: Mehmet Oren, Susan Pedersen, Sevket C. Cetin
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Despite the frequently criticized disadvantages of the traditional used paper and pencil assessment, it is the most frequently used method in our schools. Although assessments do an acceptable measurement, they are not capable of measuring all the aspects and the richness of learning and knowledge. Also, many assessments used in schools decontextualize the assessment from the learning, and they focus on learners’ standing on a particular topic but do not concentrate on how student learning changes over time. For these reasons, many scholars advocate that using simulations and games (S&G) as a tool for assessment has significant potentials to overcome the problems in traditionally used methods. S&G can benefit from the change in technology and provide a contextualized medium for assessment and teaching. Furthermore, S&G can serve as an instructional tool rather than a method to test students’ learning at a particular time point. To investigate the potentials of using educational games as an assessment and teaching tool, this study presents the implementation and the validation of an automated embedded assessment (AEA), which can constantly monitor student learning in the game and assess their performance without intervening their learning. The experiment was conducted on an undergraduate level engineering course (Digital Circuit Design) with 99 participant students over a period of five weeks in Spring 2016 school semester. The purpose of this research study is to examine if the proposed method of AEA is valid to assess student learning in a 3D Educational game and present the implementation steps. To address this question, this study inspects three aspects of the AEA for the validation. First, the evidence-centered design model was used to lay out the design and measurement steps of the assessment. Then, a confirmatory factor analysis was conducted to test if the assessment can measure the targeted latent constructs. Finally, the scores of the assessment were compared with an external measure (a validated test measuring student learning on digital circuit design) to evaluate the convergent validity of the assessment. The results of the confirmatory factor analysis showed that the fit of the model with three latent factors with one higher order factor was acceptable (RMSEA < 0.00, CFI =1, TLI=1.013, WRMR=0.390). All of the observed variables significantly loaded to the latent factors in the latent factor model. In the second analysis, a multiple regression analysis was used to test if the external measure significantly predicts students’ performance in the game. The results of the regression indicated the two predictors explained 36.3% of the variance (R2=.36, F(2,96)=27.42.56, p<.00). It was found that students’ posttest scores significantly predicted game performance (β = .60, p < .000). The statistical results of the analyses show that the AEA can distinctly measure three major components of the digital circuit design course. It was aimed that this study can help researchers understand how to design an AEA, and showcase an implementation by providing an example methodology to validate this type of assessment.Keywords: educational video games, automated embedded assessment, assessment validation, game-based assessment, assessment design
Procedia PDF Downloads 412665 Targeting Glucocorticoid Receptor Eliminate Dormant Chemoresistant Cancer Stem Cells in Glioblastoma
Authors: Aoxue Yang, Weili Tian, Haikun Liu
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Brain tumor stem cells (BTSCs) are resistant to therapy and give rise to recurrent tumors. These rare and elusive cells are likely to disseminate during cancer progression, and some may enter dormancy, remaining viable but not increasing. The identification of dormant BTSCs is thus necessary to design effective therapies for glioblastoma (GBM) patients. Glucocorticoids (GCs) are used to treat GBM-associated edema. However, glucocorticoids participate in the physiological response to psychosocial stress, linked to poor cancer prognosis. This raises concern that glucocorticoids affect the tumor and BTSCs. Identifying markers specifically expressed by brain tumor stem cells (BTSCs) may enable specific therapies that spare their regular tissue-resident counterparts. By ribosome profiling analysis, we have identified that glycerol-3-phosphate dehydrogenase 1 (GPD1) is expressed by dormant BTSCs but not by NSCs. Through different stress-induced experiments in vitro, we found that only dexamethasone (DEXA) can significantly increase the expression of GPD1 in NSCs. Adversely, mifepristone (MIFE) which is classified as glucocorticoid receptors antagonists, could decrease GPD1 protein level and weaken the proliferation and stemness in BTSCs. Furthermore, DEXA can induce GPD1 expression in tumor-bearing mice brains and shorten animal survival, whereas MIFE has a distinct adverse effect that prolonged mice lifespan. Knocking out GR in NSC can block the upregulation of GPD1 inducing by DEXA, and we find the specific sequences on GPD1 promotor combined with GR, thus improving the efficiency of GPD1 transcription from CHIP-Seq. Moreover, GR and GPD1 are highly co-stained on GBM sections obtained from patients and mice. All these findings confirmed that GR could regulate GPD1 and loss of GPD1 Impairs Multiple Pathways Important for BTSCs Maintenance GPD1 is also a critical enzyme regulating glycolysis and lipid synthesis. We observed that DEXA and MIFE could change the metabolic profiles of BTSCs by regulating GPD1 to shift the transition of cell dormancy. Our transcriptome and lipidomics analysis demonstrated that cell cycle signaling and phosphoglycerides synthesis pathways contributed a lot to the inhibition of GPD1 caused by MIFE. In conclusion, our findings raise concern that treatment of GBM with GCs may compromise the efficacy of chemotherapy and contribute to BTSC dormancy. Inhibition of GR can dramatically reduce GPD1 and extend the survival duration of GBM-bearing mice. The molecular link between GPD1 and GR may give us an attractive therapeutic target for glioblastoma.Keywords: cancer stem cell, dormancy, glioblastoma, glycerol-3-phosphate dehydrogenase 1, glucocorticoid receptor, dexamethasone, RNA-sequencing, phosphoglycerides
Procedia PDF Downloads 123664 Landing Performance Improvement Using Genetic Algorithm for Electric Vertical Take Off and Landing Aircrafts
Authors: Willian C. De Brito, Hernan D. C. Munoz, Erlan V. C. Carvalho, Helder L. C. De Oliveira
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In order to improve commute time for small distance trips and relieve large cities traffic, a new transport category has been the subject of research and new designs worldwide. The air taxi travel market promises to change the way people live and commute by using the concept of vehicles with the ability to take-off and land vertically and to provide passenger’s transport equivalent to a car, with mobility within large cities and between cities. Today’s civil air transport remains costly and accounts for 2% of the man-made CO₂ emissions. Taking advantage of this scenario, many companies have developed their own Vertical Take Off and Landing (VTOL) design, seeking to meet comfort, safety, low cost and flight time requirements in a sustainable way. Thus, the use of green power supplies, especially batteries, and fully electric power plants is the most common choice for these arising aircrafts. However, it is still a challenge finding a feasible way to handle with the use of batteries rather than conventional petroleum-based fuels. The batteries are heavy and have an energy density still below from those of gasoline, diesel or kerosene. Therefore, despite all the clear advantages, all electric aircrafts (AEA) still have low flight autonomy and high operational cost, since the batteries must be recharged or replaced. In this sense, this paper addresses a way to optimize the energy consumption in a typical mission of an aerial taxi aircraft. The approach and landing procedure was chosen to be the subject of an optimization genetic algorithm, while final programming can be adapted for take-off and flight level changes as well. A real tilt rotor aircraft with fully electric power plant data was used to fit the derived dynamic equations of motion. Although a tilt rotor design is used as a proof of concept, it is possible to change the optimization to be applied for other design concepts, even those with independent motors for hover and cruise flight phases. For a given trajectory, the best set of control variables are calculated to provide the time history response for aircraft´s attitude, rotors RPM and thrust direction (or vertical and horizontal thrust, for independent motors designs) that, if followed, results in the minimum electric power consumption through that landing path. Safety, comfort and design constraints are assumed to give representativeness to the solution. Results are highly dependent on these constraints. For the tested cases, performance improvement ranged from 5 to 10% changing initial airspeed, altitude, flight path angle, and attitude.Keywords: air taxi travel, all electric aircraft, batteries, energy consumption, genetic algorithm, landing performance, optimization, performance improvement, tilt rotor, VTOL design
Procedia PDF Downloads 105663 Anisakidosis in Turkey: Serological Survey and Risk for Humans
Authors: E. Akdur Öztürk, F. İrvasa Bilgiç, A. Ludovisi , O. Gülbahar, D. Dirim Erdoğan, M. Korkmaz, M. Á. Gómez Morales
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Anisakidosis is a zoonotic human fish-borne parasitic disease caused by accidental ingestion of anisakid third-stage larvae (L3) of members of the Anisakidae family present in infected marine fish or cephalopods. Infection with anisakid larvae can lead to gastric, intestinal, extra-gastrointestinal and gastroallergic forms of the disease. Anisakid parasites have been reported in almost all seas, particularly in the Mediterranean Sea. There is a remarkably high level of risk exposure to these zoonotic parasites as they are present in economically and ecologically important fish of Europe. Anisakid L3 larvae have been also detected in several fish species from the Aegean Sea. Turkey is a peninsular country surrounded by Black, Aegean and the Mediterranean Sea. In this country, fishing habit and fishery product consumption are highly common. In recent years, there was also an increase in the consumption of raw fish due to the increasing interest in the cuisine of the Far East countries. In different regions of Turkey, A. simplex (inMerluccius Merluccius Scomber japonicus, Trachurus mediterraneus, Sardina pilchardus, Engraulis encrasicolus, etc.), Anisakis spp., Contraceucum spp., Pseudoterronova spp. and, C. aduncum were identified as well. Although it is accepted both the presence of anisakid parasites in fish and fishery products in Turkey and the presence of Turkish people with allergic manifestations after fish consumption, there are no reports of human anisakiasis in this country. Given the high prevalence of anisakid parasites in the country, the absence of reports is likely not due to the absence of clinical cases rather to the unavailability of diagnostic tools and the low awareness of the presence of this infection. The aim of the study was to set up an IgE-Western Blot (WB) based test to detect the anisakidosis sensitization among Turkish people with a history of allergic manifestation related to fish consumption. To this end, crude worm antigens (CWA) and allergen enriched fraction (50-66% ) were prepared from L3 of A. simplex (s.l.) collected from Lepidopus caudatus fished in the Mediterranean Sea. These proteins were electrophoretically separated and transferred into the nitrocellulose membranes. By WB, specific proteins recognized by positive control serum samples from sensitized patients were visualized on nitrocellulose membranes by a colorimetric reaction. The CWA and 50–66% fraction showed specific bands, mainly due to Ani s 1 (20-22 kD) and Ani s 4 (9-10 kD). So far, a total of 7 serum samples from people with allergic manifestation and positive skin prick test (SPT) after fish consumption, have been tested and all of them resulted negative by WB, indicating the lack of sensitization to anisakids. This preliminary study allowed to set up a specific test and evidence the lack of correlation between both tests, SPT and WB. However, the sample size should be increased to estimate the anisakidosis burden in Turkish people.Keywords: anisakidosis, fish parasite, serodiagnosis, Turkey
Procedia PDF Downloads 128662 The Cost of Beauty: Insecurity and Profit
Authors: D. Cole, S. Mahootian, P. Medlock
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This research contributes to existing knowledge of the complexities surrounding women’s relationship to beauty standards by examining their lived experiences. While there is much academic work on the effects of culturally imposed and largely unattainable beauty standards, the arguments tend to fall into two paradigms. On the one hand is the radical feminist perspective that argues that women are subjected to absolute oppression within the patriarchal system in which beauty standards have been constructed. This position advocates for a complete restructuring of social institutions to liberate women from all types of oppression. On the other hand, there are liberal feminist arguments that focus on choice, arguing that women’s agency in how to present themselves is empowerment. These arguments center around what women do within the patriarchal system in order to liberate themselves. However, there is very little research on the lived experiences of women negotiating these two realms: the complex negotiation between the pressure to adhere to cultural beauty standards and the agency of self-expression and empowerment. By exploring beauty standards through the intersection of societal messages (including macro-level processes such as social media and advertising as well as smaller-scale interactions such as families and peers) and lived experiences, this study seeks to provide a nuanced understanding of how women navigate and negotiate their own presentation and sense of self-identity. Current research sees a rise in incidents of body dysmorphia, depression and anxiety since the advent of social media. Approximately 91% of women are unhappy with their bodies and resort to dieting to achieve their ideal body shape, but only 5% of women naturally possess the body type often portrayed by Americans in movies and media. It is, therefore, crucial we begin talking about the processes that are affecting self-image and mental health. A question that arises is that, given these negative effects, why do companies continue to advertise and target women with standards that very few could possibly attain? One obvious answer is that keeping beauty standards largely unattainable enables the beauty and fashion industries to make large profits by promising products and procedures that will bring one up to “standard”. The creation of dissatisfaction for some is profit for others. This research utilizes qualitative methods: interviews, questionnaires, and focus groups to investigate women’s relationships to beauty standards and empowerment. To this end, we reached out to potential participants through a video campaign on social media: short clips on Instagram, Facebook, and TikTok and a longer clip on YouTube inviting users to take part in the study. Participants are asked to react to images, videos, and other beauty-related texts. The findings of this research have implications for policy development, advocacy and interventions aimed at promoting healthy inclusivity and empowerment of women.Keywords: women, beauty, consumerism, social media
Procedia PDF Downloads 45661 Bacterial Diversity in Human Intestinal Microbiota and Correlations with Nutritional Behavior, Physiology, Xenobiotics Intake and Antimicrobial Resistance in Obese, Overweight and Eutrophic Individuals
Authors: Thais O. de Paula, Marjorie R. A. Sarmiento, Francis M. Borges, Alessandra B. Ferreira-Machado, Juliana A. Resende, Dioneia E. Cesar, Vania L. Silva, Claudio G. Diniz
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Obesity is currently a worldwide public health threat, being considered a pandemic multifactorial disease related to the human gut microbiota (GM). Add to that GM is considered an important reservoir of antimicrobial resistance genes (ARG) and little is known on GM and ARG in obesity, considering the altered physiology and xenobiotics intake. As regional and social behavior may play important roles in GM modulation, and most of the studies are based on small sample size and various methodological approaches resulting in difficulties for data comparisons, this study was focused on the investigation of GM bacterial diversity in obese (OB), overweight (OW) and eutrophic individuals (ET) considering their nutritional, clinical and social characteristics; and comparative screening of AGR related to their physiology and xenobiotics intake. Microbial community was accessed by FISH considering phyla as a taxonomic level, and PCR-DGGE followed by dendrograms evaluation (UPGMA method) from fecal metagenome of 72 volunteers classified according to their body mass index (BMI). Nutritional, clinical, social parameters and xenobiotics intake were recorded for correlation analysis. The fecal metagenome was also used as template for PCR targeting 59 different ARG. Overall, 62% of OB were hypertensive, and 12% or 4% were, regarding the OW and ET individuals. Most of the OB were rated as low income (80%). Lower relative bacterial densities were observed in the OB compared to ET for almost all studied taxa (p < 0.05) with Firmicutes/Bacteroidetes ratio increased in the OB group. OW individuals showed a bacterial density representative of GM more likely to the OB. All the participants were clustered in 3 different groups based on the PCR-DGGE fingerprint patterns (C1, C2, C3), being OB mostly grouped in C1 (83.3%) and ET mostly grouped in C3 (50%). The cluster C2 showed to be transitional. Among 27 ARG detected, a cluster of 17 was observed in all groups suggesting a common core. In general, ARG were observed mostly within OB individuals followed by OW and ET. The ratio between ARG and bacterial groups may suggest that AGR were more related to enterobacteria. Positive correlations were observed between ARG and BMI, calories and xenobiotics intake (especially use of sweeteners). As with nutritional and clinical characteristics, our data may suggest that GM of OW individuals behave in a heterogeneous pattern, occasionally more likely to the OB or to the ET. Regardless the regional and social behaviors of our population, the methodological approaches in this study were complementary and confirmatory. The imbalance of GM over the health-disease interface in obesity is a matter of fact, but its influence in host's physiology is still to be clearly elucidated to help understanding the multifactorial etiology of obesity. Although the results are in agreement with observations that GM is altered in obesity, the altered physiology in OB individuals seems to be also associated to the increased xenobiotics intake and may interfere with GM towards antimicrobial resistance, as observed by the fecal metagenome and ARG screening. Support: FAPEMIG, CNPQ, CAPES, PPGCBIO/UFJF.Keywords: antimicrobial resistance, bacterial diversity, gut microbiota, obesity
Procedia PDF Downloads 156660 Seismotectonics and Seismology the North of Algeria
Authors: Djeddi Mabrouk
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The slow coming together between the Afro-Eurasia plates seems to be the main cause of the active deformation in the whole of North Africa which in consequence come true in Algeria with a large zone of deformation in an enough large limited band, southern through Saharan atlas and northern through tell atlas. Maghrebin and Atlassian Chain along North Africa are the consequence of this convergence. In junction zone, we have noticed a compressive regime NW-SE with a creases-faults structure and structured overthrust. From a geological point of view the north part of Algeria is younger then Saharan platform, it’s changing so unstable and constantly in movement, it’s characterized by creases openly reversed, overthrusts and reversed faults, and undergo perpetually complex movement vertically and horizontally. On structural level the north of Algeria it's a part of erogenous alpine peri-Mediterranean and essentially the tertiary age It’s spread from east to the west of Algeria over 1200 km.This oogenesis is extended from east to west on broadband of 100 km.The alpine chain is shaped by 3 domains: tell atlas in north, high plateaus in mid and Saharan atlas in the south In extreme south we find the Saharan platform which is made of Precambrian bedrock recovered by Paleozoic practically not deformed. The Algerian north and the Saharan platform are separated by an important accident along of 2000km from Agadir (Morocco) to Gabes (Tunisian). The seismic activity is localized essentially in a coastal band in the north of Algeria shaped by tell atlas, high plateaus, Saharan atlas. Earthquakes are limited in the first 20km of the earth's crust; they are caused by movements along faults of inverted orientation NE-SW or sliding tectonic plates. The center region characterizes Strong Earthquake Activity who locates mainly in the basin of Mitidja (age Neogene).The southern periphery (Atlas Blidéen) constitutes the June, more Important seism genic sources in the city of Algiers and east (Boumerdes region). The North East Region is also part of the tellian area, but it is characterized by a different strain in other parts of northern Algeria. The deformation is slow and low to moderate seismic activity. Seismic activity is related to the tectonic-slip earthquake. The most pronounced is that of 27 October 1985 (Constantine) of seismic moment magnitude Mw = 5.9. North-West region is quite active and also artificial seismic hypocenters which do not exceed 20km. The deep seismicity is concentrated mainly a narrow strip along the edge of Quaternary and Neogene basins Intra Mountains along the coast. The most violent earthquakes in this region are the earthquake of Oran in 1790 and earthquakes Orléansville (El Asnam in 1954 and 1980).Keywords: alpine chain, seismicity north Algeria, earthquakes in Algeria, geophysics, Earth
Procedia PDF Downloads 394659 Paramedic Strength and Flexibility: Findings of a 6-Month Workplace Exercise Randomised Controlled Trial
Authors: Jayden R. Hunter, Alexander J. MacQuarrie, Samantha C. Sheridan, Richard High, Carolyn Waite
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Workplace exercise programs have been recommended to improve the musculoskeletal fitness of paramedics with the aim of reducing injury rates, and while they have shown efficacy in other occupations, they have not been delivered and evaluated in Australian paramedics to our best knowledge. This study investigated the effectiveness of a 6-month workplace exercise program (MedicFit; MF) to improve paramedic fitness with or without health coach (HC) support. A group of regional Australian paramedics (n=76; 43 male; mean ± SD 36.5 ± 9.1 years; BMI 28.0 ± 5.4 kg/m²) were randomised at the station level to either exercise with remote health coach support (MFHC; n=30), exercise without health coach support (MF; n=23), or no-exercise control (CON; n=23) groups. MFHC and MF participants received a 6-month, low-moderate intensity resistance and flexibility exercise program to be performed ƒ on station without direct supervision. Available exercise equipment included dumbbells, resistance bands, Swiss balls, medicine balls, kettlebells, BOSU balls, yoga mats, and foam rollers. MFHC and MF participants were also provided with a comprehensive exercise manual including sample exercise sessions aimed at improving musculoskeletal strength and flexibility which included exercise prescription (i.e. sets, reps, duration, load). Changes to upper-body (push-ups), lower-body (wall squat) and core (plank hold) strength and flexibility (back scratch and sit-reach tests) after the 6-month intervention were analysed using repeated measures ANOVA to compare changes between groups and over time. Upper-body (+20.6%; p < 0.01; partial eta squared = 0.34 [large effect]) and lower-body (+40.8%; p < 0.05; partial eta squared = 0.08 (moderate effect)) strength increased significantly with no interaction or group effects. Changes to core strength (+1.4%; p=0.17) and both upper-body (+19.5%; p=0.56) and lower-body (+3.3%; p=0.15) flexibility were non-significant with no interaction or group effects observed. While upper- and lower-body strength improved over the course of the intervention, providing a 6-month workplace exercise program with or without health coach support did not confer any greater strength or flexibility benefits than exercise testing alone (CON). Although exercise adherence was not measured, it is possible that participants require additional methods of support such as face-to-face exercise instruction and guidance and individually-tailored exercise programs to achieve adequate participation and improvements in musculoskeletal fitness. This presents challenges for more remote paramedic stations without regular face-to-face access to suitably qualified exercise professionals, and future research should investigate the effectiveness of other forms of exercise delivery and guidance for these paramedic officers such as remotely-facilitated digital exercise prescription and monitoring.Keywords: workplace exercise, paramedic health, strength training, flexibility training
Procedia PDF Downloads 132658 Food Safety in Wine: Removal of Ochratoxin a in Contaminated White Wine Using Commercial Fining Agents
Authors: Antònio Inês, Davide Silva, Filipa Carvalho, Luís Filipe-Riberiro, Fernando M. Nunes, Luís Abrunhosa, Fernanda Cosme
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The presence of mycotoxins in foodstuff is a matter of concern for food safety. Mycotoxins are toxic secondary metabolites produced by certain molds, being ochratoxin A (OTA) one of the most relevant. Wines can also be contaminated with these toxicants. Several authors have demonstrated the presence of mycotoxins in wine, especially ochratoxin A. Its chemical structure is a dihydro-isocoumarin connected at the 7-carboxy group to a molecule of L-β-phenylalanine via an amide bond. As these toxicants can never be completely removed from the food chain, many countries have defined levels in food in order to attend health concerns. OTA contamination of wines might be a risk to consumer health, thus requiring treatments to achieve acceptable standards for human consumption. The maximum acceptable level of OTA in wines is 2.0 μg/kg according to the Commission regulation No. 1881/2006. Therefore, the aim of this work was to reduce OTA to safer levels using different fining agents, as well as their impact on white wine physicochemical characteristics. To evaluate their efficiency, 11 commercial fining agents (mineral, synthetic, animal and vegetable proteins) were used to get new approaches on OTA removal from white wine. Trials (including a control without addition of a fining agent) were performed in white wine artificially supplemented with OTA (10 µg/L). OTA analyses were performed after wine fining. Wine was centrifuged at 4000 rpm for 10 min and 1 mL of the supernatant was collected and added of an equal volume of acetonitrile/methanol/acetic acid (78:20:2 v/v/v). Also, the solid fractions obtained after fining, were centrifuged (4000 rpm, 15 min), the resulting supernatant discarded, and the pellet extracted with 1 mL of the above solution and 1 mL of H2O. OTA analysis was performed by HPLC with fluorescence detection. The most effective fining agent in removing OTA (80%) from white wine was a commercial formulation that contains gelatin, bentonite and activated carbon. Removals between 10-30% were obtained with potassium caseinate, yeast cell walls and pea protein. With bentonites, carboxymethylcellulose, polyvinylpolypyrrolidone and chitosan no considerable OTA removal was verified. Following, the effectiveness of seven commercial activated carbons was also evaluated and compared with the commercial formulation that contains gelatin, bentonite and activated carbon. The different activated carbons were applied at the concentration recommended by the manufacturer in order to evaluate their efficiency in reducing OTA levels. Trial and OTA analysis were performed as explained previously. The results showed that in white wine all activated carbons except one reduced 100% of OTA. The commercial formulation that contains gelatin, bentonite and activated carbon reduced only 73% of OTA concentration. These results may provide useful information for winemakers, namely for the selection of the most appropriate oenological product for OTA removal, reducing wine toxicity and simultaneously enhancing food safety and wine quality.Keywords: wine, ota removal, food safety, fining
Procedia PDF Downloads 528657 The Impact of Reducing Road Traffic Speed in London on Noise Levels: A Comparative Study of Field Measurement and Theoretical Calculation
Authors: Jessica Cecchinelli, Amer Ali
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The continuing growth in road traffic and the resultant impact on the level of pollution and safety especially in urban areas have led local and national authorities to reduce traffic speed and flow in major towns and cities. Various boroughs of London have recently reduced the in-city speed limit from 30mph to 20mph mainly to calm traffic, improve safety and reduce noise and vibration. This paper reports the detailed field measurements using noise sensor and analyser and the corresponding theoretical calculations and analysis of the noise levels on a number of roads in the central London Borough of Camden where speed limit was reduced from 30mph to 20mph in all roads except the major routes of the ‘Transport for London (TfL)’. The measurements, which included the key noise levels and scales at residential streets and main roads, were conducted during weekdays and weekends normal and rush hours. The theoretical calculations were done according to the UK procedure ‘Calculation of Road Traffic Noise 1988’ and with conversion to the European L-day, L-evening, L-night, and L-den and other important levels. The current study also includes comparable data and analysis from previously measured noise in the Borough of Camden and other boroughs of central London. Classified traffic flow and speed on the roads concerned were observed and used in the calculation part of the study. Relevant data and description of the weather condition are reported. The paper also reports a field survey in the form of face-to-face interview questionnaires, which was carried out in parallel with the field measurement of noise, in order to ascertain the opinions and views of local residents and workers in the reduced speed zones of 20mph. The main findings are that the reduction in speed had reduced the noise pollution on the studied zones and that the measured and calculated noise levels for each speed zone are closely matched. Among the other findings was that of the field survey of the opinions and views of the local residents and workers in the reduced speed 20mph zones who supported the scheme and felt that it had improved the quality of life in their areas giving a sense of calmness and safety particularly for families with children, the elderly, and encouraged pedestrians and cyclists. The key conclusions are that lowering the speed limit in built-up areas would not just reduce the number of serious accidents but it would also reduce the noise pollution and promote clean modes of transport particularly walking and cycling. The details of the site observations and the corresponding calculations together with critical comparative analysis and relevant conclusions will be reported in the full version of the paper.Keywords: noise calculation, noise field measurement, road traffic noise, speed limit in london, survey of people satisfaction
Procedia PDF Downloads 420656 Good Governance Complementary to Corruption Abatement: A Cross-Country Analysis
Authors: Kamal Ray, Tapati Bhattacharya
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Private use of public office for private gain could be a tentative definition of corruption and most distasteful event of corruption is that it is not there, nor that it is pervasive, but it is socially acknowledged in the global economy, especially in the developing nations. We attempted to assess the interrelationship between the Corruption perception index (CPI) and the principal components of governance indicators as per World Bank like Control of Corruption (CC), rule of law (RL), regulatory quality (RQ) and government effectiveness (GE). Our empirical investigation concentrates upon the degree of reflection of governance indicators upon the CPI in order to single out the most powerful corruption-generating indicator in the selected countries. We have collected time series data on above governance indicators such as CC, RL, RQ and GE of the selected eleven countries from the year of 1996 to 2012 from World Bank data set. The countries are USA, UK, France, Germany, Greece, China, India, Japan, Thailand, Brazil, and South Africa. Corruption Perception Index (CPI) of the countries mentioned above for the period of 1996 to 2012is also collected. Graphical method of simple line diagram against the time series data on CPI is applied for quick view for the relative positions of different trend lines of different nations. The correlation coefficient is enough to assess primarily the degree and direction of association between the variables as we get the numerical data on governance indicators of the selected countries. The tool of Granger Causality Test (1969) is taken into account for investigating causal relationships between the variables, cause and effect to speak of. We do not need to verify stationary test as length of time series is short. Linear regression is taken as a tool for quantification of a change in explained variables due to change in explanatory variable in respect of governance vis a vis corruption. A bilateral positive causal link between CPI and CC is noticed in UK, index-value of CC increases by 1.59 units as CPI increases by one unit and CPI rises by 0.39 units as CC rises by one unit, and hence it has a multiplier effect so far as reduction in corruption is concerned in UK. GE causes strongly to the reduction of corruption in UK. In France, RQ is observed to be a most powerful indicator in reducing corruption whereas it is second most powerful indicator after GE in reducing of corruption in Japan. Governance-indicator like GE plays an important role to push down the corruption in Japan. In China and India, GE is proactive as well as influencing indicator to curb corruption. The inverse relationship between RL and CPI in Thailand indicates that ongoing machineries related to RL is not complementary to the reduction of corruption. The state machineries of CC in S. Africa are highly relevant to reduce the volume of corruption. In Greece, the variations of CPI positively influence the variations of CC and the indicator like GE is effective in controlling corruption as reflected by CPI. All the governance-indicators selected so far have failed to arrest their state level corruptions in USA, Germany and Brazil.Keywords: corruption perception index, governance indicators, granger causality test, regression
Procedia PDF Downloads 296655 The Distribution and Environmental Behavior of Heavy Metals in Jajarm Bauxite Mine, Northeast Iran
Authors: Hossein Hassani, Ali Rezaei
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Heavy metals are naturally occurring elements that have a high atomic weight and a density at least five times greater than that of water. Their multiple industrial, domestic, agricultural, medical, and technological applications have led to their wide distribution in the environment, raising concerns over their potential effects on human health and the environment. Environmental protection against various pollutants, such as heavy metals formed by industries, mines and modern technologies, is a concern for researchers and industry. In order to assess the contamination of soils the distribution and environmental behavior have been investigated. Jajarm bauxite mine, the most important deposits have been discovered in Iran, which is about 22 million tons of reserve, and is the main mineral of the Diaspora. With a view to estimate the heavy metals ratio of the Jajarm bauxite mine area and to evaluate the pollution level, 50 samples have been collected and have been analyzed for the heavy metals of As, Cd, Cu, Hg, Ni and Pb with the help of Inductively Coupled Plasma-Mass Spectrometer (ICP- MS). In this study, we have dealt with determining evaluation criteria including contamination factor (CF), average concentration (AV), enrichment factor (EF) and geoaccumulation index (GI) to assess the risk of pollution from heavy metals(As, Cd, Cu, Hg, Ni and Pb) in Jajarm bauxite mine. In the samples of the studied, the average of recorded concentration of elements for Arsenic, Cadmium, Copper, Mercury, Nickel and Lead are 18, 0.11, 12, 0.07, 58 and 51 (mg/kg) respectively. The comparison of the heavy metals concentration average and the toxic potential in the samples has shown that an average with respect to the world average of the uncontaminated soil amounts. The average of Pb and As elements shows a higher quantity with respect to the world average quantity. The pollution factor for the study elements has been calculated on the basis of the soil background concentration and has been categorized on the basis of the uncontaminated world soil average with respect to the Hakanson classification. The calculation of the corrected pollutant degree shows the degree of the bulk intermediate pollutant (1.55-2.0) for the average soil sampling of the study area which is on the basis of the background quantity and the world average quantity of the uncontaminated soils. The provided conclusion from calculation of the concentrated factor, for some of the samples show that the average of the lead and arsenic elements stations are more than the background values and the unnatural metal concentration are covered under the study area, That's because the process of mining and mineral extraction. Given conclusion from the calculation of Geoaccumulation index of the soil sampling can explain that the copper, nickel, cadmium, arsenic, lead and mercury elements are Uncontamination. In general, the results indicate that the Jajarm bauxite mine of heavy metal pollution is uncontaminated area and extract the mineral from the mine, not create environmental hazards in the region.Keywords: enrichment factor, geoaccumulation index, heavy metals, Jajarm bauxite mine, pollution
Procedia PDF Downloads 278654 Аnalysis of the Perception of Medical Professionalism by Specialists of Family Medicine in Kazakhstan
Authors: Nurgul A. Abenova, Gaukhar S. Dilmagambetova, Lazzat M. Zhamaliyeva
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Professionalism is a core competency that all medical students must achieve throughout their studies. Clinical knowledge, good communication skills and an understanding of ethics form the basis of professionalism. Patients, medical societies and accrediting organizations expect future specialists to be professionals in their field, which in turn leads to the best clinical results. Currently, there are no studies devoted to the study of medical professionalism in the Republic of Kazakhstan. As a result, medical education in the Kazakhstani system has a limited perception of the concept of professionalism compared to many Western medical schools. Thus, the primary purpose of this study is to analyze the perception of medical professionalism among residents and teachers of family medicine at the West Kazakhstan Marat Ospanov Medical University. А qualitative research method was used based on the content analysis methodology. A focus group discussion was held with 60 residents and 12 family medicine teachers to gather participants' views and experiences in the field of medical professionalism. The received information was processed using the MAXQDA-2020 software package. Respondents were selected for the study based on their age, gender, and educational level. The results of the conducted survey confirmed the respondents’ acknowledgment of the basic attributes of professionalism, such as medical knowledge and skills (more than 40% of the answers), personal and moral qualities of the doctor (more than 25% of the answers), respect for the interests of the patient (15% of the answers), the relationship between the doctor and the patient and among professionals themselves (15% of responses). Another important discovery of the survey was that residents are five times more likely to define the relationship between a doctor and a patient in a model “respect for the interests of the patient” in comparison with teachers of family medicine, who primarily reported responsibility and collegiality to be the basis for the development of professionalism and traditionally view doctor-patient relationship to be formed on the basis of paternalism defined by a high degree of control over patients. This significant difference demonstrates a rift among specialists in the field of family medicine, which causes a lot of problems. For example, nowadays, professional family doctors regularly face burnout problem due to many reasons and factors that force them to abandon their jobs. In addition to that, elements of professionalism such as reflective skills, time management and feedback collection were presented to the least extent (less than 1%) by both groups, which differs from the perception of the Western medical school and is a significant issue that needs to be solved. The qualitative nature of our study provides a detailed understanding of medical professionalism in the context of the Central Asian healthcare system, revealing many aspects that are inferior to the Western medical school counterparts and provides a solution, which is to teach the attributes and skills required for medical professionalism at all stages of medical education of family doctors.Keywords: family medicine, family doctors, medical professionalism, medical education
Procedia PDF Downloads 136653 An Assessment of the Trend and Pattern of Vital Registration System in Shiroro Local Government Area of Niger State, Nigeria
Authors: Aliyu Bello Mohammed
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Vital registration or registration of vital events is one of the three major sources of demographic data in Nigeria. The other two are the population census and sample survey. The former is judged to be an indispensable source of demographic data because, it provide information on vital statistics and population trends between two census periods. Various literacy works however depict the vital registration in Nigeria as incapable of providing accurate data for the country. The study has both theoretical and practical significances. The trends and pattern of vital registration has not received adequate research interest in Sub-Saharan Africa in general and Nigeria in particular. This has created a gap in understanding the extent and consequence of the scourge in Africa sub-region. Practically, the study also captures the policy interventions of government and Non-Governmental Organizations (NGOs) that would help enlighten the public on the importance of vital registration in Nigeria. Furthermore, feasible policy strategies that will enhance trends and pattern vital registration in the society would emanate from the study. The study adopted a cross sectional survey design and applied multi stage sampling techniques to sample 230 respondents from the general public in the study area. The first stage involved the splitting of the local government into wards. The second stage involves selecting streets, while the third stage was the households. In all, 6 wards were sampled for the study. The study utilized both primary and secondary sources of data. The primary sources of data used were the questionnaire, focus group discussion (FGD) and in-depth interview (IDI) guides while the secondary sources of data were journals and books, newspapers and magazines. Twelve FGD sessions with 96 study participants and five IDI sessions with the heads of vital registration facilities were conducted. The quantitative data were analyzed using Statistical Package for Social Sciences (SPSS). Descriptive statistics like tables, frequencies and percentages were employed in presenting and interpreting the data. Information from the qualitative data was transcribed and ordered in themes to ensure that outstanding points of the responses are noted. The following conclusions were drawn from the study: the available vital registration facilities are not adequate and were not evenly distributed in the study area; lack of awareness and knowledge of the existence and the importance of vital registration by majority of the people in the local government; distance to vital registration centres from their residents; most births in the area were not registered, and even among the few births that were registered, majority of them were registered after the limited period for registration. And the study reveals that socio-economic index, educational level and distance of facilities to residents are determinants of access to vital registration facility. The study concludes by discussing the need for a reliable and accurate vital registration system if Nigeria’s vision of becoming one of the top 20 economies in the world in 2020 would be realized.Keywords: trends, patterns, vital, registration and assessment
Procedia PDF Downloads 242652 Journey to Inclusive School: Description of Crucial Sensitive Concepts in the Context of Situational Analysis
Authors: Denisa Denglerova, Radim Sip
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Academic sources as well as international agreements and national documents define inclusion in terms of several criteria: equal opportunities, fulfilling individual needs, development of human resources, community participation. In order for these criteria to be met, the community must be cohesive. Community cohesion, which is a relatively new concept, is not determined by homogeneity, but by the acceptance of diversity among the community members and utilisation of its positive potential. This brings us to a central category of inclusion - appreciating diversity and using it to a positive effect. However, school diversity is a real phenomenon, which schools need to tackle more and more often. This is also indicated by the number of publications focused on diversity in schools. These sources present recent analyses of using identity as a tool of coping with the demands of a diversified society. The aim of this study is to identify and describe in detail the processes taking place in selected schools, which contribute to their pro-inclusive character. The research is designed around a multiple case study of three pro-inclusive schools. Paradigmatically speaking, the research is rooted in situational epistemology. This is also related to the overall framework of interpretation, for which we are going to use innovative methods of situational analysis. In terms of specific research outcomes this will manifest itself in replacing the idea of “objective theory” by the idea of “detailed cartography of a social world”. The cartographic approach directs both the logic of data collection and the choice of methods of their analysis and interpretation. The research results include detection of the following sensitive concepts: Key persons. All participants can contribute to promoting an inclusion-friendly environment; however, some do so with greater motivation than others. These could include school management, teachers with a strong vision of equality, or school counsellors. They have a significant effect on the transformation of the school, and are themselves deeply convinced that inclusion is necessary. Accordingly, they select suitable co-workers; they also inspire some of the other co-workers to make changes, leading by example. Employees with strongly opposing views gradually leave the school, and new members of staff are introduced to the concept of inclusion and openness from the beginning. Manifestations of school openness in working with diversity on all important levels. By this we mean positive manipulation with diversity both in the relationships between “traditional” school participants (directors, teachers, pupils) and school-parent relationships, or relationships between schools and the broader community, in terms of teaching methods as well as ways how the school culture affects the school environment. Other important detected concepts significantly helping to form a pro-inclusive environment in the school are individual and parallel classes; freedom and responsibility of both pupils and teachers, manifested on the didactic level by tendencies towards an open curriculum; ways of asserting discipline in the school environment.Keywords: inclusion, diversity, education, sensitive concept, situational analysis
Procedia PDF Downloads 189651 'Utsadhara': Rejuvenating the Dead River Edge into an Urban Activity Space along the Banks of River Hooghly
Authors: Aparna Saha, Tuhin Ahmed
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West Bengal has a number of important rivers, each with its distinctive character and a story. Traditionally, cities have ‘divulged’ to rivers at the river edges and rivers have been an inseparable part of the urban experience. Considering the research aspect, the area is taken in Barrackpore, a small but important outgrowth of Kolkata Municipal Association, West Bengal. Barrackpore, at present, has ample inadequate public open spaces at the neighborhood level where people of different socio-cultural, economic, and religious backgrounds can come together and engage in various leisure activities, but there is no opportunity either, where people can learn about and explore the rich history of the settlement. Pertaining to these issues forms the backdrop of this research paper which has been conceptualized as a place from space that will bring people back to the river and increase community interactions and will also celebrate and commemorate towards the historical importance of the river and its edges. The entire precinct bordering the river represents the transition from pre-independence (Raj era) to Sepoy phase (Swaraj era), finally culminating into the Gandhian philosophy which is being projected into the already existing Gandhi Ghat. The ultimate aim of the paper entitled ‘Utsadhara- Rejuvenating the dead river edge into an urban activity space along the banks of river Hooghly’ is to create a socio-cultural space keeping the heritage identity intact through judicious use of the water body. Also, a balance is kept between the natural ecosystem and the cosmetic development of the surrounding open spaces. It can be duly achieved by the aforementioned methodology provided in the document, but mainly it would focus into preserving the historic ethnicity of the place by holding its character through various facts and figures as well as features. Most importantly the natural topography of the place is left intact. The second priority is given in terms of hierarchy of well connected public plazas, podiums where people from different socio-economic backgrounds irrespective of age and sex could socialize and reach towards venturing into a cordial relationship with one another. The third priority is to provide a platform for the common mass for showcasing their skills and talent through different art and craft forms which in turn would enhance their individual self and also the community as a whole through economic rise. Apart from this here some spaces are created in accordance to different age groups or class of people. The paper intends to see the river as a major multifunctional public space to attract people for different activities and re-establish the relationship of the river with the settlement. Hence, it is apprehended that the paper is not only intended to a simple riverfront conservation project but unlike others it is a place which is created for the people, by the people and of the people towards a holistic community development through a sustainable approach.Keywords: holistic community development, public activity space, river-urban precinct, urban dead space
Procedia PDF Downloads 123650 A Qualitative Study to Analyze Clinical Coders’ Decision Making Process of Adverse Drug Event Admissions
Authors: Nisa Mohan
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Clinical coding is a feasible method for estimating the national prevalence of adverse drug event (ADE) admissions. However, under-coding of ADE admissions is a limitation of this method. Whilst the under-coding will impact the accurate estimation of the actual burden of ADEs, the feasibility of the coded data in estimating the adverse drug event admissions goes much further compared to the other methods. Therefore, it is necessary to know the reasons for the under-coding in order to improve the clinical coding of ADE admissions. The ability to identify the reasons for the under-coding of ADE admissions rests on understanding the decision-making process of coding ADE admissions. Hence, the current study aimed to explore the decision-making process of clinical coders when coding cases of ADE admissions. Clinical coders from different levels of coding job such as trainee, intermediate and advanced level coders were purposefully selected for the interviews. Thirteen clinical coders were recruited from two Auckland region District Health Board hospitals for the interview study. Semi-structured, one-on-one, face-to-face interviews using open-ended questions were conducted with the selected clinical coders. Interviews were about 20 to 30 minutes long and were audio-recorded with the approval of the participants. The interview data were analysed using a general inductive approach. The interviews with the clinical coders revealed that the coders have targets to meet, and they sometimes hesitate to adhere to the coding standards. Coders deviate from the standard coding processes to make a decision. Coders avoid contacting the doctors for clarifying small doubts such as ADEs and the name of the medications because of the delay in getting a reply from the doctors. They prefer to do some research themselves or take help from their seniors and colleagues for making a decision because they can avoid a long wait to get a reply from the doctors. Coders think of ADE as a small thing. Lack of time for searching for information to confirm an ADE admission, inadequate communication with clinicians, along with coders’ belief that an ADE is a small thing may contribute to the under-coding of the ADE admissions. These findings suggest that further work is needed on interventions to improve the clinical coding of ADE admissions. Providing education to coders about the importance of ADEs, educating clinicians about the importance of clear and confirmed medical records entries, availing pharmacists’ services to improve the detection and clear documentation of ADE admissions, and including a mandatory field in the discharge summary about external causes of diseases may be useful for improving the clinical coding of ADE admissions. The findings of the research will help the policymakers to make informed decisions about the improvements. This study urges the coding policymakers, auditors, and trainers to engage with the unconscious cognitive biases and short-cuts of the clinical coders. This country-specific research conducted in New Zealand may also benefit other countries by providing insight into the clinical coding of ADE admissions and will offer guidance about where to focus changes and improvement initiatives.Keywords: adverse drug events, clinical coders, decision making, hospital admissions
Procedia PDF Downloads 116649 Assessment of Nuclear Medicine Radiation Protection Practices Among Radiographers and Nurses at a Small Nuclear Medicine Department in a Tertiary Hospital
Authors: Nyathi Mpumelelo; Moeng Thabiso Maria
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BACKGROUND AND OBJECTIVES: Radiopharmaceuticals are used for diagnosis, treatment, staging and follow up of various diseases. However, there is concern that the ionizing radiation (gamma rays, α and ß particles) emitted by radiopharmaceuticals may result in exposure of radiographers and nurses with limited knowledge of the principles of radiation protection and safety, raising the risk of cancer induction. This study aimed at investigation radiation safety awareness levels among radiographers and nurses at a small tertiary hospital in South Africa. METHODS: An analytical cross-sectional study. A validated two-part questionnaire was implemented to consenting radiographers and nurses working in a Nuclear Medicine Department. Part 1 gathered demographic information (age, gender, work experience, attendance to/or passing ionizing radiation protection courses). Part 2 covered questions related to knowledge and awareness of radiation protection principles. RESULTS: Six radiographers and five nurses participated (27% males and 73% females). The mean age was 45 years (age range 20-60 years). The study revealed that neither professional development courses nor radiation protection courses are offered at the Nuclear Medicine Department understudy. However, 6/6 (100%) radiographers exhibited a high level of awareness of radiation safety principles on handling and working with radiopharmaceuticals which correlated to their years of experience. As for nurses, 4/5 (80%) showed limited knowledge and awareness of radiation protection principles irrespective of the number of years in the profession. CONCLUSION: Despite their major role of caring for patients undergoing diagnostic and therapeutic treatments, the nurses showed limited knowledge of ionizing radiation and associated side effects. This was not surprising since they never received any formal basic radiation safety course. These findings were not unique to this Centre. A study conducted in a Kuwaiti Radiology Department also established that the vast majority of nurses did not understand the risks of working with ionizing radiation. Similarly, nurses in an Australian hospital exhibited knowledge limitations. However, nursing managers did provide the necessary radiation safety training when requested. In Guatemala and Saudi Arabia, where there was shortage of professional radiographers, nurses underwent radiography training, a course that equipped them with basic radiation safety principles. The radiographers in the Centre understudy unlike others in various parts of the world demonstrated substantial knowledge and awareness on radiation protection. Radiations safety courses attended when an opportunity arose played a critical role in their awareness. The knowledge and awareness levels of these radiographers were comparable to their counterparts in Sudan. However, it was much more above that of their counterparts in Jordan, Nigeria, Nepal and Iran who were found to have limited awareness and inadequate knowledge on radiation dose. Formal radiation safety and awareness courses and workshops can play a crucial role in raising the awareness of nurses and radiographers on radiation safety for their personal benefit and that of their patients.Keywords: radiation safety, radiation awareness, training, nuclear medicine
Procedia PDF Downloads 62648 Prediction of Endotracheal Tube Size in Children by Predicting Subglottic Diameter Using Ultrasonographic Measurement versus Traditional Formulas
Authors: Parul Jindal, Shubhi Singh, Priya Ramakrishnan, Shailender Raghuvanshi
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Background: Knowledge of the influence of the age of the child on laryngeal dimensions is essential for all practitioners who are dealing with paediatric airway. Choosing the correct endotracheal tube (ETT) size is a crucial step in pediatric patients because a large-sized tube may cause complications like post-extubation stridor and subglottic stenosis. On the other hand with a smaller tube, there will be increased gas flow resistance, aspiration risk, poor ventilation, inaccurate monitoring of end-tidal gases and reintubation may also be required with a different size of the tracheal tube. Recent advancement in ultrasonography (USG) techniques should now allow for accurate and descriptive evaluation of pediatric airway. Aims and objectives: This study was planned to determine the accuracy of Ultrasonography (USG) to assess the appropriate ETT size and compare it with physical indices based formulae. Methods: After obtaining approval from Institute’s Ethical and Research committee, and parental written and informed consent, the study was conducted on 100 subjects of either sex between 12-60 months of age, undergoing various elective surgeries under general anesthesia requiring endotracheal intubation. The same experienced radiologist performed ultrasonography. The transverse diameter was measured at the level of cricoids cartilage by USG. After USG, general anesthesia was administered using standard techniques followed by the institute. An experienced anesthesiologist performed the endotracheal intubations with uncuffed endotracheal tube (Portex Tracheal Tube Smiths Medical India Pvt. Ltd.) with Murphy’s eye. He was unaware of the finding of the ultrasonography. The tracheal tube was considered best fit if air leak was satisfactory at 15-20 cm H₂O of airway pressure. The obtained values were compared with the values of endotracheal tube size calculated by ultrasonography, various age, height, weight-based formulas and diameter of right and left little finger. The correlation of the size of the endotracheal tube by different modalities was done and Pearson's correlation coefficient was obtained. The comparison of the mean size of the endotracheal tube by ultrasonography and by traditional formula was done by the Friedman’s test and Wilcoxon sign-rank test. Results: The predicted tube size was equal to best fit and best determined by ultrasonography (100%) followed by comparison to left little finger (98%) and right little finger (97%) and age-based formula (95%) followed by multivariate formula (83%) and body length (81%) formula. According to Pearson`s correlation, there was a moderate correlation of best fit endotracheal tube with endotracheal tube size by age-based formula (r=0.743), body length based formula (r=0.683), right little finger based formula (r=0.587), left little finger based formula (r=0.587) and multivariate formula (r=0.741). There was a strong correlation with ultrasonography (r=0.943). Ultrasonography was the most sensitive (100%) method of prediction followed by comparison to left (98%) and right (97%) little finger and age-based formula (95%), the multivariate formula had an even lesser sensitivity (83%) whereas body length based formula was least sensitive with a sensitivity of 78%. Conclusion: USG is a reliable method of estimation of subglottic diameter and for prediction of ETT size in children.Keywords: endotracheal intubation, pediatric airway, subglottic diameter, traditional formulas, ultrasonography
Procedia PDF Downloads 231647 Yield Loss in Maize Due to Stem Borers and Their Integrated Management
Authors: C. P. Mallapur, U. K. Hulihalli, D. N. Kambrekar
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Maize (Zea mays L.) an important cereal crop in the world has diversified uses including human consumption, animal feed, and industrial uses. A major constraint in low productivity of maize in India is undoubtedly insect pests particularly two species of stem borers, Chilo partellus (Swinhoe) and Sesamia inferens (Walker). The stem borers cause varying level of yield losses in different agro-climate regions (25.7 to 80.4%) resulting in a huge economic loss to the farmers. Although these pests are rather difficult to manage, efforts have been made to combat the menace by using effective insecticides. However, efforts have been made in the present study to integrate various possible approaches for sustainable management of these borers. Two field experiments were conducted separately during 2016-17 at Main Agricultural Research Station, University of Agricultural Sciences, Dharwad, Karnataka, India. In the first experiment, six treatments were randomized in RBD. The insect eggs at pinhead stage (@ 40 eggs/plant) were stapled to the under surface of leaves covering 15-20 % of plants in each plot after 15 days of sowing. The second experiment was planned with nine treatments replicated thrice. The border crop with NB -21 grass was planted all around the plots in the specific treatments while, cowpea intercrop (@6:1-row proportion) was sown along with the main crop and later, the insecticidal spray with chlorantraniliprole and nimbecidine was taken upon need basis in the specific treatments. The results indicated that the leaf injury and dead heart incidence were relatively more in the treatments T₂ and T₄ wherein, no insect control measures were made after the insect release (58.30 & 40.0 % leaf injury and 33.42 and 25.74% dead heart). On the contrary, these treatments recorded higher stem tunneling (32.4 and 24.8%) and resulted in lower grain yield (17.49 and 26.79 q/ha) compared to 29.04, 32.68, 40.93 and 46.38 q/ha recorded in T₁, T₃, T₅ and T₆ treatments, respectively. A maximum yield loss of 28.89 percent was noticed in T₂ followed by 19.59 percent in T₄ where no sprays were imposed. The data on integrated management trial revealed the lowest stem borer damage (19.28% leaf injury and 1.21% dead heart) in T₅ (seed treatment with thiamethoxam 70FS @ 8ml/kg seed + cow intercrop along with nimbecidine 0.03EC @ 5.0 ml/l and chlorantraniliprole 18.5SC spray @ 0.2 ml/l). The next best treatment was T₆ (ST+ NB-21 borer with nimbecidine and chlorantraniliprole spray) with 21.3 and 1.99 percent leaf injury and dead heart incidence, respectively. These treatments resulted in highest grain yield (77.71 and 75.53 q/ha in T₅ and T₆, respectively) compared to the standard check, T₁ (ST+ chlorantraniliprole spray) wherein, 27.63 percent leaf injury and 3.68 percent dead heart were noticed with 60.14 q/ha grain yield. The stem borers can cause yield loss up to 25-30 percent in maize which can be well tackled by seed treatment with thiamethoxam 70FS @ 8ml/kg seed and sowing the crop along with cowpea as intercrop (6:1 row proportion) or NB-21 grass as border crop followed by application of nimbecidine 0.03EC @ 5.0 ml/l and chlorantraniliprole 18.5SC @ 0.2 ml/l on need basis.Keywords: Maize stem borers, Chilo partellus, Sesamia inferens, crop loss, integrated management
Procedia PDF Downloads 170646 Multisensory Science, Technology, Engineering and Mathematics Learning: Combined Hands-on and Virtual Science for Distance Learners of Food Chemistry
Authors: Paulomi Polly Burey, Mark Lynch
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It has been shown that laboratory activities can help cement understanding of theoretical concepts, but it is difficult to deliver such an activity to an online cohort and issues such as occupational health and safety in the students’ learning environment need to be considered. Chemistry, in particular, is one of the sciences where practical experience is beneficial for learning, however typical university experiments may not be suitable for the learning environment of a distance learner. Food provides an ideal medium for demonstrating chemical concepts, and along with a few simple physical and virtual tools provided by educators, analytical chemistry can be experienced by distance learners. Food chemistry experiments were designed to be carried out in a home-based environment that 1) Had sufficient scientific rigour and skill-building to reinforce theoretical concepts; 2) Were safe for use at home by university students and 3) Had the potential to enhance student learning by linking simple hands-on laboratory activities with high-level virtual science. Two main components of the resources were developed, a home laboratory experiment component, and a virtual laboratory component. For the home laboratory component, students were provided with laboratory kits, as well as a list of supplementary inexpensive chemical items that they could purchase from hardware stores and supermarkets. The experiments used were typical proximate analyses of food, as well as experiments focused on techniques such as spectrophotometry and chromatography. Written instructions for each experiment coupled with video laboratory demonstrations were used to train students on appropriate laboratory technique. Data that students collected in their home laboratory environment was collated across the class through shared documents, so that the group could carry out statistical analysis and experience a full laboratory experience from their own home. For the virtual laboratory component, students were able to view a laboratory safety induction and advised on good characteristics of a home laboratory space prior to carrying out their experiments. Following on from this activity, students observed laboratory demonstrations of the experimental series they would carry out in their learning environment. Finally, students were embedded in a virtual laboratory environment to experience complex chemical analyses with equipment that would be too costly and sensitive to be housed in their learning environment. To investigate the impact of the intervention, students were surveyed before and after the laboratory series to evaluate engagement and satisfaction with the course. Students were also assessed on their understanding of theoretical chemical concepts before and after the laboratory series to determine the impact on their learning. At the end of the intervention, focus groups were run to determine which aspects helped and hindered learning. It was found that the physical experiments helped students to understand laboratory technique, as well as methodology interpretation, particularly if they had not been in such a laboratory environment before. The virtual learning environment aided learning as it could be utilized for longer than a typical physical laboratory class, thus allowing further time on understanding techniques.Keywords: chemistry, food science, future pedagogy, STEM education
Procedia PDF Downloads 159645 A Generalized Framework for Adaptive Machine Learning Deployments in Algorithmic Trading
Authors: Robert Caulk
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A generalized framework for adaptive machine learning deployments in algorithmic trading is introduced, tested, and released as open-source code. The presented software aims to test the hypothesis that recent data contains enough information to form a probabilistically favorable short-term price prediction. Further, the framework contains various adaptive machine learning techniques that are geared toward generating profit during strong trends and minimizing losses during trend changes. Results demonstrate that this adaptive machine learning approach is capable of capturing trends and generating profit. The presentation also discusses the importance of defining the parameter space associated with the dynamic training data-set and using the parameter space to identify and remove outliers from prediction data points. Meanwhile, the generalized architecture enables common users to exploit the powerful machinery while focusing on high-level feature engineering and model testing. The presentation also highlights common strengths and weaknesses associated with the presented technique and presents a broad range of well-tested starting points for feature set construction, target setting, and statistical methods for enforcing risk management and maintaining probabilistically favorable entry and exit points. The presentation also describes the end-to-end data processing tools associated with FreqAI, including automatic data fetching, data aggregation, feature engineering, safe and robust data pre-processing, outlier detection, custom machine learning and statistical tools, data post-processing, and adaptive training backtest emulation, and deployment of adaptive training in live environments. Finally, the generalized user interface is also discussed in the presentation. Feature engineering is simplified so that users can seed their feature sets with common indicator libraries (e.g. TA-lib, pandas-ta). The user also feeds data expansion parameters to fill out a large feature set for the model, which can contain as many as 10,000+ features. The presentation describes the various object-oriented programming techniques employed to make FreqAI agnostic to third-party libraries and external data sources. In other words, the back-end is constructed in such a way that users can leverage a broad range of common regression libraries (Catboost, LightGBM, Sklearn, etc) as well as common Neural Network libraries (TensorFlow, PyTorch) without worrying about the logistical complexities associated with data handling and API interactions. The presentation finishes by drawing conclusions about the most important parameters associated with a live deployment of the adaptive learning framework and provides the road map for future development in FreqAI.Keywords: machine learning, market trend detection, open-source, adaptive learning, parameter space exploration
Procedia PDF Downloads 79644 Aberrant Acetylation/Methylation of Homeobox (HOX) Family Genes in Cumulus Cells of Infertile Women with Polycystic Ovary Syndrome (PCOS)
Authors: P. Asiabi, M. Shahhoseini, R. Favaedi, F. Hassani, N. Nassiri, B. Movaghar, L. Karimian, P. Eftekhariyazdi
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Introduction: Polycystic Ovary Syndrome is a common gynecologic disorder. Many factors including environment, metabolism, hormones and genetics are involved in etiopathogenesis of PCOS. Of genes that have altered expression in human reproductive system disorders are HOX family genes which act as transcription factors in regulation of cell proliferation, differentiation, adhesion and migration. Since recent evidences consider epigenetic factors as causative mechanisms of PCOS, evaluation of association between known epigenetic marks of acetylation/methylation of histone 3 (H3K9ac/me) with regulatory regions of these genes can represent better insight about PCOS. In the current study, cumulus cells (CCs) which have critical roles during folliculogenesis, oocyte maturation, ovulation and fertilization were aimed to monitor epigenetic alterations of HOX genes. Material and methods: CCs were collected from 20 PCOS patients and 20 fertile women (18-36 year) with male infertility problems referred to the Royan Institute to have ICSI under GnRH antagonist protocol. Informed consents were obtained from the participants. Thirty six hours after hCG injection, ovaries were punctured and cumulus oocyte complexes were dissected. Soluble chromatin were extracted from CCs and Chromatin Immune precipitation (ChIP) coupled with Real Time PCR was performed to quantify the epigenetic marks of histone H3K9 acetylation/methylation (H3K9ac/me) on regulatory regions of 15 members of HOX genes from A-D subfamily. Results: Obtained data showed significant increase of H3K9ac epigenetic mark on regulatory regions of HOXA1, HOXB2, HOXC4, HOXD1, HOXD3 and HOXD4 (P < 0.01) and HOXC5 (P < 0.05) and also significant decrease of H3K9ac into regulatory regions of HOXA2, HOXA4, HOXA5, HOXB1 and HOXB5 (P < 0.01) and HOXB3 (P<0.05) in PCOS patients vs. control group. On the other side, there was a significant decrease in incorporation of H3K9me level on regulatory region of HOXA2, HOXA3, HOXA4, HOXA5, HOXB3 and HOXC4 (P≤0.01) and HOXB5 (P < 0.05) in PCOS patients vs. control group. This epigenetic mark (H3K9me2) has significant increase on regulatory region of HOXB1, HOXB2, HOXC5, HOXD1, HOXD3 and HOXD4 (P ≤ 0.01) and HOXB4 (P < 0.05) in patients vs. control group. There were no significant changes in acetylation/methylation levels of H3K9 on regulatory regions of the other studied genes. Conclusion: Current study suggests that epigenetic alterations of HOX genes can be correlated with PCOS and consequently female infertility. This finding might offer additional definitions of PCOS, and eventually provides insight for novel treatments with epidrugs for this disease.Keywords: epigenetic, HOX genes, PCOS, female infertility
Procedia PDF Downloads 313643 Exploring Barriers to Quality of Care in South African Midwifery Obstetric Units: The Perspective of Nurses and Midwives
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Achieving quality and respectful maternal health care is part of the global agenda to improve reproductive health and achieve universal reproductive rights. Barriers to quality of care in South African maternal health facilities exist at both systemic and individual levels. Addition to this, the normalization of gender violence within South Africa has a large impact on people seeking health care as well as those who provide care within health facilities. The hierarchical environment of South Africa’s public health system penalizes both patients and providers who battle to assume any assessable power. This paper explores how systemic and individual level barriers to quality of care affect the midwifery profession within South African maternal health services and create, at times, an environment of enmity rather than care. This paper analyzes and discusses the data collected from in-depth, semi-structured interviews with nurses and midwives at three maternal health facilities in South Africa. This study has taken a holistic approach to understand the realities of nurses and midwives in order to explore the ways in which experience informs their practice and treatment of pregnant women. Through collecting and analyzing narratives, linkages between nurses and midwives day-to-day and historical experiences and disrespectful care have been made. Findings from this study show that barriers to quality of care take form in complex and interrelated ways. The physical structure of the health facility, human resource shortages, and the current model of maternal health care, which often lacks a person-centered approach, is entangled within personal beliefs and attitudes of what it means to be a midwife to create an environment that is often not conducive to a positive birthing experience. This entanglement sits within a society of high rates of violence, inequality, and poverty. Having teased out the nuances of each of these barriers and the multiple ways they reinforce each other, the findings of this paper demonstrate that birth, and the work of a midwife, are situated in a mode of discipline and punishment within this context. For analytical purposes, this paper has broken down the individual barriers to quality care and discusses the current and historical significance before returning to the interrelated forms in which barriers to quality maternal health care manifest. In conclusion this paper questions the role of agency in the ability to subvert systemic barriers to quality care and ideas around shifting attitudes and beliefs of and about midwives. International and local policies and guidelines have a role to play in realizing such shifts, however, as this paper suggests, when policy does not speak to the local context there is the risk of it contributing to frustrations and impeding the path to quality and respectful maternal health care.Keywords: disrespect and abuse in childbirth, midwifery, South African maternal health care, quality of care
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