Search results for: exploratory factors analysis

Authors: Dharmendra Pratap

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Large Cardamom (Amomum subulatum), family Zingiberaceae is an aromatic spice crop and has rich medicinal value. Large Cardamom is as synonymous to Sikkim as Tea is to Darjeeling. Since Sikkim alone contributes up to 88% of India's large cardamom production which is the world leader by producing over 50% of the global yield. However, the production of large cardamom has declined almost to half since last two decade. The economic losses have been attributed to two viral diseases namely, chirke and Foorkey. Chirke disease is characterized by light and dark green streaks on leaves. The affected leaves exhibit streak mosaic, which gradually coalesce, turn brown and eventually dry up. Excessive sprouting and formation of bushy dwarf clumps at the base of mother plants that gradually die characterize the foorkey disease. In our surveys in Sikkim–Darjeeling hill area during 2012-14, 40-45% of plants were found to be affected with foorkey disease and 10-15% with chirke. Mechanical and aphid transmission study showed banana as an alternate host for both the disease. For molecular identification, total genomic DNA and RNA was isolated from the infected leaf tissues and subjected to Rolling circle amplification (RCA) and RT-PCR respectively. The DNA concatamers produced in the RCA reaction were monomerized by different restriction enzymes and the bands corresponding to ~1 kb genomes were purified and cloned in the respective sites. The nucleotide sequencing results revealed the association of Nanovirus with the foorkey disease of large cardamom. DNA1 showed 74% identity with Replicase gene of FBNYV, DNA2 showed 77% identity with the NSP gene of BBTV and DNA3 showed 74% identity with CP gene of BBTV. The finding suggests the presence of a new species of nanovirus associated with foorkey disease of large cardamom in Sikkim and Darjeeling hills. The details of their epidemiology and other factors would be discussed.

Keywords: RCA, nanovirus, large cardamom, molecular virology and microbiology

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Authors: Yidan Xu, Pim Martens, Thomas Krafft

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

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

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Authors: Yunwei Tang, Linhai Jing, Hui Li, Qingjie Liu, Xiuxia Li, Qi Yan, Haifeng Ding

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The giant panda (Ailuropoda melanoleuca) is an endangered species, mainly live in central China, where bamboos act as the main food source of wild giant pandas. Knowledge of spatial distribution of bamboos therefore becomes important for identifying the habitat of giant pandas. There have been ongoing studies for mapping bamboos and other tree species using remote sensing. WorldView-2 (WV-2) is the first high resolution commercial satellite with eight Multi-Spectral (MS) bands. Recent studies demonstrated that WV-2 imagery has a high potential in classification of tree species. The advanced classification techniques are important for utilising high spatial resolution imagery. It is generally agreed that object-based image analysis is a more desirable method than pixel-based analysis in processing high spatial resolution remotely sensed data. Classifiers that use spatial information combined with spectral information are known as contextual classifiers. It is suggested that contextual classifiers can achieve greater accuracy than non-contextual classifiers. Thus, spatial correlation can be incorporated into classifiers to improve classification results. The study area is located at Wuyipeng area in Wolong, Sichuan Province. The complex environment makes it difficult for information extraction since bamboos are sparsely distributed, mixed with brushes, and covered by other trees. Extensive fieldworks in Wuyingpeng were carried out twice. The first one was on 11th June, 2014, aiming at sampling feature locations for geometric correction and collecting training samples for classification. The second fieldwork was on 11th September, 2014, for the purposes of testing the classification results. In this study, spectral separability analysis was first performed to select appropriate MS bands for classification. Also, the reflectance analysis provided information for expanding sample points under the circumstance of knowing only a few. Then, a spatially weighted object-based k-nearest neighbour (k-NN) classifier was applied to the selected MS bands to identify seven land cover types (bamboo, conifer, broadleaf, mixed forest, brush, bare land, and shadow), accounting for spatial correlation within classes using geostatistical modelling. The spatially weighted k-NN method was compared with three alternatives: the traditional k-NN classifier, the Support Vector Machine (SVM) method and the Classification and Regression Tree (CART). Through field validation, it was proved that the classification result obtained using the spatially weighted k-NN method has the highest overall classification accuracy (77.61%) and Kappa coefficient (0.729); the producer’s accuracy and user’s accuracy achieve 81.25% and 95.12% for the bamboo class, respectively, also higher than the other methods. Photos of tree crowns were taken at sample locations using a fisheye camera, so the canopy density could be estimated. It is found that it is difficult to identify bamboo in the areas with a large canopy density (over 0.70); it is possible to extract bamboos in the areas with a median canopy density (from 0.2 to 0.7) and in a sparse forest (canopy density is less than 0.2). In summary, this study explores the ability of WV-2 imagery for bamboo extraction in a mountainous region in Sichuan. The study successfully identified the bamboo distribution, providing supporting knowledge for assessing the habitats of giant pandas.

Keywords: bamboo mapping, classification, geostatistics, k-NN, worldview-2

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Authors: Precious Roselyn Obuobi

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Background: In Ghana, water-borne diseases remain a public health concern due to its impact. While marine pollution has been linked to outbreak of diseases especially in communities along the coast, associated risks such as oil spillage, marine debris, erosion, improper waste disposal and management practices persist. Objective: The study seeks to investigate sanitation practices that contribute to marine pollution in Prampram and the prevalence of selected water-borne diseases (diarrhea and typhoid fever). Method: This study used a descriptive cross-sectional design, employing the mix-method (qualitative and quantitative) approach. Twenty-two (22) participants were selected and semistructured questionnaire were administered to them. Additionally, interviews were conducted to collect more information. Further, an observation check-list was used to aid the data collection process. Secondary data comprising information on water-borne diseases in the district was acquired from the district health directorate to determine the prevalence of selected water-borne diseases in the community. Data Analysis: The qualitative data was analyzed using NVIVO® software by adapting the six steps thematic analysis by Braun and Clarke whiles STATA® version 16 was used to analyze the secondary data collected from the district health directorate. A descriptive statistic employed using mean, standard deviation, frequencies and proportions were used to summarize the results. Results: The results showed that open defecation and indiscriminate waste disposal were the main practices contributing to marine pollution in Prampram and its effect on public health. Conclusion: These findings have implications on public health and the environment, thus effort needs to be stepped up in educating the community on best sanitation practices.

Keywords: environment, sanitation, marine pollution, water-borne diseases

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Authors: Yazeed Al-Sheikh

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Pregnancy represents a risk factor in the occurrence of vulvovaginal candidiasis. To investigate the prevalence rate of vaginal carriage of Candida species in Saudi pregnant and non-pregnant women, high vaginal swab (HVS) specimens (707) were examined by direct microscopy (10% KOH and Giemsa staining) and parallel cultured on Sabouraud Dextrose Agar (SDA) as well as on “CHROM agar Candida” medium. As expected, Candida-positive cultures were frequently observed in pregnant-test group (24%) than in non-pregnant group (17%). The frequency of culture positive was correlated to pregnancy (P=0.047), parity (P=0.001), use of contraceptive (P=0.146), or antibiotics (P=0.128), and diabetic-patients (P < 0.0001). Out of 707 HVS examined specimens, 157 specimens were yeast-positive culture (22%) on Sabouraud Dextrose Agar or “CHROM agar Candida”. In comparison, the sensitivities of the direct 10% KOH and the Giemsa stain microscopic examination methods were 84% (132/157) and 95% (149/157) respectively but both with 100% specificity. As for the identity of recovered 157 yeast isolates, based on API 20C biotype carbohydrate assimilation, germ tube and chlamydospore formation, C. albicansand C. glabrata constitute 80.3 and 12.7% respectively. Rates of C. tropicalis, C. kefyr, C. famata or C. utilis were 2.6, 1.3, and 0.6% respectively. Sachromyces cerevisiae and Rhodotorula mucilaginosa yeasts were also encountered at a frequency of 1.3 and 0.6% respectively. Finally, among all recovered 157 yeast-isolates, strains resistant to ketoconazole were not detected, whereas 5% of the C. albicans and as high as 55% of the non-albicans yeast isolates (majority C. glabrata) showed resistance to fluconazole. Our findings may prove helpful for continuous determination of the existing vaginal candidiasis causative species during pregnancy, its lab-diagnosis and/or control and possible measures to minimize the incidence of the disease-associated pre-term delivery.

Keywords: vaginal candidiasis, Candida spp., pregnancy, risk factors, API 20C-yeast biotypes, giemsa stain, antifungal agents

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Authors: Anil Sharma, Ajay Kumar Mahur, R. G. Sonkawade, A. C. Sharma, R. Prasad

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In coal fired thermal power stations, large amount of fly ash is produced after burning of coal. Fly ash is spread and distributed in the surrounding area by air and may be deposited on the soil of the region surrounding the power plant. Coal contains increased levels of these radionuclides and fly ash may increase the radioactivity in the soil around the power plant. Radon atoms entering into the pore space from the mineral grain are transported by diffusion and advection through this space until they in turn decay or are released into the atmosphere. In the present study, Soil samples were collected from the region around a Kasimpur Thermal Power Plant, Kasimpur, Aligarh (U.P.). Radon activity, radon surface exhalation and mass exhalation rates were measured using “sealed can technique” using LR 115-type II nuclear track detectors. Radon activities vary from 92.9 to 556.8 Bq m-3 with mean value of 279.8 Bq m-3. Surface exhalation rates (EX) in these samples are found to vary from 33.4 to 200.2 mBq m-2 h-1 with an average value of 100.5 mBq m-2 h-1 whereas, Mass exhalation rates (EM) vary from 1.2 to 7.7 mBq kg-1 h-1 with an average value of 3.8 mBq kg-1 h-1. Activity concentrations of radionuclides were measured in these samples by using a low level NaI (Tl) based gamma ray spectrometer. Activity concentrations of 226Ra 232Th and 40K vary from 12 to 49 Bq kg-1, 24 to 49 Bq kg-1 and 135 to 546 Bq kg-1 with overall mean values of 30.3 Bq kg-1, 38.5 Bq kg-1 and 317.8 Bq kg-1, respectively. Radium equivalent activity has been found to vary from 80.0 to 143.7 Bq kg-1 with an average value of 109.7 Bq kg-1. Absorbed dose rate varies from 36.1 to 66.4 nGy h-1 with an average value of 50.4 nGy h-1 and corresponding outdoor annual effective dose varies from 0.044 to 0.081 mSv with an average value of 0.061 mSv. Values of external and internal hazard index Hex, Hin in this study vary from 0.21 to 0.38 and 0.27 to 0.50 with an average value of 0.29 and 0.37, Respectively. The results will be discussed in light of various factors.

Keywords: natural radioactivity, radium equivalent activity, absorbed dose rate, gamma ray spectroscopy

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Authors: Sudhanshu Sharma

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Lisinopril, 1-[N-{(s)-I-carboxy-3 phenyl propyl}-L-proline dehydrate is a lysine analog of enalaprilat, the active metabolite of enalapril. It is long-acting, non-sulhydryl angiotensin-converting enzyme (ACE) inhibitor that is used for the treatment of hypertension and congestive heart failure in daily dosage 10-80 mg. Pharmacological activity of lisinopril has been proved in various experimental and clinical studies. Owing to its importance and widespread use, efforts have been made towards the development of simple and reliable analytical methods. As per our literature survey, lisinopril in pharmaceutical formulations has been determined by various analytical methodologies like polaragraphy, potentiometry, and spectrophotometry, but most of these analytical methods are not too suitable for the Identification of lisinopril from clinical samples because of the interferences caused by the amino acids and amino groups containing metabolites present in biological samples. This report is an attempt in the direction of developing a simple and reliable method for on plate identification and quantification of lisinopril in pharmaceutical formulations as well as from human urine samples using silica gel H layers developed with a new mobile phase comprising of micellar solutions of N-cetyl-N, N, N-trimethylammonium bromide (CTAB). Micellar solutions have found numerous practical applications in many areas of separation science. Micellar liquid chromatography (MLC) has gained immense popularity and wider applicability due to operational simplicity, cost effectiveness, relatively non-toxicity and enhanced separation efficiency, low aggressiveness. Incorporation of aqueous micellar solutions as mobile phase was pioneered by Armstrong and Terrill as they accentuated the importance of TLC where simultaneous separation of ionic or non-ionic species in a variety of matrices is required. A peculiarity of the micellar mobile phases (MMPs) is that they have no macroscopic analogues, as a result the typical separations can be easily achieved by using MMPs than aqueous organic mobile phases. Previously MMPs were successfully employed in TLC based critical separations of aromatic hydrocarbons, nucleotides, vitamin K1 and K5, o-, m- and p- aminophenol, amino acids, separation of penicillins. The human urine analysis for identification of selected drugs and their metabolites has emerged as an important investigation tool in forensic drug analysis. Among all chromatographic methods available only thin layer chromatography (TLC) enables a simple fast and effective separation of the complex mixtures present in various biological samples and is recommended as an approved testing for forensic drug analysis by federal Law. TLC proved its applicability during successful separation of bio-active amines, carbohydrates, enzymes, porphyrins, and their precursors, alkaloid and drugs from urine samples.

Keywords: lisnopril, surfactant, chromatography, micellar solutions

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Authors: A. Lubis, R. Widayanti, Z. Hikmah, A. Endaryanto, A. Harsono, A. Harianto, R. Etika, D. K. Handayani, M. Sampurna

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Neonatal lupus erythematous (NLE) is a rare disease marked by clinical characteristic and specific maternal autoantibody. Many cutaneous, cardiac, liver, and hematological manifestations could happen with affect of one organ or multiple. In this case, both babies were premature, low birth weight (LBW), small for gestational age (SGA) and born through caesarean section from a systemic lupus erythematous (SLE) mother. In the first case, we found a baby girl with dyspnea and grunting. Chest X ray showed respiratory distress syndrome (RDS) great I and echocardiography showed small atrial septal defect (ASD) and ventricular septal defect (VSD). She also developed anemia, thrombocytopenia, elevated C-reactive protein, hypoalbuminemia, increasing coagulation factors, hyperbilirubinemia, and positive blood culture of Klebsiella pneumonia. Anti-Ro/SSA and Anti-nRNP/sm were positive. Intravenous fluid, antibiotic, transfusion of blood, thrombocyte concentrate, and fresh frozen plasma were given. The second baby, male presented with necrotic tissue on the left ear and skin rashes, erythematous macula, athropic scarring, hyperpigmentation on all of his body with various size and facial haemorrhage. He also suffered from thrombocytopenia, mild elevated transaminase enzyme, hyperbilirubinemia, anti-Ro/SSA was positive. Intravenous fluid, methyprednisolone, intravenous immunoglobulin (IVIG), blood, and thrombocyte concentrate transfution were given. Two cases of neonatal lupus erythematous had been presented. Diagnosis based on clinical presentation and maternal auto antibody on neonate. Organ involvement in NLE can occur as single or multiple manifestations.

Keywords: neonatus lupus erythematous, maternal autoantibody, clinical characteristic, multiple organ manifestation

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Authors: Anthony Quansah, Tresor Ntaryamira, Shula Mushota

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Models for geotechnical centrifuge testing are usually made from re-formed soil, allowing for comparisons with naturally occurring soil deposits. However, there is a fundamental omission in this process because the natural soil is deposited in layers creating a unique structure. Nonlinear dynamics of clay material deposit is an essential part of changing the attributes of ground movements when subjected to solid seismic loading, particularly when diverse intensification conduct of speeding up and relocation are considered. The paper portrays a review of axis shaking table tests and numerical recreations to explore the offshore clay deposits subjected to seismic loadings. These perceptions are accurately reenacted by DEEPSOIL with appropriate soil models and parameters reviewed from noteworthy centrifuge modeling researches. At that point, precise 1-D site reaction investigations are performed on both time and recurrence spaces. The outcomes uncover that for profound delicate clay is subjected to expansive quakes, noteworthy increasing speed lessening may happen close to the highest point of store because of soil nonlinearity and even neighborhood shear disappointment; nonetheless, huge enhancement of removal at low frequencies are normal in any case the forces of base movements, which proposes that for dislodging touchy seaward establishments and structures, such intensified low-recurrence relocation reaction will assume an essential part in seismic outline. This research shows centrifuge as a tool for creating a layered sample important for modelling true soil behaviour (such as permeability) which is not identical in all directions. Currently, there are limited methods for creating layered soil samples.

Keywords: seismic analysis, layered modeling, terotechnology, finite element modeling

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Authors: Ben Yahia Nouha, Sebei Abdelaziz, Boussen Slim, Chaabani Fredj

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The present work aims to determine mineralogical and geochemical characteristics of siliceous rock levels and to clarify the origin through geochemical arguments. This study was performed on the deposit of Tabarka-Babouch, which belongs to the northwestern of Tunisia; they spread out the later Miocene. Investigations were carried out to study mineralogical structure by XRD and chemical analysis by ICP-AES. The X-ray diffraction (XRD) patterns of the powdered natural rocks show that the Babouchite is composed mainly of quartz and clay minerals (smectite, illite, and kaolinite). Siliceous rocks contain quartz as a major silica mineral, which is characterized by two broad reflections at the vicinity of 4.26Å and 3.34 Å, respectively, with a total lack of opal-CT. That confirms that these siliceous rocks are quartz-rich (can reach 90%). Indeed, the amounts of all clay minerals (ACM), constituted essentially by smectite marked by a close association with illite and kaolinite, are relatively high, where their percentages vary from 7 to 46%. Chemical analyses show that the major oxide contents are consistent with mineralogical observations. It reveals that the siliceous rocks of the Babouchite formation are rich in SiO₂. The data of whole-rock chemical analyses indicate that the SiO₂ content is generally in the range 73-91 wt.%; (average: 80.43 wt.%). The concentration of Al₂O₃, which represent the detrital fractions in the studied samples, varies from 3.99 to 10.55 wt. % and Fe₂O₃ from 0.73 to 4.41wt. %. The low levels recorded in CaO (%) show that the carbonate is considered impurities. However, these rocks contain a low amount of some others oxides, such as the following: Na₂O, MgO, K₂O, and TiO₂. The trace elemental distributions also vary with high Sr (up to 84.55 ppm), Cu (5–127 ppm), and Zn (up to 124 ppm), with a relatively lower concentration of Co (2.43-25.54 ppm), Cr (10–61 ppm) and Pb (8-22ppm). The Babouchite siliceous rocks of northwestern of Tunisia have generally high Al/ (Al+Fe+Mn) values (0.63-0.83). The majority of Al/ (Al+Fe+Mn) values are nearly of 0.6, which is the biogenic end-member. Thus, Al/ (Al+Fe+Mn) values revealed the biogenic origin of silica.

Keywords: siliceous rocks, Babouchite formation, XRD, chemical analysis, biogenic silica, Northwestern of Tunisia

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Authors: H. Zormati, J. Chebil, J. Bel Hadj Taher

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The goal of this paper is to present an addressing scheme that allows for assigning a unique IPv6 address to each node in the Internet of Things (IoT) network. This scheme guarantees uniqueness by extracting the clock skew of each communication device and converting it into an IPv6 address. Simulation analysis confirms that the presented scheme provides reductions in terms of energy consumption, communication overhead and response time as compared to four studied addressing schemes Strong DAD, LEADS, SIPA and CLOSA.

Keywords: addressing, IoT, IPv6, network, nodes

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Authors: Krzysztof Plesiewicz, Izabela Plesiewicz, Krzysztof Chiżyński, Marzenna Zielińska

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Background: Obesity is an independent risk factor for cardiovascular diseases. There are several anthropometric parameters proposed to estimate the level of obesity, but until now there is no agreement which one is the best predictor of cardiometabolic risk. Scientists defined metabolically obese normal weight, who suffer from metabolic abnormalities, the same as obese individuals, and defined this syndrome as normal weight obesity (NWO). Aim of the study: The aim of our study was to determine the occurrence of overweight and obesity in a cohort of young, adult women, using standard and complementary methods of obesity assessment and to indicate those, who are at risk of obesity. The second aim of our study was to test additional methods of obesity assessment and proof that body mass index using alone is not sufficient parameter of obesity assessment. Materials and methods: 384 young women, aged 18-32, were enrolled into the study. Standard anthropometric parameters (waist to hips ratio (WTH), waist to height ratio (WTHR)) and two other methods of body fat percentage measurement (BFPM) were used in the study: electrical bioimpendance analysis (BIA) and skinfold measurement test by digital fat body mass clipper (SFM). Results: In the study group 5% and 7% of participants had waist to hips ratio and accordingly waist to height ratio values connected with visceral obesity. According to BMI 14% participants were overweight and obese. Using additional methods of body fat assessment, there were 54% and 43% of obese for BIA and SMF method. In the group of participants with normal BMI and underweight (not overweight, n =340) there were individuals with the level of BFPM above the upper limit, for the BIA 49% (n =164) and for the SFM 36 % (n=125). Statistical analysis revealed strong correlation between BIA and SFM methods. Conclusion: BMI using alone is not a sufficient parameter of obesity assessment. High percentage of young women with normal BMI values seem to be normal weight obese.

Keywords: electrical bioimpedance, normal weight obesity, skin-fold measurement test, women

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Authors: Anucha Wittayakorn-Puripunpinyoo

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The research objectives were 1) to study the situation and its trend of agricultural product export of Thailand 2) to study the impact of agricultural product export on income of Thai economy 3) the impact of agricultural product export on employment of Thai economy and 4) to find out the recommendations of agricultural product export policy of Thailand. In this research, secondary data were collected as yearly time series data from 1990 to 2016 accounted for 27 years. Data were collected from the Bank of Thailand database. Primary data were collected from the steakholders of agricultural product export policy of Thailand. Data analysis was applied descriptive statistics such as arithmetic mean, standard deviation. The forecasting of agricultural product was applied Mote Carlo Simulation technique as well as time trend analysis. In addition, the impact of agricultural product export on income and employment by applying econometric model while the estimated parameters were utilized the ordinary least square technique. The research results revealed that 1) agricultural product export value of Thailand from 1990 to 2016 was 338,959.5 Million Thai baht with its growth rate of 4.984 percent yearly, in addition, the forecasting of agricultural product export value of Thailand has increased but its growth rate has been declined 2) the impact of agricultural product export has positive impact on income in Thai economy, increasing in agricultural product export of Thailand by 1 percent would lead income increased by 0.0051 percent 3) the impact of agricultural product export has positive impact on employment in Thai economy, increasing in agricultural product export of Thailand by 1 percent would lead income increased by 0.079 percent and 4) in the future, agricultural product export policy would focused on finished or semi-finished agricultural product instead of raw material by applying technology and innovation in to make value added of agricultural product export. The public agricultural product export policy would support exporters in private sector in order to encourage them as agricultural exporters in Thailand.

Keywords: agricultural product export, income, employment, Thai economy

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Authors: Yibeltal T. Bayou, Yohana S. Mashalla, Gloria Thupayagale-Tshweneagae

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Background: Maternal mortality has been shown to be lower in urban areas than in rural areas. However, disparities for the fast-growing population of urban poor who struggle as much their rural counterparts to access quality healthcare are masked by the urban averages. The aim of this paper is to report on the findings of antenatal adequacy among slum residents in Addis Ababa, Ethiopia. Methods and Materials: A quantitative and cross-sectional community-based study design was employed. A stratified two-stage cluster sampling technique was used to determine the sample and data was collected using structured questionnaire administered to 837 women aged 15-49 years. Binary logistic regression models were employed to identify predictors of adequacy of antenatal care. Results: The majority of slum residents did not have adequate antenatal care services i.e., only 50.7%, 19.3% and 10.2% of the slum resident women initiated early antenatal care, received adequate antenatal care service contents and had overall adequate antenatal care services. Pregnancy intention, educational status and place of ANC visits were important determinant factors for adequacy of ANC in the study area. Women with secondary and above educational status were 2.9 times more likely to have overall adequate care compared to those with no formal education. Similarly, women whose last pregnancy was intended and clients of private healthcare facilities were 1.8 and 2.8 times more likely to have overall adequate antenatal care compared to those whose last pregnancy was unintended and clients of public healthcare facilities respectively. Conclusion: In order to improve ANC adequacy in the study area, the policymaking, planning, and implementation processes should focus on the poor adequacy of ANC among the disadvantaged groups in particular and the slum residents in general.

Keywords: Addis Ababa, adequacy of antenatal care, slum residents, maternal mortality

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Authors: Sayyed-Javad Ziaolhagh, Mojtaba Hokmabadi

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Introduction: Childhood obesity is a serious medical condition that affects children and adolescents even in the central nervous system. Semaphorins also play a role in the inflammatory process of the nervous system. On the other hand, it has been stated that garlic and stevia extracts following aerobic exercise are effective on immune system inflammation in addition to aerobic activity. Materials and Methods: For 15 weeks, 50 3-week-old male Wistar rats were fed with conventional rodent chow for control and a high-fat diet to induce obesity. Obese rats then were randomly assigned into 7 groups (n=5) based on the Lee index: healthy control (C), obese (OBS), obese + garlic (OBS+GAR), obese + Stevia (OBS+STV), obese + aerobic exercise (OBS+EXE), obese + garlic + aerobic exercise (OBS+GAR+EXE), and obese + stevia + aerobic exercise (OBS+STV+EXE). Training groups completed a progressive aerobic running program (at 8-15 m/min, 5-20 min/day, 5 days/week), and Stevia and garlic extract group (250 mg/kg/day, 5 days/week) were given orally once a day. Real-time PCR was used to determine the levels of Semaphorin 4A, and Plexin D1 gene expressions in the hypothalamus. Fold change analysis with ANOVA was performed for statistical analysis, with a significance threshold of P<0.05. Results: Body weight increased significantly in OBS compared to C (p= 0.013), but was not significantly changed in all treatment rats. Moreover, Semaphorin 4A was significantly increased in obese compared to control group (p= 0.041) and after 8 weeks, stevia extract (p=0.006), aerobic exercise (p=0.012) and garlic extract + aerobic exercise (p=0.008) significantly decreased compared to obese rats. In addition, Plexin D1 genes were also found in the hypothalamus of both obese and control rats but were insignificantly up-regulated when compared with the obese group (p=0.950). Conclusion: High-fat diet caused neuroinflammation by elevation of sema4A in obese rats and stevia, stevia with aerobic and garlic with aerobic could reduce this inflammation in rats. Also, none of them could alter Plexin D1.

Keywords: sema 4A, plexin D1, garlic, stevia

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Authors: Rahma Goussi, Walid Derbali, Arafet Manaa, Simone Cantamessa, Graziella Berta, Chedly Abdelly, Roberto Barbato

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Salinity is one of the most important abiotic affecting plant growth and productivity worldwide. Photosynthesis, together with cell growth, is among the primary processes to be affected by salinity. Here, we report the effects of salinity stress on the primary processes of photosynthesis in a model halophyte Thellungiella Salsuginea. Plants were cultivated in hydroponic system with different NaCl concentrations (0, 100, 200 and 400 mM) during 2 weeks. The obtained results showed an obvious change in the photosynthetic efficiency of photosystem I (PSI) and phostosytem II (PSII), related to NaCl concentration supplemented to the medium and the stress duration considered. With moderate salinity (100 and 200 mM NaCl), no significant variation was observed in photosynthetic parameters of PSI and PSII and Chl fluorescence whatever the time of stress application. Also, the photosynthesis apparatus Fo, Fm and Fv fluorescence, as well as Fv/Fm were not affected by salt stress. While a significant decrease was observed on quantum yields Y(I), Y(II) and electron transport rate ETR(I), ETR(II) under high salt treatment (400 mM NaCl) with prolonged period (15 days). This reduction is quantitatively compensated by a corresponding increase of energy dissipation Y(NPQ) and a progressive decrease in Fv/Fm under salt treatment. The intensity of the OJIP fluorescence transient decreased with increase in NaCl concentration, with a major effect observed during prolonged period of salt stress. Ultrastructural analysis with Light Microscopy and Transmission Electron Microscopy of T. salsuginea chloroplasts showed some cellular changes, such as the shape of the mesophyll cells and number of chloroplast/cell only under higher NaCl concentration. Salt-stress caused the swelling of thylakoids in T. Salsuginea mesophyll with more accumulation of starch as compared to control plant.

Keywords: fluorescence, halophyte, photosynthesis, salt stress

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Authors: Adesomoju O. A., E. A. Onemolease, G. O. Igene

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The study analyzed the determinants of food insecurity among smallholder farming households in the Southwestern part of Nigeria with Ondo and Osun States in focus. Multi-stage sampling procedures were employed to gather data from 389 farming households (194 from Ondo State and 195 from Osun State) spread across 4 agricultural zones, 8 local governments, and 24 communities. The data was analyzed using descriptive statistics, Ordinal regression, and Friedman test. Results revealed the average age of the respondents was 47 years with majority being male 63.75% and married 82.26% and having an household size of 6. Most household heads were educated (94.09%), engaged in farming for about 19 years, and do not belong to cooperatives (73.26%). Respondents derived income from both farming and non-farm activities with the average farm income being N216,066.8/annum and non-farm income being about N360,000/annum. Multiple technologies were adopted by respondents such as application of herbicides (77.63%), pesticides (73.26%) and fertilizers (66.58%). Using the FANTA Cornel model, food insecurity was prevalent in the study area with the majority (61.44%) of the households being severely food insecure, and 35.73% being moderately food insecure. In comparison, 1.80% and 1.03% were food-secured and mildly food insecure. The most significant constraints to food security among the farming households were the inability to access credit (mean rank = 8.78), poor storage infrastructure (8.57), inadequate capital (8.56), and high cost of farm chemicals (8.35). Significant factors related to food insecurity among the farming households were age (b = -0.059), education (b = -0.376), family size (b = 0.197), adoption of technology (b = -0.198), farm income (b = -0.335), association membership (b = -0.999), engagement in non-farm activities (b = -1.538), and access to credit (b = -0.853). Linking farmers' groups to credit institutions and input suppliers was proposed.

Keywords: food insecurity, FANTA Cornel, Ondo, Osun, Nigeria, Southwest, Livelihood

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Authors: Oluyomi Stephen Adeyemi, Kentaro Kato

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Toxoplasma gondii is the etiological agent of toxoplasmosis, a common parasitic disease capable of infecting a range of hosts, including nearly one-third of the human population. Current treatment options for toxoplasmosis patients are limited. In consequence, toxoplasmosis represents a large global burden that is further enhanced by the shortcomings of the current therapeutic options. These factors underscore the need for better anti-T. gondii agents and/or new treatment approach. In the present study, we sought to find out whether preparing and capping nanoparticles (NPs) in amino acids, would enhance specificity toward the parasite versus the host cell. The selection of amino acids was premised on the fact that T. gondii is auxotrophic for some amino acids. The amino acid-nanoparticles (amino-NPs) were synthesized, purified and characterized following established protocols. Next, we tested to determine the anti-T. gondii activity of the amino-NPs using in vitro experimental model of infection. Overall, our data show evidence that supports enhanced and excellent selective action against the parasite versus the host cells by amino-NPs. The findings are promising and provide additional support that warrants exploring the prospects of NPs as alternative anti-parasite agents. In addition, the anti-parasite action by amino-NPs indicates that nutritional requirement of parasite may represent a viable target in the development of better alternative anti-parasite agents. Furthermore, data suggest the anti-parasite mechanism of the amino-NPs involves multiple cellular processes including the production of reactive oxygen species (ROS), modulation of hypoxia-inducing factor-1 alpha (HIF-1α) as well as the activation of kynurenine pathway. Taken together, findings highlight further, the prospects of NPs as alternative source of anti-parasite agents.

Keywords: drug discovery, infectious diseases, mode of action, nanomedicine

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Authors: Daniele Losanno, H. A. Hadad, Giorgio Serino

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This paper presents a numerical investigation on the seismic performance of a benchmark bridge with different optimal isolation systems under near fault ground motion. Usually, very large displacements make seismic isolation an unfeasible solution due to boundary conditions, especially in case of existing bridges or high risk seismic regions. Hence, near-fault ground motions are most likely to affect either structures with long natural period range like isolated structures or structures sensitive to velocity content such as viscously damped structures. The work is aimed at analyzing the seismic performance of a three-span continuous bridge designed with different isolation systems having different levels of damping. The case study was analyzed in different configurations including: (a) simply supported, (b) isolated with lead rubber bearings (LRBs), (c) isolated with rubber isolators and 10% classical damping (HDLRBs), and (d) isolated with rubber isolators and 70% supplemental damping ratio. Case (d) represents an alternative control strategy that combines the effect of seismic isolation with additional supplemental damping trying to take advantages from both solutions. The bridge is modeled in SAP2000 and solved by time history direct-integration analyses under a set of six recorded near-fault ground motions. In addition to this, a set of analysis under Italian code provided seismic action is also conducted, in order to evaluate the effectiveness of the suggested optimal control strategies under far field seismic action. Results of the analysis demonstrated that an isolated bridge equipped with HDLRBs and a total equivalent damping ratio of 70% represents a very effective design solution for both mitigation of displacement demand at the isolation level and base shear reduction in the piers also in case of near fault ground motion.

Keywords: isolated bridges, near-fault motion, seismic response, supplemental damping, optimal design

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Authors: Al-Amin, Huanjun Jiang, Anayat Ali

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Reinforced concrete frames (RC), especially Ordinary RC frames, are prone to structural failures/collapse during seismic events, leading to a large proportion of debris from the structures, which obstructs adjacent areas, including streets. These blocked areas severely impede post-earthquake resilience. This study uses computational simulation (FEM) to investigate the amount of debris generated by the seismic collapse of an ordinary reinforced concrete moment frame building and its effects on the adjacent pedestrian and road network. A three-story ordinary reinforced concrete frame building, primarily designed for gravity load and earthquake resistance, was selected for analysis. Sixteen different ground motions were applied and scaled up until the total collapse of the tested building to evaluate the failure mode under various seismic events. Four types of collapse direction were identified through the analysis, namely aligned (positive and negative) and skewed (positive and negative), with aligned collapse being more predominant than skewed cases. The amount and distribution of debris around the collapsed building were assessed to investigate the interaction between collapsed buildings and adjacent street networks. An interaction was established between a building that collapsed in an aligned direction and the adjacent pedestrian walkway and narrow street located in an unplanned old city. The FEM model was validated against an existing shaking table test. The presented results can be utilized to simulate the interdependency between the debris generated from the collapse of seismic-prone buildings and the resilience of street networks. These findings provide insights for better disaster planning and resilient infrastructure development in earthquake-prone regions.

Keywords: building collapse, earthquake-induced debris, ORC moment resisting frame, street network

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Authors: Jin Uk Han, Hye Won Han, Hyo Lim Kang, Tae An Kim, Seung Ho Han

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Direct-drive generators for large-scale wind turbine, which are divided into AFPM(Axial Flux Permanent Magnet) and RFPM(Radial Flux Permanent Magnet) type machine, have attracted interest because of a higher energy density in comparison with gear train type generators. Each type of the machines provides distinguishable geometrical features such as narrow width with a large diameter for the AFPM-type machine and wide width with a certain diameter for the RFPM-type machine. When the AFPM-type machine is applied, an increase of electric power production through a multi-stage arrangement in axial direction is easily achieved. On the other hand, the RFPM-type machine can be applied by using its geometric feature of wide width. In this study, a hybrid two-stage direct-drive generator for 6.2MW class wind turbine was proposed, in which the two-stage AFPM-type machine for 5 MW was composed of two models arranged in axial direction with a hollow shape topology of the rotor with annular disc, the stator and the main shaft mounted on coupled slew bearings. In addition, the RFPM-type machine for 1.2MW was installed at the empty space of the rotor. Analytic results obtained from an electro-magnetic and structural interaction analysis showed that the structural weight of the proposed hybrid two-stage direct-drive generator can be achieved as 155tonf in a condition satisfying the requirements of structural behaviors such as allowable air-gap clearance and strength. Therefore, it was sure that the 6.2MW hybrid two-stage direct-drive generator is competitive than conventional generators. (NRF grant funded by the Korea government MEST, No. 2017R1A2B4005405).

Keywords: AFPM-type machine, direct-drive generator, electro-magnetic analysis, large-scale wind turbine, RFPM-type machine

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Authors: Ioanna Skoufali

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The present study is directed towards adaptation to climate change closely related to the phenomenon of the urban heat island (UHI). This issue is widespread and common to different urban realities, but particularly in Mediterranean cities that are characterized by dense urban. The attention of this work of redevelopment of the open space is focused on mitigation techniques aiming to solve local problems such as microclimatic parameters and the conditions of thermal comfort in summer, related to urban morphology. This quantitative analysis, evaluation, and verification survey involves the methodological elaboration applied in a real study case by Serres, through the experimental support of the ENVImet Pro V4.1 and BioMet software developed: i) in two phases concerning the anteoperam (phase a1 # 2013) and the post-operam (phase a2 # 2016); ii) in scenario A (+ 25% of green # 2017). The first study tends to identify the main intervention strategies, namely: the application of cool pavements, the increase of green surfaces, the creation of water surface and external fans; moreover, it obtains the minimum results achieved by the National Program 'Bioclimatic improvement project for public open space', EPPERAA (ESPA 2007-2013) related to the four environmental parameters illustrated below: the TAir = 1.5 o C, the TSurface = 6.5 o C, CDH = 30% and PET = 20%. In addition, the second study proposes a greater potential for improvement than postoperam intervention by increasing the vegetation within the district towards the SW/SE. The final objective of this in-depth design is to be transferable in homogeneous cases of urban regeneration processes with obvious effects on the efficiency of microclimatic mitigation and thermal comfort.

Keywords: cool pavements, microclimate parameters (TAir, Tsurface, Tmrt, CDH), mitigation strategies, outdoor thermal comfort (PET & UTCI)

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Authors: O. E. Eberechi, G. P. Stevens

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Legal theory has been referred to as the explanation of why things do or do not happen. It also describes situations and why they ensue. It provides a normative framework by which things are regulated and a foundation for the establishment of legal mechanisms/institutions that can bring about a desired change in a society. Furthermore, it offers recommendations in resolving practical problems and describes what the law is, what the law ought to be and defines the legal landscape generally. Some legal theories provide a universal standard, e.g. human rights, while others are capable of organizing and streamlining the collective use, and, by extension, bring order to society. Legal theory is used to explain how the world works and how it does not work. This paper will argue for the application of the principles of legal theory in the achievement of access to justice for female victims of sexual violence in refugee camps in Africa through the analysis of legal theories underpinning the access to justice for these women. It is a known fact that female refugees in camps in Africa often experience some form of sexual violation. The perpetrators of these incidents may never be apprehended, prosecuted, convicted or sentenced. Where prosecution does occur, the perpetrators are either acquitted as a result of poor investigation, inept prosecution, a lack of evidence, or the case may be dismissed owing to tardiness on the part of the prosecutor, which accounts for the culture of impunity in refugee camps. In other words, victims do not have access to the justice that could ameliorate the plight of the victims. There is, thus, a need for a legal framework that will facilitate access to justice for these victims. This paper will start with an introduction, and be followed by the definition of legal theory, its functions and its application in law. Secondly, it will provide a brief explanation of the problems faced by female refugees who are victims of sexual violence in refugee camps in Africa. Thirdly, it will embark on an analysis of theories which will be a help to an understanding of the precarious situation of female refugees, why they are violated, the need for access to justice for these victims, and the principles of legal theory in its usefulness in resolving access to justice for these victims.

Keywords: access to justice, underpinning legal theory, refugee, sexual violence

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Authors: Yohanes Kambaru Windi, Loetfia Dwi Rahariyani, Dyah Wijayanti, Eko Rustamaji

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Surabaya, the second largest city in Indonesia, has been struggling for years with waste production and its management. Nearly 11,000 tons of waste are generated daily by domestic, commercial and industrial areas. It is predicted that approximately 1,300 tons of waste overflew the Benowo Landfill daily in 2013 and projected that the landfill operation will be critical in 2015. The Super Depo Sutorejo (SDS) is a pilot project on waste management launched by the government of Surabaya in March 2013. The project is aimed to reduce the amount of waste dumped in landfill by sorting the recyclable and organic waste for composting by employing waste pickers to sort the waste before transported to landfill. This study is intended to assess the capacity of SDS to process and reduce waste and its complementary benefits. It also overviews the benefits of the project to the waste pickers in term of satisfaction to the job. Waste processing data-sheets were used to assess the difference between input and outputs waste. A survey was distributed to 30 waste pickers and interviews were conducted as a further insight on a particular issue. The analysis showed that SDS enable to reduce waste up to 50% before dumped in the final disposal area. The cost-benefits analysis using cost differential calculation revealed the economic benefit is considerable low, but composting may substitute tangible benefits for maintain the city’s parks. Waste pickers are mostly satisfied with their job (i.e. Salary, health coverage, job security), services and facilities available in SDS and enjoyed rewarding social life within the project. It is concluded that SDS is an effective and efficient model for sustainable waste management and reliable to be developed in developing countries. It is a strategic approach to empower and open up working opportunity for the poor urban community and prolong the operation of landfills.

Keywords: cost-benefits, integration, satisfaction, waste management

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Authors: Moen Torill, Rismark Marit, Astrid M. Solvberg

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In Norway, every municipality shall provide an educational psychological service, EPS, to support kindergartens and schools in their work with children and youths with special needs. The EPS focus its work on individuals, aiming to identify special needs and to give advice to teachers and parents when they ask for it. In addition, the service also give priority to prevention and system intervention in kindergartens and schools. To master these big tasks university courses are established to support EPS counsellors' continuous learning. There is, however, a need for more in-depth and systematic knowledge on how they experience the courses they attend. In this study, EPS counsellors’ reflection logs during a particular course are investigated. The research question is: what are the content and priorities of the reflections that are communicated in the logs produced by the educational psychological counsellors during a post-graduate course? The investigated course is a credit course organized over a one-year period in two one-semester modules. The altogether 55 students enrolled in the course work as EPS counsellors in various municipalities across Norway. At the end of each day throughout the course period, the participants wrote reflection logs about what they had experienced during the day. The data material consists of 165 pages of typed text. The collaborating researchers studied the data material to ascertain, differentiate and understand the meaning of the content in each log. The analysis also involved the search for similarity in content and development of analytical categories that described the focus and primary concerns in each of the written logs. This involved constant 'critical and sustained discussions' for mutual construction of meaning between the co-researchers in the developing categories. The process is inspired by Grounded Theory. This means that the concepts developed during the analysis derived from the data material and not chosen prior to the investigation. The analysis revealed that the concept 'Useful' frequently appeared in the participants’ reflections and, as such, 'Useful' serves as a core category. The core category is described through three major categories: (1) knowledge sharing (concerning direct and indirect work with students with special needs) with colleagues is useful, (2) reflections on models and theoretical concepts (concerning students with special needs) are useful, (3) reflection on the role as EPS counsellor is useful. In all the categories, the notion of useful occurs in the participants’ emphasis on and acknowledgement of the immediate and direct link between the university course content and their daily work practice. Even if each category has an importance and value of its own, it is crucial that they are understood in connection with one another and as interwoven. It is the connectedness that gives the core category an overarching explanatory power. The knowledge from this study may be a relevant contribution when it comes to designing new courses that support continuing professional development for EPS counsellors, whether for post-graduate university courses or local courses at the EPS offices or whether in Norway or other countries in the world.

Keywords: constructing and circulating knowledge, educational-psychological counsellor, higher education, professional development

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Authors: Gökhan Karhan, Yavuz Elitok

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Nowadays, inequality between developing and underdeveloped countries has a rapid increment. Developed countries impress the underdeveloped countries to become dependent through them. For that reason, Turkey has to increase its capability of making technological innovations. It has tried to be identified by examining the expenses of R&D in public, mercantile establishments and universities in Turkey that which expense is not enough and which expense should be doubled. As a result, developing new resolution strategies will be easier.

Keywords: competitive strength, research and development, technological innovation, Turkey

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Authors: Patricia M. Boechler, Heather M. Gautreau

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In this research study, postsecondary students completed an information learning task in an avatar-based 3D virtual learning environment. Three factors were of interest in relation to learning; 1) the influence of collaborative vs. independent conditions, 2) the influence of the spatial arrangement of the virtual environment (linear, random and clustered), and 3) the relationship of individual differences such as spatial skill, general computer experience and video game experience to learning. Students completed pretest measures of prior computer experience and prior spatial skill. Following the premeasure administration, students were given instruction to move through the virtual environment and study all the material within 10 information stations. In the collaborative condition, students proceeded in randomly assigned pairs, while in the independent condition they proceeded alone. After this learning phase, all students individually completed a multiple choice test to determine information retention. The overall results indicated that students in pairs did not perform any better or worse than independent students. As far as individual differences, only spatial ability predicted the performance of students. General computer experience and video game experience did not. Taking a closer look at the pairs and spatial ability, comparisons were made on pairs high/matched spatial ability, pairs low/matched spatial ability and pairs that were mismatched on spatial ability. The results showed that both high/matched pairs and mismatched pairs outperformed low/matched pairs. That is, if a pair had even one individual with strong spatial ability they would perform better than pairs with only low spatial ability individuals. This suggests that, in virtual environments, the specific individuals that are paired together are important for performance outcomes. The paper also includes a discussion of trends within the data that have implications for virtual environment education.

Keywords: avatar-based, virtual environment, paired learning, individual differences

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Authors: Waqqas-ur-Rehman Butt, Martin Servin, Marion Pause

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In recent years, object detection has gained much attention and very encouraging research area in the field of computer vision. The robust object boundaries detection in an image is demanded in numerous applications of human computer interaction and automated surveillance systems. Many methods and approaches have been developed for automatic object detection in various fields, such as automotive, quality control management and environmental services. Inappropriately, to the best of our knowledge, object detection under illumination with shadow consideration has not been well solved yet. Furthermore, this problem is also one of the major hurdles to keeping an object detection method from the practical applications. This paper presents an approach to automatic object detection in images under non-standardized environmental conditions. A key challenge is how to detect the object, particularly under uneven illumination conditions. Image capturing conditions the algorithms need to consider a variety of possible environmental factors as the colour information, lightening and shadows varies from image to image. Existing methods mostly failed to produce the appropriate result due to variation in colour information, lightening effects, threshold specifications, histogram dependencies and colour ranges. To overcome these limitations we propose an object detection algorithm, with pre-processing methods, to reduce the interference caused by shadow and illumination effects without fixed parameters. We use the Y CrCb colour model without any specific colour ranges and predefined threshold values. The segmented object regions are further classified using morphological operations (Erosion and Dilation) and contours. Proposed approach applied on a large image data set acquired under various environmental conditions for wood stack detection. Experiments show the promising result of the proposed approach in comparison with existing methods.

Keywords: image processing, illumination equalization, shadow filtering, object detection

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Authors: Louise Elizabeth Bolton

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Statement of the problem: There are an estimated 328 million cases of COPD worldwide. It is likely to become the third biggest cause of death by 2030. The impact of living with palliative care needs arising from COPD disrupts an individual’s existential situation. Understandings of individuals' existential situations within COPD are limited within the research literature and are rarely addressed within clinical practice, yet existential suffering has been linked to poor health-related quality of life for those living with other chronic conditions. The purpose of this integrative review is to provide a synthesis of existing evidence on existential suffering for those living with palliative care needs arising from COPD. Methods: This is an integrative review undertaken in accordance with PRISMA guidelines. Nine electronic databases were searched from April 2019 to January 2021. Thirty-five empirical research papers of both qualitative and quantitative methodologies, alongside systematic literature reviews, were included. Data analysis was undertaken using an integrative thematic analysis approach. Findings: Identified themes of existential suffering when living with palliative care needs arising from COPD are as follows: Liminality, Lamented Life, Loss of Personal Liberty, Life Meaning and Existential isolation. The absence of life meaning and purpose was of most importance to patients. Conclusion and Significance: This integrative review provides a synthesis of international evidence upon the presence of existential suffering. It is present and of significant impact within the daily lives of those living with palliative care needs arising from COPD. The absence of life meaning has the most significant impact, requiring further exploration of both its physical and psychological impact. Rediscovery of life meaning diminishes feelings of worthlessness and hopelessness in daily life and facilitates feelings of inner peace. For those with COPD living with such a relentless symptom burden, a positive existential situation is desirable.

Keywords: palliative care, COPD, existential suffering, end of life care

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Authors: Zyrah Lou R. Samar, Genecarlo Liwanag

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Type 2 Diabetes Mellitus is the more prevalent type, caused by a combination of insulin resistance and inadequate insulin response to hyperglycemia1. Aside from pharmacologic interventions, medical nutrition therapy is an integral part of the management of patients with Type 2 Diabetes Mellitus. Whey protein, which is one of the best protein sources, has been investigated for its applicability in improving glycemic control in patients with Type 2 Diabetes Mellitus. This systematic review and meta-analysis was conducted to measure the magnitude of the effect of whey protein on glycemic control in type 2 diabetes mellitus. The aim of this review is to evaluate the efficacy and safety of whey protein in patients with type 2 diabetes mellitus. Methods: A systematic electronic search for studies in the PubMed and Cochrane Collaboration database was done. Included in this review were randomized controlled trials of whey protein enrolling patients with type 2 diabetes mellitus. Three reviewers independently searched, assessed, and extracted data from the individual studies. Results: A systematic literature search on online databases such as Cochrane Central Registry, PubMed, and Herdin Plus was conducted in April to September 2021 to identify eligible studies. The search yielded 21 randomized controlled trials after removing duplicates. Only 5 articles were included after reviewing the full text, which met the criteria for selection. Conclusion: Whey protein supplementation significantly reduced fasting blood glucose. However, it did not reduce post-prandial blood glucose, HbA1c level, and weight when compared with the placebo. There has been a considerate heterogeneity across all studies, which may have contributed/confounded its effects. A larger sample size and better inclusion, and a more specific study may be included in the future reviews.

Keywords: whey protein, diabetes, nutrition, fasting blood sugar, postprandial glucose, HbA1c, weight reduction

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