Search results for: concentration risk

Authors: Subhash Nerella, Ziyuan Guan, Azra Bihorac, Parisa Rashidi

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Intensive care units (ICUs) provide care to critically ill patients in severe and life-threatening conditions. However, patient monitoring in the ICU is limited by the time and resource constraints imposed on healthcare providers. Many critical care indices such as mobility are still manually assessed, which can be subjective, prone to human errors, and lack granularity. Other important aspects, such as environmental factors, are not monitored at all. For example, critically ill patients often experience circadian disruptions due to the absence of effective environmental “timekeepers” such as the light/dark cycle and the systemic effect of acute illness on chronobiologic markers. Although the occurrence of delirium is associated with circadian disruption risk factors, these factors are not routinely monitored in the ICU. Hence, there is a critical unmet need to develop systems for precise and real-time assessment through novel enabling technologies. We have developed the mobility and circadian disruption quantification system (Mobi-DiQ) by augmenting biomarker and clinical data with pervasive sensing data to generate mobility and circadian cues related to mobility, nightly disruptions, and light and noise exposure. We hypothesize that Mobi-DiQ can provide accurate mobility and circadian cues that correlate with bedside clinical mobility assessments and circadian biomarkers, ultimately important for delirium risk assessment and prevention. The collected multimodal dataset consists of depth images, Electromyography (EMG) data, patient extremity movement captured by accelerometers, ambient light levels, Sound Pressure Level (SPL), and indoor air quality measured by volatile organic compounds, and the equivalent CO₂ concentration. For delirium risk assessment, the system recognizes mobility cues (axial body movement features and body key points) and circadian cues, including nightly disruptions, ambient SPL, and light intensity, as well as other environmental factors such as indoor air quality. The Mobi-DiQ system consists of three major components: the pervasive sensing system, a data storage and analysis server, and a data annotation system. For data collection, six local pervasive sensing systems were deployed, including a local computer and sensors. A video recording tool with graphical user interface (GUI) developed in python was used to capture depth image frames for analyzing patient mobility. All sensor data is encrypted, then automatically uploaded to the Mobi-DiQ server through a secured VPN connection. Several data pipelines are developed to automate the data transfer, curation, and data preparation for annotation and model training. The data curation and post-processing are performed on the server. A custom secure annotation tool with GUI was developed to annotate depth activity data. The annotation tool is linked to the MongoDB database to record the data annotation and to provide summarization. Docker containers are also utilized to manage services and pipelines running on the server in an isolated manner. The processed clinical data and annotations are used to train and develop real-time pervasive sensing systems to augment clinical decision-making and promote targeted interventions. In the future, we intend to evaluate our system as a clinical implementation trial, as well as to refine and validate it by using other data sources, including neurological data obtained through continuous electroencephalography (EEG).

Keywords: deep learning, delirium, healthcare, pervasive sensing

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Authors: Getachew Demesa Bexa

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Building resilience to withstand extreme weather events through reduction and mitigation measures towards predicted disasters with appropriate contingency plans complemented by timely and effective emergency response demands committed and integrated/coordinated efforts. The 2006 flood disaster that claimed more than 200 people in Dire Dawa town shifted the paradigm from reactive to proactive engagement among government, NGOs and communities to contain future disasters through resilience building. Dire Dawa CMDRR Association is a model community organization that demonstrated the basic minimum and turning adversity into opportunity by mobilizing vulnerable community members. Meanwhile the birth of African Centre for Disaster Risk Management is a milestone in changing the image of the country and beyond in resilience building while linking relief and development.

Keywords: Dire Dawa, disaster, resilience, risk management

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Authors: Muhammad Yasir Tarar

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Background: Intraarticular steroid injections are an effective option in alleviating the symptoms of conditions like osteoarthritis, rheumatoid arthritis, crystal arthropathy, and rotator cuff tendinopathy. Most of these injections are conducted in the elderly who are on polypharmacy, including anticoagulants at times. Up to 6% of patients aged 80-84 years have been reported to be taking Warfarin. The literature availability on safety quotient for patients undergoing intraarticular injections on Warfarin is scarce. It has remained debatable over the years which approach is safe for these patients. Continuing warfarin has a theoretical bleeding risk, and stopping it can lead to even severe life-threatening thromboembolic events in high-risk patients. Objectives: To evaluate the risk of bleeding complications in patients on warfarin undergoing intraarticular injections or arthrocentesis. Study Design & Methods: A literature search of MEDLINE (1946 to present), EMBASE (1974 to present), and Cochrane CENTRAL (1988 to present) databases were conducted using any combination of the keywords, Injection, Knee, Shoulder, Joint, Intraarticular, arthrocentesis, Warfarin, and Anticoagulation in November 2020 for articles published in any language with no publication year limit. The study inclusion criteria included reporting on the rate of bleeding complications following injection of the knee or shoulder in patients on warfarin treatment. Randomized control trials and prospective and retrospective study designs were included. An electronic standardized Performa for data extraction was made. The Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) the methodology was used. The articles were appraised using the methodological index for nonrandomized studies. The Cochrane Risk of Bias Tool used to assess the risk of bias in included RCTs and the MINORS tool for assessment of bias in observational studies. Results: The search of databases resulted in a total of 852 articles. Relevant articles as per the inclusion criteria were shortlisted, 7 articles deemed suitable to be include. A total of 1033 joints sample size was undertaken with specified knee and shoulder joints of a total of 820. Only 6 joints had bleeding complications, 5 early bleeding at the time of injection or aspiration, and one late bleeding complication with INR of 5, additionally, 2 patients complained of bruising, 3 of pain, and 1 managed for infection. Conclusions: The results of the metanalysis show that it is relatively safe to perform intraarticular injections in patients on Warfarin regardless of the INR range.

Keywords: arthrocentesis, warfarin, bleeding, injection

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Authors: Hussam Ashwi, Magbool Oraiby, Ali Muyidi, Hamad Al-Oufi, Mohammed Al-Oufi, Adel Al-Juhani, Salman Al-Zemaa, Saeed Al-Shahrani, Amal Abuallah, Wedad Sherwani, Mohammed Alattas, Ibraheem Attafi

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Ethanol must be accurately identified and quantified to establish their use and contribution in criminal cases and forensic medicine. In some situations, it may be necessary to reanalyze an old specimen; therefore, it is essential to comprehend the effect of storage conditions and how long the result of a reanalyzed specimen can be reliable and reproducible. Additionally, ethanol can be produced via multiple in vivo and in vitro processes, particularly in diabetic patients, and the results can be affected by storage conditions and time. In order to distinguish between in vivo and in vitro alcohol generation in diabetes patient urine samples, various factors should be considered. This study identifies and quantifies ethanol and EtG in diabetic patients' urine samples stored in two different settings over time. Ethanol levels were determined using gas chromatography-headspace (GC-HS), and ethyl glucuronide (EtG) levels were determined using the immunoassay (RANDOX) technique. Ten urine specimens were collected and placed in a standard container. Each specimen was separated into two containers. The specimens were divided into two groups: those kept at room temperature (25 °C) and those kept cold (2-8 °C). Ethanol and EtG levels were determined serially over a two-week period. Initial results showed that none of the specimens tested positive for ethanol or EtG. At room temperature (15-25 °C), 7 and 14 days after the sample was taken, the average concentration of ethanol increased from 1.7 mg/dL to 2 mg/dL, and the average concentration of EtG increased from 108 ng/mL to 186 ng/mL. At 2–8 °C, the average ethanol concentration was 0.4 and 0.5 mg/dL, and the average EtG concentration was 138 and 124 ng/mL seven and fourteen days after the sample was collected, respectively. When ethanol and EtG levels were determined 14 days post collection, they were considerably lower than when stored at room temperature. A considerable increase in EtG concentrations (14-day range 0–186 ng/mL) is produced during room-temperature storage, although negative initial results for all specimens. Because EtG might be produced after a sampling collection, it is not a reliable indicator of recent alcohol consumption. Given the possibility of misleading EtG results due to in vitro EtG production in the urine of diabetic patients.

Keywords: ethyl glucuronide, ethanol, forensic toxicology, diabetic

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Authors: Elena Petersen, Inna Kornienko, Svetlana Guryeva, Sergey Dobdin, Anatoly Skripal, Andrey Usanov, Dmitry Usanov

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One of the most important unsolved problems in modern medicine is the increase of chronic diseases that lead to organ dysfunction or even complete loss of function. Current methods of treatment do not result in decreased mortality and disability statistics. Currently, the best treatment for many patients is still transplantation of organs and/or tissues. Therefore, finding a way of correct artificial matrix biofabrication in case of limited number of natural organs for transplantation is a critical task. One important problem that needs to be solved is development of a nondestructive and noninvasive method to analyze dynamic changes of mechanical characteristics of a matrix with minimal side effects on the growing cells. This research was focused on investigating the properties of matrix as a marker of graft condition. In this study, the collagen gel with human primary dermal fibroblasts in suspension (60, 120, 240*103 cells/mL) and collagen gel with cell spheroids were used as model objects. The stiffness and elasticity characteristics were evaluated by a semiconductor laser autodyne. The time and cell concentration dependency of the stiffness and elasticity were investigated. It was shown that these properties changed in a non-linear manner with respect to cell concentration. The maximum matrix stiffness was observed in the collagen gel with the cell concentration of 120*103 cells/mL. This study proved the opportunity to use the mechanical properties of matrix as a marker of graft condition, which can be measured by noninvasive semiconductor laser autodyne technique.

Keywords: graft, matrix, noninvasive method, regenerative medicine, semiconductor laser autodyne

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Authors: Mehdi Piri Ouchtapeh, Fariba Mehrkhou, Maryam Fourouzan

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The cabbage aphid, Bravicoryne brassicae (Hemiptera: Aphididae), is known as an economically important and oligophagous pest of different cole crops. The polyvolitine characteristics of B. brassicae resulted in resistance to insecticides. For this purpose, in this study, the sub-lethal concentration (LC25) of two insecticides, clothianidin and summer oil, on the life table parameters and population projection of cabbage aphid were studied at controlled condition (20±1 ℃, R.H. 60 ±5 % and a photoperiod of 16:8 h (L:D). The dipping method was used in bioassay and life table studies. Briefly, the leaves of cabbage containing 15 the same-aged (24h) adults of cabbage aphid (four replicates) were dipped into the related concentrations of insecticides for 10 s. The sub-lethal (LC25) obtained concentration were used 5.822 and 108.741 p.p.m for clothianidin and summer oil, respectively. The biological and life table studies were done using at least 100, 93 and 82 the same age of eggs for control, summer oil and clothianidin treatments respectively. The life history data of the greenhouse whitefly cohorts exposed to sublethal concentration of the aforementioned insecticides were analyzed using the computer program TWOSEX–MSChart based on the age-stage, two-sex life table theory. The results of this study showed that the used insecticides affected the developmental time, survival rate, adult longevity, and fecundity of the F1 generation. The developmental time on control, clothianidin and summer oil treatments was obtained (5.91 ± 0.10 days), (7.64 ± 0.12 days) and (6.66 ± 0.10 days), respectively. The sublethal concentration of clothianidin resulted in decreasing of adult longevity (8.63 ± 0.30 days), fecundity (14.14 ± 87 nymphs), survival rate (71%) and the life expectancy (10.26 days) of B. brassicae, as well. Additionally, usage of LC25 insecticides led to decreasing of the net reproductive rate (R0) of the cabbage aphid compared to summer oil and control treatments. The intrinsic rate of increase (r) (day-1) was decreased in F1 adults of cabbage aphid compared with other treatments. Additionally, the population projection results were accordance with the population growth rate of cabbage aphid. Therefore, the findings of this research showed that, however, both of the insecticides were effective on cabbage aphid population, but clothianidin was more effective and could be consider in the management of aforementioned pest.

Keywords: the cabbage aphid, sublethal effects, survival rate, population projection, life expectancy

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Authors: C. G. Mendez-Garcia, E. T. Romero-Guzman, H. Hernandez-Mendoza, C. Solis, E. Chavez-Lomeli, E. Chamizo, R. Garcia-Tenorio

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Plutonium is present in different concentrations in the environment and biological samples related to nuclear weapons testing, nuclear waste recycling and accidental discharges of nuclear plants. This radioisotope is considered the most radiotoxic substance, particularly when it enters the human body through inhalation of powders insoluble or aerosols. This is the main reason of the determination of the concentration of this radioisotope in the atmosphere. Besides that, the isotopic ratio of ²⁴⁰Pu/²³⁹Pu provides information about the origin of the source. PM₂.₅ sampling was carried out in the Metropolitan Zone of the Valley of Mexico (MZVM) from February 18th to March 17th in 2015 on quartz filter. There have been significant developments recently due to the establishment of new methods for sample preparation and accurate measurement to detect ultra trace levels as the plutonium is found in the environment. The accelerator mass spectrometry (AMS) is a technique that allows measuring levels of detection around of femtograms (10-15 g). The AMS determinations include the chemical isolation of Pu. The Pu separation involved an acidic digestion and a radiochemical purification using an anion exchange resin. Finally, the source is prepared, when Pu is pressed in the corresponding cathodes. According to the author's knowledge on these aerosols showed variations on the ²³⁵U/²³⁸U ratio of the natural value, suggesting that could be an anthropogenic source altering it. The determination of the concentration of the isotopes of Pu can be a useful tool in order the clarify this presence in the atmosphere. The first results showed a mean value of activity concentration of ²³⁹Pu of 280 nBq m⁻³ thus the ²⁴⁰Pu/²³⁹Pu was 0.025 corresponding to the weapon production source; these results corroborate that there is an anthropogenic influence that is increasing the concentration of radioactive material in PM₂.₅. According to the author's knowledge in Total Suspended Particles (TSP) have been reported activity concentrations of ²³⁹⁺²⁴⁰Pu around few tens of nBq m⁻³ and 0.17 of ²⁴⁰Pu/²³⁹Pu ratios. The preliminary results in MZVM show high activity concentrations of isotopes of Pu (40 and 700 nBq m⁻³) and low ²⁴⁰Pu/²³⁹Pu ratio than reported. These results are in the order of the activity concentrations of Pu in weapons-grade of high purity.

Keywords: aerosols, fallout, mass spectrometry, radiochemistry, tracer, ²⁴⁰Pu/²³⁹Pu ratio

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Authors: Srinivasulu Dasaiah, Kalyan Yakkala, Gangadhar Battala, Pavan Kumar Pindi, Ramakrishna Naidu Gurijala

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Tinospora cordifolia leaves biomass used for the removal fluoride from aqueous solutions. Batch biosorption technique was applied, pH, contact time, biosorbent dose and initial fluoride concentration was studied. The Scanning Electron Microscopy (SEM) and Fourier Transform Infrared (FTIR) techniques used to study the surface characteristics and the presence of chemical functional groups on the biosorbent. Biosorption isotherm models and kinetic models were applied to understand the sorption mechanism. Results revealed that pH, contact time, biosorbent dose and initial fluoride concentration played a significant effect on fluoride removal from aqueous solutions. The developed biosorbent derived from Tinospora cordifolia leaves biomass found to be a low-cost biosorbent and could be used for the effective removal of fluoride in synthetic as well as real water samples.

Keywords: biosorption, contact time, fluoride, isotherms

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Authors: Renate Gericke, Carol Long

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Despite the robust empirical support of attachment, advancement in the description and conceptualization of attachment has been slow and has not significantly advanced beyond the identification of attachment security or type (namely, secure, avoidant, ambivalent and disorganized). This has continued despite papers arguing for theoretical refinement in the classification of attachment presentations. For thinking and practice to advance, it is critically important that these categories and their assessment be interrogated in different contexts and across developmental age. To achieve this, a quantitative design was used with descriptive and inferential statistics, and general linear models were employed to analyze the data. The Attachment Story Completion Test (ASCT) was administered to 105 children between the ages of eight and twelve from socio-economically deprived contexts with high exposure to trauma. A staggering 93% of the children had insecure attachments (specifically, avoidant 37%, disorganized 34% and ambivalent 22%) and attachment was more complex than currently conceptualized in the attachment literature. Primary attachment did not only present as one of four discreet categories, but 70% of the sample had a complex attachment with more than one type of maternal attachment style. Attachment intensity also varied along a continuum (between 1 and 5). The findings have implications for a) research that has not considered the potential complexity of attachment or attachment intensity, b) policy to more actively support mother-infant dyads, particularly in high-risk contexts and c) question the applicability of a western conceptualization of a primary maternal attachment figure in non-western collectivist societies.

Keywords: attachment, children at risk, middle childhood, non-western context

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Authors: Mohamed Korany, Azza Gazy, Essam Khamis, Marwa Adel, Miranda Fawzy

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Background: Two new, simple and specific methods; First, a Zero-crossing first-derivative technique and second, a chemometric-assisted spectrophotometric artificial neural network (ANN) were developed and validated in accordance with ICH guidelines. Both methods were used for the simultaneous estimation of the two closely related antioxidant nutraceuticals ; Coenzyme Q10 (Q) ; also known as Ubidecarenone or Ubiquinone-10, and Vitamin E (E); alpha-tocopherol acetate, in their pharmaceutical binary mixture. Results: For first method: By applying the first derivative, both Q and E were alternatively determined; each at the zero-crossing of the other. The D1 amplitudes of Q and E, at 285 nm and 235 nm respectively, were recorded and correlated to their concentrations. The calibration curve is linear over the concentration range of 10-60 and 5.6-70 μg mL-1 for Q and E, respectively. For second method: ANN (as a multivariate calibration method) was developed and applied for the simultaneous determination of both analytes. A training set (or a concentration set) of 90 different synthetic mixtures containing Q and E, in wide concentration ranges between 0-100 µg/mL and 0-556 µg/mL respectively, were prepared in ethanol. The absorption spectra of the training sets were recorded in the spectral region of 230–300 nm. A Gradient Descend Back Propagation ANN chemometric calibration was computed by relating the concentration sets (x-block) to their corresponding absorption data (y-block). Another set of 45 synthetic mixtures of the two drugs, in defined range, was used to validate the proposed network. Neither chemical separation, preparation stage nor mathematical graphical treatment were required. Conclusions: The proposed methods were successfully applied for the assay of Q and E in laboratory prepared mixtures and combined pharmaceutical tablet with excellent recoveries. The ANN method was superior over the derivative technique as the former determined both drugs in the non-linear experimental conditions. It also offers rapidity, high accuracy, effort and money saving. Moreover, no need for an analyst for its application. Although the ANN technique needed a large training set, it is the method of choice in the routine analysis of Q and E tablet. No interference was observed from common pharmaceutical additives. The results of the two methods were compared together

Keywords: coenzyme Q10, vitamin E, chemometry, quantitative analysis, first derivative spectrophotometry, artificial neural network

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Authors: Abhinav Kumar Rajverma, Arun Kumar Misra, Abhijeet Chandra

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Family involvement in business is universal across countries, with varying characteristics. Firms of developed economies have diffused ownership structure; however, that of emerging markets have concentrated ownership structure, having resemblance with that of family firms. Optimization of dividend payout and leverage are very crucial for firm’s valuation. This paper studies dividend paying behavior of National Stock Exchange listed Indian firms from financial year 2007 to 2016. The final sample consists of 422 firms and of these more than 49% (207) are family firms. Results reveal that family firms pay lower dividend and are more leveraged compared to non-family firms. This unique data set helps to understand dividend behavior and capital structure of sample firms over a long-time period and across varying family ownership concentration. Using panel regression models, this paper examines factors affecting dividend payout and capital structure and establishes a link between the two using Two-stage Least Squares regression model. Profitability shows a positive impact on dividend and negative impact on leverage, confirming signaling and pecking order theory. Further, findings support bankruptcy theory as firm size has a positive relation with dividend and leverage and volatility shows a negative relation with both dividend and leverage. Findings are also consistent with agency theory, family ownership concentration has negative relation with both dividend payments and leverage. Further, the impact of family ownership control confirms the similar finding. The study further reveals that firms with high family ownership concentration (family control) do have an impact on determining the level of private benefits. Institutional ownership is not significant for dividend payments. However, it shows significant negative relation with leverage for both family and non-family firms. Dividend payout and leverage show mixed association with each other. This paper provides evidence of how varying level of family ownership concentration and ownership control influences the dividend policy and capital structure of firms in an emerging market like India and it can have significant contribution towards understanding and formulating corporate dividend policy decisions and capital structure for emerging economies, where majority of firms exhibit behavior of family firm.

Keywords: dividend, family firms, leverage, ownership structure

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Authors: Abdel-Monem Sayed Mohamed

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Egypt rapidly growing development is accompanied by increasing levels of standard living particular in its urban areas. However, there is a limited experience in quantifying the sources of risk management in Egypt and in designing efficient strategies to keep away serious impacts of earthquakes. From the historical point of view and recent instrumental records, there are some seismo-active regions in Egypt, where some significant earthquakes had occurred in different places. The special tectonic features in Egypt: Aswan, Greater Cairo, Red Sea and Sinai Peninsula regions are the territories of a high seismic risk, which have to be monitored by up-to date technologies. The investigations of the seismic events and interpretations led to evaluate the seismic hazard for disaster prevention and for the safety of the dense populated regions and the vital national projects as the High Dam. In addition to the monitoring of the recent crustal movements, the most powerful technique of satellite geodesy GPS are used where geodetic networks are covering such seismo-active regions. The results from the data sets are compared and combined in order to determine the main characteristics of the deformation and hazard estimation for specified regions. The final compiled output from the seismological and geodetic analysis threw lights upon the geodynamical regime of these seismo-active regions and put Aswan and Greater Cairo under the lowest class according to horizontal crustal strains classifications. This work will serve a basis for the development of so-called catastrophic models and can be further used for catastrophic risk management. Also, this work is trying to evaluate risk of large catastrophic losses within the important regions including the High Dam, strategic buildings and archeological sites. Studies on possible scenarios of earthquakes and losses are a critical issue for decision making in insurance as a part of mitigation measures.

Keywords: b-value, Gumbel distribution, seismic and GPS data, strain parameters

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Authors: Hsin-Yi Huang

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This study mainly discussed the disease-induced and surgery-induced physical, psychological, and spiritual issues faced by a patient who suffered from emphysema and respiratory failure and had underwent a right-lung transplantation surgery. Nursing care was provided from May 21 to May 29. Based on the observations, interviews, physical examinations, and evaluations that were carried out using Roy’s adaptation model, the following nursing issues were identified: risk of infection, lack of knowledge, and anxiety. Active care was provided and a good nursing relationship with the patient and the patient’s family was established. The four strategies of Bandura’s self-efficacy theory (self-transcendence, vicarious experience, verbal persuasion, and biofeedback) were employed. Instructions for the appropriate rehabilitation exercises were given, immunosuppressant concentration was monitored, and special measures were taken to prevent infection. The patient was encouraged to express feelings and was provided with sufficient information to alleviate anxiety. With assistance from nursing personnel and the medical team, the patient was successfully discharged from the hospital and thereafter embarked on the path of postoperative recovery. The patient learned about the importance of home self-care and regular follow-up outpatient visits, and patient management was implemented for discharge preparation services. This nursing case study may serve as a reference to nurses managing similar cases in future.

Keywords: anxiety, lung transplantation, Roy's adaptation model, self-efficacy theory

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Authors: Gil Soriano, Aubreyrose Casilang

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Soil-transmitted helminth infection remains to be one of the leading public health problem worldwide, which is common in the rural developing regions especially among children. This study aimed to detect the presence of soil transmitted helminths among children and its associated transmission factors. Descriptive cross sectional research was the design used in the study and questionnaires were administered. Stool samples were collected among the samples (n=108) and were analyzed using kato thick method. Results showed that 61 out of 108 respondents are infected by soil transmitted helminth infection with A. lumbricoides the highest, followed by hookworm and T. trichuria. Parent's educational attainment, hand washing practices, and water sources were found to be associated with presence of Soil Transmitted Helminth infection.

Keywords: associated risk factors, barangay, school children, soil transmitted helminth infection

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Authors: S. Kumar, R. Sultana

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This study was conducted to evaluate the effect of Aspergillus species on acridid populations which are major agricultural pests of rice, sugarcane, wheat, maize and fodder crops in Pakistan. Three and replicates i.e. Aspergillus flavus, A. fumigatus and A. niger, excluding the control, were held under laboratory conditions. It was observed that consumption faecal production of acridids was significantly reduced after the pathogenic application of Aspergillus. In the control replicate, the mortality ratio for stage (N₄-N₆) was maximum on day 2^nd i.e. [F_10.7 = 18.33, P < 0.05] followed by [F_4.20 = 07.85, P < 0.05] and [F_3.77 = 06.11, P < 0.05] on 4^th and 3^rd day, respectively. Similarly, it was a minimum i.e. [F_0.48 = 84.65, P < 0.05] on the 1^st day. It was also noted that faecal production of Acridid nymphs was not significantly affected when treated with conidial concentration in H₂O formulation; however, it was significantly reduced after the contamination with conidial concentration in oil. The high morality of acridids after contamination of Aspergillus supports their use as bio-control agent for reducing pest population. The present study recommends that exploration and screening must be conducted to provide additional pathogens for evaluation as potential biological control against grasshoppers and locusts.

Keywords: acridid, agriculture, formulation, grasshoppers

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Authors: Bill D. Geis

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Suicide wrongful death forensic cases are the fastest rising tort in mental health law. It is estimated that suicide-related cases have accounted for 15% of U.S. malpractice claims since 2006. Most suicide-related personal injury claims fall into the legal category of “wrongful death.” Though mental health experts may be called on to address a range of forensic questions in wrongful death cases, the central consultation that most experts provide is about the negligence element—specifically, the issue of whether the clinician met the clinical standard of care in assessing, treating, and managing the deceased person’s mental health care. Standards of care, varying from U.S. state to state, are broad and address what a reasonable clinician might do in a similar circumstance. This fact leaves the issue of the suicide standard of care, in each case, up to forensic experts to put forth a reasoned estimate of what the standard of care should have been in the specific case under litigation. Because the general state guidelines for standard of care are broad, forensic experts are readily retained to provide scientific and clinical opinions about whether or not a clinician met the standard of care in their suicide assessment, treatment, and management of the case. In the past and in much of current practice, the assessment of suicide has centered on the elicitation of verbalized suicide ideation. Research in recent years, however, has indicated that the majority of persons who end their lives do not say they are suicidal at their last medical or psychiatric contact. Near-term risk assessment—that goes beyond verbalized suicide ideation—is needed. Our previous research employed structural equation modeling to predict lethal suicide risk--eight negative thought patterns (feeling like a burden on others, hopelessness, self-hatred, etc.) mediated by nine transdiagnostic clinical factors (mental torment, insomnia, substance abuse, PTSD intrusions, etc.) were combined to predict acute lethal suicide risk. This structural equation model, the Lethal Suicide Risk Pattern (LSRP), Acute model, had excellent goodness-of-fit [χ2(df) = 94.25(47)***, CFI = .98, RMSEA = .05, .90CI = .03-.06, p(RMSEA = .05) = .63. AIC = 340.25, ***p < .001.]. A further SEQ analysis was completed for this paper, adding a measure of Acute Suicide Ideation to the previous SEQ. Acceptable prediction model fit was no longer achieved [χ2(df) = 3.571, CFI > .953, RMSEA = .075, .90% CI = .065-.085, AIC = 529.550].This finding suggests that, in this additional study, immediate verbalized suicide ideation information was unhelpful in the assessment of lethal risk. The LSRP and other dynamic, near-term risk models (such as the Acute Suicide Affective Disorder Model and the Suicide Crisis Syndrome Model)—going beyond elicited suicide ideation—need to be incorporated into current clinical suicide assessment training. Without this training, the standard of care for suicide assessment is out of sync with current research—an emerging dilemma for the forensic evaluation of suicide wrongful death cases.

Keywords: forensic evaluation, standard of care, suicide, suicide assessment, wrongful death

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Authors: Yusra Ibrahim

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Parental involvement in their children’s education and behavioral modification is important. This article provides a policy analysis that describes laws and public education regulations concerning justice-involved youth and youth at risk of delinquency in the United Arab Emirates. The article aims to clarify the UAE laws for parents and guardians regarding their involvement in addressing school violations and crimes committed by their children, particularly those with emotional and behavioral disorders, youths at risk for delinquency, and justice-involved youths. The article concludes with implications for parents, policymakers, and educators and suggests ways to improve services and support for these parents and their youth.

Keywords: justice-involved youth, parents, incarceration, incarcerated youth, United Arab Emirates.

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Authors: Végh Ádám, Mekler Csaba, Dezső András, Szabó Dávid, Stomp Dávid, Kaptay György

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Grain boundary segregation transition (GBST) has been calculated by a thermodynamic model in binary alloys. The method is used on cementite (Fe3C) segregation in base-centered cubic (ferrite) iron (Fe) in the Fe-C binary system. The GBST line is shown in the Fe3C lacking part of the phase diagram with high solvent (Fe) concentration. At a lower solute content (C) or at higher temperature the grain boundary is composed mostly of the solvent atoms (Fe). On higher concentration compared to the GBST line or at lower temperature a phase transformation occurs at the grain boundary, the latter mostly composed of the associates (Fe3C). These low-segregation and high-segregation states are first order interfacial phase transitions of the grain boundary and can be transformed into each other reversibly. These occur when the GBST line is crossed by changing the bulk composition or temperature.

Keywords: GBST, cementite, segregation, Fe-C alloy

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Authors: Maliheh Raji, Hossein Abolghasemi, Jaber Safdari, Ali Kargari

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Dysprosium is a rare earth element which is essential for many growing high-technology applications. Dysprosium along with neodymium plays a significant role in different applications such as metal halide lamps, permanent magnets, and nuclear reactor control rods preparation. The purification and separation of rare earth elements are challenging because of their similar chemical and physical properties. Among the various methods, membrane processes provide many advantages over the conventional separation processes such as ion exchange and solvent extraction. In this work, selective extraction and separation of dysprosium from aqueous solutions containing an equimolar mixture of dysprosium and neodymium by emulsion liquid membrane (ELM) was investigated. The organic membrane phase of the ELM was a nanofluid consisting of multiwalled carbon nanotubes (MWCNT), Span80 as surfactant, Cyanex 272 as carrier, kerosene as base fluid, and nitric acid solution as internal aqueous phase. Factors affecting separation of dysprosium such as carrier concentration, MWCNT concentration, feed phase pH and stripping phase concentration were analyzed using Taguchi method. Optimal experimental condition was obtained using analysis of variance (ANOVA) after 10 min extraction. Based on the results, using MWCNT nanofluid in ELM process leads to increase the extraction due to higher stability of membrane and mass transfer enhancement and separation factor of 6 for dysprosium over neodymium can be achieved under the optimum conditions. Additionally, demulsification process was successfully performed and the membrane phase reused effectively in the optimum condition.

Keywords: emulsion liquid membrane, MWCNT nanofluid, separation, Taguchi method

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Authors: Javier Paul Montalvo Andia, Adriana Larrea Valdivia, Adolfo Pillihuaman Zambrano

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The most common lixiviant in the leaching process of copper minerals is H₂SO₄, however, the current situation requires more environmentally friendly reagents and in certain situations that have a lower consumption due to the presence of undesirable gangue as muscovite or kaolinite that can make the process unfeasible. The present work studied the leaching of an oxidized copper mineral in an aqueous solution of ammonium nitrate, in order to obtain the optimum leaching conditions of the copper contained in the malachite mineral from Peru. The copper ore studied comes from a deposit in southern Peru and was characterized by X-ray diffractometer, inductively coupled-plasma emission spectrometer (ICP-OES) and atomic absorption spectrophotometry (AAS). The experiments were developed in batch reactor of 600 mL where the parameters as; temperature, pH, ammonium nitrate concentration, particle size and stirring speed were controlled according to experimental planning. The sample solution was analyzed for copper by atomic absorption spectrophotometry (AAS). A simulation in the HSC Chemistry 6.0 program showed that the predominance of the copper compounds of a Cu-H₂O aqueous system is altered by the presence in the system of ammonium complexes, the compound being thermodynamically more stable Cu(NH3)₄²⁺, which predominates in pH ranges from 8.5 to 10 at a temperature of 25 °C. The optimum conditions for copper leaching of the malachite mineral were a stirring speed of 600 rpm, an ammonium nitrate concentration of 4M, a particle diameter of 53 um and temperature of 62 °C. These results showed that the leaching of copper increases with increasing concentration of the ammonium solution, increasing the stirring rate, increasing the temperature and decreasing the particle diameter. Finally, the recovery of copper in optimum conditions was above 80%.

Keywords: ammonium nitrate, malachite, copper oxide, leaching

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Authors: Shih Yu Pan, Pao Chen Hung, Chuan Yao Lin, Charles C.-K. Chou, Yu Chi Lin, Kai Hsien Chi

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This study analyzed 16 atmospheric PAHs species which were controlled by USEPA and IARC. To measure the concentration of PAHs, four rural sampling sites and two urban sampling sites were selected in Central Taiwan during spring and summer. In central Taiwan, the rural sampling stations were located in the downstream of Da-An River, Da-Jang River, Wu River and Chuo-shui River. On the other hand, the urban sampling sites were located in Taichung district and close to the roadside. Ambient air samples of both vapor phase and particle phase of PAHs compounds were collected using high volume sampling trains (Analitica). The sampling media were polyurethane foam (PUF) with XAD2 and quartz fiber filters. Diagnostic ratio, Principal component analysis (PCA), Positive Matrix Factorization (PMF) models were used to evaluate the apportionment of PAHs in the atmosphere and speculate the relative contribution of various emission sources. Because of the high temperature and low wind speed, high PAHs concentration in the atmosphere was observed. The total PAHs concentration, especially in vapor phase, had significant change during summer. During the sampling periods the total PAHs concentration of atmospheric at four rural and two urban sampling sites in spring and summer were 3.70±0.40 ng/m3,3.40±0.63 ng/m3,5.22±1.24 ng/m3,7.23±0.37 ng/m3,7.46±2.36 ng/m3,6.21±0.55 ng/m3　; 15.0± 0.14 ng/m3,18.8±8.05 ng/m3,20.2±8.58 ng/m3,16.1±3.75 ng/m3,29.8±10.4 ng/m3,35.3±11.8 ng/m3, respectively. In order to identify PAHs sources, we used diagnostic ratio to classify the emission sources. The potential sources were diesel combustion and gasoline combustion in spring and summer, respectively. According to the principal component analysis (PCA), the PC1 and PC2 had 23.8%, 20.4% variance and 21.3%, 17.1% variance in spring and summer, respectively. Especially high molecular weight PAHs (BaP, IND, BghiP, Flu, Phe, Flt, Pyr) were dominated in spring when low molecular weight PAHs (AcPy, Ant, Acp, Flu) because of the dominating high temperatures were dominated in the summer. Analysis by using PMF model found the sources of PAHs in spring were stationary sources (34%), vehicle emissions (24%), coal combustion (23%) and petrochemical fuel gas (19%), while in summer the emission sources were petrochemical fuel gas (34%), the natural environment of volatile organic compounds (29%), coal combustion (19%) and stationary sources (18%).

Keywords: PAHs, source identification, diagnostic ratio, principal component analysis, positive matrix factorization

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Authors: Ifeyinwa Victor-Uadiale, Georgina Pearson, Sophie Witter, D. Reidpath

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Introduction: Smoking, alcohol misuse, unhealthy diet, and physical inactivity are the primary drivers of noncommunicable diseases (NCD), including cardiovascular diseases, cancers, respiratory diseases, and diabetes, worldwide. Collectively, these diseases are the leading cause of all global deaths, most of which are premature, affecting people between 30 and 70 years. Empirical evidence suggests that these risk behaviors can be modified by community-based interventions (CBI). However, there is little insight into the mechanisms and contextual factors of successful community interventions that impact risk behaviours for chronic diseases. This study examined “Under what circumstances, for whom, and how, do community-based interventions modify smoking, alcohol use, unhealthy diet, and physical inactivity among adults”. Adopting the Capability (C), Opportunity (O), Motivation (M), Behavior (B) (COM-B) framework for behaviour change, it sought to: (1) identify the mechanisms through which CBIs could reduce tobacco use and alcohol consumption and increase physical activity and the consumption of healthy diets and (2) examine the contextual factors that trigger the impact of these mechanisms on these risk behaviours among adults. Methods: Pawson’s realist review method was used to examine the literature. Empirical evidence and theoretical understanding were combined to develop a realist program theory that explains how CBIs influence NCD risk behaviours. Documents published between 2002 and 2020 were systematically searched in five electronic databases (CINAHL, Cochrane Library, Medline, ProQuest Central, and PsycINFO). They were included if they reported on community-based interventions aimed at cardiovascular diseases, cancers, respiratory diseases, and diabetes in a global context; and had an outcome targeted at smoking, alcohol, physical activity, and diet. Findings: Twenty-nine scientific documents were retrieved and included in the review. Over half of them (n = 18; 62%) focused on three of the four risk behaviours investigated in this review. The review identified four mechanisms: capability, opportunity, motivation, and social support that are likely to change the dietary and physical activity behaviours in adults given certain contexts. There were weak explanations of how the identified mechanisms could likely change smoking and alcohol consumption habits. In addition, eight contextual factors that may affect how these mechanisms impact physical activity and dietary behaviours were identified: suitability to work and family obligations, risk status awareness, socioeconomic status, literacy level, perceived need, availability and access to resources, culture, and group format. Conclusion: The findings suggest that CBIs are likely to improve the physical activity and dietary habits of adults if the intervention function seeks to educate, incentivize, change the environment, and model the right behaviours. The review applies and advances theory, realist research, and the design and implementation of community-based interventions for NCD prevention.

Keywords: community-based interventions, noncommunicable disease, realist program theory, risk behaviors

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Authors: Hamad Al-Turaif, Usman Saeed

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The development of nanofibers with the help of electrospinning is being prioritized as a method of choice because of the simplicity and efficiency of the process. The parameters of the electrospinning process effectively convert the polymer solution into an electrospun final product made of the desired diameter of nanofiber. The aim of the study presented is to recognize and analyze the effect of proposed parameters on biodegradable and biocompatible polylactic acid (PLA)/polybutylene succinate (PBS) nanofiber developed by the electrospinning process. The morphology of the fiber is characterized by implementing Scanning Electron Microscope. Studies were conducted to characterize the result of using different electrospinning parameters on the final diameter and orientation of fiber. It was determined that varying polymer solution concentration, feed rate, and applied voltage show different outcomes. The best results were obtained at 6% polymer solution concentration, 20 kV, and 0.5 ml/h, which can be applicable for biomedical applications. Finally, protein adsorption and mechanical testing were conducted on the PLA/PBS fiber.

Keywords: electrospinning, polylactic acid, polybutylene succinate, morphology

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Authors: Jožef Ritonja

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The biochemical industry is one of the most important modern industries. Biochemical reactors are crucial devices of the biochemical industry. The essential bioprocess carried out in bioreactors is the fermentation process. A thorough insight into the fermentation process and the knowledge how to control it are essential for effective use of bioreactors to produce high quality and quantitatively enough products. The development of the control system starts with the determination of a mathematical model that describes the steady state and dynamic properties of the controlled plant satisfactorily, and is suitable for the development of the control system. The paper analyses the fermentation process in bioreactors thoroughly, using existing mathematical models. Most existing mathematical models do not allow the design of a control system for controlling the fermentation process in batch bioreactors. Due to this, a mathematical model was developed and presented that allows the development of a control system for batch bioreactors. Based on the developed mathematical model, a control system was designed to ensure optimal response of the biochemical quantities in the fermentation process. Due to the time-varying and non-linear nature of the controlled plant, the conventional control system with a proportional-integral-differential controller with constant parameters does not provide the desired transient response. The improved adaptive control system was proposed to improve the dynamics of the fermentation. The use of the adaptive control is suggested because the parameters’ variations of the fermentation process are very slow. The developed control system was tested to produce dairy products in the laboratory bioreactor. A carbon dioxide concentration was chosen as the controlled variable. The carbon dioxide concentration correlates well with the other, for the quality of the fermentation process in significant quantities. The level of the carbon dioxide concentration gives important information about the fermentation process. The obtained results showed that the designed control system provides minimum error between reference and actual values of carbon dioxide concentration during a transient response and in a steady state. The recommended control system makes reference signal tracking much more efficient than the currently used conventional control systems which are based on linear control theory. The proposed control system represents a very effective solution for the improvement of the milk fermentation process.

Keywords: biochemical reactor, fermentation process, modelling, adaptive control

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Authors: Benedicta N. Nkeh-Chungag, Constance R. Sewani-Rusike, Isaac M. Malema, Daniel T. Goon, Oladele V. Adeniyi, Idowu A. Ajayi

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Background: Childhood and adolescent obesity is an important predictor of adult cardiometabolic diseases. Current data on age- and gender-specific cardiometabolic risk factors are lacking in the peri-urban Eastern Cape Province, South Africa. However, such information is important in designing innovative strategies to promote healthy living among children and adolescents. The purpose of this pilot study was to compare and determine the extent of cardiometabolic risk factors between samples of lean and overweight/obese adolescent population in a peri-urban township of South Africa. Methods: In this case-control study, age-matched, non-pregnant and non-lactating female adolescents consisting of equal number of cases (50 overweight/obese) and control (50 lean) participated in the study. Fasting venous blood samples were obtained for total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglyceride (Trig), highly sensitive C-reactive protein (hsCRP) and blood sugar. Anthropometric measurements included weight, height, waist and hip circumferences. Body mass index was calculated. Blood pressure was measured; and metabolic syndrome was assessed using appropriate diagnostic criteria for children and adolescents. Results: Of the 76 participants with complete data, 12/38 of the overweight/obese and 1/38 of the lean group met the criteria for adolescent metabolic syndrome. All cardiometabolic risk factors were elevated in the overweight/obese group compared with the lean group: low HDL-C (RR = 2.21), elevated TC (RR = 1.23), elevated LDL-C (RR = 1.42), elevated Trig (RR = 1.73), and elevated hsCRP (RR = 1.9). There were significant atherosclerotic indices among the overweight/obese group compared with the lean group: TC/HDL and LDL/HDL (2.99±0.91 vs 2.63±0.48; p=0.016 and 1.73±0.61 vs 1.41±0.46; p= 0.014, respectively). Conclusion: There are multiple cardiometabolic risk factors among the overweight/obese female adolescent group compared with lean adolescent group in the study. Female adolescent who are overweight and obese have higher relative risks of developing cardiometabolic diseases compared with their lean counterparts in the peri-urban Mthatha, South Africa. School health programme focusing on promoting physical exercise, healthy eating and keeping appropriate weight are needed in the country.

Keywords: adolescents, cardiometabolic risk factors, obesity, peri-urban South Africa

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Authors: Kossigan Bernard Dedey, David Grenier, Tiphaine Lucas

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Bread dough is often described as a dispersion of gas cells in a continuous gluten/starch matrix. The final bread crumb structure is strongly related to gas cell walls (GCWs) rupture during baking. At the end of proofing and during baking, part of the thinnest GCWs between expanding gas cells is reduced to a gluten film of about the size of a starch granule. When such size is reached gluten and starch granules must be considered as interacting phases in order to account for heterogeneities and appropriately describe GCW rupture. Among experimental investigations carried out to assess GCW rupture, no experimental work was performed to observe the GCW rupture in the baking conditions at GCW scale. In addition, attempts to numerically understand GCW rupture are usually not performed at the GCW scale and often considered GCWs as continuous. The most relevant paper that accounted for heterogeneities dealt with the gluten/starch interactions and their impact on the mechanical behavior of dough film. However, stress concentration in GCW was not discussed. In this study, both experimental and numerical approaches were used to better understand GCW rupture in bread dough during baking. Experimentally, a macro-scope placed in front of a two-chamber device was used to observe the rupture of a real GCW of 200 micrometers in thickness. Special attention was paid in order to mimic baking conditions as far as possible (temperature, gas pressure and moisture). Various differences in pressure between both sides of GCW were applied and different modes of fracture initiation and propagation in GCWs were observed. Numerically, the impact of gluten/starch interactions (cohesion or non-cohesion) and rheological moduli ratio on the mechanical behavior of GCW under unidirectional extension was assessed in 2D/3D. A non-linear viscoelastic and hyperelastic approach was performed to match the finite strain involved in GCW during baking. Stress concentration within GCW was identified. Simulated stresses concentration was discussed at the light of GCW failure observed in the device. The gluten/starch granule interactions and rheological modulus ratio were found to have a great effect on the amount of stress possibly reached in the GCW.

Keywords: dough, experimental, numerical, rupture

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Authors: Mohammad H. Yarmohammadian, Fatemeh Rezaei

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Introduction: Improving patient safety in health systems is one of the main priorities in healthcare systems, so clinical risk management in organizations has become increasingly significant. Although several tools have been developed for clinical risk management, each has its own limitations. Aims: This study aims to develop a comprehensive tool that can complete the limitations of each risk assessment and management tools with the advantage of other tools. Methods: Procedure was determined in two main stages included development of an initial model during meetings with the professors and literature review, then implementation and verification of final model. Subjects and Methods: This study is a quantitative − qualitative research. In terms of qualitative dimension, method of focus groups with inductive approach is used. To evaluate the results of the qualitative study, quantitative assessment of the two parts of the fourth phase and seven phases of the research was conducted. Purposive and stratification sampling of various responsible teams for the selected process was conducted in the operating room. Final model verified in eight phases through application of activity breakdown structure, failure mode and effects analysis (FMEA), healthcare risk priority number (RPN), root cause analysis (RCA), FT, and Eindhoven Classification model (ECM) tools. This model has been conducted typically on patients admitted in a day-clinic ward of a public hospital for surgery in October 2012 to June. Statistical Analysis Used: Qualitative data analysis was done through content analysis and quantitative analysis done through checklist and edited RPN tables. Results: After verification the final model in eight-step, patient's admission process for surgery was developed by focus discussion group (FDG) members in five main phases. Then with adopted methodology of FMEA, 85 failure modes along with its causes, effects, and preventive capabilities was set in the tables. Developed tables to calculate RPN index contain three criteria for severity, two criteria for probability, and two criteria for preventability. Tree failure modes were above determined significant risk limitation (RPN > 250). After a 3-month period, patient's misidentification incidents were the most frequent reported events. Each RPN criterion of misidentification events compared and found that various RPN number for tree misidentification reported events could be determine against predicted score in previous phase. Identified root causes through fault tree categorized with ECM. Wrong side surgery event was selected by focus discussion group to purpose improvement action. The most important causes were lack of planning for number and priority of surgical procedures. After prioritization of the suggested interventions, computerized registration system in health information system (HIS) was adopted to prepare the action plan in the final phase. Conclusion: Complexity of health care industry requires risk managers to have a multifaceted vision. Therefore, applying only one of retrospective or prospective tools for risk management does not work and each organization must provide conditions for potential application of these methods in its organization. The results of this study showed that the integrated clinical risk management model can be used in hospitals as an efficient tool in order to improve clinical governance.

Keywords: failure modes and effective analysis, risk management, root cause analysis, model

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Authors: Mohammed Abdulridha Hamdan

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To face the water crisis, understanding the role of human activities on nutrient concentrations in aquatic ecosystems needs more investigations to compare to extensively studies which have been carried out to understand these impacts on the water quality of different aquatic ecosystems. We hypothesized human activates on the catchments of Tigris river may change nutrient concentrations in water along the river. The results showed that phosphate concentration differed significantly among the studied sites due to distributed human activities, while nitrate concentration did not. Phosphate and nitrate concentrations were not affected by water temperature. We concluded that human activities on the surrounding landscapes could be more essential sources for nutrients of aquatic ecosystems than role of ongoing climate warming. Despite the role of warming in driving nutrients availability in aquatic ecosystems, our findings suggest to take the different activities on the surrounding catchments into account in the studies caring about the trophic status classification of aquatic ecosystems.

Keywords: nitrate, phosphate, anthropogenic, warming

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Authors: Sumeyra Sevim, Gulsum Gizem Topal, Mercan Merve Tengilimoglu-Metin, Mevlude Kizil

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Aflatoxin M1 (AFM1) is a major toxic and carcinogenic molecule in milk and milk products. Therefore, it poses a risk for public health. Probiotics can be biological agent to remove AFM1. The aim of this study is to evaluate the effect of probiotic bacteria on AFM1 detoxification in phosphate buffer saline. The PBS samples artificially contaminated with AFM1 at concentration 100 pg/ml were prepared with probiotics bacteria that including monoculture (L. plantarum, B. bifidum ATCC, B. animalis ATCC 27672) and binary culture (L. bulgaricus + S. thermophiles, B. bifidum ATCC + B. animalis ATCC 27672, L. plantarum+B. bifidum ATCC, L. plantarum+ B. animalis ATCC 27672). The samples were incubated at 37°C for 4 hours and stored for 1, 5 and 10 days. The toxin was measured by the ELISA. The highest levels of AFM1 binding ability (63.6%) in PBS were detected yoghurt starter bacteria, while L. plantarum had the lowest levels of AFM1 binding ability (35.5%) in PBS. In addition, it was found that there was significant effect of storage on AFM1 binding ability in all groups except the one including B. animalis (p < 0.05). Consequently, results demonstrate that AFM1 detoxification by probiotic bacteria has a potential application to reduce toxin concentrations in yoghurt. Moreover, probiotic strains can react with itself as synergic or antagonist.

Keywords: aflatoxin M1, ELISA, probiotics, storage

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Authors: Thakur Pushpawati, Singh Vinita, Agrawal Sarita, Mohapatra Eli

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Polycystic ovary syndrome (PCOS) is a disease of endocrine and frequently encountered in women in their reproductive period, and it is characterized by clinical features of anovulation, clinical and biochemical features of hyperandrogenism, and PCOS morphology on ultrasonographic examination. In Indian scenario, only a few studies are available on the correlation of serum 25-dihydroxy vitamin D3 level and insulin level. The present study is a prospective case-control study and aims to estimate the concentration of serum 25-dihydroxy vitamin D3 and insulin resistance and determine the association of serum 25-dihydroxy vitamin D3 with insulin resistance in PCOS women of 18-40 years age group. In this study, the primary objective is to estimate the concentration of 25-dihydroxy vitamin D3, insulin, glycaemic status, calcium and phosphorus levels in 18-40 year age women with polycystic ovary syndrome and to compare these parameters with age and BMI matched healthy control of same age group women. The secondary objective is to determine the association between 25-dihydroxy vitamin D3 concentration and insulin resistance among PCOS cases in 18-40 years age group women. This study was carried on at outpatient Department of Obstetrics & Gynaecology, Aiims Raipur. It took one year from the date of approval. In case, 32 women were diagnosed (Diagnosed PCOS cases as per Rotterdoms criteria among women of 18-40 years of age), as control group 32 women of 18-40 years of age were diagnosed As a result, serum insulin level was elevated among PCOS women along with 25-dihydroxy vitamin D3 deficiency.Conclude up, PCOS is more common in the age group of 20-40 years. There is a strong correlation between vitamin D deficiency and insulin resistance among PCOS patients.

Keywords: vitamin D, insulin resistance, PCOS, reproductive age group

Procedia PDF Downloads 135