Search results for: experimental study
32755 Study of COVID-19 Intensity Correlated with Specific Biomarkers and Environmental Factors
Authors: Satendra Pal Singh, Dalip Kr. Kakru, Jyoti Mishra, Rajesh Thakur, Tarana Sarwat
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COVID-19 is still an intrigue as far as morbidity or mortality is concerned. The rate of recovery varies from person to person, & it depends upon the accessibility of the healthcare system and the roles played by the physicians and caregivers. It is envisaged that with the passage of time, people would become immune to this virus, and those who are vulnerable would sustain themselves with the help of vaccines. The proposed study deals with the severeness of COVID-19 is associated with some specific biomarkers linked to correlate age and gender. We will be assessing the overall homeostasis of the persons who were affected by the coronavirus infection and also of those who recovered from it. Some people show more severe effects, while others show very mild symptoms, however, they show low CT values. Thus far, it is unclear why the new strain of Covid has different effects on different people in terms of age, gender, and ABO blood typing. According to data, the fatality rate with heart disease was 10.5 percent, 7.3 percent were diabetic, and 6 percent who are already infected from other comorbidities. However, some COVID-19 cases are worse than others & it is not fully explainable as of date. Overall data show that the ABO blood group is effective or prone to the risk of SARS-COV2 infection, while another study also shows the phenotypic effects of the blood group related to covid. It is an accepted fact that females have more strong immune systems than males, which may be related to the fact that females have two ‘X’ chromosomes, which might contain a more effective immunity booster gene on the X chromosome, and are capable to protect the female. Also specific sex hormones also induce a better immune response in a specific gender. This calls for in-depth analysis to be able to gain insight into this dilemma. COVID-19 is still not fully characterized, and thus we are not very familiar with its biology, mode of infection, susceptibility, and overall viral load in the human body. How many virus particles are needed to infect a person? How, then, comorbidity contribute to coronavirus infection? Since the emergence of this virus in 2020, a large number of papers have been published, and seemingly, vaccines have been prepared. But still, a large number of questions remain unanswered. The proneness of humans for infection by covid-19 needs to be established to be able to develop a better strategy to fight this virus. Our study will be on the Impact of demography on the Severity of covid-19 infection & at the same time, will look into gender-specific sensitivity of Covid-19 and the Operational variation of different biochemical markers in Covid-19 positive patients. Besides, we will be studying the co-relation, if any, of COVID severity & ABO Blood group type and the occurrence of the most common blood group type amongst positive patience.Keywords: coronavirus, ABO blood group, age, gender
Procedia PDF Downloads 9832754 Mild Hypothermia Versus Normothermia in Patients Undergoing Cardiac Surgery: A Propensity Matched Analysis
Authors: Ramanish Ravishankar, Azar Hussain, Mahmoud Loubani, Mubarak Chaudhry
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Background and Aims: Currently, there are no strict guidelines in cardiopulmonary bypass temperature management in cardiac surgery not involving the aortic arch. This study aims to compare patient outcomes undergoing mild hypothermia and normothermia. The aim of this study was to compare patient outcomes between mild hypothermia and normothermia undergoing on-pump cardiac surgery not involving the aortic arch. Methods: This was a retrospective cohort study from January 2015 until May 2023. Patients who underwent cardiac surgery with cardiopulmonary bypass temperatures ≥32oC were included and stratified into mild hypothermia (32oC – 35oC) and normothermia (>35oC) cohorts. Propensity matching was applied through the nearest neighbour method (1:1) using the risk factors detailed in the EuroScore using RStudio. The primary outcome was mortality. Secondary outcomes included post-op stay, intensive care unit readmission, re-admission, stroke, and renal complications. Patients who had major aortic surgery and off-pump operations were excluded. Results: Each cohort had 1675 patients. There was a significant increase in overall mortality with the mild hypothermia cohort (3.59% vs. 2.32%; p=0.04912). There was also a greater stroke incidence (2.09% vs. 1.13%; p=0.0396) and transient ischaemic attack (TIA) risk (3.1% vs. 1.49%; p=0.0027). There was no significant difference in renal complications (9.13% vs. 7.88%; p=0.2155). Conclusions: Patient’s who underwent mild hypothermia during cardiopulmonary bypass have a significantly greater mortality, stroke, and transient ischaemic attack incidence. Mild hypothermia does not appear to provide any benefit over normothermia and does not appear to provide any neuroprotective benefits. This shows different results to that of other major studies; further trials and studies need to be conducted to reach a consensus.Keywords: cardiac surgery, therapeutic hypothermia, neuroprotection, cardiopulmonary bypass
Procedia PDF Downloads 6832753 A Study of the Use of Arguments in Nominalizations as Instanciations of Grammatical Metaphors Finished in -TION in Academic Texts of Native Speakers
Authors: Giovana Perini-Loureiro
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The purpose of this research was to identify whether the nominalizations terminating in -TION in the academic discourse of native English speakers contain the arguments required by their input verbs. In the perspective of functional linguistics, ideational metaphors, with nominalization as their most pervasive realization, are lexically dense, and therefore frequent in formal texts. Ideational metaphors allow the academic genre to instantiate objectification, de-personalization, and the ability to construct a chain of arguments. The valence of those nouns present in nominalizations tends to maintain the same elements of the valence from its original verbs, but these arguments are not always expressed. The initial hypothesis was that these arguments would also be present alongside the nominalizations, through anaphora or cataphora. In this study, a qualitative analysis of the occurrences of the five more frequent nominalized terminations in -TION in academic texts was accomplished, and thus a verification of the occurrences of the arguments required by the original verbs. The assembling of the concordance lines was done through COCA (Corpus of Contemporary American English). After identifying the five most frequent nominalizations (attention, action, participation, instruction, intervention), the concordance lines were selected at random to be analyzed, assuring the representativeness and reliability of the sample. It was possible to verify, in all the analyzed instances, the presence of arguments. In most instances, the arguments were not expressed, but recoverable, either in the context or in the shared knowledge among the interactants. It was concluded that the realizations of the arguments which were not expressed alongside the nominalizations are part of a continuum, starting from the immediate context with anaphora and cataphora; up to a knowledge shared outside the text, such as specific area knowledge. The study also has implications for the teaching of academic writing, especially with regards to the impact of nominalizations on the thematic and informational flow of the text. Grammatical metaphors are essential to academic writing, hence acknowledging the occurrence of its arguments is paramount to achieve linguistic awareness and the writing prestige required by the academy.Keywords: corpus, functional linguistics, grammatical metaphors, nominalizations, academic English
Procedia PDF Downloads 14632752 Exploring Factors Related to Unplanning Readmission of Elderly Patients in Taiwan
Authors: Hui-Yen Lee, Hsiu-Yun Wei, Guey-Jen Lin, Pi-Yueh Lee Lee
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Background: Unplanned hospital readmissions increase healthcare costs and have been considered a marker of poor healthcare performance. The elderly face a higher risk of unplanned readmission due to elderly-specific characteristics such as deteriorating body functions and the relatively high incidence of complications after treatment of acute diseases. Purpose: The aim of this study was exploring the factors that relate to the unplanned readmission of elderly within 14 days of discharge at our hospital in southern Taiwan. Methods: We retrospectively reviewed the medical records of patients aged ≥65 years who had been re-admitted between January 2018 and December 2018.The Charlson Comorbidity score was calculated using previous used method. Related factors that affected the rate of unplanned readmission within 14 days of discharge were screened and analyzed using the chi-squared test and logistic regression analysis. Results: This study enrolled 829 subjects aged more than 65 years. The numbers of unplanned readmission patients within 14 days were 318 cases, while those did not belong to the unplanned readmission were 511 cases. In 2018, the rate of elderly patients in unplanned 14 days readmissions was 38.4%. The majority patients were females (166 cases, 52.2%), with an average age of 77.6 ± 7.90 years (65-98). The average value of Charlson Comorbidity score was 4.42±2.76. Using logistic regression analysis, we found that the gastric or peptic ulcer (OR=1.917 , P< 0.002), diabetes (OR= 0.722, P< 0.043), hemiplegia (OR= 2.292, P< 0.015), metastatic solid tumor (OR= 2.204, P< 0.025), hypertension (OR= 0.696, P< 0.044), and skin ulcer/cellulitis (OR= 2.747, P< 0.022) have significantly higher risk of 14-day readmissions. Conclusion: The results of the present study may assist the healthcare teams to understand the factors that may affect unplanned readmission in the elderly. We recommend that these teams give efficient approach in their medical practice, provide timely health education for elderly, and integrative healthcare for chronic diseases in order to reduce unplanned readmissions.Keywords: unplanning readmission, elderly, Charlson comorbidity score, logistic regression analysis
Procedia PDF Downloads 13032751 An Investigation of Community Radio Broadcasting in Phutthamonthon District, Nakhon Pathom, Thailand
Authors: Anchana Sooksomchitra
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This study aims to explore and compare the current condition of community radio stations in Phutthamonthon district, Nakhon Pathom province, Thailand, as well as the challenges they are facing. Qualitative research tools including in-depth interviews; documentary analysis; focus group interviews; and observation, are used to examine the content, programming, and management structure of three community radio stations currently in operation within the district. Research findings indicate that the management and operational approaches adopted by the two non-profit stations included in the study, Salaya Pattana and Voice of Dhamma, are more structured and effective than that of the for-profit Tune Radio. Salaya Pattana – backed by the Faculty of Engineering, Mahidol University, and the charity-funded Voice of Dhamma, are comparatively free from political and commercial influence, and able to provide more relevant and consistent community-oriented content to meet the real demand of the audience. Tune Radio, on the other hand, has to rely solely on financial support from political factions and business groups, which heavily influence its content.Keywords: radio broadcasting, programming, management, community radio, Thailand
Procedia PDF Downloads 40032750 Doing Bad for a Greater Good: Moral Disengagement in Social and Commercial Entrepreneurial Contexts
Authors: Thorsten Auer, Sumaya Islam, Sabrina Plaß, Colin Wooldridge
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Whether individuals are more likely to forgo some ethical values if it is for a “great” social mission remains questionable. Research interest in the mechanism of moral disengagement has risen sharply in the organizational context over the last decades. Moral disengagement provides an explanatory approach to why individuals decide against their moral intent and describes the tendency to make unethical decisions due to a lack of self-regulation given various actions and their consequences. In our study, we examine the differences between individual decision-making given a commercial and social entrepreneurial context. Thereby, we investigate whether individuals in a social entrepreneurial context, characterized by pro-social goals and purpose beyond profit maximization, tend to make more or less “unethical” decisions in trade-off situations than those given a profit-focused commercial, entrepreneurial context. While a general priming effect may explain the tendency for individuals to make less unethical decisions given a social context, it remains unclear how individuals decide given a trade-off in that specific context. The trade-off in our study is characterized by the option to decide (un-) ethically to enhance the business purpose (in the social context, a social purpose, in the commercial context, a profit-maximization purpose). To investigate which characteristics of the context –and specifically of a trade-off – lead individuals to disregard and override their ethical values for a “greater good”, we design a conjoint analysis. This approach allows us to vary the attributes and scenarios and to test which attributes of a trade-off increase the probability of making an unethical choice. We add survey data to examine the individual propensity to morally disengage as an influencing factor to prefer certain attributes. Currently, we are in the final process of designing the conjoint analysis and plan to conduct the study by December 2022. We contribute to a better understanding of the role of moral disengagement in individual decision-making in a (social) entrepreneurial trade-off.Keywords: moral disengagement, social entrepreneurship, unethical decision, conjoint analysis
Procedia PDF Downloads 8732749 Re-Use of Waste Marble in Producing Green Concrete
Authors: Hasan Şahan Arel
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In this study, literature related to the replacement of cement with waste marble and the use of waste marble as an aggregate in concrete production was examined. Workability of the concrete decreased when marble powder was used as a substitute for fine aggregate. Marble powder contributed to the compressive strength of concrete because of the CaCO3 and SiO2 present in the chemical structure of the marble. Additionally, the use of marble pieces in place of coarse aggregate revealed that this contributed to the workability and mechanical properties of the concrete. When natural standard sand was replaced with marble dust at a ratio of 15% and 75%, the compressive strength and splitting tensile strength of the concrete increased by 20%-26% and 10%-15%, respectively. However, coarse marble aggregates exhibited the best performance at a 100% replacement ratio. Additionally, there was a greater improvement in the mechanical properties of concrete when waste marble was used in a coarse aggregate form when compared to that of when marble was used in a dust form. If the cement was replaced with marble powder in proportions of 20% or more, then adverse effects were observed on the compressive strength and workability of the concrete. This study indicated that marble dust at a cement-replacement ratio of 5%-10% affected the mechanical properties of concrete by decreasing the global annual CO2 emissions by 12% and also lowering the costs from US$40/m3 to US$33/m3.Keywords: cement production, concrete, CO2 emission, marble, mechanical properties
Procedia PDF Downloads 31632748 Effectiveness of Column Geometry in High-Rise Buildings
Authors: Man Singh Meena
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Structural engineers are facing different kind of challenges due to innovative & bold ideas of architects who are trying to design every structure with uniqueness. In RCC frame structures different geometry of columns can be used in design and rectangular columns can be placed with different type orientation. The analysis is design of structures can also be carried out by different type of software available i.e., STAAD Pro, ETABS and TEKLA. In recent times high-rise building modeling & analysis is done by ETABS due to its certain features which are superior to other software. The case study in this paper mainly emphasizes on structural behavior of high rise building for different column shape configurations like Circular, Square, Rectangular and Rectangular with 90-degree Rotation and rectangular shape plan. In all these column shapes the areas of columns are kept same to study the effect on design of concrete area is same. Modelling of 20-storeys R.C.C. framed building is done on the ETABS software for analysis. Post analysis of the structure, maximum bending moments, shear forces and maximum longitudinal reinforcement are computed and compared for three different story structures to identify the effectiveness of geometry of column.Keywords: high-rise building, column geometry, building modelling, ETABS analysis, building design, structural analysis, structural optimization
Procedia PDF Downloads 8132747 A Cost-Evaluation Study on the Use of Negative Pressure Wound Therapy with Instillation for Salvage of Infected Implant-Based Breast Reconstructions
Authors: S. Haque, M. Kanapathy, E. Bollen, I. Younis, A. Mosahebi
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Background: Implant loss due to infection is the most devastating complication of implant-based breast reconstruction. The use of negative pressure wound therapy with instillation (NPWTi) for salvage of infected implant-based breast reconstructions has shown promising results to allow early reinsertion of a new implant as an alternative to current management of delayed reinsertion. This study compares the cost implication of NPWTi against current management of delayed reinsertion of infected breast implants. Methods: 20 cases of an infected breast implant treated with NPWTi (V.A.C. VERAFLO™ Therapy) followed by early re-insertion of a new implant were compared with 20 cases who had delayed reinsertion (non-NPWTi). Average cost per person was calculated using total operative expenses, cost of inpatient stay, cost of investigations, cost of antibiotics, and cost of outpatient visits. Results: Treatment with NPWTi allowed for earlier re-insertion of a new implant (NPWTi: 9.04 ± 2.92 days vs. non-NPWTi: 236.25 ± 123.89 days). The average cost per patient for NPWTi and non-NPWTi was £14,343.13 ± £2,786.70 and £8,920.31 ± £3,005.73 respectively. All patients treated with NPWTi had one admission and spent 11.9 ± 4.1days as an inpatient while non-NPWTi patients had 2.1 ± 0.3 admissions with total length of inpatient stay of 7.1 ± 5.8days. Patients treated with NPWTi had more surgeries (NPWTi: 3.35 ± 0.81 vs. non-NPWTi: 2.2 ± 0.41), however 3 non-NPWTi cases required flap reconstruction. Patients treated with NPWTi had fewer total outpatient visits (NPWTi: 12 ± 6 vs. non-NPWTi: 14.2 ± 6.3). Conclusion: Patients treated with NPWTi incurred higher average cost per patient, longer inpatient stay, and more procedures; however, had early re-insertion of new implants and fewer admissions and outpatient visits. A further study on patient-reported outcome is essential to compare cost against patient benefit.Keywords: breast reconstruction, cost evaluation, infection, negative pressure wound therapy
Procedia PDF Downloads 12532746 Genetic Evaluation of Locally Flock Sheep in Gabaraka Village
Authors: Salim Omar Raoof
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This study was conducted in a private local sheep herd at Gabaraka village-Kirkuk-Iraq. Analysis of 77 ewes recorded and 7 Rams of local sheep presented in Gabaraka village farm plain, the age of ewes ranged between (2-4) years. The aim of this study is to investigate the genetic and non-genetic factors (type of birth, sex, and age of dam) affecting daily milk yield (DMY), birth weight (BW), weaning weight (WW) and Gain characteristics of local sheep raised under Iraq conditions, and it also aims at estimating heritability’s, BLUP. The overall mean of daily milk yield, (BW), (WW), and gain. Was 444.15gm,4.92kg,43.08kg, and 38.16kg, respectively. The results showed there was a significant effect of the type of birth and sex on (BW) and (WW). Also, the age of the dam had a significant effect on daily milk yield (BW), (WW), and gain. Generally, the estimate of heritability of DMP, BWT, WWT, and Gain tend to be 0.22, 0.17, 0.27, and 0.22, respectively. The breeding value (BLUP) for rams ranged between (-0.1684 to 0.188), (-0.205 to 0.310), and ( -0.0171 to 0.029) according to growth traits of Lambs BW, WW, and Gain, respectively. It concluded that the selection of ewes and rams at the population level in planned selection schemes is based on BLUP value and heritability.Keywords: locally sheep, milk yield, Genetic parameters, BLUP value
Procedia PDF Downloads 7732745 Community Participation in Decentralized Management of Natural Resources in the Sudano-Sahelian Zone of West Africa
Authors: Clarisse Umutoni, Augustine Ayantunde, Matthew Turner, Germain J. Sawadogo
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Decentralized governance of natural resources is considered one of the key strategies for promoting sustainable management of natural resources at local level. The rationale behind decentralization of natural resources is that local populations are both better situated and more highly motivated than outside agencies to manage the resources in an ecologically and economically sustainable manner. Effective decentralized natural resource management requires strong local natural resource institutions. Therefore, strengthening local institutions governing natural resource management is essential to promoting strong participation of local communities in managing their resources. This paper investigated the existing local institutions (rules, norms and or local conventions) governing the management of natural resources and forms of community participation in the development of these natural resource institutions. Group discussions and individual interviews were conducted to collect data. Our findings showed significant variation within the study sites regarding the level of knowledge of existing local rules and norms governing the management of natural resources by the respondents. The results also show that participation was dominated by a small group of individuals, often community leaders and elites. The results suggest that women are marginalized. In general, factors which influence the level of participation include; age, year of residence in the community, gender and education level. This study also highlights the strengths of local natural resource institutions especially if enforced. Presently, the big challenge that faces the institutions governing natural resource use in the study area is the system of representativeness in the community in the development of local rules and norms as community leaders and household heads often dominate, which does not encourage active participation of community members. Therefore, for effective implementation of local natural resource institutions, the interest of key natural resource users should be taken into account. It is also important to promote rules and norms that attempt to protect or strengthen women’s access to natural resources in the community.Keywords: decentralization, land use plan, local institutions, Mali
Procedia PDF Downloads 38732744 Thermodynamic Analysis of a Multi-Generation Plant Driven by Pine Sawdust as Primary Fuel
Authors: Behzad Panahirad, UğUr Atikol
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The current study is based on a combined heat and power system with multi-objectives, driven by biomass. The system consists of a combustion chamber (CC), a single effect absorption cooling system (SEACS), an air conditioning unit (AC), a reheat steam Rankine cycle (RRC), an organic Rankine cycle (ORC) and an electrolyzer. The purpose of this system is to produce hydrogen, electricity, heat, cooling, and air conditioning. All the simulations had been performed by Engineering Equation Solver (EES) software. Pine sawdust is the selected biofuel for the combustion process. The overall utilization factor (εₑₙ) and exergetic efficiency (ψₑₓ) were calculated to be 2.096 and 24.03% respectively. The performed renewable and environmental impact analysis indicated a sustainability index of 1.316 (SI) and a specific CO2 emission of 353.8 kg/MWh. The parametric study is conducted based on the variation of ambient (sink) temperature, biofuel mass flow rate, and boilers outlet temperatures. The parametric simulation showed that the increase in biofuel mass flow rate has a positive effect on the sustainability of the system.Keywords: biomass, exergy assessment, multi-objective plant, CO₂ emission, irreversibility
Procedia PDF Downloads 16932743 Regulating the Emerging Platform Economy in Ethiopia: Issues in the Ride-Hailing Platforms
Authors: Nebiat Lemenih Lenger
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Today, the digital economy is evolving faster than ever in Ethiopia. Platforms that provide a ride-hailing service are growing fast in the country. The market welcomed them as they disrupt it with quality services and lower prices. This revolution is, however, not without challenges. These include cybersecurity breaches, facilitating illegal economic activities, and challenging concepts of privacy. To mitigate the risks and utilize the benefits, appropriate regulation should be introduced in the economy. By identifying legal and institutional gaps in Ethiopia`s digital economy, this research work assists the government`s effort to create a better digital economy. Moreover, this study, being a pioneer study in the area, will be an input for further studies in academia. The research employs a qualitative legal research method and analyzes various legal and policy instruments in Ethiopia in comparison with best international experiences. As this research applies a qualitative research method, a grounded theory method of data analysis is used. The research concluded that Ethiopia is far from designing appropriate legal and regulatory infrastructures. Due to the government monopoly of the sector, there is poor digital infrastructure in the country. The existing labor laws have no specific provisions on the rights and obligations of gig workers.Keywords: Ethiopia, gig economy, digital, ride-hailing, regulation
Procedia PDF Downloads 9332742 Association of Dietary Intake with the Nutrition Knowledge, Food Label Use, and Food Preferences of Adults in San Jose del Monte City, Bulacan, Philippines
Authors: Barby Jennette A. Florano
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Dietary intake has been associated with the health and wellbeing of adults, and lifestyle related diseases. The aim of this study was to investigate whether nutrition knowledge, food label use, and food preference are associated with the dietary intake in a sample of San Jose Del Monte City, Bulacan (SJDM) adults. A sample of 148 adults, with a mean age of 20 years, completed a validated questionnaire related to their demographic, dietary intake, nutrition knowledge, food label use and food preference. Data were analyzed using Pearson correlation and there was no association between dietary intake and nutrition knowledge. However, there were positive relationships between dietary intake and food label use (r=0.1276, p<0.10), and dietary intake and food preference (r=0.1070, p<0.10). SJDM adults who use food label and have extensive food preference had better diet quality. This finding magnifies the role of nutrition education as a potential tool in health campaigns to promote healthy eating patterns and reading food labels among students and adults. Results of this study can give information for the design of future nutrition education intervention studies to assess the efficacy of nutrition knowledge and food label use among a similar sample population.Keywords: dietary intake, nutrition knowledge, food preference, food label use
Procedia PDF Downloads 9132741 Basic Study of Mammographic Image Magnification System with Eye-Detector and Simple EEG Scanner
Authors: Aika Umemuro, Mitsuru Sato, Mizuki Narita, Saya Hori, Saya Sakurai, Tomomi Nakayama, Ayano Nakazawa, Toshihiro Ogura
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Mammography requires the detection of very small calcifications, and physicians search for microcalcifications by magnifying the images as they read them. The mouse is necessary to zoom in on the images, but this can be tiring and distracting when many images are read in a single day. Therefore, an image magnification system combining an eye-detector and a simple electroencephalograph (EEG) scanner was devised, and its operability was evaluated. Two experiments were conducted in this study: the measurement of eye-detection error using an eye-detector and the measurement of the time required for image magnification using a simple EEG scanner. Eye-detector validation showed that the mean distance of eye-detection error ranged from 0.64 cm to 2.17 cm, with an overall mean of 1.24 ± 0.81 cm for the observers. The results showed that the eye detection error was small enough for the magnified area of the mammographic image. The average time required for point magnification in the verification of the simple EEG scanner ranged from 5.85 to 16.73 seconds, and individual differences were observed. The reason for this may be that the size of the simple EEG scanner used was not adjustable, so it did not fit well for some subjects. The use of a simple EEG scanner with size adjustment would solve this problem. Therefore, the image magnification system using the eye-detector and the simple EEG scanner is useful.Keywords: EEG scanner, eye-detector, mammography, observers
Procedia PDF Downloads 21532740 Vitamin D Deficiency is Associated with Increases IgE Receptors in Children with Asthma
Authors: A. Vijayendra Chary, R. Hemalatha
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Background: Vitamin D is a potent modulator of the immune system and is involved in regulating cell proliferation and differentiation. Vitamin D deficiency has been linked to increased severity of asthma in children. Asthma has dramatically increased in past decades, particular in developing countries and affects up to 20% of the population. IgE and its receptors, CD23 (FcεRII) and CD 21, play an essential role in all allergic conditions. Methods: A case control study was conducted on asthma and age and sex matched control children. 25 hydroxyvitamin D3 was quantified by HPLC; CD23; and CD21 expression on B cells were performed by flow cytometry. Total Histamine, total IGE and IL-5 and IFN-γ cytokines were determined by ELISA in blood samples of bronchial asthma (n=45) and control children (n=45). Results: The mean ± SE of vitamin D was significantly (p<0.05) low in asthma children (13.6±0.54 ng/mL) than in controls (17.4 ± 0.37 ng/mL). The mean (%) ± SE of CD23 and CD21 expression on B cells were significantly (p<0.01) high in asthma (1.02±0.09; 1.67± 0.13), when compared to controls (0.24±0.01; 0.94±0.03) respectively. The mean± SE of Serum IgE and blood histamine levels in asthma children (354.52 ± 17.33 IU/mL; 53.27 ± 2.54 nM/mL) were increased (P<0.05) when compared to controls (183.12±17.62 IU/mL 39.34±4.16 nM/mL) respectively and IFN-γ (Th1 cytokine) was lower (P<0.01) (16.37±1.27 pg/mL) than in controls (43.34±6.21 pg/mL). Conclusion: Our study provides evidence that low vitamin D levels are associated with increased IgE receptors CD23 and CD21 on B cells. In addition, there was preferential activation of Th2 (IL-5) and suppression of Th1 (IFN-γ) cytokines in children with asthma.Keywords: bronchial asthma, CD23, IgE, vitamin D
Procedia PDF Downloads 47432739 Rain Gauges Network Optimization in Southern Peninsular Malaysia
Authors: Mohd Khairul Bazli Mohd Aziz, Fadhilah Yusof, Zulkifli Yusop, Zalina Mohd Daud, Mohammad Afif Kasno
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Recent developed rainfall network design techniques have been discussed and compared by many researchers worldwide due to the demand of acquiring higher levels of accuracy from collected data. In many studies, rain-gauge networks are designed to provide good estimation for areal rainfall and for flood modelling and prediction. In a certain study, even using lumped models for flood forecasting, a proper gauge network can significantly improve the results. Therefore existing rainfall network in Johor must be optimized and redesigned in order to meet the required level of accuracy preset by rainfall data users. The well-known geostatistics method (variance-reduction method) that is combined with simulated annealing was used as an algorithm of optimization in this study to obtain the optimal number and locations of the rain gauges. Rain gauge network structure is not only dependent on the station density; station location also plays an important role in determining whether information is acquired accurately. The existing network of 84 rain gauges in Johor is optimized and redesigned by using rainfall, humidity, solar radiation, temperature and wind speed data during monsoon season (November – February) for the period of 1975 – 2008. Three different semivariogram models which are Spherical, Gaussian and Exponential were used and their performances were also compared in this study. Cross validation technique was applied to compute the errors and the result showed that exponential model is the best semivariogram. It was found that the proposed method was satisfied by a network of 64 rain gauges with the minimum estimated variance and 20 of the existing ones were removed and relocated. An existing network may consist of redundant stations that may make little or no contribution to the network performance for providing quality data. Therefore, two different cases were considered in this study. The first case considered the removed stations that were optimally relocated into new locations to investigate their influence in the calculated estimated variance and the second case explored the possibility to relocate all 84 existing stations into new locations to determine the optimal position. The relocations of the stations in both cases have shown that the new optimal locations have managed to reduce the estimated variance and it has proven that locations played an important role in determining the optimal network.Keywords: geostatistics, simulated annealing, semivariogram, optimization
Procedia PDF Downloads 30232738 Examining Attrition in English Education: A Qualitative Study of the Impact of Preparation, Persistence, and Dispositions in Teacher Education
Authors: Pamela K. Coke, Heidi Frederiksen, Ann Sebald
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Over the past three years, the researchers have been tracking a rise in the number of teacher education candidates leaving the field before completing their university’s educator preparation program. At their institution, this rise is most pronounced in English Education. The purpose of this qualitative research study is to understand English Education teacher candidates' expectations in becoming prepared educators at each phase of their four phase teacher education program at one institution of higher education in the United States. Research questions include: To what extent do we find differences in teacher candidates' expectations of their teacher training program and student teaching experiences based upon undergraduate and graduate programs? Why do (or do not) teacher candidates persist in their teacher training program and student teaching experiences? How do dispositions develop through the course of the teacher training program? What supports do teacher candidates self-identify as needing at each phase of the teacher training program? Based upon participant interviews at each phase of the teacher education program, the researchers, all teacher educators, examine the extent to which English Education students feel prepared to student teach, focusing on preparation, persistence, and dispositions. The Colorado State University Center for Educator Preparation (CEP) provides students with information about teaching dispositions, or desired professional behaviors, throughout their education program. CEP focuses these dispositions around nine categories: Professional Behaviors, Initiative and Dependability, Tact and Judgment, Ethical Behavior and Integrity, Collegiality and Responsiveness, Effective Communicator, Desire to Improve Own Performance, Culturally Responsive, and Commitment to the Profession. Currently, in the first phase of a four phase study, initial results indicate participants expect their greatest joys will be working with and learning from students. They anticipate their greatest challenges will involve discipline and confidence. They predict they will persist in their program because they believe the country needs well-prepared teachers and they have a commitment to their professional growth. None of the participants thus far could imagine why they would leave the program. With regard to strongest and weakest dispositions, results are mixed. Some participants see Tact and Judgment as their strongest disposition; others see it as their weakest. All participants stated mentoring is a necessary support at every phase of the teacher preparation process. This study informs the way teacher educators train and evaluate teacher candidates, and has implications for the frequency and types of feedback students receive from mentors and supervisors. This research contributes to existing work on teacher retention, candidate persistence, and dispositional development.Keywords: English education, dispositions, persistence, teacher preparation
Procedia PDF Downloads 32232737 Evaluation of Two DNA Vaccine Constructs in Labeo rohita against Edwardsiella tarda
Authors: Ranjeeta Kumari, Makesh M, Gayatri Tripathi, K V Rajendran, Megha Bedekar
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A comparative study on DNA immunization with recombinant glyceraldehyde-3-phosphate dehydrogenase (GAPDH) construct of Edwardsiella tarda (pGPD group) and a bicistronic construct expressing GAPDH plus IFN-γ of Labeo rohita as adjuvant (pGPD+IFN group) was undertaken in Labeo rohita along with the control animals. Successful co-expression of two genes that is GAPDH and IFN-γ was confirmed in SSN-1 cells line by RT-qPCR and western blot. The protective immune response of host to DNA vaccine construct was determined by RPS and specific antibody production. Fishes immunized with plasmids via intramuscular injection (I/M) exhibited a considerable relative percentage survivability of 66.66% in pGPD+IFN immunized group and 53.34% in pGPD immunized group after challenge with E. tarda. Antibody response was also significantly high in pGPD+IFN group at all time points under study. This was analysed by competitive ELISA, using anti GAPDH monoclonal antibodies. The experiment revealed that the GAPDH gene of E. tarda is one of the ideal candidates for generating protective immune response in L. rohita. Further addition of Interferon gamma to DNA vaccine construct can enhance the immune response in host.Keywords: DNA vaccine, Edwardsiella tarda, Labeo rohita, zoonosis, immune response
Procedia PDF Downloads 20332736 Antifungal Nature of Bacillus Subtilis in Controlling Post Harvest Fungal Rot of Yam
Authors: Ifueko Oghogho Ukponmwan, Mike O. Orji
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This study investigated the antifungal activity of Bacilluss subtilis in the control of postharvest fungal rot of white yam (Dioscorea spp). Bacillus subtilis was isolated from the soil and fungi (Aspergillus spp, Mucor and yeasts) were isolated from rotten yam. The organisms were paired in yam nutrient agar (YNA) and yam Sabourraud dextrose agar media. In the yam dextrose agar media (YSDA) plates, the Bacillus grew rapidly and established itself and restricted the growth of the fungi organisms, but there was no zone of inhibition. This behaviour of Bacillus on the plates of YSDA was also observed in the yams where the fungi caused rot but the rot was suppressed by the presence of the Bacillus as compared to the degree of rot observed in the control that had only spoilage fungi. The control yam showed greater rot than other yams that contained a combination of Bacillus and fungi. The t-Test analysis showed that the difference in the rot between the treated samples and the control sample is significant and this implies that the presence of Bacillus significantly reduced the growth of fungi in the samples (yams). It was revealed from this study that Bacillus subtilis treatment can be successfully used to preserve white yams in storage. Its fast growth and early establishment in the sample accounts for its antifungal strength.Keywords: Bacillus subtilis, rot, fungi, yam
Procedia PDF Downloads 18132735 Effects of Dietary Copper Supplementation on the Freshwater Prawn, Macrobrachium rosenbergii
Authors: Muralisankar Thirunavukkarasu, Saravana Bhavan Periyakali, Santhanam Perumal
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The present study was performed to assess the effects of dietary copper (Cu) on growth, biochemical constituents, digestive enzyme activities, enzymatic antioxidant and metabolic enzymes of the freshwater prawn, Macrobrachium rosenbergii post larvae (PL). The Cu was supplemented at 0, 10, 20, 40, 60 and 80 mg kg-1 with the basal diets. Cu supplemented diets were fed to M. rosenbergii PL for a period of 90 days. At the end of the feeding experiment, 40 mg kg-1 Cu supplemented feeds fed PL showed significant (P < 0.05) improvement in survival, growth, digestive enzyme activities and concentrations of biochemical constituents. However, PL fed with 60 to 80 mg Cu kg-1 showed negative performance. Activities of enzymatic antioxidants, metabolic enzymes and lipid peroxidation in the muscle and hepatopancreas showed insignificant alterations (P > 0.05) up to 40 mg kg-1 Cu supplemented feeds fed PL. Whereas, 60 and 80 mg of Cu kg-1 supplemented feeds fed PL showed significant alterations on these antioxidants and metabolic enzymes levels. It indicates that beyond 40 mg Cu kg-1 diets were produced some toxic to M. rosenbergii PL. Therefore, the present study suggests that 40 mg Cu kg-1 can be supplemented in the diets of M. rosenbergii PL for regulating better survival and growth.Keywords: antioxidants, biochemical constituents, copper, growth, Macrobrachium rosenbergii
Procedia PDF Downloads 22532734 Income Analysis of Beef Cattle Breeders for Traditional Profit-Sharing System, Tesang, in South Sulawesi Province
Authors: Sitti Nurani Sirajuddin, Muh. Aminawar, Siti Nurlaelah, Amidah Amrawaty
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This study aimed to determine the income of beef cattle breeders from the traditional profit-sharing system named Tesang. This study was conducted in the province of South Sulawesi start from April to July 2014, used quantitative methods and data analysis is of income. The population is all beef cattle breeders who perform for the traditional profit-sharing system (Tesang) in Barru Regency and Bone Regency, province of South Sulawesi. Samples are beef cattle breeders who breeding the cattle with the traditional profit-sharing system (Tesang) in Barru Regency and Bone Regency using breeding system and cattle enlargement system (expense) by fifty breeders. The results showed beef cattle breeder’s income from the profit-sharing system (Tesang) where enlargement system (expense) at6th month maintenance periods higher than the profit-sharing system (Tesang) with using breeding the cattle.Keywords: income, beef cattle, profit-sharing system, Teseng
Procedia PDF Downloads 28432733 Authigenic Mineralogy in Nubian Sandstone Reservoirs
Authors: Mohamed M. A. Rahoma
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This paper presents the results of my sedimentological and petrographical study of the Nubian Formation in the north Gialo area in the Sirte basin in Libya that was used for identifying and recognizing the facies type and their changes through the studied interval. It also helped me to interpret the depositional processes and the depositional environments and describe the textural characteristics, detrital mineralogy, Authigenic mineralogy and porosity characteristics of the rocks within the cored interval. Thus, we can identify the principal controls on porosity and permeability within the reservoir sections for the studied interval. To achieve this study, I described the cores studied well and marked all features represented in color, grain size, lithology, and sedimentary structures and used them to identify the facies. Then, I chose a number of samples according to a noticeable change in the facies through the interval for microscopic investigation. The results of the microscopic investigation showed that the authigenic clays and the authigenic types of cement have an important influence on the reservoir quality by converting intergranular macropores to microporosity and reducing permeability. It is recommended to give these authigenic minerals more investigation in future studies since they have an essential influence on the potential of sandstones reservoirs.Keywords: diagenesis processes, authigenic minerals, Nubian Sandstone, reservoir quality
Procedia PDF Downloads 13532732 Biosorption of Heavy Metals by Low Cost Adsorbents
Authors: Azam Tabatabaee, Fereshteh Dastgoshadeh, Akram Tabatabaee
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This paper describes the use of by-products as adsorbents for removing heavy metals from aqueous effluent solutions. Products of almond skin, walnut shell, saw dust, rice bran and egg shell were evaluated as metal ion adsorbents in aqueous solutions. A comparative study was done with commercial adsorbents like ion exchange resins and activated carbon too. Batch experiments were investigated to determine the affinity of all of biomasses for, Cd(ΙΙ), Cr(ΙΙΙ), Ni(ΙΙ), and Pb(ΙΙ) metal ions at pH 5. The rate of metal ion removal in the synthetic wastewater by the biomass was evaluated by measuring final concentration of synthetic wastewater. At a concentration of metal ion (50 mg/L), egg shell adsorbed high levels (98.6 – 99.7%) of Pb(ΙΙ) and Cr(ΙΙΙ) and walnut shell adsorbed high levels (35.3 – 65.4%) of Ni(ΙΙ) and Cd(ΙΙ). In this study, it has been shown that by-products were excellent adsorbents for removal of toxic ions from wastewater with efficiency comparable to commercially available adsorbents, but at a reduced cost. Also statistical studies using Independent Sample t Test and ANOVA Oneway for statistical comparison between various elements adsorption showed that there isn’t a significant difference in some elements adsorption percentage by by-products and commercial adsorbents.Keywords: adsorbents, heavy metals, commercial adsorbents, wastewater, by-products
Procedia PDF Downloads 41232731 Consumers’ Perceptions of Non-Communicable Diseases and Perceived Product Value Impacts on Healthy Food Purchasing Decisions
Authors: Khatesiree Sripoothon, Usanee Sengpanich, Rattana Sittioum
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The objective of this study is to examine the factors influencing consumer purchasing decisions about healthy food. This model consists of two latent variables: Consumer Perception relating to NCDs and Consumer Perceived Product Value. The study was conducted in the northern provinces of Thailand, which are popular with tourists and have received support from the government for health tourism. A survey was used as the data collection method, and the questionnaire was applied to 385 tourists. An accidental sampling method was used to identify the sample. The statistics of frequency, percentage, mean, and structural equation model were used to analyze the data obtained. Additionally, all factors had a significant positive influence on healthy food purchasing decisions (p<0.01) and were predictive of healthy food purchasing decisions at 46.20 (R2=0.462). Also, these findings seem to underline a supposition that consumer perceptions of NCDs and perceived product value are key variables that strengthens the competitive effects of a healthy-friendly business entrepreneur. Moreover, reduce the country's public health costs for treating patients with the disease of NCDs in Thailand.Keywords: healthy food, perceived product value, perception of non-communicable diseases, purchasing decisions
Procedia PDF Downloads 16132730 Communication Barriers in Disaster Risk Management
Authors: Pooja Pandey
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The role of communication plays an integral part in the management of any disaster, whether natural or human-induced, both require effective and strategic delivery of information. The way any information is conveyed carries the most weight while dealing with the disaster. Hence, integrating communication strategies in disaster risk management (DRM) are extensively acknowledged however, these integration and planning are missing from the practical books. Researchers are continuously exploring integrated DRM and have established substantial vents between research and implementation of the strategies (gaps between science and policy). For this reason, this paper reviews the communication barriers that obstruct effective management of the disaster. Communication between first responders (government agencies, police, medical services) and the public (people directly affected by the disaster) is most critical and lacks proper delivery during a disaster. And these challenges can only be resolved if the foundation of the problem is properly dealt with, which is resolving the issues within the organizations. Through this study, it was found that it is necessary to build the communication gap between the organizations themselves as most of the hindrances occur during the mitigation, preparedness, response and recovery phase of the disaster. The study is concluded with the main aim to review the communication barriers within and at the organizational, technological, and social levels that impact effective DRM. In the end, some suggestions are made to strengthen the knowledge for future improvement in communication between the responders and their organizations.Keywords: communication, organization, barriers, first responders, disaster risk management
Procedia PDF Downloads 30032729 Response Analysis of a Steel Reinforced Concrete High-Rise Building during the 2011 Tohoku Earthquake
Authors: Naohiro Nakamura, Takuya Kinoshita, Hiroshi Fukuyama
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The 2011 off The Pacific Coast of Tohoku Earthquake caused considerable damage to wide areas of eastern Japan. A large number of earthquake observation records were obtained at various places. To design more earthquake-resistant buildings and improve earthquake disaster prevention, it is necessary to utilize these data to analyze and evaluate the behavior of a building during an earthquake. This paper presents an earthquake response simulation analysis (hereafter a seismic response analysis) that was conducted using data recorded during the main earthquake (hereafter the main shock) as well as the earthquakes before and after it. The data were obtained at a high-rise steel-reinforced concrete (SRC) building in the bay area of Tokyo. We first give an overview of the building, along with the characteristics of the earthquake motion and the building during the main shock. The data indicate that there was a change in the natural period before and after the earthquake. Next, we present the results of our seismic response analysis. First, the analysis model and conditions are shown, and then, the analysis result is compared with the observational records. Using the analysis result, we then study the effect of soil-structure interaction on the response of the building. By identifying the characteristics of the building during the earthquake (i.e., the 1st natural period and the 1st damping ratio) by the Auto-Regressive eXogenous (ARX) model, we compare the analysis result with the observational records so as to evaluate the accuracy of the response analysis. In this study, a lumped-mass system SR model was used to conduct a seismic response analysis using observational data as input waves. The main results of this study are as follows: 1) The observational records of the 3/11 main shock put it between a level 1 and level 2 earthquake. The result of the ground response analysis showed that the maximum shear strain in the ground was about 0.1% and that the possibility of liquefaction occurring was low. 2) During the 3/11 main shock, the observed wave showed that the eigenperiod of the building became longer; this behavior could be generally reproduced in the response analysis. This prolonged eigenperiod was due to the nonlinearity of the superstructure, and the effect of the nonlinearity of the ground seems to have been small. 3) As for the 4/11 aftershock, a continuous analysis in which the subject seismic wave was input after the 3/11 main shock was input was conducted. The analyzed values generally corresponded well with the observed values. This means that the effect of the nonlinearity of the main shock was retained by the building. It is important to consider this when conducting the response evaluation. 4) The first period and the damping ratio during a vibration were evaluated by an ARX model. Our results show that the response analysis model in this study is generally good at estimating a change in the response of the building during a vibration.Keywords: ARX model, response analysis, SRC building, the 2011 off the Pacific Coast of Tohoku Earthquake
Procedia PDF Downloads 16432728 Relation of Mean Platelet Volume with Serum Paraoxonase-1 Activity and Brachial Artery Diameter and Intima Media Thickness in Diabetic Patients with Respect to Obesity and Diabetic Complications
Authors: Pınar Karakaya, Meral Mert, Yildiz Okuturlar, Didem Acarer, Asuman Gedikbasi, Filiz Islim, Teslime Ayaz, Ozlem Soyluk, Ozlem Harmankaya, Abdulbaki Kumbasar
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Objective: To evaluate the relation of mean platelet volume (MPV) levels with serum paraoxonase-1 activity and brachial artery diameter and intima media thickness in diabetic patients with respect to obesity and diabetic complications. Methods: A total of 201 diabetic patients grouped with respect to obesity [obese (n=89) and non-obese (n=112) and diabetic complications [with (n=50) or without (n=150) microvascular complications and with (n=91) or without (n=108) macrovascular complications] groups were included. Data on demographic and lifestyle characteristics of patients, anthropometric measurements, diabetes related microvascular and macrovascular complications, serum levels for MPV, bBrachial artery diameter and intima media thickness (IMT) and serum paraoxonase and arylesterase activities were recorded. Correlation of MPV values to paraoxonase and arylesterase activities as well as to brachial artery diameter and IMT was evaluated in study groups. Results: Mean(SD) paraoxonase and arylesterase values were 119.8(37.5) U/L and 149.0(39.9) U/L, respectively in the overall population with no significant difference with respect to obesity and macrovascular diabetic complications, whereas significantly lower values for paraoxonase (107.5(30.7) vs. 123.9(38.8) U/L, p=0.007) and arylesterase (132.1(30.2) vs. 154.7(41.2) U/L, p=0.001) were noted in patients with than without diabetic microvascular complications. Mean(SD) MPV values were 9.10 (0.87) fL in the overall population with no significant difference with respect to obesity and diabetic complications. No significant correlation of MPV values to paraoxonase, arylesterase activities, to brachial artery diameter and IMT was noted in the overall study population as well as in study groups. Conclusion: In conclusion, our findings revealed a significant decrease I PON-1 activity in diabetic patients with microvascular rather than macrovascular complications, whereas regardless of obesity and diabetic complications, no increase in thrombogenic activity and no relation of thrombogenic activity with PON-1 activity and brachial artery diameter and IMK.Keywords: atherosclerosis, diabetes mellitus, microvascular complications, macrovascular complications, obesity, paraoxonase
Procedia PDF Downloads 35632727 Decoding Mental Disorders: The Value of Practical Experience in Perceptions of Autism Spectrum Disorder
Authors: Ryan Tehini
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The purpose of this paper is to explore the value of practical experience with Autism Spectrum Disorder (ASD) as a microcosm of mental disorders, in psychology students’ attempt to fully understand it in all of its intricacies. The study follows a one-year program where students of psychology volunteer at a school for Autistic children of ages 3-18. The individual levels of experience with, and theoretical understanding of, ASD varies measurably amongst the volunteers; these volunteers are then intermittently interviewed, observed and surveyed throughout the program in order to determine any decline or growth in their understanding of Autism Spectrum Disorder. A panel of professionals all of whom are active in the world of ASD (headmasters of Autistic schools, psychologists, child development specialists, special needs teachers, parents of autistic children and Occupational Therapists) were used specifically for this study, in order to develop the guideline for understanding ASD that will be used comparatively against the information gained from the volunteers in order to establish the individual results. The paper concludes by illustrating how psychology has a responsibility to the community to understand disorders past what is academic and theoretical, and how increasing student experience with a disorder can aid in a more holistic psychological approach to mental disorders in the future.Keywords: autism, mental disorders, practical experience, psychology
Procedia PDF Downloads 26132726 Zoledronic Acid with Neoadjuvant Chemotherapy in Advanced Breast Cancer Prospective Study 2011–2014
Authors: S. Sakhri
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Background: The use of Zoledronic acid (ZA) is an established place in the treatment of malignant tumors with a predilection for the skeleton of interest (in particular metastasis). Although the main target of Zoledronic acid was osteoclasts, there are preclinical data suggest that Zoledronic acid may have an antitumor effect on cells other than osteoclasts, including tumor cells. Antitumor activity, including the inhibition of tumor cell growth and the induction of apoptosis of tumor cells, inhibition of tumor cell adhesion and invasion, and anti-angiogenic effects have been demonstrated. Methods. From (2012 to 2014), 438 patients were included respondents the inclusion criteria, respectively. This is a prospective study over a 4 year period. Of all patients (N=438), 432 received neoadjuvant chemotherapy with Zoledronic acid. The primary end point was the pathologic complete response in advancer breast cancer stage. The secondary end point is to evaluate Clinical response according to RECIST criteria; estimate the bone density before and at the end of chemotherapy in women with locally advanced breast cancer, Toxicity Evaluation and Overall survival using Kaplan-Meier and log test. Result: The Objective response rate was 97% after (C4) with 3% stabilizations and 99, 3% of which 0.7% C8 after stabilization. The clinical complete response was 28% after C4 respectively, and 46.8% after C8, the pathologic complete response rate was 40.13% according to the classification Sataloff. We observed that the pathologic complete response rate was the most raised in the group including Her2 (luminal Her2 and Her2) the lowest in the triple negative group as classified by Sataloff. We found that the pCR is significantly higher in the age group (35-50 years) with 53.17%. Those who have more than 50 years in 2nd place with 27.7% and the lower in young woman 35 years pCR was 19%, not statistically significant, -The pCR was also in favor of the menopausal group in 51, 4%, and 48, 55% for non-menopausal women. The average duration of overall survival was also significantly in the subgroup (Luminal -Her2, Her2) compared with triple negative. It is 47.18 months in the luminal group vs. 38.95 in the triple negative group. -Was observed in our study a difference in quality of life between (C1) was the admission of the patient, and after (C8), we found an increase in general signs and a deterioration in the psychological state C1, in contrast to the C8 these general signs and mental status improves, up to 12, and 24 months. Conclusion The results of this study suggest that the addition of ZA to néoadjuvant CT has potential anti-cancer benefit in patients (Luminal -Her2, Her2) compared with triple negative with or without menopause status.Keywords: HER2+, RH+, breast cancer, tyrosine kinase
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