Search results for: therapeutic assessment
4317 EU Regulation 868/04: Report of a Unilateral Approach on Unfair Subsidisation and Unfair Pricing Practices and Its Failure
Authors: Andrea Trimarchi
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This paper is designed to provide a comprehensive overview on the EU Regulation No. 868/2004 concerning protection against subsidisation and unfair pricing practices regarding non-EU carriers and causing injury to Community air carriers. The analysis will focus, at first, on the exegetical scrutiny of the legal categories encompassed by the Regulation. In addition to that, while considering the peculiarities of such legal instrument, the attention will be addressed on the assessment on its effectiveness. The Regulation, indeed, having received lots of criticism, is in need of a profound revision. In this context, the present work will try to take into account the policy alternatives. In light of the failure of Regulation 868, which is to be seen as the expression of a unilateral and regional approach, there would seem to be the necessity for the aviation sector to reconsider the topic of subsidisation and unfair pricing practices in a more international oriented manner.Keywords: non-EU airlines, aviation, subisidisation, unfair
Procedia PDF Downloads 3444316 Gender Identify and Agency of Traumatized Subjects in Incestuous Family
Authors: Jenyu Peng
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Incestuous abuse can be considered a form of domestic violence that exemplifies gender inequality. It challenges the common image of home as “haven of safety”. In Taiwan, even after years of feminist NGOs’ effort to encourage victims to speak up, the shared cultural representations of family, still praising piety towards the parents, seem to keep the incest trauma in secret. As clinical practitioners have observed, most devastating psychological sequels of incest trauma are often related to silencing. Thus one can expect that in families centered cultures, the difficulties for victims to disclose are greater, and the traumatic consequences more severe. This poses crucial therapeutic issues for clinicians working in those cultures. Since 2009, the author, a trained psychoanalyst and researcher, has been conducting “clinical fieldwork” on incest trauma in Taiwan. Employing ethnographical method, our theoretical references are both psychoanalytical and anthropological. The necessity of interdisciplinary efforts in incest trauma research will be addressed and discussed. The analyses of the present paper will focus on five incestuous families: four Han families, and one aboriginal. Although Taiwanese aboriginal peoples have been pretty much sinicized since decades, it is worth observing the convergent and divergent aspects in these two cultures. Moreover, findings of a previous research conducted in France during 2002-2004 will serve as background for the purpose of comparison. The results will be presented along with three questions: 1) How the perception of family influences the process of disclosure? 2) How the incestuous experience comes into play with victims’ gender identity and sexuality, pivotal for the subjectification? 3) How victims more successful in gendered subjectification modify their dynamics with their traumatizing family? This research finds that most victims tend to defend their own incestuous families, and that victims’ subjectivity and agency are actually entangled in the power structure of incestuous family.Keywords: incestuous family, subjectification, gender identity, agency
Procedia PDF Downloads 3524315 Ethical Considerations in In-Utero Gene Editing
Authors: Shruti Govindarajan
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In-utero gene editing with CRISPR-Cas9 opens up new possibilities for treating genetic disorders during pregnancy while still in mother’s womb. By targeting genetic mutations in the early stages of fetal development, this approach could potentially prevent severe conditions—like cystic fibrosis, sickle cell anemia, and muscular dystrophy—from causing harm. CRISPR-Cas9, which allows precise DNA edits, could be delivered into fetal cells through vectors such as adeno-associated viruses (AAVs) or nanoparticles, correcting disease-causing mutations and possibly offering lifelong relief from these disorders. For families facing severe genetic diagnoses, in-utero gene editing could provide a transformative option. However, technical challenges remain, including ensuring that gene editing only targets the intended cells and verifying long-term safety. Ethical considerations are also at the forefront of this technology. The editing of a fetus's genes brings up difficult questions about consent, especially since these genetic changes will affect the child’s entire life without their input. There's also concern over possible unintended side effects, or changes passed down to future generations. Moreover, if used beyond therapeutic purposes, this technology could be misused for ‘enhancements,’ like selecting for certain physical or cognitive traits, raising concerns about inequality and social pressures. In this way, in-utero gene editing brings both exciting potential and complex moral questions. As research progresses, addressing these scientific and ethical concerns will be key to ensuring that this technology is used responsibly, prioritizing safety, fairness, and a focus on alleviating genetic disease. A cautious and inclusive approach, along with clear regulations, will be essential to realizing the benefits of in-utero gene editing while protecting against unintended consequences.Keywords: in-utero gene editing, CRISPR, bioethics, genetic disorder
Procedia PDF Downloads 84314 Metagenomic Assessment of the Effects of Genetically Modified Crops on Microbial Ecology and Physicochemical Properties of Soil
Authors: Falana Yetunde Olaitan, Ijah U. J. J, Solebo Shakirat O.
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Genetically modified crops are already phenomenally successful and are grown worldwide in more than eighteen countries on more than 67 million hectares. Nigeria, in October 2018, approved Bacillus thuringiensis (Bt) cotton and maize; therefore, the need to carry out environmental risk assessment studies. A total of 15 4L octagonal ceramic pots were filled with 4kg of soil and placed on the bench in 2 rows of 10 pots each and the 3rd row of 5 pots, 1st-row pots were used to plant GM cotton seeds, while the 2nd-row pots were used for non-GM cotton seeds and the 3rd row of 5 pots served as control, all in the screen house. Soil samples for metagenomic DNA extraction were collected at random and at the monthly interval after planting at a distance of 2mm from the plant’s root and at a depth of 10cm using a sterile spatula. Soil samples for physicochemical analysis were collected before planting and after harvesting the GM and non-GM crops as well as from the control soil. The DNA was extracted, quantified and sequenced; Sample 1A (DNA from GM cotton Soil at 1st interval) gave the lowest sequence read with 0.853M while sample 2B (DNA from GM cotton Soil at 2nd interval) gave the highest with 5.785M, others gave between 1.8M and 4.7M. The samples treatment were grouped into four, Group 1 (GM cotton soil from 1 to 3 intervals) had between 800,000 and 5,700,000 strains of microbes (SOM), Group 2 (non GM cotton soil from 1 to 3 intervals) had between 1,400,600 and 4,200,000 SOM, Group 3 (control soil) had between 900,000 and 3,600,000 SOM and Group 4 (initial soil) had between 3,700,000 and 4,000,000 SOM. The microbes observed were predominantly bacteria (including archaea), fungi, dark matter alongside protists and phages. The predominant bacterial groups were the Terrabacteria (Bacillus funiculus, Bacillus sp.), the Proteobacteria (Microvirga massiliensis, sphingomonas sp.) and the Archaea (Nitrososphaera sp.), while the fungi were Aspergillus fischeri and Fusarium falciforme. The comparative analysis between groups was done using JACCARD PERMANOVA beta diversity analysis at P-value not more than 0.76 and there was no significant pair found. The pH for initial, GM cotton, non-GM cotton and control soil were 6.28, 6.26, 7.25, 8.26 and the percentage moisture was 0.63, 0.78, 0.89 and 0.82, respectively, while the percentage Nitrogen was observed to be 17.79, 1.14, 1.10 and 0.56 respectively. Other parameters include, varying concentrations of Potassium (0.46, 1,284.47, 1,785.48, 1,252.83 mg/kg) and Phosphorus (18.76, 17.76, 16.87, 15.23 mg/kg) were recorded for the four treatments respectively. The soil consisted mainly of silt (32.09 to 34.66%) and clay (58.89 to 60.23%), reflecting the soil texture as silty – clay. The results were then tested with ANOVA at less than 0.05 P-value and no pair was found to be significant as well. The results suggest that the GM crops have no significant effect on microbial ecology and physicochemical properties of the soil and, in turn, no direct or indirect effects on human health.Keywords: genetically modified crop, microbial ecology, physicochemical properties, metagenomics, DNA, soil
Procedia PDF Downloads 1454313 Utility of CK7, CK20 and CDX-2 as a Potential Panel in Differentiating Primary Ovarian Surface Epithelial Tumors from Metastatic Adenocarcinoma to the Ovary
Authors: Ghada Esheba, Ghadeer Aldoobi, Salwa Almalk, Abrar Alshareef, Eman Al-khairi, Eman Yaseen
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Background: In Saudi Arabia, ovarian cancer ranked seventh among female population and is the most common female genital tract malignancy after endometrial cancer. A slight increase in the incidence of ovarian cancer was observed from 2001–2008. Makkah, Riyadh, and the eastern region of Saudi Arabia had the highest incidence rate ratio for the number of ovarian cancer cases (1). Differentiating metastatic adenocarcinomas from primary ovarian carcinomas, especially those of endometrioid and mucinous type is clinically significant and a challenge for clinicians and pathologists, yet the distinction has important therapeutic and prognostic implications. Aim: To clarify the most important histopathological criteria to differentiate between primary ovarian surface epithelial tumors especially mucinous and endometrioid subtypes, and metastatic adenocarcinoma and to evaluate the value of a panel of antibodies consisting of CK7, CK20, and CDX-2 in the distinction between primary ovarian surface epithelial tumors and metastatic adenocarcinoma. Material and methods: This study was carried out on 26 cases of primary ovarian surface epithelial neoplasms and 14 cases of metastatic ovarian adenocarcinoma. All cases were studied immunohistochemically using CK7, CK20, and CDX-2. Results: All cases of primary ovarian adenocarcinoma were positive for CK7. 25% and 58% of mucinous borderline mucinous tumor and mucinous carcinoma respectively were positive for CK20. Only 42% of mucinous carcinoma were positive for CDX-2. All cases of endometrioid carcinomas were negative for both CK20 and CDX-2. All cases of metastatic adenocarcinoma from the colon were negative for CK7 and positive for CK20 and CDX-2. Conclusions: CK7 is an important positive marker for primary ovarian tumors, while CK20 and CDX-2 are useful markers for colorectal carcinoma metastatic to the ovary. Caution should be taken as primary ovarian mucinous tumors may stain positive for CK20, CDX-2, or both, however, they usually exhibit a focal pattern of reactivity.Keywords: adenoma, endometrioid, malignancy, ovarian
Procedia PDF Downloads 2324312 A Novel Epitope Prediction for Vaccine Designing against Ebola Viral Envelope Proteins
Authors: Manju Kanu, Subrata Sinha, Surabhi Johari
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Viral proteins of Ebola viruses belong to one of the best studied viruses; however no effective prevention against EBOV has been developed. Epitope-based vaccines provide a new strategy for prophylactic and therapeutic application of pathogen-specific immunity. A critical requirement of this strategy is the identification and selection of T-cell epitopes that act as vaccine targets. This study describes current methodologies for the selection process, with Ebola virus as a model system. Hence great challenge in the field of ebola virus research is to design universal vaccine. A combination of publicly available bioinformatics algorithms and computational tools are used to screen and select antigen sequences as potential T-cell epitopes of supertypes Human Leukocyte Antigen (HLA) alleles. MUSCLE and MOTIF tools were used to find out most conserved peptide sequences of viral proteins. Immunoinformatics tools were used for prediction of immunogenic peptides of viral proteins in zaire strains of Ebola virus. Putative epitopes for viral proteins (VP) were predicted from conserved peptide sequences of VP. Three tools NetCTL 1.2, BIMAS and Syfpeithi were used to predict the Class I putative epitopes while three tools, ProPred, IEDB-SMM-align and NetMHCII 2.2 were used to predict the Class II putative epitopes. B cell epitopes were predicted by BCPREDS 1.0. Immunogenic peptides were identified and selected manually by putative epitopes predicted from online tools individually for both MHC classes. Finally sequences of predicted peptides for both MHC classes were looked for common region which was selected as common immunogenic peptide. The immunogenic peptides were found for viral proteins of Ebola virus: epitopes FLESGAVKY, SSLAKHGEY. These predicted peptides could be promising candidates to be used as target for vaccine design.Keywords: epitope, b cell, immunogenicity, ebola
Procedia PDF Downloads 3144311 Coumestrol Induced Apoptosis in Breast Cancer MCF-7 Cells via Redox Cycling of Copper and ROS Generation: Implications of Copper Chelation Strategy in Cancer Treatment
Authors: Atif Zafar Khan, Swarnendra Singh, Imrana Naseem
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Breast cancer is one of the most frequent malignancies in women worldwide and a leading cause of cancer-related deaths among women. Therefore, there is a need to identify new chemotherapeutic strategies for cancer treatment. Unlike normal cells, cancer cells contain elevated copper levels which play an integral role in angiogenesis. Copper is an important metal ion associated with the chromatin DNA, particularly with guanine. Thus, targeting copper via copper-specific chelators in cancer cells can serve as effective anticancer strategy. Keeping in view these facts, we evaluated the anticancer activity and copper-dependent cytotoxic effect of coumestrol (phytoestrogen in soybean products) in breast cancer MCF-7 cells. Coumestrol inhibited proliferation and induced apoptosis in MCF-7 cells, which was prevented by copper chelator neocuproine and ROS scavengers. Coumestrol treatment induced ROS generation coupled to DNA fragmentation, up-regulation of p53/p21, cell cycle arrest at G1/S phase, mitochondrial membrane depolarization and caspases 9/3 activation. All these effects were suppressed by ROS scavengers and neocuproine. These results suggest that coumestrol targets elevated copper for redox cycling to generate ROS leading to DNA fragmentation. DNA damage leads to p53 up-regulation which directs the cell cycle arrest at G1/S phase and promotes caspase-dependent apoptosis of MCF-7 cells. In conclusion, coumestrol induces pro-oxidant cell death by chelating cellular copper to produce copper-coumestrol complexes that engages in redox cycling in breast cancer cells. Thus, targeting elevated copper levels might be a potential therapeutic strategy for selective cytotoxic action against malignant cells.Keywords: apoptosis, breast cancer, copper chelation, coumestrol, reactive oxygens species, redox cycling
Procedia PDF Downloads 2454310 The Interplay of Factors Affecting Learning of Introductory Programming: A Comparative Study of an Australian and an Indian University
Authors: Ritu Sharma, Haifeng Shen
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Teaching introductory programming is a challenging task in tertiary education and various factors are believed to have influence on students’ learning of programming. However, these factors were largely studied independently in a chosen context. This paper aims to investigate whether interrelationships exist among the factors and whether the interrelationships are context-dependent. In this empirical study, two universities were chosen from two continents, which represent different cultures, teaching methodologies, assessment criteria and languages used to teach programming in west and east worlds respectively. The results reveal that some interrelationships are common across the two different contexts, while others appear context-dependent.Keywords: introductory programming, tertiary education, factors, interrelationships, context, empirical study
Procedia PDF Downloads 3634309 Botulinum Toxin type A for Lower Limb Lengthening and Deformity Correction: A Systematic Review and Meta-analysis
Authors: Jawaher F. Alsharef, Abdullah A. Ghaddaf, Mohammed S. Alomari, Abdullah A. Al Qurashi, Ahmed S. Abdulhamid, Mohammed S. Alshehri, Majed Alosaimi
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Botulinum toxin type A (BTX-A) is the most popular therapeutic agent for muscle relaxation and pain control. Lately, BTX-A injection received great interest as a part of multimodal pain management for lower limb lengthening and deformity correction. This systematic review aimed to determine the role of BTX-A injection in pain management for during lower limb lengthening and/or deformity correction. We searched Medline, Embase, and CENTRAL. We included randomized controlled trials (RCTs) that compared the BTX-A injection to placebo for individuals undergoing lower limb lengthening and/or deformity correction. We sought to evaluate the following outcomes: pain on visual analogue scale (VAS), range of motion parameters, average opioid consumption, and adverse events. The standardized mean difference (SMD) was used to represent continuous outcomes while risk ratio (RR) was used to represent dichotomous outcomes. A total of 4 RCTs that enrolled 257 participants (337 limbs) deemed eligible. Adjuvant BTX-A injection showed a significant reduction in post-operative pain compared to placebo (SMD=–0.28, 95% CI –0.53 to –0.04). No difference was found between BTX-A injection and placebo in terms of range of motion parameters, average opioid consumption, or adverse events after surgical limb lengthening and/or deformity correction (RR= 0.77, 95% CI –0.58 to 1.03). Conclusions: Adjuvant BTX-A injection conferred a discernible reduction in post-operative pain during surgical limb lengthening and/or deformity without increasing the risk of adverse events.Keywords: botulinum toxin type A, limb lengthening, distraction osteogenesis, deformity correction, pain management
Procedia PDF Downloads 1424308 Assessment of Collapse Potential of Degrading SDOF Systems
Authors: Muzaffer Borekci, Murat Serdar Kirçil
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Predicting the collapse potential of a structure during earthquakes is an important issue in earthquake engineering. Many researchers proposed different methods to assess the collapse potential of structures under the effect of strong ground motions. However most of them did not consider degradation and softening effect in hysteretic behavior. In this study, collapse potential of SDOF systems caused by dynamic instability with stiffness and strength degradation has been investigated. An equation was proposed for the estimation of collapse period of SDOF system which is a limit value of period for dynamic instability. If period of the considered SDOF system is shorter than the collapse period then the relevant system exhibits dynamic instability and collapse occurs.Keywords: collapse, degradation, dynamic instability, seismic response
Procedia PDF Downloads 3784307 Psychedelic Assisted-Treatment for Patients with Opioid Use Disorder
Authors: Daniele Zullino, Gabriel Thorens, Léonice Furtado, Federico Seragnoli, Radu Iuga, Louise Penzenstadler
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Context: Since the start of the 21st century, there has been a resurgence of interest in psychedelics, marked by a renewed focus on scientific investigations into their therapeutic potential. While psychedelic therapy has gained recognition for effectively treating depression and anxiety disorders, notable progress has been made in the clinical development of substances like psilocybin. Moreover, mounting evidence suggests promising applications of Lysergic acid diethylamide (LSD) and psilocybin in the field of addiction medicine. In Switzerland, compassionate treatment with LSD and psilocybin has been permitted since 2014 through exceptional licenses granted by the Federal Office of Public Health. This treatment approach is also available within the Geneva treatment program, extending its accessibility to patients undergoing opioid-assisted treatment involving substances like morphine and diacetylmorphine. The aim of this study is to assess the feasibility of psychedelic-assisted therapy in patients with opioid use disorder who are undergoing opioid-assisted treatment. This study addresses the question of whether psychedelic-assisted therapy can be successfully implemented in patients with opioid use disorder. It also explores the effects of psychedelic therapy on the patient's experiences and outcomes. Methodology: This is an open case series on six patients who have undergone at least one session with either LSD (100-200 micrograms) or psilocybin (20-40 mg). The patients were assessed using the Five Dimensional Altered States of Consciousness (5D-ASC)-Scale. The data were analyzed descriptively to identify patterns and trends in the patients' experiences. Results: The patients experienced substantial positive psychedelic effects during the psychedelic sessions without significant adverse effects. The patients reported positive experiences and improvements in their condition. Conclusion: The findings of this study support the feasibility and potential efficacy of psychedelic-assisted therapy in patients undergoing opioid-assisted treatment.Keywords: psychedelics, psychedelic-assisted treatment, opioid use disorder, addiction, LSD, psilocybin
Procedia PDF Downloads 554306 Attention Problems among Adolescents: Examining Educational Environments
Authors: Zhidong Zhang, Zhi-Chao Zhang, Georgianna Duarte
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This study investigated the attention problems with the instrument of Achenbach System of Empirically Based Assessment (ASEBA). Two thousand eight hundred and ninety-four adolescents were surveyed by using a stratified sampling method. We examined the relationships between relevant background variables and attention problems. Multiple regression models were applied to analyze the data. Relevant variables such as sports activities, hobbies, age, grade and the number of close friends were included in this study as predictive variables. The analysis results indicated that educational environments and extracurricular activities are important factors which influence students’ attention problems.Keywords: adolescents, ASEBA, attention problems, educational environments, stratified sampling
Procedia PDF Downloads 2844305 Role of Pulsed-Dye Laser in the Treatment of Inflammatory Acne Vulgaris
Authors: Shirajul Islam Khan, Muhammad Ashraful Alam Bhuiyan, Syeda Tania Begum
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Introduction: Acne vulgaris is one of the most common dermatologic conditions and affects the vast majority of people at some point during their lifetime, so effective treatment is of major importance. The failure of usual treatment modalities, teratogenic effects with some severe side effects, and resistance to P.Acne by Retinoides have been focusing on new therapeutic options for the treatment of acne. More recently, pulsed dye laser therapy has been reported to reduce acne lesion counts. The negligible morbidity of these treatment modalities and some other benefits of subsequent acne scar management lead this therapy more attractive. Objective: The objective of this study is to assess the efficacy and safety of pulsed dye laser therapy in the treatment of inflammatory acne vulgaris. Materials and Methods: A prospective clinical trial was done in the Department of Dermatology and Venereology, Combined Military Hospital (CMH), Dhaka, to find out the role of pulse dye laser in the treatment of inflammatory acne vulgaris. The study was carried out with 60 patients with mild to moderate acne vulgaris, and those were treated with pulsed dye laser therapy at baseline and after 4, 8, and 12 weeks. Results: Among 60 patients with inflammatory acne, 42(70%) were in the age group of less than 20 years, and 36(60%) were female. Regarding the number of inflammatory lesions, the baseline mean number (± SD) was 12.77 ± 4.01; after 4 weeks of treatment of inflammatory acne by pulsed dye laser was 7.80 ± 4.11; after 8 weeks of treatment, 6.10 ± 4.03 and after 12 weeks of treatment was 4.17 ± 4.02. After 4 weeks of treatment by pulse dye laser, the level of improvement was excellent at 3.3%, good at 10%, fair at 60%, and poor at 26.7%; after 8 weeks of treatment, excellent was 13.3%, good was 46.7%, the fair was 30% and poor 10% and after 12 weeks of treatment, excellent was 56.7%, good 13.3%, fair 23.3% and poor 6.7%. Regarding safety level, out of 60 patients of inflammatory acne vulgaris treated by pulsed dye laser, about 52(86.7%) patients did not observe any side effects. Conclusions: On the basis of the study results, it can be concluded that pulsed-dye laser is highly effective and well tolerated by patients in the treatment of inflammatory acne.Keywords: pulsed-dye laser, inflammatory acne, acne vulgaris, retinoids
Procedia PDF Downloads 924304 An Architectural Model of Multi-Agent Systems for Student Evaluation in Collaborative Game Software
Authors: Monica Hoeldtke Pietruchinski, Andrey Ricardo Pimentel
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The teaching of computer programming for beginners has been presented to the community as a not simple or trivial task. Several methodologies and research tools have been developed; however, the problem still remains. This paper aims to present multi-agent system architecture to be incorporated to the educational collaborative game software for teaching programming that monitors, evaluates and encourages collaboration by the participants. A literature review has been made on the concepts of Collaborative Learning, Multi-agents systems, collaborative games and techniques to teach programming using these concepts simultaneously.Keywords: architecture of multi-agent systems, collaborative evaluation, collaboration assessment, gamifying educational software
Procedia PDF Downloads 4644303 Developmental Delays among Children with Neonatal Hyperbilirubinemia
Authors: Simplejit Kaur Dhanoa, Manmohan Singh
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This study was done with the primary objective to evaluate the motor and mental developmental delays among children having neonatal Jaundice. A total sample of 300 neonates were collected; out of them, 150 were preterm neonates, and 150 were full term neonates from the hospital setting and follow up study was done with the help of the Developmental Assessment scale of the Indian Infant. The registered samples were assessed up to 2.6 years with a gap of 6 months. The outcomes of this study reveal that developmental delays were present among children who had preterm neonatal jaundice as compare to full term normal babies. Further, It was reported that both motor and mental development is affected due to neonatal hyperbilirubinemia in addition to preterm birth.Keywords: hyperbinirubinemia, preterm neonates, developmental delays, preterm
Procedia PDF Downloads 1634302 Apoptosis Pathway Targeted by Thymoquinone in MCF7 Breast Cancer Cell Line
Authors: M. Marjaneh, M. Y. Narazah, H. Shahrul
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Array-based gene expression analysis is a powerful tool to profile expression of genes and to generate information on therapeutic effects of new anti-cancer compounds. Anti-apoptotic effect of thymoquinone was studied in MCF7 breast cancer cell line using gene expression profiling with cDNA micro array. The purity and yield of RNA samples were determined using RNeasyPlus Mini kit. The Agilent RNA 6000 Nano LabChip kit evaluated the quantity of the RNA samples. AffinityScript RT oligo-dT promoter primer was used to generate cDNA strands. T7 RNA polymerase was used to convert cDNA to cRNA. The cRNA samples and human universal reference RNA were labelled with Cy-3-CTP and Cy-5-CTP, respectively. Feature Extraction and GeneSpring software analysed the data. The single experiment analysis revealed involvement of 64 pathways with up-regulated genes and 78 pathways with down-regulated genes. The MAPK and p38-MAPK pathways were inhibited due to the up-regulation of PTPRR gene. The inhibition of p38-MAPK suggested up-regulation of TGF-ß pathway. Inhibition of p38 - MAPK caused up-regulation of TP53 and down-regulation of Bcl2 genes indicating involvement of intrinsic apoptotic pathway. Down-regulation of CARD16 gene as an adaptor molecule regulated CASP1 and suggested necrosis-like programmed cell death and involvement of caspase in apoptosis. Furthermore, down-regulation of GPCR, EGF-EGFR signalling pathways suggested reduction of ER. Involvement of AhR pathway which control cytochrome P450 and glucuronidation pathways showed metabolism of Thymoquinone. The findings showed differential expression of several genes in apoptosis pathways with thymoquinone treatment in estrogen receptor-positive breast cancer cells.Keywords: cDNA microarray, thymoquinone, CARD16, PTPRR, CASP10
Procedia PDF Downloads 3484301 Neurological Complications of HIV/AIDS: Case of Meningitis Caused by Cryptococcus neoformans and Tuberculous Meningitis
Authors: Ndarusanze Berchmans
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This research work focused on the analysis of the observations of tuberculous meningitis in HIV-positive patients who were treated by the Prince Regent Charles Hospital in Bujumbura. A number of 246 seropositive patients were examined by the laboratory of Prince Regent Charles in the period between 2010 and 2015. We did a retrospective study; we used data from the registers of the laboratories mentioned above; the objective was to approach the epidemiological, biological, clinical, and therapeutic characteristics of tuberculosis meningitis infection: 124 women (50.40% of AIDS patients) and 122 men (49.59% of AIDS patients) were subject to the diagnosis by identification of cerebrospinal fluid (CSF). The average age of the patients was 30 years for this period. The population at risk has an average age of between 34 and 42 years for the years between 2010-2015. From 2010 to 2012, cases of opportunistic diseases (e.g., tuberculous meningitis and Cryptococcus neoformans meningitis), often found in immunocompromised, were observed at a high rate; in this period, there was a disturbance of the rhythm providing antiretroviral drugs to people with AIDS. The rate of the two meningitis (tuberculous meningitis and Cryptococcus neoformans meningitis) remained above 10% to gradually decrease until 2015, with the gradual return of antiretrovirals. This period records an overall average of 25 cases of tuberculous meningitis, or a percentage of 10.16%. For the year 2015, there were 4 cases of tuberculous meningitis out of a total of 35 seropositive examined (11.42%). This year's percentage shows that the number of tuberculous meningitis cases has fallen from the rate in previous years. This is the result of the care given by associations against HIV/AIDS to HIV-positive people. This decrease in cases of tuberculous meningitis is due to the acquisition of antiretrovirals by all HIV-positive people treated by hospitals. For the moment, these hospitals are taking care of many AIDS patients by providing them permanently with antiretrovirals; Besides that, there are many patients who are supported by associations whose activities are directed against HIV/AIDS.Keywords: Cryptococcus neoformans meningitis, tuberculosis meningitis, neurological complications, epidemiology of meningitis
Procedia PDF Downloads 2244300 Emergency Surgery in the Elderly, What Particularities
Authors: Mekroud Amel
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Introduction The rate of use by the elderly of emergency departments, operating rooms and intensive care units has increased worldwide. Emergency surgery is a context where evaluation is often insufficient, with incomplete information gathering. The aim of this work is to shed light on the frequent use of emergency surgeries by the elderly and their characteristics, as well as on the lack of geriatric assessment scores in the emergency room. Material : Prospective, observational and descriptive, monocentric study. Patients aged 65 and over, admitted for emergency surgery in the operating room, were counted. Emergency operating room including visceral surgery, urology, traumatology and neurosurgery. Parameters studied: Patient characteristics, degree of autonomy, type of surgical pathology, operative management times, preoperative evaluation, postoperative outcome Results : 192 patients were identified over 12 months, from 09.01.2017 to 08.31.2018 Age from 65 to 101 years, 79.81 years +/- 8.38. With predominance of the age group between [65-75 years] 41.1% Female predominance, Sexratio = 0.81 Elderly subjects with total motor autonomy are in the majority at 57.8% Subjects without pathological ATCD represent 12.5% of cases Those who are on only one type of medication or without any treatment are at 36.9% Discussion : The emergency operative care of the elderly patient for a surgical or traumatological pathology is characterized by many specificities linked first to the emergency context, where the evaluation is often insufficient, besides the fact that the elderly patient has particularities requiring reception in centers with experience in the care of this category of patient, or, failing that, a center which uses the minimum of geriatric evaluation scores which are simplified for the emergency departments. In our hospital, we have not yet made this evaluation routine in the emergency room and this delay in the introduction of these scores can be directly attributed to the covid 19 pandemic. Besides the standard preoperative assessment, only 43.2% of patients were assessed in the preoperative period by an anesthesiologist. Traumatological emergencies come first 68.2% followed by visceral emergencies 19.2% (including proctological, urological emergencies), neurosurgical emergencies 7.8% and finally peripheral emergency surgery all acts combined 4.7%. Hospital stay at 9.6 +/- 16.8 days, average operability time of 4.5 +/- 3 days. Death rate at 7.29% Conclusion This work has demonstrated the major impact of emergency surgery, which remains curable for the most part, on the elderly patient despite total motor and cognitive autonomy preoperatively. The improvement of the preoperative evaluation, the reduction of the operating time and enhanced recovery after surgery, with personalized protocols, are the only guarantee for the resumption of preoperative autonomy in these patients.Keywords: emergency surgery, elderly patients, preoperative geriatric scores, curable emergency surgical pathologies
Procedia PDF Downloads 784299 Effect of Salvadora Persica Gel on Clinical and Microbiological Parameters of Chronic Periodontitis
Authors: Tahira Hyder, Saima Quraeshi, Zohaib Akram
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Salvadora Persica (SP) is known to have anti-inflammatory, antioxidant, anti-coagulant and anti-bacterial properties that may provide therapeutic benefits in the treatment of chronic periodontitis (CP). The current clinical trial was designed to investigate the clinical and anti-microbial effects of SP gel as an adjunct to scaling and root planning (SRP) in subjects with generalized CP. Sixty-six subjects with CP were randomized allocated into two groups: SRP + SP gel (test group) and SRP only (control group). Clinical parameters (periodontal pocket depth, gingival recession, clinical attachment level, bleeding score and plaque score) were recorded at baseline before SRP and at 6 weeks. At baseline and 6 weeks subgingival plaque samples were collected and periodontopathogen Porphyromonas Gingivalis (Pg) quantified using Real-time Polymerase Chain Reaction (RT-PCR). Both therapies reduced the mean periodontal pocket depth (PPD), plaque score (PS) and bleeding score (BOP) and improved the mean clinical attachment level (CAL) between baseline and 6 weeks. In subjects receiving adjunctive SP gel a statistically significant improvement was observed in BOP at follow-up compared to control group (15.01±3.47% and 22.81±6.81% respectively, p=0.001), while there was no statistically significant difference in periodontal pocket depth, gingival recession, clinical attachment level and plaque score between both groups. The test group displayed significantly greater Pg reduction compared to the control group after 6 weeks. The current study establishes that local delivery of SP gel into periodontal pocket in CP stimulated a significant reduction in bacteria Pg level and an improvement in gingival health, as evident from a reduced bleeding score, when used as an adjunct to SRP.Keywords: miswak, scaling and root planing, porphyromonas gingivalis, chronic periodontitis
Procedia PDF Downloads 874298 The Role of Metaphor in Communication
Authors: Fleura Shkëmbi, Valbona Treska
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In elementary school, we discover that a metaphor is a decorative linguistic device just for poets. But now that we know, it's also a crucial tactic that individuals employ to understand the universe, from fundamental ideas like time and causation to the most pressing societal challenges today. Metaphor is the use of language to refer to something other than what it was originally intended for or what it "literally" means in order to suggest a similarity or establish a connection between the two. People do not identify metaphors as relevant in their decisions, according to a study on metaphor and its effect on decision-making; instead, they refer to more "substantive" (typically numerical) facts as the basis for their problem-solving decision. Every day, metaphors saturate our lives via language, cognition, and action. They argue that our conceptions shape our views and interactions with others and that concepts define our reality. Metaphor is thus a highly helpful tool for both describing our experiences to others and forming notions for ourselves. In therapeutic contexts, their shared goal appears to be twofold. The cognitivist approach to metaphor regards it as one of the fundamental foundations of human communication. The benefits and disadvantages of utilizing the metaphor differ depending on the target domain that the metaphor portrays. The challenge of creating messages and surroundings that affect customers' notions of abstract ideas in a variety of industries, including health, hospitality, romance, and money, has been studied for decades in marketing and consumer psychology. The aim of this study is to examine, through a systematic literature review, the role of the metaphor in communication and in advertising. This study offers a selected analysis of this literature, concentrating on research on customer attitudes and product appraisal. The analysis of the data identifies potential research questions. With theoretical and applied implications for marketing, design, and persuasion, this study sheds light on how, when, and for whom metaphoric communications are powerful.Keywords: metaphor, communication, advertising, cognition, action
Procedia PDF Downloads 994297 In vitro and vivo Studies for Assessing the Anti-Proliferative, Anti-Migration and Apoptotic Activity of A. squamosa L. Leaves Extract
Authors: Rawan Al-Nemari, Abdulrahman Al-Senaidy, Abdelhabib Semlali
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Background and objectives: The most common cause of death in women worldwide is breast cancer. Regarding all chemotherapy disadvantages and side effects, it’s becoming necessary to identify natural products that target cancer cells with lesser harmful side effects on non-targeted cells and biological environment. Different parts of A. squamosa L., commonly known as custard apple, show varied therapeutic effects. The objective of this study is to investigate in vitro and in vivo, the anti-cancer activity of A. squamosa leaves extract. Methods: The physiological responses using MTT, nucleus staining, and LDH assays were used to evaluate cell survival and proliferation in both ER+ and ER- cells when they were exposed to extract. Monolayer wound repair assay was used to investigate the effect of extracts on cell migration. Apoptotic gene’s expression was investigated by real-time polymerase chain reaction. To study the effect of the extract on the size of tumor, breast cancer induced rats were used. Results: A. squamosa leaves extract showed high anti-proliferative and cytotoxicity effects against different breast cancer cell lines with high concentration, 100 ug/ml. The extracts have reduced the cells wound closure. Polymerase chain reaction revealed downregulation of Bcl-2 and upregulation of Bax. In breast cancer model animal developed in our laboratory, after 4 weeks treatment, treated groups have shown smaller tumor size in comparison with control group (n=4). Conclusion: These results suggest that A. squamosa leaves extract has anti-cancer activity against breast cancer in both in vitro and in vivo, and it may be developed as a potential novel agent to treat breast cancer.Keywords: apoptosis, breast cancer, migration, proliferation
Procedia PDF Downloads 1474296 A Method for Improving the Embedded Runge Kutta Fehlberg 4(5)
Authors: Sunyoung Bu, Wonkyu Chung, Philsu Kim
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In this paper, we introduce a method for improving the embedded Runge-Kutta-Fehlberg 4(5) method. At each integration step, the proposed method is comprised of two equations for the solution and the error, respectively. This solution and error are obtained by solving an initial value problem whose solution has the information of the error at each integration step. The constructed algorithm controls both the error and the time step size simultaneously and possesses a good performance in the computational cost compared to the original method. For the assessment of the effectiveness, EULR problem is numerically solved.Keywords: embedded Runge-Kutta-Fehlberg method, initial value problem, EULR problem, integration step
Procedia PDF Downloads 4644295 Audit Examining Maternity Assessment Suite Triage Compliance with Birmingham Symptom Specific Obstetric Triage System in a London Teaching Hospital
Authors: Sarah Atalla, Shubham Gupta, Kim Alipio, Tanya Maric
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Background: Chelsea and Westminster Hospital have introduced the Birmingham Symptom Specific Obstetric Triage System (BSOTS) for patients who present acutely to the Maternity Assessment Suite (MAS) to prioritise care by urgency. The primary objective was to evaluate whether BSOTS was used appropriately to assess patients (defined as a 90% threshold). The secondary objective was to assess whether patients were seen within their designated triaged timeframe (defined as a 90% threshold). Methodology: MAS records were retrospectively reviewed for a randomly selected one-week period of data from 2020 (21/09/2020 - 27/09/2020). 189 patients presented to MAS during this time. Data were collected on the presenting complaint, time of attendance (divided into four time categories), and triage colour code for the urgency of a review by a doctor (red: immediately, orange: within 15 minutes, yellow: within 1 hour, green: within 4 hours). The number of triage waiting times that were breached and the outcome of the attendance was noted. Results: 49% of patients presenting to MAS during this time period were triaged, which therefore did not meet the 90% target. 67% of patients who were triaged were seen within their allocated timeframe as designated by their triage colour code, which therefore did not meet the 90% target. The most frequent reason for patient attendance was reduced fetal movements (30.5% of attendances). The busiest time of day (when most patients presented) was between 06:01-12:00, and this was also when the highest number of patients were not triaged (26 patients or 54% of patients presenting in this time category). The most used triage category (59%) was the green colour code (to be seen by a doctor within 4 hours), followed by orange (24%), yellow (14%), and red (3%). 45% of triaged patients were admitted, whilst 55% were discharged. 62% of patients allocated to the green triage category were discharged, as compared to 56% of yellow category patients, 27% of orange category patients, and 50% of red category patients. The time of patient presentation to the hospital was also associated with the level of urgency and outcome. Patients presenting from 12:01 to 18:00 were more likely to be discharged (72% discharged) compared to 00:01-06:00 where only 12.5% of patients were discharged. Conclusion: The triage system for assessing the urgency of acutely presenting obstetric patients is only being effectively utilised for 49% of patients. There is potential for enhancing the employment of the triage system to enable further efficiency and boost the promotion of patient safety. It is noted that MAS was busiest at 06:01 - 12:00 when there was also the highest number of non-triaged patients – this highlights some areas where we can improve, including higher levels of staffing, better use of BSOTS to triage patients, and patient education.Keywords: birmingham, BSOTS, maternal, obstetric, pregnancy, specific, symptom, triage
Procedia PDF Downloads 1054294 Online Course of Study and Job Crafting for University Students: Development Work and Feedback
Authors: Hannele Kuusisto, Paivi Makila, Ursula Hyrkkanen
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Introduction: There have been arguments about the skills university students should have when graduated. Current trends argue that as well as the specific job-related skills the graduated students need problem-solving, interaction and networking skills as well as self-management skills. Skills required in working life are also considered in the Finnish national project called VALTE (short for 'prepared for working life'). The project involves 11 Finnish school organizations. As one result of this project, a five-credit independent online course in study and job engagement as well as in study and job crafting was developed at Turku University of Applied Sciences. The aim of the oral or e-poster presentation is to present the online course developed in the project. The purpose of this abstract is to present the development work of the online course and the feedback received from the pilots. Method: As the University of Turku is the leading partner of the VALTE project, the collaborative education platform ViLLE (https://ville.utu.fi, developed by the University of Turku) was chosen as the online platform for the course. Various exercise types with automatic assessment were used; for example, quizzes, multiple-choice questions, classification exercises, gap filling exercises, model answer questions, self-assessment tasks, case tasks, and collaboration in Padlet. In addition, the free material and free platforms on the Internet were used (Youtube, Padlet, Todaysmeet, and Prezi) as well as the net-based questionnaires about the study engagement and study crafting (made with Webropol). Three teachers with long teaching experience (also with job crafting and online pedagogy) and three students working as trainees in the project developed the content of the course. The online course was piloted twice in 2017 as an elective course for the students at Turku University of Applied Sciences, a higher education institution of about 10 000 students. After both pilots, feedback from the students was gathered and the online course was developed. Results: As the result, the functional five-credit independent online course suitable for students of different educational institutions was developed. The student feedback shows that students themselves think that the developed online course really enhanced their job and study crafting skills. After the course, 91% of the students considered their knowledge in job and study engagement as well as in job and study crafting to be at a good or excellent level. About two-thirds of the students were going to exploit their knowledge significantly in the future. Students appreciated the variability and the game-like feeling of the exercises as well as the opportunity to study online at the time and place they chose themselves. On a five-point scale (1 being poor and 5 being excellent), the students graded the clarity of the ViLLE platform as 4.2, the functionality of the platform as 4.0 and the easiness of operating as 3.9.Keywords: job crafting, job engagement, online course, study crafting, study engagement
Procedia PDF Downloads 1534293 Mechanism of Modeling the Level of Bcr-Abl Oncoprotein by Ubiquitin-Proteasome System in Chronic Myeloid Leukemia
Authors: Svitlana Antonenko, Gennady Telegeev
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Introductive statement: The development of chronic myeloid leukemia (CML) is caused by Bcr-Abl oncoprotein. Modern treatments with tyrosine kinase inhibitors are greatly complicated by the mutational variability of the Bcr-Abl oncoprotein, which causes drug resistance. Therefore, there is an urgent need to develop new approaches to the treatment of the disease, which will allow modeling the level of Bcr-Abl oncoprotein in the cell. Promising in this direction is the identification of proteases that can selectively promote cellular proteolysis of oncoproteins. The aim of the study was to study the effect of the interaction of Bcr-Abl with deubiquitinase USP1 on the level of oncoprotein in CML cells. Methodology: K562 cells were selected for the experiment. Сells were incubated with ML323 inhibitor for 24 hours. Precipitation of endogenous proteins from K562 cell lysate was performed using anti-Bcr-Abl antibodies. Cell lysates and precipitation results were studied by Western blot. Subcellular localization of proteins was studied by immunofluorescence analysis followed by confocal microscopy. The results were analyzed quantitatively and statistically. Major findings: The Bcr-Abl/USP1 protein complex was detected in CML cells, and it was found that inhibition of USP1 deubiquitinating activity by the compound ML323 leads to disruption of this protein complex and a decrease in the level of Bcr-Abl oncoprotein in cells. The interaction of Bcr-Abl with USP1 may result in deubiquitination of the oncoprotein, which disrupts its proteasomal degradation and leads to the accumulation of CML in cells. Conclusion: We believe that the interaction of oncoprotein with USP1 may be one of the prerequisites that contribute to malignant cell transformation due to the deubiquitination of oncoprotein, which leads to its accumulation and disease progression. A correlation was found between the deubiquitinating activity of USP1 and the level of oncoprotein in CML cells. Thus, we identify deubiquitinase USP1 as a promising therapeutic target for the development of a new strategy for the treatment of CML by modulating the level of Bcr-Abl in the cell.Keywords: chronic myeloid leukemia, Bcr-Abl, USP1, deubiquitination Bcr-Abl, K562 cell
Procedia PDF Downloads 694292 Evaluating the Latest Advances in Dry Powder Inhaler Technology
Authors: Leila Asadollahi
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Dry powder inhalers (DPIs) have come a long way since their creation, starting with the Spinhaler Fisons in 1967. For optimal performance, it is important to consider the interplay between formulation, device, and patient. DPIs have shown great potential in treating systemic disorders, as evidenced by their success in clinical practices. Ongoing clinical trials and market availability of DPI products for systemic disease treatment are also examined. Furthermore, the current COVID-19 pandemic has sparked increased interest in dry powder inhalation as a potential avenue for vaccines and antiviral drugs, prompting further exploration of its applications. To achieve optimal treatment outcomes for respiratory diseases, a thorough understanding of the various types of DPIs currently available is crucial. These include single-dose, multiple-unit dose, and multi-dose DPIs. This informative article delves into the administration of drugs via inhalation, examining its diverse routes of administration. Additionally, it illuminates the exciting advancements in inhalation delivery systems and investigates the latest therapeutic approaches for the treatment of respiratory ailments. Additionally, the article discusses the historical development of DPIs and the need for improved designs to enhance efficacy and patient adherence. The potential of DPIs in treating systemic diseases is also examined. Overall, this review provides valuable insights into the advancements, challenges, and future prospects of inhalation drug delivery systems, highlighting the potential they hold for respiratory and systemic disorders. The review aims to provide valuable insights into the advancements, challenges, and future prospects of inhalation drug delivery systems, highlighting the potential they hold for respiratory and systemic disorders.Keywords: dry powder inhalers (DPIs), respiratory diseases, systemic disorders, pulmonary drug delivery
Procedia PDF Downloads 704291 Unveiling the Chaura Thrust: Insights into a Blind Out-of-Sequence Thrust in Himachal Pradesh, India
Authors: Rajkumar Ghosh
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The Chaura Thrust, located in Himachal Pradesh, India, is a prominent geological feature that exhibits characteristics of an out-of-sequence thrust fault. This paper explores the geological setting of Himachal Pradesh, focusing on the Chaura Thrust's unique characteristics, its classification as an out-of-sequence thrust, and the implications of its presence in the region. The introduction provides background information on thrust faults and out-of-sequence thrusts, emphasizing their significance in understanding the tectonic history and deformation patterns of an area. It also outlines the objectives of the paper, which include examining the Chaura Thrust's geological features, discussing its classification as an out-of-sequence thrust, and assessing its implications for the region. The paper delves into the geological setting of Himachal Pradesh, describing the tectonic framework and providing insights into the formation of thrust faults in the region. Special attention is given to the Chaura Thrust, including its location, extent, and geometry, along with an overview of the associated rock formations and structural characteristics. The concept of out-of-sequence thrusts is introduced, defining their distinctive behavior and highlighting their importance in the understanding of geological processes. The Chaura Thrust is then analyzed in the context of an out-of-sequence thrust, examining the evidence and characteristics that support this classification. Factors contributing to the out-of-sequence behavior of the Chaura Thrust, such as stress interactions and fault interactions, are discussed. The geological implications and significance of the Chaura Thrust are explored, addressing its impact on the regional geology, tectonic evolution, and seismic hazard assessment. The paper also discusses the potential geological hazards associated with the Chaura Thrust and the need for effective mitigation strategies in the region. Future research directions and recommendations are provided, highlighting areas that warrant further investigation, such as detailed structural analyses, geodetic measurements, and geophysical surveys. The importance of continued research in understanding and managing geological hazards related to the Chaura Thrust is emphasized. In conclusion, the Chaura Thrust in Himachal Pradesh represents an out-of-sequence thrust fault that has significant implications for the region's geology and tectonic evolution. By studying the unique characteristics and behavior of the Chaura Thrust, researchers can gain valuable insights into the geological processes occurring in Himachal Pradesh and contribute to a better understanding and mitigation of seismic hazards in the area.Keywords: chaura thrust, out-of-sequence thrust, himachal pradesh, geological setting, tectonic framework, rock formations, structural characteristics, stress interactions, fault interactions, geological implications, seismic hazard assessment, geological hazards, future research, mitigation strategies.
Procedia PDF Downloads 794290 Assessment of Trust in Virtual Teams of College Students in Egypt
Authors: Bashayer Alsana
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Emerging technologies present human interaction with new challenges. Individuals are required to interact and collaborate to achieve mutual gain. Accomplishing shared goals requires all parties involved to trust others commitment to fulfill their specified obligations. Trust is harder to establish when groups work virtually and members transcend time, space, and culture. This paper identifies the importance of trust in virtual groups of students at Cairo University by exposing them to electronic projects on which they collaborate.Students respond to a survey to assess their range of trust within their teams and how the outcome is affected. Gender differences and other demographic factors are analyzed to understand results and rates of trust. The paper concludes with summarizing factors influencing trust development and possible implications.Keywords: students, teams, trust, virtual
Procedia PDF Downloads 2634289 Review on Japan Environmental Future City: Development, Critics and Cases
Authors: Runlang Zhu, Weijun Gao, Yinqi Zhang, Gangwei Cai
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In order to deal with issues such as the environmental problems and aging of the population, the Japanese government wanted to achieve goals like 'a city where everyone wants to live' and 'a city full of energy for everyone' by creating environmental, social, and economic values in the process of urban development. They began to promote the concept of 'Environmental Future City' in 2010, aiming to create cities and regions with excellent environments, sustainable economic development, and social systems. After taking a look at the history, concept, and development of environmental future cities, the paper will discuss the evaluation system of them, introduce representative cases, and point out what other cities can learn from their development process.Keywords: environmental future city, city concept, CASBEE, environmental performance assessment
Procedia PDF Downloads 1574288 Heavy Metal Contamination in Sediments of North East Coast of Tamilnadu by EDXRF Technique
Authors: R. Ravisankar, Tholkappian A. Chandrasekaran, Y. Raghu, K. K. Satapathy, M. V. R. Prasad, K. V. Kanagasabapathy
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The coastal areas of Tamilnadu are assuming greater importance owing to increasing human population, urbanization and accelerated industrial activities. sIn the present study, sediment samples are collected along the east coast of Tamilnadu for assessment of heavy metal pollution. The concentration of 13 selected heavy metals such as Mg, Al, Si, K, Ca, Ti, Fe, V, Cr, Mn, Co, Ni and Zn determined by Energy dispersive X-ray fluorescence (EDXRF) technique. In order to describe the pollution status, Contamination factor and pollution load index are calculated and reported. This result suggests that sources of metal contamination were mainly attributed to natural inputs from surrounding environments.Keywords: sediments, heavy metals, EDXRF, pollution contamination factors
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