Search results for: association rule mining
Commenced in January 2007
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Edition: International
Paper Count: 3917

Search results for: association rule mining

1067 Informational Support, Anxiety and Satisfaction with Care among Family Caregivers of Patients Admitted in Critical Care Units of B.P. Koirala Institute of Health Sciences, Nepal

Authors: Rosy Chaudhary, Pushpa Parajuli

Abstract:

Background and Objectives: Informational support to family members has a significant potential for reducing this distress related to hospitalization of their patient into the critical care unit, enabling them to cope better and support the patient. The objective of the study is to assess family members’ perception of informational support, anxiety, satisfaction with care and to reveal the association with selected socio-demographic variables and to investigate the correlation between informational support, anxiety and satisfaction with care. Materials and Methods: A descriptive cross-sectional study was conducted in 39 family caregivers of patients admitted in critical care unit of BPKIHS(B.P. Koirala Institute of Health Sciences). Consecutive sampling technique was used wherein data was collected over duration of one month using interview schedule. Descriptive and inferential statistics were used. Results: The mean age of the respondents was 34.97 ± 10.64 and two third (66.70%) were male. Mean score for informational support was 25.72(SD = 5.66; theoretical range of 10 - 40). Mean anxiety was 10.41 (SD = 5.02; theoretical range of 7 - 21). Mean score for satisfaction with care was 40.77 (SD = 6.77; theoretical range of 14 - 64). A moderate positive correlation was found between informational support and satisfaction with care (r = 0.551, p < .001) and a moderate negative correlation was found between anxiety and satisfaction with care (r = -0.590; p = 0.000). No relationship was noted between informational support and anxiety. Conclusion: The informational support and satisfaction of the family caregivers with the care provided to their patients was satisfactory. More than three fourth of the family caregivers had anxiety; the factors associated being educational status of the caregivers, the family income and duration of visiting hours. There was positive correlation between informational support and satisfaction with care provided justifying the need for comprehensive information to the family caregivers by the health personnel. There was negative correlation between anxiety and satisfaction with care.

Keywords: anxiety, caregivers, critical care unit, informational support, family

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1066 Assessment of Growth Variation and Phytoextraction Potential of Four Salix Varieties Grown in Zn Contaminated Soil Amended with Lime and Wood Ash

Authors: Mir Md Abdus Salam, Muhammad Mohsin, Pertti Pulkkinen, Paavo Pelkonen, Ari Pappinen

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Soils contaminated with metals, e.g., copper (Cu), zinc (Zn) and nickel (Ni) are one of the main global environmental problems. Zn is an important element for plant growth, but excess levels may become a threat to plant survival. Soils polluted with metals may also pose risks and hazards to human health. Afforestation based on short rotation Salix crops may be a good solution for the reduction of metals toxicity levels in the soil and in ecosystem restoration of severely polluted sites. In a greenhouse experiment, plant growth and zinc (Zn) uptake by four Salix cultivars grown in Zn contaminated soils collected from a mining area in Finland were tested to assess their suitability for phytoextraction. The sequential extraction technique and inductively coupled plasma‒mass spectrometry (ICP–MS) were used to determine the extractable metals and evaluate the fraction of metals in the soil that could be potentially available for plant uptake. The cultivars displayed resistance to heavily polluted soils throughout the whole experiment. After uptake, the total mean Zn concentrations ranged from 776 to 1823 mg kg⁻¹. The average uptake percentage of Zn across all cultivars and treatments ranged from 97 to 223%. Lime and wood ash addition showed a significant effect on plant dry biomass growth and metal uptake percentage of Zn in most of the cultivars. The results revealed that Salix cultivars have the potential to accumulate and take up significant amounts of Zn. Ecological restoration of polluted soils could be environmentally favorable in conjunction with economically profitable practices, such as forestry and bioenergy production. As such, the utilization of Salix for phytoextraction and bioenergy purposes is of considerable interest.

Keywords: lime, phytoextraction, Salix, wood ash, zinc

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1065 Grassroots Feminist Organizing in the Shadow of State Feminism in Ethiopia

Authors: Tina Beyene

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In this paper examines the state of grassroots feminist activism in the backdrop of state feminism in Ethiopia. Specifically, I examine the impact of the Charities and Societies Proclamation (aka CSO law), a 2009 law that banned so-called foreign NGOs—i.e., those receiving more than 10% of its operating budget from non-local sources— from working in the areas of human rights, democracy, governance, and gender equality. Viewed as government retribution for the NGO opposition to the government in the 2005 elections, the law aimed to halt the work groups such as the Ethiopian Women Lawyers Association (EWLA), who were defined as a “foreign” NGO. Based on interviews with prominent Ethiopian women’s rights leaders in Addis Ababa, Ethiopia, I assess how grassroots feminist organizing adapts to state suppression on the one hand, and the aggressive entry of the state into women’s rights work on the other hand. While the 2009 law has slowed down the work of women’s rights activism, displaced feminists view feminist advocacy as cyclical and the state as neither fully adversarial nor an ally but rather as an instable entity that at times provides political openings to push ambitious feminist agendas. Grassroots activists are regrouping and developing new political responses strategies such as coding rights issues to fit state mandate; dissembling rights work in permissible social provision language; rechanneling political work into informal spaces and unregistered social clubs; innovating new funding partnerships, and reassembling as privately held research and advocacy companies. my study reveals how grassroots feminist politics operates in the shadow of a hostile state and within the confines of local politics.

Keywords: grassroots feminism, ethiopian feminism, civil society and gender, state feminism

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1064 Cultural Routes: A Study of Anatolian Seljuks Madrasahs

Authors: Zeynep İnan Ocak, Gülsün Tanyeli

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One of the most important architectural types of Islamic architecture is madrasah used as educational institutions, hospital or observatory. This type of buildings has one or two storeys, central open or closed courtyards, four iwans and students cells located among the iwans. The main characteristic of the designs featured in the portals. The Islamic art features and adornments are seen well on these buildings made of stone. The earliest examples date to late 12th century in Anatolia after the Battle of Manzikert. Under the Seljuks rule over the one thousand facilities were built in 12th and 13th centuries and there are one hundred thirty five madrasah in total list. But today no all of them are conserved only forty percent are remained. The Seljuks madrasah located in many Anatolian were registered as immovable cultural property in several times by Turkish Culture and Tourism Ministry. The first Turkish buildings inscribed on the World Heritage List are the Great Mosque and Hospital of Divriği in 1985. Also the nominated site named as Anatolian Seljuks Madrasah is in the tentative list of UNESCO World Heritage in 2014. The property is composed some of notable madrasah such as İnce Minareli Madrasah and Karatay Madrasah in Konya; Çifte Madrasah and Sahibiye Madrasah in Kayseri; Buruciye Madrasah, Çifte Minareli Madrasah and Gök Madrasah in Sivas; Çifte Minareli Madrasah and Yakutiye Madrasah in Erzurum; Cacabey Madrasah in Kirşehir. Certainly the advantage of tourism is important for conducting the preservation of heritage. It offers much kind of cultural heritage products by means of visiting monuments. In spite of advantage of tourism, it can be the negative effects of tourism on sites and places of cultural significance. While assisting and guiding the conservation works of madrasah, it should be get reference to international charters and other doctrinal texts about the relation between heritage and tourism. Thereby the monuments will be conserved in good condition promoting by tourism. It should be plan a project about the correlation of visitors and heritage to focus on theme of Seljuks architecture. This study aims to set out the principles about the conservation of madrasah as world heritage taking advantages of tourism. The madrasah as a heritage should be evaluated not only a monument but also cultural route. So the cultural route for madrasah is determined by means of a journey through space and time, how the heritage of the different Anatolian cities. Also the cultural route is created visiting both the madrasah and the other medieval structures. In this study, the route, the principles, relation of tourism are represented considering the conservation of Seljuks madrasah.

Keywords: architectural heritage, cultural routes, Seljuks madrasah, Anatolia

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1063 LGR5 and Downstream Intracellular Signaling Proteins Play Critical Roles in the Cell Proliferation of Neuroblastoma, Meningioma and Pituitary Adenoma

Authors: Jin Hwan Cheong, Mina Hwang, Myung Hoon Han, Je Il Ryu, Young ha Oh, Seong Ho Koh, Wu Duck Won, Byung Jin Ha

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Leucine-rich repeat-containing G-protein coupled receptor 5 (LGR5) has been reported to play critical roles in the proliferation of various cancer cells. However, the roles of LGR5 in brain tumors and the specific intracellular signaling proteins directly associated with it remain unknown. Expression of LGR5 was first measured in normal brain tissue, meningioma, and pituitary adenoma of humans. To identify the downstream signaling pathways of LGR5, siRNA-mediated knockdown of LGR5 was performed in SH-SY5Y neuroblastoma cells followed by proteomics analysis with 2-dimensional polyacrylamide gel electrophoresis (2D-PAGE). In addition, the expression of LGR5-associated proteins was evaluated in LGR5-inꠓhibited neuroblastoma cells and in human normal brain, meningioma, and pituitary adenoma tissue. Proteomics analysis showed 12 protein spots were significantly different in expression level (more than two-fold change) and subsequently identified by peptide mass fingerprinting. A protein association network was constructed from the 12 identified proteins altered by LGR5 knockdown. Direct and indirect interactions were identified among the 12 proteins. HSP 90-beta was one of the proteins whose expression was altered by LGR5 knockdown. Likewise, we observed decreased expression of proteins in the hnRNP subfamily following LGR5 knockdown. In addition, we have for the first time identified significantly higher hnRNP family expression in meningioma and pituitary adenoma compared to normal brain tissue. Taken together, LGR5 and its downstream sigꠓnaling play critical roles in neuroblastoma and brain tumors such as meningioma and pituitary adenoma.

Keywords: LGR5, neuroblastoma, meningioma, pituitary adenoma, hnRNP

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1062 Stabilization of Lateritic Soil Sample from Ijoko with Cement Kiln Dust and Lime

Authors: Akinbuluma Ayodeji Theophilus, Adewale Olutaiwo

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When building roads and paved surfaces, a strong foundation is always essential. A durable material that can withstand years of traffic while staying trustworthy must be used to build the foundation. A frequent problem in the construction of roads and pavements is the lack of high-quality, long-lasting materials for the pavement structure (base, subbase, and subgrade). Hence, this study examined the stabilization of lateritic soil samples from Ijoko with cement kiln dust and lime. The study adopted the experimental design. Laboratory tests were conducted on classification, swelling potential, compaction, California bearing ratio (CBR), and unconfined compressive tests, among others, were conducted on the laterite sample treated with cement kiln dust (CKD) and lime in incremental order of 2% up to 10% of dry weight soft soil sample. The results of the test showed that the studied soil could be classified as an A-7-6 and CL soil using the American Association of State Highway and transport officials (AASHTO) and the unified soil classification system (USCS), respectively. The plasticity (PI) of the studied soil reduced from 30.5% to 29.9% at the application of CKD. The maximum dry density on the application of CKD reduced from 1.9.7 mg/m3 to 1.86mg/m3, and lime application yielded a reduction from 1.97mg/m3 to 1.88.mg/m3. The swell potential on CKD application was reduced from 0.05 to 0.039%. The study concluded that soil stabilizations are effective and economic way of improving road pavement for engineering benefit. The degree of effectiveness of stabilization in pavement construction was found to depend on the type of soil to be stabilized. The study therefore recommended that stabilized soil mixtures should be used to subbase material for flexible pavement since is a suitable.

Keywords: lateritic soils, sand, cement, stabilization, road pavement

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1061 Industrial Kaolinite Resource Deposits Study in Grahamstown Area, Eastern Cape, South Africa

Authors: Adeola Ibukunoluwa Samuel, Afsoon Kazerouni

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Industrial mineral kaolin has many favourable properties such as colour, shape, softness, non-abrasiveness, natural whiteness, as well as chemical stability. It occurs extensively in North of Bedford road Grahamstown, South Africa. The relationship between both the physical and chemical properties as lead to its application in the production of certain industrial products which are used by the public; this includes the prospect of production of paper, ceramics, rubber, paint, and plastics. Despite its interesting economic potentials, kaolinite clay mineral remains undermined, and this is threatening its sustainability in the mineral industry. This research study focuses on a detailed evaluation of the kaolinite mineral and possible ways to increase its lifespan in the industry. The methods employed for this study includes petrographic microscopy analysis, X-ray powder diffraction analysis (XRD), and proper field reconnaissance survey. Results emanating from this research include updated geological information on Grahamstown. Also, mineral transformation phases such as quartz, kaolinite, calcite and muscovite were identified in the clay samples. Petrographic analysis of the samples showed that the study area has been subjected to intense tectonic deformation and cement replacement. Also, different dissolution patterns were identified on the Grahamstown kaolinitic clay deposits. Hence incorporating analytical studies and data interpretations, possible ways such as the establishment of processing refinery near mining plants, which will, in turn, provide employment for the locals and land reclamation is suggested. In addition, possible future sustainable industrial applications of the clay minerals seem to be possible if additives, cellulosic wastes are used to alter the clay mineral.

Keywords: kaolinite, industrial use, sustainability, Grahamstown, clay minerals

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1060 Low-Cost Image Processing System for Evaluating Pavement Surface Distress

Authors: Keerti Kembhavi, M. R. Archana, V. Anjaneyappa

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Most asphalt pavement condition evaluation use rating frameworks in which asphalt pavement distress is estimated by type, extent, and severity. Rating is carried out by the pavement condition rating (PCR), which is tedious and expensive. This paper presents the development of a low-cost technique for image pavement distress analysis that permits the identification of pothole and cracks. The paper explores the application of image processing tools for the detection of potholes and cracks. Longitudinal cracking and pothole are detected using Fuzzy-C- Means (FCM) and proceeded with the Spectral Theory algorithm. The framework comprises three phases, including image acquisition, processing, and extraction of features. A digital camera (Gopro) with the holder is used to capture pavement distress images on a moving vehicle. FCM classifier and Spectral Theory algorithms are used to compute features and classify the longitudinal cracking and pothole. The Matlab2016Ra Image preparing tool kit utilizes performance analysis to identify the viability of pavement distress on selected urban stretches of Bengaluru city, India. The outcomes of image evaluation with the utilization semi-computerized image handling framework represented the features of longitudinal crack and pothole with an accuracy of about 80%. Further, the detected images are validated with the actual dimensions, and it is seen that dimension variability is about 0.46. The linear regression model y=1.171x-0.155 is obtained using the existing and experimental / image processing area. The R2 correlation square obtained from the best fit line is 0.807, which is considered in the linear regression model to be ‘large positive linear association’.

Keywords: crack detection, pothole detection, spectral clustering, fuzzy-c-means

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1059 Concept of a Pseudo-Lower Bound Solution for Reinforced Concrete Slabs

Authors: M. De Filippo, J. S. Kuang

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In construction industry, reinforced concrete (RC) slabs represent fundamental elements of buildings and bridges. Different methods are available for analysing the structural behaviour of slabs. In the early ages of last century, the yield-line method has been proposed to attempt to solve such problem. Simple geometry problems could easily be solved by using traditional hand analyses which include plasticity theories. Nowadays, advanced finite element (FE) analyses have mainly found their way into applications of many engineering fields due to the wide range of geometries to which they can be applied. In such cases, the application of an elastic or a plastic constitutive model would completely change the approach of the analysis itself. Elastic methods are popular due to their easy applicability to automated computations. However, elastic analyses are limited since they do not consider any aspect of the material behaviour beyond its yield limit, which turns to be an essential aspect of RC structural performance. Furthermore, their applicability to non-linear analysis for modeling plastic behaviour gives very reliable results. Per contra, this type of analysis is computationally quite expensive, i.e. not well suited for solving daily engineering problems. In the past years, many researchers have worked on filling this gap between easy-to-implement elastic methods and computationally complex plastic analyses. This paper aims at proposing a numerical procedure, through which a pseudo-lower bound solution, not violating the yield criterion, is achieved. The advantages of moment distribution are taken into account, hence the increase in strength provided by plastic behaviour is considered. The lower bound solution is improved by detecting over-yielded moments, which are used to artificially rule the moment distribution among the rest of the non-yielded elements. The proposed technique obeys Nielsen’s yield criterion. The outcome of this analysis provides a simple, yet accurate, and non-time-consuming tool of predicting the lower-bound solution of the collapse load of RC slabs. By using this method, structural engineers can find the fracture patterns and ultimate load bearing capacity. The collapse triggering mechanism is found by detecting yield-lines. An application to the simple case of a square clamped slab is shown, and a good match was found with the exact values of collapse load.

Keywords: computational mechanics, lower bound method, reinforced concrete slabs, yield-line

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1058 Linkages of Environment with the Health Condition of Poor Women and Children in the Urban Areas of India

Authors: Barsharani Maharana

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India is the country that shelters the largest number of poor. One of the major areas of concern in India is the unsatisfactory situation of the poor in social developmental and health parameters, not only in rural areas which are partly devoid of the facilities but also in the urban areas where the facilities are insufficient to provide services of a satisfactory quality. Objectives: 1) to examine the association between the environmental condition and health condition among poor women in urban areas. 2) to find out the significance of the effect of environment on the child health among the poor children. 3) to present the scenario of poor among highly urbanized and less urbanized states with respect to the health and environment. Data: data from National Family Health survey-3 and census are used to fulfill the objectives. Methodology: In this study, the standard of living condition of people living in urban areas is computed by taking some household characteristics and assets. People possessing low standard of living are considered as poor. Bivariate and multivariate analysis are employed to examine the effect of environment on poor women and children. A geographical information system is used to present the health and environmental condition of poor in highly and less urbanized states. Results: The findings reveal that the poor women who are not accessed to improved source of water, and sanitation facility are facing more health problems. Children who are living in a dirty environment and are not accessed to improved source of drinking water, among them prevalence of diarrhea and fever is found to be high. As well, the health condition of poor in highly urbanized states is dreadful. Policy implications: Government should emphasize on the implementation of programs regarding the improvement in the infrastructural facilities and health care treatment of urban poor.

Keywords: environment, urban poor, health, sanitation

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1057 The Comparison of Safety Factor in Dry and Rainy Condition at Coal Bearing Formation. Case Study: Lahat Area South Sumatera Province, Indonesia

Authors: Teguh Nurhidayat, Nurhamid, Dicky Muslim, Zufialdi Zakaria, Irvan Sophian

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This paper presents the role of climate change as the factor that induces landslide. Case study is located at Lahat Regency, South Sumatera Province, Indonesia. Study area has high economic value of coal reserves (mostly subbituminous – bituminous), which is developable for open pit coal mining in the future. Seams are found in Muara Enim Formation. This formation is at south Sumatera basin which is formed at Tertiary as a result of collision between the indian plate and eurasian plate. South Sumatera basin which is a basin located in back arc basin. This study aims to unravel the relationship between slope stability with different season condition in tropical climate. Undisturbed soil samples were obtained in the field along with other geological data. Laboratory works were carried out to obtain physical and mechanical properties of soils. Methodology to analyze slope stability is bishop method. Bishop methods are used to identify safety factor of slope. Result shows that slopes in rainy season conditions are more prone to landslides than in dry season. In the dry seasons with moisture content is 22.65%, safety factor is 1.28 the slope in stable condition. If rain is approaching with moisture content increasing to 97.8%, the slope began to be critical. On wet condition groundwater levels is increased, followed by γ (unit weight), c (cohesion), and φ (angle of friction) at 18.04, 5,88 kN/m2, and 28,04°, respectively, which ultimately determines the security factor FS to be 1.01 (slope in unstable conditions).

Keywords: rainfall, moisture content, slope analysis, landslide prone

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1056 Friction and Wear, Including Mechanisms, Modeling,Characterization, Measurement and Testing (Bangladesh Case)

Authors: Gor Muradyan

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The paper is about friction and wear, including mechanisms, modeling, characterization, measurement and testing case in Bangladesh. Bangladesh is a country under development, A lot of people live here, approximately 145 million. The territory of this country is very small. Therefore buildings are very close to each other. As the pipe lines are very old, and people get almost dirty water, there are a lot of ongoing projects under ADB. In those projects the contractors using HDD machines (Horizontal Directional Drilling ) and grundoburst. These machines are working underground. As ground in Bangladesh is very sludge, machine can't work relevant because of big friction in the soil. When drilling works are finished machine is pulling the pipe underground. Very often the pulling of the pipes becomes very complicated because of the friction. Therefore long section of the pipe laying can’t be done because of a big friction. In that case, additional problems rise, as well as additional work must be done. As we mentioned above it is not possible to do big section of the pipe laying because of big friction in the soil, Because of this it is coming out that contractors must do more joints, more pressure test. It is always connected with additional expenditure and losing time. This machine can pull in 75 mm to 500 mm pipes connected with the soil condition. Length is possible till 500m related how much friction it will had on the puller. As less as much it can pull. Another machine grundoburst is not working at this soil condition at all. The machine is working with air compressor. This machine are using for the smaller diameter pipes, 20 mm to 63 mm. Most of the cases these machines are being used for the installing of the house connection pipes, for making service connection. To make a friction less contractors using bigger pulling had then the pipe. It is taking down the friction, But the problem of this machine is that it can't work at sludge. Because of mentioned reasons the friction has a big mining during this kind of works. There are a lot of ways to reduce the friction. In this paper we'll introduce the ways that we have researched during our practice in Bangladesh.

Keywords: Bangladesh, friction and wear, HDD machines, reducing friction

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1055 Forecast of the Small Wind Turbines Sales with Replacement Purchases and with or without Account of Price Changes

Authors: V. Churkin, M. Lopatin

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The purpose of the paper is to estimate the US small wind turbines market potential and forecast the small wind turbines sales in the US. The forecasting method is based on the application of the Bass model and the generalized Bass model of innovations diffusion under replacement purchases. In the work an exponential distribution is used for modeling of replacement purchases. Only one parameter of such distribution is determined by average lifetime of small wind turbines. The identification of the model parameters is based on nonlinear regression analysis on the basis of the annual sales statistics which has been published by the American Wind Energy Association (AWEA) since 2001 up to 2012. The estimation of the US average market potential of small wind turbines (for adoption purchases) without account of price changes is 57080 (confidence interval from 49294 to 64866 at P = 0.95) under average lifetime of wind turbines 15 years, and 62402 (confidence interval from 54154 to 70648 at P = 0.95) under average lifetime of wind turbines 20 years. In the first case the explained variance is 90,7%, while in the second - 91,8%. The effect of the wind turbines price changes on their sales was estimated using generalized Bass model. This required a price forecast. To do this, the polynomial regression function, which is based on the Berkeley Lab statistics, was used. The estimation of the US average market potential of small wind turbines (for adoption purchases) in that case is 42542 (confidence interval from 32863 to 52221 at P = 0.95) under average lifetime of wind turbines 15 years, and 47426 (confidence interval from 36092 to 58760 at P = 0.95) under average lifetime of wind turbines 20 years. In the first case the explained variance is 95,3%, while in the second –95,3%.

Keywords: bass model, generalized bass model, replacement purchases, sales forecasting of innovations, statistics of sales of small wind turbines in the United States

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1054 The Effects of Acute Physical Activity on Measures of Inhibition in Pre-School Children

Authors: Antonia Stergiou

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Background: Due to the developmental trajectory of executive function in preschool age, the majority of existing studies investigating the association between acute physical activity and cognitive control have focused on adolescents and adult population. Aim- The aim of this study was to investigate the possible effects of physical activity on the inhibitory control of pre-school children. Methods: This is a prospectively designed study that was conducted in a primary school in Bristol in June 2015. The total number of subjects was n=61 and 20 trials of a modified Eriksen Flanker Task were completed before and after a 30-minutes session of moderate exercise (including both 5 minutes of warm up and cool down). For each test a pre- and post-test assessment took place that included both congruent and incongruent trials. The congruent trials were considered as the control condition and the incongruent trials as those that measure inhibitory control (experimental condition). At the end of the assessment, the participants were instructed to choose the face that described their current feelings between three options (happy, neutral, sad). Results: There was a trend for increased accuracy following moderate exercise, but there was statistical significance (p > .05). However, there was statistically significant improvement in the reaction time following the same type of exercise (p = .005). Face board assessment revealed positive emotions after 30 minutes of moderate exercise. Conclusions: The current study supports findings from previous studies related to the benefits of physical activity on the children’s inhibitory control and provides evidence of those benefits in even younger ages. Further research should take place considering each child individually. Implementation of those findings could result in an improved curriculum in schools with additional time spent on physical education courses.

Keywords: cognitive control, inhibition, physical activity, pre-school children

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1053 Life Cycle Assessment of Rare Earth Metals Production: Hotspot Analysis of Didymium Electrolysis Process

Authors: Sandra H. Fukurozaki, Andre L. N. Silva, Joao B. F. Neto, Fernando J. G. Landgraf

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Nowadays, the rare earth (RE) metals play an important role in emerging technologies that are crucial for the decarbonisation of the energy sector. Their unique properties have led to increasing clean energy applications, such as wind turbine generators, and hybrid and electric vehicles. Despite the substantial media coverage that has recently surrounded the mining and processing of rare earth metals, very little quantitative information is available concerning their subsequent life stages, especially related to the metallic production of didymium (Nd-Pr) in fluoride molten salt system. Here we investigate a gate to gate scale life cycle assessment (LCA) of the didymium electrolysis based on three different scenarios of operational conditions. The product system is modeled with SimaPro Analyst 8.0.2 software, and IMPACT 2002+ was applied as an impact assessment tool. In order to develop a life cycle inventories built in software databases, patents, and other published sources together with energy/mass balance were utilized. Analysis indicates that from the 14 midpoint impact categories evaluated, the global warming potential (GWP) is the main contributors to the total environmental burden, ranging from 2.7E2 to 3.2E2 kg CO2eq/kg Nd-Pr. At the damage step assessment, the results suggest that slight changes in materials flows associated with enhancement of current efficiency (between 2.5% and 5%), could lead a reduction up to 12% and 15% of human health and climate change damage, respectively. Additionally, this paper highlights the knowledge gaps and future research efforts needing to understand the environmental impacts of Nd-Pr electrolysis process from the life cycle perspective.

Keywords: didymium electrolysis, environmental impacts, life cycle assessment, rare earth metals

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1052 The Associations between Ankle and Brachial Systolic Blood Pressures with Obesity Parameters

Authors: Matei Tudor Berceanu, Hema Viswambharan, Kirti Kain, Chew Weng Cheng

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Background - Obesity parameters, particularly visceral obesity as measured by the waist-to-height ratio (WHtR), correlate with insulin resistance. The metabolic microvascular changes associated with insulin resistance causes increased peripheral arteriolar resistance primarily to the lower limb vessels. We hypothesize that ankle systolic blood pressures (SBPs) are more significantly associated with visceral obesity than brachial SBPs. Methods - 1098 adults enriched in south Asians or Europeans with diabetes (T2DM) were recruited from a primary care practice in West Yorkshire. Their medical histories, including T2DM and cardiovascular disease (CVD) status, were gathered from an electronic database. The brachial, dorsalis pedis, and posterior tibial SBPs were measured using a Doppler machine. Their body mass index (BMI) and WHtR were calculated after measuring their weight, height, and waist circumference. Linear regressions were performed between the 6 SBPs and both obesity parameters, after adjusting for covariates. Results - Generally, the left posterior tibial SBP (P=4.559*10⁻¹⁵) and right posterior tibial SBP (P=1.114* 10⁻¹³ ) are the pressures most significantly associated with the BMI, as well as in south Asians (P < 0.001) and Europeans (P < 0.001) specifically. In South Asians, although the left (P=0.032) and right brachial SBP (P=0.045) were associated to the WHtR, the left posterior tibial SBP (P=0.023) showed the strongest association. Conclusion - Regardless of ethnicity, ankle SBPs are more significantly associated with generalized obesity than brachial SBPs, suggesting their screening potential for screening for early detection of T2DM and CVD. A combination of ankle SBPs with WHtR is proposed in south Asians.

Keywords: ankle blood pressures, body mass index, insulin resistance, waist-to-height-ratio

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1051 The Prognostic Prediction Value of Positive Lymph Nodes Numbers for the Hypopharyngeal Squamous Cell Carcinoma

Authors: Wendu Pang, Yaxin Luo, Junhong Li, Yu Zhao, Danni Cheng, Yufang Rao, Minzi Mao, Ke Qiu, Yijun Dong, Fei Chen, Jun Liu, Jian Zou, Haiyang Wang, Wei Xu, Jianjun Ren

Abstract:

We aimed to compare the prognostic prediction value of positive lymph node number (PLNN) to the American Joint Committee on Cancer (AJCC) tumor, lymph node, and metastasis (TNM) staging system for patients with hypopharyngeal squamous cell carcinoma (HPSCC). A total of 826 patients with HPSCC from the Surveillance, Epidemiology, and End Results database (2004–2015) were identified and split into two independent cohorts: training (n=461) and validation (n=365). Univariate and multivariate Cox regression analyses were used to evaluate the prognostic effects of PLNN in patients with HPSCC. We further applied six Cox regression models to compare the survival predictive values of the PLNN and AJCC TNM staging system. PLNN showed a significant association with overall survival (OS) and cancer-specific survival (CSS) (P < 0.001) in both univariate and multivariable analyses, and was divided into three groups (PLNN 0, PLNN 1-5, and PLNN>5). In the training cohort, multivariate analysis revealed that the increased PLNN of HPSCC gave rise to significantly poor OS and CSS after adjusting for age, sex, tumor size, and cancer stage; this trend was also verified by the validation cohort. Additionally, the survival model incorporating a composite of PLNN and TNM classification (C-index, 0.705, 0.734) performed better than the PLNN and AJCC TNM models. PLNN can serve as a powerful survival predictor for patients with HPSCC and is a surrogate supplement for cancer staging systems.

Keywords: hypopharyngeal squamous cell carcinoma, positive lymph nodes number, prognosis, prediction models, survival predictive values

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1050 Biophysical Characterization of the Inhibition of cGAS-DNA Sensing by KicGAS, Kaposi's Sarcoma-Associated Herpesvirus Inhibitor of cGAS

Authors: D. Bhowmik, Y. Tian, Q. Yin, F. Zhu

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Cyclic GMP-AMP synthase (cGAS), recognises cytoplasmic double-stranded DNA (dsDNA), indicative of bacterial and viral infections, as well as the leakage of self DNA by cellular dysfunction and stresses, to elicit the host's immune responses. Viruses also have developed numerous strategies to antagonize the cGAS-STING pathway. Kaposi's sarcoma-associated herpesvirus (KSHV) is a human DNA tumor virus that is the causative agent of Kaposi’s sarcoma and several other malignancies. To persist in the host, consequently causing diseases, KSHV must overcome the host innate immune responses, including the cGAS-STING DNA sensing pathway. We already found that ORF52 or KicGAS (KSHV inhibitor of cGAS), an abundant and basic gamma herpesvirus-conserved tegument protein, directly inhibits cGAS enzymatic activity. To better understand the mechanism, we have performed the biochemical and structural characterization of full-length KicGAS and various mutants in regarding binding to DNA. We observed that KicGAS is capable of self-association and identified the critical residues involved in the oligomerization process. We also characterized the DNA-binding of KicGAS and found that KicGAS cooperatively oligomerizes along the length of the double stranded DNA, the highly conserved basic residues at the c-terminal disordered region are crucial for DNA recognition. Deficiency in oligomerization also affects DNA binding. Thus DNA binding by KicGAS sequesters DNA and prevents it from being detected by cGAS, consequently inhibiting cGAS activation. KicGAS homologues also inhibit cGAS efficiently, suggesting inhibition of cGAS is evolutionarily conserved mechanism among gamma herpesvirus. These results highlight the important viral strategy to evade this innate immune sensor.

Keywords: Kaposi's sarcoma-associated herpesvirus, KSHV, cGAS, DNA binding, inhibition

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1049 The Effects of Subsidised Irrigation Service Fees on Irrigation Performance in Vietnam

Authors: Trang Pham

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Approximately 70% of the Vietnamese population lives in rural areas where the main livelihood is farming. For many years, the Vietnamese Government has been working towards improving farmers’ quality of life. In 2008, the Government issued the decree 115/2008/ND-CP to subsidize farmers’ water fees. The subsidy covers operation and management costs of major water infrastructure. Water users have only to pay for the operation and management of minor or tertiary canal systems. But the “subsidized water fee” has become contentious; there are two opposing schools of thought. One view is that the subsidy lessens the burden on farmers in terms of reducing their production costs, at the same time generating a sufficient budget for Irrigation Management Companies (IMCs) and Water User Association (WUAs). The alternate point of view is that the subsidy negatively effects irrigation performance, especially in tertiary canals. The aim of this study was to gain clear awareness of the perceptions of farmers, WUA members, and IMC staffs in regard to irrigation performance and management since the introduction of subsidies and local water fees. In order to find out how the government intervention has affected local farming communities, a series of questionnaires and interviews were administered in 2013. Four case studies were chosen which represent four different agricultural areas and four different irrigation systems in Vietnam. Interviews were conducted with IMC staffs and WUA members and questionnaires were used to gather information from farmers. The study compares the difference in operation and management costs across the four case studies both before and after the implementation of the decree. The results disclose factors behind the subsidized water fee that either allow or hinder improved irrigation performance and better irrigation management.

Keywords: water fee, irrigation performance, local farming, tertiary canal systems

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1048 The Position of Islamic Jurisprudence in UAE Private Law: Analytical Study

Authors: Iyad Jadalhaq, Mohammed El Hadi El Maknouzi

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The place of Islamic law in the legal system of the UAE is best understood by introducing a differentiation between its role as a formal source of law and its influence as a material source of law. What this differentiation helps clarify is that the corpus of Islamic law constitutes a much deeper influence on adjudication, law-making and the legal profession in the UAE, than it might appear at first sight, by considering its formal position in the division of labor between courts, or legislative lists of sources of law. This paper aims to examine the role of Shariah in the UAE private law system by determining the comprehensiveness of Sharia in the legal system as a whole, and not in a limited way related to it as a source of law according to Article 1 of the Civil Transactions Law. Turning to the role of the Shariah as a formal source of law, it is useful to start from Article 1 of the UAE Civil Code. This provision lays out the formal hierarchy of sources of UAE private law, these being legislation, Islamic law, and custom. Hence, when deciding a civil dispute, a judge should first refer to positive legislation in force in the UAE. Lacking the rule to cover the case before him/her, the judge ought then to refer directly to Islamic law. If the matter lacks regulation in Islamic law, only then may the judge appeal to custom. Accordingly, in connection to civil transactions, Shariah is presented here, formally, as the second source of law. Still, Shariah law addresses many other issues beyond civil transactions, including matters of morals, worship, and belief. However, in Article 1 of the UAE Civil Code, the reference to Islamic law ought to be understood as limited to the rules it lays out for civil transactions. There are four main sets of courts in the judicial systems of the UAE, whose competence is based on whether a dispute touches upon civil and commercial transactions, criminal offenses, personal statuses, or labor relations. This sectorial and multi-tiered organization of courts as a whole constitutes an institutional development compatible with the long-standing affirmation in the Shariah of the legitimacy of the judiciary. Indeed, Islamic law authorizes the governing authorities to organize the judiciary, including by allocating specific types of cases to particular kinds of judges depending on the value of the case, or by assigning judges to a specific place in which they are to exercise their jurisdictional function. In view of this, the contemporary organization of courts in the UAE can be regarded as an organic adaptation, aligned with Shariah rules on the assignment of jurisdictional authority, to the growing complexity of modern society. Therefore, we can conclude to the comprehensive role of Shariah in the entire legal system of the United Arab Emirates, including legislation, a judicial system, institutional, and administrative work.

Keywords: Islamic jurisprudence, Shariah, UAE civil code, UAE private law

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1047 Association of Maternal Age, Ethnicity and BMI with Gestational Diabetes Prevalence in Multi-Racial Singapore

Authors: Nur Atiqah Adam, Mor Jack Ng, Bernard Chern, Kok Hian Tan

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Introduction: Gestational diabetes (GDM) is a common pregnancy complication with short and long-term health consequences for both mother and fetus. Factors such as family history of diabetes mellitus, maternal obesity, maternal age, ethnicity and parity have been reported to influence the risk of GDM. In a multi-racial country like Singapore, it is worthwhile to study the GDM prevalences of different ethnicities. We aim to investigate the influence of ethnicity on the racial prevalences of GDM in Singapore. This is important as it may help us to improve guidelines on GDM healthcare services according to significant risk factors unique to Singapore. Materials and Methods: Obstetric cohort data of 926 singleton deliveries in KK Women’s and Children’s Hospital (KKH) from 2011 to 2013 was obtained. Only patients aged 18 and above and without complicated pregnancies or chronic illnesses were targeted. Factors such as ethnicity, maternal age, parity and maternal body mass index (BMI) at booking visit were studied. A multivariable logistic regression model, adjusted for confounders, was used to determine which of these factors are significantly associated with an increased risk of GDM. Results: The overall GDM prevalence rate based on WHO 1999 criteria & at risk screening (race alone not a risk factor) was 8.86%. GDM rates were higher among women above 35 years old (15.96%), obese (15.15%) and multiparous women (10.12%). Indians had a higher GDM rate (13.0 %) compared to the Chinese (9.57%) and Malays (5.20%). However, using multiple logistic regression model, variables that are significantly related to GDM rates were maternal age (p < 0.001) and maternal BMI at booking visit (p = 0.006). Conclusion: Maternal age (p < 0.001) and maternal booking BMI (p = 0.006) are the strongest risk factors for GDM. Ethnicity per se does not seem to have a significant influence on the prevalence of GDM in Singapore (p = 0.064). Hence we should tailor guidelines on GDM healthcare services according to maternal age and booking BMI rather than ethnicity.

Keywords: ethnicity, gestational diabetes, healthcare, pregnancy

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1046 Building Transparent Supply Chains through Digital Tracing

Authors: Penina Orenstein

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In today’s world, particularly with COVID-19 a constant worldwide threat, organizations need greater visibility over their supply chains more than ever before, in order to find areas for improvement and greater efficiency, reduce the chances of disruption and stay competitive. The concept of supply chain mapping is one where every process and route is mapped in detail between each vendor and supplier. The simplest method of mapping involves sourcing publicly available data including news and financial information concerning relationships between suppliers. An additional layer of information would be disclosed by large, direct suppliers about their production and logistics sites. While this method has the advantage of not requiring any input from suppliers, it also doesn’t allow for much transparency beyond the first supplier tier and may generate irrelevant data—noise—that must be filtered out to find the actionable data. The primary goal of this research is to build data maps of supply chains by focusing on a layered approach. Using these maps, the secondary goal is to address the question as to whether the supply chain is re-engineered to make improvements, for example, to lower the carbon footprint. Using a drill-down approach, the end result is a comprehensive map detailing the linkages between tier-one, tier-two, and tier-three suppliers super-imposed on a geographical map. The driving force behind this idea is to be able to trace individual parts to the exact site where they’re manufactured. In this way, companies can ensure sustainability practices from the production of raw materials through the finished goods. The approach allows companies to identify and anticipate vulnerabilities in their supply chain. It unlocks predictive analytics capabilities and enables them to act proactively. The research is particularly compelling because it unites network science theory with empirical data and presents the results in a visual, intuitive manner.

Keywords: data mining, supply chain, empirical research, data mapping

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1045 Prevalence of Diabetes Mellitus Among Human Immune Deficiency Virus-Positive Patients Under Anti-retroviral Attending in Rwanda, a Case Study of University Teaching Hospital of Butare

Authors: Venuste Kayinamura, V. Iyamuremye, A. Ngirabakunzi

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Anti-retroviral therapy (ART) for HIV patient can cause a deficiency in glucose metabolism by promoting insulin resistance, glucose intolerance, and diabetes, diabetes mellitus keep increasing among HIV-infected patients worldwide but there is limited data on levels of blood glucose and its relationship with antiretroviral drugs (ARVs) and HIV-infection worldwide, particularly in Rwanda. A convenient sampling strategy was used in this study and it involved 323 HIV patients (n=323). Patients who are HIV positive under ARVs were involved in this study. The patient’s blood glucose was analyzed using an automated machine or glucometer (COBAS C 311). Data were analyzed using Microsoft Excel and SPSS V. 20.0 and presented in percentages. The highest diabetes mellitus prevalence was 93.33 % in people aged >40 years while the lowest diabetes mellitus prevalence was 6.67% in people aged between 21-and 40 years. The P-value was (0.021). Thus, there is a significant association between age and diabetes occurrence. The highest diabetes mellitus prevalence was 28.2% in patients under ART treatment for more than 10 years, 16.7% were <5years while 20% of patients were on ART treatment between 5-10 years. The P-value here is (0.03), thus the incidence of diabetes is associated with long-term ART use in HIV-infected patients. This study assessed the prevalence of diabetes among HIV-infected patients under ARVs attending the University Teaching Hospital of Butare (CHUB), it shows that the prevalence of diabetes is high in HIV-infected patients under ARTs. This study found no significant relationship between gender and diabetes mellitus growth. Therefore, regular assessment of diabetes mellitus especially among HIV-infected patients under ARVs is highly recommended to control other health issues caused by diabetes mellitus.

Keywords: anti-retroviral, diabetes mellitus, antiretroviral therapy, human immune deficiency virus

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1044 Induced Affectivity and Impact on Creativity: Personal Growth and Perceived Adjustment when Narrating an Intense Emotional Experience

Authors: S. Da Costa, D. Páez, F. Sánchez

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We examine the causal role of positive affect on creativity, the association of creativity or innovation in the ideation phase with functional emotional regulation, successful adjustment to stress and dispositional emotional creativity, as well as the predictive role of creativity for positive emotions and social adjustment. The study examines the effects of modification of positive affect on creativity. Participants write three poems, narrate an infatuation episode, answer a scale of personal growth after this episode and perform a creativity task, answer a flow scale after creativity task and fill a dispositional emotional creativity scale. High and low positive effect was induced by asking subjects to write three poems about high and low positive connotation stimuli. In a neutral condition, tasks were performed without previous affect induction. Subjects on the condition of high positive affect report more positive and less negative emotions, more personal growth (effect size r = .24) and their last poem was rated as more original by judges (effect size r = .33). Mediational analysis showed that positive emotions explain the influence of the manipulation on personal growth - positive affect correlates r = .33 to personal growth. The emotional creativity scale correlated to creativity scores of the creative task (r = .14), to the creativity of the narration of the infatuation episode (r = .21). Emotional creativity was also associated, during performing the creativity task, with flow (r = .27) and with affect balance (r = .26). The mediational analysis showed that emotional creativity predicts flow through positive affect. Results suggest that innovation in the phase of ideation is associated with a positive affect balance and satisfactory performance, as well as dispositional emotional creativity is adaptive.

Keywords: affectivity, creativity, induction, innovation, psychological factors

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1043 Re-Defining Academic Literacy: An Information Literacy Approach to Helping Chinese International Students Succeed in American Colleges

Authors: Yi Ding

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With the upsurge of Chinese international students in American higher education, serious academic problems Chinese international students are suffering from are also striking. While most practices and research in higher education focus on the role of professors, writing centers, and tutoring centers to help international students succeed in college, this research study focuses on a more fundamental skill that is neglected in most conversations: information literacy, which is usually addressed by academic librarians. Transitioning from an East-Asian, developing educational system that values authority, set knowledge more than independent thinking, scholarly conversation, Chinese international students need support from academic librarians to acquire information literacy, which is crucial to understand expectations of a Western academic setting and thus to succeed in college. This research study illustrates how academic librarians can play an integral role in helping Chinese international students acclimate to the expectations of American higher education by teaching information literacy as academic literacy unique to the Western academic setting. Six keys of information literacy put forward by Association of College and Research Libraries, which are 'Authority Is Constructed and Contextual', 'Information Creation as a Process', 'Information Has Value', 'Research as Inquiry', 'Scholarship as Conversation', and 'Searching as Strategic Exploration', are analyzed through the lens of Chinese educational system and students’ backgrounds. Based on the analysis as well as results from surveys and interviews among academic librarians, professors, and international students, this research further examines current practices from a wide range of academic libraries and finally, provides evidence-based recommendations for academic librarians to use information literacy instruction to help Chinese international students succeed in American higher education.

Keywords: academic librarians, Chinese international students, information literacy, student success

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1042 Evaluation of Environmental and Social Management System of Green Climate Fund's Accredited Entities: A Qualitative Approach Applied to Environmental and Social System

Authors: Sima Majnooni

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This paper discusses the Green Climate Fund's environmental and social management framework (GCF). The environmental and social management framework ensures the accredited entity considers the GCF's accreditation standards and effectively implements each of the GCF-funded projects. The GCF requires all accredited entities to meet basic transparency and accountability standards as well as environmental and social safeguards (ESMS). In doing so, the accredited entity sets up different independent units. One of these units is called the Grievance Mechanism. When allegations of environmental and social harms are raised in association with GCF-funded activities, affected parties can contact the entity’s grievance unit. One of the most challenging things about the accredited entity's grievance unit is the lack of available information and resources on the entities' websites. Many AEs have anti-corruption or anti-money laundering unit, but they do not have the environmental and social unit for affected people. This paper will argue the effectiveness of environmental and social grievance mechanisms of AEs by using a qualitative approach to indicate how many of AEs have a poor or an effective GRM. Some ESMSs seem highly effective. On the other hand, other mechanisms lack basic requirements such as a clear, transparent, uniform procedure and a definitive timetable. We have looked at each AE mechanism not only in light of how the website goes into detail regarding the process of grievance mechanism but also in light of their risk category. Many mechanisms appear inadequate for the lower level risk category entities (C) and, even surprisingly, for many higher-risk categories (A). We found; in most cases, the grievance mechanism of AEs seems vague.

Keywords: grievance mechanism, vague environmental and social policies, green climate fund, international climate finance, lower and higher risk category

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1041 Usefulness of Web Sites in Starting Up Wineries: A Comparative study of Canadian, Moroccan and American Small Firms

Authors: Jocelyn D. Perreault

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An exploratory study has been launched in 2013-2014 in the province of Quebec, the state of Vermont (USA) and the region of Zaer in Morocco. We have realized three first case studies in order to better understand the marketing strategies of starting up vineries, which are defined as having a maximum of five years of operations. The methodology used consisted of visiting the vineyards; conducting semi-directed interviews with owner-managers; visiting points-of-sale of the wines and analysing the web sites using an assessment grid. The results indicate many differences between the three firms in their use of their web sites. More precisely, we have noticed that: -The Quebec vineyard uses its web site in collaboration with the touristic actors of its region and the association of the wine makers of the province of Quebec.Positioning is as a touristic attraction. -In comparison,the Moroccan firm limits the content of the web site to itself and its activities and somehow to the wine industry.Positioning is as a wine specialist. -The american firm associated its web site more to farm markets actors and activities of the region.Positioning is as an agricultural actor. -The positionings of the three vineyards are very different from each others and will be discussed more thoroughly during the presentation to better understand the use of web sites, thus contributing to the «brand image». -Improvements to the three web sites have been identified and suggested by more than a hundred of persons using the same grid and comprising students of bachelor and MBA degrees from our university. In general, the web sites have been considered satisfying but requiring several improvements at different levels. Changes or updates have been observed for the Quebec winery web site but practically no changes have been made to the others in the last months. The assessment grid will be presented in more details as well as the global and the partial scores given by the respondents. In conclusion, we have noticed that only one winery is considered as a «heavy and strategic user» of its web site and of Facebook and Twitter.

Keywords: web site, wineries, marketing, positioning, starting up strategies

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1040 An Analysis on Clustering Based Gene Selection and Classification for Gene Expression Data

Authors: K. Sathishkumar, V. Thiagarasu

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Due to recent advances in DNA microarray technology, it is now feasible to obtain gene expression profiles of tissue samples at relatively low costs. Many scientists around the world use the advantage of this gene profiling to characterize complex biological circumstances and diseases. Microarray techniques that are used in genome-wide gene expression and genome mutation analysis help scientists and physicians in understanding of the pathophysiological mechanisms, in diagnoses and prognoses, and choosing treatment plans. DNA microarray technology has now made it possible to simultaneously monitor the expression levels of thousands of genes during important biological processes and across collections of related samples. Elucidating the patterns hidden in gene expression data offers a tremendous opportunity for an enhanced understanding of functional genomics. However, the large number of genes and the complexity of biological networks greatly increase the challenges of comprehending and interpreting the resulting mass of data, which often consists of millions of measurements. A first step toward addressing this challenge is the use of clustering techniques, which is essential in the data mining process to reveal natural structures and identify interesting patterns in the underlying data. This work presents an analysis of several clustering algorithms proposed to deals with the gene expression data effectively. The existing clustering algorithms like Support Vector Machine (SVM), K-means algorithm and evolutionary algorithm etc. are analyzed thoroughly to identify the advantages and limitations. The performance evaluation of the existing algorithms is carried out to determine the best approach. In order to improve the classification performance of the best approach in terms of Accuracy, Convergence Behavior and processing time, a hybrid clustering based optimization approach has been proposed.

Keywords: microarray technology, gene expression data, clustering, gene Selection

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1039 Association between Substance Use Disorder, PTSD and the Effectiveness of Collaborative Care for Depression in Primary Care: A Systematic Literature Search and Narrative Review

Authors: J. Raub, H. Schillok, L. Kaupe, C. Jung-Sievers, G. Pitschel-Walz, M. Bühner, J. Gensichen, F. D. Pokal-Gruppe

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Introduction: In Germany, depression ranks among the top ten diseases with the highest disease burden and often occurs with comorbidities. Collaborative Care (CC), a concept developed in the United States for the primary care management of chronic diseases, has been identified as an efficient model for the treatment of depression in general medicine. A recent meta-analysis highlights research gaps regarding CC in patients with psychiatric multimorbidity. The highest prevalence of psychiatric comorbidities in depression is observed in anxiety disorders, post-traumatic stress disorder (PTSD), and substance use disorders. Methods: We conducted a literature search following the PRISMA guidelines with three components: Collaborative Care, Depression and randomized controlled trial on the common databases. We focused on the examination of psychiatric comorbidities in depression, specifically Posttraumatic Stress Disorder (PTSD) and Substance Use Disorder (SUD). Results: During the screening process, we identified nine relevant articles related to PTSD, the number of articles related to Substance Use Disorder (SUD) was ten. We examined a total of 8,634 individuals. Our literature review did not reveal any overall significant superiority of the Collaborative Care model compared to Usual Care in patients with depression with comorbid Substance Use Disorder (SUD) or Posttraumatic Stress Disorder (PTSD). Discussion: Five studies demonstrate a faster and statistically significant improvement in depression outcomes among patients with Substance Use Disorder (SUD) and Posttraumatic Stress Disorder (PTSD). Currently, several randomized controlled trials on the topic of Collaborative Care in depression with psychiatric comorbidity are ongoing, such as miCare, Claro and COMET.

Keywords: Depression, primary care, collaborative care, PTSD, Substance use Disorder

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1038 Clinical and Chemokine Profile in Leprosy Patients During Multidrug Therapy (MDT) and Their Healthy Contacts: A Randomized Control Trial

Authors: Rohit Kothari

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Background: Leprosyis a chronic granulomatous diseasecaused by Mycobacterium leprae (M. Lepra). Reactions may interrupt its usual chronic course.Type-1 (T1R)and type-2 lepra reaction(T2R) are acute events and signifytype-IV and type-III hypersensitivity responses, respectively. Various chemokines like CCL3, 5, 11, and CCL24 may be increased during the course of leprosy or during reactions and may serve as markers of early diagnosis, response to therapy, and prognosis. Objective: To find correlation of CCL3, 5, 11, and CCL24 in leprosy patients on multidrug therapy and their family contacts after ruling out active disease during leprosy treatment and during periods of lepra reactions. Methodology: This randomized control trial was conducted in 50 clinico-histopathologically diagnosed cases of leprosy in a tertiary care hospital in Bengaluru, India. 50 of their family contacts were adequately examined and investigated should the need be to rule out active disease. The two study-groups comprised of leprosy cases, and the age, sex, and area of residence matched healthy contactswho were given single-dose rifampicin prophylaxis, respectively. Blood samples were taken at baseline, six months, and after one yearin both the groups (on completion of MDT in leprosy cases)and also during periods of reaction if occurred in leprosy cases. Results: Our study found that at baseline, CCL5, 11, and 24 were higher in leprosy cases as compared to the healthy contacts, and the difference was statistically significant.CCL3 was also found to be higherat baseline in leprosy cases, however, the difference was not statistically significant. At six months and one year, the levels of CCL 5, 11, and 24 reduced, and the difference was statistically significant in leprosy cases, whereas it remained almost static in all the healthy contacts. Twenty patients of leprosy developed lepra reaction during the course of one year, and during reaction, the increase in CCL11 and 24 was statistically significant from baseline, whereas CCL3 and 5 did not rise significantly. One of the healthy contacts developed signs of leprosy in the form of hypopigmented numb patch and was clinico-histopathologically, and CCL11 and 24 were found to be higher with a statistically significant difference from the baseline values. Conclusion: CCL5, 11, and 24 are sensitive markers of diagnosing leprosy, response to MDT, and prognosis and are not increased in healthy contacts. CCL11 and 24 are sensitive markers of lepra reactions and may serve as one of the early diagnostic modalities for identifying lepra reaction and also leprosy in healthy contacts. To the best of our knowledge, this is the first study to evaluate these biomarkers in leprosy cases and their healthy contacts with a follow-up of upto one year with one of them developing the disease, and the same was confirmed based on these biomarkers as well.

Keywords: chemokine profile, healthy contacts, leprosy, lepra reactions

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