Search results for: Holy Cross Mountains

Authors: O. Elkana, O Heyman, S. Hamdan, M. Franko, J. Vatine

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Objective: To investigate whether a direct link exists between perceived pain (PP) and executive functions (EF), above and beyond the influence of depression symptoms, in the context of medical rehabilitation. Design: Cross-sectional study. Setting: Rehabilitation Hospital. Participants: 125 medical records of hospitalized patients were screened for matching to our inclusion criteria. Only 60 patients were found fit and were asked to participate. 19 decline to participate on personal basis. The 41 neurologically intact patients (mean age 46, SD 14.96) that participated in this study were in their sub-acute stage of recovery, with fluent Hebrew, with intact upper limb (to neutralize influence on psychomotor performances) and without an organic brain damage. Main Outcome Measures: EF were assessed using the Wisconsin Card Sorting Test (WCST) and the Stop-Signal Test (SST). PP was measured using 3 well-known pain questionnaires: Pain Disability Index (PDI), The Short-Form McGill Questionnaire (SF-MPQ) and the Pain Catastrophizing Scale (PCS). Perceived pain index (PPI) was calculated by the mean score composite from the 3 pain questionnaires. Depression symptoms were assessed using the Patient Health Questionnaire (PHQ-9). Results: The results indicate that irrespective of the presence of depression symptoms, PP is directly correlated with response inhibition (SST partial correlation: r=0.5; p=0.001) and mental flexibility (WSCT partial correlation: r=-0.37; p=0.021), suggesting decreased performance in EF as PP severity increases. High correlations were found between the 3 pain measurements: SF-MPQ with PDI (r=0.62, p<0.001), SF-MPQ with PCS (r=0.58, p<0.001) and PDI with PCS (r=0.38, p=0.016) and each questionnaire alone was also significantly associated with EF; thus, no specific questionnaires ‘pulled’ the results obtained by the general index (PPI). Conclusion: Examining the direct association between PP and EF, beyond the contribution of depression symptoms, provides further clinical evidence suggesting that EF and PP share underlying mediating neuronal mechanisms. Clinically, the importance of assessing patients' EF abilities as well as PP severity during rehabilitation is underscored.

Keywords: depression, executive functions, mental-flexibility, neuropsychology, pain perception, perceived pain, response inhibition

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Authors: Cytha Nilam Chairani, Ditha Noviantika, Hidayati Amir, Nurul Khairiyah, Siti Rahmadita, Fadila Khairani

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Background: Dental caries is one of the most common diseases with high prevalence in children. The first permanent molar (FPM) has an essential role in establishing the occlusion. Nevertheless, FPM is very prone to caries because of various factors, such as their anatomical structure and early emergence in oral cavity. It is due to the little knowledge from parents and children regarding the timing of emergence of FPM in oral cavity which is still considered as primary teeth. Furthermore, the lack of knowledge from parents and children may affect their oral hygiene practice resulting to carious process. Objective: The aim of this study was to assess the status of FPM caries and its association with children’s oral hygiene practice in 9-12-year-old school children in Lubuk Kilangan Community Health Centre, Padang City. Methods: A cross-sectional study was performed in 50 school children (9-12 years old) using random sampling technique from two randomly selected schools in Lubuk Kilangan Community Health Centre, Padang City. A questionnaire was developed from other studies consisting of four closed ended questions regarding oral health practice. The data obtained were analyzed statistically using Mann-Whitney Test to assess the status of FPM caries and its association with children’s oral hygiene practice. Results: The results showed that 32% of children had FPMs sound and the remaining 68% had FPMs carious which were grouped into 1-2 FPMs carious (60%) and 3-4 FPMs carious (8%). The caries status of mandibular FPM (64%) was higher compared to maxillary FPM (10%). Conclusion: There was significant association in subject who did not visit dentist in the last 6 months which had more carious FPMs compared to subject who visited dentist (p < 0.05). There was no significant association between the status of FPM caries and knowledge of the timing eruption of FPM, oral hygiene instruction from parents and tooth brushing (p > 0.05).

Keywords: dental caries, children, first permanent molar, oral hygiene practice

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Authors: Fei Sun, Meilan Xu, Jianghui Zhu, Maria Stefanie Dwiyanti, Cheolwoo Park, Fanjiang Kong, Baohui Liu, Tetsuya Yamada, Jun Abe

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Reduced or lack of sensitivity to long daylengths is a key character for soybean, a short-day crop, to adapt to higher latitudinal environments. However, the photoperiod-insensitivity often results in a reduction of the duration of vegetative growth and final yield. To overcome this limitation, a photoperiod insensitive line (RIL16) was developed in this study that delayed flowering from the recombinant inbred population derived from a cross between a photoperiod-insensitive cultivar AGS292 and a late-flowering Thai cultivar K3. Expression analyses under SD and LD conditions revealed that the expression levels of FLOWERING LOCUS T (FT) orthologues, FT2a and FT5a, were lowered in RIL16 relative to AGS292, although the expression of E1, a soybean-specific suppressor for FTs, was inhibited in both conditions. A soybean orthologue of TARGET OF EAT1 (TOE1), another suppressor of FT, showed an upregulated expression in RIL16, which appeared to reflect a lower expression of miR172a. Our data suggest that the delayed flowering of RIL16 most likely is controlled by genes involved in an age-dependent pathway in flowering. The QTL analysis based on 1,125 SNPs obtained from Restriction Site Associated DNA Sequencing revealed two major QTLs for flowering dates in Chromosome 16 and two minor QTLs in Chromosome 4, all of which accounted for 55% and 48% of the whole variations observed in natural day length and artificially-induced long day length conditions, respectively. The intervals of the major QTLs harbored FT2a and FT5a, respectively, on the basis of annotated genes in the Williams 82 reference genome. Sequencing analysis further revealed a nonsynonymous mutation in FT2a and an SNP in the 3′ UTR region of FT5a. A further study may elucidate a detailed mechanism underlying the QTL for late flowering. The alleles from K3 at the two QTLs can be used singly or in combination to retain an appropriate duration of vegetative growth to maximize the final yield of photoperiod-insensitive soybeans.

Keywords: FT genes, miR72a, photoperiod-insensitive, soybean flowering

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Authors: Subas Chandra Biswas, Kazi Sameen Naser, Farzana Misha

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Little is known about the sexual behavior of male youth, particularly unmarried young men in Bangladesh as most of the sexual and reproductive health and rights-related research and intervention are mainly focused on females and married couples. To understand the unmarried youth’s sexual behavior, data from a nationwide survey conducted in all 64 districts of Bangladesh were analyzed. Using multistage systematic random sampling, a survey was conducted among 11,113 male youth aged 15-24 years from May-August, 2019. This article analyzed and presented findings of the sexual behavior of unmarried respondents based on the data collected from 10,026 unmarried male youth. Findings showed that 18% had ever experience of sexual relationship, and the reported mean age of first sexual intercourse was 16.5years. For unmarried male youth, those who had a sexual experience, their first sexual partners were female friends/classmate (57%), female neighbors (16%), and female sex workers (12%), relatives (6%) and girlfriends with whom they had love relationship (4%). However, about 36% reported that they had a love relationship with girlfriends, and among them, 23% reported that they had sexual intercourse with their girlfriend. Those who had sexual relations with their girlfriend, 47% reported that they did not use the condom in their last sex with their girlfriend. Furthermore, 29% reported that they had sexual relationships with others besides their girlfriends. Other reported partners were female sex workers (32%), neighbors (29%), female friends (19%), relatives (12%), and cousins (5%). Also, 46% reported that they did not even use the condom during sex with other partners. About 9% used some sort of sexual stimulant to increase their libido. Among the respondents, 376 reported that they bought sex in the last six months, and the mean expenditure of buying sex for the respondent was 1,140 Taka (13.46 US Dollar). Though premarital sexual relations are not socially accepted, findings showed a large portion of male youth are engaged in these relationships and risky sexual behavior. Lack of awareness of sexual and reproductive health, unprotected sexual intercourse, use of the drug during sexual intercourse also increase the threats to health. Thus these findings are important to understand the sexual behavior of male youth in policy and programmatic implications. Therefore, to ensure a healthy sexual life and wellbeing, an immediate and culturally sensitive sexual health promotion intervention is needed for male youth in Bangladesh.

Keywords: Bangladesh, male youth, sexual and reproductive health, sexual behavior

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Authors: Jevonte Abioye, Dylan Savary

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The aim of this research is to present a disaggregated geostatistical analysis of the subnational provincial trends of child mortality variation in Zimbabwe from a child health policy perspective. Soon after gaining independence in 1980, the government embarked on efforts towards promoting equitable health care, namely through the provision of primary health care. Government intervention programmes brought hope and promise, but achieving equity in primary health care coverage was hindered by previous existing disparities in maternal health care disproportionately concentrated in urban settings to the detriment of rural communities. The article highlights policies and programs adopted by the government during the millennium development goals period between 1990-2015 as a response to the inequities that characterised the country’s maternal health care. A longitudinal comparative method for a spatial variation on child mortality rates across provinces is developed based on geostatistical analysis. Cross-sectional and time-series data was extracted from the World Health Organisation (WHO) global health observatory data repository, demographic health survey reports, and previous academic and technical publications. Results suggest that although health care policy was uniform across provinces, not all provinces received the same antenatal and perinatal services. Accordingly, provincial rates of child mortality growth between 1994 and 2015 varied significantly. Evidence on the trends of child mortality rates and maternal health policies in Zimbabwe can be valuable for public child health policy planning and public service delivery design both in Zimbabwe and across developing countries pursuing the sustainable development agenda.

Keywords: antenatal care, perinatal care, infant mortality rate, neonatal mortality rate, under-five mortality rate, millennium development goals, sustainable development agenda

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Authors: P. Saha, R. Ganguly, N. K .Singha, A. Pich

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Microgel, a smart class of material, has drawn attention in the past few years due to its response to external stimuli like temperature, pH, and ionic strength of the solution. Among them, one type of polymer becomes soluble, and the other becomes insoluble in water upon heating displaying upper critical solution temperature (UCST) (e.g., polysulfobetaine, PSB) and lower critical solution temperature (LCST) (e.g., poly(N-vinylcaprolactam, PVCL)) respectively. Polyzwitterions, electrically neutral polymers are biocompatible, biodegradable, and non-cytotoxic in nature, and presence of zwitterionic pendant group in the main backbone makes them stable against temperature and pH variations and strong hydration capability in salt solution promotes them to be used as interfacial bio-adhesion resistance material. Majority of zwitterionic microgels have been synthesized in mini- emulsion technique using free radical polymerization approach. Here, a new route to synthesize dual thermo-responsive PVCL microgels decorated with appreciable amount of zwitterionic PSB chains was developed by a purely water-based surfactant-free reversible addition–fragmentation chain transfer (RAFT) precipitation polymerization. PSB macro-RAFTs having different molecular weights were synthesized and utilized for surface-grafting with PVCL microgels varying the macro-RAFT concentration using N,N′-methylenebis(acrylamide) (BIS) as cross-linker. Increasing the PSB concentration in the PVCL microgels resulted in a linear increase in UCST but decrease in hydrodynamic radius due to strong intrachain coulombic attraction forces acting between the opposite charges present in the zwitterionic groups. Anti- fouling effect was observed on addition of BSA protein solution on the microgel-coated membrane surfaces as studied by fluorescence spectrophotoscopy.

Keywords: microgels, polyzwitterions, upper critical solution temperature-lower critical solution temperature, UCST-LCST, ionic crosslinking

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Authors: Zeb Hussain, Muhammad Asif Qureshi, Shaheen Sharafat

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Background: Measles is a contagious viral infection common in childhood. Vaccination against measles is included in the expanded program of immunization (EPI). However, and alarmingly, a high mortality rate is observed due to measles infection in Pakistan. Moreover a recent outbreak of measles in various areas of Pakistan further highlights the problem. It is therefore important to investigate measles specific IgG (antibody) levels in our population. Objective: To quantify measles specific IgG antibodies amongst vaccinated children in district Qamber Shahdadkot, Sindh. Methodology: This cross-sectional study was conducted at the Microbiology section of the Dow-Diagnostic-Research-and-Reference-Laboratory (DDRRL), DUHS after Institutional Review Board approval (IRB-516/DUHS/-14) during August-December-2014. A total of 173 participants (residents of district Qamber Shahdadkot, Sindh) aged between 1-5 years were recruited in the study. Blood samples were collected as per standard phlebotomy guidelines. Blood was stored at 4 °C overnight. Samples were subsequently spun at a speed of 10000rpm to separate sera, which were divided into small aliquots to be frozen at -20 °C. Frozen sera were transported to the DDRRL on dry ice. Measles specific IgG (antibody) titers were quantified using enzyme linked immunosorbant assay (ELISA). Results: Blood was collected from a total of 173 individuals ranging between 1-5 years of age. Of these, a total of 88 participants were males and 85 were females. Of the 173 investigated samples, only 53 (30.6%) showed protective IgG titers against measles while 120 (69%) were sero-negative. Measles specific IgG antibodies titers were higher in female participants compared to the males. Conclusion: Our data demonstrate that a substantial percentage of vaccinated children in district Qamber-Shahdadkot did not have protective antibody titres against measles. It is therefore extremely important to investigate measles specific IgG levels in various parts of Pakistan in order to implement appropriate protective measures.

Keywords: sero-surveillance, measles, vaccinated children, Pakistan

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Authors: Varsha Chorsiya, Pooja Aneja, Dhananjay Kaushik, Abhinav Yadav

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Intoduction: Women’s Health Initiatives (WHI) focuses on defining the risks and benefits of strategies that could potentially reduce the incidence of obesity, heart disease, breast cancer and colorectal cancer, and fractures in menopause women. The utility of the present research work determines to find the role of Hormone Replacement Therapy (HRT) in changing the different component of body composition during perimenopause period. Methods: A comparative cross-sectional study included 30 subjects, aged between 40 and 50 years which were assigned into 2 groups i.e. 15 subjects in HRT (Group A) and 15 subjects in non-HRT (Group B). The subjects were taken from the hospitals and clinics of Faridabad undergoing HRT in supervision of the consultant gynecologist. The informed consents were signed before including the participants in the study. The body composition and lipid profile were evaluated for all the subjects. Result and Discussion: The BMI, body density, percent body fats and fat mass in both groups showed statistically significant differences i.e. p < 0.05. Our study did not reveal any statistically significant difference between non-HRT and HRT for lipid profile composition of HDL, LDL, VLDL, ratio, triglycerides and total cholesterol although these indicators (LDL, VLDL, ratio, triglycerides and total cholesterol) showed difference clinically with a higher mean values for non-HRT as compared to HRT group. The mean value for HDL was higher for HRT group in contrast to non-HRT group. The result clearly showed that HRT group has a good lipid profile composition. Conclusion: In conclusion, our data show that HRT has statistically significant role in determining BMI, fat percent mass and fat mass. The lipid profile including LDL, HDL, VLDL, ratio, triglycerides and total cholesterol found to be clinically better in HRT group as compared to the non-HRT group. The rationale for non-significant lipid profile probably lie in the fact that hormonal changes need a particular time period and might become significant in post-menopausal period.

Keywords: body composition, hormone replacement therapy, perimenopause, women health

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Authors: Usama Massoud, Abeer A. Kenawy, El-Said A. Ragab, Abbas M. Abbas, Heba M. El-Kosery

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Vertical Electrical Sounding (VES) and Transient Electro Magnetic (TEM) survey have been applied for characterizing the groundwater aquifers at El Sadat industrial area. El-Sadat city is one of the most important industrial cities in Egypt. It has been constructed more than three decades ago at about 80 km northwest of Cairo along the Cairo–Alexandria desert road. Groundwater is the main source of water supplies required for domestic, municipal, and industrial activities in this area due to the lack of surface water sources. So, it is important to maintain this vital resource in order to sustain the development plans of this city. In this study, VES and TEM data were identically measured at 24 stations along three profiles trending NE–SW with the elongation of the study area. The measuring points were arranged in a grid like pattern with both inter-station spacing and line–line distance of about 2 km. After performing the necessary processing steps, the VES and TEM data sets were inverted individually to multi-layer models, followed by a joint inversion of both data sets. Joint inversion process has succeeded to overcome the model-equivalence problem encountered in the inversion of individual data set. Then, the joint models were used for the construction of a number of cross sections and contour maps showing the lateral and vertical distribution of the geo-electrical parameters in the subsurface medium. Interpretation of the obtained results and correlation with the available geological and hydrogeological information revealed TWO aquifer systems in the area. The shallow Pleistocene aquifer consists of sand and gravel saturated with fresh water and exhibits large thickness exceeding 200 m. The deep Pliocene aquifer is composed of clay and sand and shows low resistivity values. The water bearing layer of the Pleistocene aquifer and the upper surface of Pliocene aquifer are continuous and no structural features have cut this continuity through the investigated area.

Keywords: El Sadat city, joint inversion, VES, TEM

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Authors: Mohammad Julhas Sujan, Md. Ferdous Alam

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Maternal, neonatal, and child health (MNCH) holds one of the prime focuses in Bangladesh’s national healthcare system. To save the lives of mothers and children, knowing the stock of MNCH medicines in different healthcare facilities and when to replenish them are essential. A robust information system not only facilitates efficient management of the essential MNCH medicines but also helps effective allocation of scarce resources. In Bangladesh, Supply chain management of the 25-essential life-saving medicines are currently tracked and monitored via an electronic logistics management information system (eLMIS). Our aim was to conduct a cross-sectional study with a year (2020) worth of data from 24 districts of Bangladesh to evaluate how eLMIS is helping the Government and other stakeholders in efficient supply chain management. Data were collected from 4711 healthcare facilities ranging from primary to secondary levels within a district. About 90% (4143) are community clinics which are considered primary health care facilities in Bangladesh. After eLMIS implementation, the average reporting rate across the districts has been increased (> 97%). The month of stock (MOS) of zinc is an average 6 months compared to Inj. Magnesium Sulphate which will take 2.5 years to consume according to the current average monthly consumption (AMC). Due to first approaching expiry, Tab. Misoprostol, 7.1% Chlorhexidine and Inj. Oxytocin may become unusable. Moreover, Inj. Oxytocin is temperature sensitive and may reduce its efficacy if it is stocked for a longer period. In contrast, Zinc should be sufficiently stocked to prevent sporadic stockouts. To understand how data are collected, transmitted, processed, and aggregated for MNCH medicines in a faster and timely manner, an electronic logistics management information system (eLMIS) is necessary. We recommend the use of such a system in developing countries like Bangladesh for efficient supply chain management of essential MNCH medicines.

Keywords: adaption, eLMIS, MNCH, live-saving medicines

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Authors: Afshan Channa, Sameeha Aleem, Harim Mohsin

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First rank symptoms (FRS) are considered to be pathognomic for Schizophrenia. However, FRS is not a distinctive feature of Schizophrenia. It has also been noticed in affective disorder, albeit not inclusive in diagnostic criteria. The presence of FRS in Mania leads to misdiagnosis of psychotic illness, further complicating the management and delay of appropriate treatment. FRS in Mania is associated with poor clinical and functional outcome. Its existence in the first episode of bipolar disorder may be a predictor of poor short-term outcome and decompensating course of illness. FRS in Mania is studied in west. However, the cultural divergence and detriments make it pertinent to study the frequency of FRS in affective disorder independently in Pakistan. Objective: The frequency of first rank symptoms in manic patients, who were under treatment at psychiatric services of tertiary care hospital. Method: The cross sectional study was done at psychiatric services of Aga Khan University Hospital, Karachi, Pakistan. One hundred and twenty manic patients were recruited from November 2014 to May 2015. The patients who were unable to comprehend Urdu or had comorbid psychiatric or organic disorder were excluded. FRS was assessed by administration of validated Urdu version of Present State Examination (PSE) tool. Result: The mean age of the patients was 37.62 + 12.51. The mean number of previous manic episode was 2.17 + 2.23. 11.2% males and 30.6% females had FRS. This association of first rank symptoms with gender in patients of mania was found to be significant with a p-value of 0.008. All-inclusive, 19.2% exhibited FRS in their course of illness. 43.5% had thought broadcasting, made feeling, impulses, action and somatic passivity. 39.1% had thought insertion, 30.4% had auditory perceptual distortion, and 17.4% had thought withdrawal. However, none displayed delusional perception. Conclusion: The study confirms the presence of FRS in mania in both male and female, irrespective of the duration of current manic illness or previous number of manic episodes. A substantial difference was established between both the genders. Being married had no protective effect on the presence of FRS.

Keywords: first rank symptoms, Mania, psychosis, present state examination

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Authors: Dheyaa W. Abbood, Rafa H. AL-Suhaili, May S. Saleh

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A model using the artificial neural networks and genetic algorithm technique is developed for obtaining optimum dimensions of the foundation length and protections of small hydraulic structures. The procedure involves optimizing an objective function comprising a weighted summation of the state variables. The decision variables considered in the optimization are the upstream and downstream cutoffs length sand their angles of inclination, the foundation length, and the length of the downstream soil protection. These were obtained for a given maximum difference in head, depth of impervious layer and degree of anisotropy.The optimization carried out subjected to constraints that ensure a safe structure against the uplift pressure force and sufficient protection length at the downstream side of the structure to overcome an excessive exit gradient. The Geo-studios oft ware, was used to analyze 1200 different cases. For each case the length of protection and volume of structure required to satisfy the safety factors mentioned previously were estimated. An ANN model was developed and verified using these cases input-output sets as its data base. A MatLAB code was written to perform a genetic algorithm optimization modeling coupled with this ANN model using a formulated optimization model. A sensitivity analysis was done for selecting the cross-over probability, the mutation probability and level ,the number of population, the position of the crossover and the weights distribution for all the terms of the objective function. Results indicate that the most factor that affects the optimum solution is the number of population required. The minimum value that gives stable global optimum solution of this parameters is (30000) while other variables have little effect on the optimum solution.

Keywords: inclined cutoff, optimization, genetic algorithm, artificial neural networks, geo-studio, uplift pressure, exit gradient, factor of safety

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Authors: Peter Mc Coll, Alberto Caro, Chiara Gandolfo, Montserrat Labbe, Francisca Schnaidt, Michela Palazzi

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Self-esteem and emotional intelligence are variables that are related to people's nutritional status. Self-esteem may be at low levels in people living with obesity, while emotional intelligence can play an important role in the way people living with obesity cope. The objective of the study was to measure the association between self-esteem and emotional intelligence to nutritional status in adolescent population. Methodology: A cross-sectional study was carried out with 179 adolescent schoolchildren between 13 and 19 years old from a public school. The objective was to evaluate nutritional status; weight and height were measured by calculating the body mass index and Z score. Self-esteem was evaluated using the Coopersmith Self-esteem Inventory adapted by Brinkmann and Segure. Emotional intelligence was measured using the Emotional Quotient Inventory: short, by Bar On, adapted questionnaire, translated into Spanish by López Zafra. For statistical analysis: Pearson's Chi-square test, Pearson's correlation, and odd ratio calculation were used, with a p value at a significance level < 5%. Results: The study group was composed of 71% female and 29% male. The nutritional status was distributed as eutrophic 41.9%, overweight 20.1%, and obesity 21.1%. In relation to self-esteem, 44.1% presented low and very low levels, without differences by gender. Emotional intelligence was distributed: low 3.4%, medium 81%, and high 13.4% -no differences according to gender. The association between nutritional status (overweight and obesity) with low and very low self-esteem, an odds ratio of 2.5 (95% CI 1.12 – 5.59) was obtained with a p-value = 0.02. The correlation analysis between the intrapersonal sub-dimension emotional intelligence scores and the Z score of nutritional status presented a negative correlation of r = - 0.209 with a p-value < 0.005. The correlation between emotional intelligence subdimension stress management with Z score presented a positive correlation of r = 0.0161 with a p-value < 0.05. In conclusion, the group of adolescents studied had a high prevalence of overweight and obesity, a high prevalence of low self-esteem, and a high prevalence of average emotional intelligence. Overweight and obese adolescents were 2.5 times more likely to have low self-esteem. As overweight and obesity increase, self-esteem decreases, and the ability to manage stress increases.

Keywords: self-esteem, emotional intelligence, obesity, adolescent, nutritional status

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Authors: Mohammed Alasel, Michael Keusgen

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Gold is a noble metal; in its nano-scale level (e.g. spherical nanoparticles), the conduction electrons are triggered to collectively oscillate with a resonant frequency when certain wavelengths of electromagnetic radiation interact with its surface; this phenomenon is known as surface plasmon resonance (SPR). SPR is responsible for giving the gold nanoparticles its intense red color depending mainly on its size, shape and distance between nanoparticles. A decreased distance between gold nanoparticles results in aggregation of them causing a change in color from red to blue. This aggregation enables gold nanoparticles to serve as a sensitive biosensoric indicator. In the proposed work, gold nanoparticles were modified with two proteins: i) Borrelia antigen, variable lipoprotein surface-exposed protein (VlsE), and ii) protein A. VlsE antigen induces a strong antibody response against Lyme disease and can be detected from early to late phase during the disease in humans infected with Borrelia. In addition, it shows low cross-reaction with the other non-pathogenic Borrelia strains. The high specificity of VlsE antigen to anti-Borrelia antibodies, combined simultaneously with the high specificity of protein A to the Fc region of all IgG human antibodies, was utilized to develop a rapid test for serological point of care diagnosis of borreliosis in human serum. Only in the presence of anti-Borrelia antibodies in the serum probe, an aggregation of gold nanoparticles can be observed, which is visible by a concentration-dependent colour shift from red (low IgG) to blue (high IgG). Experiments showed it is clearly possible to distinguish between positive and negative sera samples using a simple suspension of the two-protein modified gold nanoparticles in a very short time (30 minutes). The proposed work showed the potential of using such modified gold nanoparticles generally for serological diagnosis. Improved specificity and reduced assay time can be archived in applying increased salt concentrations combined with decreased pH values (pH 5).

Keywords: gold nanoparticles, gold aggregation, serological diagnosis, protein A, lyme borreliosis

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Authors: Chun-Fang Hsueh, Chen-Kang Chang

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Introduction: Branched-chain amino acids (BCAA) could reduce cerebral uptake of tryptophan, leading to decreased synthesis of serotonin in the brain. Arginine and citrulline could reduce exercise-induced hyperammonemia by increasing nitric oxide synthesis and the urea cycle. The combination of these supplements could reduce exercise-induced central fatigue. The purpose of this study was to examine the effect of BCAA, arginine, and citrulline supplementation on repeated swimming performance in teenage athletes. Methods: Eight male and eight female high school swimmers ingested 0.085 g/kg BCAA, 0.05 g/kg arginine and 0.05 g/kg citrulline (AA trial) or placebo (PL trial) in a randomized cross-over design. One hour after the ingestion, the subjects performed a 50 m sprint with their best style every 2 min for 8 times in an indoor 25 m pool. The subjects were asked to swim with their maximal effort each time. The time, stroke frequency and stroke length in each sprint were recorded. Venous blood samples were collected before and after the exercise. The time for each sprint was analyzed by 2-way analysis of variance with repeated measurement. Results: When all subjects were pooled together, total time for the AA trial was significantly faster than the PL trial (AA: 244.02 ± 22.94 s; PL: 247.55 ± 24.17 s, p < .001). Individual sprint time showed significant trial (p= .001) and trial x time (p= .004) effects. The post-hoc analysis revealed that the AA trial was significantly faster than the PL trial in the 2nd, 5th, and 6th sprint. In female subjects, there is a significant trial effect (p= .004) with the AA trial being faster in the 1st, 2nd, and 5th sprint. On the other hand, the trial effect was not significant (p= .072) in male subjects. Conclusions: The combined supplementation could improve 8 x 50 m performance in high school swimmers. The blood parameters including BCAA, tryptophan, NH₃, nitric oxide, and urea, as well as the stroke frequency and length in each sprint, are being analyzed. The results will be presented in the conference.

Keywords: central fatigue, hyperammonemia, tryptophan, urea

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Authors: Martin Adlington, Boris Ceranic, Sally Shazhad

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In an effort to reduce carbon emissions, changes in UK regulations, such as Part L Conservation of heat and power, dictates improved thermal insulation and enhanced air tightness. These changes were a direct response to the UK Government being fully committed to achieving its carbon targets under the Climate Change Act 2008. The goal is to reduce emissions by at least 80% by 2050. Factors such as climate change are likely to exacerbate the problem of overheating, as this phenomenon expects to increase the frequency of extreme heat events exemplified by stagnant air masses and successive high minimum overnight temperatures. However, climate change is not the only concern relevant to overheating, as research signifies, location, design, and occupation; construction type and layout can also play a part. Because of this growing problem, research shows the possibility of health effects on occupants of buildings could be an issue. Increases in temperature can perhaps have a direct impact on the human body’s ability to retain thermoregulation and therefore the effects of heat-related illnesses such as heat stroke, heat exhaustion, heat syncope and even death can be imminent. This review paper presents a comprehensive evaluation of the current literature on the causes and health effects of overheating in buildings and has examined the differing applied assessment approaches used to measure the concept. Firstly, an overview of the topic was presented followed by an examination of overheating research work from the last decade. These papers form the body of the article and are grouped into a framework matrix summarizing the source material identifying the differing methods of analysis of overheating. Cross case evaluation has identified systematic relationships between different variables within the matrix. Key areas focused on include, building types and country, occupants behavior, health effects, simulation tools, computational methods.

Keywords: overheating, climate change, thermal comfort, health

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Authors: Burcu Doymus, Fatma N. Kok, Sakip Onder

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Titanium and titanium-based materials are commonly used to replace or regenerate the injured or lost tissues because of accidents or illnesses. Hospital infections and strong bond formation at the implant-tissue interface are directly affecting the success of the implantation as weak bonding with the native tissue and hospital infections lead to revision surgery. The purpose of the presented study is to modify the surface of the titanium substrates with nano/microspheres for local drug delivery and to prevent hospital infections. Firstly, titanium surfaces were silanized with APTES (3-Triethoxysilylpropylamine) following the negatively charged oxide layer formation. Then characterization studies using Scanning Electron Microscopy (SEM) and Fourier transform infrared spectroscopy (FTIR) were done on the modified surfaces. Secondly, microspheres/nanospheres were prepared with chitosan that is a natural polymer and having valuable properties such as non-toxicity, high biocompatibility, low allergen city and biodegradability for biomedical applications. Antibiotic (ciprofloxacin) loaded micro/nanospheres have been fabricated using emulsion cross-linking method and have been immobilized onto the titanium surfaces with different immobilization techniques such as covalent bond and entrapment. Optimization studies on size and drug loading capacities of micro/nanospheres were conducted before the immobilization process. Light microscopy and SEM were used to visualize and measure the size of the produced micro/nanospheres. Loaded and released drug amounts were determined by using UV- spectrophotometer at 278 nm. Finally, SEM analysis and drug release studies on the micro/nanospheres coated Ti surfaces were done. As a conclusion, it was shown that micro/nanospheres were immobilized onto the surfaces successfully and drug release from these surfaces was in a controlled manner. Moreover, the density of the micro/nanospheres after the drug release studies was higher on the surfaces where the entrapment technique was used for immobilization. Acknowledgement: This work is financially supported by The Scientific and Technological Research Council Of Turkey (Project # 217M220)

Keywords: chitosan, controlled drug release, nanosphere, nosocomial infections, titanium

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Authors: Balazs Patczai, Katalin Gocze, Gabriella Kiss, Dorottya Szabo, Tibor Mintal

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Introduction: Running has become increasingly popular on a global scale in the past decades. Amateur athletes are taking their sport to a new level in an attempt to surpass their performance goals. The aim of our study was to assess the musculoskeletal condition of amateur runners and the prevalence of injuries with a special focus on stress fracture risk. Methods: The cross sectional analysis included ankle mobility, hamstring and lower back flexibility, the use of Renne’s test for iliotibial band syndrome, functional tests for trunk and rotary stability, and measurements of bone density. Data was collected at 2 major half-marathon events in Hungary. Results: Participants (n=134) mean age was 41.76±8.57 years (males: 40.67±8.83, females: 42.08±8.56). Measures of hamstring and lower back flexibility fell into the category of good for both genders (males: 7.13±6.83cm, females: 10.17±6.67cm). No side asymmetry nor gender differences were characteristic in the case of ankle mobility. Trunk stability was significantly better for males than in females (p=0.004). Markers of bone health were in the low normal range for females and were significantly better for males (T-score: p=0.003, T-ratio: p=0.014, Z-score: p=0.034, Z-ratio: p=0.011). 5.2% of females had a previous stress fracture and 24.1% experienced irregular menstrual cycles during the past year. As for the knowledge on the possible association of energy deficiency, menstrual disturbances and their effect on bone health, Only 8.6% of females have heard of the female athlete triad either during their studies or from a health professional. Discussion: The overall musculoskeletal state was satisfactory for both genders both physically and functionally. More attention and effort should be placed on primary and secondary prevention of amateur runners. Very few active women are well informed about the effects of low energy availability and menstrual dysfunction and the negative impact these have on bone health.

Keywords: bone health, flexibility, running, stress fracture

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Authors: Kemal Efe Eseller, Göktuğ Yazici

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Laser-induced breakdown spectroscopy (LIBS) is a rapid optical atomic emission spectroscopy which is used for material identification and analysis with the advantages of in-situ analysis, elimination of intensive sample preparation, and micro-destructive properties for the material to be tested. LIBS delivers short pulses of laser beams onto the material in order to create plasma by excitation of the material to a certain threshold. The plasma characteristics, which consist of wavelength value and intensity amplitude, depends on the material and the experiment’s environment. In the present work, medicine samples’ spectrum profiles were obtained via LIBS. Medicine samples’ datasets include two different concentrations for both paracetamol based medicines, namely Aferin and Parafon. The spectrum data of the samples were preprocessed via filling outliers based on quartiles, smoothing spectra to eliminate noise and normalizing both wavelength and intensity axis. Statistical information was obtained and principal component analysis (PCA) was incorporated to both the preprocessed and raw datasets. The machine learning models were set based on two different train-test splits, which were 70% training – 30% test and 80% training – 20% test. Cross-validation was preferred to protect the models against overfitting; thus the sample amount is small. The machine learning results of preprocessed and raw datasets were subjected to comparison for both splits. This is the first time that all supervised machine learning classification algorithms; consisting of Decision Trees, Discriminant, naïve Bayes, Support Vector Machines (SVM), k-NN(k-Nearest Neighbor) Ensemble Learning and Neural Network algorithms; were incorporated to LIBS data of paracetamol based pharmaceutical samples, and their different concentrations on preprocessed and raw dataset in order to observe the effect of preprocessing.

Keywords: machine learning, laser-induced breakdown spectroscopy, medicines, principal component analysis, preprocessing

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Authors: Yuwaratu Syafira, Wahyu K. Y. Putra, Kusharisupeni Djokosujono

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Background/Objective: Body Mass Index (BMI) serves various purposes, including measuring the prevalence of obesity in a population, and also in formulating a patient’s diet at a hospital, and can be calculated with the equation = body weight (kg)/body height (m)². However, the BMI of an individual with difficulties in carrying their weight or standing up straight can not necessarily be measured. The aim of this study was to form a prediction model for the BMI of young adult students of Public Health Faculty of University of Indonesia. Subject/Method: This study used a cross sectional design, with a total sample of 132 respondents, consisted of 58 males and 74 females aged 21- 30. The dependent variable of this study was BMI, and the independent variables consisted of sex and anthropometric measurements, which included ulna length, arm length, tibia length, knee height, mid-upper arm circumference, and calf circumference. Anthropometric information was measured and recorded in a single sitting. Simple and multiple linear regression analysis were used to create the prediction equation for BMI. Results: The male respondents had an average BMI of 24.63 kg/m² and the female respondents had an average of 22.52 kg/m². A total of 17 variables were analysed for its correlation with BMI. Bivariate analysis showed the variable with the strongest correlation with BMI was Mid-Upper Arm Circumference/√Ulna Length (MUAC/√UL) (r = 0.926 for males and r = 0.886 for females). Furthermore, MUAC alone also has a very strong correlation with BMI (r = 0,913 for males and r = 0,877 for females). Prediction models formed from either MUAC/√UL or MUAC alone both produce highly accurate predictions of BMI. However, measuring MUAC/√UL is considered inconvenient, which may cause difficulties when applied on the field. Conclusion: The prediction model considered most ideal to estimate BMI is: Male BMI (kg/m²) = 1.109(MUAC (cm)) – 9.202 and Female BMI (kg/m²) = 0.236 + 0.825(MUAC (cm)), based on its high accuracy levels and the convenience of measuring MUAC on the field.

Keywords: body mass index, mid-upper arm circumference, prediction model, ulna length

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Authors: Arjun Prakash, Samanvitha H.

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BACKGROUND: Breast cancer is the commonest malignancy among women globally, with an estimated incidence of 2.3 million new cases as of 2020, representing 11.7% of all malignancies. As per Globocan data 2020, it accounted for 13.5% of all cancers and 10.6% of all cancer deaths in India. Early diagnosis and treatment can improve the overall morbidity and mortality, which necessitates the importance of differentiating benign from malignant breast masses. OBJECTIVE: The objective of the present study was to evaluate and compare the role of Digital Mammography (DM), B mode Ultrasound (USG), Shear Wave Elastography (SWE) and Strain Elastography (SE) in differentiating benign and malignant breast masses (ACR BI-RADS 3 - 5). Histo-Pathological Examination (HPE) was considered the Gold standard. MATERIALS & METHODS: We conducted a cross-sectional study on 53 patients with 64 breast masses over a period of 10 months. All patients underwent DM, USG, SWE and SE. These modalities were individually assessed to know their accuracy in differentiating benign and malignant masses. All Digital Mammograms were done using the Fujifilm AMULET Innovality Digital Mammography system and all Ultrasound examinations were performed on SAMSUNG RS 80 EVO Ultrasound system equipped with 2 to 9 MHz and 3 – 16 MHz linear transducers. All masses were subjected to HPE. Independent t-test and Chi-square or Fisher’s exact test were used to assess continuous and categorical variables, respectively. ROC analysis was done to assess the accuracy of diagnostic tests. RESULTS: Of 64 lesions, 51 (79.68%) were malignant and 13 (20.31%) (p < 0.0001) were benign. SE was the most specific (100%) (p < 0.0001) and USG (98%) (p < 0.0001) was the most sensitive of all the modalities. E max, E mean, E max ratio, E mean ratio and Strain Ratio of the malignant masses significantly differed from those of the benign masses. Maximum SWE value showed the highest sensitivity (88.2%) (p < 0.0001) among the elastography parameters. A combination of USG, SE and SWE had good sensitivity (86%) (p < 0.0001). CONCLUSION: A combination of USG, SE and SWE improves overall diagnostic yield in differentiating benign and malignant breast masses. Early diagnosis and treatment of breast carcinoma will reduce patient mortality and morbidity.

Keywords: digital mammography, breast cancer, ultrasound, elastography

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Authors: Hassan Taimoor, Piotr Krajewski, Piotr Gabrielzcak

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Being responsible for the largest source of energy-related emissions, the transportation sector is driven by more than half of global oil demand and total energy consumption, making it a crucial factor in tackling climate change and environmental degradation. The present study empirically tests the effectives of the energy-related tax (TXEN) in curbing transport-related carbon emissions (CO2TRANSP) in Organization for Economic Cooperation and Development (OECD) economies over the period of 1990-2020. Moreover, Green Finance (GF), Technology (TECH), and Gross domestic product (GDP) have also been added as explanatory factors which might affect CO2TRANSP emissions. The study employs the Method of Moment Quantile Regression (MMQR), an advance econometric technique to observe the variations along each quantile. Based on the results of the preliminary test, we confirm the presence of cross-sectional dependence and slope heterogeneity. Whereas the result of the panel unit root test report mixed order of variables’ integration. The findings reveal that rise in income level activates CO2TRANSP, confirming the first stage of Environmental Kuznet Hypothesis. Surprisingly, the present TXEN policies of OECD member states are not mature enough to tackle the CO2TRANSP emissions. However, the findings confirm that GF and TECH are solely responsible for the reduction in the CO2TRANSP. The outcomes of Bootstrap Quantile Regression (BSQR) further validate and support the earlier findings of MMQR. Based on the findings of this study, it is revealed that the current TXEN policies are too moderate, and an incremental and progressive rise in TXEN may help in a transition toward a cleaner and sustainable transportation sector in the study region.

Keywords: transport-related CO2 emissions, energy-related tax, green finance, technological development, oecd member states

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Authors: Showkat Ahmad Bhat, M. S. Bhatt

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The study evaluates the ex-post impact of institutional credit on agricultural output. It first examines the key factors that influence the accessibility of institutional credit by farm households. For quantitative analysis both program participant and non-participant respondents were drawn and cross-sectional survey data were collected from 412 households in Pulwama District of Jammu & Kashmir (India). Propensity Score Matching Method was employed to analyze the impact of the institutional credit on agricultural output. Results show that institutional credit has a positive and significant impact on the agricultural output measured in terms of farm income and crop productivity. To estimate the accessibility of credit, an examination of both demand side and supply side factors were carried out. The demand for credit was measured with respect to respondents who applied for credit. Supply side credit allocation measured in terms of the proportion of ‘credit amount’ farmers obtained. Logit and Two-limit Tobit Regression Models were used to investigate the determinants that influence the accessibility of formal credit for Demand for and supply of credit respectively. The estimated results suggested that the demand for credit is positively and significantly affected by the factors such as: age of the household head, formal education, membership, cash crop grown, farm size and saving account. All the variables were found significantly increasing the household’s likelihood to demand for and supply of credit from banks. However, the impact of these factors varies considerably across the credit markets. Factors which were found negatively and significantly influencing the accessibility of credit were: ‘square of the age’, household assets and rate of interest. The credit constraints analysis suggested that square of the age; household assets and rate of interest were the three most important factors that increased the probability of being constrained. The study finally discusses these results in detail and draws some recommendations.

Keywords: institutional credit, agriculture, propensity score matching logit model, Tobit model

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Authors: Zhang Qingzhong

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Though there exists an increasing number of research studies on the headquarters-subsidiary relationship, and within this context, there is a focus on subsidiaries' contributory role to multinational corporations (MNC), subsidiary autonomy, and the conditions under which autonomy exerts an effect on subsidiary performance still constitute a subject of debate in the literature. The objective of this research is to study the MNC subsidiary autonomy and performance relationship and the effect of subsidiary entrepreneurial orientation and trust on subsidiary autonomy in the China environment, a phenomenon that has not yet been studied. The research addresses the following three questions: (i) Is subsidiary autonomy associated with MNC subsidiary performance in the China environment? (ii) How do subsidiary entrepreneurship and its trust in headquarters affect the level of subsidiary autonomy and its relationship with subsidiary performance? (iii) Does subsidiary autonomy have a mediating effect on subsidiary performance with subsidiary’s entrepreneurship and trust in headquarters? In the present study, we have reviewed literature and conducted semi-structured interviews with multinational corporation (MNC) subsidiary senior executives in China. Building on our insights from the interviews and taking perspectives from four theories, namely the resource-based view (RBV), resource dependency theory, integration-responsiveness framework, and social exchange theory, as well as the extant articles on subsidiary autonomy, entrepreneurial orientation, trust, and subsidiary performance, we have developed a model and have explored the direct and mediating effects of subsidiary autonomy on subsidiary performance within the framework of the MNC. To test the model, we collected and analyzed data based on cross-industry two waves of an online survey from 102 subsidiaries of MNCs in China. We used structural equation modeling to test measurement, direct effect model, and conceptual framework with hypotheses. Our findings confirm that (a) subsidiary autonomy is positively related to subsidiary performance; (b) subsidiary entrepreneurial orientation is positively related to subsidiary autonomy; (c) subsidiary’s trust in headquarters has a positive effect on subsidiary autonomy; (d) subsidiary autonomy mediates the relationship between entrepreneurial orientation and subsidiary performance; (e) subsidiary autonomy mediates the relationship between trust and subsidiary performance. Our study highlights the important role of subsidiary autonomy in leveraging the resource of subsidiary entrepreneurial orientation and its trust relationship with headquarters to achieve high performance. We discuss the theoretical and managerial implications of the findings and propose directions for future research.

Keywords: subsidiary entrepreneurial orientation, trust, subsidiary autonomy, subsidiary performance

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Authors: H. Kalboussi, A. Aloui, W. Boughattas, M. Maoua, A. Brahem, S. Chatti, O. El Maalel, F. Debbabi, N. Mrizak, Y. Ben Youssef, A. Khlif, I. Bougmiza

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Background: In recent decades, the incidence of children's hematological malignancies has been increasing worldwide including Tunisia. Their severity is reflected in the importance of the medical, social and economic impact. This increase remains fully unexplained, and the involvement of genetic, environmental and occupational factors is strongly suspected. Materials and Methods: Our study is a cross-sectional survey of the type case-control conducted in the University Hospital of Farhat Hached of Sousse during the period ranging between 1 July 2011 and 30 June 2012,and which included children with acute leukemia compared to children unharmed by neoplastic disease . Cases and controls were matched by age and gender. Our objective was to: - Describe the socio-occupational characteristics of the parents of children with acute leukemia. - Identify potential occupational factors implicated in the genesis of acute leukemia. Result: The number of acute leukemia cases in the Hematology Service and day hospital of the University Hospital of Farhat Hached during the study period was 66 cases divided into in 40 boys and 26 girls with a sex ratio of 1.53. Our cases and controls were matched by age and gender. The risk of incidence of leukemia in children from smoking fathers was higher (p = 0.02, OR = 2.24, IC = [1.11 - 4.52]). The risk of incidence of leukemia in children from alcoholic fathers was higher with p = 0,009, OR = 3.9; CI = [1.33 - 11.39]. After adjusting different variables, the difference persisted significantly with pa = 0.03 and ORa = 3.5; ICa = [1.09 -11.6]. 25.7 % of cases had a family history of blood disease and neoplasia, whereas no control presented that. The difference was statistically significant (p = 0.006), OR = 1.46, IC = [1.38 - 1.56]. The parental occupational exposures associated to the occurrence of acute leukemia in children were: - Pesticides with a statistically significant difference (p = 0.03), OR = 2.94, IC = [1.06 - 8.13]. This difference persisted after adjustment with different variables pa = 0.01, ORa 3.75; ICa = [1.27 - 11.03]. - Cement without a statistically non-significant difference (p = 0.2). This difference has become significant after adjustment with the different variables pa = 0.03; ORa = 2.67; ICa = [1.06 - 6.7]. Conclusion: Parental exposure to occupational risk factors may play a role in the pathogenesis of acute leukemia in children.

Keywords: hematological malignancies, children, parents, occupational exposure

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Authors: N. M. Sani, I. Bitrus, A. M. Sarki, N. S. Mujahid

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Hepatitis is one of the neglected infectious diseases in sub Saharan Africa, and most of the available data is based on blood donors. Health care workers (HCWs) often get infected as a result of their close contact with patients. A cross-sectional study was conducted to determine the prevalence of hepatitis B and C among this group of professionals with a view to improving the quality of care to their patients. Hepatitis B and C infections pose a major public health problem worldwide. While infection is highest in the developing world particularly Asia and sub-Saharan Africa, healthcare workers are at higher risk of acquiring blood-borne viral infections, particularly Hepatitis B and C which are mostly asymptomatic. This study was aimed at determining the prevalence of Hepatitis B and C infections and associated risk factors among health care workers in Dutse Metropolis, Jigawa State - Nigeria. A standard rapid immuno-chromatographic technique i.e. rapid ELISA was used to screen all sera for Hepatitis B surface antigen (HBsAg) and Hepatitis C viral antibody (HCVAb) respectively. Strips containing coated antibodies and antigens to HBV and HCV respectively were removed from the foil. Strips were labeled according to samples. Using a separate disposable pipette, 2 drops of the sample (plasma) were added into each test strip and allowed to run across the absorbent pad. Results were read after 15 minutes. The prevalence of HBV and HCV infection in 100 healthcare workers was determined by testing the plasma collected from the clients during their normal checkup using HBsAg and HCVAb test strips. Results were subjected to statistical analysis using chi-square test. The prevalence of HBV among HCWs was 19 out of 100 (19.0%) and that of HCV was 5 out of 100 (5.0%) where in both cases, higher prevalence was observed among female nurses. It was also observed that all HCV positive cases were recorded among nurses only. The study revealed that nurses are at greater risk of contracting HBV and HCV due to their frequent contact with patients. It is therefore recommended that effective vaccination and other infection control measures be encouraged among healthcare workers.

Keywords: prevalence, hepatitis, viruses, healthcare workers, infection

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Authors: Einat Peles, Anat Sason, Ariel Claman, Gabriel Barkay, Miriam Adelson

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Individuals with opioid addiction are characterized as suffering from stress responses disturbance, including the hypothalamic-pituitary-adrenal (HPA) axis, and autonomic nervous system function. HPA axis is known to be stabilized during methadone maintenance treatment (MMT). Mindfulness (present-oriented, nonjudgmental awareness of cognitions, emotions, perceptions, and habitual behavioral reactions in daily life) counteracts stress. To our knowledge, the relation between perceived stress and mindfulness trait among MMT patients has never been studied. To measure indices of mindfulness and their relation to perceived stress among MMT patients, a cross-sectional random sample of current MMT patients was performed using questionnaires for perceived stress (PSS) and mindfulness trait (FFMQ- yields a total score and individual scores for five internally consistent mindfulness factors: Observing, Describing, Acting with awareness and consciousness, Non-judging the inner experience, Non-reactivity to the inner experience). Two additional groups were studied to serve as reference groups; Medical students that are known to suffer from stress, and Axis II psychiatric diagnosis patients that are known to characterized with poor mindfulness trait. Results: Groups included 41 MMT patients, 27 Axis II patients and 36 medical students. High perceived stressed (PSS≥18) defined among 61% of the MMT patients and 50% of the medical students. Highest mindfulness score observed among non-stressed MMT patients (153.5±17.2) followed by the groups of stressed MMT and non-stressed student (128.9±17.0 and 130.5±13.3 respectively), with the lowest score among stressed students (116.3±17.9) (multivariate analyses, corrected model p (F=14.3) < 0.0005, p (group) < 0.0005, p (stress) < 0.0005, p (interaction) =0.2). Linear inverse correlations were found between perceived stress score and mindfulness score among MMT patients (R=-0.65, p < 0.0005) and students (R=-0.51, p=0.002). Axis II patients had the lowest mindfulness score (103.4±25.3). Conclusion: High prevalence of high perceived stressed which characterized with poor mindfulness trait observed in both MMT patients and medical students, two different population groups. The effectiveness of mindfulness treatment in reducing stress and improve mindfulness trait should be evaluated to improve rehabilitation of MMT patients, and students success.

Keywords: mindfulness, stress, methadone maintenance treatment, medical students

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Authors: Noreen Noreen, Aamir Ijaz, Hamza Akhtar

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Background: Screening plays a major role to detect chromosomal abnormalities, Down syndrome, neural tube defects and other inborn diseases of the newborn. Serum biomarkers in the second trimester are useful in determining risk of most common chromosomal anomalies; these test include Alpha-fetoprotein (AFP), Human chorionic gonadotropin (hCG), Unconjugated Oestriol (UEȝ)and inhibin-A. Quadruple biomarkers are worth test in diagnosing the congenital pathology during pregnancy, these procedures does not form a part of routine health care of pregnant women in Pakistan, so the median value is lacking for population in Pakistan. Objective: To determine median values of biochemical maternal serum markers in local population during second trimester maternal screening. Study settings: Department of Chemical Pathology and Endocrinology, Armed Forces Institute of Pathology (AFIP) Rawalpindi. Methods: Cross-Sectional study for estimation of reference values. Non-probability consecutive sampling, 155 healthy pregnant women, of 30-40 years of age, will be included. As non-parametric statistics will be used, the minimum sample size is 120. Result: Total 155 women were enrolled into this study. The age of all women enrolled ranged from 30 to39 yrs. Among them, 39 per cent of women were less than 34 years. Mean maternal age 33.46±2.35 SD and maternal body weight were 54.98±2.88. Median value of quadruple markers calculated from 15-18th week of gestation that will be used for calculation of MOM for screening of trisomy21 in this gestational age. Median value at 15 week of gestation were observed hCG 36650 mIU/ml, AFP 23.3 IU/ml, UEȝ 3.5 nmol/L, InhibinA 198 ng/L, at 16 week of gestation hCG 29050 mIU/ml, AFP 35.4 IU/ml, UEȝ 4.1 nmol/L, InhibinA 179 ng/L, at 17 week of gestation hCG 28450 mIU/ml, AFP 36.0 IU/ml, UEȝ 6.7 nmol/L, InhibinA 176 ng/L and at 18 week of gestation hCG 25200 mIU/ml, AFP 38.2 IU/ml, UEȝ 8.2 nmol/L, InhibinA 190 ng/L respectively.All the comparisons were significant (p-Value <0.005) with 95% confidence Interval (CI) and level of significance of study set by going through literature and set at 5%. Conclusion: The median values for these four biomarkers in Pakistani pregnant women can be used to calculate MoM.

Keywords: screening, down syndrome, quadruple test, second trimester, serum biomarkers

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Authors: Lynn Louis, Bor Shin Chee, Marion McAfee, Michael Nugent

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This article aims to develop a sustained release formulation of microspheres containing the mTOR inhibitor Everolimus (EVR) using Polyvinyl alcohol (PVA) to enhance the bioavailability of the drug and to overcome poor solubility characteristics of Everolimus. This paper builds on recent work in the manufacture of microspheres using the sessile droplet technique by freezing the polymer-drug solution by suspending the droplets into pre-cooled ethanol vials immersed in liquid nitrogen. The spheres were subjected to 6 freezing cycles and 3 freezing cycles with thawing to obtain proper geometry, prevent aggregation, and achieve physical cross-linking. The prepared microspheres were characterised for surface morphology by SEM, where a 3-D porous structure was observed. The in vitro release studies showed a 62.17% release over 12.5 days, indicating a sustained release due to good encapsulation. This result is comparatively much more than the 49.06% release achieved within 4 hours from the solvent cast Everolimus film as a control with no freeze-thaw cycles performed. The solvent cast films were made in this work for comparison. A prolonged release of Everolimus using a polymer-based drug delivery system is essential to reach optimal therapeutic concentrations in treating SEGA tumours without systemic exposure. These results suggest that the combination of PVA and Everolimus via a rheological synergism enhanced the bioavailability of the hydrophobic drug Everolimus. Physical-chemical characterisation using DSC and FTIR analysis showed compatibility of the drug with the polymer, and the stability of the drug was maintained owing to the high molecular weight of the PVA. The obtained results indicate that the developed PVA/EVR microsphere is highly suitable as a potential drug delivery system with improved bioavailability in treating Subependymal Giant cell astrocytoma (SEGA).

Keywords: drug delivery system, everolimus, freeze-thaw cycles, polyvinyl alcohol

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Authors: Faisal G. Khamis, Ghaleb A. El-Refae

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Many researchers have studied socioeconomic, health, and security variables in the developed countries; however, very few studies used multivariate analysis in developing countries. The current study contributes to the scarce literature about the determinants of the variance in socioeconomic, health, and security factors. Questions raised were whether the independent variables (IVs) of governorate and year impact the socioeconomic, health, and security dependent variables (DVs) in Jordan, whether the marginal mean of each DV in each governorate and in each year is significant, which governorates are similar in difference means of each DV, and whether these DVs vary. The main objectives were to determine the source of variances in DVs, collectively and separately, testing which governorates are similar and which diverge for each DV. The research design was time series and cross-sectional analysis. The main hypotheses are that IVs affect DVs collectively and separately. Multivariate and univariate analyses of variance were carried out to test these hypotheses. The population of 12 governorates in Jordan and the available data of 15 years (2000–2015) accrued from several Jordanian statistical yearbooks. We investigated the effect of two factors of governorate and year on the four DVs of divorce rate, mortality rate, unemployment percentage, and crime rate. All DVs were transformed to multivariate normal distribution. We calculated descriptive statistics for each DV. Based on the multivariate analysis of variance, we found a significant effect in IVs on DVs with p < .001. Based on the univariate analysis, we found a significant effect of IVs on each DV with p < .001, except the effect of the year factor on unemployment was not significant with p = .642. The grand and marginal means of each DV in each governorate and each year were significant based on a 95% confidence interval. Most governorates are not similar in DVs with p < .001. We concluded that the two factors produce significant effects on DVs, collectively and separately. Based on these findings, the government can distribute its financial and physical resources to governorates more efficiently. By identifying the sources of variance that contribute to the variation in DVs, insights can help inform focused variation prevention efforts.

Keywords: ANOVA, crime, divorce, governorate, hypothesis test, Jordan, MANOVA, means, mortality, unemployment, year

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