Search results for: Young Children.

Authors: Orkide Donma, Mustafa M. Donma

Abstract:

Association between insulin resistance (IR) and hematological parameters has long been a matter of interest. Within this context, body mass index (BMI), red blood cells, white blood cells and platelets were involved in this discussion. Parameters related to platelets associated with IR may be useful indicators for the identification of IR. Platelet indices such as mean platelet volume (MPV), platelet distribution width (PDW) and plateletcrit (PCT) are being questioned for their possible association with IR. The aim of this study was to investigate the association between platelet (PLT) count as well as PLT indices and the surrogate indices used to determine IR in morbid obese (MO) children. A total of 167 children participated in the study. Three groups were constituted. The number of cases was 34, 97 and 36 children in the normal BMI, MO and metabolic syndrome (MetS) groups, respectively. Sex- and age-dependent BMI-based percentile tables prepared by World Health Organization were used for the definition of morbid obesity. MetS criteria were determined. BMI values, homeostatic model assessment for IR (HOMA-IR), alanine transaminase-to-aspartate transaminase ratio (ALT/AST) and diagnostic obesity notation model assessment laboratory (DONMA-lab) index values were computed. PLT count and indices were analyzed using automated hematology analyzer. Data were collected for statistical analysis using SPSS for Windows. Arithmetic mean and standard deviation were calculated. Mean values of PLT-related parameters in both control and study groups were compared by one-way ANOVA followed by Tukey post hoc tests to determine whether a significant difference exists among the groups. The correlation analyses between PLT as well as IR indices were performed. Statistically significant difference was accepted as p-value < 0.05. Increased values were detected for PLT (p < 0.01) and PCT (p > 0.05) in MO group compared to those observed in children with N-BMI. Significant increases for PLT (p < 0.01) and PCT (p < 0.05) were observed in MetS group in comparison with the values obtained in children with N-BMI (p < 0.01). Significantly lower MPV and PDW values were obtained in MO group compared to the control group (p < 0.01). HOMA-IR (p < 0.05), DONMA-lab index (p < 0.001) and ALT/AST (p < 0.001) values in MO and MetS groups were significantly increased compared to the N-BMI group. On the other hand, DONMA-lab index values also differed between MO and MetS groups (p < 0.001). In the MO group, PLT was negatively correlated with MPV and PDW values. These correlations were not observed in the N-BMI group. None of the IR indices exhibited a correlation with PLT and PLT indices in the N-BMI group. HOMA-IR showed significant correlations both with PLT and PCT in the MO group. All of the three IR indices were well-correlated with each other in all groups. These findings point out the missing link between IR and PLT activation. In conclusion, PLT and PCT may be related to IR in addition to their identities as hemostasis markers during morbid obesity. Our findings have suggested that DONMA-lab index appears as the best surrogate marker for IR due to its discriminative feature between morbid obesity and MetS.

Keywords: Children, insulin resistance, metabolic syndrome, plateletcrit, platelet indices.

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Authors: Mustafa M. Donma

Abstract:

Metabolic syndrome (MetS) is characterized by a series of biochemical, physiological and anthropometric indicators and is a life-threatening health problem due to its close association with chronic diseases such as obesity, diabetes mellitus, hypertension, cancer and cardiovascular diseases. The syndrome deserves great interest both in adults and children. Particularly, children with morbid obesity have a great tendency to develop the disease. The diagnostic decision is not so easy and may not be complete particularly in the pediatric population. Therefore, preventive measures should be considered at this stage. The aim of the study was to develop a MetS index capable of predicting MetS, while children are at the morbid obesity stage. This study was performed on morbid obese (MO) children, which were divided into two groups. MO children, who do not possess MetS criteria comprised the first group (n = 44). The second group was composed of children with MetS diagnosis (n = 42). Anthropometric measurements including weight, height, waist circumference (WC), hip C, head C, neck C, biochemical tests including fasting blood glucose (FBG), insulin (INS), triglycerides (TRG), high density lipoprotein cholesterol (HDL-C) and blood pressure measurements (systolic (SBP) and diastolic (DBP)) were performed. Body fat percentage (BFP) values were determined by TANITA’s Bioelectrical Impedance Analysis technology. Body mass index and MetS indices were calculated. Descriptive statistics including median values, t-test, Mann Whitney U test, correlation-regression analysis were performed within the scope of data evaluation using the statistical package program, SPSS. Statistically significant mean differences were determined by a p value smaller than 0.05. Median values for MetSI and ADMI in MO (MetS-) and MO (MetS+) groups were calculated as 25.9 and 36.5 and 74.0 and 106.1, respectively. Corresponding mean ± SD values for BFPs were 35.9 ± 7.1 and 38.2 ± 7.7 in groups. Correlation analysis of these two indices with corresponding general BFP values exhibited significant association with ADMI, close to significance with MetSI in MO group. Any significant correlation was found with neither of the indices in MetS group. In conclusion, important associations observed with MetS indices in MO group were quite meaningful. The presence of these associations in MO group was important for showing the tendency towards the development of MetS in MO (MetS-) participants. The other index, ADMI, was more helpful for predictive purpose.

Keywords: Body fat percentage, child obesity, metabolic syndrome index, morbid obesity.

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Authors: Mustafa M. Donma, Orkide Donma

Abstract:

Obesity in children particularly draws attention, because it may threaten the individual’s future life due to many chronic diseases it may lead to. Most of these diseases including obesity itself altogether are related to inflammation. For this reason, inflammation-related parameters gain importance. Within this context, complete blood cell counts, ratios or indices derived from these counts have recently found some platform to be used as inflammatory markers. So far, mostly adipokines were investigated within the field of obesity. Metabolic inflammation is closely associated with cellular dysfunction. In this study, hematologic inflammatory markers and cytokines produced predominantly by the liver (fibroblast growth factor-21 (FGF-21) and fetuin A) were investigated in pediatric obesity. Two groups were constituted from 76 obese children based on World Health Organization criteria. Group 1 was composed of children, whose age- and sex-adjusted body mass index (BMI) percentiles were between 95 and 99. Group 2 consists of children, who are above 99th percentile. The first and the latter groups were defined as obese (OB) and morbid obese (MO). Anthropometric measurements of the children were performed. Informed consent forms and the approval of the institutional ethics committee were obtained. Blood cell counts and ratios were determined by automated hematology analyzer. The related ratios and indexes were calculated. Statistical evaluation of the data was performed by SPSS program. There was no statistically significant difference in terms of neutrophil-to lymphocyte ratio, monocyte-to-high density lipoprotein cholesterol ratio and platelet-to-lymphocyte ratio between the groups. Mean platelet volume and platelet distribution width values were decreased (p < 0.05), total platelet count, red cell distribution width (RDW) and systemic immune inflammation index values were increased (p < 0.01) in MO group. Both hepatokines were increased in the same group, however increases were not statistically significant. In this group, also a strong correlation was calculated between FGF-21 and RDW when controlled by age, hematocrit, iron and ferritin (r = 0.425; p < 0.01). In conclusion, the association between RDW, a hematologic inflammatory marker, and FGF-21, an inflammation-related hepatokine, found in MO group is an important finding discriminating between OB and MO children. This association is even more powerful when controlled by age and iron-related parameters.

Keywords: Childhood obesity, fetuin A, fibroblast growth factor-21, hematologic markers, red cell distribution width.

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Authors: Sh. Khoshemehry, M. E. Bahram, M. J. Pourvaghar

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Sport has found a special place as an effective phenomenon in all societies of the contemporary world. The relationship between physical activity and exercise with different sciences has provided new fields for human study. The range of issues related to exercise and physical education is such that it requires specialized sciences and special studies. In this article, the psychological and social sections of exercise have been investigated for children and adults. It can be used for anyone in different age groups. Exercise and regular physical movements have a great impact on the mental and social health of the individual in addition to body health. It affects the individual's adaptability in society and his/her personality. Exercise affects the treatment of diseases such as depression, anxiety, stress, body image, and memory. Exercise is a safe haven for young people to achieve the optimum human development in its shelter. The effects of sensorimotor skills on mental actions and mental development are such a way that many psychologists and sports science experts believe these activities should be included in training programs in the first place. Familiarity of students and scholars with different programs and methods of sensorimotor activities not only causes their mental actions; but also increases mental health and vitality, enhances self-confidence and, therefore, mental health.

Keywords: Anxiety, mental health, physical activity, serotonin.

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Authors: Mustafa M. Donma

Abstract:

Obesity increases the risk of elevated blood pressure, which is a metabolic syndrome (MetS) component. Waist circumference (WC) is accepted as an indispensable parameter for the evaluation of these health problems. The close relationship of height with blood pressure values revealed the necessity of including height in tense indices. The association of tense indices with WC has also become an increasingly important topic. The purpose of this study was to develop a tense index that could contribute to differential diagnosis of MetS more than the indices previously introduced. 194 children, aged 6-11 years, were considered to constitute four groups. The study was performed on normal weight (Group 1), overweight + obese (Group 2), morbid obese [without (Group 3) and with (Group 4) MetS findings] children. Children were included in the groups according to the recommendations of World Health Organization based on age- and gender-dependent body mass index percentiles. For MetS group, MetS components well-established before were considered. Anthropometric measurements as well as blood pressure values were taken. Statistical calculations were performed. 0.05 was accepted as the p value indicating statistical significance. There were no statistically significant differences between the groups for pulse pressure, systolic-to-diastolic pressure ratio and tense index. Increasing values were observed from Group 1 to Group 4 in terms of mean arterial blood pressure and ADTI, which was highly correlated with WC in all groups except Group 1. Both tense index and ADTI exhibited significant correlations with WC in Group 3. However, in Group 4, ADTI, which includes height parameter in the equation, was unique in establishing a strong correlation with WC. In conclusion, ADTI was suggested as a tense index while investigating children with MetS.

Keywords: Blood pressure, metabolic syndrome, waist circumference.

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Authors: Soo-young Ye, Jun-mo Park, Jae-hyung Kim, Jae-hee Jung, Ah-young Jeon, In-cheol Kim, Jung-man Son, Ki-gon Nam, Seong-wan Baik, Jung-hoon Ro, Gye-rok Jeon

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The linear SEF (Spectral Edge Frequency) parameter and spectrum analysis method can not reflect the non-linear of EEG. This method can not contribute to acquire real time analysis and obtain a high confidence in the clinic due to low discrimination. To solve the problems, the development of a new index is carried out using the bispectrum analyzing the EEG(electroencephalogram) including the non-linear characteristic. After analyzing the bispectrum of the 2 dimension, the most significant power spectrum density peaks appeared abundantly at the specific area in awakening and anesthesia state. These points are utilized to create the new index since many peaks appeared at the specific area in the frequency coordinate. The measured range of an index was 0-100. An index is 20-50 at an anesthesia, while the index is 90-60 at the awake. New index could afford to effectively discriminate the awake and anesthesia state.

Keywords: Bispectrum, anesthesia depth, EEG, SEF.

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Authors: Young-Jin Baik, Minsung Kim, Young-Soo Lee, Ki-Chang Chang, Seong-Ryong Park

Abstract:

The compression-absorption heat pump (C-A HP), one of the promising heat recovery equipments that make process hot water using low temperature heat of wastewater, was evaluated by computer simulation. A simulation program was developed based on the continuity and the first and second laws of thermodynamics. Both the absorber and desorber were modeled using UA-LMTD method. In order to prevent an unfeasible temperature profile and to reduce calculation errors from the curved temperature profile of a mixture, heat loads were divided into lots of segments. A single-stage compressor was considered. A compressor cooling load was also taken into account. An isentropic efficiency was computed from the map data. Simulation conditions were given based on the system consisting of ordinarily designed components. The simulation results show that most of the total entropy generation occurs during the compression and cooling process, thus suggesting the possibility that system performance can be enhanced if a rectifier is introduced.

Keywords: Waste heat recovery, Heat Pump.

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Authors: R. Ziaie Moayed , S. Tamassoki , E. Izadi

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Investigation of sandy clay behavior is important since urban development demands mean that sandy clay areas are increasingly encountered, especially for transportation infrastructures. This paper presents the results of the finite element analysis of the direct shear test (under three vertical loading 44, 96 and 192 kPa) and discusses the effects of different parameters such as cohesion, friction angle and Young's modulus on the shear strength of sandy clay. The numerical model was calibrated against the experimental results of large-scale direct shear tests. The results have shown that the shear strength was increased with increase in friction angle and cohesion. However, the shear strength was not influenced by raising the friction angle at normal stress of 44 kPa. Also, the effect of different young's modulus factors on stress-strain curve was investigated.

Keywords: Shear strength, Finite element analysis, Large direct shear test, Sandy clay.

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Authors: Hasan Atak, Figen Çok

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Emerging Adulthood, the period during ages 18 to 25, is a new conceptualitation proposed by Arnett which is especially prevalent in the industrialized countries. Turkey is basically a developing country having a young population structure. Investigating the presence of such a life period in such a culture might be helpful in understanding educational and psychological needs of people who are in their twenties. With the aim of investigating Emerging Adulthood in Turkey, a well-known instrument (IDEA, 2003) was adapted to Turkish language and Turkish culture. The scale was administered to 296 participants between 15 and 34 ages and validity and reliability were conducted. Exploratory factor analysis revealed three subscales. Reliability coefficients of the scale (Cronbach a) was found as .69. Test-retest reliability coefficients was found for the scale as .81. Finally, “The IDEA" with 20 items was obtained to be used in the Turkish population. The instrument is ready to be administered among Turkish young people for the investigation of transition to adulthood, and whether such a emerging adulthood period really existed.

Keywords: Adaptation, Emerging Adulthood, Turkey, IDEA.

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Authors: Mustafa M. Donma, Orkide Donma

Abstract:

Obesity is known to be associated with many clinically important diseases including metabolic syndrome (MetS). Vitamin B₁₂ plays essential roles in fat and protein metabolisms and its cooperation with vitamin B₉ is well-known. The aim of this study is to investigate the possible contributions as well as associations of these micronutrients upon obesity and MetS during childhood. A total of 128 children admitted to Namik Kemal University, Medical Faculty, Department of Pediatrics Outpatient Clinics were included into the scope of this study. The mean age±SEM of 92 morbid obese (MO) children and 36 with MetS were 118.3±3.8 months and 129.5±6.4 months, respectively (p > 0.05). The study was approved by Namık Kemal University, Medical Faculty Ethics Committee. Written informed consent forms were obtained from the parents. Demographic features and anthropometric measurements were recorded. WHO BMI-for age percentiles were used. The values above 99 percentile were defined as MO. Components of MetS [waist circumference (WC), fasting blood glucose (FBG), triacylglycerol (TRG), high density lipoprotein cholesterol (HDL-Chol), systolic pressure (SP), diastolic pressure (DP)] were determined. Routine laboratory tests were performed. Serum vitamin B₁₂ concentrations were measured using electrochemiluminescence immunoassay. Vitamin B₉ was analyzed by an immunoassay analyzer. Values for vitamin B₁₂ < 148 pmol/L, 148-221 pmol/L, > 221 pmol/L were accepted as low, borderline and normal, respectively. Vitamin B₉ levels ≤ 4 mcg/L defined deficiency state. Statistical evaluations were performed by SPSSx Version 16.0. p≤0.05 was accepted as statistical significance level. Statistically higher body mass index (BMI), WC, hip circumference (C) and neck C were calculated in MetS group compared to children with MO. No difference was noted for head C. All MetS components differed between the groups (SP, DP p < 0.001; WC, FBG, TRG p < 0.01; HDL-Chol p < 0.05). Significantly decreased vitamin B₉ and vitamin B₁₂ levels were detected (p < 0.05) in children with MetS. In both groups percentage of folate deficiency was 5.5%. No cases were below < 148 pmol/L. However, in MO group 14.3% and in MetS group 22.2% of the cases were of borderline status. In MO group B₁₂ levels were negatively correlated with BMI, WC, hip C and head C, but not with neck C. WC, hip C, head C and neck C were all negatively correlated with HDL-Chol. None of these correlations were observed in the group of children with MetS. Strong positive correlation between FBG and insulin as well as strong negative correlation between TRG and HDL-Chol detected in MO children were lost in MetS group. Deficiency state end-products of both B₉ and B₁₂ may interfere with the expected profiles of MetS components. In this study, the alterations in MetS components affected vitamin B₁₂ metabolism and also its associations with anthropometric body measurements. Further increases in vitamin B₁₂ and vitamin B₉ deficiency in MetS associated with the increased vitamin B₁₂ as well as vitamin B₉ deficiency metabolites may add to MetS parameters.

Keywords: Children, cobalamin, folate, metabolic syndrome, obesity.

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Authors: Mustafa M. Donma, Orkide Donma

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Obesity is a low-grade inflammatory state. Childhood obesity is a multisystem disease, which is associated with a number of complications as well as potentially negative consequences. Gender is an important universal risk factor for many diseases. Hematological indices differ significantly by gender. This should be considered during the evaluation of obese children. The aim of this study is to detect hematologic indices that differ by gender in morbid obese (MO) children. A total of 134 MO children took part in this study. The parents filled an informed consent form and the approval from the Ethics Committee of Namik Kemal University was obtained. Subjects were divided into two groups based on their genders (64 females aged 10.2±3.1 years and 70 males aged 9.8±2.2 years; p ≥ 0.05). Waist-to-hip as well as head-to-neck ratios and body mass index (BMI) values were calculated. The children, whose WHO BMI-for age and sex percentile values were > 99 percentile, were defined as MO. Hematological parameters [haemoglobin, hematocrit, erythrocyte count, mean corpuscular volume, mean corpuscular haemoglobin, mean corpuscular haemoglobin concentration, red blood cell distribution width, leukocyte count, neutrophil %, lymphocyte %, monocyte %, eosinophil %, basophil %, platelet count, platelet distribution width, mean platelet volume] were determined by the automatic hematology analyzer. SPSS was used for statistical analyses. P ≤ 0.05 was the degree for statistical significance. The groups included children having mean±SD value of BMI as 26.9±3.4 kg/m² for males and 27.7±4.4 kg/m² for females (p ≥ 0.05). There was no significant difference between ages of females and males (p ≥ 0.05). Males had significantly increased waist-to-hip ratios (0.95±0.08 vs 0.91±0.08; p=0.005) and mean corpuscular hemoglobin concentration values (33.6±0.92 vs 33.1±0.83; p=0.001) compared to those of females. Significantly elevated neutrophil (4.69±1.59 vs 4.02±1.42; p=0.011) and neutrophil-to-lymphocyte ratios (1.70±0.71 vs 1.39±0.48; p=0.004) were detected in females. There was no statistically significant difference between groups in terms of C-reactive protein values (p ≥ 0.05). Adipose tissue plays important roles during the development of obesity and associated diseases such as metabolic syndrom and cardiovascular diseases (CVDs). These diseases may cause changes in complete blood cell count parameters. These alterations are even more important during childhood. Significant gender effects on the changes of neutrophils, one of the white blood cell subsets, were observed. The findings of the study demonstrate the importance of considering gender in clinical studies. The males and females may have distinct leukocyte-trafficking profiles in inflammation. Female children had more circulating neutrophils, which may be the indicator of an increased risk of CVDs, than male children within this age range during the late stage of obesity. In recent years, females represent about half of deaths from CVDs; therefore, our findings may be the indicator of the increasing tendency of this risk in females starting from childhood.

Keywords: Children, gender, morbid obesity, neutrophil-to-lymphocyte ratio.

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Authors: Mustafa M. Donma, Orkide Donma

Abstract:

Obesity is associated with cardiovascular disease risk factors and metabolic syndrome (MetS). In this study, associations between adipokines and adipokine as well as obesity indices were evaluated. Plasma adipokine levels may exhibit variations according to body adipose tissue mass. Besides, upon consideration of obesity as an inflammatory disease, adipokines may play some roles in this process. The ratios of proinflammatory adipokines to adiponectin may act as highly sensitive indicators of body adipokine status. The aim of the study is to present some adipokine indices, which are thought to be helpful for the evaluation of childhood obesity and also to determine the best discriminators in the diagnosis of MetS. 80 prepubertal children (aged between 6-9.5 years) included in the study were divided into three groups; 30 children with normal weight (NW), 25 morbid obese (MO) children and 25 MO children with MetS. Physical examinations were performed. Written informed consent forms were obtained from the parents. The study protocol was approved by Ethics Committee of Namik Kemal University Medical Faculty. Anthropometric measurements, such as weight, height, waist circumference (C), hip C, head C, neck C were recorded. Values for body mass index (BMI), diagnostic obesity notation model assessment Index-II (D2 index) as well as waist-to-hip, head-to-neck ratios were calculated. Adiponectin, resistin, leptin, chemerin, vaspin, progranulin assays were performed by ELISA. Adipokine-to-adiponectin ratios were obtained. SPSS Version 20 was used for the evaluation of data. p values ≤ 0.05 were accepted as statistically significant. Values of BMI and D2 index, waist-to-hip, head-to-neck ratios did not differ between MO and MetS groups (p ≥ 0.05). Except progranulin (p ≤ 0.01), similar patterns were observed for plasma levels of each adipokine. There was not any difference in vaspin as well as resistin levels between NW and MO groups. Significantly increased leptin-to-adiponectin, chemerin-to-adiponectin and vaspin-to-adiponectin values were noted in MO in comparison with those of NW. The most valuable adipokine index was progranulin-to-adiponectin (p ≤ 0.01). This index was strongly correlated with vaspin-to-adiponectin ratio in all groups (p ≤ 0.05). There was no correlation between vaspin-to-adiponectin and chemerin-to--adiponectin in NW group. However, a correlation existed in MO group (r = 0.486; p ≤ 0.05). Much stronger correlation (r = 0.609; p ≤ 0.01) was observed in MetS group between these two adipokine indices. No correlations were detected between vaspin and progranulin as well as vaspin and chemerin levels. Correlation analyses showed a unique profile confined to MetS children. Adiponectin was found to be correlated with waist-to-hip (r = -0.435; p ≤ 0.05) as well as head-to-neck (r = 0.541; p ≤ 0.05) ratios only in MetS children. In this study, it has been investigated if adipokine indices have priority over adipokine levels. In conclusion, vaspin-to-adiponectin, progranulin-to-adiponectin, chemerin-to-adiponectin along with waist-to-hip and head-to-neck ratios were the optimal combinations. Adiponectin, waist-to-hip, head-to-neck, vaspin-to-adiponectin, chemerin-to-adiponectin ratios had appropriate discriminatory capability for MetS children.

Keywords: Adipokine indices, metabolic syndrome, obesity indices, pediatric obesity.

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Authors: Mustafa M. Donma, Orkide Donma

Abstract:

Cardiovascular (CV) pathology is one of the expected consequences of excessive fat gain. The role of zinc (Zn) in thyroid hormone metabolism (THM) is a matter of debate. Both thyroid stimulating hormone (TSH) and Zn levels are subject to variation in obese individuals. Zn participates in THM. It is closely related to TSH. Since thyroid hormones are required for Zn absorption, hypothyroidism can lead to Zn deficiency and vice versa. Zn exhibits protective effects on CV health and it is inversely correlated with CV markers in childhood obesity. The association between subclinical hypothyroidism (SCHT) and metabolic disorders is under investigation due to its clinical importance. SCHT is defined as the elevated serum TSH levels in the presence of normal free thyroxin (T4) concentrations. The aim of this study is to evaluate the associations between TSH levels and Zn concentrations in SCHT cases detected in morbid obese (MO) children with and without metabolic syndrome (MetS) [(MOMetS+ and MOMetS-)], respectively. 42 children were present in each study group. Informed consent forms were obtained. Tekrdag Namik Kemal University Faculty of Medicine Non-Interventional Clinical Investigations Ethical Committee approved the study protocol. World Health Organization criteria were used for obesity classification. Children with age and sex-dependent body mass index percentile values above 99 were defined as MO. Children exhibiting at least two of MetS criteria were included in MOMetS+ group. Elevated fasting blood glucose, elevated triglycerides (TRG)/decreased high density lipoprotein-cholesterol (HDL-C) concentrations, elevated blood pressure values in addition to central obesity were listed as MetS criteria. Anthropometric measures were recorded. Routine biochemical analyses were performed. In MOMetS- group 13, in MOMetS+ group 15 children were with SCHT. Statistical analyses were performed. p < 0.05 was accepted as statistically significant. In MOMetS- and MOMetS+ groups, TSH levels were 4.1 ± 2.9 mU/L and 4.6 ± 3.1 mU/L, respectively. Corresponding values for SCHT cases were 7.3 ± 3.1 mU/L and 8.0 ± 2.7 mU/L. Free T4 levels were within normal limits. Zn concentrations were negatively correlated with TSH levels in both groups. Significant negative correlation calculated in MOMetS+ group (r = -0.909; p < 0.001) was much stronger than that found in MOMetS- group (r = -0.706; p < 0.05). This strong correlation (r = -0.909; p < 0.001) calculated for cases with SCHT in MOMetS+ group was much lower in the same group (r = -0.793; p < 0.001) when all cases were considered. In conclusion, the presence of strong correlations between TSH and Zn in SCHT in both MOMetS- and MOMetS+ groups have pointed out that MO children were under the threat of CV pathologies. The detection of the much stronger correlation in MOMetS+ group in comparison with the correlation found in MOMetS- group was the indicator of greater CV risk due to the presence of MetS. In MOMetS+ group, correlation in SCHT cases found higher than correlation calculated for all cases confirmed much higher CV risk due to the contribution of SCHT.

Keywords: Cardiovascular risk, child morbid obesity, subclinical hypothyroidism, zinc.

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Authors: Lucky Farha, Martha L. Hall

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The current adaptive clothing brands are limited in numbers and specific categories. This study explores clothing challenges for children with Down syndrome and factors that influence their perception of adaptive clothing brands. Another aim of this study was to explore brands' challenges in the adaptive business and factors that influence their perceptions towards the adaptive market. In order to determine the market barriers affecting adaptive target market needs, we applied Technology Acceptance Model. After interviewing and surveying parents/caregivers having children with Down syndrome and current adaptive brands, the results found education as the significant gap in the adaptive clothing market yet to be overcome. Based on the finding, several recommendations were suggested to improve the current barriers in the adaptive clothing market.

Keywords: Adaptive fashion, disability, functional clothing, clothing needs assessment, Down syndrome, clothing challenge.

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Authors: P. Kowalska, P. Gabka, K. Kamieniarz, M. Kamieniarz, W. Stryla, P. Guzik, T. Krauze

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We have developed a computer program consisting of 6 subtests assessing the children hand dexterity applicable in the rehabilitation medicine. We have carried out a normative study on a representative sample of 285 children aged from 7 to 15 (mean age 11.3) and we have proposed clinical standards for three age groups (7-9, 9-11, 12-15 years). We have shown statistical significance of differences among the corresponding mean values of the task time completion. We have also found a strong correlation between the task time completion and the age of the subjects, as well as we have performed the test-retest reliability checks in the sample of 84 children, giving the high values of the Pearson coefficients for the dominant and non-dominant hand in the range 0.740.97 and 0.620.93, respectively. A new MATLAB-based programming tool aiming at analysis of cardiologic RR intervals and blood pressure descriptors, is worked out, too. For each set of data, ten different parameters are extracted: 2 in time domain, 4 in frequency domain and 4 in Poincaré plot analysis. In addition twelve different parameters of baroreflex sensitivity are calculated. All these data sets can be visualized in time domain together with their power spectra and Poincaré plots. If available, the respiratory oscillation curves can be also plotted for comparison. Another application processes biological data obtained from BLAST analysis.

Keywords: Biomedical data base processing, Computer software, Hand dexterity, Heart rate and blood pressure variability.

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Authors: S. Brahim, M. S. Mohamad, E. Zakaria, N. Sarnon@Kusenin

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This study aimed to explore the practical experience of child welfare caseworkers and professionalism in child case management in Malaysia. This paper discussed the specific social work practice competency and the challenges faced by child caseworkers in the fieldwork. This research was qualitative with grounded theory approach. Four sessions of focused group discussion (FGD) were conducted involving a total of 27 caseworkers (child protector and probation officers) in the Klang Valley. The study found that the four basic principles of knowledge in child case management namely: 1. knowledge in child case management; 2. professional values of caseworkers towards children; 3. skills in managing cases; and 4. culturally competent practice in child case management. In addition, major challenges faced by the child case manager are the capacity and commitment of the family in children’s rehabilitation program, the credibility of caseworkers are being challenged, and the challenges of support system from intra and interagency. This study is important for policy makers to take into account the capacity and the needs of the child’s caseworker in accordance with the national social work competency framework. It is expected that case management services for children will improve systematically in line with national standards.

Keywords: Social work practice, child case management, competency-based knowledge, and professionalism.

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Authors: Erten Gokce

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This study was carried out in Ankara, the capital city of Turkey, in order to determine how people living in the slums of Ankara benefit from educational equality. Within the scope of the research, interviews were made with 64 families whose children have been getting education from the primary schools of these parts and the data of the study was collected by the researcher. The results of the research demonstrate that the children getting education in the slums of Ankara can not experience educational equality and justice. The results of this study show that the opportunities of the schools in the slums of Ankara are very limited, so the individuals in these districts can not equally benefit from the education. The families are aware of the problem they are faced with. KeywordsDiscrimination, inequality, primary education, slums of Turkey.

Keywords: Discrimination, inequality, primary education, slums of Turkey.

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Authors: C. Sridawruang

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Young people today has sexual activities differing from those of earlier generations, in that teenagers are likely to have multiple partners, and are frequently in short-term relationships or with partners that are not well known to them. The proportion of teenage mothers in Thailand has increased. Young people were not specifically addressed during the overall very successful HIV-prevention campaigns. Because of this missed opportunity, they are still unaware of the risk of unsafe sexual behavior. Aims: To describe the reproductive health care services in perspectives of rural Thai teenagers Methods: This survey was one part of a mixed method approach taken using survey and focus groups with 439 teenagers aged 12-18 years in 5 villages, Udon Thani, Thailand. The standard questionnaire survey had been used for collecting data. The numeric data was checked and analyzed by using descriptive statistics. Results: Most teenager respondents stated that they do not know where sexual reproductive health services provided for them. Most teenagers felt difficult to access and talk with health staff about sexual related issues. They stated that discussing, or consulting with health providers might not be safe. Teenagers might lose opportunities to access and get advice from health care services. The mean knowledge score of contraception and condom reproductive was 6.34 from a total score 11. Most teenagers especially girls expressed a need for counseling services and reported a need for telephone services. Conclusions: The need of appropriate information focusing on sexual relationships and contraception should be designed to help young people make wise decisions and there should be set health care services for Thai teenagers to make sure that teenagers could access easily. Health care providers need to be trained to improve their knowledge, attitudes and skills in reproductive health care practices for Thai teenagers.

Keywords: Youth friendly health services, rural, Thai, teenagers.

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Authors: Qing Liu, Jean-Fabien Capsal, Claude Richard

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In this current contribution, authors are dedicated to investigate influence of the crystal lamellae orientation on electromechanical behaviors of relaxor ferroelectric Poly (vinylidene fluoride –trifluoroethylene -chlorotrifluoroethylene) (P(VDF-TrFE-CTFE)) films by control of polymer microstructure, aiming to picture the full map of structure-property relationship. In order to define their crystal orientation films, terpolymer films were fabricated by solution-casting, stretching and hot-pressing process. Differential scanning calorimetry, impedance analyzer, and tensile strength techniques were employed to characterize crystallographic parameters, dielectric permittivity, and elastic Young’s modulus respectively. In addition, large electrical induced out-of-plane electrostrictive strain was obtained by cantilever beam mode. Consequently, as-casted pristine films exhibited surprisingly high electrostrictive strain 0.1774% due to considerably small value of elastic Young’s modulus although relatively low dielectric permittivity. Such reasons contributed to large mechanical elastic energy density. Instead, due to 2 folds increase of elastic Young’s modulus and less than 50% augmentation of dielectric constant, fullycrystallized film showed weak electrostrictive behavior and mechanical energy density as well. And subjected to mechanical stretching process, Film C exhibited stronger dielectric constant and out-performed electrostrictive strain over Film B because edge-on crystal lamellae orientation induced by uniaxially mechanical stretch. Hot-press films were compared in term of cooling rate. Rather large electrostrictive strain of 0.2788% for hot-pressed Film D in quenching process was observed although its dielectric permittivity equivalent to that of pristine as-casted Film A, showing highest mechanical elastic energy density value of 359.5 J/m3. In hot-press cooling process, dielectric permittivity of Film E saw values at 48.8 concomitant with ca.100% increase of Young’s modulus. Films with intermediate mechanical energy density were obtained.

Keywords: Crystal orientation, electrostrictive strain, mechanical energy density, permittivity, relaxor ferroelectric.

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Authors: Yu-Chin Kuo, Szu-Wei Yang, Hsin-Hung Kuo

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A Reading Comprehend (RC) Platform has been constructed and developed to facilitate children-s English reading comprehension. Like a learning bridge, the RC Platform focuses on the integration of rich media and picture-book texts. The study is to examine the effects of the project within the RC Platform for children. Two classes of fourth graders were selected from a public elementary school in an urban area of central Taiwan. The findings taken from the survey showed that the students demonstrated high interest in the RC Platform. The students benefited greatly and enjoyed reading via the technology-enhanced project within the RC Platform. This Platform is a good reading bridge to enrich students- learning experiences and enhance their performance in English reading comprehension.

Keywords: English Teaching, Multimedia-based Learning, Learning Platform, Reading Comprehension, Technology EnhancedLearning.

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Authors: Helmi Adly Mohd Noor, Faaizah Shahbodin, Naim Che Pee

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Autism Spectrum Disorder (ASD) is a pervasive developmental disorder which affects individuals with varying degrees of impairment. Currently, there has been ample research done in serious game for autism children. Although serious games are traditionally associated with software developments, developing them in the autism field involves studying the associated technology and paying attention to aspects related to interaction with the game. Serious Games for autism cover matters related to education, therapy for communication, psychomotor treatment and social behavior enhancement. In this paper, a systematic review sets out the lines of development and research currently being conducted into serious games which pursue some form of benefit in the field of autism. This paper includes a literature review of relevant serious game developments since in year 2007 and examines new trends.

Keywords: Serious Game, Autism, Education, Therapy

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Authors: Jeong-Min Jo, Young-Jae Han, Chang-Young Lee

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Attracting ferromagnetic forces between magnet and reaction rail provide the supporting force in Electromagnetic Suspension. Miniature maglev using permanent magnets and electromagnets is based on the idea to generate the nominal magnetic force by permanent magnets and superimpose the variable magnetic field required for stabilization by currents flowing through control windings in electromagnets. Permanent magnets with a high energy density have lower power losses with regard to supporting force and magnet weight. So the advantage of the maglev using electromagnets and permanent magnets is partially reduced by the power required to feed the remaining onboard supply system so that the overall onboard power is diminished as compared to that of the electromagnet. In this paper we proposed the how to design and control the miniature maglev and confirmed the feasibility of the levitation system using electromagnets and permanent magnets through the manufacturing the miniature maglev

Keywords: Magnetic Levitation system, Maglev, Permanent Magnets, Hybrid Magnet.

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Authors: Melani Arnaldi, Suzy Yusna Dewi

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School brawls have taken casualties to the life of students in Jakarta. In the last time, school brawl studies investigate the cause with groups approach such as cognitive dissonance that provocation and resentment among student in the schools. This research focus on individual factors as the cause of school brawls, where the characteristics of children with ADHD, lack of self-control regulation, and level of depression. The results show that in fact the lower influence of individual factor to be come conduct disorder. The meaning students have good self-regulation control, insignificant characteristics of children with ADHD, and moderate of depression level. Concluded group factor more significant than individual factor to caused school brawl.

Keywords: ADHD, depression, school brawl, self-regulation control.

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Authors: C. Copilusi, C. Ploscaru

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This paper addresses attention to a research regarding the design of a knee orthosis in a modular form used on children walking rehabilitation. This research is focused on the human lower limb kinematic analysis which will be used as input data on virtual simulations and prototype validation. From this analysis, important data will be obtained and used as input for virtual simulations of the knee modular orthosis. Thus, a knee orthosis concept was obtained and validated through virtual simulations by using MSC Adams software. Based on the obtained results, the modular orthosis prototype will be manufactured and presented in this article.

Keywords: Human lower limb, children orthoses, kinematic analysis, knee orthosis.

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Authors: C. Cruz, A. Breda

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Emotions are manifestations of everything that happens around us, influencing, consequently, our actions. People experience emotions continuously when socialize with friends, when facing complex situations, and when at school, among many other situations. Although the influence of emotions in the teaching and learning process is nothing new, its study in the academic field has been more popular in recent years, distinguishing between positive (e.g., enjoyment and curiosity) and negative emotions (e.g., boredom and frustration). There is no doubt that emotions play an important role in the students’ learning process since the development of knowledge involves thoughts, actions, and emotions. Nowadays, one of the most significant changes in acquiring knowledge, accessing information, and communicating is the way we do it through technological and digital resources. Faced with an increasingly frequent use of technological or digital means with different purposes, whether in the acquisition of knowledge or in communicating with others, the emotions involved in these processes change naturally. The speed with which the Internet provides information reduces the excitement for searching for the answer, the gratification of discovering something through our own effort, the patience, the capacity for effort, and resilience. Thus, technological and digital devices are bringing changes to the emotional domain. For this reason and others, it is essential to educate children from an early age to understand that it is not possible to have everything with just one click and to deal with negative emotions. Currently, many curriculum guidelines highlight the importance of the development of so-called soft skills, in which the emotional domain is present, in academic contexts. Within the scope of the Portuguese reality, the “Students’ profile by the end of compulsory schooling” and the “Health education reference” also emphasize the importance of emotions in education. There are several resources to stimulate good emotions in articulation with cognitive development. One of the most predictable and not very used resources in the most diverse areas of knowledge after pre-school education is the literature. Due to its characteristics, in the narrative or in the illustrations, literature provides the reader with a journey full of emotions. On the other hand, literature makes it possible to establish bridges between narrative and different areas of knowledge, reconciling the cognitive and emotional domains. This study results from the presentation session of a children's book, entitled “From the Outside to Inside and from the Inside to Outside”, to children attending the 2nd, 3rd, and 4th years of basic education in the Portuguese education system. In this book, rationale and emotion are in constant dialogue, so in this session, based on excerpts from the book dramatized by the authors, some questions were asked to the children in a large group, with an aim to explore their perception regarding certain emotions or events that trigger them. According to the aim of this study, qualitative, descriptive, and interpretative research was carried out based on participant observation and audio records.

Keywords: Emotions, children’s literature, basic education, soft skills.

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Authors: Ayat Bani Rashaid, Zain Khasawneh, Mazin Alqhazo, Shreen Nusair, Mohammad El-Khateeb, Mahmoud Bashtawi

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Autism Spectrum disorder (ASD) is a psychiatric disorder with unknown etiology that mainly affects children in the first three years of life. Alterations of amino acid levels are believed to contribute to ASD. The levels of six essential amino acids (methionine, histidine, valine, leucine, threonine, and phenylalanine), five conditional amino acids (proline, tyrosine, glutamine, cysteine, and cystine), and five non-essential amino acids (asparagine, aspartic acid, alanine, serine, and glutamic acid) in hair samples of children with ASD (n = 25) were analyzed and compared to corresponding levels in healthy age-matched controls (n = 25). The results showed that the levels of methionine, alanine, and asparagine were significantly lower in the hair samples of ASD group compared to those of the control group (p ≤ 0.05). However, the levels of glutamic acid were significantly higher in the ASD group than the control group (p ≤ 0.05). The current findings could contribute towards further understanding of ASD etiology and provide specialists with a hair amino acid profile utilized as a biomarker for early diagnosis of ASD. Such biomarkers could participate in future developments of therapies that reduce ASD-related symptoms.

Keywords: Autism spectrum disorder, amino acids, liquid chromatography-tandem mass spectrometry, human hair.

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Authors: A. A. Alshabanat, R. B. Albacker, A. A. Basalama, A. A. Bin Salamah, A. S. Alfrayh

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The study was conducted to investigate the profile of hepatitis in Kingdom of Saudi Arabia, and to determine which age group hepatitis viruses most commonly infect. The epidemiology of viral hepatitis in Saudi Arabia has undergone major changes, concurrent with major socioeconomic developments over the last two to three decades. This disease represents a major public health problem in Saudi Arabia resulting in the need for considerable healthcare resources. A retrospective cross sectional analysis of the reported cases of viral hepatitis was conducted based on the reports of The Ministry of Health in Saudi Arabia about Hepatitis A, B and C infections in all regions from the period of January 2006 to December 2010. The study demonstrated that incidence of viral Hepatitis is decreasing, except for Hepatitis B that showed minimal increase. Of hepatitis A, B, and C, Hepatitis B virus (HBV) was the most predominant type, accounting for (53%) of the cases, followed by Hepatitis C virus (HCV) (30%) and HAV (17%). HAV infection predominates in children (5–14 years) with 60% of viral hepatitis cases, HBV in young adults (15–44 years) with 69% of viral hepatitis cases, and HCV in older adults (>45 years) with 59% of viral hepatitis cases. Despite significant changes in the prevalence of viral hepatitis A, B and C, it remains a major public health problem in Saudi Arabia; however, it showed a significant decline in the last two decades that could be attributed to the vaccination programs and the improved health facilities. Further researches are needed to identify the risk factors making a specific age group or a specific region in Saudi Arabia targeted for a specific type of hepatitis viruses.

Keywords: Epidemiology, Hepatitis, Saudi Arabia.

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Authors: Alexander A. Karabutov, Natalia B. Podymova, Elena B. Cherepetskaya, Vladimir A. Makarov, Yulia G. Sokolovskaya

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The laser-ultrasonic method is realized for quantifying the influence of porosity on the local Young’s modulus of isotropic composite materials. The method is based on a laser thermooptical method of ultrasound generation combined with measurement of the phase velocity of longitudinal and shear acoustic waves in samples. The main advantage of this method compared with traditional ultrasonic research methods is the efficient generation of short and powerful probing acoustic pulses required for reliable testing of ultrasound absorbing and scattering heterogeneous materials. Using as an example samples of a metal matrix composite with reinforcing microparticles of silicon carbide in various concentrations, it is shown that to provide an effective increase in Young’s modulus with increasing concentration of microparticles, the porosity of the final sample should not exceed 2%.

Keywords: Laser ultrasonic, longitudinal and shear ultrasonic waves, porosity, composite, local elastic moduli.

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Authors: R. Bourziza, A. Hammani, M. Kuper, A. Bouaziz

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In oases, the surface water resources are becoming increasingly scarce and groundwater resources, which generally have a poor quality due to the high levels of salinity, are often overexploited. Water saving have therefore become imperative for better oases sustainability. If drip irrigation is currently recommended in Morocco for saving water and valuing, its use in the sub-desert areas does not keep water safe from high evaporation rates. An alternative to this system would be the use of subsurface drip irrigation. This technique is defined as an application of water under the soil surface through drippers, which deliver water at rates generally similar to surface drip irrigation. As subsurface drip irrigation is a recently introduced in Morocco, a better understanding of the infiltration process around a buried source, in local conditions, and its impact on plant growth is necessarily required. This study aims to contribute to improving the water use efficiency by testing the performance of subsurface irrigation system, especially in areas where water is a limited source. The objectives of this research are performance evaluation in arid conditions of the subsurface drip irrigation system for young date palms compared to the surface drip. In this context, an experimental test is installed at a farmer’s field in the area of Erfoud (Errachidia Province, southeastern Morocco), using the subsurface drip irrigation system in comparison with the classic drip system for young date palms. Flow measurement to calculate the uniformity of the application of water was done through two methods: a flow measurement of drippers above the surface and another one underground. The latter method has also helped us to estimate losses through evaporation for both irrigation techniques. In order to compare the effect of two irrigation modes, plants were identified for each type of irrigation to monitor certain agronomic parameters (cumulative numbers of palms and roots development). Experimentation referred to a distribution uniformity of about 88%; considered acceptable for subsurface drip irrigation while it is around 80% for the surface drip irrigation. The results also show an increase in root development and in the number of palm, as well as a substantial water savings due to lower evaporation losses compared to the classic drip irrigation. The results of this study showed that subsurface drip irrigation is an efficient technique, which allows sustainable irrigation in arid areas.

Keywords: Subsurface drip irrigation, Water conservation, Arid areas, Young date palms.

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Authors: F. Jiménez, R. Jódar, M. Martín, G. Sánchez, G. Sciavicco

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Abstract—Attribute or feature selection is one of the basic strategies to improve the performances of data classification tasks, and, at the same time, to reduce the complexity of classifiers, and it is a particularly fundamental one when the number of attributes is relatively high. Its application to unsupervised classification is restricted to a limited number of experiments in the literature. Evolutionary computation has already proven itself to be a very effective choice to consistently reduce the number of attributes towards a better classification rate and a simpler semantic interpretation of the inferred classifiers. We present a feature selection wrapper model composed by a multi-objective evolutionary algorithm, the clustering method Expectation-Maximization (EM), and the classifier C4.5 for the unsupervised classification of data extracted from a psychological test named BASC-II (Behavior Assessment System for Children - II ed.) with two objectives: Maximizing the likelihood of the clustering model and maximizing the accuracy of the obtained classifier. We present a methodology to integrate feature selection for unsupervised classification, model evaluation, decision making (to choose the most satisfactory model according to a a posteriori process in a multi-objective context), and testing. We compare the performance of the classifier obtained by the multi-objective evolutionary algorithms ENORA and NSGA-II, and the best solution is then validated by the psychologists that collected the data.

Keywords: Feature selection, multi-objective evolutionary computation, unsupervised classification, behavior assessment system for children.

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