Search results for: Ghada E. El-Refaye
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 21

Search results for: Ghada E. El-Refaye

21 New DES based on Elliptic Curves

Authors: Ghada Abdelmouez M., Fathy S. Helail, Abdellatif A. Elkouny

Abstract:

It is known that symmetric encryption algorithms are fast and easy to implement in hardware. Also elliptic curves have proved to be a good choice for building encryption system. Although most of the symmetric systems have been broken, we can create a hybrid system that has the same properties of the symmetric encryption systems and in the same time, it has the strength of elliptic curves in encryption. As DES algorithm is considered the core of all successive symmetric encryption systems, we modified DES using elliptic curves and built a new DES algorithm that is hard to be broken and will be the core for all other symmetric systems.

Keywords: DES, Elliptic Curves, hybrid system, symmetricencryption.

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20 Identification of Roadway Wavelengths Affecting the Dynamic Responses of Bridges due to Vehicular Loading

Authors: Ghada Karaki

Abstract:

The bridge vibration due to traffic loading has been a subject of extensive research during the last decades. A number of these studies are concerned with the effects of the unevenness of roadways on the dynamic responses of highway bridges. The road unevenness is often described as a random process that constitutes of different wavelengths. Thus, the study focuses on examining the effects of the random description of roadways on the dynamic response and its variance. A new setting of variance based sensitivity analysis is proposed and used to identify and quantify the contributions of the roadway-s wavelengths to the variance of the dynamic response. Furthermore, the effect of the vehicle-s speed on the dynamic response is studied.

Keywords: vehicle bridge interaction, sensitivity analysis, road unevenness, random processes, critical speeds

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19 An Analysis of Classification of Imbalanced Datasets by Using Synthetic Minority Over-Sampling Technique

Authors: Ghada A. Alfattni

Abstract:

Analysing unbalanced datasets is one of the challenges that practitioners in machine learning field face. However, many researches have been carried out to determine the effectiveness of the use of the synthetic minority over-sampling technique (SMOTE) to address this issue. The aim of this study was therefore to compare the effectiveness of the SMOTE over different models on unbalanced datasets. Three classification models (Logistic Regression, Support Vector Machine and Nearest Neighbour) were tested with multiple datasets, then the same datasets were oversampled by using SMOTE and applied again to the three models to compare the differences in the performances. Results of experiments show that the highest number of nearest neighbours gives lower values of error rates. 

Keywords: Imbalanced datasets, SMOTE, machine learning, logistic regression, support vector machine, nearest neighbour.

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18 Immunohistochemical Expression of β-catenin and Epidermal Growth Factor Receptor in Adamantinomatous Craniopharyngioma

Authors: Ghada Esheba, Fatimah Alturkistani, Arwa Obaid, Ahdab Bashehab, Moayad Alturkistani

Abstract:

Introduction: Craniopharyngiomas (CPs) are rare epithelial tumors located mainly in the sellar/parasellar region. CPs have been classified histopathologically, genetically, clinically and prognostically into two distinctive subtypes: adamantinomatous and papillary variants. Aim: To examine the pattern of expression of both the β-catenin and epidermal growth factor receptor (EGFR) in surgically resected samples of adamantinomatous CP, and to asses for the possibility of using anti-EGFR in the management of ACP patients. Materials and methods: β-catenin and EGFR immunostaining was performed on paraffin-embedded tissue sections of 18 ACP cases. Result: 17 out of 18 cases (94%) of ACP exhibited strong nuclear/cytoplasmic expression of β-catenin, 15 (83%) of APC cases were positive for EGFR. Conclusion: Nuclear accumulation of β-catenin is a diagnostic hallmark of ACP. EGFR positivity in most cases of ACP could qualify the use of anti-EGFR therapy. 

Keywords: Craniopharyngioma, adamantinomatous, papillary, epidermal growth factor receptor, B-catenin.

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17 Vehicle Type Classification with Geometric and Appearance Attributes

Authors: Ghada S. Moussa

Abstract:

With the increase in population along with economic prosperity, an enormous increase in the number and types of vehicles on the roads occurred. This fact brings a growing need for efficiently yet effectively classifying vehicles into their corresponding categories, which play a crucial role in many areas of infrastructure planning and traffic management.

This paper presents two vehicle-type classification approaches; 1) geometric-based and 2) appearance-based. The two classification approaches are used for two tasks: multi-class and intra-class vehicle classifications. For the evaluation purpose of the proposed classification approaches’ performance and the identification of the most effective yet efficient one, 10-fold cross-validation technique is used with a large dataset. The proposed approaches are distinguishable from previous research on vehicle classification in which: i) they consider both geometric and appearance attributes of vehicles, and ii) they perform remarkably well in both multi-class and intra-class vehicle classification. Experimental results exhibit promising potentials implementations of the proposed vehicle classification approaches into real-world applications.

Keywords: Appearance attributes, Geometric attributes, Support vector machine, Vehicle classification.

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16 Effect of Addition of Separan at Different Concentrations as a Flocculants on Quality of Sugar Cane Juice

Authors: Ghada A. Abdel-Razig , Isam A. Mohamed Ahmed, Elfadil E. Babiker & Abu ElGasim A. Yagoub

Abstract:

The study was designed to evaluate the use of low concentrations of separan flocculent (Less than 3 ppm) on physicochemical properties of sugar cane juice. Colour, pH, purity, turbidity, pol, brix, reducing sugars tannins and polyphenols of crushed cane (green and burned) juice, mixed juice and clarified juice were studied. The results showed that pol, brix, reducing sugar and turbidity are higher in crushed cane juice. Clarified burned juice had low turbidity, reducing sugars, pol and brix but had significantly lower pH, purity and colour when compared to crushed juice. Polyphenols of the crushed juice (1.19%) decreased significantly in the clarified juice to 0.006%. Addition of separan at a concentration of 0.015 ppm reduced significantly colour, polyphenols and tannins and reducing sugar compared to the control.

Keywords: Separan, Sugar cane, Reducing sugar, Polyphenols, Clarified juice.

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15 Level of Behavioral Development for Hepatitis C Virus Cases versus Their Contacts: Does Infection Make a Difference and What Is Beyond?

Authors: Ammal M. Metwally, Lobna A. El Etreby, Rehan M. Saleh, Ghada Abdrabou, Somia I. Salama, Amira Orabi, Mohamed Abdelrahman

Abstract:

Hepatitis C virus infection is a public health threat in Egypt. To control infection, efforts should be spent to encourage healthy behavior. This study aimed to assess the level of behavioral development in order to create a positive environment for the adoption of the recommended behaviors. The study was conducted over one year from Jan. 2011 till Jan. 2012.Knowledge, attitude and behavior of 540 HCV patients and 102 of their contacts were assessed and the level of behavioral development was determined. The study revealed that the majority of patients and contacts knew that HCV infection is dangerous with perceived concern for early diagnosis and treatment. More than 75% knew the correct modes of transmission. The assessment showed positive attitudes towards the recommended practices with intention to adopt those practices. Strategies of creating opportunities to continue the recommended behaviors should be adopted together with the reinforcement of social support.

Keywords: Hepatitis C virus, Level of behavioral development, recommended behaviors.

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14 A New Framework and a Model for Product Development with an Application in the Telecommunications Services Sector

Authors: Ghada A. El Khayat

Abstract:

This paper argues that a product development exercise involves in addition to the conventional stages, several decisions regarding other aspects. These aspects should be addressed simultaneously in order to develop a product that responds to the customer needs and that helps realize objectives of the stakeholders in terms of profitability, market share and the like. We present a framework that encompasses these different development dimensions. The framework shows that a product development methodology such as the Quality Function Deployment (QFD) is the basic tool which allows definition of the target specifications of a new product. Creativity is the first dimension that enables the development exercise to live and end successfully. A number of group processes need to be followed by the development team in order to ensure enough creativity and innovation. Secondly, packaging is considered to be an important extension of the product. Branding strategies, quality and standardization requirements, identification technologies, design technologies, production technologies and costing and pricing are also integral parts to the development exercise. These dimensions constitute the proposed framework. The paper also presents a mathematical model used to calculate the design targets based on the target costing principle. The framework is used to study a case of a new product development in the telecommunications services sector.

Keywords: Product Development Framework, Quality FunctionDeployment, Mathematical Models, Telecommunications.

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13 Optimization of Strategies and Models Review for Optimal Technologies - Based On Fuzzy Schemes for Green Architecture

Authors: Ghada Elshafei, Abdelazim Negm

Abstract:

Recently, the green architecture becomes a significant way to a sustainable future. Green building designs involve finding the balance between comfortable homebuilding and sustainable environment. Moreover, the utilization of the new technologies such as artificial intelligence techniques are used to complement current practices in creating greener structures to keep the built environment more sustainable. The most common objectives in green buildings should be designed to minimize the overall impact of the built environment that effect on ecosystems in general and in particularly human health and natural environment. This will lead to protecting occupant health, improving employee productivity, reducing pollution and sustaining the environmental. In green building design, multiple parameters which may be interrelated, contradicting, vague and of qualitative/quantitative nature are broaden to use. This paper presents a comprehensive critical state- ofart- review of current practices based on fuzzy and its combination techniques. Also, presented how green architecture/building can be improved using the technologies that been used for analysis to seek optimal green solutions strategies and models to assist in making the best possible decision out of different alternatives.

Keywords: Green architecture/building, technologies, optimization, strategies, fuzzy techniques and models.

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12 A Novel Solution Methodology for Transit Route Network Design Problem

Authors: Ghada Moussa, Mamoud Owais

Abstract:

Transit route Network Design Problem (TrNDP) is the most important component in Transit planning, in which the overall cost of the public transportation system highly depends on it. The main purpose of this study is to develop a novel solution methodology for the TrNDP, which goes beyond pervious traditional sophisticated approaches. The novelty of the solution methodology, adopted in this paper, stands on the deterministic operators which are tackled to construct bus routes. The deterministic manner of the TrNDP solution relies on using linear and integer mathematical formulations that can be solved exactly with their standard solvers. The solution methodology has been tested through Mandl’s benchmark network problem. The test results showed that the methodology developed in this research is able to improve the given network solution in terms of number of constructed routes, direct transit service coverage, transfer directness and solution reliability. Although the set of routes resulted from the methodology would stand alone as a final efficient solution for TrNDP, it could be used as an initial solution for meta-heuristic procedures to approach global optimal. Based on the presented methodology, a more robust network optimization tool would be produced for public transportation planning purposes.

Keywords: Integer programming, Transit route design, Transportation, Urban planning.

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11 Enhancements in Blended e-Learning Management System

Authors: Ibrahim S AlNomay, Alaa Jaber, Ghada AlNasser

Abstract:

A learning management system (commonly abbreviated as LMS) is a software application for the administration, documentation, tracking, and reporting of training programs, classroom and online events, e-learning programs, and training content (Ellis 2009). (Hall 2003) defines an LMS as \"software that automates the administration of training events. All Learning Management Systems manage the log-in of registered users, manage course catalogs, record data from learners, and provide reports to management\". Evidence of the worldwide spread of e-learning in recent years is easy to obtain. In April 2003, no fewer than 66,000 fully online courses and 1,200 complete online programs were listed on the TeleCampus portal from TeleEducation (Paulsen 2003). In the report \" The US market in the Self-paced eLearning Products and Services:2010-2015 Forecast and Analysis\" The number of student taken classes exclusively online will be nearly equal (1% less) to the number taken classes exclusively in physical campuses. Number of student taken online course will increase from 1.37 million in 2010 to 3.86 million in 2015 in USA. In another report by The Sloan Consortium three-quarters of institutions report that the economic downturn has increased demand for online courses and programs.

Keywords: LMS, Interactive Materials, Exam Centers, Learning Outcomes

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10 CompPSA: A Component-Based Pairwise RNA Secondary Structure Alignment Algorithm

Authors: Ghada Badr, Arwa Alturki

Abstract:

The biological function of an RNA molecule depends on its structure. The objective of the alignment is finding the homology between two or more RNA secondary structures. Knowing the common functionalities between two RNA structures allows a better understanding and a discovery of other relationships between them. Besides, identifying non-coding RNAs -that is not translated into a protein- is a popular application in which RNA structural alignment is the first step A few methods for RNA structure-to-structure alignment have been developed. Most of these methods are partial structure-to-structure, sequence-to-structure, or structure-to-sequence alignment. Less attention is given in the literature to the use of efficient RNA structure representation and the structure-to-structure alignment methods are lacking. In this paper, we introduce an O(N2) Component-based Pairwise RNA Structure Alignment (CompPSA) algorithm, where structures are given as a component-based representation and where N is the maximum number of components in the two structures. The proposed algorithm compares the two RNA secondary structures based on their weighted component features rather than on their base-pair details. Extensive experiments are conducted illustrating the efficiency of the CompPSA algorithm when compared to other approaches and on different real and simulated datasets. The CompPSA algorithm shows an accurate similarity measure between components. The algorithm gives the flexibility for the user to align the two RNA structures based on their weighted features (position, full length, and/or stem length). Moreover, the algorithm proves scalability and efficiency in time and memory performance.

Keywords: Alignment, RNA secondary structure, pairwise, component-based, data mining.

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9 Evaluation of Microleakage of a New Generation Nano-Ionomer in Class II Restoration of Primary Molars

Authors: Ghada Salem, Nihal Kabel

Abstract:

Objective: This in vitro study was carried out to assess the microleakage properties of nano-filled glass ionomer in comparison to resin-reinforced glass ionomers. Material and Methods: 40 deciduous molar teeth were included in this study. Class-II cavity was prepared in a standard form for all the specimens. The teeth were randomly distributed into two groups (20 per group) according to the restorative material used either nano-glass ionomer or Photac Fill glass ionomer restoration. All specimens were thermocycled for 1000 cycles between 5 and 55 °C. After that, the teeth were immersed in 2% methylene blue dye then sectioned and evaluated under a stereomicroscope. Microleakage was assessed using linear dye penetration and on a scale from zero to five. Results: Two way ANOVA test revealed a statistically significant lower degree of microleakage in both occlusal and gingival restorations (0.4±0.2), (0.9±0.1) for nano-filled glass ionomer group in comparison to resin modified glass ionomer (2.3±0.7), (2.4±0.5). No statistical difference was found between gingival and occlusal leakage regarding the effect of the measured site. Conclusion: Nano-filled glass ionomer shows superior sealing ability which enables this type of restoration to be used in minimum invasive treatment.

Keywords: Microleakage, nano-ionomer, resin-reinforced glass ionomer, proximal cavity preparation.

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8 Risk Management Strategy for Protecting Cultural Heritage: Case Study of the Institute of Egypt

Authors: Amany A. Ragheb, Ghada Ragheb, Abd ElRahman A.

Abstract:

Egypt has a countless heritage of mansions, castles, cities, towns, villages, industrial and manufacturing sites. This richness of heritage provides endless and matchless prospects for culture. Despite being famous worldwide, Egypt’s heritage still is in constant need of protection. Political conflicts and religious revolutions form a direct threat to buildings in various areas, historic, archaeological sites, and religious monuments. Egypt has witnessed two revolutions in less than 60 years; both had an impact on its architectural heritage. In this paper, the authors aim to review legal and policy framework to protect the cultural heritage and present the risk management strategy for cultural heritage in conflict. Through a review of selected international models of devastated architectural heritage in conflict zones and highlighting some of their changes, we can learn from the experiences of other countries to assist towards the development of a methodology to halt the plundering of architectural heritage. Finally, the paper makes an effort to enhance the formulation of a risk management strategy for protection and conservation of cultural heritage, through which to end the plundering of Egypt’s architectural legacy in the Egyptian community (revolutions, 1952 and 2011); and by presenting to its surrounding community the benefits derived from maintaining it.

Keywords: Cultural heritage, legal regulation, risk management, preservation.

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7 Life Cycle Assessment as a Decision Making for Window Performance Comparison in Green Building Design

Authors: Ghada Elshafei, Abdelazim Negm

Abstract:

Life cycle assessment is a technique to assess the environmental aspects and potential impacts associated with a product, process, or service, by compiling an inventory of relevant energy and material inputs and environmental releases; evaluating the potential environmental impacts associated with identified inputs and releases; and interpreting the results to help you make a more informed decision. In this paper, the life cycle assessment of aluminum and beech wood as two commonly used materials in Egypt for window frames are heading, highlighting their benefits and weaknesses. Window frames of the two materials have been assessed on the basis of their production, energy consumption and environmental impacts. It has been found that the climate change of the windows made of aluminum and beech wood window, for a reference window (1.2m×1.2m), are 81.7 mPt and -52.5 mPt impacts respectively. Among the most important results are: fossil fuel consumption, potential contributions to the green building effect and quantities of solid waste tend to be minor for wood products compared to aluminum products; incineration of wood products can cause higher impacts of acidification and eutrophication than aluminum, whereas thermal energy can be recovered.

Keywords: Aluminum window, beech wood window, green building, life cycle assessment, life cycle analysis, SimaPro software, window frame.

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6 Impact of Hepatitis C Virus Chronic Infection on Quality of Life in Egypt

Authors: Ammal M. Metwally, Ghada A. Abdel-Latif, Walaa A. Fouad, Thanaa M. Rabah, Amira Mohsen, Fatma A. Shaaban, Iman I. Salama

Abstract:

The study aimed at determining the impact of chronic hepatitis C virus (HCV) infection on patients’ Quality of Life (QoL), its relation to geographical characteristics of patients, awareness of the disease, treatment regimen, co-morbid psychiatric or other diseases. 457 patients were randomly selected from ten National Treatment Reference Centers of Ministry of Health hospitals from four community locations representing Egypt. Health related QoL assessment questionnaire with the 36-item Short Form used for assessment of the enrolled patients. The study showed no significant difference between HCV patients in different governorates as regards total QoL. Females, illiterate patients and those had bilharziasis, diabetes mellitus, hypertension or were depressed had significantly the lowest QoL score. HCV patients who knew the danger of the disease had significant lower mean score of physical and mental health components. Optimal care of overall well-being of HCV patients requires adequate knowledge of their neurological and psychological status. It is important to know how to cope with having a family member with hepatitis C and more importantly to know what should you say and what shouldn’t you say as a positive hopeful attitude is essential for combating HCV chronic infection.

Keywords: Hepatitis C virus chronic infection, physical health component and mental health component of QoL, total quality of life.

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5 BeamGA Median: A Hybrid Heuristic Search Approach

Authors: Ghada Badr, Manar Hosny, Nuha Bintayyash, Eman Albilali, Souad Larabi Marie-Sainte

Abstract:

The median problem is significantly applied to derive the most reasonable rearrangement phylogenetic tree for many species. More specifically, the problem is concerned with finding a permutation that minimizes the sum of distances between itself and a set of three signed permutations. Genomes with equal number of genes but different order can be represented as permutations. In this paper, an algorithm, namely BeamGA median, is proposed that combines a heuristic search approach (local beam) as an initialization step to generate a number of solutions, and then a Genetic Algorithm (GA) is applied in order to refine the solutions, aiming to achieve a better median with the smallest possible reversal distance from the three original permutations. In this approach, any genome rearrangement distance can be applied. In this paper, we use the reversal distance. To the best of our knowledge, the proposed approach was not applied before for solving the median problem. Our approach considers true biological evolution scenario by applying the concept of common intervals during the GA optimization process. This allows us to imitate a true biological behavior and enhance genetic approach time convergence. We were able to handle permutations with a large number of genes, within an acceptable time performance and with same or better accuracy as compared to existing algorithms.

Keywords: Median problem, phylogenetic tree, permutation, genetic algorithm, beam search, genome rearrangement distance.

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4 Efficacy of Biofeedback-Assisted Pelvic Floor Muscle Training on Postoperative Stress Urinary Incontinence

Authors: Asmaa M. El-Bandrawy, Afaf M. Botla, Ghada E. El-Refaye, Hassan O. Ghareeb

Abstract:

Background: Urinary incontinence is a common problem among adults. Its incidence increases with age and it is more frequent in women. Pelvic floor muscle training (PFMT) is the first-line therapy in the treatment of pelvic floor dysfunction (PFD) either alone or combined with biofeedback-assisted PFMT. The aim of the work: The purpose of this study is to evaluate the efficacy of biofeedback-assisted PFMT in postoperative stress urinary incontinence. Settings and Design: A single blind controlled trial design was. Methods and Material: This study was carried out in 30 volunteer patients diagnosed as severe degree of stress urinary incontinence and they were admitted to surgical treatment. They were divided randomly into two equal groups: (Group A) consisted of 15 patients who had been treated with post-operative biofeedback-assisted PFMT and home exercise program (Group B) consisted of 15 patients who had been treated with home exercise program only. Assessment of all patients in both groups (A) and (B) was carried out before and after the treatment program by measuring intra-vaginal pressure in addition to the visual analog scale. Results: At the end of the treatment program, there was a highly statistically significant difference between group (A) and group (B) in the intra-vaginal pressure and the visual analog scale favoring the group (A). Conclusion: biofeedback-assisted PFMT is an effective method for the symptomatic relief of post-operative female stress urinary incontinence.

Keywords: Stress urinary incontinence, pelvic floor muscles, pelvic floor exercises, biofeedback.

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3 Sustainable Balanced Scorecard for Kaizen Evaluation: Comparative Study between Egypt and Japan

Authors: Ola I. S. El Dardery, Ismail Gomaa, Adel R. M. Rayan, Ghada El Khayat, Sara H. Sabry

Abstract:

Continuous improvement activities are becoming a key organizational success factor; those improvement activities include but are not limited to kaizen, six sigma, lean production, and continuous improvement projects. Kaizen is a Japanese philosophy of continuous improvement by making small incremental changes to improve an organization’s performance, reduce costs, reduce delay time, reduce waste in production, etc. This research aims at proposing a measuring system for kaizen activities from a sustainable balanced scorecard perspective. A survey was developed and disseminated among kaizen experts in both Egypt and Japan with the purpose of allocating key performance indicators for both kaizen process (critical success factors) and result (kaizen benefits) into the five sustainable balanced scorecard perspectives. This research contributes to the extant literature by presenting a kaizen measurement of both kaizen process and results that will illuminate the benefits of using kaizen. Also, the presented measurement can help in the sustainability of kaizen implementation across various sectors and industries. Thus, grasping the full benefits of kaizen implementation will contribute to the spread of kaizen understanding and practice. Also, this research provides insights on the social and cultural differences that would influence the kaizen success. Determining the combination of the proper kaizen measures could be used by any industry, whether service or manufacturing for better kaizen activities measurement. The comparison between Japanese implementation of kaizen, as the pioneers of continuous improvement, and Egyptian implementation will help recommending better practices of kaizen in Egypt and contributing to the 2030 sustainable development goals. The study results reveal that there is no significant difference in allocating kaizen benefits between Egypt and Japan. However, with regard to the critical success factors some differences appeared reflecting the social differences and understanding between both countries, a single integrated measurement was reached between the Egyptian and Japanese allocation highlighting the Japanese experts’ opinion as the ultimate criterion for selection.

Keywords: continuous improvements, kaizen, performance, sustainable balanced scorecard

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2 Preparation and in vivo Assessment of Nystatin-Loaded Solid Lipid Nanoparticles for Topical Delivery against Cutaneous Candidiasis

Authors: Rawia M. Khalil, Ahmed A. Abd El Rahman, Mahfouz A. Kassem, Mohamed S. El Ridi, Mona M. Abou Samra, Ghada E. A. Awad, Soheir S. Mansy

Abstract:

Solid lipid nanoparticles (SLNs) have gained great attention for the topical treatment of skin associated fungal infection as they facilitate the skin penetration of loaded drugs. Our work deals with the preparation of nystatin loaded solid lipid nanoparticles (NystSLNs) using the hot homogenization and ultrasonication method. The prepared NystSLNs were characterized in terms of entrapment efficiency, particle size, zeta potential, transmission electron microscopy, differential scanning calorimetry, rheological behavior and in vitro drug release. A stability study for 6 months was performed. A microbiological study was conducted in male rats infected with Candida albicans, by counting the colonies and examining the histopathological changes induced on the skin of infected rats. The results showed that SLNs dispersions are spherical in shape with particle size ranging from 83.26±11.33 to 955.04±1.09 nm. The entrapment efficiencies are ranging from 19.73±1.21 to 72.46±0.66% with zeta potential ranging from -18.9 to -38.8 mV and shear-thinning rheological Behavior. The stability studies done for 6 months showed that nystatin (Nyst) is a good candidate for topical SLN formulations. A least number of colony forming unit/ ml (cfu/ml) was recorded for the selected NystSLN compared to the drug solution and the commercial Nystatin® cream present in the market. It can be fulfilled from this work that SLNs provide a good skin targeting effect and may represent promising carrier for topical delivery of Nyst offering the sustained release and maintaining the localized effect, resulting in an effective treatment of cutaneous fungal infection.

Keywords: Candida infections, Hot homogenization, Nystatin, Solid lipid nanoparticles, Stability, Topical delivery.

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1 The Association between C-Reactive Protein and Hypertension of Different United States Participants Categorized by Ethnicity: Applying the National Health and Nutrition Examination Survey from 1999-2010

Authors: Ghada Abo-Zaid

Abstract:

Objectives: The main objective of this study was to examine the association between the elevated level of C-reactive protein (CRP) and incidence of hypertension before and after adjustments for age, BMI, gender, SES, smoking, diabetes, cholesterol LDL and cholesterol HDL, and to determine whether the association differs by race. Method: Cross sectional data for participants from aged 17 years to 74 years, included in The National Health and Nutrition Examination Survey (NHANES) from 1999 to 2010 were analyzed. The CRP level was classified into three categories (> 3 mg/L, between 1 mg/L and 3 mg/L, and < 3 mg/L). Blood pressure categorization was done using JNC 7 indicator. Hypertension is defined as either systolic blood pressure (SBP) of 140 mmHg or more and diastolic blood pressure (DBP) of 90 mmHg or more, otherwise a self-reported prior diagnosis by a physician. Pre-hypertension was defined as 139 ≥ SBP > 120 or 89 ≥ DBP >80. Multinominal regression model was undertaken to measure the association between CRP level and hypertension. Results: In univariable models, CRP concentrations > 3 mg/L were associated with a 73% greater risk of incident hypertension compared with CRP concentrations < 1 mg/L (Hypertension: odds ratio [OR] = 1.73; 95% confidence interval [CI], 1.50-1.99). Ethnic comparisons showed that American Mexicans had the highest risk of incident hypertension (OR = 2.39; 95% CI, 2.21-2.58). This risk was statistically insignificant after controlling by other variables (Hypertension: OR = 0.75; 95% CI, 0.52-1.08), or categorized by race [American Mexican: OR= 1.58; 95% CI, 0.58-4.26, Other Hispanic: OR = 0.87; 95% CI, 0.19-4.42, Non-Hispanic white: OR = 0.90; 95% CI, 0.50-1.59, Non-Hispanic Black: OR = 0.44; 95% CI, 0.22-0.87. The same results were found for pre-hypertension, and the Non-Hispanic black segment showed the highest significant risk for Pre-Hypertension (OR = 1.60; 95% CI, 1.26-2.03). When CRP concentrations were between 1.0 and 3.0 mg/L in unadjusted models, prehypertension was associated with higher likelihood of elevated CRP (OR = 1.37; 95% CI, 1.15-1.62). The same relationship was maintained in Non-Hispanic white, Non-Hispanic black, and other race (Non-Hispanic white: OR = 1.24; 95% CI, 1.03-1.48, Non-Hispanic black: OR = 1.60; 95% CI, 1.27-2.03, other race: OR = 2.50; 95% CI, 1.32-4.74) while the association was insignificant with American Mexican and other Hispanic. In the adjusted model, the relationship between CRP and prehypertension were no longer available. Contrary, hypertension was not independently associated with elevated CRP, and the results were the same after being grouped by race or adjustments for the possible confounder variables. The same results were obtained when SBP or DBP were on a continuous measure. Conclusions: This study confirmed the existence of an association between hypertension, prehypertension and elevated level of CRP, however this association was no longer available after adjusting by other variables. Ethic group differences were statistically significant at the univariable models, while it disappeared after controlling by other variables. 

Keywords: CRP, hypertension, ethnicity, NHANES, blood pressure.

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