Search results for “complexity

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22 articles
Language Research Open Access

Exploring syntactic complexity and its relationship with writing quality in EFL argumentative essays

May 2024 DOI 10.14302/issn.2998-4122.jlr-24-4985
Wondemagegne EliasCorresponding author

Despite a large number of studies examining syntactic features that are predictive of second language (L2) writing quality, assessed by human raters at the university level, few have systematically investigated this link using a large set of indices in the foreign language learning (EFL) classroom context. The current study sought to determine the extent to which a variety of syntactic complexity and sophistication indices are associated with and may predict writing quality by analyzing 30 argumentative essays written by undergraduate EFL students in an Ethiopian university classroom setting. To represent syntactic complexity as a multidimensional construct, we used conventional absolute measures, fine-grained clausal and phrasal indices, and newly proposed sophistication indices related to the use of verb argument constructions (VACs) indexed by TAASSC (Tool for the Automatic Analysis of Syntactic Sophistication and Complexity; 17. Essays were graded, and five separate predicted models of writing quality were created utilizing each complex feature index and all of the measures. Robust predictors of writing quality were identified at both syntactic complexity and sophistication dimensions. Regression analyses showed that the combined model including both fine-grained clausal complexity and VAC-based indices could account for 53.6% of the variance (the largest amount of variance in the study) in writing scores. The finding indicates that the inclusion of diversified adverbial modifiers and nonfinite clauses such as modal auxiliaries controlled by less frequent verbs were predictive of higher-quality writing. These findings shed light on some characteristics of L2 learners' writing growth and enable us to draw pedagogical implications for teaching and assessing writing in the Ethiopian EFL context.

Evolutionary Science Open Access

Structuredness as a Measure of the Complexity of the Structure and the Role of Post-Dissipative Structures and Ratchet Processes in Evolution

Jan 2020 DOI 10.14302/issn.2689-4602.jes-19-3155
Mikhailovsky GeorgeCorresponding author Global Mind Share, 878 W Ocean View Ave., Norfolk, VA, 23503, USA 

As shown earlier, the algorithmic complexity, like Shannon information and Boltzmann entropy, tends to increase in accordance with the general law of complification. However, the algorithmic complexity of most material systems does not reach its maximum, i.e. chaotic state, due to the various laws of nature that create certain structures. The complexity of such structures is very different from the algorithmic complexity, and we intuitively feel that its maximal value should be somewhere between order and chaos. I propose a formula for calculation such structural complexity, which can be called - structuredness. The structuredness of any material system is determined by structures of three main types: stable, dissipative, and post-dissipative. The latter are defined as stable structures created by dissipative ones, directly or indirectly. Post-dissipative structures, as well as stable, can exist for an unlimited time, but at the micro level only, without energy influx. The appearance of such structures leads to the “ratchet” process, which determines the structure genesis in non-living and, especially, in living systems. This process allows systems with post-dissipative structures to develop in the direction of maximum structuring due to the gradual accumulation of these structures, even when such structuring contradicts the general law of complification. 

Human Psychology Open Access

Enduring Struggles and Protracted War: Hatred as a Multi-Faceted Construct

Jan 2025 DOI 10.14302/issn.2644-1101.jhp-24-5355
Abuelaish IzzeldinCorresponding author

This paper examines the concept of conflict- and war-related hatred as a multifaceted construct. Drawing upon various theoretical frameworks, we hypothesized that hatred in the context of conflict and war would encompass five distinct dimensions: Groupthink (Contagious Hatred), Destructiveness, Exposure, Chronicity, and Extreme-Severe Affect. To empirically validate this conceptual framework, we conducted a second-order factor analysis using data from 709 questionnaire responses collected from citizens in the Gaza Strip. The findings revealed that the optimal model comprises three primary constructs: Contagious Hatred, Chronicity, and Extreme- Severe Affect. Based on these results, we argue that collective existential threats in contexts of protracted conflict and war amplify groupthink, foster a sense of chronicity, and evoke intense negative affect. These findings underscore the complexity of hatred as a psychological and social phenomenon in conflict zones.

Mental Health Disparities Among LGBTQ+ Youth and The Strategies to Promote Their Well-Being

Jun 2024 DOI 10.14302/issn.2641-4538.jphi-24-5106
Mohammadnezhad MasoudCorresponding author

Introduction Compared to their heterosexual counterparts, cisgender LGBTQ+ youth are more likely to experience numerous mental health conditions, for instance, suicidal ideation, stress, and anxiety. This study aimed to explore mental health disparities among LGBTQ+ youth while identifying strategies to promote their well-being. Methodology Incorporating a systematic approach, studies were selected according to the predefined inclusion criteria, ensuring recentness and relevance. Five databases were systematically searched while the PRISMA flowchart was employed for illustrating the systematic selection process. The PEO framework directed the study selection. Thematic analysis was applied to identify themes that were related to the study aim. Results Five themes were emerged including policy changes and legal frameworks, contextual and cultural factors, family and social support, underlying factors of mental health, and healthcare services access. The synthesis of the literature uncovers the multifaceted relationship between cultural and contextual factors and policy changes, social and family support and healthcare services. The study also underlines the importance of implementing an intersectional minority stress model for comprehensively understanding mental health disparities among LGBTQ+ youth. Conclusion The results emphasize the importance of ongoing research in policy alterations, accessibility to healthcare, and creating supportive surroundings to tackle differences in mental health. Recognizing the complexity of these issues, this paper requires an in-depth examination that considers intersecting factors, promotes inclusivity, and involves long-term studies in providing mental health support to enhance the well-being of LGBTQ+ young individuals.

Temporal Trends in Syphilis Epidemiology in the UAE: A Five-Year Retrospective Analysis (2018-2022)

Apr 2024 DOI 10.14302/issn.2994-6743.ijstd-24-5005
Khatoon Hossein Mehdi Poor NargisCorresponding author

Objectives This study examined the frequency and dynamics of syphilis in the United Arab Emirates (UAE) between 2018 and 2022. Recognizing the significance of understanding syphilis trends, this study intends to conduct further research on sexually transmitted diseases in the context of the UAE. Methods This was a retrospective cross-sectional study. This study focused on patients who underwent syphilis screening between January 2018 and December 2022. Cases were classified as conclusive only if they passed the first screening and subsequent confirmatory tests. Results The findings demonstrate that Syphilis frequency varied throughout the UAE during the study period. Demographic trends and sex variations were discovered, providing insight into how syphilis patterns change. Additionally, this study identified a broad spectrum of clinical manifestations, confirming the complexity of the disease. It was also noted that males had a higher frequency of syphilis than females. Conclusion Understanding the complexity of the frequency of syphilis is critical for developing effective public health interventions. Variations in frequency, demographic trends, sex disparities, and clinical manifestations indicate the need for personalized preventive and control measures. This study provides important information that may be utilized to motivate focused initiatives to address the difficulties associated with syphilis in the UAE, thus enhancing overall public health.

Evolutionary Science Open Access

Rbm45 Phylogenetics, Protein Domain Conservation, and Gene Architecture in Clade Metazoa

Mar 2024 DOI 10.14302/issn.2689-4602.jes-24-4982
O. Henderson JeffreyCorresponding author

Mammalian Rbm45 is predominately expressed in neuronal tissue and is integral in brain development and neuronal differentiation under physiological conditions. Dysregulation of Rbm45 has been strongly associated with neurodegenerative disorders in humans and can drive hepatocellular carcinoma through reprogramming lipid metabolism. Intriguingly, Rbm45 is an ancient protein, evolutionarily conserved throughout metazoans, including in sponges which lack a nervous system. Curiously, the evolution of Rbm45 gene structure and protein domain conservation across kingdom Animalia is largely unknown. We performed phylogenetic analysis of Rbm45 nucleotide and amino acid sequences from 36 species representing 9 phyla: Porifera, Cnidaria, Priapulida, Mollusca, Brachiopoda, Arthropoda, Echinodermata, Hemichordata, and Chordata. While the tree from Rbm45 nucleotide sequence data resulted in clades Protostomia and Deuterostomia showing paraphyly, the phylogeny derived from Rbm45 amino acid sequence largely recapitulated known monophyletic relationships among metazoans. Human RBM45 protein structure includes three RNA-binding domains (RBD), a homo-oligomerization association (HOA) domain, a nuclear localization sequence (NLS), and a nuclear export sequence (NES). Multiple sequence alignment across the same 36 taxa used for phylogenetic analysis revealed conservation of all three RBDs, the HOA, and NLS; in contrast the NES was only detected in clade Craniata and not in clades Ambulacraria and Protostomia. Rbm45 gene structure analysis revealed increasing gene complexity concomitant with increasing evolutionary complexity. Rbm45 from non-bilaterian taxa had from 2 to 4 large exons, while bilaterian taxa had between 6 to17 small exons. These findings demonstrate that Rbm45 is an ancient, highly conserved gene among metazoans suggesting a function in a breadth of neural/sensory systems.

Evolution of the Solid Human Tumor Cells Properties in Various Experimental Systems in Vitro

Jan 2022 DOI 10.14302/issn.2372-6601.jhor-22-4061
B. Danilova AnnaCorresponding author N.N. Petrov National Medicine Research Center of Oncology, Department of Oncoimmunology, 197758, Leningradskaya str., 68, Pesochny, Saint-Petersburg, Russian Federation

Background Human malignant cell models which reflect the structural and physiological complexity of tumor tissue are of great importance for preclinical research in oncology. Spheroids/tumoroids derived from solid tumors are of great interest as cellular models mimicking the first vascular-free growth phase of a tumor node. The fact of the identity between artificially created tumor multicellular aggregates and the real tumor tissue, however, needs to be specified, described and validated in order to see how closely the spheroids are biologically similar to the malignized tissues in vivo compared to the monolayer cell cultures traditionally used. We present here a comparison study of the characteristics of solid tumor cells of different histogenesis (melanomas, soft tissue sarcomas and bone sarcomas, epithelial tumors) cultured in two dimensions (monolayer culture) and three dimensional space (spheroid), namely: spatial organization, multiplication, metabolic activity. Patients and Methods For the creation of 2 D and 3D cell models the cells isolated from the patient's solid tumor fragments obtained intraoperatively were used. 15 samples of skin melanoma, 20 samples of soft tissue and osteogenic sarcomas (STBS), and 9 samples of epithelial tumors (ET). The tumor cells were all cultivated for at least 10 passages. We used phase contrast, confocal microscopy, and immunohistochemistry to investigate spheroids and monolayer cultures. The supernatants of tumor cells grown in 2D and 3D cultures were studied using ELISA and multiplex analysis for the production of a spectrum of chemokines and cytokines supporting the immunosuppression, invasion and metastasis processes. Results Tumor specimens received were predominantly of metastatic origin (75%). In 100% of cases 2D cultures were received, in 88.6% of cases (39 out of 44) we succeeded in obtaining spheroids. There was no direct correlation between the efficiency of tumoroid formation and the tumor's histogenetic origin and the stage of the cancer process (primary tumor, recurrence, metastasis). The median size of spheroids by 4-5 days of cultivation with a starting concentration of 10000 cells per well was 657.14 μm for melanoma (min 400 - max 1000 μm), 571.42 μm (min 400 - max 700 μm), 507.14 μm (min 300 - max 600 μm) for soft tissue sarcomas, 650.0 μm (min 400 - max 900 μm) for osteogenic sarcomas. Immunochemical analysis of Ki-67, GLUT1, and Ecadherin markers was carried out for tumor tissue samples, single-layer tumor cultures, and tumoroids of every patient. The distribution of the stained groups in the spheroids was distinct from the monolayer cultures and more in accordance with the distribution of such in the tissue tumor, the number of Ki-67+ cells was increasing in the spheroids. We detected no dependence of Ki-67+ and GLUT1+ cell localization grade on spheroid size. We identified E-cadherin in tumor tissue and tumoroids of breast carcinoma and one melanoma culture. Monolayer cultures did not express it. The increase in secretory cell activity of the solid tumor cells from 2D to 3D system was observed when CCL2, CCL3, CXCL1, CXCL16, MIF, IL10, MICA (p<0.01) were investigated. Conclusion The presence of patient-specific cells of solid tumors in a 3D environment causes activation of the proliferative and metabolic processes as compared to monolayer cultures, which makes these models approximate the real world clinical picture. The production of chemokines that can attract to the tumor various types of immune system cells, to include their immature versions, as well as production of cytokines and Immunosuppression factors that, when present in the tumor microenvironment in the high concentrations, contribute to the formation of immune cells having suppressive capacities occurs in the 3D cell system. Three-dimensional model of the initial tumor nodule formation stage thus demonstrates the forming process of tumor cells favorable for them microenvironment. Construction of three-dimensional models - spheroids of tumor cells of differing histogenesis demands individual approach and more thorough investigation.

GATES/GEB as the Best Thermodynamic Approach to Electrolytic Redox Systems - a Review

Oct 2020 DOI 10.14302/issn.2377-2549.jndc-20-3583
Michałowski TadeuszCorresponding author

The Generalized Approach To Electrolytic Systems (GATES) provides the best possible thermodynamic formulation of redox and non-redox, equilibrium and metastable, mono-, two- and three-phase systems, with all attainable/pre-selected physicochemical knowledge involved, without any simplifying assumptions made for calculation purposes, where different species may occur in batch or dynamic systems, of any degree of complexity. The Generalized Electron Balance (GEB) is the key concept completing the set of algebraic balances referred to redox systems, described according to GATES/GEB ⊂ GATES principles. The GEB, considered as the law of Nature, is fully compatible with charge and concentration balances, and relations for the corresponding equilibrium constants. Within GATES, the electrolytic systems are resolvable with use of MATLAB, or other iterative computer programs, if all necessary physicochemical knowledge is attainable.

Laboratory Tests Used in the Diagnosis of Immune Thrombocytopenia and General Treatment Approaches

Jun 2020 DOI 10.14302/issn.2372-6601.jhor-20-3372
Ozcelik FatihCorresponding author University of Health Sciences, Sultan 2. Abdulhamid Han Training and Research Hospital, Department of Medical Biochemistry, Istanbul, Turkey

Immune thrombocytopenia currently called under its’ new name, immune thrombocytopenic purpura (ITP) is a disease characterized by thrombocytopenia, in which the body attacks its own platelets due to the disorders in immune system. The pathophysiology of this disease includes increased platelet destruction and most megakaryocyte production in bone marrow. The most common clinical manifestation of ITP is mild or severe progressive bleeding that could result in death. ITP is generally named as primary or secondary ITP according to thrombocytopenia severity, disease duration, bleeding status and secondary occurrence of the disease. Currently for diagnosis, despite the blood count, antiglobulin test and laboratory tests that can detect platelet-bound antibodies, they are not enough for definitive diagnosis. Like the difficulty in diagnosis, ITP treatment is quite complicated which varies depending on age, characteristics and risk of the patient. It is classified as first, second and third-line treatment options. Also, depending on the condition of patients, combined treatment might be an option which increases the complexity of the treatment. Unfortunately, discussions related to different clinical applications in diagnosis and treatments continue recently. For this reason, we considered that preparation of a review containing recent updates in diagnostic approaches and treatment options in ITP will be remarkable and beneficial for physicians interested in this subject. 

General Doctor's Consultation Work Begins before Entering the Patient and does not End when Patient Comes Out

May 2020 DOI 10.14302/issn.2692-5257.ijgp-20-3335
Luis Turabian JoseCorresponding author Specialist in Family and Community Medicine, Health Center Santa Maria de Benquerencia, Regional Health Service of Castilla la Mancha (SESCAM), Toledo, Spain

The consultation is the activity of meeting and communication between an individual and the doctor for the knowledge and solution of a health problem. In today's busy world of general medicine, constant demands for the general practitioner (GP) arise: she or he should not only make a diagnosis not only should make a differential diagnosis during consultation, but must also establish a good relationship, explore patient ideas, concerns and expectations and negotiate a management plan, taking into account limited resources, the quality framework and results, having Information technology skills, plus, the need to promote health during any consultation. Normally the GP has only 10 minutes to achieve all that, as well as to manage your own emotions, agendas and uncertainty. In this way, novice doctors may find it difficult to move in this situation of complexity, and they can also observe a gap in the literature that really guides them in practice. Rigorous preparation is the key to success for many endeavours. Some tips to perform an efficient and safe consultation work in general medicine are suggested: 1) Focus on the next patient; 2) Preparing the consultation before entering the patient, memorizing the patient's previous history; 3) Establishing a connection with the patient; 4) Remembering the elements that must be in each consultation (the current reason, update other previous processes, chronic diseases and continued attention, "case finding", health promotion); 5) Striking a balance between empathy and assertiveness; 6) Putting in writing and contextualized the clinical record; and 7) Making reflection-safety questions, learning questions, and preparation questions for the next visit. Rigorous preparation is the key to success for the general practitioner in every consultation. Think about these topics of the consultation before doing it, and after it, prepare the next consultation of that patient. All these things are force multipliers.

Model Based Research Open Access

Design Support to steer Creative Wicked Problem Solving Processes with Knowledge Management and Artificial Intelligence

Mar 2019 DOI 10.14302/issn.2643-2811.jmbr-19-2659
C LangenhanCorresponding author Technische Universität München

As the complexity of building tasks and requirements increases, designers often find themselves confronted with interdisciplinary problems that go beyond the specific challenges and methods of architecture. The iterative nature of the design process results in a continuous exchange between creative, analytical and evaluative activities, through which the designer explores and identifies promising design variants. The ability to compare and evaluate relevant reference examples of already built or designed buildings helps designers to assess their own design and informs the design process.

Quantification of Micrornas by Absolute Dpcr for the Diagnostic Screening of Colon Cancer

Feb 2019 DOI 10.14302/issn.2471-7061.jcrc-18-2526
E. Ahmed FaridCorresponding author GEM Tox Labs, Institute for Research in Biotechnology, 2905 South Memorial Drive, Greenville, NC 27834, USA.

There is currently no validated micro(mi)RNA diagnostic stool test to screen for colon cancer (CC) on the market because of the complexity of fecal density, vulnerability of stool to daily changes, and the presence of three sources of miRNAs in stool (cell-free from fecal homogenates, exsosomal miRNAs from fecal exosomes, and fecal colonocytes). To address these complexities, we have first carried out a microarray miRNA experiment, using Affymetrix GeneChip miRNA 2.0 Arrays, on immunocaptured and enriched stool colonocytes of 15 subjects (three healthy controls and twelve colon cancer patients [three TNM stage 0-1 (e.g., polyps◻ ³ 1 cm, villous or tubvillous, or with high grade dysplasia), three stage 2, three stage 3, and three stage 4 in triplicates to select a smaller panel of 14 preferentially expressed mature miRNAs associated with colon cancer (12 Up-Regulated, miR-19a, miR-20a, miR-21, miR-31, miR-34a, miR-96, miR-106a, miR-133a, miR-135b, miR-206, miR-224 and miR-302; and 2 Down-Regulated, miR-143 and miR-145). In a subsequent validation study carried out on total small RNA extracted by immunocapture, followed by RT that employed TaqMan® miRNA Reverse Transcription (RT) Kit and a Custom TaqMan RT Primer Pool, absolute quantification of miRNAs, in copies/µl, was measured using a chip-based Absolute QuantStudio 3D Digital PCR analysis. To ensure that we have chosen human and not bacterial small total RNA, we have carried out coextraction protocols with E. coli K1 strain RS18, compare Agilent electrophoretic patterns, and also sequenced random samples throughout this research using mRNA/miRNA sequencing. Our initial quantitative dPCR miRNA data presented herein showe that the quantitative changes in the expression of a few mature miRNA genes in stool, which are associated with right and left colon cancer, would provide for a more convenient, sensitive and specific diagnostic screening markers thatare more useful than those test markers currently available on the market, such as the low-sensitivity (<15%) fecal occult blood test (FOBT); result in better compliance; and is more economical than the invasive and expensive colonoscopy exam in colon cancer, which can be cured if that cancer is detected at the early TNM stages, and that becomes incurable and deadly if not diagnosed before metastasis. Initial test performance characteristics of the miRNA approach showed that the test has a high numerical predictive value in colon cancer. Moreover, underpinning of the miRNA markers as a function of total RNA showed that the test can numerically differentiate between control subjects and colon cancer patients, particularly at the early stages of that curable cancer. We propose to extend our initial research results to a larger prospective and randomized five-years nested case-control study, to validate the expression of the above 14 miRNAs, in stool of 180 individuals in an epidemiologically designed study, using (30 controls and 150 colon cancer patients (thirty precancerous polyps (stage 0-1), forty five stage 2, and seventy-five colon cancer stages 3 or 4). chosen randomly by an epidemiological method from 900 control and CC subjects to allow for an adequate time to collect the required 900 stool samples, as well as allowing for statistically valid analysis, standardized test conditions, and to provide a mean for determining the true sensitivity and specificity of a miRNA-screening approach in noninvasive human stool. Power-analysis has indicated that a total of 180 individuals, which will take us 5 years to enroll in testing, is an appropriate number of subjects to standardize and validate our proposed miRNA screening test. We may find out at the end of the proposed validation study in stool that fewer miRNAs, or even one miRNA, may suffice to serve as an efficient and a quantitative marker for the non-invasive diagnostic screening of colon cancer in human stool. The above approach when combined with bioinformatics analysis, to correlate miRNA seed data with our previously published messenger (m)RNA target data in stool, allows for a thorough mechanistic understanding of how miRNA genes regulate mRNA expression, and would offer a better comprehensive diagnostic screening test for the non-invasive early detection stage (0-1) of colon cancer. In order to show the clinical sensitivity and specificity of the proposed miRNA test, the absolute miRNA PCR values, in copies/µl, will be correlated with FOBT, colonoscopy, and pathology data. Standardization will establish test’s performance characteristics (sample selection, optimal sample running conditions, preservation and storage) to ensure that the assay will perform the same way in any laboratory, by any trained personnel, anywhere in the World. Ultimately, a smaller number of selected validated miRNAs (<10) showing increased and reduced expression could suffice to give quantitative miRNAs colon cancer expression values, useful for the early diagnostic screening of that curable cancer.

In Silico Inhibition of Essential Candida albicans Proteins by Arenicin, a Marine Antifungal Peptide

Jan 2019 DOI 10.14302/issn.2643-0282.imsj-18-2448
Santiago Freitas e Silva KleberCorresponding author Biological Sciences Institute, Federal University of Goiás, Brazil

Fungal infections increased substantially in the last years, becoming a relevant public health problem. Many of these infections account for high rates of morbidity and mortality. The emergence of resistant fungal clinical isolates have also motivate studies to find new antifungal therapies. Candida albicans is an oportunistic pathogen and affects a great number of immunocompromised patients worldwide. The marine ecosystem has been considered a rich source of bioactive metabolites due to the complexity and originality of its structures. Proteins and peptides from marine organisms have been shown to have antiviral, anti-inflammatory, antimalarial, anticancer, antimicrobial and antifungal properties. Arenicins are antimicrobial peptides isolated from the marine lugworm Arenicola marina with 21 amino acid residues in a β-hairpin structure. Dihydrofolate reductase, exo-b-(1,3)-glucanase and sterol 14α-demethylase are essential C. albincas enzymes that take part in DNA, cell wall and membrane metabolism, respectively. The present study evaluates the interaction of arenicin with important enzymes of C. albicans related to cell wall, ergosterol and DNA metabolism in order to elucidate possible molecular targets. We showed through an in silico approach, that a single compound from a marine worm (A. marina), can bind to three C. albicans essential proteins. The interaction occurs in regions inside the active site or at least near, with amino acid residues evaluated as hot spots. Arenicin is a new promising antifugal drug. The next step is to investigate protein-protein interactions performed by DHFR, EBG and CYP51 and assess whether arenicin is able to disrupt essential interaction or not.

Evaluation of the Effects of Health Impact Assessment (Hia) Practice in Monteregie

Jan 2019 DOI 10.14302/issn.2693-1176.ijgh-18-2523
Nour KareenCorresponding author University of Sherbrooke and CISSS Montérégie-Centre

This study explores the effects of the collaborative model of health impact assessment (HIA), as deployed in Monteregie (Quebec), on the development, adoption and implementation of municipal projects that include health considerations. Nine HIA processes were studied in nine territories and 35 individuals were interviewed. Data collection was based on the six steps of contribution analysis, and included document analysis, semi-structured interviews, and on-site observations. The study design is cross-sectional design were every HIA was analysed at least six month after completion. The individuals interviewed where those implicated into the HIA process (no matter at what point of the process). No exclusion criteria were applied considering that all points of view were important for this analysis. The Contribution Analysis (CA) was used to analyze the data. The study results emerged form by the interviews, the field observations and document analysis. They showed that the HIAs had varying results. First, the actors involved acquired new knowledge. However, the HIAs had little impact in terms of increasing the municipal actors’ awareness of health issues. Rather, it helped them acquire arguments for raising awareness among and convincing their municipal council members of the merits of certain actions and their potential positive impacts on citizens’ health. In fact, the HIAs were generally undertaken by municipal actors already aware of the importance of promoting citizen health. Second, as observed in the document, in a few of the HIAs, some recommendations were integrated into planning documents, but usually, as reported by the actor, the HIA report constituted an additional planning document and was not merged with the original planning documents. Lastly, following the HIAs, document analysis and interviews showed that most of the municipal actors continued to include health considerations in their subsequent planning of public policies and projects. Prerequisites for effective HIA include the presence of municipal actors, who are aware of the importance of their role in their local population’s health, municipal policies that include health considerations, and the municipality’s active participation in the HIA process. This study sheds light on the complexity of the factors that ensure HIA impact on municipal decision making and decisions. The particularities of each HIA process play a major role.

Biological Networks: An Introductory Review

Oct 2018 DOI 10.14302/issn.2326-0793.jpgr-18-2312
Saad Zaghloul Salem MohammadCorresponding author Professor of Medical Genetics, Faculty of Medicine, Ain-Shams University, Cairo, Egypt

All aspects of life activities in living cells are mediated/executed and regulated by a vast number of networks, comprising a wide spectrum of components, starting with simple biomolecules and ending with the whole organism, and functioning within a precisely organized tight framework. Proper mediation of cellular activities necessitates their inclusion within the context of structured and organized network systems capable of regulating/coordinating and synchronizing the countless numbers of biological processes occurring within living cells. The number of biological networks and pathways within the living cell is considerably huge, being dependent on the structural complexity and functional capabilities of the cell. Pathogenesis and progression of human diseases result from functional disturbances of biological networks within the cell as disturbed network function leads to deleterious effects on physiological processes dependent on, and mediated by, affected network(s). Ensuing pathological processes, defined by the nature of disturbed networks and the specific organs or tissues affected, pave the way for the development of pathognomonic and characteristic disease entities. As most network functions are dependent on relatively small number of key regulatory biomolecules, i.e. enzymes/proteins and signal transducing factors, it follows that functional disturbances of biological networks and pathogenesis of disease states can be attributed, in most instances, to quantitative and/or qualitative abnormalities of these key regulatory molecules. Study and analysis of the structural designs and the functional mechanisms of biological networks would have crucial and important impacts on many theoretical and applied aspects of biology, in general, and of medical sciences in particular. Meticulous study of biological networks represents an important and integral aspect in study of biology. Interpretation and analysis of key information deduced from observing and analyzing structural designs and functional characteristics and dynamics of biological networks discloses and defines the basic framework within which life activities in living cells are initiated, adapted to physiological requirements, maintained, and terminated upon completion of their aims. More important, however, is the contribution of this information to proper understanding of the different mechanisms responsible for regulating and synchronizing the functions and performances of the vast spectrum of different network categories within the cell. In addition to its vital scientific significance, discovering and defining the key pivotal structural and regulatory molecules within life-mediating networks, and along different pathways responsible for controlling functional dynamics of the network, represent an indispensable diagnostic approach insistent for designing proper therapeutic approaches to diseases caused by network defects.

Endocrine Disrupting Chemicals: Epigenetic Relevance and Mechanisms

May 2018
Alatsathianos IoannisCorresponding author Laboratory of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece.

Genetics alone cannot thoroughly expound the environmental impact on the molecular complexity of the endocrine system. Epigenetic-induced alteration in gene expression has emerged as a way in which environmental compounds may exert endocrine effects. The environmental compounds that interfere with normal endocrine signaling are one of the largest classes of toxicants we are exposed to, on a daily basis. Epigenetic mechanisms, mainly the methylation of DNA and the modification of histones, lead to differentiated activation and deactivation of genome domains creating phenotype plasticity and divergent endocrine function among populations and individuals, as well. The issues examined in the present review are related to environmental epigenetics, and more precisely, the epigenetic-mediated modulation and relevance of endocrine disrupting chemicals, focusing on three broad aspects: 1) persistence of EDs, 2) their major hormonal effects and 3) the potential of compounds previously considered as endocrine disruptors to induce epigenetic effects. Evidence suggests that environmental exposures notably impact expression of endocrine-related genes and, thus, affect clinical endocrine outcomes.

Human Health Research Open Access

Exploration of the Implementation of Music Therapy into the Health Services: Lituanian Experience

Dec 2017 DOI 10.14302/issn.2576-9383.jhhr-17-1788
Lesinskiene SigitaCorresponding author Vilnius University, Faculty of Medicine, Clinic of Psychiatry, Email: [email protected]

Integration of music therapy into medical treatment facilities is very uneven in different countries. Scientific evidence of successful examples and sharing of good practices between countries is essential for the further development of music therapy and the improvement of the quality of complex medical services. The goal of this study was to analyse the situation of music therapy implementation into the health services in Lithuania. Analysis of historical background, legislation and overview on music therapy training has been made. Music therapy in Lithuania has gone through more than thirty years of development. Acqaintance and acceptance of music therapy as a relevant and fruitful component to the complexity of the existing medical services was long but successful process. Overview of current initiatives and achievements of the implementation of music therapy into clinical practice and research has shown promissing positive results in developmental pediatrics, psychiatry, special education, neurology, neonatology, oncology, somatic and preventive medicine, rehabilitation. The Music Therapy Master program in Lithuania is being implemented. Possibilities to use music therapy as an inovative service and resourse in various medical settings are in the process of the rapid growth. Collaboration involving music therapists in interdisciplinary teams would help to achieve a comprehensive, versatile patient-centered and health-centered complex service.

How Harm Reduction Programs Work in The Context of Village and Commune Safety Policy: Lessons Learned from A National Non-Governmental Organization in Cambodia

Dec 2017
Yi SiyanCorresponding author Public Health Program, Touro University California, Vallejo, CA, the United States

This paper aims to examine the challenges and implications of the Village and Commune Safety Policy (VCSP) on harm-reduction programs and describe lessons learned from a harm-reduction program within the context of the VCSP in Cambodia. Data were collected from a monitoring and evaluation database and reports of a drop-in center that provides a wide range of harm-reduction services. In addition, qualitative data were collected through key informant interviews and focus group discussions with 38 participants including people who use drugs (PWUD) and people who inject drugs (PWID). Desk reviews and consultative meetings with key stakeholders were also conducted. In total, 496 PWUD were registered into the program between 2010 and 2012, of which 22.4% were PWID, and 15.0% were women. The mean age of participants was 26 years old. HIV prevalence among PWUD was 1.0% compared to 16.2% among PWID. Remarkable achievements were observed such as high uptake of services by PWUD and PWID with active referrals to methadone maintenance treatment (MMT) and voluntary HIV confidential counseling and testing (VCCT). However, distribution of clean needles and syringes in communities was limited. Also, the newly initiated needle and syringe program (NSP) based in pharmacies failed to reach PWUD and PWID. Appropriate coordination and collaboration with law enforcement and authorities were observed given the complexity of the VCSP. However, the implementation of the VCSP poses challenges including NSP and accessibility to harm reduction services. For future successes of harm-reduction programs, it is important to maintain close coordination and collaboration between program implementers and local authorities with mutual understanding and flexibility.

Evaluation of the Impact of Clinical, Functional and Social Factors on the Readmission of Patients with Pluripathologies

Apr 2016 DOI 10.14302/issn.2474-7785.jarh-15-699
Coronado-Vázquez ValleCorresponding author Healthcare Director, Hospital of Riotinto, Mines of Riotinto, Huelva

Purpose Hospital readmission of patients with pluripathologies is frequent and costly. This study describes the impact of patients’ pluripathologies, functional capacity and social complexity on readmissions during a 12-month period following hospital discharge. Methods A prospective cohort study. Monthly monitoring of 111 patients over 12 months in Hospital of Riotinto. The primary endpoint was readmission rate. Predictive variables: age, gender, hospitalizations the year before, illnesses that define the pluripathology, medication prescribed on discharge, social situation (Gijón Scale), functional state (Barthel) and cognitive impairment (Pfeiffer). Results Readmissions accounted for 21.6% of the patients surveyed. Of those readmitted, the mean age was lower than those who did not return to hospital (75.4 vs.79.6) (p=0.031), the average amount of medication prescribed greater (10.5 vs.8.7) (p=0.014), the Barthel score higher (52.5 vs.50.6) and the Gijón value lower (13.8 vs.14.6), but no results was significant. The mean survival time (without readmission) was 310.9 days (95% CI, 289.4-332.5). Category B (chronic renal disease and vasculitis) and F (diabetes with microangiopathy and artery disease) had a lower average survival time (X2=7.02; p=0.008) (X2=7.07; p=0.008). The readmission risk was hazard ratio (HR) = 3.13 (95% CI, 1.37-7.14) for category B, and HR = 3.38 (95% CI, 1.37-8.36) for category F. Conclusions There is a high proportion of readmissions among patients with pluripathologies in the year following discharge from hospital. The greater risk occurs in patients with chronic renal insufficiency and diabetes with microvascular complications. Factors that can be modified are polymedication and the proper control of patients’ diabetes.

Antioxidant Activity Open Access

The Total Antioxidant Capacity of Foods: A Reappraisal. Application to Commercial Orange Juices

Dec 2015 DOI 10.14302/issn.2471-2140.jaa-15-715
Kevers ClaireCorresponding author Plant Molecular Biology and Biotechnology and CEDEVIT B22, University of Liège Chemin de la Vallée, 4, Sart Tilman, 4000 Liège Belgium

Since a few years, more and more attention has been specifically given to dietary antioxidants as agents promoting health and preventing the incidence of diseases. As part of these efforts, analytical methods and assays have been developed to measure the antioxidant content in food substances. In this paper, the antioxidant capacity of 17 orange juices is determined by various assays (DPPH, ORAC, heamolysis, xanthine/xanthine oxidase) as the content in ascorbic acid and total phenolics. The results evidence all the complexity to evaluate the in vitro antioxidant capacity of foods. In very general terms, in spite of the wide utilization in these tests (FRAP, TAC, ORAC TRAP and others), their significance remains obscure. The discrepancy of the results and the absence of good correlation between the assays clearly highlight all the importance of understanding the strengths and weakness of assays evaluating antioxidant potential of a food at the risk of giving erroneous information to the consumer. It is clear that the use of "total antioxidant capacity" assays for the in vitro assessment of antioxidant quality of food does not be employed by food industrials as a marketing argument or for the assessment of the "wholesomeness" of a food.

Factors Influencing the Effectiveness of a One-day CBT for Insomnia Workshop

Dec 2015 DOI 10.14302/issn.2574-4518.jsdr-14-592
Steele AnnCorresponding author Psychosis Research Unit, Rico House, Harrop House, Bury New Road, Prestwich, M25 3BL, United Kingdom.

Insomnia is highly prevalent and has severe negative consequences. Cognitive Behavioural Therapy for Insomnia (CBT-I) is an evidence-based treatment that is usually delivered individually. Given the high prevalence, accessible one-day CBT-I workshops (each for up to 30 people) were developed to be run in the community for the general public 1. These CBT-I workshops have been found to reduce levels of insomnia 23 and are now run on a routine basis. As yet, little is known about the impact of factors such as co-morbid depression or anxiety, or receipt of previous treatment, on the effectiveness of the CBT-I workshop. This study aimed to evaluate the accessibility and clinical effectiveness of a series of nine one-day CBT-I workshops (n=120) run in routine practice and to explore the impact of factors including co-morbid depression or anxiety and receipt of previous treatment, on the effectiveness of the CBT-I workshops. The CBT-I workshops were found to be effective at reducing insomnia at one-month follow-up and broadly accessible across a wide group of people in the community. In addition, significant reductions in depression and anxiety were found and the severity of depression or anxiety at baseline did not interfere with the effectiveness of the workshop. People with no previous experience of counselling or psychological therapy showed greater reduction of insomnia symptoms. It is concluded that the CBT-I workshop is an accessible and effective treatment for insomnia across a range of clinical severity and complexity. Further benefits include reductions in both depression and anxiety.

Thyroid Cancer Open Access

Medullary Thyroid Cancer: Is the Adequacy of Pre-Operative Evaluation Influenced by Training Background?

May 2015 DOI 10.14302/issn.2574-4496.jtc-14-395
Alhefdhi AmalCorresponding author Section of Endocrine Surgery, Department of Surgery, University of Wisconsin, Madison, WI

Background: Medullary Thyroid Cancer (MTC) is a rare malignancy, accounting for less than 3% of all thyroid cancers and causes significant morbidity and mortality. MTC is often due to an underlying mutation of the RET proto-oncogene, which can result in additional endocrinopathies that must be screened for pre-operatively. The project aim was to determine if surgical training background influenced patient pre-operative evaluation for MTC. Methods: A retrospective review was performed of patients undergoing thyroidectomy for MTC at a single academic institution. Patients were analyzed based on who performed the initial operative procedure, a surgeon with specific endocrine surgery training or a surgeon without. Results: From 1994 to 2011, 37 patients with MTC were identified. Thirty percent were managed by an endocrine surgeon and 70% by a non-endocrine surgeon. A complete thyroid work-up was done for all the patients managed by an endocrine surgeon vs. 38.5% of the non-endocrine surgeon patients (p<0.01). Appropriate preoperative endocrine screening was performed in 91% of the endocrine surgeon patients vs. 50% of the non-endocrine surgeon patients (p= 0.03). RET mutation genetic testing was done for all endocrine surgeon patients vs. 85% of non-endocrine surgeon patients (p= 0.30). Conclusion: Endocrine trained surgeons recognize and appropriately manage the complexity of MTC and associated endocrinopathies, more often than surgeons without an endocrine surgery background. This may result in optimized management of these patients.

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