The Malaysian adenosine receptor antagonist has experienced the highest growth over the past decade (Sheng et al., 2008). However, little attention has been given to parking and transportation matters in most areas within cities in Malaysia (Tey, 2003). Keeping in view that private cars are now a much more convenient form of transportation than public transport. In the majority of regions within Kuala Lumpur, land use patterns reflect most respective areas (Ariffin and Zahari, 2013).
The most significant reason for applying network analysis and route planning to transportation is that businesses are interested in determining the best routes to minimize cost and time (Memon, 2005). The focus of this study is therefore on network analysis application for determining the quickest routes in terms of time, to deliver fresh vegetables to selected hypermarkets around Kuala Lumpur and Selangor.
Like an index model, a regression model can use overlay operations in a GIS to combine variables needed for the analysis (Chang, 2008). The regression model is applied in this study as well, and the variables are tested via this model. The most significant variables are taken into account in the model, and one that has not contributed any value to drive time is omitted from the analysis. In the final regression model process, a proper formula is identified as the variables demonstrate the most significant place in the context of this study.
The traditions of GIS are strongly based on the maps, and even today it is common to introduce GIS through the ideas of representing of contents of maps in computer databases. GIS shows the real world objects on map and user friendly spatial tools to accomplish complex task. Geographic Information System is used to display, manipulate and analyze spatial (map) data. Spatial data are data that contain a reference to a place (Nayati, 2008).
The society is the best decision maker on Land Use. Land use can be changed based on society decisions whether to be a farmland or industrial or suitable for residential area Ashraf et al. (2012).
The main objective of this research is to identify the effect that the most critical factors have on the selection of the fastest routes for fresh vegetable delivery in terms of time. As another objective, a GIS model is proposed to solve the distribution problem based on the variables derived from the GIS model. Visualization, as the outcome of this research, will help people approach problems in the dimensions of space and time and in the form of digital maps rather than dimensionally-restricted data tables and graphs (Han, 2001).
The price of fossil fuel has been on the rise over the past decade. Vehicle fuel consumption is approximately 30% greater under heavy congestion conditions, especially during peak hours, with the result being longer delay time. A study was conducted on the effects of different levels of traffic on delay time to identify the ideal routes in static and dynamic traffic networks, with the parameters considered being drive time and fuel cost (Shokri et al., 2009).
Winyoopradist and Siangsuebchart (1999) developed a model on Network Analyst based on vehicle speed at different times of the day. In their work, the Network Analyst tool has the capability of calculating the shortest traveling time between two locations by specifying the starting time. Focus was on the speed patterns on some roads at different times of day and days of the week. Echols (2003) developed a GIS application to determine the quickest route between two destinations based on distance and travel time. Unfortunately, Echols (2003) did not consider land use as a variable for calculating efficient transportation routes.
To solve routing problems and find the most suitable paths for dispatching fresh produce, several methods have been applied. Although the GIS system provides calculations that result in visual solutions, which users can utilize to make prompt decisions. For example, Osvald and Stirn (2008) did research on the distribution of fresh vegetables, Belenguer et al. (2005) studied delivery routes for the meat industry, while Tarantilis and Kiranoudis (2001) analyzed the distribution of fresh milk. Incidentally, Tarantilis and Kiranoudis (2002) solved the fresh meat distribution problem by applying several algorithms to identify optimal sets of routes. The limitation of the mentioned research is that the author applied the mathematical equation instead of spatial data for finding the efficient routes. Moreover, the parameters that have an impact on traffic issues have not been considered.
Siddique et al. (2014) showed markedly higher concentrations of total phenols and crucial activity of protease, malondialdehyde (MDA), superoxide dismutase (SOD), and polyphenol oxidase (PPO) in resistant genotype after infection with Cotton Leaf Curl Burewala virus (CLCuBuV).They proposed a kind of correlation between constitutively induced levels of these enzymes and plant defense that could be contemplated as biochemical parameters for studying plant-virus compatible and incompatible interactions.
Comet Assay showed numerical measurements of the DNA damages by calculating the length of the tail and percentage of total DNA in the tail. The “tail moment unites” (TM) is the most significant and informative feature of the comet image that has 522.40% in the infected group (Table 1 and B). The value resembles the amount of DNA in the tail and the mean distance of migration in the tail. The higher tail moments indicate greater DNA damages. Accordingly, “tail moment”(TM) was capable, with 100% sensitivity and specificity (Cutoff value=3.201) as reported in Tables 2 and 5. It measures and detects single- and double-strand breaks in genomic DNA. As Accordingly, our findings (Tables 1, 2 and 5, B, 3A and B and 4) could explain and evaluate the high genotoxic response toward TMV infection in D. metel due to the rapid and transient production of the oxidative burst, with AOS. The Asymptomatic value was 1.50units while the TMV-infected Puromycin had 7.85units, i.e. DNA triggering response for damage to be considered equal to that value or more. The control value of the “tail moment”(TM) was 2.181units while the TMV-infected cells had 18.870units, i.e. ten times DNA damage after one week from infection (Al-Huqail et al., 2014). Fig. 4 showed a high correlation between H2O2 and tail length of DNA in the symptomatic studied group with R2=0.895.
Concerning chlorophyll immune response, Chl-a is a crucial predictor variable parameter for the plant resistance as illustrated in Table 4. Using Multiple Regression Analysis, an R2 of 0.90 and (ß) coefficient=-1.256 indicate that Chl-a explains 90% of the variation in the dependent (H2O2) parameter in a negative direction. Moreover, Chl-a (+) strongly correlated with protein and salicylic acid. Contrarily, had (−) strong association with DNA damage parameters in addition to H2O2 (Tables 3 and 4, Figs. 5 and 6). The SA level usually interconnected with the increase in plant tolerance to environmental stress (Noreen and Ashraf, 2008). Thus, in conditions where plants are at a danger of elevating ROS-dependent; signaling systems and metabolic processes need to be initiated depending on photosynthesis reaction. Failure to keep redox balance results in growth defects or the begining of cell death (Mateo et al., 2004). Acclimation of plant leaves to excess excitation energy (EEE) is controlled, partially by a particular alteration in the redox level of the plastoquinone (PQ) pool. It proved that the plant’s response to EEE could be regulated by multiple hormonal/ROS signaling pathways, and EEE stimulates systemic acquired resistance as well as basal defenses to virulent biotrophic bacteria (Kruk and Karpinski, 2006). Chl-b acts indirectly in photosynthesis by transferring light absorbed to Chl-a and conceded an accessory pigment (Mateo et al., 2004).
Results of the present study proved a high correlation between Chlorophyll-a as a predictor of variant and redox changes of H2O2. 90% of the dependent variable (H2O2) could be explained by the predictor variables of Chlorophyll-a while the ß coefficients value (−1.256) showed a negative contribution (Table 4).
It also proved that local and systemic acclimatization in Arabidopsis thaliana leaves in swift response to EEE, connected with cell death and managed by specific redox changes of the plastoquinone (PQ) pool. This redox alteration caused a rapid reduction of stomatal conductance, global induction of ASCORBATE PEROXIDASE2 and PATHOGEN RESISTANCE1, and elevation production of ROS and ethylene that signals through ETHYLENE INSENSITIVE2 (EIN2) (Mühlenbock et al., 2008).
For Cases 1-3, the exercise began with a hand saw followed by a high-speed motor saw Each saw was used continuously for 15 minutes, with a 30-minute break in between. A personal air sampling, which began immediately just before the mitering, was taken for each of the two cuts, lasting about 30 minutes. An area sampling was taken for the entire test for 60 minutes. Placed in a wooden box, the samples were carried back to the laboratory and prepared for the counting by the phase EZ Cap Reagent GG (3\’ OMe) microscopy, equipped with Walton-Beckett Graticule type G-22 counting area of 0.00785 mm2. The sample analysis was in accordance with the NIOSH\’s counting Rule A, which sets the limit of detection at 7 fibers/mm2.
Case 1 was conducted under the roof in a ventilated area (Fig. 1). Only one sheet at a time was cut using wood-cutting saw and two slowly being cut by a motor saw with the speed of 800 rpm. The worker was aware of the dust and positioned himself up-wind.
Case 2 (Fig. 2) was conducted in a roof-shaded area and without any building nearby. The wind was stagnant for most of the time. Both the metal-cutting and high-speed motor (1,200 rpm) saws were used. One to 2 sheets were cut at a time by the metal-cutting saw and 4 to 5 by the latter. The worker performed the task quickly and was conscious of putting himself at risk from dust exposure.
Case 3 (Fig. 3) was tested in an outdoor area where the wind often changed direction. One or more was cut at the same time by a metal-cutting saw and then 3-4 by a high-speed motor (1,200 rpm) saw Aware of the dust, the worker tried to protect himself by moving up-wind. The wind changed direction dramatically, and the worker was unable to escape the dust.
Case 4 was conducted in a ventilated area situated between 2 buildings (Fig. 4). Using only a high-speed motor (1,200 rpm) saw, the worker slowly cut the roof-tile one at a time. The wind changed direction occasionally, but the worker\’s attempts to stay ahead of the wind were restricted by the site\’s space limitation.
As shown in Table 1, the fiber concentration levels of all personal samples taken for 30 minutes from a high-speed motor saw exceeded the Occupational Safety and Health Administration of the United States (OSHA) 30 minutes excursion standard of 1 fibers/cc, with the median of 4.11 fibers/cc and the range in between 1.33-12.41 fibers/cc. During the tests using hand saws, only one sample, taken from the Case 2, was over the excursion standard, showing the median of 0.13 fibers/cc and the range of 0.01-5.00 fibers/cc. All area samples from the 2 cutting tools showed the median of 0.59 fibers/cc with the range of 0.14-3.32 fibers/cc.
The workers\’ behaviors and practices had an adverse effect on the exposure problem. Among the 4 cases, Case 2\’s worker faced the greatest exposure risk from working rapidly and from positioning himself closer to the task (Fig. 2). In Cases 3 and 4, each worker tried to minimize the impact by staying upwind during the cuttings, which were performed at a normal speed. To avoid the dust, Case 4\’s worker performed the cutting slowly.
Many studies on occupational lung cancer on construction workers blame asbestos as one of the leading causes of the workers\’ disease [13,14]. There is a counter-argument Zoo blot construction materials used in Europe, the United States, and other cold-weathered regions are of the friable ACM type, which is claimed to generate more asbestos concentrations than the non-friable substances, such as the AC sheets that are used extensively in Thailand and in other Asian countries. According to the argument, the AC sheets are safe to use for workers and others living nearby. This study shows that the argument is invalid. The AC sheets release asbestos dust at concentrations harmful not only to the workers, but also to the general public as well.
According to a survey of cancer patients in Thailand, lung cancer was most common among men between 2001-2009 (incidence rates) . A Thai public health study found the country\’s northern region to have the highest lung cancer incidence rate during 1998-2000. Another study blamed radon , air pollutions and home-made cigarettes for age-standardized incidence rate (ASR, 30.7) . However, asbestos exposure from the roof-tile mitering is not considered as a contributing cause of lung cancer among Thais. However in Thailand, corrugated AC roof sheets have been used extensively for sometime.
Our laboratory has completed a clinical trial investigating the effects of low-dose aspirin therapy on firefighter physiology, platelet activation, and vascular function during and following uncompensable heat stress (clinicaltrials.govNCT01066923). Aspirin has been shown to reduce cardiac events in individuals of the general population who have cardiovascular disease (CVD) risk factors  and may decrease the overall prothrombotic state resulting from exertional heat stress during fire suppression. Data from our laboratory have demonstrated that aspirin therapy blunts heat-induced platelet activation and did not adversely affect core body temperature during work in an uncompensable heat stress environment . However, other reports have suggested that systemic platelet inhibition by aspirin with standard therapeutic doses subsequently inhibited reflex cutaneous vasodilation [16–18]. Specifically, anticoagulation therapy inhibits the release of vasodilator substances from activated platelets [19–21], decreases the shear stimulus on the cutaneous microvasculature , and/or alters the internal temperature threshold for heat dissipation [16,17], eventually resulting in decreased dry heat loss capacity and increased thermal strain.
To our knowledge, this is the first study to comprehensively examine the effects of low-dose aspirin therapy on multiple indices of thermoregulation, inflammation, and physiological responses to exertion in the heat while wearing thermal-protective clothing. Previous studies demonstrating an attenuation in skin blood-flow responses were primarily done under passive heat stress conditions in middle-aged and older adults [16,17], with large doses of aspirin , or using anodal current-induced vasodilation [18,22], none of which is reflective of the environmental conditions or exertional loads that firefighters are exposed to. In addition, doing exercise in the heat leads to total body water and Epigenetics Compound Library volume losses, which further reduce blood flow to the gut . Hypoperfusion of the gut leads to mucosal damage and the invasion of endotoxins into the blood. Low-dose aspirin has also been reported to damage the gut mucosa [24,25]. Elevated endotoxin levels can lead to fever, shivering, dizziness, nausea, vomiting, and diarrhea, all of which have been reported in endurance athletes [26–28]. The level of plasma tumor necrosis factor-α (TNF-α) is significantly increased in response to endotoxin . Endotoxin and cytokine release may be indicative of poor thermal compensation. Understanding the impact of aspirin therapy on endotoxin release and the subsequent cytokine response is vital with regard to the safety profile of aspirin use during exertion under uncompensable heat stress conditions.
Materials and methods
Eighteen male firefighters were enrolled in the study. Two were excluded from participation for medical reasons and one dropped out due to a nonstudy-related illness (Table 2).
Fourteen days of low-dose aspirin therapy blunts platelet activation under uncompensable heat stress condition. In this group of young, healthy firefighters, there were no differences in skin blood-flow responses following exertion while wearing thermal-protective clothing after aspirin therapy. Firefighters reached near-maximal heart rates, and their core body and skin temperature exceeded 39.0°C at the end of exertion, which is similar to what our laboratory has reported following live fire exercises [37,38].
Bruning et al  reported that core temperature was elevated after passive heat stress and remained elevated following an exercise bout after 7 days of low-dose aspirin. However, there were no differences in the rate of rise in core body temperature or subjective perception of effort between the aspirin and placebo trials. This is in agreement with our results that there were no significant differences in core body temperature, with both groups reaching temperatures above 39.0°C. Bruning et al  also reported a reduction in CVCmax of approximately 10% and a rightward shift in the threshold for the onset of reflex vasodilation following aspirin therapy. We did not find this to be true in our experiment. This may be due to differences in the mode of exercise (cycle vs. treadmill), higher exercise intensity resulting in higher maximal heart rates and core body temperature during exercise, and uncompensable heat stress conditions in our report.
These purposes of the WHS imply a job-specific approach rather than a general one. Following the International Labor Organization (ILO) guidelines, WHS should take into account the occupational hazards in the workplace and the health requirements of the work, to make sure the surveillance of worker\’s health is appropriate to the occupational risks of the job . The ILO considers investigating occupational risk factors as part of the WHS; in the Netherlands this is regulated differently and is done prior to the WHS in a so-called structured risk assessment and evaluation. This job-specific approach of a WHS is necessary because in the case of work-related health complaints, attention should be directed at finding the exact mismatch between job demands and the individual\’s abilities to meet these demands . Furthermore, not only does a job-specific approach of a WHS allow for interventions that best fit with the occupation of interest—therefore increasing the likelihood of effective interventions to increase work functioning—but workers should also be protected from an abundance of screening tests and assessments that do not forecast how well they nobiletin perform their job .
Materials and methods
To determine the content of the job-specific WHS for hospital physicians, a decision tree was developed based on answers to four questions (Fig. 1). Subdecision trees were developed for the different type of job demands and occupational exposures. Irrespective of the type of demands or occupational exposures, all decision trees were designed to establish whether or not to include work-related health effects known to be related to job demands, or whether or not to include aspects of health that reflect insufficient job requirements of the individual hospital physician to meet the demands of the job.
Before question 1 of the decision tree could be answered (Fig. 1), occupational exposures and job demands in the work of hospital physicians needed to be identified. Information regarding physical job demands was gathered in two ways: through self-reporting or direct observations of hospital physicians of one Academic Medical Center in the Netherlands [8,17]. Direct observations, to gather data in terms of duration, frequency, and intensity, and data regarding mean and peak energetic load, were performed during the work of 126 hospital physicians [3,17]. To account for the differences in tasks and activities between several medical specialties, the physical job demands were reported, when possible, for three clusters of medical specialties. The clusters of medical specialties were: (1) observational medical specialties (e.g., Internal Medicine); (2) supportive (e.g., Radiology), and (3) surgical (e.g., General Surgery). Psychological job demands and biological exposures were obtained from evidence-based information from international studies, and locally through self-reporting . Insight into chemical and physical exposure was obtained through international evidence . Once the occupational physical exposures and job demands were identified, they were compared with the guidelines of occupational exposures and job demands, e.g., with Dutch guidelines of occupational exposures and job demands (Fig. 1, question 1) . When the occupational physical exposures and job demands did not exceed these guidelines, but a considerable proportion of hospital physicians felt bothered by the physical job demand (Fig. 1, question 1B), it was still considered a potential threat to good health and work-functioning. Question 1PsEx served to gather information regarding the prevalence of emotionally demanding situations, thereby contributing to the evidence base of the WHS. A cut-off of 10% was established beforehand, because this cut-off was used in the final process of deciding on inclusion or exclusion in the WHS. Data that were needed to answer questions 1B and 1PsEx (Fig. 1) of the decision tree were obtained locally through self-reporting by 900 hospital physicians and medical residents and through evidence-based information from international literature [8,17].
Levy a réalisé en 1972 la première étude épidémiologique sur les troubles sexuels chez les malades en insuffisance rénale chronique (IRC) . Depuis lors, la majorité des études épidémiologiques, bien que peu nombreuses, a suggéré que l’importance des problèmes sexuels chez ces patients est bien fondée et mérite d’être approfondie [2–4].
Patients et méthodes
L’âge moyen de nos malades était de 45,5+/-1,5ans avec une médiane de 45ans et des extrêmes allant de 18 à 75ans. Environ 56% de nos malades étaient de sexe masculin.
La fréquence de la dysfonction sexuelle chez nos patients était de 78%, tous ces malades ont affirmé l’apparition de ces troubles après le début de l’HD (Figure N̊1).
Les résultats cliniques et paracliniques ont été résumés dans les tableaux N° 1 et 2.
Dans notre étude, les patients présentant une dysfonction sexuelle avaient un âge plus avancé, un début de dialyse plus ancien et des troubles hormonaux significativement plus marqués que les patients sans troubles sexuels. Le taux de téstostéronémie était bas chez 32 patients (78% des hommes) et a été significativement plus bas chez les hommes présentant une dysfonction (p=0,020).
L’anémie était un facteur significatif d’apparition de troubles sexuels (p=0,031). Dans notre étude, nous n’avons pas objectivé de corrélation entre les taux des LH, FSH et œstradiol et l’existence de dysfonction sexuelle.
Il a été démontré que les troubles sexuels sont fréquemment rencontrés chez les malades souffrant d’IRC en stade d’HD [2,3]. Ces malades sont exposés à un certain nombre de comorbidités (HTA, diabète, dépression…) qui augmentent la fréquence de ces troubles par rapport à la harpagoside générale. Notre étude confirme l’importance de ces troubles dans notre population de malades (78%) qui s’associent à d’autres facteurs contribuant à la détérioration de la qualité de vie. Le diagnostic et le traitement de ces troubles sexuels doivent entrer dans le cadre d’une prise en charge globale du malade.
Les troubles sexuels étaient très fréquents chez nos malades (73% des hommes et 84% des femmes), ces résultats rejoignent ceux de la littérature où ces taux atteignent 70% (95% CI, 62%-77%) chez les hommes et 30% à 80% chez les femmes [4–6]. Quoiqu’on doit noter la rareté des études sur la prévalence de ces troubles chez les femmes en HD. Mais dans tous les cas on trouvait que ces troubles étaient plus fréquents chez IRCT que dans la population générale malgré les avancées importante de la prise en charge des IRCT ces dernières décennies [4,6].
Il est démontré dans la littérature que l’apparition de ces troubles est liée à l’âge [6–8]. Malekmakan et al.  avait mené une étude sur 73 hommes âgés de 18 à 70ans et avait trouvé que la prévalence du dysfonctionnement érectile (DE) augmentait proportionnellement avec l’âge des patients allant de 70,8% pour les patients âgés de moins de 50ans à 95,9% pour les plus de 50ans. Strippoli et al.  a réalisé l’une des études les plus larges et les plus approfondies sur la dysfonction sexuelle chez 1472 femmes en HD, et a trouvé que leur apparition était intimement liée à l’âge, la ménopause et le niveau éducatif. Dans notre étude l’âge était significativement lié à la survenue de ces troubles chez les 2 sexes avec p<0,0001.
Dans notre série, les malades avec une dysfonction sexuelle avaient une durée de dialyse supérieure aux malades sans trouble. Au contraire, plusieurs études trouvaient que la durée d’HD n’influençait pas la survenue de ces troubles [7,8].
Des études ont rapporté l’existence d’une relation significative entre la survenue des troubles sexuels et un poids sec diminué , ceci n’a pas été retrouvé dans notre travail.
Il n’existait pas de lien entre diabète, HTA, dyslipidémie et tabagisme et la survenue de troubles sexuels chez nos patients. Néanmoins, on trouve dans la littérature que la néphropathie diabétique est un facteur de risque déterminant, induisant des neuropathies, artériopathies ou lésions endothéliales [6,9]. De même pour l’existence de facteurs de risque cardiovasculaires, d’une HTA, d’une surcharge pondérale ou dyslipidémie .
La información anterior concuerda con los datos obtenidos por nosotros do baicalein cost de se observa que la mayor parte (84.17 %) de la población encuestada es hablante de la lengua maya, ya sea monolingüe (15.06 %) o bilingüe maya-español (69.11 %). Esta información nos permite constatar la vitalidad de la lengua maya, al mismo tiempo que nos sirve para demostrar la relación que existe entre el origen maya que pueda estar implícito en el apellido y la utilización de la lengua maya como principal medio de comunicación. Si nos apoyamos en los datos estadísticos podemos decir que existe una mayor probabilidad de que quien tenga apellido maya sea hablante de esta lengua. Si comparamos la información de cada uno de los municipios analizados encontramos que existen diferencias entre ambas zonas que son resultado de los diferentes procesos históricos que se desarrollaron en cada una.
Así, en el municipio de Valladolid, que se encuentra en la zona considerada como la “más tradicional” del estado de Yucatán, el Censo General de Población y Vivienda del 2000 reporta que de una población de 49 381 habitantes, casi la mitad (25 182) mayores de cinco años son bilingües maya-español, en tanto que 5 957 mayores de cinco años son monolingües de maya y el resto es monolingüe de español. Si comparamos estos datos con los obtenidos en nuestra investigación (cuadro 4), encontramos que también en este municipio se presenta el más alto porcentaje (100 %) de hablantes de maya (71.68 % son bilingües maya-español, en tanto que 28.32 % son monolingües maya) y no encontramos monolingües de español originarios de Yucatán. Por ejemplo, don José Koyoc, habitante de Kanxoc nos dijo: “Entre los kanxoques todos hablamos la maya porque es la lengua que nos enseñaron nuestros padres y la que hablaban los antiguos que vivieron aquí. Por eso en todos lados se habla. El que es kanxoque es mayero, hablamos la maya aunque estemos en Valladolid”.
Encontramos que en el municipio de Motul, localizado en la “moderna” zona henequenera, el censo del 2000 señala que de un total de 29 485 habitantes, 10 483 son hablantes de maya, de los cuales casi la totalidad son bilingües mientras que solamente 302 son monolingües. De acuerdo con nuestros datos, aunque también se reporta un alto porcentaje de hablantes de maya (67.90 %), el índice de monolingües de maya es muy bajo (2.63 %), en tanto que una población significativa (29.47 %) es monolingüe de español. Comparando ambos municipios podemos ver que, si tomamos en cuenta el alto porcentaje de bilingüismo y monolingüismo de español, podemos inferir que en Motul existe una clara tendencia a Recombination-repair sustituir el uso del maya por el español como lengua materna, en tanto que en Valladolid se sigue conservando el maya como primera lengua (cuadro 4).
El alto porcentaje de bilingüismo maya-español expresa el dominio del español y la subordinación lingüística del maya, así como el proceso de desplazamientode esta lengua por aquella especialmente en la llamada ex zona henequenera, donde la maya (como le llaman los hablantes) ha pasado a ser la segunda lengua, entre un cada vez más amplio sector de la población compuesto principalmente por las familias de los migrantes, entre quienes el uso del maya se ha restringido casi exclusivamente a las personas de más edad y al ámbito privado, no sólo intracomunitario sino incluso intrafamiliar. Esta situación puede representar el principio de un proceso de erosión lingüística que suele suceder tanto por causas de migración como por una adquisición insuficiente de la lengua minoritaria (en este caso el maya) como lengua materna (Pfailer 1994). Al respecto dice don Adelaido Uicab, dueño de una tienda en Ucí:
Valoración y transmisión de la lengua materna
Sin embargo, cabe señalar que el principio de integración unitaria conlleva códigos y reglas que, en el caso de las identidades colectivas, tienen que ver con la cooperación y solidaridad del grupo. En el cuadro 4 podemos ver que la mayoría de los sujetos sociales hacen una valoración positiva de su lengua debido, básicamente, a su funcionalidad como medio de intercomunicación con el “nosotros”, en tanto que el reducido porcentaje que la valoró negativamente lo hizo en función de los “otros”. La valoración que denominamos neutra es aquella que no expresó claramente una percepción positiva o negativa, sino que dijo hablarla “porque es la costumbre” o “porque sus padres, familiares y amigos la hablan”. Este principio se expresa también en la transmisión de la lengua materna en los primeros años de vida, tal como se ve en el cuadro anterior, el cual refleja que la mayoría de los que integraron la muestra continúa enseñando “la maya a sus hijos”.
The increased material parameter increases the resultant viscosity of the fluid and generates more heat due to the increased viscous forces. Therefore, the temperature as well as thermal boundary layer thickness increases with the increasing value of as seen in Figure 16. Due to the increased temperature and thickening of thermal boundary layer, the local Nusselt number decreases with the increasing value of material parameter. The variation of Nusselt number is shown in Table 4. This table also signifies that an increase in JQ1 friction, increases the heat transfer rate.
Physically the Eckert number is the measure of viscous dissipation. Therefore, increasing the value of implies more dissipation, i.e. an increase in the temperature of the fluid. Figure 17 depicts that the temperature at the surface of the wedge, as well as the thermal boundary layer thickness increases with the increase in Ec. This causes a decrease in heat transfer rate.
Figure 18 shows that increasing the value of Prandtl number decreases the thermal boundary layer thickness and results in a decreasing heat transfer rate. This effect is very obvious from the physical meaning of , i.e. the ratio of kinematic viscosity to thermal. These variations are also presented in Table 2.
The effects of other parameters on local skin friction coefficients and local Nusselt number are given in Table 5. From this table it is concluded that the increasing value of magnetic field decreases skin friction coefficients and increases heat transfer rate. Further, the inertial parameter shows an increase in skin friction coefficients upto a fixed value of the parameter, but after this value the trend gets reversed. Similarly the local Nusselt number decreases with the increase in material parameter, but after the same fixed value of the parameter it decreases.
Internal flow condensation or condensation inside pipes has two forms : condensation inside horizontal pipes and condensation inside vertical pipes. Condensation inside horizontal pipes begins with an annular flow pattern but, then, due to gravitational effect, changes into some other, usually complicated, flow patterns, such as stratified flow. However, condensation inside vertical pipes begins and ends as an annular flow pattern i.e., the flow pattern is annular in the whole process of condensation inside vertical pipes until the condensate is removed from the bottom end of the condensing pipe. In other words, annular flow pattern is the dominant flow pattern in the condensation inside vertical pipes.
For analysis of the annular flow pattern in steam condensation inside vertical pipes, two-fluid models have been the dominant ones over the past two decades. However, some researchers have presented developed forms of two-fluid models for other two-phase flows. For instance, Chung  developed a new hyperbolic two-dimensional, two-fluid model to properly solve two-phase gas–liquid flows. The two-fluid models consider the pipe core gas phase and the wall-adjacent liquid film as the two fluids for which the mass, momentum and energy conservation equations are considered. Nevertheless, during the last two decades, two-fluid models have been replaced by three-fluid models, due to their compared efficiency. Three-fluid models are based on the mass, momentum and energy conservation equations for three fluid flows in the annular flow, i.e. pipe core gas phase, wall-adjacent liquid film and entrained droplets, as shown in Figure 1. In this framework, Kishore and Jayanti  developed a finite volume method-based CFD model to simulate steady turbulent two-dimensional annular gas–liquid flow in a duct, in which the presence of droplets is accounted for by solving an additional scalar transport equation for the mass fraction of droplets. Alipchenkov et al.  suggested a three-fluid model of the dispersed-annular regime of two-phase flow that includes the equation for the number density of particles of the dispersed phase used to determine the mean particle size. Stevanovic et al.  predicted pressure changes in annular downward flow of condensing steam in vertical pipes with a three-fluid model. They applied several available correlations for the steam–liquid film interfacial friction in the three-fluid model, and since discrepancies were obtained between calculated and measured pressure changes, they proposed a new correlation for the interfacial friction coefficient, which provided good agreement.
We present a case of severe abdominal cramp that developed during the use of levofloxacin by a 46-year-old female. Use of the Naranjo probability scale demonstrated a possible association between levofloxacin and this adverse effect (Naranjo et al., 1981). Although factors that may cause abdominal pain (e.g. irritable bowel syndrome) were ruled out, not all factors that may cause abdominal cramp could be ruled out with certainty. Nevertheless, we believe levofloxacin was the most likely agent, since the patient was pursuing a normal routine lifestyle, she was not on her menstrual period, and she had not experienced any physical strain or injury to her abdominal region. We believe that the abdominal cramp may have been caused by the high dose of levofloxacin.
The fluoroquinolone antibiotic class can cause the gastrointestinal tract problems such as nausea and diarrhoea, and adverse CGP41251 effects such as headache and dizziness. These adverse events are usually mild and do not require discontinuation of therapy (Mandel and Tillotson, 2002). Although abdominal pain is also listed as an adverse effect of levofloxacin, abdominal cramp due to fluoroquinolone requiring discontinuation of therapy is a rare adverse effect, and makes this case worth sharing. In this patient, abdominal cramp started 2–3h after taking levofloxacin and was resolved upon discontinuation of levofloxacin.
The fluoroquinolone antibiotic class is generally well tolerated (Mandel and Tillotson, 2002). The incidence of abdominal pain due to levofloxacin is estimated to be 2% (Lacy et al., 2010). Levofloxacin-induced tendinopathy has been well reported, and carriers are required by the United States Food and Drug Administration to display a black box warning describing possible tendinopathy (Ganske and Horning, 2012). To our knowledge, this case is unique, since the case involved severe abdominal cramp believed to be caused by levofloxacin which required stopping levofloxacin and changing to other medication. The exact cause of levofloxacin induced abdominal pain is not known but levofloxacin might have caused inflammation of the parietal peritoneum which caused innervations of somatic nerve. The pain was exacerbated by movement and developed as abdominal rigidity and guarding (Nicki et al., 2010). While systematic studies are lacking, there have been reports of levofloxacin induced abdominal pain by patients in various forms, but most were not as severe as this case. (Treato Pharma, 2012). Another study by eHealthMe (2012) involving 5341 levofloxacin users showed that 155 people (2.90%) reported abdominal pain while taking levofloxacin.
The patient was taking amlodipine 5mg once daily, and amlodipine is not known to cause severe abdominal pain. The patient was not having a menstrual period which could cause abdominal cramp. Though the patient is obese (BMI 30.6), she was not involved in any strenuous physical activity which could cause or worsen abdominal cramp. The dose of levofloxacin for acute bacterial sinusitis is 500mg once daily for 10–14days or 750mg once daily for 5days, while this patient received a dose of 1000mg of levofloxacin once daily. This is higher than the recommended daily dose, and may have caused abdominal cramp, or had a role in worsening abdominal cramp. A multicenter randomized double-blind study conducted in United States comparing the effect of levofloxacin 500mg once daily for 10days versus levofloxacin 750mg once daily for 5days for acute bacterial sinusitis showed that levofloxacin 750mg once daily for 5days was not inferior to the lower dose (Poole et al., 2006). Thus the high dose of levofloxacin was not justified. Though there is not clear evidence for dose-related adverse events with levofloxacin, the higher dose might have caused abdominal cramp or worsened the pain. Treatment for abdominal pain associated with levofloxacin involves discontinuation of therapy, using antispasmodic drugs such as hyoscine butylbromide, proper rest, and avoidance of strenuous physical activity. The symptoms disappear after discontinuation of the drug. Use of subjective assessment tools to determine patients’ abdominal pain and careful palpation may be useful in detecting abdominal cramp (McCaffery and Pasero, 1999). Consideration should be given to proper counselling of the patient about the possible adverse effect of medicines. Though Nepal does not provide systematic clinical practice guidelines for the treatment of specific medical conditions, the physician should adhere to the antibiotic dosing recommendations of international professional societies (Rosenfeld et al., 2007). Exceeding the daily recommended dose of antibiotics may lead to an adverse drug reaction, or worsen an existing reaction.
Diabetes types 2 as well as the impaired fasting glucose (IFG) are common among Jordanian population. The estimated age standardized prevalence rate of (IFG) and diabetes were 7.8% and 17.1%, respectively, with no significant gender differences according to a recent study (Ajlouni et al., 2008). To complicate things further, there are alarming rates of obesity and its associated co-morbidities among Jordanians, especially among women (Khader et al., 2008). This study aims to evaluate the serum levels of adiponectin in type 2 diabetic patients and to establish a correlation between adiponectin serum levels and insulin resistance in those patients. In contrast, previous studies had investigated the association of adiponectin serum levels and obesity and DM type 2. Jordan is an ideal place to conduct the current study due to the high prevalence of DM type 2 and prediabetes, as mentioned earlier.
The clinical and demographic characteristics of the study population are presented in Table 1. In the study population, diabetic patients had lower adiponectin serum level compared to non-diabetics control group. However, statistically this difference was not significant (Fig. 1A).
Females had a significantly higher adiponectin serum levels than males. A possible explanation for this gender based difference in adiponectin serum levels might be due to the following reasons; first, is the effect of sex hormones on the production of adiponectin rate (Kadowaki et al., 2006). Experimental studies have proved that androgens have an inhibitory effect on adiponectin secretion (Bottner et al., 2004; Nishizawa et al., 2002). Second, is the different body fat distribution between males and females. It has been reported that the number of fat 5-Iodotubercidin cost and their size are possible determinants of adiponectin production rates since it is mainly secreted from adipocytes (Cnop et al., 2003).
It is known that insulin resistance increases with age, which would predict the lower adiponectin levels in the elderly (Cnop et al., 2003). Interestingly, our study has shown that the adiponectin levels were correlated positively with age. The increase in adiponectin levels with age could be explained by the fact that the decline in sex steroidal hormones with age might rise the adiponectin levels in the elderly (Bottner et al., 2004; Nishizawa et al., 2002). Moreover, the decline in renal function with aging might reduce the adiponectin clearance by kidney (Isobe et al., 2005).
Generally, obesity is associated with insulin resistance (Cnop et al., 2002). Abdominal obesity, where the fat is centrally distributed, is particularly an important determinant of insulin resistance (Cnop et al., 2003; Gierach et al., 2014). It has been reported that abdominal obesity, measured by waist circumferences, is strongly associated with lower levels of adiponectin and decrease in insulin sensitivity among diabetic patients (Cnop et al., 2003; Mohammadzadeh and Ghaffari, 2014).
This study has shown low levels of adiponectin in both obese diabetic patients and patients with abdominal obesity and negative correlation between adiponectin levels and both BMI and WC. Given the fact that adiponectin is a major modulator of insulin action for its role in enhancing insulin sensitivity (Cnop et al., 2003; Schulze et al., 2004), it is therefore of critical importance to note that factors decreasing adiponectin levels such as obesity, and specially the abdominal obesity, could correlate with insulin resistance.
In addition, diabetic patients included in this study had a variable adiponectin serum levels. The majority of them had levels between (1.02–6.9)μg/ml while the remaining had levels ⩾7μg/ml. This variability in adiponectin serum levels might indicate that there are some factors affect the adiponectin levels among type 2 diabetic patients. It is important to note that the majority of diabetic patients who have adiponectin levels ⩾7μg/ml were elderly, females, and had lower mean of BMI compared to the second group (Table.4). Taken together, these characteristics of diabetic patients who have adiponectin levels ⩾7μg/ml are possible factors for increasing adiponectin level in this subgroup of diabetic patients.