Assessment of anxiety and depression after lower limb amputation in Jordanian patients

Ziad M Hawamdeh1, Yasmin S Othman2, Alaa I Ibrahim31Department of Physical Therapy, Faculty of Rehabilitation Sciences, University of Jordan, Amman, Jordan; 2Department of Orthotics and Prosthetics, Faculty of Rehabilitation Sciences, University of Jordan, Amman, Jordan; 3Lecturer, Department of Physical Therapy for Pediatrics and Pediatric surgery, Faculty of Physical Therapy, Cairo University, Giza, EgyptObjective: This study aimed to assess the prevalence of anxiety and depression among Jordanian lower limb amputees with different clinical characteristics and sociodemographic data (gender, marital status, social support, income, type and level of amputation, and occupation).Methods: Participants were 56 patients with unilateral lower limb amputation with mean duration (8.4 ± 5.75 years). They were recruited from inpatient and outpatient clinics of Jordan University hospital, Royal Farah Rehabilitation Center, and Al-basheer hospital in Amman, Jordan. Participants responded to a questionnaire that included a battery of questions requesting brief information about sociodemographic variables and characteristics of amputation. The level of depression and anxiety in each participating patient was assessed by the Hospital Anxiety and Depression Scale (HADS).Results: The prevalence of anxiety and depressive symptoms were 37% and 20%, respectively. Factors associated with high prevalence of psychological symptoms included female gender, lack of social support, unemployment, traumatic amputation, shorter time since amputation, and amputation below the knee. These findings were confirmed by a significant reduction of anxiety and depression scores in patients who received social support, patients with amputation due to disease, and patients with amputation above the knee. Presence of pain and use of prosthesis had no effect on the prevalence.Conclusions: The findings of the present study highlight the high incidence of psychiatric disability and depression in amputees; it also showed the importance of sociodemographic factors in psychological adjustment to amputation. It is suggested that psychiatric evaluation and adequate rehabilitation should form a part of their overall management.Keywords: amputees, depression; anxiety, rehabilitatio

Load balancing and server consolidation in cloud computing environments: a meta-study

The data-center is considered the heart of cloud computing. Recently, the growing demand for cloud computing services has caused a growing load on data centers. In terms of system behavior and workload, patterns of cloud computing are very dynamic; and that might serve to imbalance the load among data center resources. Eventually, some data-center resources could come to be over-loaded/under-loaded, which leads to an increase in energy consumption in addition to decreased functioning and wastage of resources. Just considering energy-efficiency (that can be attained efficiently by consolidate the servers) may not be enough for real applications because it may cause problems such as unbalanced load for each Physical Machine (PM). Therefore, this paper surveys published load balancing algorithms that achieved by server consolidation via a meta-analysis. Load balancing with server consolidation enriches the exploitation of resource utilization and can enhance Quality of Service (QoS) metrics, since data-centers and their applications are increasing exponentially. This meta-study, reviews the literature on load balancing and server consolidation and presents a ready reference taxonomy on the most efficient algorithms that achieve load balancing and server consolidation. This work attempts to present a taxonomy with a new classification for load balancing and server consolidation, such as migration overhead, hardware threshold, network traffic, and reliability

Altered Distribution of Unesterified Cholesterol among Lipoprotein Subfractions of Patients with Diabetes Mellitus Type 2

Biomarkers are important tools to improve the early detection of patients at high risk for developing diabetes as well as the stratification of diabetic patients towards risks of complications. In addition to clinical variables, we analyzed 155 metabolic parameters in plasma samples of 51 healthy volunteers and 66 patients with diabetes using nuclear magnetic resonance (NMR) spectrometry. Upon elastic net analysis with lasso regression, we confirmed the independent associations of diabetes with branched-chain amino acids and lactate (both positive) as well as linoleic acid in plasma and HDL diameter (both inverse). In addition, we found the presence of diabetes independently associated with lower concentrations of free cholesterol in plasma but higher concentrations of free cholesterol in small HDL. Compared to plasmas of non-diabetic controls, plasmas of diabetic subjects contained lower absolute and relative concentrations of free cholesterol in all LDL and HDL subclasses except small HDL but higher absolute and relative concentrations of free cholesterol in all VLDL subclasses (except very small VLDL). These disbalances may reflect disturbances in the transfer of free cholesterol from VLDL to HDL during lipolysis and in the transfer of cell-derived cholesterol from small HDL via larger HDL to LDL

Investigation the Effect of Nano–Particles and Recycling Mortar Additives on Physical and Mechanical Properties of Concrete

In this paper a lower ratio of nano powder were used from (Al2O3 and ZrO2) (0.5, 1.5and 2. 5 wt %) from cement weight, the average particle size of nano-powder were (20nm). These powders were used in fabrication of Concrete with recycle fine aggregate was replaced Natural fine aggregate(sand) in order to be used in construction application and studies the effect on the concrete. Investigation were done on the concrete including dry density, water absorption%, porosity%, compression strength, and wear rate. The results shows that The nano-Al2O3, nano-ZrO2, and recycle aggregate were adding causes difference effect in the physical and mechanical properties of concrete. Compared with control concrete specimens (Co) results for same curing time, the density, and compression strength of concrete were decreased with addition recycle fine aggregate(RFA), while wear rate, water absorption, and porosity % were increased, the lower values of density, compression strength were decreased by (2.3%, 10.8% ), respectively, while the higher values wear rat for 7 and 28 day curing time, water absorption and porosity % were increased by (19.8%, 21.4%, 8.8%, and 5.6%), respectively were obtained with addition (50%)RFA. While, the addition nano-Al2O3 and ZrO2 with RFA were increasing the density, and compression strength, but decreasing wear rate, water absorption, and porosity %, the higher values of compression strength was increased by (9.8%), while the lower values water absorption and porosity % were decreased by (24.1%, and 16.6% ), respectively were obtained with addition (1.5%) of nano-Al2O3 and 50% RFA. But the higher values of density was increased by (9.8% ) and lower values of wear rate for 7 and 28 day curing time were decreased by (71.1%, and 66.9%), respectively was obtained with addition (1.5%) of nano-ZrO2 and 50% RFA

Organizational Intelligence and its Relationship to Administrative Excellence among the Principals of Private Schools in the Capital, Amman

The study aimed to identify the level of organizational intelligence and administrative excellence among private school principals in the capital, Amman, from the teachers ’point of view, and the relationship between them. the relational descriptive approach was used to achieve the aim of the study, also the study sample consisted of (396) male and female teachers, who work in Private schools affiliated to the directorates of the capital, Amman two questionnaires were developed: the first consists of (42) items about organizational intelligence the second consists of (34) items about administrative excellence. according to this the results showed that the level of organizational intelligence and administrative excellence among private school principals is high, and there is a positive and statistically significant correlation between the level of organizational intelligence of managers and the level of managerial excellence. According to these results, several recommendations were made, the most important of them are establishing a department specialized in organizational intelligence in all educational institutions, holding workshops to study gaps in organizational intelligence, and engaging school principals in training programs and courses to enable them to achieve administrative excellence in educational institution

NPC1 links cholesterol trafficking to microglial morphology via the gastrosome

Microglia play important roles in brain development and homeostasis by removing dying neurons through efferocytosis. Morphological changes in microglia are hallmarks of many neurodegenerative conditions, such as Niemann-Pick disease type C. Here, NPC1 loss causes microglia to shift from a branched to an ameboid form, though the cellular basis and functional impact of this change remain unclear. Using zebrafish, we show that NPC1 deficiency causes an efferocytosis-dependent expansion of the microglial gastrosome, a collection point for engulfed material. In vivo and in vitro experiments on microglia and mammalian macrophages demonstrate that NPC1 localizes to the gastrosome, and its absence leads to cholesterol accumulation in this compartment. NPC1 loss and neuronal cell death synergistically affect gastrosome size and cell shape, increasing the sensitivity of NPC1-deficient cells to neuronal cell death. Finally, we demonstrate conservation of cholesterol accumulation and gastrosome expansion in NPC patient-derived fibroblasts, offering an interesting target for further disease investigation

Structural and Morphological Investigation of Cr2O3/WO3Oxides Films Composite Using Modified Spray Pyrolysis Technique

Cr2O3/WO3 oxides film composite was successfully synthesized via advanced controlled chemical spray pyrolysis deposition technique using two nozzles. Two solutions of tungstic acid and chromium chloride was sprayed separately at various ratios of (W: Cr) at the same time on a silicon substrate at 500 °C, the film then heat-treated at 400 °C for the 60s. The crystal structure, microstructure and morphology properties of prepared films were studied. Based on characterization techniques, crystallized Cr2O3/WO3 mixed oxides films were investigated by X-ray diffraction after the annealing process, with film thickness of about 500 nm. The SEM and AFM revealed that rough and porous microstructures of Cr2O3/WO3 were formed. The obtained microstructure has been known as one of the most effective microstructures due to having high surface area particularly in gas detection application

Altered sphingoid base profiles in type 1 compared to type 2 diabetes

Background: Sphingolipids are increasingly recognized to play a role in insulin resistance and diabetes. Recently we reported significant elevations of 1-deoxysphingolipids (1-deoxySL) - an atypical class of sphingolipids in patients with metabolic syndrome (MetS) and diabetes type 2 (T2DM). It is unknown whether 1-deoxySL in patients with diabetes type 1 (T1DM) are similarly elevated. Findings: We analyzed the long chain base profile by LC-MS after hydrolyzing the N-acyl and O-linked headgroups in plasma from individuals with T1DM (N = 27), T2DM (N = 30) and healthy controls (N = 23). 1-deoxySLs were significantly higher in the groups with T2DM but not different between T1DM and controls. In contrast to patients with T2DM, 1-deoxSL levels are not elevated in T1DM. Conclusions: Our study indicates that the 1-deoxySL formation is not per-se caused by hyperglycemia but rather specifically associated with metabolic changes in T2DM, such as elevated triglyceride levels. Electronic supplementary material The online version of this article (doi:10.1186/1476-511X-13-161) contains supplementary material, which is available to authorized users

Hepatocyte ABCA1 deficiency is associated with reduced HDL sphingolipids

ATP binding cassette transporter A1 (ABCA1) limits the formation of high density lipoproteins (HDL) as genetic loss of ABCA1 function causes virtual HDL deficiency in patients with Tangier disease. Mice with a hepatocyte-specific ABCA1 knockout (Abca1 HSKO) have 20% of wild type (WT) plasma HDL-cholesterol levels, suggesting a major contribution of hepatic ABCA1 to the HDL phenotype. Whether plasma sphingolipids are reduced in Tangier disease and to what extent hepatic ABCA1 contributes to plasma sphingolipid (SL) levels is unknown. Here, we report a drastic reduction of total SL levels in plasma of a Tangier patient with compound heterozygosity for mutations in ABCA1. Compared to mutation-free controls, heterozygous mutations in ABCA1 had no significant effect on total SLs in plasma; however, apoB-depleted plasma showed a reduction in total SL also in het carriers. Similarly, liver specific Abca1 KO mice (Abca1 HSKO) showed reduced total sphingolipids in plasma and liver. In parallel, apoM and sphingosine-1-phosphate (S1P) levels were reduced in plasma of Abca1 HSKO mice. Primary hepatocytes from Abca1 HSKO mice showed a modest, but significant reduction in total SLs concentration compared to WT hepatocytes, although SL de novo synthesis and secretion were slightly increased in Abca1 HSKO hepatocytes. We conclude that hepatic ABCA1 is a signficant contributor to maintaining total plasma pool of HDL sphingolipids, including sphingomyelins and S1P

Deoxysphingoid bases as plasma markers in Diabetes mellitus

BACKGROUND: Sphingoid bases are formed from the precursors L-serine and palmitoyl-CoA-a reaction which is catalyzed by the serine-palmitoyltransferase (SPT). SPT metabolizes, besides palmitoyl-CoA also other acyl-CoAs but shows also variability towards the use of other amino acid substrates. The enzyme is also able to metabolize alanine, which results in the formation of an atypical deoxy-sphingoid base (DSB). This promiscuous activity is greatly increased in the case of the sensory neuropathy HSAN1, and pathologically elevated DSB levels have been identified as the cause of this disease. Clinically, HSAN1 shows a pronounced similarity to the diabetic sensory neuropathy (DSN), which is the most common chronic complication of diabetes mellitus. Since serine and alanine metabolism is functionally linked to carbohydrate metabolism by their precursors 3-phosphoglycerate and pyruvate, we were interested to see whether the levels of certain sphingoid base metabolites are altered in patients with diabetes. RESULTS: In a case-control study we compared plasma sphingoid base levels between healthy and diabetic individuals. DSB levels were higher in the diabetic group whereas C16 and C18 sphingoid bases were not significantly different. Plasma serine, but not alanine levels were lower in the diabetic group. A subsequent lipoprotein fractionation showed that the DSBs are primarily present in the LDL and VLDL fraction. CONCLUSION: Our results suggest that DSBs are a novel category of plasma biomarkers in diabetes which reflect functional impairments of carbohydrate metabolism. Furthermore, elevated DSB levels as we see them in diabetic patients might also contribute to the progression of the diabetic sensory neuropathy, the most frequent complication of diabetes