**4. Conclusions**

Studies strongly suggest that the tRNA cloverleaf structure unfolded prior to the appearance of a fully functional ribosomal core, making it one of the most ancient RNAs of the RNA world [70, 97] or even the oldest [98]. Though the "RNA-world" hypothesis is well accepted, the successive events leading to the emergence of different partners playing a role in translation and the involvement of tRNAs in this evolution are highly controversial coveted field [99]. However, some hypotheses as the "tRNA core" [88] strongly suggest that tRNAs would be at the origin of the primitive genetic material and gave rise to mRNA and rRNA, as well as the conformational structure of the first proto-ribozymes. The base module being a pleiofunctional RNA that can adopt the cloverleaf structure is found today in various sequences without direct link with translation. One may conclude that "one should not change a winning secondary structure." In a precellular context, a molecule with ss-tRNA characteristics (small ORF associated with cloverleaf structure) would be advantageous. Putatively, ss-tRNA-like molecules cumulating both tRNA and mRNA functions would have been the first molecules on Earth to support nonrandom protein synthesis.

The antiquity of ss-tRNAs can be discussed, and it is very likely that the TAR10 (and especially TAG) triplets played very early a critical role in the tertiary folding of some tRNAs. Their implication in translation termination would be an exaptation where firstly, they were part of a structural signal. Origin of ATR49 triplets is less clear perhaps tracing to the first endosymbiosis. Hence it would be apomorphic (derived character). Analyzes by taxa and tRNA species suggest a nonhomogeneous evolution. At the beginning of the RNA/protein world, it has quickly become essential to start peptide synthesis at particular codons and one cannot exclude that ATR49 was an ancestral state which would have not been retained as intergenic spaces increased. Analyzes of known tRNAs of α-proteobacteria and cyanobacteria could suggest that in organelles, ATR49 triplets would have been selected with genome reduction. Organelle genomes may be under increased pressure for size reduction with resulting overlaps (see, [100]). However, several features strongly suggest that overlapping genes are not a direct mechanism to substantially reduce genome size. Gene overlaps allow mtDNA genome compaction while avoiding the loss of tRNA genes [53]. Nevertheless, overlaps may allow a more efficient control in the regulation of gene expression, the regulatory pathways are simplified, and the number of proteins (and genes) required decreases [100]. Among others, short antiparallel overlaps may be involved in antisense regulatory mechanisms. Consequently, genomes with compact sizes enable putatively less flexible but more efficient physiologies.

The selection of tRNAs had to be done mainly on two seemingly opposite criteria, stability and plasticity, making it a kind of Swiss army knife of the RNA world. This explains that beyond their central role in protein synthesis, tRNAs have many other crucial functions. To date, it can be hypothesized that ss-tRNAs might regulate gene expression, stress responses, and metabolic processes. Indeed, *in silico* analyzes allowed to speculate that several overlapping sequences may code simultaneously for mRNAs and tRNAs in most of the metazoan mt-genomes. These overlaps can have a variable (sometimes large) number of nts; however, when annotating their genomes, several authors voluntarily underestimated the number and the size of overlaps, speculating that there would be upstream abbreviated stop codons or downstream alternative start codons but most often without any direct demonstration so far. However, the high number of possible overlaps on the same strand in which the first in-frame complete stop codon or standard start codon are located at specific positions in the sequences of *trn* genes (TAR10 and ATR49, respectively) strongly suggest an exclusive relationship between obtaining tRNAs and translation of mRNAs and/or the development of repair system to keep the two genes functional due in some cases to co-evolution during several hundred MY. We can therefore speculate that ss-*trn* genes could allow true tRNA punctuation and initiation. Noted that ss-tRNAs seem to be hybrid molecules which would contain three essential coding or decoding informations in the form of nt triplets (i.e., anticodon and stop/ start codons) which are all at least in part integrated into stem or loop; moreover, after the ATR49, nt triplets play the role of internal sense codons. To date, it is unclear what biochemical mechanism would allow to choose between different alternate cleavage sites, leading to the complete tRNA rather than to the mRNA or *vice versa*, but reduced/expanded proteins can be functional, and various processes including editing suggest this also for incomplete tRNAs. Hence, despite lacking experimental evidence, TAR10 and ATR49 triplets have probable roles, including regulation. Future analyzes of the processed bicistronic transcripts (tRNA/ protein-encoding or the contrary) are required. Moreover, even if mt-*trn* genes are most often expressed at very low levels [53], only direct sequencing of tRNAs can validate transcription, epitranscriptomic maturation and can pinpoint nt modifications including post-transcriptionally edited positions. Purified native, or even synthetic, tRNAs should also be tested for their *in vitro* activity to confirm the functionality of aberrant transcripts. Similar experiments must be made on the flanking mRNAs and their products. If as we think, ss-tRNAs could play regulatory roles, initially experiments should compare stress and nonstress conditions.

Here, the bias for metazoan mtDNA does not allow for a complete picture of variation in the entire eukaryotic world, and protist mt-genomes should also be considered. Special attention should also be paid to noncanonical base pairings potentially formed by UAR10 and AUR49 nts, in perspective with tRNA structure and V-R length. Accounting for TAR10 and ATR49 triplet presences in the algorithms predicting tRNAs could improve mt-genome annotations, reducing numbers of false positives and negatives, and more accurately determine tRNA termini while accounting tRNA species, taxa, and genomic systems.

MtDNA plays a central role in apoptosis, aging, and cancer [13]. Moreover, mt-diseases are among the most common inherited metabolic and neurological disorders [101]. In addition, as new functions and new mechanisms of action of tRNAs are continuously discovered [1] and as ss-*trn* genes could affect the cellular dynamic during normal and stress conditions leading to pathologies, potential subtleties of action and regulation of these genes and products should be more thoroughly investigated.


**9. Conclusion**

Sexual health and intimate relationships need further attention among health professionals, since many individuals with RA have decreased sexual health which can affect their intimate relationships negatively, and thereby decrease their general wellbeing and overall happiness. Each profession has a professional expertise that can assist RA patients in this field. Optimal treatment of RA can decrease sexual health problems for persons with RA,

Sexual Health and Intimate Relationships in Rheumatoid Arthritis 231

Britto, M. T., S. L. Rosenthal, J. Taylor, and M. H. Passo. 2000. Improving rheumatologists'

Brodin, N., E. Eurenius, I. Jensen, R. Nisell, and C. H. Opava. 2008. Coaching patients with

Cairns, A. P., and J. G. McVeigh. 2009. A systematic review of the effects of dynamic exercise

Cameron, M. 2002. Is manual therapy a rational approach to improving health-related quality of life in people with arthritis? *Australas Chiropr Osteopathy* 10 (1):9-15. Carr, A., S. Hewlett, R. Hughes, H. Mitchell, S. Ryan, M. Carr, and J. Kirwan. 2003. Rheumatology outcomes: the patient's perspective. *J Rheumatol* 30 (4):880-3. Casimiro, L., L. Brosseau, S. Milne, V. Robinson, G. Wells, and P. Tugwell. 2002.

Chauffier, K., C. Salliot, F. Berenbaum, and J. Sellam. 2011. Effect of biotherapies on fatigue

Clayton, A., and S. Ramamurthy. 2008.

Coll, J., A. Rives, M. C. Grino, J. Setoain, J. Vivancos, and A. Balcells. 1987. Prevalence of Sjogren's syndrome in autoimmune diseases. *Ann Rheum Dis* 46 (4):286-9. Cooney, J. K., R. J. Law, V. Matschke, A. B. Lemmey, J. P. Moore, Y. Ahmad, J. G. Jones, P.

Couldrick, L. , S. Gaynor, and V. Cross. 2010.  Report of a technical consultation on sexual health, 28-31 January

Elst, P., T. Sybesma, R. J. van der Stadt, A. P. Prins, W. H. Muller, and A. den Butter. 1984.

Englund, M., A. Joud, P. Geborek, D. T. Felson, L. T. Jacobsson, and I. F. Petersson. 2010.

Fries, J. F., P. Spitz, R. G. Kraines, and H. R. Holman. 1980. Measurement of patient outcome

Gard, G. Lundvik Gyllensten, A. 2000. The importance of emotions in physiotherapeutic

Garip, Y., F. Eser, and H. Bodur. 2010. Health-related quality of life in rheumatoid arthritis:

comparison of RAQoL with other scales in terms of disease activity, severity of

controlled study. *Arthritis Rheum* 59 (3):325-31.

*Rheumatology (Oxford)* Epub ahead of print.

in rheumatoid arthritis. *Rheumatol Int* 30 (2):147-58.

83.

*Syst Rev* (3):CD003788.

*Aging Res* 2011:681640.

*Rheum* 27 (2):217-20.

Group. 1990. *Health Policy* 16 (3):199-208.

in arthritis. *Arthritis Rheum* 23 (2):137-45.

practice. *Physical Therapy Reviews* 5:155-160.

pain, and functional status. *Rheumatol Int* 31 (6):769-72.

298.

Geneva.

*Adv Psychosom Med* 29:70-88.

screening for alcohol use and sexual activity. *Arch Pediatr Adolesc Med* 154 (5):478-

early rheumatoid arthritis to healthy physical activity: a multicenter, randomized,

Acupuncture and electroacupuncture for the treatment of RA. *Cochrane Database*

in rheumatoid arthritis: a systematic review of the literature and meta-analysis.

Maddison, and J. M. Thom. 2011. Benefits of exercise in rheumatoid arthritis. *J*

practice for disability teams: the Recognition Model. *Int J Ther Rehabil* 17 (6):290-

2002, Geneva. 2006. In *Sexual health document series*, edited by W. H. Organization.

Sexual problems in rheumatoid arthritis and ankylosing spondylitis. *Arthritis*

Prevalence and incidence of rheumatoid arthritis in southern Sweden 2008 and their relation to prescribed biologics. *Rheumatology (Oxford)* Aug;49 (8):1563-9. EuroQol--a new facility for the measurement of health-related quality of life. The EuroQol

since the difficulties are often connected with clinical disease activity. In order to give holistic care to persons with RA it is important to have a strategy within the rheumatological team on how to communicate and address problems concerning sexual health, and to acknowledge the need to protect, support and restore the sexual health of RA patients. To enhance the communication of sexual health there are useful communication models that are appropriate to rheumatological care.

#### **10. Acknowledgment**

We would like to acknowledge Futurum- the Academy for Healthcare, County Council, Jönköping, Sweden, for funding the authors' research in sexual health and RA.

#### **11. References**

since the difficulties are often connected with clinical disease activity. In order to give holistic care to persons with RA it is important to have a strategy within the rheumatological team on how to communicate and address problems concerning sexual health, and to acknowledge the need to protect, support and restore the sexual health of RA patients. To enhance the communication of sexual health there are useful communication models that

We would like to acknowledge Futurum- the Academy for Healthcare, County Council,

Abdel-Nasser, A. M., and E. I. Ali. 2006. Determinants of sexual disability and dissatisfaction in female patients with rheumatoid arthritis. *Clin Rheumatol* 25 (6):822-30. Akkas, Y. Nakas, D. Kalyoncu, U. 2010. Factors Affecting the Sexual Satisfaction of Patients

Aletaha, D., T. Neogi, A. J. Silman, J. Funovits, D. T. Felson, C. O. Bingham, 3rd, N. S.

Annon, J.S. 1974. *The Behavioural Treatment of Sexual Problems: Brief Therapy*. Honolulu:

Areskoug-Josefsson, K., ed. 2006.  A literature review of the sexual health of

Basson, R., and W. W. Schultz. 2007. Sexual sequelae of general medical disorders. *Lancet*

Bermas, B. L., J. S. Tucker, D. K. Winkelman, and J. N. Katz. 2000. Marital satisfaction in

Bitzer, J., G. Platano, S. Tschudin, and J. Alder. 2007. Sexual counseling for women in the

Bortz, W. M., 2nd, and D. H. Wallace. 1999. Physical fitness, aging, and sexuality. *West J Med*

Breton, A., C. M. Miller, and K. Fisher. 2008. Enhancing the sexual function of women living

context of physical diseases: a teaching model for physicians. *J Sex Med* 4 (1):29-37.

with chronic pain: a cognitive-behavioural treatment group. *Pain Res Manag* 13

women with rheumatoid arthritis. *Musculoskeletal Care* 7(4):219-26.

couples with rheumatoid arthritis. *Arthritis Care Res* 13 (3):149-55.

*von Menschen mit rheumatoider Arthritis?* Edited by W. Bautz, Harms, J., Ulbricht-Thiede, S., *Europäische Anregungen zu Sozialer Inklusion*. Berlin: Frank & Timme

with Rheumatoid Arthritis and Ankylosing Spondylitis *Sexuality and Disability* 28

Birnbaum, G. R. Burmester, V. P. Bykerk, M. D. Cohen, B. Combe, K. H. Costenbader, M. Dougados, P. Emery, G. Ferraccioli, J. M. Hazes, K. Hobbs, T. W. Huizinga, A. Kavanaugh, J. Kay, T. K. Kvien, T. Laing, P. Mease, H. A. Menard, L. W. Moreland, R. L. Naden, T. Pincus, J. S. Smolen, E. Stanislawska-Biernat, D. Symmons, P. P. Tak, K. S. Upchurch, J. Vencovsky, F. Wolfe, and G. Hawker. 2010. 2010 Rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative.

**10. Acknowledgment**

(4):223-232.

*Arthritis Rheum* 62 (9):2569-81.

Gmbh Verlag für wissenschaftliche Literatur.

Kapiolani Health Services.

369 (9559):409-24.

170 (3):167-9.

(3):219-24.

**11. References**

Sexual Health and Intimate Relationships in Rheumatoid Arthritis 233

Kraaimaat, F. W., A. H. Bakker, E. Janssen, and J. W. Bijlsma. 1996. Intrusiveness of

Lapsley, H. M., L. M. March, K. L. Tribe, M. J. Cross, B. G. Courtenay, and P. M. Brooks.

Lee, E. O., J. I. Kim, A. H. Davis, and I. Kim. 2006. Effects of regular exercise on pain, fatigue,

Lindau, S. T., and N. Gavrilova. 2010. Sex, health, and years of sexually active life gained

Majerovitz, S. D., and T. A. Revenson. 1994. Sexuality and rheumatic disease: the

Matheson, L., D. Harcourt, and S. Hewlett. 2010. 'Your whole life, your whole world, it

Meenan, R. F., J. H. Mason, J. J. Anderson, A. A. Guccione, and L. E. Kazis. 1992. AIMS2. The

Monga, T. N., G. Tan, H. J. Ostermann, U. Monga, and M. Grabois. 1998. Sexuality and sexual adjustment of patients with chronic pain. *Disabil Rehabil* 20 (9):317-29. Neuberger, G. B., L. S. Aaronson, B. Gajewski, S. E. Embretson, P. E. Cagle, J. K. Loudon,

Ostensen, M. 1999. Sex hormones and pregnancy in rheumatoid arthritis and systemic lupus

Perdriger, A., C. Solano, and L. Gossec. 2010. Why should rheumatologists evaluate the impact of rheumatoid arthritis on sexuality? *Joint Bone Spine* 77 (6):493-5. Pincus, T., T. Sokka, and H. Kautiainen. 2005. Further development of a physical function

Pollard, L., E. H. Choy, and D. L. Scott. 2005. The consequences of rheumatoid arthritis:

Post, M.W.M., W. L. Gianotten, L. Heijnen, E. J. Lambers, Hille R., and M. Willems. 2008.

discipline-specific sexological training. *Sexuality and Disability* 26 (1):3-14. Reinseth, L., T. Uhlig, I. Kjeken, H. S. Koksvik, J. F. Skomsvoll, and G. A. Espnes. 2010.

rheumatoid arthritis. *Scand J Occup Ther* E-pub ahead of print.

le Gallez, P. 1993. Rheumatoid arthritis: effects on the family. *Nurs Stand* 7 (39):30-4.

*Arthritis Care Res* 9 (2):120-5.

of ageing. *BMJ* 340:c810.

*Care* 8 (1):46-54.

*Rheum* 57 (6):943-52.

39):S43-52.

(4):320-7.

impact on patients. *Ann Rheum Dis* 61 (9):818-21.

significance of gender. *Arthritis Care Res* 7 (1):29-34.

erythematosus. *Ann N Y Acad Sci* 876:131-43.

diseases. *J Rheumatol* 32 (8):1432-9.

McInnes, R. A. 2003. Chronic illness and sexuality. *Med J Aust* 179 (5):263-6.

Scales Health Status Questionnaire. *Arthritis Rheum* 35 (1):1-10.

rheumatoid arthritis on sexuality in male and female patients living with a spouse.

2002. Living with rheumatoid arthritis: expenditures, health status, and social

and disability in patients with rheumatoid arthritis. *Fam Community Health* 29

due to good health: evidence from two US population based cross sectional surveys

changes': partners' experiences of living with rheumatoid arthritis. *Musculoskeletal*

content and properties of a revised and expanded Arthritis Impact Measurement

and P. A. Miller. 2007. Predictors of exercise and effects of exercise on symptoms, function, aerobic fitness, and disease outcomes of rheumatoid arthritis. *Arthritis*

scale on a MDHAQ [corrected] for standard care of patients with rheumatic

quality of life measures in the individual patient. *Clin Exp Rheumatol* 23 (5 Suppl

Sexological competence of different rehabilitation disciplines and effects of a

Performance in leisure-time physical activities and self-efficacy in females with

Gerosa, M., V. De Angelis, P. Riboldi, and P. L. Meroni. 2008. Rheumatoid arthritis: a female

Gettings, L. 2010. Psychological well-being in rheumatoid arthritis: a review of the literature.

Giorgi, A. 2000. Concerning the application of phenomenology to caring research. *Scand J*

Giorgi, Amadeo, ed. 1985. *Phenomenology and Psychological research*. Pittsburgh, U.S.A.:

Gott, M., E. Galena, S. Hinchliff, and H. Elford. 2004. "Opening a can of worms": GP and

Gutweniger, S., M. Kopp, E. Mur, and V. Gunther. 1999. Body image of women with

Haboubi, N. H., and N. Lincoln. 2003. Views of health professionals on discussing sexual

Helland, Y., H. Dagfinrud, and T. K. Kvien. 2008. Perceived influence of health status on

Helland, Y., I. Kjeken, E. Steen, T. K. Kvien, M. I. Hauge, and H. Dagfinrud. 2011. Rheumatic

Hewlett, S., Z. Cockshott, M. Byron, K. Kitchen, S. Tipler, D. Pope, and M. Hehir. 2005.

Hill, J., H. Bird, and R. Thorpe. 2003. Effects of rheumatoid arthritis on sexual activity and

Josefsson, K. A., and G. Gard. 2010. Women's experiences of sexual health when living with

Karlsson, B., E. Berglin, and S. Wallberg-Jonsson. 2006. Life satisfaction in early rheumatoid

Kavuncu, V., and D. Evcik. 2004. Physiotherapy in rheumatoid arthritis. *MedGenMed* 6 (2):3. Kedde, H., H. B. Van De Wiel, W. C. Schultz, W. M. Vanwesenbeek, and J. L. Bender. 2010.

Khan, N. A., Y. Yazici, J. Calvo-Alen, J. Dadoniene, L. Gossec, T. M. Hansen, M. Huisman, R.

arthritis: a prospective study. *Scand J Occup Ther* 13 (3):193-9.

rheumatoid arthritis activity. *J Rheumatol* 36 (11):2435-42.

Rheumatoid Arthritis - an explorative qualitative study. *BMC Musculoskelet Disord*

Efficacy of sexological healthcare for people with chronic diseases and physical

Kallikorm, R. Muller, M. Liveborn, R. Oding, E. Luchikhina, A. Naranjo, S. Rexhepi, P. Taylor, W. Tlustochowich, A. Tsirogianni, and T. Sokka. 2009. Reevaluation of the role of duration of morning stiffness in the assessment of

Hull, T.H. 2008. Sexual pleasure and wellbeing. *Journal of Sexual Health* 20 (1-2):133-145. Ibn Yacoub, Y., B. Amine, A. Laatiris, F. Wafki, F. Znat, and N. Hajjaj-Hassouni. 2011. Fatigue and severity of rheumatoid arthritis in Moroccan patients. *Rheumatol Int*. *International Classification of Functioning, Disability and Health.* 2001. Edited by W. H.

practice nurse barriers to talking about sexual health in primary care. *Fam Pract* 21

sexual activity in RA patients: associations with demographic and disease-related

diseases and sexuality: Disease impact and self management strategies. *Arthritis*

Patients' perceptions of fatigue in rheumatoid arthritis: overwhelming,

challenge. *Womens Health (Lond Engl)* 4 (2):195-201.

rheumatoid arthritis. *Clin Exp Rheumatol* 17 (4):413-7.

uncontrollable, ignored. *Arthritis Rheum* 53 (5):697-702.

relationships. *Rheumatology (Oxford)* 42 (2):280-6.

disabilities. *J Sex Marital Ther* 36 (3):282-94.

issues with patients. *Disabil Rehabil* 25 (6):291-6.

variables. *Scand J Rheumatol* 37 (3):194-9.

*Musculoskeletal Care* 8 (2):99-106.

Duquesene University Press.

*Caring Sci* 14 (1):11-5.

*Care Res (Hoboken)*.

Organization. Geneva.

11:240.

(5):528-36.

**13**

*USA*

G.S. Kerr1 et al.\*

**Association of Cardiovascular Disease with the**

Despite the therapeutic advances in RA that have led to reduced pain, joint destruction and disability, as many as 50% of patients are at risk of death from a cardiovascular event (Maradit-Kremers et al., 2005; Stevens et al., 2005). Inexplicable by the usual traditional risk factors, the accelerated atherosclerosis (Gaonzalez-Gay et al., 2005) has been postulated to result from the increased systemic inflammatory burden of rheumatoid disease (Del Rincon

The metabolic syndrome (MetS) is a composite diagnosis, combining phenotypic features that portend an increased risk for cardiovascular disease (CVD). The syndrome consists of visceral obesity, atherogenic dyslipidemia, hypertension, and impaired fasting glucose/glucose tolerance test or overt diabetes mellitus (DM) (National Cholesterol Education Program, 2001). Studies have reported the presence of MetS to be associated with an approximate 2- fold increased risk for incident cardiovascular morbidity and mortality (Lakka et al., 2002), a 2.1 fold increase for initial stroke (Najarian et al., 2006), and 3.5 fold increased risk for Type II DM (Lorenzo et al., 2003). The complex interplay of genetic and environmental factors, insulin resistance and inflammation, are all believed to contribute to

The overall prevalence of MetS in the US population, as evaluated by the National Health and Nutrition Examination Survey (NHANES III), is 23.1%, and increases with age to as high as 44% in those 65 years or older (Ford et al., 2002). Several studies have established an increased prevalence of insulin resistance and increased risk for CVD in RA patients (Dessein et al., 2002a, 2002b). However, there are few reports regarding MetS in RA, and the

\* I. Sabahi1, J.S. Richards1, T.R. Mikuls2, B.V. Rangan3, A. Reimold3, G.W. Cannon4,

*3Dallas Veterans Affairs and University of Texas Southwestern, Dallas, TX, USA 4George E. Wahlen Veterans Affairs and University of Utah, Salt Lake City, UT, USA 5Jackson Veterans Affairs and University of Mississippi, Jackson, MS, USA*

*2Omaha Veterans Affairs and University of Omaha, Omaha, NE, USA*

*6Denver Veterans Affairs and University of Colorado, Denver, CO, USA*

et al., 2001; Gabriel et al., 1999; Kremers & Gabriel, 2006; McEntegart et al., 2001).

**1. Introduction**

the pathogenesis of the syndrome.

D. Johnson5 and L. Caplan6

**Metabolic Syndrome in a Predominantly Male**

**Cohort with Rheumatoid Arthritis**

*1Washington DC Veterans Affairs Medical Center and Georgetown University, Washington, DC*


**3.6 HDL-C**

Replacing SFAs with MUFAs and/or PUFAs generates lower total cholesterol and LDL-C concentrations, with modest HDL-C reductions; however, a lower total cholesterol: HDL-C ratio results [4, 97]. It is thought that dietary fat increases the "transport rate" and decreases the "fractional catabolic rate" of HDL cholesterol ester and apolipoprotein A1 [98]. However, more research is needed to describe the mechanisms by which individual fatty acids impact HDL-C.

#### **3.7 Lipoprotein(a)**

Lipoprotein(a) is synthesized in the liver and contains apolipoprotein A, which is bound to apolipoprotein B-100 [99–101]. The biological activity of lipoprotein(a) is unknown [102]; however, high concentrations have been associated with CVD [101, 103, 104]. Genetics seem to be the primary determinant of lipoprotein(a) [105]. Hence, diet and exercise do not appear to be significant contributors to lipoprotein(a) concentrations. There have also been inconsistent findings of fatty acid consumption (including PUFAs) on lipoprotein(a) concentrations [106]. However, it has been suggested that fatty acids may affect liver apolipoprotein(a) synthesis, thereby impacting lipoprotein(a) [106–108]. As such, more research is needed to determine the effects of dietary composition on lipoprotein(a) concentrations.

#### **3.8 Apolipoprotein A1**

HDL particles contain apolipoprotein A1, which interacts with the ATP-binding cassette transporter on the surface of cells. Furthermore, apolipoprotein A1 is a cofactor for lecithin cholesterol acyl transferase, which generates mature HDL particles [43, 109]. Plasma apolipoprotein A1 concentration typically coincide with HDL-C concentrations [43]. The significance of apolipoprotein A2 is less clear [110]. Interestingly, PPARα also interacts with PPREs in the promoter region of the apolipoprotein A1 gene in the liver [75]. Hence, PUFAs may exert their effects on apolipoprotein A1 via PPARα [73].

### **3.9 Apolipoprotein B**

Apolipoprotein B also occurs in two forms: apolipoprotein B-48 and apolipoprotein B-100. The intestine synthesizes apolipoprotein B-48, which is a component of chylomicrons. The liver produces apolipoprotein B-100, which is associated with VLDL and LDL particles. Apolipoprotein B is necessary for the binding of lipoproteins to the LDL receptor. Apolipoprotein B plasma concentrations are significantly associated with LDL-C concentrations [43, 111]. It has been reported that high apolipoprotein B concentrations increase the risk for CVD, whereas apolipoprotein A1 concentrations decrease CVD risk [43, 112]. As mentioned previously, PUFAs increase LDL catabolism, thereby reducing apolipoprotein B [87].


*3.9. Statistical Analysis*

SPSS Statistics 21 (IBM SPSS Statistics 21, SPSS Inc., New York, NY, USA) analyzed the triplicate data and presented it as mean ± standard error. Figures with Y-error bars represent the standard error. *p* < 0.05, n = 3.

#### **4. Results and Discussions**

#### *4.1. FTIR Analysis*

The FT-IT spectral profile of the hydrogel can, as shown in Figure 1, determine the structural and functional analysis of the material present in hydrogels. The vibration band from 1110 to 1000 cm−1 is attributed to the asymmetric stretching of –Si–O–C and –Si–O–Si due to TEOS and confirmed the successful crosslinking of bacterial cellulose and polyvinyl alcohol. These polymers and GO were also crosslinked due to hydrogen bonding (H–bonding) that presents the absence peak at 1759 cm−1 and broadband at 3600–3200 cm−1. The increased broadband valley is due to increased intra and interhydrogen bonding [21]. The characteristic peaks of BC are hydroxyl, COO−, and pyranose rings. The absorption peak of the saccharine structure and pyranose ring is confirmed at 1060 cm−1 and 876 cm−1, respectively. The stretching peak at 2950 cm−1 is due to alkyl –CH of BC. The stretching peaks at 1643 and 1469 cm−1 are attributed to functional groups of C=O and C–C and confirm the presence of GO and it is associated with the polymeric matrix via H-bonding. Hence, the FT-IR spectral confirms successful crosslinking of the polymers and GO interaction with the polymeric matrix that has been determined via available functional groups and interaction.

**Figure 1.** FTIR spectra of composite hydrogels to determine the structural, and functional groups and their physicochemical interactions.

#### *4.2. SEM Morphology*

The surface of hydrogel is a fundamental phenomenon for drug release and interaction with the body's biological system. Therefore, SEM analysis was performed to investigate the surface properties of the hydrogel materials, as shown in Figure 2. The increasing amount of GO causes more particulate-like (GO-flakes) morphology than smooth surface morphology. These GO-flakes impart their unique role in the hydrogels' morphology by increasing surface roughness and closing the packing of the hydrogel. Such surface morphology helps burn and chronic wounds by providing them with important hydration [22,23]. However, it was also observed that an increasing GO amount also causes cracking on drying. Hence, it is essential to introduce the only optimized amount of GO to have the desired surface morphology with structural integrity.

**Figure 2.** The surface morphology of the hydrogels via SEM.


**1. Introduction**

80 Multivariate Analysis in Management, Engineering and the Sciences

203-245, 1997.

Weiss K D. Paint and Coatings: a mature industry in transition. Prog. Polym. Sci, v. 22, p.

The monitoring of a dam structure can generate an enormous mass of data of which the analysis and interpretation are not always trivial. It is important to select the information that better "explain" the behavior of the dam, making possible the prediction and resolution of eventual problems that may occur.

The world largest hydroelectricity generator, Itaipu hydroelectric power plant, has more than 2.200 instruments that monitor its geotechnical and structural behavior, and these instruments have readings stored on a database for over 30 years. The high dimensionality and the large quantity of records stored on the databases are nontrivial problems that are kept so that one can pursue "knowledge" through these data.

The detailed analysis of the auscultation instrumental data requires a combination of knowledge of Engineering, Mathematics and Statistics, as well as the previous experience of the engineer or the technician responsible for the analysis of these data. That consumes a lot of time, and often makes it impossible to accomplish this task in an efficient way. This is the reason why the use of techniques and computational instrumentation to help the decisions maker is extremely important.

There are no records of the existence of methods that perform the classification of monitoring instruments in dams. In case of reading intensification this hierarchy could be useful to define which instrument to chose.

© 2012 Villwock et al., licensee InTech. This is an open access chapter distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. © 2012 Villwock et al., licensee InTech. This is a paper distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

The aim of this paper is to identify the tools that are the most significant for the analysis of a dam behavior, which maximizes the effectiveness and efficiency of the analysis of the readings. It shows a methodology based on the field of Multivariate Analysis, applied to the Hierarchical Cluster Analysis in order to identify the groups of instruments similar to Ward's linkage method. The factor analysis of the strain gauge of each instrument group was also applied, performing the hierarchical cluster of monitoring instruments in dams, detecting the main instruments.

Itaipu Hydroelectric Power Plant Structural Geotechnical Instrumentation

Temporal Data Under the Application of Multivariate Analysis – Grouping and Ranking Techniques 83

In [5] show a table which contains the estimative for the most common causes of ruptures on dams. Among them, the following are highlighted: problems of the foundation; inappropriate spillway; structural problem; different declinations; extreme low-pressure; rupture of landfills; defective materials; incorrect operation; actions of war, and earthquakes. All these problems can be diagnosed with the monitoring of the dam instrumentation, with exception of the last two ones, which percentage of frequencies sum

According to [6], the global experience shows that the expenses in order to guarantee the safety of a dam are little when compared to the costs of its rupture. The author quotes the importance of the use of a database of instrumentation for supporting the preliminary

The principles established on NBR 8681 – *Ações e Segurança das Estruturas* (Actions and safety of structures) [7] conceptualizes the safety of the concrete constructions of a dam. For concrete gravity-dam projects, some verification corresponding to the stability analysis are necessary in order to evaluate the safety of the movements of: sliding, overturning, floating,

The stability of dams must be primary analyzed during the phase of the project. The geometry of the structures and the property of the materials involved must be well considered, as well as the load condition. Some of the basic load conditions are shown on

**Figure 1.** Illustration of the basic conditions of load and lack of stability of gravity concrete dams.

Through Physics, it is possible to explain that the difference of the water level (downstreamupstream) generates a hydraulic gradient between the dam downstream and upstream

tension at base and on structure, deformations, consolidation and vibrations.

analysis of the readings in order to detect problems.

just 4%.

Figure 1.

**3. Application area**

**3.1. Safety of dams**

This chapter is organized as follows: Section 2 features the problem statement which addresses the importance of the safety on dams and the risks faced when dam rupture accident occurs. Section 3 describes the application area focusing on the safety of dams, on the conditions of load and on the conditions of the monitoring instrument. Section 4 approaches a "research course". Section 5 describes the used data and the Multivariate Statistical Analysis techniques. Section 6 shows the status. Section 7 shows the results. Section 8 approaches the future researches. Section 9 shows the results.


*Edited by Alireza Bananej*

As a reason of information explosion, electronic communication networks are not sufficient for high bit rate data transmission. This problem has been solved by optical networks which caused the birth of a new area of technology, photonics. In photonic circuits photons play the dominant role and they transfer the optical data. With the growth of the photonics technology, a new area started to grow as photonic crystals which now play an important role in designing and manufacturing compact photonic devices. Photonic crystals are structures with alternative dielectric constant in one, two or three dimensions which are called one, two or three dimensional photonic crystals. By using the properties of photonic band gap, many interesting phenomena such as slow light generation, dispersion engineering in a compact and low size device can be achieved.

ISBN 978-953-51-2121-3

Photonic Crystals

Photo by Besjunior / iStock


**Robin Rinehart**

Department of Religious Studies, Lafayette College, Easton, PA 18042, USA<EMAIL_ADDRESS>Received:15October2019;Accepted:12November2019;Published:19November2019

**Abstract:** Controversy has swirled round the writings attributed to Guru Gobind Singh in the Dasam Granth, for not all Sikhs agree that he composed the entire text. Disputes about the Dasam Granth and its status have addressed the fact that many of the text's compositions are concerned with gender with respect to the nature of both divinity and humans, thus playing a key role in the ongoing construction of notions of gender in Sikhism. Female voices, however, have been largely absent from this discourse despite the presence of two key gender-related themes—the figure of the goddess/sword [*bhagaut¯ı*], a topic throughout the text, and the nature of women [*triya caritra ¯* ], the subject of the longest composition in the Dasam Granth. Through analysis of the intersection of the presence of goddesses and women but the relative absence of female voices in Dasam Granth exegesis, this paper demonstrates that the ongoing reception of the Dasam Granth has been a site for both proclaiming idealized constructions of gender equality, but also instantiating constructions of femininity that run counter to this ideal.

**Keywords:** Sikhism; gender; gender construction; Dasam Granth