Search results for: women in surgery
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 4001

Search results for: women in surgery

941 A Five–Year Review Study of Epidemiology of Ocular and Adnexal Injuries Requiring Surgical Intervention in a Middle Eastern Area: Al Ain, UAE

Authors: Tahra AlMahmoud, Sameeha Mohamed Al Hadhrami, Mohamed Elhanan, Hanan Naser Alshamsi, Fikri Abu-Zidan

Abstract:

Background: To the best of the author(s)’ knowledge there are no epidemiological studies for traumatic eye injuries in UAE, neither data on groups at risk or mechanisms for ocular trauma. Purpose: To report the epidemiology of eye injuries that required hospital admission and surgery at a referral center at the eastern part of Abu Dhabi. Method: Retrospective charts review of all patients who had suffered an eye injury that required surgical intervention between 2012 and 2017 at Al Ain Hospital. Demographic data, place of occurrence, the cause of injury, visual acuity (VA) before and after treatment, number of admission days and follow up were extracted. Data were tabulated and presented as number (%), mean (SD), or median (range) as appropriate. Wilcoxon signed rank test was used for VA outcome. Results: One hundred forty-one patients were identified, 96 eyes with open-globe and 48 other types of injuries. The mean age of the patients was 26±15.5 years, and 89% were male. Majority of injuries occurred at the workplace (50.4%) followed by home (31.2%). Trauma with a sharp object (24.1%), blunt object (16.3%), nail (11.3%), and hammer on metal (7.8%) were the most common etiologies of injury. Corneas injuries (48.2%) was the most frequent cause for visual acuity limitation followed by lens/cataract (23.4%). Among the traumatized eyes, 30 eyes (21.3%) retained intraocular foreign body, Mean admission days was 3.16± 2.81days (1-16) and a number of follow up visit was 3.17± 4.11times (0-26). Conclusion: Ocular trauma requiring surgical intervention is an area of concern in particular for occupations involving work with metals. This work may give insight into the value and necessity of implementing preventive measures.

Keywords: epidemiology, Middle Eastern area, occupational injury, ocular traumas

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940 Stress Hyperglycemia: A Predictor of Major Adverse Cardiac Events in Non-Diabetic Patients With Acute Heart Failure

Authors: Fahad Raj Khan, Suleman Khan

Abstract:

There is a lack of consensus about the predictive value of raised blood glucose levels in terms of major adverse cardiac events (MACEs) in non-diabetic patients admitted for acute decompensated heart failure. The purpose of this research was to examine the long-term prognosis of acute decompensated heart failure (ADHF) in non-diabetic persons who had increased blood glucose levels, i.e., stress hyperglycemia, at the time of their ADHF hospitalization. The research involved 650 non-diabetic patients. Based on their admission stress hyperglycemia, they were divided into two groups.ie with and without (SHGL). The two groups' one-year outcomes for major adverse cardiac events (MACEs) were compared, and key predictors of MACEs were discovered. For statistical analysis, the two-tailed Mann-Whitney U test, Fisher's exact test, and binary logistic regression analysis were utilized. SHGL was found in 353 (54.3%) individuals. It was more frequent in men than in women. About 27% of patients with SHGL had previously been admitted for ADHF. Almost 62% were hypertensive, whereas 14 % had CKD. MACEs were significantly predicted by SHGL, HTN, prior hospitalization for ADHF, CKD, and cardiogenic shock upon admission. SHGL at the time of ADHF admission, independent of DM status, may be a predictive indication of MACEs.

Keywords: stress hyperglycemia, acute heart failure, major adverse cardiac events, MACEs

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939 Seroprevalence Study of Cystic Echinococcosis and Its Associated Risk Factors in Fars Province, Southern Iran

Authors: Mahmoud Reza Tahamtan, Mohammad Saleh Bahreini

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Background and Purpose: Cystic echinococcosis, caused by the larval stage of Echinococcus granulosus, is a common parasitic infection of humans and is endemic in many parts of the world, including Iran. So that, one percent of those admitted to surgery departments are hydatid cyst patients, and using the ELISA method, the infection rate has been reported in different regions of Iran from 1.2% to 21.4%. Therefore, the aim of this study was to investigate the seroepidemiology of human hydatid cysts in Fars province, southern Iran, by ELISA method. Methods: In this cross-sectional study, 600 serum samples of persons who were referred to the laboratory of Nemazi Hospital in Shiraz for normal tests were examined for the presence of specific Anti-IgG antibodies to hydatid cysts by ELISA method. During the sampling, a structured questionnaire was used to obtain social data of individuals with determinants of risk factors for Cystic echinococcosis. Finally, the results of the ELISA test, along with demographic information completed by individuals, were analyzed using SPSS software. Results: The average age of the subjects in this study was 40.01 ± 9.166. The prevalence of hydatidosis was reported as 5.66% (34/600). The disease was more in the age group of 21-30, people living in villages, working in rural areas, and people with a history of other parasitic diseases. Statistically, a significant difference was observed between the prevalence of the disease and two risk factors, contact with dogs (OR= 0.042; 95%CI: 0.014-0.12; P= 0.001) and washing vegetables with water (OR= 0.08; 95%CI: 0.011-0.56; P= 0.012). Conclusion: The present study showed that hydatid cyst disease has a significant prevalence in this area. Also, based on the results, contact with dogs and not properly washing vegetables are two important factors of disease transmission.

Keywords: Echinococcus granulosus, Cystic echinococcosis, hydatid cyst, Fars province

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938 Flexible Work Arrangements for Managers-Gender Diversity and Organizational Development in German Firms

Authors: Marc Gärtner, Monika Huesmann, Katharina Schiederig

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While workplace flexibility provides opportunities to better balance work and family care, careers in management are still predominantly based on physical presence, blurred boundaries and a culture of availability at the workplace. Thus, carers (mostly women) still experience disadvantages and stalled careers. In a multi-case study, funded by the German Federal Ministry of Education and Research, success factors and barriers of flexible work arrangements in five big organizations, including three of the largest German companies, have been identified. Using qualitative interview methods, the working models of 10 female and male users of flexible work arrangements like part time, home office and job sharing have been studied. The study group applied a 360-degree approach with focus groups, covering the users’ themselves, their superiors, colleagues and staff as well as in-house human resource managers. The group interviews reveal that success of flexible models is mainly built on three factors: (a) the inclusiveness of the organizational culture, (b) the commitment of leaders and especially the supervisors, and (c) the fitting of the model and the user(s). Flexibilization of time and space can indeed contribute to a better work-life balance. This is, however, not a necessary outcome, as the interviews suggest, but depends on the right implementation of the right model in the particular work environment. Beyond the actual study results, the presentation will also assess the methodological approach.

Keywords: flexible work, leadership, organizational culture, work-life balance

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937 Regenerative Therapeutic Effect of Statin Nanoparticle-Loaded Adipose-Derived Stem Cells on Myocardial Infarction

Authors: Masaaki Ii, Takashi Saito, Yasuhiko Tabata, Shintaro Nemoto

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Background: Clinical trials of autologous adipose-derived stem cell (AdSC) therapy for ischemic heart diseases (IHD) are now on-going. We have investigated the hypothesis that combination of AdSCs and statin, an agent with pleiotropic effects, could augment the therapeutic effect on myocardial infarction (MI). Methods and Results: Human AdSC functions with different doses of simvastatin-conjugated nanoparticle (STNP) uptake were evaluated by in vitro assays. STNP promoted the migration activity without changing the proliferation activity, and also up-regulated growth factors. Next, MI was induced by LAD ligation in nude mice, and the mice were assigned in the following groups 3 days after MI: 1) PBS (control), 2) NP-AdSCs (50000 cells), 3) STNP, and 4) STNP-AdSCs (50000 cells). Cardiac functional recovery assessed by echocardiography was improved at 4 weeks after surgery in STNP-AdSC group. Masson’s trichrome-stained sections revealed that LV fibrosis length was reduced, and the number of TUNEL-positive cardiomyocytes was less in STNP-AdSC group. Surprisingly, a number of de novo endogenous Nkx-2.5/GATA4 positive immature cardiomyocytes as well as massive vascular formation were observed in outer layer of infarcted myocardium despite of a few recruited/retained transfused STNP-AdSCs 4 weeks after MI in STNP-AdSC group. Finally, massive myocardial regeneration was observed 8 weeks after MI. Conclusions: Intravenously injected small number of statin nanoparticle-loaded hAdSCs exhibited a potent therapeutic effect inducing endogenous cardiac tissue regeneration.

Keywords: statin, drug delivery system, stem cells, cardiac regeneration

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936 Racism in Drug Policies: A Report on United States Legislation

Authors: Frederick Monyepao

Abstract:

Crack cocaine first appeared on the scene in the form of cocaine freebasing in the late 1970s. Stockbrokers, investment bankers, rock stars, Hollywood elites, and a few pro athletes were regular users of the substance. As criminogenic factors associated with substance abuse began to surface, congress passed new legislation. The laws led to the increase of health coverage insurances and the expansion of hospitals. By the mid-1980s, crack use spread into America's inner cities among impoverished African Americans and Latinos. While substance abuse increased among minority communities, legislation pertaining to substance abuse evolved. The prison industry also expanded the number of cells available. A qualitative approach was taken, drawing from a range secondary sources for contextual analysis. This paper traces out the continued marginalisation and racist undertones towards minorities as perpetuated by certain drug policies. It was discovered that the new legislation on crack was instrumental in the largest incarcerations the United States ever faced. Drug offenders increased in prisons eightfold from 1986 to 2000. The paper concludes that American drug control policies are consistently irrational and ineffective when measured by levels of substance use and abuse. On the contrary, these policies have been successful as agents of social control in maintaining the stratification patterns of racial/ethnic minorities and women. To move beyond prohibition, radical law and policy reform may require a change in narratives on substance use.

Keywords: crack, drug policy, minorities, racism, substance abuse

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935 The Limits to Self-Defense Claims in Case of Domestic Violence Homicides

Authors: Maria Elisabete Costa Ferreira

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Domestic violence is a serious social issue in which victims are mostly women. Domestic violence develops in cycles, starting with the building of tension, passing through the incident of abuse and ending with reconciliation, also known as honeymoon. As time goes by, the shorter these phases become, and the greater and more severe the attacks, rarely leading to the death of the victim of abuse. Sometimes, the victim stops the abuse by killing the aggressor, usually after the immediate aggression has taken place. This poses an important obstacle to the claim of self-defense by the victim of domestic violence pending trial for the homicide of her long-time abuser. The main problem with self-defense claims in such cases is that the law requires the act of aggression to be present or imminent (imminent threat or immediate danger) so that it permits the victim to take her defense into her own hands. If the episode of aggression has already taken place, this general requirement for the admissibility of self-defense is not satisfied. This paper sheds new light on the concept of the actuality of the aggression, understanding that, since domestic violence is a permanent offense, for as long as the victim stays under the domain of the aggressor, imminent threat will be present, allowing the self-defense claim of a woman who kills her abuser in such circumstances to be admissible. An actualist interpretation of the requirement of the necessity of the means used in self-defense will be satisfied when evaluated from the subjective perspective of the intimate partner victim. Necessity will be satisfied if it is reasonable for the victim to perceive the use of lethal force as the only means to release herself from the abuser.

Keywords: domestic violence, homicide, self-defense, imminent threat, necessity of lethal force

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934 Molecular Portraits: The Role of Posttranslational Modification in Cancer Metastasis

Authors: Navkiran Kaur, Apoorva Mathur, Abhishree Agarwal, Sakshi Gupta, Tuhin Rashmi

Abstract:

Aim: Breast cancer is the most common cancer in women worldwide, and resistance to the current therapeutics, often concurrently, is an increasing clinical challenge. Glycosylation of proteins is one of the most important post-translational modifications. It is widely known that aberrant glycosylation has been implicated in many different diseases due to changes associated with biological function and protein folding. Alterations in cell surface glycosylation, can promote invasive behavior of tumor cells that ultimately lead to the progression of cancer. In breast cancer, there is an increasing evidence pertaining to the role of glycosylation in tumor formation and metastasis. In the present study, an attempt has been made to study the disease associated sialoglycoproteins in breast cancer by using bioinformatics tools. The sequence will be retrieved from UniProt database. A database in the form of a word document was made by a collection of FASTA sequences of breast cancer gene sequence. Glycosylation was studied using yinOyang tool on ExPASy and Differential genes expression and protein analysis was done in context of breast cancer metastasis. The number of residues predicted O-glc NAc threshold containing 50 aberrant glycosylation sites or more was detected and recorded for individual sequence. We found that the there is a significant change in the expression profiling of glycosylation patterns of various proteins associated with breast cancer. Differential aberrant glycosylated proteins in breast cancer cells with respect to non-neoplastic cells are an important factor for the overall progression and development of cancer.

Keywords: breast cancer, bioinformatics, cancer, metastasis, glycosylation

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933 Burn/Traumatic Scar Maturation Using Autologous Fat Grafts + SVF

Authors: Ashok K. Gupta

Abstract:

Over the past few decades, since the bio-engineering revolution, autologous cell therapy (ACT) has become a rapidly evolving field. Currently, this form of therapy has broad applications in modern medicine and plastic surgery, ranging from the treatment/improvement of wound healing to life-saving operations. A study was conducted on 50 patients having to disfigure, and deform post burn scars and was treated by injection of extracted, refined adipose tissue grafts with their unique stem cell properties. To compare the outcome, a control of 20 such patients was treated with conventional skin or soft-tissue flaps or skin grafting, and a control of 10 was treated with more advanced microsurgical techniques such as Pre-fabricated flaps/pre laminated flaps / free flaps. Assessment of fat volume and survival post- follow up period was done by radiological aid, using MRI and clinically (Survival of the autograft and objective parameters for scar elasticity were evaluated skin elasticity parameters 3 to 9 months postoperatively). Recently, an enzyme that is involved in collagen crosslinking in fibrotic tissue, lysyl hydroxylase (LH2), was identified. This enzyme is normally active in bone and cartilage but hardly in the skin. It has been found that this enzyme is highly expressed in scar tissue and subcutaneous fat; this is in contrast to the dermis, where the enzyme is hardly expressed. Adipose tissue-derived stem cell injections are an effective method in the treatment of various extensive post-burn scar deformities that makes it possible to re-create the lost sub-dermal tissue for improvement in the function of involved joint movements.

Keywords: adipose tissue-derived stem cell injections, treatment of various extensive post-burn scar deformities, re-create the lost sub-dermal tissue, improvement in function of involved joint movements

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932 A New Manoeuvre for Prevention of Post-Partum Haemorrhage

Authors: Amr Hamdy

Abstract:

Background: Postpartum haemorrhage (PPH) is the leading cause of maternal mortality worldwide. Many methods have been developed to decrease its rate. The aim of this study was to evaluate the applicability of a new non-pharmacologic maneuver in decreasing its rate. Methods: This case series study was conducted in one centre in Cairo, Egypt, from January-2010 to June-2013. 400 pregnant–women aged 18 years or more and candidate for normal labour; were enrolled to this study. High-risk subjects for PPH were excluded. After placental delivery, the new maneuver was done by sustained traction of the anterior and posterior lips of the cervix by two ovum forceps for duration of 90 seconds. The amount of blood loss was estimated by standardized visual estimation after removal of the forceps. All subjects were followed up for 6 hours. Results: The rate of PPH, defined as more than 500 ml, was 8 cases (2%) with 95% CI (0.63-3.37%). The rate of PPH was not affected by parity, gestational age, episiotomy or the presence of tears. PPH is more in cases with anemia (p 0.032). It occurred in all cases with uterine atony (p <0.001). The range of estimated blood loss was 550-600ml in cases with PPH and 150-450ml in cases without PPH. Severe PPH more than 1000 ml, did not occur. Conclusion: This pilot study introduced a novel maneuver that can be helpful in decreasing the rate of PPH and reducing the amount of post partum blood loss.Despite the low rate of PPH showed in this study, the need for conducting a randomized controlled study is at its highest level before further inclusion of such manoeuvre to be a part of the current medical practice and before considering it as an evident tool to decrease the burden of PPH.

Keywords: maternal mortality, new manoeuvre, post-partum haemorrhage, uterine atony

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931 Endoscopic Versus Open Treatment of Carpal Tunnel Syndrome: Postoperative Complications in Patients with Diabetes Mellitus

Authors: Arman Kishan, Mark Haft, Steve Li, Duc Nguyen, Dawn Laporte

Abstract:

Objective: Patients with Type 2 diabetes (T2DM) often face higher postoperative complication rates. Limited data exist on outcomes in T2DM patients undergoing carpal tunnel release (CTR). This study aims to compare complication rates between endoscopic CTR (ECTR) and open CTR (OCTR) in patients with T2DM. Methods: This was a retrospective cohort study using the TriNetX database of 56741 patients with T2DM undergoing ECTR (N= 14,949) or OCTR (N= 41,792). Demographic data, medical comorbidities, and complication rates were analyzed. We used multivariable analysis to identify differences in postoperative complication rates between the two treatment methods in patients with T2DM. Results: Patients with T2DM undergoing ECTR had a significantly lower incidence of 90-day wound infection (p < 0.001), 90-day wound dehiscence (p < 0.001), and nerve injury (p < 0.001) when compared to patients who underwent OCTR. After matching, there was a significantly higher number of T2DM patients undergoing ECTR who had peripheral vascular disease (p = 0.045) and hypertension (p = 0.020) when compared to the OCTR group. These patients also had a lower incidence of fluid and electrolyte disorders (p = 0.002) and chronic blood loss anemia (p = 0.025). Conclusion: ECTR presents a superior choice for T2DM patients undergoing CTR, yielding significantly lower rates of wound infection, wound dehiscence, and nerve injury within 90 days post-surgery—reducing the risk by 31%, 48%, and 59%, respectively. These findings support the adoption of ECTR as the preferred method in this patient population, potentially leading to improved postoperative outcomes.

Keywords: endoscopic treatment of carpal tunnel syndrome, open treatment of carpal tunnel syndrome, carpal tunnel syndrome, postoperative complications in patients with diabetes mellitus

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930 Dietary Practices of Adult Type 2 Diabetes Mellitus Patients Attending Kitui Out Patient Clinic at Kitui County, Kenya

Authors: Alice W. Theuri, Anselimo O. Makokha, Florence M. Kyallo

Abstract:

Type 2 diabetes mellitus (T2DM) is a serious metabolic disorder whose prevalence among adults has been increasing in the last decade. It is estimated that by 2030, the number of cases in Africa will almost double. Diet and lifestyle modifications are considered the cornerstone for the treatment and management of T2DM. Despite this, there is minimum literature assessing the dietary practices and glycemic control in a semi arid region context in Kenya. The objective of this study was to determine the dietary practices of adult T2DM patients attending Kitui out patient clinic in Kitui County. This was a cross sectional study design where every consenting second patient attending diabetic clinic was interviewed. A total of 138 T2DM patients were interviewed using a structured interview guide on socio-economic and dietary practices administered. The study was carried out in April and May 2017. There were more female (64%) than male (36%) in this study with majority being unemployed (38.4%). Forty seven percent (47.6%) had elevated HbA1c. Majority took three meals per day while DDS was 4.3 ± 1.09. The mean energy intake for men and women was 2823.8 ± 82.45 and 2766.3.30 ± 76.74 respectively. There was a non significant positive relationship (r= 131; P value = 0.124) between amount energy consumed and glycemic control. There were suboptimal dietary practices leading to poor glycemic control among T2DM patients attending diabetic clinic at Kitui District Hospital.

Keywords: adults, dietary practices, semi arid region, T2DM

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929 A Case Study on the Effectiveness of the Physical Therapy Home Exercise Program for Pelvic Floor Muscle Training in a Middle-Aged Female Post- Surgical Repair of Stage III Pelvic Organ Prolapse

Authors: Iwona Kasior

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Purpose: Pelvic organ prolapse is the descent of pelvic organs into the vaginal opening. Currently, few trials have been conducted to determine the influence of pelvic floor muscle training in decreasing stage or symptoms associated with pelvic organ prolapse. The purpose of this case study is to determine whether pelvic floor muscle training can decrease the stage of pelvic organ prolapse and related symptoms. Case Presentation: This is the case of a 55-year-old female; recently diagnosed with midline cystocele, stage three. She has undergone corrective surgery that failed. She has now resorted to managing the condition with a home exercise regimen of voluntary pelvic floor muscle contractions, topical vaginal crème prescribed by her gynecologist, and slight lifestyle modifications. Methods: The patient was treated by a physical therapist for evaluation, vaginal exam, and educated in the ‘knack’ maneuver, lifestyle modifications, and proper technique of performing pelvic floor muscle contractions. The subject continued with a home exercise program with a specific regimen of pelvic floor muscle contractions and topical vaginal crème. Outcome: As determined by her physical therapist and the subject, her pelvic floor muscle strength had increased following the pelvic floor muscle training regimen and the use of the ‘knack’ maneuver. The subject reported a small decrease in the size of bulging prolapse and related symptoms of dryness, odor, vaginal discomfort, and the sensation of descent. Conclusion: Pelvic floor muscle training helped to lessen the degree of the prolapse, but not significantly enough to decrease the diagnosed stage.

Keywords: Kegel exercises, pelvic floor, pelvic organ prolapse, physical therapy

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928 Reversible Cerebral Vasoconstriction Syndrome at Emergency Department

Authors: Taerim Kim, Shin Ahn, Chang Hwan Sohn, Dong Woo Seo, Won Young Kim

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Object: Reversible cerebral vasospasm syndrome (RCVS) remains an underrated cause of thunderclap headache which shares similar history of the ‘worst-ever’ headache with subarachnoid hemorrhage (SAH) to the emergency physicians. This study evaluated the clinical manifestations, radiological features, and outcomes of patients with RCVS so that the physicians could raise the high index of suspicion to detect RCVS in more patients with thunderclap headache before having life-threatening complications. Methods: The electric medical records of 18 patients with diagnostic criteria of RCVS at the emergency department (ED) between January 2013 and December 2014 were retrospective reviewed. Results: The mean age was 50.7 years, and 80% were women. Patients with RCVS visit an average of 4.7 physicians before receiving an accurate diagnosis and mean duration of symptom until diagnosis is 9.3 days. All patients except one experienced severe headache, from 8 to 10 pain intensity on a numerical rating scale (NRS). 44% of patients had nausea as an associated symptom, 66% of patients experienced worsening of headache while gagging, leaning forward, defecating, urinating or having sex. The most frequently affected vessels are middle cerebral arteries demonstrating the characteristic diffuse “string of beads” appearance. Four patients had SAH as a complication. Conclusion: Patients with RCVS have a unique set of clinical and imaging features. Emergency physicians should raise the high index of suspicion to detect RCVS in more patients with thunderclap headache before life-threatening complications.

Keywords: headache, thunderclap, subarachnoid haemorrhage, stroke

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927 Measurement of the Quadriceps Angle with Respect to Various Body Parameters in Arab Countries

Authors: Ramada R. Khasawneh, Mohammed Z. Allouh, Ejlal Abu-El Rub

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The quadriceps angle (Q angle), formed between the quadriceps muscles and the patella tendon, is considered clinically as a very important parameter which displays the biomechanical effect of the quadriceps muscle on the knee, and it is also regarded as a crucial factor for the proper posture and movement of the knee patella. This study had been conducted to measure the normal Q angle values range in the Arab nationalities and determine the correlation between Q angle values and several body parameters, including gender, height, weight, dominant side, and the condylar distance of the femur. The study includes 500 healthy Arab students from Yarmouk University and Jordan University of Science and Technology. The Q angle of those volunteers was measured using a universal manual Goniometer with the subjects in the upright weight-bearing position. It was found that the Q angle was greater in women than in men. The analysis of the data revealed an insignificant increase in the dominant side of the Q angle. In addition, the Q was significantly higher in the taller people of both sexes. However, the Q angle did not present any considerable correlation with weight in the study population; conversely, it was observed that there was a link with the condylar distance of the femur in both sexes. It was also noticed that the Q angle increased remarkably when there was an increase in the condylar distance. Consequently, it turned out that the gender, height, and the condylar distance were momentous factors that had an impact on the Q angle in our study samples. However, weight and dominance factors did not show to have any influence on the values in our study.

Keywords: Q angle, Jordanian, anatomy, condylar distance

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926 The Relationship between Characteristics of Nurses and Organizational Commitment of Nurses in Geriatric Intermediate Care Facilities in Japan

Authors: Chiharu Miyata, Hidenori Arai

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Background: The quality of care in geriatric intermediate facilities (GIFs) in Japan is not in a satisfied level. To improve it, it is crucial to reconsider nurses’ professionalism. Our goal is to create an organizational system that allows nurses to succeed professionally. To do this, we must first discuss the relationship between nurses’ characteristics and the organization. Objectives: The aim of the present study was to determine the extent to which demographic and work-related factors are related to organizational commitment among nurses in GIFs. Method: A quantitative, cross-sectional method was adopted, using a self-completion questionnaire survey. The questionnaires consisted of 49 items for job satisfaction, the three-dimensional commitment model of organizational commitment and the background information of respondents. Results: A total of 1,189 nurses participated. Of those, 91% (n=1084) were women, and mean age was 48.2 years. Most participants were staff nurses (n=791; 66%). Significant differences in 'affective commitment' (AC) scores were found for age (p < .001), overall work experience (p < .001), and work status (p < .001). For work experience in the current facility, significant differences were found in all organizational commitment scores (p < .001). The group with high job satisfaction scored significantly higher in all types of organizational commitment (p < 0.001). Conclusions: These results led to a conclusion that understanding the expectations of nurses at the workplace to adapt with the organization, and creating a work environment that clarifies contents of tasks, especially allowing for nurses to feel significance and achievement with tasks, would increase AC.

Keywords: geriatric intermediate care facilities, geriatric nursing, job satisfaction, organizational commitment

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925 Shikonin Reduces Endometriosis by Inhibiting RANTES Secretion and Mononuclear Macrophage Chemotaxis

Authors: Dong-ping Yuan, Lin Gu, Jun Long, Jie Chen, Ni Jie, Ying-Li Shi

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Endometriosis is a common disease in women of reproductive age, whose classic characteristic is mononuclear cell infiltration into lesions. Shikonin is an anti-inflammatory phytocompound from Lithospermum erythrorhizon, whose potential therapeutic effects for the endometriosis remain unclear. The working hypothesis was that shikonin can inhibit the development of endometriosis by the inhibition of chemotactic effect. Shikonin significantly inhibited the growth of human endometrial tissue implanted into mice (P<0.05). No observable adverse effects were found. The mouse regulated upon activation normal T-cell expressed and secreted (mRANTES) level in peritoneal fluid of animal endometriosis model was higher than that in normal SCID mice (P<0.05), and decreased dramatically after shikonin treatment in a dose-dependent manner (P<0.05). Peritoneal fluid from NOD/SCID mice treated with shikonin inhibited monocytes chemotaxis, which could be abolished by mRANTES antibody. In vitro, shikonin significantly inhibited RANTES expression of U937 cells cultured alone or co-cultured with human methothelail cells and endometrial stromal cells, and inhibited RANTES-induced chemotaxis of U937 cells (P<0.05). The present results suggest that shikonin can inhibit the development of endometriosis by mechanisms that at least include the inhibition of RANTES expression and decreased migration of mononuclear cells to lesions. Shikonin may be a useful and safe new approach for treating endometriosis.

Keywords: endometriosis, shikonin, RANTES chemotaxis

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924 A Study on Compromised Periodontal Health Status among the Pregnant Woman of Jamshedpur, Jharkhand, India

Authors: Rana Praween Kumar

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Preterm-low birth weight delivery is a major cause of infant morbidity and mortality in developing countries and has been linked to poor periodontal health during pregnancy. Gingivitis and chronic periodontitis are highly prevalent chronic inflammatory oral diseases. The detection and diagnosis of these common diseases is a fundamentally important component of oral health care. This study is intended to investigate predisposing and enabling factors as determinants of oral health indicators in pregnancy as well as the association between periodontal problems during pregnancy with age and socio economic status of the individual. A community –based prospective cohort study will be conducted in Jamshedpur, Jharkhand, India among pregnant women using completed interviews and a full mouth oral clinical examination using the CPITN (Community Periodontal Index of Treatment Need) and OHI-S (Simplified Oral Hygiene) indices with adequate sample size and informed consent to the patient following proper inclusion and exclusion criteria. Multiple logistic regression analyses will be used to identify independent determinants of periodontal problems and use of dental services during pregnancy. Analysis of covariance (ANCOVA) will be used to investigate the relationship between periodontal problems with the age and socioeconomic status. The result will help in proper monitoring of periodontal health during pregnancy encouraging the delivery of healthy child and the maintenance of proper health of the mother.

Keywords: infant, periodontal problems, pregnancy, pre-term-low birth weight delivery

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923 Human Immunodeficiency Virus (HIV) Test Predictive Modeling and Identify Determinants of HIV Testing for People with Age above Fourteen Years in Ethiopia Using Data Mining Techniques: EDHS 2011

Authors: S. Abera, T. Gidey, W. Terefe

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Introduction: Testing for HIV is the key entry point to HIV prevention, treatment, and care and support services. Hence, predictive data mining techniques can greatly benefit to analyze and discover new patterns from huge datasets like that of EDHS 2011 data. Objectives: The objective of this study is to build a predictive modeling for HIV testing and identify determinants of HIV testing for adults with age above fourteen years using data mining techniques. Methods: Cross-Industry Standard Process for Data Mining (CRISP-DM) was used to predict the model for HIV testing and explore association rules between HIV testing and the selected attributes among adult Ethiopians. Decision tree, Naïve-Bayes, logistic regression and artificial neural networks of data mining techniques were used to build the predictive models. Results: The target dataset contained 30,625 study participants; of which 16, 515 (53.9%) were women. Nearly two-fifth; 17,719 (58%), have never been tested for HIV while the rest 12,906 (42%) had been tested. Ethiopians with higher wealth index, higher educational level, belonging 20 to 29 years old, having no stigmatizing attitude towards HIV positive person, urban residents, having HIV related knowledge, information about family planning on mass media and knowing a place where to get testing for HIV showed an increased patterns with respect to HIV testing. Conclusion and Recommendation: Public health interventions should consider the identified determinants to promote people to get testing for HIV.

Keywords: data mining, HIV, testing, ethiopia

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922 Identification of Ice Hockey World Championship International Sports Event through Brand Personality

Authors: Eva Čáslavová, Andrej Višněvský

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This research focused on the dimensions of brand personality of the Ice Hockey World Championship sporting event. The authors compared the elements in relation to different demographic groups including gender, age, level of education and student status of the population of Prague. Moreover, the differences of opinions of respondents who had experience of visiting a sports event and those who had not were assessed. In the research, the modified brand personality scale was used. This modified scale consists of five dimensions: responsibility, activity, toughness, individuality and emotionality, none of which was previously tested. The authors had an intentional sample of 291 respondents from Prague available, ranging in age from 18 years to 75 years, with either a high school or university education. The respondents rated the characteristic features in a seven-point Likert Scale and the data was collected in November 2012. The results suggest that the Ice Hockey World Championship is most identified with these dimensions: responsibility, emotionality and activity. Men had higher mean scores (4.93) on the Likert Scale in the emotionality dimension, while women had higher mean scores (4.91) in the activity dimension. Those respondents with experience visiting an Ice Hockey World Championship match had the highest mean score (5.10) in the emotionality dimension. This research had expected to show more pronounced mean values (above six) on the Likert scale in the emotionality and activity dimensions that more strongly characterize the brand personality of the Ice Hockey World Championship, however this expectation was not confirmed.

Keywords: dimensions, brand personality, ice hockey, international sports event, marketing

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921 Using Systems Theory and Collective Impact Approaches to Increase the Retention and Success of University Student Stem Majors

Authors: Araceli Martínez Ortiz

Abstract:

An educational research effort is analyzed using systems theory to document the power of collective impact when addressing multiple factors contributing towards the retention of students majoring in science, technology, engineering and mathematics (STEM) academic programs. This research promotes understanding on how networked communities may work effectively toward a shared vision and mutually aligned activities that result in sustained, large scale change. The actions of a team of researchers in their third year of collaboration are presented to describe a model that positively aligns work efforts resulting in greater total gains. The goals of the multiple programs managed by the funded program team are to: 1) expand the number of students who choose to study a STEM field of study; 2) promote student collaborative learning; 3) support faculty understanding of the funds of knowledge of diverse students and 4) establish innovative and robust STEM education research that will lead to the development of nationally replicable, scalable models for broadening participation in STEM. The impacts of this research effort are measured through quantitative statistical analysis of the changes in second-year STEM undergraduate student retention rates and representation rates of women, Hispanics and African American STEM majors.

Keywords: collaborative impact, diversity, student retention, systems theory, STEM education

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920 Antibiogram Profile of Antibacterial Multidrug Resistance in Democratic Republic of Congo: Situation in Bukavu City Hospitals

Authors: Justin Ntokamunda Kadima, Christian Ahadi Irenge, Patient Birindwa Mulashe, Félicien Mushagalusa Kasali, Patient Wimba

Abstract:

Background: Bacterial strains carrying multidrug resistance traits are gaining ground worldwide, especially in countries with limited resources. This study aimed to evaluate the spreading of multidrug-resistant bacteria strains in Bukavu city hospitals in the Democratic Republic of Congo. Methods: We analyzed 758 antibiogram data recorded in files of patients consulted between January 2016 and December 2017 at three reference hospitals selected as sentinel sites, namely the Panzi General Reference Hospital (HGP), BIO -PHARM hospital (HBP), and Saint Luc Clinic (CSL). Results: Of 758 isolates tested, the laboratories identified 12 bacterial strains in 712 isolates, of which 223 (29.42%) presented MDR profile, including Escherichia coli (11.48%), Klebsiella pneumonia (6.07%), Enterobacter (5.8%), Staphylococcus aureus and coagulase-negative Staphylococci (1.58%), Proteus mirabilis (1.85%), Salmonella enterica (1.19%), Pseudomonas aeruginosa (0.53%), Streptococcus pneumonia (0.4%)), Citrobacter (0.13%), Neisseria gonorrhea (0.13%), Enterococcus faecalis (0.13%), and Morganella morganii (0.13%). Infected patients were significantly more adults (73.1% vs. 21.5%) compared to children and mainly women (63.7% vs. 30.9%; p = 0.001). Conclusion: The observed expansion requires that hospital therapeutic committees set up an effective clinical management system and define the right combinations of antibiotics.

Keywords: multidrug resistance, bacteria, antibiogram, Bukavu

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919 The Efficacy of Box Lesion+ Procedure in Patients with Atrial Fibrillation: Two-Year Follow-up Results

Authors: Oleg Sapelnikov, Ruslan Latypov, Darina Ardus, Samvel Aivazian, Andrey Shiryaev, Renat Akchurin

Abstract:

OBJECTIVE: MAZE procedure is one of the most effective surgical methods in atrial fibrillation (AF) treatment. Nowadays we are all aware of its modifications. In our study we conducted clinical analysis of “Box lesion+” approach during MAZE procedure in two-year follow-up. METHODS: We studied the results of the open-heart on-pump procedures performed in our hospital from 2017 to 2018 years. Thirty-two (32) patients with atrial fibrillation (AF) were included in this study. Fifteen (15) patients had concomitant coronary bypass grafting and seventeen (17) patients had mitral valve repair. Mean age was 62.3±8.7 years; prevalence of men was admitted (56.1%). Mean duration of AF was 4.75±5.44 and 7.07±8.14 years. In all cases, we performed endocardial Cryo-MAZE procedure with one-time myocardium revascularization or mitral-valve surgery. All patients of this study underwent pulmonary vein (PV) isolation and ablation of mitral isthmus with additional isolation of LA posterior wall (Box-lesion+ procedure). Mean follow-up was 2 years. RESULTS: All cases were performed without any complications. Additional isolation of posterior wall did not prolong the operative time and artificial circulation significantly. Cryo-MAZE procedure directly lasted 20±2.1 min, the whole operation time was 192±24 min and artificial circulation time was 103±12 min. According to design of the study, we performed clinical investigation of the patients in 12 months and in 2 years from the initial procedure. In 12 months, the number of AF free patients 81.8% and 75.8% in two years of follow-up. CONCLUSIONS: Isolation of the left atrial posterior wall and perimitral area may considerably improve the efficacy of surgical treatment, which was demonstrated in significant decrease of AF recurrences during the whole period of follow-up.

Keywords: atrial fibrillation, cryoablation, left atrium isolation, open heart procedure

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918 Interaction Design In Home Appliance: An Integrated Approach InKanseiAnd Hedonomic “Cases: Rice Cooker, Juicer, Mixer”

Authors: Sara Mostowfi, Hassan Sadeghinaeini, Sana Behnamasl, Leila Ensaniat, Maryam Mostafaee

Abstract:

Nowadays, most of product producers, e.g. home appliance, electronic machines and vehicles focus on quality and comfort, and promise consumers ease of use and pleasurable experiences during product using. Consumers make their purchase decisions according to two needs: functional and emotional needs. Functional needs are fulfilled by product functionality, besides emotional needs are related to psychologists’ aspects of production. Emotions are distinctive elements which should be added to products and services to lead them up. In this case, the authors’ survey conducted pleasurable and hedonomic aspects in products of a home appliance company in Iran. In this regard, three samples of home appliance were selected: mixer, rice cooker, iron. Fifteen women (20-60) participated in this study. Every user evaluated each product by questionnaire based on 7 point semantic differential scale. After analyzing the results with statistical methods, results showed that 90% of users aren’t satisfied with hedonic and pleasurable criteria in interaction with these products. They notified that regarding hedonomics and pleasurable criteria’s they will have better ease of use and functionality. Our findings show a significant association between products’ features and user satisfaction. It seems that industrial design has a significant impression on the company’s products and with regard the pleasurable criteria the company sales will be more successful.

Keywords: home appliance, interaction, pleasure, hedonomy, ergonomy

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917 Impacted Maxillary Canines and Associated Dental Anomalies

Authors: Athanasia Eirini Zarkadi, Despoina Balli, Olga Elpis Kolokitha

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Objective: Impacted maxillary canines are a frequent condition and a common reason for patients seeking orthodontic treatment. Their simultaneous presence with dental anomalies raises a question about their possible connection. The aim of this study was to investigate the association of maxillary impacted canines with dental anomalies. Materials and Methods: Files of 874 patients from an orthodontic private practice in Greece were evaluated for the presence of maxillary impacted canines. From this sample, a group of 97 patients (39 males and 58 females) with at least one impacted maxillary canine were selected and consisted of the study group (canine impaction group) of this study. This group was compared to a control group of 97 patients (42 males and 55 females) that was created by random selection from the initial sample without maxillary canine impaction. The impaction diagnosis was made from the panoramic radiographs and confirmed from the surgery. The association between maxillary canine impaction and dental anomalies was examined with the chi-square test. A classification tree was created to further investigate the relations between impaction and dental anomalies. The reproducibility of diagnoses was assessed by re-examining the records of 25 patients two weeks after the first examination. Results: The found associated anomalies were cone-shaped upper lateral incisors and infraocclusion of deciduous molars. There is a significant increase in the prevalence of 12,4% of distal displacement of the unerupted mandibular second premolar in the canine impaction group compared to the control group that was 7,2%. The classification tree showed that the presence of a cone-shaped maxillary lateral incisor gave rise to the probability of an impacted canine to 83,3%. Conclusions: The presence of cone-shaped maxillary lateral incisors and infraocclusion of deciduous molars can be considered valuable early risk indicators for maxillary canine impaction.

Keywords: cone-shaped maxillary lateral incisors, dental anomalies, impacted canines, infraoccluded deciduous molars

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916 Family Cohesion, Interpersonal Difficulties and Mental Health Problems in University Students

Authors: Narmeen Ali, Muhammad Arshad

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Cohesion has an exact association with family functioning and enmeshment (togetherness) on one side and disengagement (separateness) on the other. Family cohesion can apprehend as a concerned association that family members have with each other and an affirmation of association inside the family. Family cohesion, assigned as the level of congruity or sympathetic or emotional attachment that relatives have toward each other, and it was seen to be associated with relational well-being and feeling of comfort in the young generation. The cross-sectional research design was used by the researcher to answer the research questions. A stratified sampling technique was used to collect the data from the participants. The data was collected equally from the males and females of different universities and different departments of Lahore, Pakistan. A self-report questionnaire was developed of given literature and which were found to be associated with family cohesion, interpersonal difficulties and mental health problems of university students. The demographic information included age, gender, university’s name, class, family system, parent’s education, parent’s profession, number of siblings and birth order. Correlation shows the negative relation between balanced cohesion and interpersonal difficulties, while interpersonal difficulties have a highly positive relationship with mental health problems. Mental health problems also have a negative correlation with the balanced family cohesion. Gender, family system, depression and anxiety are the significant predictors of interpersonal difficulties scale in university students. And gender showed a significant difference regarding family cohesion and interpersonal difficulty scale, as women reported more interpersonal difficulties than men.

Keywords: family cohesion, interpersonal difficulties, mental health problems, university students

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915 Chemistry and Sources of Solid Biofuel Derived Ambient Aerosols during Cooking and Non-Cooking Hours in Rural Area of Khairatpur, North-Central India

Authors: Sudha Shukla, Bablu Kumar, Gyan Prakash Gupta, U. C. Kulshrestha

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Air pollutants emitted from solid biofuels during cooking are the major contributors to poor air quality, respiratory problems, and radiative forcing, etc. in rural areas of most of developing countries. The present study reports the chemical characteristics and sources of ambient aerosols and traces gases during cooking and non-cooking hours emitted during biofuel combustion in a village in North-Central India. Fine aerosol samples along with gaseous species (Sox, NOx, and NH₃) were collected during September 2010-March 2011 at Khairatpur village (KPV) which is located in the Uttar Pradesh state in North-Central India. Results indicated that most of the major ions in aerosols and Sox, NOx, and NH₃ gases were found to be higher during cooking hours as compared to non-cooking hours suggesting that solid biofuel combustion is an important source of air pollution. Results of Principal Component Analysis (PCA) revealed that combustion of solid biofuel, vehicular emissions, and brick kilns were the major sources of fine aerosols and trace gases in the village. A health survey was conducted to find out the relation between users of biofuels and their health effects and the results revealed that most of the women in the village were suffering from diseases associated with biofuel combustion during cooking.

Keywords: ambient aerosols, biofuel combustion, cooking, health survey, rural area

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914 Electrochemotherapy of Portal Vein Tumor Thrombus as Dowstaging to Liver Transplantation

Authors: Luciano Tarantino, Emanuele Balzano, Paolo Tarantino, Riccardo Aurelio Nasto, Aurelio Nasto

Abstract:

Liver transplantation (OLT) is contraindicate in Portal Vein tumor Thrombosis (PVTT) from Hepatocellular Carcinoma at hepatic hilum(pH-HCC) Surgery,Thermal ablation and chemotherapy show poorer outcomes Electrochemotherapy (ECT) has been successfully used in patients with pH-HCC with PVTT. We report the results of ECT as downstaging aimed to definitive cure by OLT. F.P. 53 years HBV related Cirrhosis Child-Pugh B7 class; EGDS F2 aesophageal Varices. Diabetes. April 2016 : Enhanced Computed Tomography (CT) detected HCC(n.3 nodules in VII-VIII-VI;diameter range=25 cm) and PVTT of right portal vein. The patient was considered ineligible for OLT. May 2016: first ablation session with percutaneous Radiofrequency-ablation(RFA) of 3 HCC-nodules . August 2016: second ablation session with ECT of PVTT. CT october 2016: disappearance of PVTT and patent right portal vein. No intraparenchymal recurrence. CT march 2017: No recurrence in portal vein and in the left lobe. local recurrence in the VII-VIII segments. May 2017 : transarterial chemoembolization (TACE) of right lobe recurrences. CT October 2017: patent right portal vein. No recurrence. The patient was reconsidered for OLT. He underwent OLT in April 2018. At 36-months follow-up , no intrahepatic recurrence of HCC occurred. March 2021: enhanced CT and PET/CT detected a single small nodule (1.5 cm) uptaking tracer in the left upper pulmonary lobe, no hepatic recurrence . CT-guided FNB showed metastasis from HCC . June 2021: left lung upper lobectomy . At the current time the patient is alive and recurrence-free at 64 months follow-up. ECT Could be aneffective technique as pre-OLT dowstaging in HCC with PVTT.

Keywords: liver tumor ablation, interventional ultrasound, electrochemotherapy, liver transplantation

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913 Exploring the Intricate Microbiology of Street Cuisine: Delving into Potential Dangers in Order to Enhance Safety and Quality

Authors: Raana Babadi Fathipour

Abstract:

Street foods hold a significant place in the tapestry of socioeconomic and cultural norms, beloved across the globe. Serving as a convenient and affordable option for city dwellers seeking nourishment, these culinary delights also serve as a vital source of income for vendors, particularly women. Additionally, street food acts as a mirror reflecting traditional local customs and practices, an element that draws tourists to experience the authenticity of a culture firsthand. Despite its many virtues, concerns have emerged regarding the microbiological safety of street food worldwide. Often prepared and sold in subpar conditions without proper oversight or regulation, street food has become synonymous with potential health risks. The presence of elevated levels of fecal indicator bacteria and various pathogens in these unregulated delicacies further perpetuates anxieties surrounding their consumption. This analysis delves into the intricate microbiological intricacies inherent in street food, shedding light on the pertinent safety concerns and prevalent pathogens. Additionally, it elaborates on the worldwide standing of this vital economic endeavor. Moreover, it advocates for the adoption of molecular detection techniques over conventional culture-based methods to gain a more comprehensive grasp of the true microbial risks posed by street cuisine. Acknowledgment marks the initial step towards resolving any given issue.

Keywords: foodborne pathogens, microbiological safety, street food, viruses

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912 South Africa’s Post-Apartheid Film Narratives of HIV/AIDS: A Case of ‘Yesterday’

Authors: Moyahabo Molefe

Abstract:

The persistence of HIV/AIDS infection rates in SA has not only been a subject of academic debate but a mediated narrative that has dominated SA’s post-apartheid film space over the last two decades. SA’s colonial geo-spatial architecture still influences migrant labour patterns, which the Oscar-nominated (2003) SA film ‘Yesterday’ has erstwhile reflected upon, yet continues to account for the spread of HIV/AIDS in SA society. Accordingly, men who had left their homes in the rural areas to work in the mines in the cities become infected with HIV/AIDS, only to return home to infect their wives or partners in the rural areas. This paper analyses, through Social Semiotic theory, how SA geo-spatial arrangement had raptured family structures with both men and women taking new residences in the urban areas where they work away from their homes. By using Social semiotic theory, this paper seeks to understand how images and discourses have been deployed in the film ‘Yesterday’ to demonstrate how HIV/AIDS is embedded in the socio-cultural, economic and political architect of SA society. The study uses qualitative approach and content/text/visual semiotic analysis to decipher meanings from array of imagery and discourses/dialogues that are used to mythologise the relationship between the spread of HIV/AIDS and SA migrant labour patterns. The findings of the study are significant to propose a conceptual framework that can be used to mitigate the spread of HIV/AIDS among SA populace, against the backdrop of changing migrant labour patterns and other related factors

Keywords: colonialism, decoloniality, HIV/AIDS, labour migration patterns, social semiotics

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