Search results for: breast conservation surgery

Authors: Javier Enciso-Benavides, Fredy Fabian, Carlos Castaneda, Luis Alfaro, Alex Choque, Aparicio Aguilar, Javier Enciso

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Background: The use of biomarkers in breast cancer diagnosis, therapy, and prognosis has gained increasing interest. Cancer stem cells (CSCs) are a subpopulation of tumor cells that can drive tumor initiation and may cause relapse. Therefore, due to the importance of diagnosis, therapy, and prognosis, several biomarkers that characterize CSCs have been identified; however, in treatment-naïve triple-negative breast tumors, there is an urgent need to identify new biomarkers and therapeutic targets. According to this, the aim of this study was to identify serum proteins associated with cancer stem cells and pluripotency in women with triple-negative breast tumors in order to subsequently identify a biomarker for this type of breast tumor. Material and Methods: Whole blood samples from 12 women with histopathologically diagnosed triple-negative breast tumors were used after obtaining informed consent from the patient. Blood serum was obtained by conventional procedure and frozen at -80ºC. Identification of cancer stem cell-associated proteins was performed by matrix-assisted laser desorption/ionisation-assisted laser desorption/ionisation mass spectrometry (MALDI-TOF MS), protein analysis was obtained using the AB Sciex TOF/TOF™ 5800 system (AB Sciex, USA). Sequences not aligned by ProteinPilot™ software were analyzed by Protein BLAST. Results: The following proteins related to pluripotency and cancer stem cells were identified by MALDI TOF/TOF mass spectrometry: A-chain, Serpin A12 [Homo sapiens], AIEBP [Homo sapiens], Alpha-one antitrypsin, AT {internal fragment} [human, partial peptide, 20 aa] [Homo sapiens], collagen alpha 1 chain precursor variant [Homo sapiens], retinoblastoma-associated protein variant [Homo sapiens], insulin receptor, CRA_c isoform [Homo sapiens], Hydroxyisourate hydrolase [Streptomyces scopuliridis], MUCIN-6 [Macaca mulatta], Alpha-actinin-3 [Chrysochloris asiatica], Polyprotein M, CRA_d isoform, partial [Homo sapiens], Transcription factor SOX-12 [Homo sapiens]. Recommendations: The serum proteins identified in this study should be investigated in the exosome of triple-negative breast cancer stem cells and in the blood serum of women without breast cancer. Subsequently, proteins found only in the blood serum of women with triple-negative breast cancer should be identified in situ in triple-negative breast cancer tissue in order to identify a biomarker to study the evolution of this type of cancer, or that could be a therapeutic target. Conclusions: Eleven cancer stem cell-related serum proteins were identified in 12 women with triple-negative breast cancer, of which MUCIN-6, retinoblastoma-associated protein variant, transcription factor SOX-12, and collagen alpha 1 chain are the most representative and have not been studied so far in this type of breast tumor. Acknowledgement: This work was supported by Proyecto CONCYTEC–Banco Mundial “Mejoramiento y Ampliacion de los Servicios del Sistema Nacional de Ciencia Tecnología e Innovacion Tecnologica” 8682-PE (104-2018-FONDECYT-BM-IADT-AV).

Keywords: triple-negative breast cancer, MALDI TOF/TOF MS, serum proteins, cancer stem cells

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Authors: Ashraf Mohammadzadeh, Ahmad Shah Farhat, Azin Vaezi, Aradokht Vaezi

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Background & Aim: Preterm infants born at less than 34 weeks postconceptional age are not as neurologically mature as their term counterparts and thus have difficulty coordinating sucking, swallowing and breathing. As a result, they are traditionally gavage fed until they are able to oral feed successfully. The aim of study was to evaluate comparative effect of orogastric and breast feeding on oxygen saturation in very low birth weight infant (<1500gm). Patients and Methods: In this clinical trial all babies admitted in the Neonatal Research Center of Imamreza Hospital, Mashhad during a 4 months period were elected. Criteria for entrance to study included birth weight ≤ 1500 grams, exclusive breastfeeding, having no special problem after 48 hours, receivinge only routine care and intake of milk was 100cc/kg/day. Each neonate received two rounds of orogastric and breast feeding in the morning and in the afternoon, during which mean oxygen saturation was measured by pulse-oxymetry. During the study the heart rate and temperature of the neonates were monitored, and in case of hypothermia, bradycardia(less than 100 per minute) or apnea the feeding was discontinued and the study was repeated the following day. Data analysis was carried out using SPSS. Results: Fifty neonates were studied. The average birth weight was 1267.20±165.42 grams and average gestational age was 31.81±1.92 and female/male ratio was 1.2. There was no significant statistical difference in arterial oxygen saturation in orogastric and breast feeding in the morning and in the afternoon. (p=0.16 in the morning and p=0.6 in the afternoon). There was no complication of apnea, hypothermia or bradycardia. Conclusion: There was no significant statistical difference between the two methods in arterial oxygen saturation. It seems that oral feeding (which is a natural route) and skin contact between the mother and neonate causes a strong emotional bonding between the two and brings about better social adaptation for the neonate. Also shorter period of stay in hospital is more preferred, and breast feeding should be started at the earliest possible time after birth.

Keywords: Very low birth weight (V.L.B.W), O2 Saturation, Breast Feeding, Tube Feeding

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Authors: K. Bensafia, A. Mansour, G. Le Maillot, B. Clement, O. Reynet, P. Ariès, S. Haddab

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This paper presents a system designed for wireless acquisition, the recording of electrocardiogram (ECG) signals and the monitoring of the heart’s health during surgery. This wireless recording system allows us to visualize and monitor the state of the heart’s health during a surgery, even if the patient is moved from the operating theater to post anesthesia care unit. The acquired signal is transmitted via a Bluetooth unit to a PC where the data are displayed, stored and processed. To test the reliability of our system, a comparison between ECG signals processed by a conventional ECG monitoring system (Datex-Ohmeda) and by our wireless system is made. The comparison is based on the shape of the ECG signal, the duration of the QRS complex, the P and T waves, as well as the position of the ST segments with respect to the isoelectric line. The proposed system is presented and discussed. The results have confirmed that the use of Bluetooth during surgery does not affect the devices used and vice versa. Pre- and post-processing steps are briefly discussed. Experimental results are also provided.

Keywords: electrocardiography, monitoring, surgery, wireless system

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Authors: Nadir Sidiqi

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Biodiversity conservation is humanity’s building block to sustain lives - ultimately allowing all living and nonliving creatures to interact in a balanced proportion. Humanity’s challenge in the 21st century is to maintain biodiversity without harming the natural habitat of plants, animals and beneficial microorganisms. There are many good reasons to consider why biodiversity is important to every nation around the world, especially for a nation like Afghanistan. One of the major values of biodiversity is its economic value: biodiversity provides goods and services to the Afghan nation directly through links and components such as the maintenance of traditional crops, medicine, fruits, animals, grazing, fuel, timber, harvesting, fishing, hunting and related supplies. Biodiversity is the variety of the living components, such as humans, plants, animals, and microorganisms, and nonliving components interaction, including air, water, sunlight, soil, humidity and environmental factors in an area. There are many ways of gauging the value of biodiversity. As an ecosystem, biodiversity includes such benefits as soil fertility, erosion control, crop pollination, crop rotation, and pest control. The conservation of biodiversity is crucial for these benefits, which would be impossible to replace. Biodiversity conservation also has heritage values; this wealth of genetic diversity provides backup to rural people living close together.

Keywords: Afghanistan, biodiversity, conservation, economy, environment

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Authors: Farhad Fakoursevom

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Heart disease is one of the diseases which is found in abundance today. Various types of surgeries, such as bypasses, angiography, angioplasty, etc., are used to treat patients. People may receive such surgeries, some of which are invasive and some non-invasive, throughout their lives. People might cope with pre-surgery anxiety and stress, which can disrupt their normal life and even reduce the effects of the surgery, so the desired result can not be achieved in surgery. Considering this issue, the present study aimed to do a comparative assessment of people who received sedatives before surgery and people who did not receive sedatives. In terms of the purpose, this is an applied research and descriptive survey in terms of method. The statistical population included patients who underwent surgeries in the specialist heart hospitals of Mashhad, Iran; 60 people were considered as a statistical population, 30 of them received sedatives before surgery, and 30 others had not received sedatives before surgery. Valid and up-to-date articles were systematically used to collect theoretical bases, and a researcher-made questionnaire was used to examine the level of stress and anxiety of people. The questionnaire content validity was assessed by a panel of experts in psychology and medicine. The construct validity was tested using the software. Cronbach's alpha and composite reliability were used for reliability, which shows the appropriate reliability of the questionnaire. SPSS software was used to compare the research results between two groups, and the research findings showed that there is no significant association between the people who received sedatives and those who did not receive sedatives in terms of the amount of stress and anxiety. The longer the time of taking the drugs before the surgery, the more the mental peace of the patients will be. According to the results, it can be said that if we don't need to have an emergency operation and need more time, we have to use sedative drugs with different doses compared to the severity of the surgery, and also in case of a medical emergency such as heart surgery due to a stroke, we have to take advantage of psychological services during and before the operation and sedative drugs so that the patients can control their stress and anxiety and achieve better outcomes.

Keywords: sedative drugs, stress, anxiety, surgery

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Authors: Angel Champion, Sadia Kanwal, Rafat Siddiqui

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Harnessing phytochemicals from plant sources presents a novel opportunity to prevent or treat malignant diseases, including breast cancer. Chemotherapy lacks precision in targeting cancerous cells while sparing normal cells, but a phytopharmaceutical approach may offer a solution. Dandelion, a common weed plant, is rich in phytochemicals and provides a safer, more cost-effective alternative with lower toxicity than traditional pharmaceuticals for conditions such as breast cancer. In this study, an in-vitro experiment will be conducted using the ethanol extract of Dandelion on triple-negative MDA-231 breast cancer cell lines. The polyphenolic analysis revealed that the Dandelion extract, particularly from the root and leaf (both cut and sifted), had the most potent antioxidant properties and exhibited the most potent antioxidation activity from the powdered leaf extract. The extract exhibits prospective promising effects for inducing cell proliferation and apoptosis in breast cancer cells, highlighting its potential for targeted therapeutic interventions. Standardizing methods for Dandelion use is crucial for future clinical applications in cancer treatment. Combining plant-derived compounds with cancer nanotechnology holds the potential for effective strategies in battling malignant diseases. Utilizing liposomes as carriers for phytoconstituent anti-cancer agents offers improved solubility, bioavailability, immunoregulatory effects, advancing anticancer immune function, and reducing toxicity. This integrated approach of natural products and nanotechnology has significant potential to revolutionize healthcare globally, especially in underserved communities where herbal medicine is prevalent.

Keywords: apoptosis, antioxidant activity, cancer nanotechnology, phytopharmaceutical

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Authors: Luksanaporn Krungkraipetch

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Currently, surgery is the only known effective treatment for pterygium. In certain groups, the probability of recurrence after basic sclera excision is very significant. Tissue grafting is substantially more time-consuming and challenging than keeping the sclera uncovered, but it reduces the chance of recurrence. Conjunctival autograft surgery is older than amniotic membrane graft surgery. The purpose of this study was to compare pterygium surgery with conjunctival autograft against an amniotic membrane transplant. In the study, a randomized controlled trial was used. Four cases were ruled out (two for failing to meet inclusion criteria and the other for refusing to participate). Group I (n = 40) received the intervention, whereas Group II (n = 40) served as the control. Both descriptive and inferential statistical approaches were used, including data analysis and data analysis statistics. The descriptive statistics analysis covered basic pterygium surgery information as well as the risk of recurrent pterygium. As an inferential statistic, the chi-square was used. A p-value of 0.05 is statistically significant. The findings of this investigation were the majority of patients in Group I were female (70.0%), aged 41–60 years, had no underlying disease (95.0%), and had nasal pterygium (97.5%). The majority of Group II patients were female (60.0%), aged 41–60 years, had no underlying disease (97.5%) and had nasal pterygium (97.5%). Group I had no recurrence of pterygium after surgery, but Group II had a 7.5% recurrence rate. Typically, the recurrence time is twelve months. The majority of pterygium recurrences occur in females (83.3%), between the ages of 41 and 60 (66.7%), with no underlying disease. The recurrence period is typically six months (60%) and a nasal pterygium site (83.3%). Pterygium recurrence after surgery is associated with nasal location (p =.002). 16.7% of pterygium surgeries result in complications; one woman with nasal pterygium underwent autograft surgery six months later. The presence of granulation tissue at the surgical site is a mild complication. A pterygium surgery recurrence rate comparison of conjunctival autograft and amniotic membrane transplantation revealed that conjunctival autograft had a higher recurrence rate than amniotic membrane transplantation (p =.013).

Keywords: pterygium, pterygium surgery, conjunctival autograft, amniotic membrane transplantation

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Authors: Mohammad T. Uddin, Aurup R. Dhar

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The study was conducted to assess the impact of conservation agriculture practice on farmers’ socioeconomic condition and soil environmental quality in Bangladesh. A total of 450 (i.e., 50 focal, 150 proximal and 250 control) farmers from five districts were selected for this study. Descriptive statistics like sum, averages, percentages, etc. were calculated to evaluate the socioeconomic data. Using Enyedi’s crop productivity index, it was found that the crop productivity of focal, proximal and control farmers was increased by 0.9, 1.2 and 1.3 percent, respectively. The result of DID (Difference-in-difference) analysis indicated that the impact of conservation agriculture practice on farmers’ average annual income was significant. Multidimensional poverty index (MPI) indicates that poverty in terms of deprivation of health, education and living standards was decreased; and a remarkable improvement in farmers’ socioeconomic status was found after adopting conservation agriculture practice. Most of the focal and proximal farmers stated about increased soil environmental condition where majority of control farmers stated about constant environmental condition in this regard. The Probit model reveals that minimum tillage operation, permanent organic soil cover, and application of compost and vermicompost were found significant factors affecting soil environmental quality under conservation agriculture. Input support, motivation, training programmes and extension services are recommended to implement in order to raise the awareness and enrich the knowledge of the farmers on conservation agriculture practice.

Keywords: conservation agriculture, crop productivity, socioeconomic status, soil environment quality

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Authors: Talbi Mohammed, Oustous Aziz, Ben Messaoud Mounir, Sebihi Rajaa, Khalis Mohammed

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Background: Breast cancer is the leading cause of death for women around the world. Screening mammography is the reference examination, due to its sensitivity for detecting small lesions and micro-calcifications. Therefore, it is essential to ensure quality mammographic examinations with the most optimal dose. These conditions depend on the choice of exposure parameters. Clinically, practices must be evaluated in order to determine the most appropriate exposure parameters. Material and Methods: We performed our measurements on a mobile mammography unit (PLANMED Sofie-classic.) in Morocco. A solid dosimeter (AGMS Radcal) and a MTM 100 phantom allow to quantify the delivered dose and the image quality. For image quality assessment, scores are defined by the rate of visible inserts (MTM 100 phantom), obtained and compared for each acquisition. Results: The results show that the parameters of the mammography unit on which we have made our measurements can be improved in order to offer a better compromise between image quality and breast dose. The last one can be reduced up from 13.27% to 22.16%, while preserving comparable image quality.

Keywords: Mammography, Breast Dose, Image Quality, Phantom

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Authors: Khalid Iqbal

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This work presents a comparison of an anthropomorphic PRESAGE® dosimeter and radiochromic film measurements with a commercial treatment planning system to determine the feasibility of PRESAGE® for 3D dosimetry in breast IMRT. An anthropomorphic PRESAGE® phantom was created in the shape of a breast phantom. A five-field IMRT plan was generated with a commercially available treatment planning system and delivered to the PRESAGE® phantom. The anthropomorphic PRESAGE® was scanned with the Duke midsized optical CT scanner (DMOS-RPC) and the OD distribution was converted to dose. Comparisons were performed between the dose distribution calculated with the Pinnacle3 treatment planning system, PRESAGE®, and EBT2 film measurements. DVHs, gamma maps, and line profiles were used to evaluate the agreement. Gamma map comparisons showed that Pinnacle3 agreed with PRESAGE® as greater than 95% of comparison points for the PTV passed a ± 3%/± 3 mm criterion when the outer 8 mm of phantom data were discluded. Edge artifacts were observed in the optical CT reconstruction, from the surface to approximately 8 mm depth. These artifacts resulted in dose differences between Pinnacle3 and PRESAGE® of up to 5% between the surface and a depth of 8 mm and decreased with increasing depth in the phantom. Line profile comparisons between all three independent measurements yielded a maximum difference of 2% within the central 80% of the field width. For the breast IMRT plan studied, the Pinnacle3 calculations agreed with PRESAGE® measurements to within the ±3%/± 3 mm gamma criterion. This work demonstrates the feasibility of the PRESAGE® to be fashioned into anthropomorphic shape, and establishes the accuracy of Pinnacle3 for breast IMRT. Furthermore, these data have established the groundwork for future investigations into 3D dosimetry with more complex anthropomorphic phantoms.

Keywords: 3D dosimetry, PRESAGE®, IMRT, QA, EBT2 GAFCHROMIC film

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Authors: Marwa M. Abu-Serie, Marwa M. Eltarahony

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The search for reliable, effective, and safe nanoparticles (NPs) as a treatment for cancer is a pressing priority. In this study, Cu-NPs were fabricated by Streptomyces cyaneofuscatus through simultaneous bioreduction strategy of copper nitrate salt. The as-prepared Cu-NPs subjected to structural analysis; energy-dispersive X-ray spectroscopy, elemental mapping, X-ray diffraction, transmission electron microscopy, and ζ-potential. These biological synthesized Cu-NPs were mixed with disulfiram (DS), forming a nanocomplex of Cu-DS with a size of ~135 nm. The prepared nanocomplex (nanoCu-DS) exhibited higher anticancer activity than that of free complex of DS-Cu, Cu-NPs, and DS alone. This was illustrated by the lowest IC50 of nanoCu-DS (< 4 µM) against human breast and liver cancer cell lines comparing with DS-Cu, Cu-NPs, and DS (~8, 22.98-33.51 and 11.95-14.86, respectively). Moreover, flow cytometric analysis confirmed that higher apoptosis percentage range of nanoCu-DS-treated in MDA-MB 231, MCF-7, Huh-7, and HepG-2 cells (51.24-65.28%) than free complex of Cu-DS ( < 4.5%). Regarding inhibition potency of liver and breast cancer cell migration, no significant difference was recorded between free and nanocomplex. Furthermore, nanoCu-DS suppressed gene expression of β-catenine, Akt, and NF-κB and upregulated p53 expression (> 3, >15, > 5 and ≥ 3 folds, respectively) more efficiently than free complex (all ~ 1 fold) in MDA-MB 231 and Huh-7 cells. Our finding proved this prepared nano complex has a powerful anticancer activity relative to free complex, thereby offering a promising cancer treatment.

Keywords: biologically prepared Cu-NPs, breast cancer cell lines, liver cancer cell lines, nanoCu- disulfiram

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Authors: Maryam Zahedifard, Fadhil Lafta Faraj, Maryam Hajrezaie, Nazia Abdul Majid, Mahmood Ameen Abdulla, Hapipah Mohd Ali

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In the current study, we prepared two new quinazoline schiff bases through condensation reaction of 2-aminobenzhydrazide with 5-bromosalicylaldehyde and 3-methoxy-5-bromosalicylaldehyde. The chemical structures of both newly synthesized compounds (1 and 2) were confirmed by FT-IR and X-ray crystallography studies. The cytotoxic effect of compounds was investigated against MCF-7 human breast cancer cells. MTT results showed that (1) and (2) decreased the viability of MCF-7 cells in a time-dependent manner, exhibiting an IC50 value of 3.23 ± 0.28 µg/mL and 3.41 ± 0.34 µg/mL, respectively, after a 72-hours treatment period. In contrast, they did not show significant anti-proliferative effect towards MCF-10A normal breast cells and WRL-68 normal liver cells. We found a perturbation in mitochondrial membrane potential and increased cytochrome c release from the mitochondria to the cytosol, suggesting an activation of apoptosis by compounds, which was confirmed by activation of the initiator caspase-9 and the executioner caspases-3/7. (1) was also able to trigger extrinsic pathway via activation of caspase-8 and inhibition of NF-κB translocation. The acute toxicity test showed no toxicity effect of the compounds in rats. Our results showed that the selected synthesized compounds are highly potent to induce apoptosis in MCF-7 cells via either intrinsic or extrinsic mitochondrial pathway.

Keywords: Quinazoline Schiff base, apoptosis, MCF-7 human breast cancer cell line, caspase, NF-κB translocation

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Authors: Ying Chen

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Conservation Agriculture in a sustainable way of farming, as it brings many benefits, such as preventing soil from erosion and degradation, improving soil health, conserving energy, and sequestrating carbon. However, adoption of conservation agriculture has been progressing slowly in some part of the world due to some challenges. Among them, seeding in heavy crop residue is challenging, especially in corn production systems. Weed control is also challenging in conservation agriculture. This research aimed to investigate some technologies that can address these challenges. For crop residue management, vertical tillage and vertical seeding have been studied in multiple research projects. Results showed that vertical tillage and seeding were able to deal with crop residue through cutting residue into small segments, which would not plug seeder in the sub-sequent seeding. Vertical tillage is a conservation tillage system, as it leaves more than 30% crop residue on soil surface while incorporating some residue into the shallow soil layer for fast residue decomposition. For weed control, mechanical weeding can reduce chemical inputs in crop production. A tine weeder was studied for weed control during the early growing season of several field crops (corn, soybean, flax, and pea). Detail results of these studies will be shared at the conference.

Keywords: tillage, seeding, mechanical weeding, crop residue

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Authors: Atif Zafar Khan, Swarnendra Singh, Imrana Naseem

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Breast cancer is one of the most frequent malignancies in women worldwide and a leading cause of cancer-related deaths among women. Therefore, there is a need to identify new chemotherapeutic strategies for cancer treatment. Unlike normal cells, cancer cells contain elevated copper levels which play an integral role in angiogenesis. Copper is an important metal ion associated with the chromatin DNA, particularly with guanine. Thus, targeting copper via copper-specific chelators in cancer cells can serve as effective anticancer strategy. Keeping in view these facts, we evaluated the anticancer activity and copper-dependent cytotoxic effect of coumestrol (phytoestrogen in soybean products) in breast cancer MCF-7 cells. Coumestrol inhibited proliferation and induced apoptosis in MCF-7 cells, which was prevented by copper chelator neocuproine and ROS scavengers. Coumestrol treatment induced ROS generation coupled to DNA fragmentation, up-regulation of p53/p21, cell cycle arrest at G1/S phase, mitochondrial membrane depolarization and caspases 9/3 activation. All these effects were suppressed by ROS scavengers and neocuproine. These results suggest that coumestrol targets elevated copper for redox cycling to generate ROS leading to DNA fragmentation. DNA damage leads to p53 up-regulation which directs the cell cycle arrest at G1/S phase and promotes caspase-dependent apoptosis of MCF-7 cells. In conclusion, coumestrol induces pro-oxidant cell death by chelating cellular copper to produce copper-coumestrol complexes that engages in redox cycling in breast cancer cells. Thus, targeting elevated copper levels might be a potential therapeutic strategy for selective cytotoxic action against malignant cells.

Keywords: apoptosis, breast cancer, copper chelation, coumestrol, reactive oxygens species, redox cycling

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Authors: Shradha Parsekar, Suma Nair, Ajay Bailey, Binu V. S.

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Background: Concealing of cancer-related information is seen in many low-and-middle-income countries and may be associated with multiple factors. Comparatively, there is lack of information about, how breast cancers diagnosed women disclose cancer-related information to their social contacts and vice versa. To get more insights on the participant’s experience, opinions, expectations, and attitudes, a qualitative study is a suitable approach. Therefore, this study involving in-depth interviews was planned to lessen this gap. Methods: Interviews were conducted separately among breast cancer patients and their caregivers with semi-structured qualitative interview guide. Purposive and convenient sampling was being used to recruit patients and caregivers, respectively. Ethical clearance and permission from the tertiary hospital were obtained and participants were selected from the Udupi district, Karnataka, India. After obtaining a list of breast cancer diagnosed cases, participants were contacted in person and their willingness to take part in the study was taken. About 39 caregivers and 35 patients belonging to different breast cancer stages were recruited. Interviews were recorded with prior permission. Data was managed by Atlas.ti 8 software. The recordings were transcribed, translated and coded in two cycles. Most of the patients belonged to stage II and III cancer. Codes were grouped together into to whom breast cancer status was concealed to and underneath reason for the same. Main findings: followings are the codes and code families which emerged from the data. 1) Concealing the breast cancer status from social contacts other than close family members (such as extended family, neighbor and friends). Participants perceived the reasons as, a) to avoid questions which people probe (which doesn’t have answers), b) to avoid people paying courtesy visit (to inquire about the health as it is Indian culture to visit the sick person) making it inconvenient for patient and caregivers have to offer something and talk to them, c) to avoid people getting shocked (react as if cancer is different from other diseases) or getting emotional/sad, or getting fear of death d) to avoid getting negative suggestion or talking anything in front of patient as it may affect patient negatively, e) to avoid getting stigmatized, f) to avoid getting obstacle in child’s marriage. 2) Participant concealed the breast cancer status of young children as they perceived that it may a) affect studies, b) affect emotionally, c) children may get scared. 3) Concealing the breast cancer status from patients as the caregivers perceived that they have fear of a) worsening patient’s health, b) patient getting tensed, c) patient getting shocked, and d) patient getting scared. However, some participants stressed important in disclosing the cancer status to social contact/patient to make the people aware of the disease. Conclusion: The news of breast cancer spreads like electricity in the wire, therefore, patient or family avoid it for many reasons. Although, globally, due to physicians’ ethical obligations, there is an inclination towards more disclosure of cancer diagnosis and status of prognosis to the patient. However, it is an ongoing argument whether patient/social contacts should know the status especially in a country like India.

Keywords: breast cancer, concealing cancer status, India, qualitative study

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Authors: Haonan Hu, Shuge Lei, Dasheng Sun, Huabin Zhang, Kehong Yuan, Jian Dai, Jijun Tang

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This paper focuses on the classification task of breast ultrasound images and conducts research on the reliability measurement of classification results. A dual-channel evaluation framework was developed based on the proposed inference reliability and predictive reliability scores. For the inference reliability evaluation, human-aligned and doctor-agreed inference rationals based on the improved feature attribution algorithm SP-RISA are gracefully applied. Uncertainty quantification is used to evaluate the predictive reliability via the test time enhancement. The effectiveness of this reliability evaluation framework has been verified on the breast ultrasound clinical dataset YBUS, and its robustness is verified on the public dataset BUSI. The expected calibration errors on both datasets are significantly lower than traditional evaluation methods, which proves the effectiveness of the proposed reliability measurement.

Keywords: medical imaging, ultrasound imaging, XAI, uncertainty measurement, trustworthy AI

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Authors: Beloulou Mohamed Lamine, Fedili Benamar, Meliani Walid, Chaid Dalila, Lamara Abdelhak

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Introduction: Post-surgical chronic pain (PSCP) is a pathological condition with a rather complex etiopathogenesis that extensively involves sensitization processes and neuronal damage. The neuropathic component of these pains is almost always present, with variable expression depending on the type of surgery. Objective: To assess the presumed beneficial effect of Regional Anesthesia-Analgesia Techniques (RAAT) on the development of post-surgical chronic neuropathic pain (PSCNP) in various surgical procedures. Patients and Methods: A comparative study involving 510 patients distributed across five surgical models (mastectomy, thoracotomy, hernioplasty, cholecystectomy, and major abdominal-pelvic surgery) and randomized into two groups: Group A (240) receiving conventional postoperative analgesia and Group B (270) receiving balanced analgesia, including the implementation of a Regional Anesthesia-Analgesia Technique (RAAT). These patients were longitudinally followed over a 6-month period, with postsurgical chronic neuropathic pain (PSCNP) defined by a Neuropathic Pain Score DN2≥ 3. Comparative measurements through univariate and multivariable analyses were performed to identify associations between the development of PSCNP and certain predictive factors, including the presumed preventive impact (protective effect) of RAAT. Results: At the 6th month post-surgery, 419 patients were analyzed (Group A= 196 and Group B= 223). The incidence of PSCNP was 32.2% (n=135). Among these patients with chronic pain, the prevalence of neuropathic pain was 37.8% (95% CI: [29.6; 46.5]), with n=51/135. It was significantly lower in Group B compared to Group A, with respective percentages of 31.4% vs. 48.8% (p-value = 0.035). The most significant differences were observed in breast and thoracopulmonary surgeries. In a multiple regression analysis, two predictors of PSCNP were identified: the presence of preoperative pain at the surgical site as a risk factor (OR: 3.198; 95% CI [1.326; 7.714]) and RAAT as a protective factor (OR: 0.408; 95% CI [0.173; 0.961]). Conclusion: The neuropathic component of PSCNP can be observed in different types of surgeries. Regional analgesia included in a multimodal approach to postoperative pain management has proven to be effective for acute pain and seems to have a preventive impact on the development of PSCNP and its neuropathic nature, particularly in surgeries that are more prone to chronicization.

Keywords: post-surgical chronic pain, post-surgical chronic neuropathic pain, regional anesthesia-analgesia techniques, neuropathic pain score DN2, preventive impact

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Authors: Huynh Viet Khai, Mitsuyasu Yabe

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The study investigated the economic value of biodiversity attributes that could provide policy-makers reliable information to estimate welfare losses due to biodiversity reductions and analyse the trade-off between biodiversity and economics. In order to obtain the non-market benefits of biodiversity conservation, an indirect utility function and willingness to pay for biodiversity attributes were applied using the approach of choice modelling with the analysis of conditional logit model. The study found that Mekong Delta residents accepted their willingness to pay for VND 913 monthly for a one percent increase in healthy vegetation, VND 360 for an additional mammal species and VND 2,440 to avoid the welfare losses of 100 local farmers.

Keywords: choice modelling, genetic resources, wetland conservation, marginal willingness to pay

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Authors: Monisha Edirisooriya, Wilma Jack, Dominique Twelves, Jennifer Royds, Fiona Scott, Nicola Mason, Arran Turnbull, J. Michael Dixon

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Introduction: Excision biopsy has been the investigation of choice for patients presenting with pathological axillary lymphadenopathy without a breast abnormality. Core biopsy of nodes can provide sufficient tissue for diagnosis and has advantages in terms of morbidity and speed of diagnosis. This study evaluates the diagnostic accuracy of core biopsy in patients presenting with axillary lymphadenopathy. Methods: Between 2009 and 2019, 165 patients referred to the Edinburgh Breast Unit had a total of 179 axillary lymph node core biopsies. Results: 152 (92%) of the 165 initial core biopsies were deemed to contain adequate nodal tissue. Core biopsy correctly established malignancy in 75 of the 78 patients with haematological malignancy (96%) and in all 28 patients with metastatic carcinoma (100%) and correctly diagnosed benign changes in 49 of 57 (86%) patients with benign conditions. There were no false positives and no false negatives. In 67 (85.9%) of the 78 patients with hematological malignancy, there was sufficient material in the first core biopsy to allow the pathologist to make an actionable diagnosis and not ask for more tissue sampling prior to treatment. There were no complications of core biopsy. On follow up, none of the patients with benign cores has been shown to have malignancy in the axilla and none with lymphoma had their initial disease incorrectly classified. Conclusions: This study shows that core biopsy is now the investigation of choice for patients presenting with axillary lymphadenopathy even in those suspected as having lymphoma.

Keywords: core biopsy, excision biopsy, axillary lymphadenopathy, non-breast malignancy

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Authors: Wen-Yu Chen, Chia-Yuan Hsu, Sasinee Vongsrikul

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The present study is to explore the perception of Taiwanese females towards medical tourism in Thailand for the development of applicable marketing strategy, integrating travel motivation and cosmetic surgery trend to attract potential medical tourists from Taiwan. Since previous studies relevant to this research issue are limited, qualitative study is firstly employed by using one focus group interview and in-depth interviews with Taiwanese females. Moreover, the present research collected questionnaires from 290 Taiwanese females to provide greater understanding of research results. The top three factors that affect Taiwanese females’ decision for not going to Thailand for medical tourism are “physicians and nurses cannot speak Chinese”, “low quality of the cosmetic surgery product that I want to do”, and “the county does not have laws to protect medical tourists’ right”. The finding of the empirical part would suggest the area in medical tourism industry which Thailand should promote and emphasizes in order to increase its presence as a hub for cosmetic surgery and attract Taiwanese female market. Therefore, the study contributes to the potential development of marketing strategy for medical tourism, specifically in the area of cosmetic surgery in Thailand while targeting Taiwan market.

Keywords: Thailand, Taiwanese female tourists, medical tourism, cosmetic surgery

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Authors: Milagros S. Salibad, Levita B. Grana

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The presence and role of Indigenous Peoples (IPs) residing in key biodiversity, protected, and watershed areas within the ancestral domain in the Caraga region, Mindanao, Philippines, hold immense significance. Recognizing their importance and rights, this study aimed to determine the level of biodiversity conservation practices and extent of environmental stewardship among the Mamanwas, Manobos, and Higaonons, assess potential differences in these practices, and identify factors that facilitate or hinder them. Employing an explanatory sequential mixed-method research design, 421 respondents participated through a researcher-made questionnaire. Additional data were collected through focus group discussions, key informant interviews, researcher field notes, community immersions, and secondary sources. The results revealed a high level of biodiversity conservation practices across the three IP groups, with variations influenced by their cultural and traditional practices, awareness, and access to resources and information. Each group exhibited unique environmental practices shaped by their distinct cultures, traditions, and customary knowledge. They have a strong sense of ownership and responsibility towards their ancestral lands and territories and adopt traditional knowledge and practices that promote sustainable resource management and biodiversity conservation. These practices align with the Indigenous Peoples Rights Act (IPRA), also known as Republic Act No. 8371. Various facilitating and hindering factors influenced their conservation efforts. To uphold the region's biodiversity resources, it is recommended that government agencies continue to evaluate and monitor the sustainability of IPs' local biodiversity conservation practices. Additionally, efforts should be made to involve IP communities as essential contributors and stakeholders in these conservation endeavors.

Keywords: biodiversity, conservation, indigenous peoples, traditional knowledge, environmental stewardship

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Authors: Leah Ning

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This paper discusses the development of a machine learning algorithm that accurately detects metastatic breast cancer (cancer has spread elsewhere from its origin part) in selected images that come from pathology scans of lymph node sections. Being able to develop an accurate artificial intelligence (AI) algorithm would help significantly in breast cancer diagnosis since manual examination of lymph node scans is both tedious and oftentimes highly subjective. The usage of AI in the diagnosis process provides a much more straightforward, reliable, and efficient method for medical professionals and would enable faster diagnosis and, therefore, more immediate treatment. The overall approach used was to train a convolution neural network (CNN) based on a set of pathology scan data and use the trained model to binarily classify if a new scan were benign or malignant, outputting a 0 or a 1, respectively. The final model’s prediction accuracy is very high, with 100% for the train set and over 70% for the test set. Being able to have such high accuracy using an AI model is monumental in regard to medical pathology and cancer detection. Having AI as a new tool capable of quick detection will significantly help medical professionals and patients suffering from cancer.

Keywords: breast cancer detection, AI, machine learning, algorithm

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Authors: Bruno Di Pace, Roxanne H. Padley

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Aims: The recent increase in remote video interaction has increased the number of requests for teleconsultations with plastic surgeons in private practice (70% in the UK and 64% in the USA). This study investigated the motivations for such an increase and the underlying psychological impact on patients. Method: An anonymous web-based poll of 8 questions was designed and distributed to patients seeking cosmetic surgery through social networks in both Italy and the UK. The questions gathered responses regarding 1. Reasons for pursuing cosmetic surgery; 2. The effects of delays caused by the SARS-COV-2 pandemic; 3. The effects on mood; 4. The influence of video conferencing on body-image perception. Results: 85 respondents completed the online poll. Overall, 68% of respondents stated that seeing themselves more frequently online had influenced their decision to seek cosmetic surgery. The types of surgeries indicated were predominantly to the upper body and face (82%). Delays and access to surgeons during the pandemic were perceived as negatively impacting patients' moods (95%). Body-image perception and self-esteem were lower than in the pre-pandemic, particularly during lockdown (72%). Patients were more inclined to undergo cosmetic surgery during the pandemic, both due to the wish to improve their “lockdown face” for video conferencing (77%) and also due to the benefits of home recovery while in smart working (58%). Conclusions: Overall, findings suggest that video conferencing has led to a significant increase in requests for cosmetic surgery and the so-called “Zoom Boom” effect.

Keywords: cosmetic surgery, remote communication, telehealth, zoom boom

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Authors: Salwa Hagag Abdelaziz, Naglaa Fathy Youssef, Nadia Abdellatif Hassan, Rasha Wesam Abdelrahman

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Breast cancer is considered as a substantial health concern and practicing mammography screening [MS] is important in minimizing its related morbidity. So it is essential to have a better understanding of breast cancer screening behaviors of women and factors that influence utilization of them. The aim of this study is to identify the factors that are linked to MS behaviors among the Egyptian women. A cross-sectional descriptive design was carried out to provide a snapshot of the factors that are linked to MS behaviors. A convenience sample of 311 women was utilized and all eligible participants admitted to the Women Imaging Unit who are 40 years of age or above, coming for mammography assessment, not pregnant or breast feeding and who accepted to participate in the study were included. A structured questionnaire was developed by the researchers and contains three parts; Socio-demographic data; Motivating factors associated with MS; and association between MS and model of behavior change. The analyzed data indicated that most of the participated women (66.6 %) belonged to the age group of 40-49.A high proportion of participants (58.1%) of group having previous MS influenced by their neighbors to practice MS, whereas 32.7 % in group not having previous MS were influenced by family members which indicated significant differences (P <0.05). Doctors and media are shown to be the least influence of others to practice MS. Women with intention to have a future mammogram had higher OR (1.404) for practicing MS compared with women with no intention. Further studies are needed to examine the relation between Trans-theoretical Model [TTM] and practicing MS.

Keywords: breast cancer, mammography, screening behaviors, morbidity

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Authors: Rinaldi Ikhram, R. A. Julia Satriani

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The discovery of historical objects in Indonesia, especially in the area around Bandung and Priangan zone in general, have been inventorized and recorded by Dutch geologists during the colonial time. Among artefacts such as axes made of chalcedony and quartzite; arrowheads, knives, shrivel, and drill bit all made from obsidian; grindstones, even bracelet from stones. Ceramic mold for smelting bronze or iron were also found. The abundance of artefacts inspired DR. W. Docters van Leeuwen and his colleagues to initiate the establishment of Sunda Open-air Museum "Soenda Openlucht Museum" in 1917, located in the hills of North Bandung area, the site of pre-historic settlements that needs conservation. Unfortunately, this plan was not implemented because shortly after, World War II occurred. The efforts of heritage conservation is one of our responsibilities as a geologist today. Open-air Museum may be one of the solutions of heritage conservation for historic sites around the world. In this paper, the study of the development of Open-air Museum will be focused on the area of Dago, North Bandung. Method used is data analysis of field surveys, and data analysis of the remaining artefacts stored at both the National Museum in Jakarta, and the Bandung Museum of Geology. The museum is based on Geotourism and further research on pre-historic culture, while its purpose is to give people a common interest and to motivate them to participate in the research and conservation of pre-historic relics. This paper will describe more details about the concept, form, and management of the geopark and the Open-air Museum within.

Keywords: geoparks, heritage conservation, open-air museum, sustainable tourism

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Authors: Loveneet Kaur

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Introduction: Osteoarthritis (OA) is one of the leading causes of disability, and the knee is the most commonly affected joint in the body. The last resort for treatment of knee OA is Total Knee Replacement (TKR) surgery. Despite numerous advances in prosthetic design, patients do not reach normal function after surgery. Current surgical decisions are made on 2D radiographs and patient interviews. Aims: The aim of this study was to compare knee kinematics pre and post-TKR surgery using computer-animated images of patient-specific models under everyday conditions. Methods: 7 subjects were recruited for the study. Subjects underwent 3D gait analysis during 4 everyday activities and medical imaging of the knee joint pre- and one-month post-surgery. A 3D model was created from each of the scans, and the kinematic gait analysis data was used to animate the images. Results: Improvements were seen in a range of motion in all 4 activities 1-year post-surgery. The preoperative 3D images provide detailed information on the anatomy of the osteoarthritic knee. The postoperative images demonstrate potential future problems associated with the implant. Although not accurate enough to be of clinical use, the animated data can provide valuable insight into what conditions cause damage to both the osteoarthritic and prosthetic knee joints. As the animated data does not require specialist training to view, the images can be utilized across the fields of health professionals and manufacturing in the assessment and treatment of patients pre and post-knee replacement surgery. Future improvements in the collection and processing of data may yield clinically useful data. Conclusion: Although not yet of clinical use, the potential application of 3D animations of the knee joint pre and post-surgery is widespread.

Keywords: Orthoporosis, Ortharthritis, knee replacement, TKR

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Authors: Seyyed Naeim Saber, Javad Usefi

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This study was conducted to determine the effect of salbutamol (beta-adrenergic agonist) on carcass characteristics and some blood parameters in male broiler chicks. Four hundred and twenty day-old (Coob-500) male broiler were used in this experiment for six weeks. All birds were randomly divided into 7 treatment groups with 4 replicates of 15 birds per pen. Treatment groups included: control, 5, 10, and 15 mg salbutamol per liter water and 10, 20 and 30 mg salbutamol per kg diet. The data obtained from this study indicated that supplementation of salbutamol in water and diets have significant effect on live body weight, abdominal fat, and gizzard weight (p<0.05). Also adding salbutamol in broiler water and feed did not have significant effect on thigh and breast dry matter, thigh and breast crude protein, and thigh and breast crude fat (p>0.05). The results from this study demonstrated that salbutamol has significant (p<0.05) effect on hemoglobin content and RV/TV but it does not have significant effect (p>0.05) on hematocrit amount.

Keywords: salbutamol, beta-adrenergic agonist, broiler chicks, carcass characteristic

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Authors: Lubomir Vecera, Tomas Gabrhelik, Benjamin Tolmaci, Josef Srovnal, Emil Berta, Petr Prasil, Petr Stourac

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Cancer is the second leading cause of death worldwide and colon cancer is the second most common type of cancer. Currently, there are only a few studies evaluating the effect of postoperative analgesia on the prognosis of patients undergoing radical colon cancer surgery. Postoperative analgesia in patients undergoing colon cancer surgery is usually managed in two ways, either with strong opioids (morphine, piritramide) or epidural analgesia. In our prospective study, we evaluated the effect of postoperative analgesia on the presence of circulating tumor cells or minimal residual disease after colon cancer surgery. A total of 60 patients who underwent radical colon cancer surgery were enrolled in this prospective, randomized, two-center study. Patients were randomized into three groups, namely piritramide, morphine and postoperative epidural analgesia. We evaluated the presence of carcinoembryonic antigen (CEA) and cytokeratin 20 (CK-20) mRNA positive circulating tumor cells in peripheral blood before surgery, immediately after surgery, on postoperative day two and one month after surgery. The presence of circulating tumor cells was assessed by quantitative real-time reverse transcriptase-polymerase chain reaction (qRT-PCR). In the priritramide postoperative analgesia group, the presence of CEA mRNA positive cells was significantly lower on a postoperative day two compared to the other groups (p=0.04). The value of CK-20 mRNA positive cells was the same in all groups on all days. In all groups, both types of circulating tumor cells returned to normal levels one month after surgery. Demographic and baseline clinical characteristics were similar in all groups. Compared with morphine and epidural analgesia, piritramide significantly reduces the amount of CEA mRNA positive circulating tumor cells after radical colon cancer surgery.

Keywords: cancer progression, colon cancer, minimal residual disease, perioperative analgesia.

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Authors: A. Kaeotawee, N. Bunmas, W. Chomthong

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Background: The cancellation of elective surgery is a major indicator of poor operating room efficiency. Furthermore, it is recognized as a major cause of emotional trauma to patients as well as their families. This study was carried out to assess the incidence and causes of elective surgery cancellation in our setting and to find the appropriate solutions for better quality management. Objective: To determine the incidence and causes of elective surgery cancellations in Songklanagarind Hospital. Material and Method: A prospective survey was conducted from September to November 2012. All patients who had their scheduled elective operations cancelled were assessed. Data was collected on the following 2 components: (1) patient demographics;(2) main reasons for cancellations, which were grouped into patient-related factors and organizational-related factors. Data are reported as a percentage of patients whose operations were cancelled. The association between cancellation status and patient demographics was assessed using univariate logistic regression. Results: 2,395 patients were scheduled for elective surgery and of these 343 (14.3%) had their operations cancelled. Cardiothoracic surgery had the highest rate of cancellations (28.7%) while the least number of cancellations occurred in ophthalmology (10.1%). The main reasons for cancellations were related to the unit's organization (53.6%), due to the surgeon (48.4%). Patient related causes (46.4%), due to non medical reasons (32.1%). The most common cause of cancellation by the surgeon was lack of theater time (21.3%), by patients due to the patient’s nonappearance (25.1%). Cancellation was significantly associated with type of patient, health insurance, type of anesthesia and specialties (p<0.05). Conclusion: Surgery cancellations by surgeons relating to a lack of theater time was a significant problem in our setting. Appropriate solutions for better quality improvement are needed.

Keywords: elective cases, surgery cancellation, quality management, appropriate solutions

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Authors: Abdullah Kattan, Khalid Alzahrani, Saud Alsaleh, Loui Ezzat, Khalid Murad, Bader Alghamdi

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Background and Significance: Patients are often bothered by the excess skin laxity and redundancy that they are left with after losing weight. Body-contouring surgery offers a solution to this problem; however, there is scarce literature on the psychological and social effects of these surgeries. This study was conducted to assess the psychosocial impact of body-contouring surgery on patients after weight loss. Methodology: In this cross-sectional study, a specifically designed questionnaire was administered to forty three patients whom have undergone body-contouring surgery. All included patients had lost no less than 20 Kg before body-contouring surgery, and were interviewed at least 6 months after surgery. The twenty-question interviewer based questionnaire was used to assess the psychosocial status of the patients before and after undergoing body-contouring surgery. The questionnaire assessed the quality of life (social life, job performance and sexual activity), presence of symptoms of depression and overall satisfaction. Data was analyzed as paired variables in SPSS using McNemar’s test. Results: Among the 43 participants, 19 (44.2%) have undergone mammoplasty, 12 (27.9%) have undergone abdominoplasty and the remainder of the patients have undergone other various procedures including brachioplasty, thigh lifts and nick liposuction. The mean age of patients was 34 +/- 10, the sample included 24 (55.8%) females and 19 (44.2%) males. The patients’ quality of life significantly improved in the following areas; social life (P<0.001), job performance (P<0.002) and sexual activity (P<0.001). Moreover, 17 (39.5%) patients suffered symptoms of depression before body-contouring surgery; however, only 1 (2.3%) patient suffered symptoms of depression after surgery. Overall satisfaction rate was found to be 62.8%; with mammoplasty being the highest satisfaction rate procedure (66.6 %). Conclusion: Body-contouring surgery after weight loss has shown to improve the psychological and social aspects in patients. These findings have been found to be consistent with the majority of relevant published studies, further increasing reliability of our study.

Keywords: abdominoplasty, body-contouring, mammoplasty, psychosocial

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