Search results for: facility-based maternal death review

Authors: Kedwadee Sombultawee, Sakun Boon-Itt

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This research demonstrates a systematic literature review of 62 peer-reviewed articles published in academic journals from 2000-2016 focusing on the operation and marketing interface area. The findings show the three major clusters of recent research domains, which is a review of the alignment between operations and marketing, identification of variables that impact the company and analysis of the effect of interface. Moreover, the Main Path Analysis (MPA) is mapped to show the knowledge structure of the operation and marketing interface issue. Most of the empirical research focused on company performance and new product development then analyzed the data by the structural equation model or regression. Whereas, some scholars studied the conflict of these two functions and proposed the requirement or step for alignment. Finally, the gaps in the literature are provided for future research directions.

Keywords: operations management, marketing, interface, systematic literature review

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Authors: Slwa Al-Hammad

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Adaptation studies have been closely aligned to translation studies as both deal with the process of rendering the meaning from one culture to another. These two disciplines are related to each other, but the theories are still being developed. This research aims to fill this gap and provide a contribution to the growing discipline of adaptation studies through a theoretical perspective while investigating how different cultural interpretations of adaptation influence the final literary product. This research focuses on the theoretical concepts of Barthes’s death of the author and Benjamin’s afterlife of the text in translation, which is believed to lead to the birth of the adapter in a literary work. That is, in adaptation, the ‘death’ of the author allows for the ‘birth’ of the adapter, offering them all the creative possibilities of authorship. It also explores the differences between the meanings of adaptation in the West and the Arab world through the analysis of adapted texts in Arabic initially deriving from the European and American literature of the 19th and 20th centuries. The methodology of this thesis is based upon qualitative literary analysis, in which original and adapted works are compared and contrasted, with the additional insights of literary and adaptation theories and prior scholarship. The main works discussed are the Arabic adaptations of William Faulkner’s novels. The analysis is guided by theories of adaptation studies to help in explaining the concepts of relocating, recreating, and rewriting in the process of adaptation. It draws on scholarship on adaptations to inquire into the status of the adapted texts in relation to the original texts. Also, these theories prove that adaptation is the process that is used to transfer text from source to adapted text, not some other analytical practice. Through the textual analysis, concepts of the death of the author and the birth of the adapter will be illustrated, as will the roles of the adapter and the task of rendering works for a different culture, and the understanding of adaptation and Arabization in Arabic literature.

Keywords: adaptation, Arabization, authorship, recreating, relocating

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Authors: Zeynep Turhan

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This review emphasized the effectiveness of men’s participation, and whether non-violent (NV) boys’ and men’s perceptions of IPV prevention programs affect their involvement. Additionally, the review aimed to identify the barriers of non-engagement as well as the most effective approaches to end and prevent violence-against-women (VAW). The main goals of this assessment were to investigate 1) how NV men engage in anti-violence prevention programs that empower women, 2) what are the possible perceptions of NV men involved in prevention programs 3) how to identify effective approaches and strategies that encourage NV men to become involved in prevention programs. This critical review also included the overview of prevention programs such as The Mentors in Violence Prevention Programs (MVP), The White Ribbon Campaign (WRC), and Domestic Violence Prevention Enhancement and Leadership through Alliances (DELTA). The review recommended expanding these programs to reach more macro settings such as workplace, faith-based and other community-based organizations. Additionally, secondary and territory prevention programs need to expand through addressing the long-term effects of violence.

Keywords: engagement, non-violent men, prevention programs

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Authors: Razieh Rezaeekalantari

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Objective: The purpose of this study was to investigate the prediction of parenting orientations in terms of the components of couples' sexual review. Methods: This was a descriptive correlational research method. The population consisted of 500 couples referring to Sari Health Center. Two hundred and fifteen (215) people were selected randomly by using Krejcie-Morgan-sample-size-table. For data collection, the childbearing orientations scale and the Multidimensional Sexual Self-Concept Questionnaire were used. Result: For data analysis, the mean and standard deviation were used and to analyze the research hypothesis regression correlation and inferential statistics were used. Conclusion: The findings indicate that there is not a significant relationship between the tendency to childbearing and the predictive value of sexual review (r = 0.84) with significant level (sig = 219.19) (P < 0.05). So, with 95% confidence, we conclude that there is not a meaningful relationship between sexual orientation and tendency to child-rearing.

Keywords: couples referring, health center, sexual review component, parenting orientations

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Authors: Raj Raghupathy

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Recurrent Spontaneous Miscarriage (RSM) is a common form of pregnancy loss, 50% of which are due to ‘unexplained’ causes. Evidence exists to suggest that RSM may be caused by immunologic factors such as cytokines which are critical molecules of the immune system, with an impressive array of capabilities. An association appears to exist between Th2-type reactivity (mediated by Th2 or anti-inflammatory cytokines) and normal, successful pregnancy, and between unexplained RSM and Th1 cytokine dominance. If pro-inflammatory cytokines are indeed associated with pregnancy loss, the suppression of these cytokines, and thus the ‘redirection’ of maternal reactivity, may help prevent cytokine-mediated pregnancy loss. The objective of this study was to explore the possibility of modulating cytokine production using Dydrogesterone (Duphaston®), an orally-administered progestogen. Peripheral blood mononuclear cells from 34 women with a history of at least 3 unexplained recurrent miscarriages were stimulated in vitro with a mitogen (to elicit cytokine production) in the presence and absence of dydrogesterone. Levels of selected pro- and anti-inflammatory cytokines produced by peripheral blood mononuclear cells were measured after exposure to these progestogens. Dydrogesterone down-regulates the production of pro-inflammatory cytokines and up-regulates the production of anti-inflammatory cytokines. The ratios of Th2 to Th1 cytokines are markedly elevated in the presence of dydrogesterone, indicating a shift from potentially harmful maternal Th1 reactivity to a more pregnancy-conducive Th2 profile. We used a progesterone receptor antagonist to show that this cytokine-modulating effect of dydrogesterone is mediated via the progesterone receptor. Dydrogesterone also induces the production of the Progesterone-Induced Blocking Factor (PIBF); lymphocytes exposed to PIBF produce higher levels of Th2 cytokines, affecting a Th1 → Th2 cytokine shift which could be favourable to the success of pregnancy. We conclude that modulation of maternal cytokine production profiles is possible with dydrogesterone which has the merits that it can be administered orally and that it is safe.

Keywords: cytokines, dydrogesterone, progesterone, recurrent spontaneous miscarriage

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Authors: Davod Ahmadigheidari

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The main objective of this study was to explore prevalence of anthropometric indicators as well the factors associated with the anthropometric indications in Mali. Data on 2015, downloaded from the website of Unicef, were analyzed. A total of 16,467 women (ages 15-49 years) and 16,467 children (ages 0-59 months) were selected for the sample. Different statistical analyses, such as descriptive, crosstabs and binary logistic regression form the basis of this study. Child anthropometric indicators (i.e., wasting, stunting, underweight and BMI for age) were used as the dependent variables. SPSS Syntax from WHO was used to create anthropometric indicators. Different factors, such as child’s sex, child’s age groups, child’s diseases symptoms (i.e., diarrhea, cough and fever), maternal education, household wealth index and area of residence were used as independent variables. Results showed more than forty percent of Malian households were in nutritional crises (stunting (42%) and underweight (34%). Findings from logistic regression analyses indicated that low score of wealth index, low maternal education and experience of diarrhea in last two weeks increase the probability of child malnutrition.

Keywords: Mali, wasting, stunting, underweight, BMI for age and wealth index

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Authors: E. Botchway, C. Godfrey, V. Anderson, C. Catroppa

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Introduction: Sleep disturbances are common after childhood traumatic brain injury (TBI). This systematic review aimed to assess the prevalence, types, and predictors of sleep disturbances in childhood TBI. Methods: Medline, Pubmed, PsychInfo, Web of Science, and EMBASE databases were searched. Out of the 547 articles assessed, 15 met selection criteria for this review. Results: Sleep disturbances were common in children and adolescents with TBI, irrespective of injury severity. Excessive daytime sleepiness and insomnia were the most common sleep disturbances reported. Sleep disturbance was predicted by sex, injury severity, pre-existing sleep disturbances, younger age, pain, and high body mass index. Conclusions: Sleep disturbances are highly prevalent in childhood TBI, regardless of the injury severity. Routine assessment of sleep in survivors of childhood TBI is recommended.

Keywords: traumatic brain injury, sleep diatiurbances, childhood, systematic review

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Authors: Hussein Alahmer, Amr Ahmed

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Liver cancer is one of the common diseases that cause the death. Early detection is important to diagnose and reduce the incidence of death. Improvements in medical imaging and image processing techniques have significantly enhanced interpretation of medical images. Computer-Aided Diagnosis (CAD) systems based on these techniques play a vital role in the early detection of liver disease and hence reduce liver cancer death rate.  This paper presents an automated CAD system consists of three stages; firstly, automatic liver segmentation and lesion’s detection. Secondly, extracting features. Finally, classifying liver lesions into benign and malignant by using the novel contrasting feature-difference approach. Several types of intensity, texture features are extracted from both; the lesion area and its surrounding normal liver tissue. The difference between the features of both areas is then used as the new lesion descriptors. Machine learning classifiers are then trained on the new descriptors to automatically classify liver lesions into benign or malignant. The experimental results show promising improvements. Moreover, the proposed approach can overcome the problems of varying ranges of intensity and textures between patients, demographics, and imaging devices and settings.

Keywords: CAD system, difference of feature, fuzzy c means, lesion detection, liver segmentation

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Authors: Hashem Al Argha

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Cerebral Aneurysms are the ballooning and defect that occurs in the arteries of the brain. This ballooning might enlarge in size due to mechanical forces and could lead to rupture and death. Computational Fluid Dynamics has been used in the recent years in creating a link between engineering sciences and medical sciences. In this paper, the effects of mechanical forces on cerebral aneurysms will be studied. Results of this study show that mechanical forces could lead to rupture of the aneurysm and could lead to death. High mechanical forces including stresses up to 1.7 MPa could pop aneurysms and lead to a brain hemorrhage.

Keywords: computational fluid dynamics, numerical, aneurysm, mechanical forces

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Authors: A. Lubis, R. Widayanti, Z. Hikmah, A. Endaryanto, A. Harsono, A. Harianto, R. Etika, D. K. Handayani, M. Sampurna

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Neonatal lupus erythematous (NLE) is a rare disease marked by clinical characteristic and specific maternal autoantibody. Many cutaneous, cardiac, liver, and hematological manifestations could happen with affect of one organ or multiple. In this case, both babies were premature, low birth weight (LBW), small for gestational age (SGA) and born through caesarean section from a systemic lupus erythematous (SLE) mother. In the first case, we found a baby girl with dyspnea and grunting. Chest X ray showed respiratory distress syndrome (RDS) great I and echocardiography showed small atrial septal defect (ASD) and ventricular septal defect (VSD). She also developed anemia, thrombocytopenia, elevated C-reactive protein, hypoalbuminemia, increasing coagulation factors, hyperbilirubinemia, and positive blood culture of Klebsiella pneumonia. Anti-Ro/SSA and Anti-nRNP/sm were positive. Intravenous fluid, antibiotic, transfusion of blood, thrombocyte concentrate, and fresh frozen plasma were given. The second baby, male presented with necrotic tissue on the left ear and skin rashes, erythematous macula, athropic scarring, hyperpigmentation on all of his body with various size and facial haemorrhage. He also suffered from thrombocytopenia, mild elevated transaminase enzyme, hyperbilirubinemia, anti-Ro/SSA was positive. Intravenous fluid, methyprednisolone, intravenous immunoglobulin (IVIG), blood, and thrombocyte concentrate transfution were given. Two cases of neonatal lupus erythematous had been presented. Diagnosis based on clinical presentation and maternal auto antibody on neonate. Organ involvement in NLE can occur as single or multiple manifestations.

Keywords: neonatus lupus erythematous, maternal autoantibody, clinical characteristic, multiple organ manifestation

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Authors: Aidin Foroutan, David S. Wishart, Leluo L. Guan, Carolyn Fitzsimmons

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Maximizing efficiency and growth potential of beef cattle requires not only genetic selection (i.e. residual feed intake (RFI)) but also adequate nutrition throughout all stages of growth and development. Nutrient restriction during gestation has been shown to negatively affect post-natal growth and development as well as fertility of the offspring. This, when combined with RFI may affect progeny traits. This study aims to investigate the impact of selection for divergent genetic potential for RFI and maternal nutrition during early- to mid-gestation, on bull calf traits such as fertility and muscle development using multiple ‘omics’ approaches. Comparisons were made between High-diet vs. Low-diet and between High-RFI vs. Low-RFI animals. An epigenetics experiment on semen samples identified 891 biomarkers associated with growth and development. A gene expression study on Longissimus thoracis muscle, semimembranosus muscle, liver, and testis identified 4 genes associated with muscle development and immunity of which Myocyte enhancer factor 2A [MEF2A; induces myogenesis and control muscle differentiation] was the only differentially expressed gene identified in all four tissues. An initial metabolomics experiment on serum samples using nuclear magnetic resonance (NMR) identified 4 metabolite biomarkers related to energy and protein metabolism. Once all the biomarkers are identified, bioinformatics approaches will be used to create a database covering all the ‘omics’ data collected from this project. This database will be broadened by adding other information obtained from relevant literature reviews. Association analyses with these data sets will be performed to reveal key biological pathways affected by RFI and maternal nutrition. Through these association studies between the genome and metabolome, it is expected that candidate biomarker genes and metabolites for feed efficiency, fertility, and/or muscle development are identified. If these gene/metabolite biomarkers are validated in a larger animal population, they could potentially be used in breeding programs to select superior animals. It is also expected that this work will lead to the development of an online tool that could be used to predict future traits of interest in an animal given its measurable ‘omics’ traits.

Keywords: biomarker, maternal nutrition, omics, residual feed intake

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Authors: Sachinkumar Patil, Sonali Patil, Shitalkumar Patil

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Nanoparticles played important role in the biomedicine. New advanced methods having great potential apllication in the diagnosis and therapy of cancer. Now a day’s magnetic nanoparticles used in cancer therapy. Cancer is the major disease causes death. Magnetic nanoparticles show response to the magnetic field on the basis of this property they are used in cancer therapy. Cancer treated with hyperthermia by using magnetic nanoparticles it is unconventional but more safe and effective method. Magnetic nanoparticles prepared by using different innovative techniques that makes particles in uniform size and desired effect. Magnetic nanoparticles already used as contrast media in magnetic resonance imaging. A magnetic nanoparticle has been great potential application in cancer diagnosis and treatment as well as in gene therapy. In this review we will discuss the progress in cancer therapy based on magnetic nanoparticles, mainly including magnetic hyperthermia, synthesis and characterization of magnetic nanoparticles, mechanism of magnetic nanoparticles and application of magnetic nanoparticles.

Keywords: magnetic nanoparticles, synthesis, characterization, cancer therapy, hyperthermia, application

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Authors: Shameka Stanford

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This presentation will discuss how cognitive and communication disorders in the areas of executive functioning, receptive and expressive language can impact the problem-solving and decision making of individuals with such impairments. More specifically, this presentation will discuss approaches the legal defense team of capital case lawyers can add to their experience when servicing individuals who have a history of educational decline, special education, and limited intervention and treatment. The objective of the research is to explore and identify the correlations between impaired executive function skills and decision making and competency for individuals facing death penalty charges. To conduct this research, experimental design, randomized sampling, qualitative analysis was employed. This research contributes to the legal and criminal justice system related to how they view, defend, and characterize, and judge individuals with documented cognitive and communication disorders who are eligible for capital case charges. More importantly, this research contributes to the increased ability of death penalty lawyers to successfully defend clients with a history of academic difficulty, special education, and documented disorders that impact educational progress and academic success.

Keywords: communication disorders, cognitive disorders, capital murder, death penalty, executive function

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Authors: K. R. Thabethe, G. A. Adefolaju, M. J. Hosie

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Cervical cancer is the third most commonly diagnosed cancer globally and it is one of three AIDS defining malignancies. Highly active antiretroviral therapy (HAART) is a combination of three or more antiretroviral drugs and has been shown to play a significant role in reducing the incidence of some AIDS defining malignancies, although its effect on cervical cancer is still unclear. The aim of this study was to investigate the relationship between cervical cancer and HAART. This was achieved by studying the expression of two signalling molecules expressed in cervical cancer; MUC1 and P65. Following the 24 hour treatment of a cervical cancer cell line, HCS-2, with drugs which are commonly used as part of HAART at their clinical plasma concentrations, real-time qPCR and immunofluorescence were used in order to study gene and protein expression. A one way ANOVA followed by a Tukey Kramer Post Hoc test was conducted using JMP 11 software on both sets of data. The drug classified as a protease inhibitor (PI) (i.e. LPV/r) reduced MUC1 and P65 gene and protein expression more than the other drug tested. PIs are known to play a significant role in cell death, therefore the cells were thought to be more susceptible to cell death following treatment with PIs. In conclusion, the drugs used, especially the PI showed some anticancer effects by facilitating cell death through decreased gene and protein expression of MUC1 and P65 and present promising agents for cancer treatment.

Keywords: cervical cancer, haart, MUC1, P65

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Authors: Roseminu Varghese, Laveena Anitha Barboza, Jyothi Chakrabarty, Ravishankar

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Depression among post-stroke survivors is prevalent, but it is unidentified. The purpose of this review was to determine the pooled prevalence of depression among post-stroke survivors in the South Asian region from all published health sciences research articles. The review also aimed to analyze the disparities in the prevalence of depression among the post-stroke survivors from different study locations. Data search to identify the relevant research articles published from 2005 to 2016 was done by using mesh terms and keywords in Web of Science, PubMed Medline, CINAHL, Scopus, J gate, IndMED databases. The final analysis comprised of 9 studies, including a population of 1,520 men and women. Meta-analysis was performed in STATA version 13.0. The overall pooled post-stroke depression prevalence was 0.46, 95% (CI), (0.3- 0.62). The prevalence rate in this systematic review is evident of depression among post-stroke survivors in the South Asian Region. Identifying the prevalence of post-stroke depression at an early stage is important to improve outcomes of the rehabilitative process of stroke survivors and for its early intervention.

Keywords: depression, post stroke survivors, prevalence, systematic review

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Authors: HengJiang Cai, RuiJin Zhang, JinSong Gui

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Enhanced UV-B (280-320nm) radiation resulting from ozone depletion was one of the global environmental problems. The effects of enhanced UV-B radiation on marine macro-algae were exposed to be the greatest in shallow intertidal environments because the macro-alga was often at or above the water during low tide. Ulva pertusa Kjellman was belonged to Chlorophyta (Phylum), Ulvales (Order), Ulvaceae (Family) which was widely distributed in the western Pacific coast, and the resources were extremely rich in China. Therefore, the effects of UV-B radiation on the growth of Ulva pertusa seedling were studied in this research. Ulva pertusa seedling appearances were mainly characterized by rod shapes and tadpole shapes. The percentage of rod shapes was 90.68%±2.50%. UV-B radiation could inhibit the growth of Ulva pertusa seedling, and the growth inhibition was more significant with the increased doses of UV-B radiation treatment. The relative inhibition rates of Ulva pertusa seedling length were16.11%, 24.98%and 39.04% respectively on the 30th day at different doses (30.96, 61.92 and 123.84 Jm-2d-1) of UV-B radiation. Ulva pertusa seedling had emerged death under UV-B radiation, and the death rates were increased with the increased doses of UV-B radiation treatment. Physiology and biochemistry of Ulva pertusa seedling could be affected by UV-B radiation treatment. The SOD (superoxide dismutase) activity was increased at low-dose UV-B radiation (30.96 Jm-2d-1), while was decreased at high-dose UV-B radiation (61.92 and 123.84 Jm-2d-1). UV-B radiation could inhibit CAT (catalase) activity all the while. It speculated that the reasons for growth inhibition and death of Ulva pertusa seedling were excess ROS (reactive oxygen species), which produced by UV-B radiation.

Keywords: growth, physiology and biochemistry, Ulva pertusa Kjellman, UV-B radiation

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Authors: Dhval Chauhan, Mahesh Chudasama

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This study has been undertaken to give a review of Polyethylene Terephthalate Glycol (PETG) material used in Fused Deposition Modelling (FDM). This paper offers a review of the existing literature on polyethylene terephthalate glycol (PETG) material, the objective of the paper is to providing guidance on different process parameters that can be used to improve the strength of the part by performing various testing like tensile, compressive, flexural, etc. This work is target to find new paths that can be used for further development of the use of fiber reinforcement in PETG material.

Keywords: PETG, FDM, tensile strength, flexural strength, fiber reinforcement

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Authors: Xiaoyu Sun

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In recent years, the rapid development of Artificial Intelligence (AI) has extensively promoted medicine, pharmaceutical, and other related fields. The medical research and development of artificial intelligence by scientific and commercial organizations are on the fast track. The ethics review is one of the critical procedures of registration to get the products approved and launched. However, the SOPs for ethics review is not enough to guide the healthy and rapid development of artificial intelligence in healthcare in China. Ethical Review Measures for Biomedical Research Involving Human Beings was enacted by the National Health Commission of the People's Republic of China (NHC) on December 1st, 2016. However, from a legislative design perspective, it was neither updated timely nor in line with the trends of AI international development. Therefore, it was great that NHC published a consultation paper on the updated version on March 16th, 2021. Based on the most updated laws and regulations in the States and EU, and in-depth-interviewed 11 subject matter experts in China, including lawmakers, regulators, and key members of ethics review committees, heads of Regulatory Affairs in SaMD industry, and data scientists, several suggestions were proposed on top of the updated version. Although the new version indicated that the Ethics Review Committees need to be created by National, Provincial and individual institute levels, the review authorities of different levels were not clarified. The suggestion is that the precise scope of review authorities for each level should be identified based on Risk Analysis and Management Model, such as the complicated leading technology, gene editing, should be reviewed by National Ethics Review Committees, it will be the job of individual institute Ethics Review Committees to review and approve the clinical study with less risk such as an innovative cream to treat acne. Furthermore, to standardize the research and development of artificial intelligence in healthcare in the age of AI, more clear guidance should be given to data security in the layers of data, algorithm, and application in the process of ethics review. In addition, transparency and responsibility, as two of six principles in the Rome Call for AI Ethics, could be further strengthened in the updated version. It is the shared goal among all countries to manage well and develop AI to benefit human beings. Learned from the other countries who have more learning and experience, China could be one of the most advanced countries in artificial intelligence in healthcare.

Keywords: biomedical research involving human beings, data security, ethics committees, ethical review, medical artificial intelligence

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Authors: Małgorzata Jakubowska, Monika Michałowska

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Since the beginning of the cinematographic industry, there has been a visible interest in two leading themes: death and sexuality. One of the reasons of the unfading popularity of these motives was the fact that death or sex employed as leitmotivs attracted great attention of the viewers, and this guaranteed a financial success. What seems interesting is the fact that the themes of death and sexuality/eroticism seem to be mutually exclusive in the mainstream movies to such extent that they almost never appear together on the screen. As leitmotivs they describe opposite experiences of human life, one refers to affirmation of life, the other points to atrophy and decay. This film paradigm is rarely challenged. Thus, a relatively less attention has been devoted so far to entwining dying and sexuality/eroticism in one movie. In our paper, we wish to have a closer look at the visualizations of dying with focus on the aspect of sexuality/eroticism. Our analysis will concentrate on the contemporary European and American cinema, and especially the recent productions that contribute to the cultural phenomenon of entwining the two realms of human life. We will investigate the main clichés, plot and visual schemes, motives and narrative techniques on the examples of Sweet November (2001), A Little Bit of Heaven (2011) and Now is good (2012). We will also shed some light on the recent film productions that seem to provide a shift in portraying the realms of dying and sexuality concentrating on The Garden of Earthly Delights (2003) as the most paradigmatic example.

Keywords: contemporary cinema, dying and sexuality, narrative techniques, plot and visual schemes

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Authors: Dorra Kallel, Ines Kanoun, Diala Dhouib

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This paper elaborates a Systematic Literature Review SLR) to select the most outstanding studies that address the Menu Planning Problem (MPP) and to classify them according to the to the three following criteria: the used methods, types of patients and the required constraints. At first, a set of 4165 studies was selected. After applying the SLR’s guidelines, this collection was filtered to 13 studies using specific inclusion and exclusion criteria as well as an accurate analysis of each study. Second, the selected papers were invested to answer the proposed research questions. Finally, data synthesis and new perspectives for future works are incorporated in the closing section.

Keywords: Menu Planning Problem (MPP), Systematic Literature Review (SLR), classification, exact and approaches methods

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Authors: Partha Saha, Uttam Kumar Banerjee

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Maternal and Child Healthcare (MCH) has always been regarded as one of the important issues globally. Reduction of maternal and child mortality rates and increase of healthcare service coverage were declared as one of the targets in Millennium Development Goals till 2015 and thereafter as an important component of the Sustainable Development Goals. Over the last decade, worldwide MCH indicators have improved but could not match the expected levels. Progress of both maternal and child mortality rates have been monitored by several researchers. Each of the studies has stated that only less than 26% of low-income and middle income countries (LMICs) were on track to achieve targets as prescribed by MDG4. Average worldwide annual rate of reduction of under-five mortality rate and maternal mortality rate were 2.2% and 1.9% as on 2011 respectively whereas rates should be minimum 4.4% and 5.5% annually to achieve targets. In spite of having proven healthcare interventions for both mothers and children, those could not be scaled up to the required volume due to fragmented health systems, especially in the developing and under-developed countries. In this research, a knowledge discovery based interactive Decision Support System (DSS) has been developed on web platform which would assist healthcare policy makers to develop evidence-based policies. To achieve desirable results in MCH, efficient resource planning is very much required. In maximum LMICs, resources are big constraint. Knowledge, generated through this system, would help healthcare managers to develop strategic resource planning for combatting with issues like huge inequity and less coverage in MCH. This system would help healthcare managers to accomplish following four tasks. Those are a) comprehending region wise conditions of variables related with MCH, b) identifying relationships within variables, c) segmenting regions based on variables status, and d) finding out segment wise key influential variables which have major impact on healthcare indicators. Whole system development process has been divided into three phases. Those were i) identifying contemporary issues related with MCH services and policy making; ii) development of the system; and iii) verification and validation of the system. More than 90 variables under three categories, such as a) educational, social, and economic parameters; b) MCH interventions; and c) health system building blocks have been included into this web-based DSS and five separate modules have been developed under the system. First module has been designed for analysing current healthcare scenario. Second module would help healthcare managers to understand correlations among variables. Third module would reveal frequently-occurring incidents along with different MCH interventions. Fourth module would segment regions based on previously mentioned three categories and in fifth module, segment-wise key influential interventions will be identified. India has been considered as case study area in this research. Data of 601 districts of India has been used for inspecting effectiveness of those developed modules. This system has been developed by importing different statistical and data mining techniques on Web platform. Policy makers would be able to generate different scenarios from the system before drawing any inference, aided by its interactive capability.

Keywords: maternal and child heathcare, decision support systems, data mining techniques, low and middle income countries

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Authors: Mengying Wang, Dongjing Liu, Holger Schwender, Ping Wang, Hongping Zhu, Tao Wu, Terri H Beaty

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Background: Maternal smoking is a recognized risk factor for nonsyndromic cleft lip with or without cleft palate (NSCL/P). It has been reported that the effect of maternal smoking on oral clefts is mediated through genes that influence nicotine dependence. The polymorphisms of cholinergic receptor nicotinic alpha (CHRNA) and beta (CHRNB) subunits genes have previously shown strong associations with nicotine dependence. Here, we attempted to investigate whether the above genes are associated with clefting risk through testing for potential gene-gene (G×G) and gene-environment (G×E) interaction. Methods: We selected 120 markers in 14 genes associated with nicotine dependence to conduct transmission disequilibrium tests among 806 Chinese NSCL/P case-parent trios ascertained in an international consortium which conducted a genome-wide association study (GWAS) of oral clefts. We applied Cordell’s method using “TRIO” package in R to explore G×G as well as G×E interaction involving environmental tobacco smoke (ETS) based on conditional logistic regression model. Results: while no SNP showed significant association with NSCL/P after Bonferroni correction, we found signals for G×G interaction between 10 pairs of SNPs in CHRNA3, CHRNA5, and CHRNB4 (p<10-8), among which the most significant interaction was found between RS3743077 (CHRNA3) and RS11636753 (CHRNB4, p<8.2×10-12). Linkage disequilibrium (LD) analysis revealed only low level of LD between these markers. However, there were no significant results for G×ETS interaction. Conclusion: This study fails to detect association between nicotine dependence genes and NSCL/P, but illustrates the importance of taking into account potential G×G interaction for genetic association analysis in NSCL/P. This study also suggests nicotine dependence genes should be considered as important candidate genes for NSCL/P in future studies.

Keywords: Gene-Gene Interaction, Maternal Smoking, Nicotine Dependence, Non-Syndromic Cleft Lip with or without Cleft Palate

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Authors: M. Weller Jones, J. Moffat, J. Taylor, J. Hartland, M. Natarajan

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Background: Uganda’s teenage pregnancy rate remains a significant problem for female and maternal health in the country. Teenage pregnancy is linked to higher rates of maternal and neonatal mortality and morbidity, including preterm labour, obstructed labour, vesicovaginal fistulae, infections, and maternal mental health morbidity. In 2015, the National Strategy to End Child Marriage and Teenage Pregnancy was launched in Uganda. Research is needed so that the interventions in this Strategy can be effectively applied at a local level. This study at Kitovu and Villa Maria Hospitals, two local community hospitals near Masaka, Uganda, aimed to measure change in the local teenage pregnancy rate over the past 5 years; and to explore the awareness and attitudes of teenagers and healthcare professionals towards 1) teenage pregnancy and, 2) the challenges female adolescents still currently face. Method: Teenage delivery rate, type of delivery, incidence of complications in labour and neonatal and maternal outcomes were collected from the labour ward admission books, at both hospitals, for a six month time period in 2011 and 2016. At Kitovu Hospital, qualitative data regarding the experience of, and attitudes towards teenage pregnancy was collected from interviews conducted with 12 maternity staff members and with eight female teenagers, aged 16-19, who were pregnant or post-partum. Results: The proportion of total births to teenage mothers fell from 14% in 2011 to 7% in 2016 (Kitovu), but it remains higher in rural locations (19%, Villa Maria). Beliefs about exacerbating factors included: poor access to contraception; misconceptions that contraception is damaging to women’s health; failing sex education in schools; and poor awareness of national campaigns to reduce teenage pregnancy. Staff felt that the best way to tackle teenage pregnancy was to improve sex education in schools and to sensitise families to these issues. Six of the eight teenagers wanted more frequent sex education and easier, cheap access to contraception. Only one teenager saw positive consequences stating that teenage pregnancy would ‘avoid operations later in life.’ Discussion: Teenage pregnancy is a recognised problem and strategies in the Masaka region should focus on improving sex education in schools and initiating an organisation that educates and supplies free contraception to teenagers.

Keywords: adolescents, attitudes, teenage pregnancy, Uganda

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Authors: Rozan El-Khateeb

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This literature review examines the effectiveness of therapy programs that utilize play as an intervention for reducing symptoms associated with Autism Spectrum Disorder (ASD). Play-based therapy approaches provide a child-centered and developmentally appropriate framework to address the core symptoms of ASD, including social communication deficits, restricted and repetitive behaviors, and sensory sensitivities. The review explores various play-based therapy strategies and their impact on improving social skills, communication abilities, adaptive behaviors, and overall functioning in individuals with ASD. The findings suggest that play-based therapy programs hold promise as effective interventions for reducing symptoms and enhancing the quality of life for individuals with ASD. However, further research is necessary to establish standardized protocols, identify optimal dosage and duration, and evaluate long-term outcomes.

Keywords: autism, ABA, play, NET, systematic review

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Authors: Szu-Mei Hsiao

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Many nurses have concerns about the difficulties of providing spiritual care for ethnic-Chinese patients and family members within their cultural context. This is due to a lack of knowledge and training. Most family caregivers are female. There has been little research exploring the potential impact of Chinese cultural values on the spiritual distress of couple dyadic participants in Taiwan. This study explores the spiritual issues of Taiwanese women coping with their husband’s advanced cancer during palliative care to death. Qualitative multiple case studies were used. Data was collected through participant observation and in-depth face-to-face interviews. Transcribed interview data was analyzed by using qualitative content analysis. Three couples were recruited from a community-based rural hospital in Taiwan where the husbands were hospitalized in a medical ward. Four spiritual distress themes emerged from the analysis: (1) A personal conflict in trying to come to terms with love and forgiveness; the inability to forgive their husband’s mistakes; and, lack of their family’s love and support. (2) A feeling of hopelessness due to advanced cancer, such as a feeling of disappointment in their destiny and karma, including expressing doubt on survival. (3) A feeling of uncertainty in facing death peacefully, such as fear of facing the unknown world; and, (4) A feeling of doubt causing them to question the meaning and values in their lives. This research has shown that caregivers needed family support, friends, social welfare, and the help of their religion to meet their spiritual needs in coping within the final stages of life and death. The findings of this study could assist health professionals to detect the spiritual distress of ethnic-Chinese patients and caregivers in the context of their cultural or religious background as early as possible.

Keywords: advanced cancer, Buddhism, Confucianism, Taoism, qualitative research, spiritual distress

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Authors: Amira D. Ali

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Action research studies in education often address learners’ needs and empower practitioner-researcher to effectively change instructional practices and school communities. A systematic review of action research (AR) studies undertaken in EFL/ESL settings was conducted in this paper to systematically analyze empirical studies on action research published within a ten-year period (between 2010 and 2019). The review also aimed at investigating the focal strategies in teaching the language skills at school level and evaluating the overall quality of AR studies concerning focus, purpose, methodology and contribution. Inclusion criteria were established and 41 studies that fit were finally selected for the systematic review. Garrard’s (2007) Matrix Method was used to structure and synthesize the literature. Results showed a significant diversity in teaching strategies and implementation of the AR model. Almost a quarter of the studies focused on improving writing skills at elementary school level. In addition, findings revealed that (44%) of the studies used a mixed approach followed by qualitative method approach (41%), whereas only (15%) employed quantitative methodology. Research gaps for future action research in developing language skills were pointed out, and recommendations were offered.

Keywords: action research, EFL/ESL context, language skills, systematic review

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Authors: Maria Elisabete da Costa Ferreira

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Violent crimes, such as terrorism, organized crime and homicides, are increasing all around the World. This fact calls for the necessity to reflect upon the effectiveness of the deterrence offered by the criminal sanctions set today. The severity of the penalties depends on the social, cultural and even religious background of the State in question. In some States, such as Portugal, the common citizen finds the sentences too soft on the perpetrator and too long to be obtained. On the other hand, in 2023, several States still apply the death penalty, among which the USA, China, and most Middle Eastern countries. As for life in prison without the possibility of parole, the number of countries accepting this possibility in their criminal law is much higher, including England and Wales, the Netherlands, Moldova, Bulgaria, Italy, Ukraine, Poland, Turkey, Russia, and Serbia. This research aims to demonstrate that both the death penalty and life in prison penalty violate the principles of human dignity and social rehabilitation of the perpetrator and propose alternative penalties that can effectively protect society from crime. The research utilizes three main methodologies: the historical method, the comparative method, and the critical method. The historical method is employed to investigate the evolution of criminal penalties over time. The comparative method is used to compare the practices of different states regarding the death penalty and life in prison penalty. Finally, the critical method is applied to analyze and evaluate the shortcomings of these penalties. From a theoretical point of view, there have been drawn several theories throughout the years to support the idea that perpetrators of crimes should be punished. Today, one of the most commonly accepted theories sustains that the penalty will only be legitimate when necessary to protect society from the perpetrator and to rehabilitate him into society. Foremost, the choice of the penalty and the form of its execution should be guided by the principle of human dignity. The death penalty and life in prison penalty fail to achieve the goal of rehabilitation and disregard the human dignity principle. The right to life is a fundamental right declared in the Universal Declaration of Human Rights and stated in most Constitutions in the World. In conclusion, the research demonstrates that the death penalty and life in prison penalty are in violation of the principles of human dignity and social rehabilitation. These penalties fail to achieve their intended goals and disregard fundamental human rights. Although it may sound tempting to some States to rethink the current system of instated penalties to the admission of these penalties, it is imperative to take the inverse road because the protection of society must be achieved with respect to the perpetrator's fundamental rights, so, alternative penalties must be enforced. Society's belief in its citizen's ability to change must be reinforced, and, ultimately, the belief in Humankind. The findings of this research contribute to the discussion on the use of these penalties and aim to contribute to their decreasing usage in society.

Keywords: death penalty, life in prison penalty, human dignity, rehabilitation

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Authors: Sylvia Szabo, Thilini Navaratne, Indrajit Pal, Seree Park

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Deltaic and coastal regions are often strategically important both from local and regional perspectives. While deltas are known to be bread baskets of the world, delta inhabitants often face the risk of food and nutritional insecurity. These risks are highly exacerbated by the impacts of climate and environmental change. While numerous regional studies examined the prevalence and the determinants of food security in specific delta and coastal regions, there is still a lack of a systematic analysis of the most widely used scientific food security indicators. In order to fill this gap, a systematic review was carried out using Covidence, a Cochrane-adopted systematic review processing software. Papers included in the review were selected from the SCOPUS, Thomson Reuters Web of Science, Science Direct, ProQuest, and Google Scholar databases. Both scientific papers and grey literature (e.g., reports by international organizations) were considered. The results were analyzed by food security components (access, availability, quality, and strategy) and by world regions. Suggestions for further food security, nutrition, and health research, as well as policy-related implications, are also discussed.

Keywords: delta regions, coastal, food security, indicators, systematic review

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Authors: Rabah Iratni, Husain El Hasasna, Khawlah Athamneh, Halima Al Sameri, Nehla Benhalilou, Asma Al Rashedi

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Background: Cancer therapies have witnessed great advances in the recent past, however, cancer continues to be a leading cause of death, with colorectal cancer being the fourth cause of cancer-related deaths. Colorectal cancer affects both sexes equally with poor survival rate once it metastasizes. Phytochemicals, which are plant derived compounds, have been on a steady rise as anti-cancer drugs due to the accumulation of evidences that support their potential. Here, we investigated the anticancer effect of Rhus coriaria on colon cancer cells. Material and Method: Human colon cancer HT-29 cell line was used. Protein expression and protein phosphorylation were examined using Western blotting. Transcription activity was measure using Quantitative RT-PCR. Human tumoral clonogenic assay was used to assess cell survival. Senescence was assessed by the senescence-associated beta-galactosidase assay. Results: Rhus coriaria extract (RCE) was found to significantly inhibit the viability and colony growth of human HT-29 colon cancer cells. RCE induced senescence and cell cycle arrest at G1 phase. These changes were concomitant with upregulation of p21, p16, downregulation of cyclin D1, p27, c-myc and expression of Senescence-associated-β-Galactosidase activity. Moreover, RCE induced non-canonical beclin-1independent autophagy and subsequent apoptotic cell death through activation of activation caspase 8 and caspase 7. The blocking of autophagy by 3-methyladenine (3-MA) or chloroquine (CQ) reduced RCE-induced cell death. Further, RCE induced DNA damage, reduced mutant p53 protein level and downregulated phospho-AKT and phospho-mTOR, events that preceded autophagy. Mechanistically, we found that RCE inhibited the AKT and mTOR pathway, a regulator of autophagy, by promoting the proteasome-dependent degradation of both AKT and mTOR proteins. Conclusion: Our findings provide strong evidence that Rhus coriaria possesses strong anti-colon cancer activity through induction of senescence and autophagic cell death, making it a promising alternative or adjunct therapeutic candidate against colon cancer.

Keywords: autophagy, proteasome degradation, senescence, mTOR, apoptosis, Beclin-1

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Authors: Leila Azadbakht, Maedeh Moradi, Mohammad Reza Merasi, Farzaneh Jahangir

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Maternal dietary intake during lactation might affect the growth rate of an exclusive breastfed infant. The present study was conducted to evaluate the effect of maternal dietary patterns and quality during lactation on the growth of the exclusive breastfed infant. Methods: 484 healthy lactating mothers with their infant were enrolled in this study. Only exclusive breastfed infants were included in this study which was conducted in Iran. Dietary intake of lactating mothers was assessed using a validated and reliable semi-quantitative food frequency questionnaire. Diet quality indices such as alternative Healthy eating index (HEI), Dietary energy density (DED), and adherence to Mediterranean dietary pattern score, Nordic and dietary approaches to stop hypertension (DASH) eating pattern were created. Anthropometric features of infant (weight, height, and head circumference) were recorded at birth, two and four months. Results: Weight, length, weight for height and head circumference of infants at two months and four months age were mostly in the normal range among those that mothers adhered more to the HEI in lactation period (normal weight: 61%; normal height: 59%). The prevalence of stunting at four months of age among those whose mothers adhered more to the HEI was 31% lower than those with the least adherence to HEI. Mothers in the top tertiles of HEI score had the lowest frequency of having underweight infants (18% vs. 33%; P=0.03). Odds ratio of being overweight or obese at four months age was the lowest among those infants whose mothers adhered more to the HEI (OR: 0.67 vs 0.91; Ptrend=0.03). However, there was not any significant association between adherence of mothers to Mediterranean diet as well as DASH diet and Nordic eating pattern and the growth of infants (none of weight, height or head circumference). Infant weight, length, weight for height and head circumference at two months and four months did not show significant differences among different tertile categories of mothers’ DED. Conclusions: Higher diet quality indices and more adherence of lactating mother to HEI (as an indicator of diet quality) may be associated with better growth indices of the breastfed infant. However, it seems that DED of the lactating mother does not affect the growth of the breastfed infant. Adherence to the different dietary patterns such as Mediterranean, DASH or Nordic among mothers had no different effect on the growth indices of the infants. However, higher diet quality indices and more adherence of lactating mother to HEI may be associated with better growth indices of the breastfed infant. Breastfeeding is a complete way that is not affected much by the dietary patterns of the mother. However, better diet quality might be associated with better growth.

Keywords: breastfeeding, growth, infant, maternal diet

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