Search results for: female and male rats

Authors: Devendra Gupta, S. P. Ambesh, P. K Singh

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Introduction: Minimally invasive coronary artery bypass grafting (MICABG) is a less invasive method of performing surgical revascularization. Minimally invasive direct coronary artery bypass (MIDCAB) provides many anesthetic challenges including one lung ventilation (OLV), managing myocardial ischemia, and pain. We present an early and midterm result of the use of this technique with OLV. Method: We enrolled 62 patients for analysis operated between 2008 and 2012. Patients were anesthetized and left endobronchial tube was placed. During the procedure left lung was isolated and one lung ventilation was maintained through right lung. Operation was performed utilizing off pump technique of coronary artery bypass grafting through a minimal invasive incision. Left internal mammary artery graft was done for single vessel disease and radial artery was utilized for other grafts if required. Postoperative ventilation was done with single lumen endotracheal tube. Median follow-up is 2.5 years (6 months to 4 years). Results: Median age was 58.5 years (41-77) and all were male. Single vessel disease was present in 36, double vessel in 24 and triple vessel disease in 2 patients. All the patients had normal left ventricular size and function. In 2 cases difficulty were encounter in placement of endobronchial tube. In 1 case cuff of endobronchial tube was ruptured during intubation. High airway pressure was developed on OLV in 1 case and surgery was accomplished with two lung anesthesia with low tidal volume. Mean postoperative ventilation time was 14.4 hour (11-22). There was no perioperative and 30 day mortality. Conversion to median sternotomy to complete the operation was done in 3.23% (2 out of 62 patients). One patient had acute myocardial infarction postoperatively and there were no deaths during follow-up. Conclusion: MICABG is a safe and effective method of revascularization with OLV in low risk candidates for coronary artery bypass grafting.

Keywords: MIDCABG, one lung ventilation, coronary artery bypass grafting, endobronchial tube

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Authors: Saraswati Suna

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The outbreak of the COVID-19 epidemic and the subsequent lockdown have significantly impacted India's political, structural, and economic systems and a rising gap between the rich and the disadvantaged, upper and lower caste. For Dalit women, such forms of subjugation were followed by socioeconomic uncertainty due to the pandemic's economic shutdown and labour oppressions. Dalit women have been the victims of the most oppression among the nation's underprivileged groups. Dalit women undergo systemic oppression at the hands of the state, caste, class, gender, and religious hegemons historically. Dalit women hold a subordinate position within the gender to their male counterparts and caste to their upper-caste counterparts. This paper examines how Brahminical patriarchy and state power severely affected Dalit/Adivasi women during COVID-19 in Odisha, India. In order to understand caste-based sexual violence, a total of five cases have been analysed from newspapers. Findings revealed that Covid-19 appears to have a significant physical, psychological, and economic impact on Dalit women. The intention of sexual harassment and rape perpetrated by upper caste men is to maintain power and patriarchal culture in society. Dalit women are economically, socially, and culturally marginalised, which effectively exacerbates the sense of impunity by perpetrators of violence against Dalit women. This issue requires special attention to end atrocities against Dalit women. Dalit women become the target of rape, sexual assault, and murder. Sexual violence against Dalit women cannot be fully explained without linkage to caste, gender, and power. Dominant caste comes through caste privilege-socio-economic and politically; these factors contribute to sexual violence against Dalit women. The findings revealed that state police manipulate sexual violence, and in so doing, they create and deny access to both services to get justice. This article has argued that understanding Brahminical culture and the legal impacts of state police on Dalit women's identity requires a nuanced analysis.

Keywords: COVID-19, dalit women, sexual violence, brahminical patriarchy, power

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Authors: Yousef Reda

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Pancreatic cancer has an overall dismal prognosis. CT, MRI and Endoscopic Ultrasound are most often used to establish the diagnosis. We present a case of a patient found on abdominal CT and MRI to have an 8 mm cystic lesion within the head of the pancreas which was thought to be a benign intraductal papillary mucinous neoplasm (IPMN). Further evaluation by EUS demonstrated a 1 cm predominantly solid mass that was proven to be an adenocarcinoma by EUS-guided FNA. The patient underwent a Whipple procedure. The final pathology confirmed a 1 cm pT1 N0 pancreatic ductal adenocarcinoma. Case: A 63-year-old male presented with left upper quadrant pain and an abdominal CT demonstrated an 8 mm lesion within the head of the pancreas that was thought to represent a side branch IPMN. An MRI also showed similar findings. Four months later due to ongoing symptoms an EUS was performed to re-evaluate the pancreatic lesion. EUS revealed a predominantly solid hypoechoic, homogeneous mass measuring 12 mm x 9 mm. EUS-guided FNA was performed and was positive for adenocarcinoma. The patient underwent a Whipple procedure that confirmed it to be a ductal adenocarcinoma, pT1N0. The solid mass was noted to be adjacent to a cystic dilation with no papillary architecture and scant epithelium. The differential diagnosis resided between cystic degeneration of a primary pancreatic adenocarcinoma versus malignant degeneration within a side-branch IPMN. Discussion: The reported sensitivity of CT for pancreatic cancer is approximately 90%. For pancreatic tumors, less than 3 cm the sensitivity of CT is reduced ranging from 67-77%. MRI does not significantly improve overall detection rates compared to CT. EUS, however is superior to CT in the detection of pancreatic cancer, in particular among lesions smaller than 3 cm. EUS also outperforms CT and MRI in distinguishing neoplastic from non-neoplastic cysts. In this case, both MRI and CT failed to detect a small pancreatic adenocarcinoma. The addition of EUS and FNA to abdominal imaging can increase overall accuracy for the diagnosis of neoplastic pancreatic lesions. It may be prudent that when small lesions although appearing as a benign IPMN should further be evaluated by EUS as this would lead to potentially identifying earlier stage pancreatic cancers and improve survival in a disease which has a dismal prognosis.

Keywords: IPMN, MRI, EUS, CT

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Authors: Szu-Yi Chang, Jiin-Ru Rong

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This paper discussed a case involving a young female patient with schizophrenia. The patient's condition was deteriorating, and she was becoming increasingly reliant on her family to take care of her, and as her father did not understand the illness well and was afraid that others will learn about the presence of a mentally ill individual in their family, he and the patient's mother were thus unable to cope with the patient's deteriorating condition, which in turn caused her to suffer from a lack of self-confidence and low self-esteem. The patient received nursing care from July 26th to October 25th, 2017, during which counseling, family visits, and phone interviews were carried out, and her condition was monitored. By referring to the practical ability indicators for community psychiatric mental health nursing that were developed by the psychiatric mental health nurses' association of the Republic of China, defining categories such as 'self-construction,' 'self-management,' 'disease management,' and 'family nursing,' and incorporating indicators for empowerment and various skills into the steps and strategies used for nursing care, we will able to help the patient to construct her own identity, raise her self-esteem, improve her ability to independently perform activities of daily living, strengthen her disease management ability, and gradually build up her life management skills. The patient's family was also encouraged to communicate more among themselves, so as to align them with the nursing care objectives of improving the patient's ability to adapt to community life and her disease. The results indicated that the patient was able to maintain her mental stability within her community. By implementing effective self-management and maintaining a routine life, the patient was able to continue her active participation in community work and rehabilitation activities. Improvements were also achieved with respect to family role issues by establishing mutual understanding among the patient's family members and gaining their support. It is recommended that mental health nurses can leverage their community mental health nursing skills and the related strategies to promote adaptation to community life among mental life patients.

Keywords: community psychiatric mental health nursing, family nursing, schizophrenia, self-management

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Authors: Akhigbe Mark, Abang Roger, Mwoltu Nanaribet, Edet Blessing

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Introduction.: The introduction of pre- exposure prophylaxis (PrEP) as a biomedical prevention method for HIV/AIDS has been around for more than a decade since the first confirmed evidence of its effectiveness when used daily as an oral pill. It is now a very valuable addition for people who are at higher risk of contracting HIV. Although globalacceptanceof PrEP hasincreased, PrEP is still highly concentrated in a small number of countries and within a small sub-population, with Kenya and South Africa accounting for only 19% of people who have received PrEP in Africa region, there is still a significant regionGap in PrEP availability and use, with only 28% of the target of 3 million in low-and middle countries currently using PrEP. Description: The purpose of this study is to find out if serum creatinine could be used as an incentive to improve PrEP uptake among Key population.Numerous approaches to increasing the uptake ofPrEP as a prevention mechanism for HIV in KPs has beenemployed, and one of them is serum creatinine. This approach is a biomarker of renal function, which was used in study as an incentive to increase PrEP uptake among key population groups (female sex workers, men who have sex with men, persons who inject drugs, transgender) in 3 states from South-South Nigeria. Whole blood samples are collected from clients, analysis of the samples is done using the clinical chemistry analyzer before they are initiated onto PrEP. Lessons learned and Recommendations: Secondary data was extracted from 3 states of HALG Implementing facilities in Southern part of Nigeria, PrEP uptake before and afterthe introduction of serum creatinine between March 2020 and August 2020 among key populationsin Nigeria. A total of 5664 patients were initiated on PrEP before, and after the introduction of serum creatinine, the PrEP uptake rate before (March 2020 to May 2020) introduction of serum creatinine accounted for only 5% of the total onset, and after (June 2020 to August 2020) introduction of serum creatinine, the uptake rate accounted for 95% of the total onset. These finding shows that increased uptake of PrEP before/after serum creatineindicates that serum creatine may be an effective stimulus for promoting PrEP in key populations.

Keywords: serum creatinine, incentives, PrEP, key populations, Nigeria

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Authors: Ningfei Xiao, Simon Twose, Hannah Hopewell

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In urban settings worldwide, artists and researchers have drawn from shamanic healing, providing insightful responses to the environment. This project is a transdisciplinary creative research project where architecture and art practice draw from shamanic healing and provide the potential to expand knowledge of public space and inspire more aesthetic explorations of public spatial visions. The research started from the encounters with the Ewengki/Evenki shaman tribe in settlement areas of northern China in 2019 and extended through the partnerships with Maori artists in Poneke Aotearoa, New Zealand, in 2023. Based on the learnings and collaborations with female indigenous tradition practitioners and the healing that the researcher received from the land, a spatial installation exhibition was developed in this project. Indigenous practices are intricately woven with contemporary technology, merging visuals, soundscapes, and other non-visual aesthetics influenced by the researcher's personal experiences of embodied shamanic healing with brainwave generative technology. This synthesis seeks to ritualize and reimagine future public spaces, encompassing streetscapes and greenscapes from China to Aotearoa, and fostering connections between urbanized human body, mind, spirit, and land. In doing so, the project presents a feminist posthuman inquiry into how individuals perceive materiality within the context of a future city. Grounded in creative research and embodied methodologies, this paper focuses on the conceptual and autoethnographic aspects of visual-non-visual aesthetics and their creative representation. Through the exploration of aesthetics beyond the visual realm within urban and spatial contexts, this project showcases the spatial installation exhibition as an example of shamanic influence and related response to public space through embodied artistry and transdisciplinary creative inquiry.

Keywords: aesthetic, embodiment, visual and/or non-visual, spatial installation, shamanic healing, public space

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Authors: Ekaterina Sánchez Romero, Emily Gabriela Aguirre Herrera, Sandra Luz Espinoza Esquerra, Jorge García Campos

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Female, 7 months old, daughter of a mother with anemia during pregnancy, with no history of atopy in the family, since birth she presents with recurrent dermatological and gastrointestinal infections, chronically treated for recurrent diaper dermatitis. At 6 months of age, she begins with generalized pallor, hyperpigmentation in hands and feet, smooth tongue, psychomotor retardation with lack of head support, sedation, and hypoactivity. She was referred to our hospital for a fever of 38°C, severe diaper rash, and pancytopenia with HB 9.3, platelets 38000, neutrophils 0.39 MCV: 86.80 high for her age. The approach was initiated to rule out myeloproliferative syndrome, with negative immunohistochemical results of bone marrow aspirate; during her stay, she presented neurological regression, lack of sucking, and focal seizures. CT scan showed cortical atrophy. The patient was diagnosed with primary immunodeficiency due to history; gamma globulin was administered without improvement with normal results of immunoglobulins and metabolic screening. When dermatological and neurological diagnoses were ruled out as the primary cause, a nutritional factor was evaluated, and a therapeutic trial was started with the administration of vitamin B12 and zinc, presenting clinical neurological improvement and resolution of pancytopenia in 2 months. It was decided to continue outpatient management. Discussion: We present a patient with neurological, dermatological involvement, and pancytopenia, so the most common differential diagnoses in this population were ruled out. Vitamin B12 deficiency is an uncommon entity. Due to maternal and clinical history, a therapeutic trial was started resulting in an improvement. Conclusion: VitaminB12 deficiency should be considered one of the differential diagnoses in the approach to pancytopenia with megaloblastic anemia associated with dermatologic and neurologic manifestations. Early treatment can reduce irreversible damage in these patients.

Keywords: vitamin B12 deficiency, pediatrics, pancytopenia, diaper dermatitis

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Authors: Go Iwashita

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The paper describes how the frequencies of heatstroke occurring in indoor built environment are related to the outdoor thermal environment with big statistical data. As the statistical accident data of heatstroke, the nationwide accident data were obtained from the National Agency for the Advancement of Sports and Health (NAASH) . The meteorological database of the Japanese Meteorological Agency supplied data about 1-hour average temperature, humidity, wind speed, solar radiation, and so forth. Each heatstroke data point from the NAASH database was linked to the meteorological data point acquired from the nearest meteorological station where the accident of heatstroke occurred. This analysis was performed for a 10-year period (2005–2014). During the 10-year period, 3,819 cases of heatstroke were reported in the NAASH database for the investigated secondary/high schools of the nine Japanese representative cities. Heatstroke most commonly occurred in the outdoor schoolyard at a wet-bulb globe temperature (WBGT) of 31°C and in the indoor gymnasium during athletic club activities at a WBGT > 31°C. The determined accident ratio (number of accidents during each club activity divided by the club’s population) in the gymnasium during the female badminton club activities was the highest. Although badminton is played in a gymnasium, these WBGT results show that the risk level during badminton under hot and humid conditions is equal to that of baseball or rugby played in the schoolyard. Except sports, the high risk of heatstroke was observed in schools houses during cultural activities. The risk level for indoor environment under hot and humid condition would be equal to that for outdoor environment based on the above results of WBGT. Therefore control measures against hot and humid indoor condition were needed as installing air conditions not only schools but also residences.

Keywords: accidents in schools, club activity, gymnasium, heatstroke

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Authors: Mohana Basu, Snehamanju Basu

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Urbanization has an immense impact on the holistic development of a region. In that same context, the level of women empowerment plays a significant role in the development of any region, particularly a region belonging to a developing country. The present study investigates the status of women empowerment in the Asansol Durgapur Planning Area of the state of West Bengal, India by investigating the status of women and their access to various facilities and awareness about the various governmental and non-governmental schemes meant for their elevation. Through this study, an attempt has been to made to understand the perception of the respondents on the context of women's empowerment. The study integrates multiple sources of qualitative and quantitative data collected from various reports, field-based measurements, questionnaire survey and community based participatory appraisals. Results reveal that women of the rural parts of the region are relatively disempowered due to the various restrictions imposed on them and enjoy lower socioeconomic clout than their male counterparts in spite of the several remedial efforts taken by the government and NGOs to elevate their position in the society. A considerable gender gap still exists regarding access to education, employment and decision-making power in the family and significant differences in attitude towards women are observable in the rural and urban areas. Freedom of women primarily vary according to their age group, educational level, employment and income status and also on the degree of urbanization. Asansol Durgapur Planning Area is primarily an industrial region where huge employment generation scope exists. But these disparities are quite alarming and indicate that economic development does not always usher in socially justifiable rights and access to resources for both men and women alike in its awake. In this backdrop, this study will attempt to forward relevant suggestions which can be followed for betterment of the status of women.

Keywords: development, disempowered, economic development, urbanization, women empowerment

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Authors: Roongtiwa Chobchuen, Angkana Srikhan, Pattra Wattanapan

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Background: Neurogenic bowel is common condition after spinal cord injury. Most of spinal cord injured patients have motor weakness, mobility impairment which leads to constipation. Moreover, the neural pathway involving bowel function is interrupted. Therefore, the bowel management program should be implemented in nursing care in the earliest time after the onset of the disease to prevent the morbidity and mortality. Objective: To study the outcome of bowel management program of the patients with spinal cord injury who admitted for rehabilitation program. Study design: Descriptive study. Setting: Rehabilitation ward in Srinagarind Hospital. Populations: patients with subacute to chronic spinal cord injury who admitted at rehabilitation ward, Srinagarind hospital, aged over 18 years old. Instrument: The neurogenic bowel dysfunction score (NBDS) was used to determine the severity of neurogenic bowel. Procedure and statistical analysis: All participants were asked to complete the demographic data; age gender, duration of disease, diagnosis. The individual bowel function was assessed using NBDS at admission. The patients and caregivers were trained by nurses about the bowel management program which consisted of diet modification, abdominal massage, digital stimulation, stool evacuation including medication and physical activity. The outcome of the bowel management program was assessed by NBDS at discharge. The chi-square test was used to detect the difference in severity of neurogenic bowel at admission and discharge. Results: Sixteen spinal cord injured patients were enrolled in the study (age 45 ± 17 years old, 69% were male). Most of them (50%) were tetraplegia. On the admission, 12.5%, 12.5%, 43.75% and 31.25% were categorized as very minor (NBDS 0-6), minor (NBDS 7-9), moderate (NBDS 10-13) and severe (NBDS 14+) respectively. The severity of neurogenic bowel was decreased significantly at discharge (56.25%, 18.755%, 18.75% and 6.25% for very minor, minor, moderate and severe group respectively; p < 0.001) compared with NBDS at admission. Conclusions: Implementation of the effective bowel program decrease the severity of the neurogenic bowel in patient with spinal cord injury.

Keywords: neurogenic bowel, NBDS, spinal cord injury, bowel program

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Authors: Marah Joy A. Nanglegan

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A survey was conducted to describe knowledge, attitude, practices, information needs, and information seeking behavior of small-scale farmers on Organic Agriculture Production (OAP) in a rural community in Ifugao, Philippines. Respondents’ age ranged from 23-67 years old. Most of them are male, married, and have reached high school level. The major source of income is farming with an average monthly income of less than Php 5,000 for a household size of seven. More than fifty percent of the respondents are members of a farmer’s organization. Farm size is less than one hectare. Majority of them own their farms and have been farming for more than twenty years. Very few attended training on Organic Agriculture Production (OAP). Most of them are not aware of any OAP program in their community. Hence, their farming practices are mostly conventional. The overall level of knowledge on OAP among all respondents was below the average. On attitude, most of the respondents agreed that organic farming would decrease production costs by reducing input purchases. They believe it benefits both the consumer and the producer. In fact, they are aware of the many benefits of organic farming, especially on health. Likewise, many of them agreed on the benefits of organic farming to soil fertility, to the environment, and to increase the income of farmers. Many of them, however, see organic farming as troublesome and difficult in terms of time and effort, obtaining organic inputs, limited production, and marketing aspects. They also have heavy reliance on pesticides and herbicides to control pests and diseases. On practices, majority of the respondents stated that they practiced crop rotation, manual weeding, and the use of animal manure. Most of them desired to do organic farming but needed information such as production techniques, costs, and marketing opportunities. Their most preferred communication channel is through extension agents and contact farmers. Their most preferred communication method is through trainings and seminars as well as through farm demonstrations. Results of this study will serve as a basis for developing appropriate communication strategies to improve knowledge, attitude, and practices of respondents on organic agriculture as well as enhance the promotion of organic agriculture production in the community.

Keywords: Ifugao, knowledge attitude practices, organic agriculture, Philippines

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Authors: Theresa Belema Chris-Biriowu

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The change in trends in relation to gender representation in beer brand commercials was the thrust of the study. The study investigated how beer brand commercials reflect societal realities in their portrayals of gender roles within the span of a decade. The major objective of the study was to find out how gender was contextualized in selected beer brand commercials that both air on Nigerian television and stream on YouTube. The study was anchored on the muted group theory. The population of the study was in two streams: the total number of beer beverages that are produced by the eleven breweries in Nigeria and the registered advertising agencies in Lagos, Nigeria. The sample size was also two-pronged: the purposive selection of beer brands that have their commercials on television and YouTube and the purposive selection of an ad agency that has produced running commercials for beer brands within the period between 2010s and 2020s. They adopted visual framing analysis and narrative analysis research techniques. The study qualitatively analyzed the contents of beer brand commercials and conducted an interview with the management of the ad agency for data collection. The data was presented in images and words. The findings showed that females are underrepresented and misrepresented in the beer brand commercials and that the beer brands are not producing commercials that adequately reflect the realities of present times. It was also found that very little has changed in the ad industry between the periods studied, and commercial screenplays are not written with a specific aim to either target the female demographics or give them equal opportunities to thrive in the beer economy. The study concluded that the gender gap in beer commercials subsists and translates to gender discrimination, especially since it is established that females are also stakeholders in the beer economy. The study recommends that beer brands should produce commercials that appeal to their audience irrespective of gender, reflect contemporary realities, and give all genders equal opportunities to thrive in the increasingly competitive industry.

Keywords: beer brands, commercials, gender representation, visuals, television, YouTube

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Authors: Anshu Gupta, Charu Gupta

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Background: Punjab, a border state in India has achieved notoriety world over for its drug abuse problem. People right from school kids to elderly are hooked to drugs. This pattern of substance abuse is prevalent in both cities and villages alike. Excess of younger population in India has further aggravated the situation. It is feared that the benefits of India’s economic growth may well be negated by the rising substance abuse especially in this part of the country. It is quite evident that the pattern of substance abuse tends to change over time which is an impediment in the formulation of effective strategies to tackle this issue. Aim: Purpose of the study was to ascertain the change in the pattern of drug abuse for two consecutive years in the out patient department (OPD) population. Method: The study population comprised of all the patients reporting for deaddiction to the psychiatry outpatient department over a period of twelve months for two consecutive years. All the patients were evaluated by the International Classification of Diseases; 10 criteria for substance abuse/dependence. Results: A considerably high prevalence of substance abuse was present in the Indian population. In general, there was an increase in prevalence from first to the second year, especially among the female population. Increase in prevalence of substance abuse appeared to be more prominent among the younger age group of both the sexes. A significant increase in intravenous drug abuse was observed. Peer pressure and parental imitation were the major factors fueling substance abuse. Precipitation or fear of withdrawal symptoms was the major factor preventing abstinence. Substance abuse had a significant effect on the health and interpersonal relations of these patients. Summary/Conclusion: Drug abuse and addiction are on the rise throughout India. Changing cultural values, increasing economic stress and dwindling supportive bonds appear to be leading to initiation of substance abuse. Need of the hour is to formulate a comprehensive strategy to bring about an overall reduction in the use of drugs.

Keywords: deaddiction, peer pressure, parental imitation, substance abuse/dependance

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Authors: Orly Yona Drori, Shirley Ben Shlomo

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Objectives: The participants will be able to recognize the predictors of binge eating addiction among women who suffer from psychological abuse in their relationships and will recognize the role of woman's defense mechanisms in moderating the association between psychological abuse and binge eating addiction. Methods: A convenience sample of 380 Israeli women in relationships were located via the Internet, and after consenting to participate in the study, they completed a series of structured questionnaires (The Yale Food Addiction Scale; The Defense Style Questionnaire; psychological maltreatment of women by their male partners; level of differentiation of self; sociodemographic questionnaire). Results: The higher the level of differentiation and mature defense mechanisms, the less addictive a woman is. However, the level of addiction among women who experience psychological abuse within their intimate relations is higher than women who do not experience psychological abuse in their relationship. Among women who experienced psychological abuse in their relations, the defense mechanisms moderate the association between psychological abuse within intimate relations and the extent of the addiction to binge eating. Conclusions: The study contributes to the therapy of women with binge eating addictions, as it raises awareness of therapeutic-related content that could strengthen women and help them to cope with situations in their lives without the need to binge. One of the significant variables for therapeutic work is the level of differentiation of the self. In addition, identifying the types of defense mechanisms might help to match treatment to the woman's emotional needs. The current study found also that it is important to identify the environmental systems by which the addict is surrounded, such as whether woman is in an abusive relationship. Finally the study leads to the recognition that binge eating, which is usually treated with an emphasis on nutritional behavior change, is an addiction, and as such, it requires a combination of mental, nutritional and behavioral therapy. In view of this approach, it is recommended that treating a woman who is addicted to binge eating should involve a multi-disciplinary team comprised of physicians, clinical dietitians, and clinical psychotherapists.

Keywords: binge eating, defence mechanism, food addiction, psychological abuse

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Authors: Chante J. De Klerk

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The potential of music to facilitate superior performance during high to elite level gymnastics conditioning instigated this research. A team of seven gymnasts completed a fixed conditioning programme eight times, alternating the two variable conditions. Four sessions of each condition were conducted: without music (session 1), with music (session 2), without music (3), with music (4), without music (5), and so forth. Quantitative data were collected in both conditions through physiological monitoring of the gymnasts, and administration of the Situational Motivation Scale (SIMS). Statistical analysis of the physiological data made it possible to quantify the presence as well as the magnitude of the musical intervention’s impact on various aspects of the gymnasts' physiological functioning during conditioning. The SIMS questionnaire results were used to evaluate if their motivation towards conditioning was altered by the intervention. Thematic analysis of qualitative data collected through semi-structured interviews revealed themes reflecting the gymnasts’ sentiments towards the data collection process. Gymnast-specific descriptions and experiences of the team as a whole were integrated with the quantitative data to facilitate greater dimension in establishing the impact of the intervention. The results showed positive physiological, motivational, and emotional effects. In the presence of music, superior sympathetic nervous activation, and energy efficiency, with more economic breathing, dominated the physiological data. Fatigue and arousal levels (emotional and physiological) were also conducive to improved conditioning outcomes compared to conventional conditioning (without music). Greater levels of positive affect and motivation emerged in analysis of both the SIMS and interview data sets. Overall, the intervention was found to promote psychophysiological coherence during the physical activity. In conclusion, a strategically constructed musical intervention, designed to accompany a gymnastics conditioning session for high to elite level gymnasts, has ergogenic potential.

Keywords: arousal, fatigue, gymnastics conditioning, motivation, musical intervention, psychophysiological coherence

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Authors: Luksanaporn Krungkraipetch

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A pterygium is an eye surface lesion that begins in the limbal conjunctiva and progresses to the cornea. The lesion is more common in the nasal limbus than in the temporal, and it has a distinctive wing-like aspect. Indications for surgery, in decreasing order of significance, are grown over the corneal center, decreased vision due to corneal deformation, documented growth, sensations of discomfort, and aesthetic concerns. Recurrent pterygium results in the loss of time, the expense of therapy, and the potential for vision impairment. The objective of this study is to find out how often the recurrence of pterygium after surgery occurs, what effect the surgery technique has, and what causes them to come back in people with pterygium. Materials and Methods: Observational case control in retrospect: the study involves a retrospective analysis of 164 patient samples. Data analysis is descriptive statistics analysis, i.e., basic data details about pterygium surgery and the risk of recurrent pterygium. For factor analysis, the inferential statistics odds ratio (OR) and 95% confidence interval (CI) ANOVA are utilized. A p-value of 0.05 was deemed statistically important. Results: The majority of patients, according to the results, were female (60.4%). Twenty-four of the 164 (14.6%) patients who underwent surgery exhibited recurrent pterygium. The average age is 55.33 years old. Postoperative recurrence was reported in 19 cases (79.3%) of bare sclera techniques and five cases (20.8%) of conjunctival autograft techniques. The recurrence interval is 10.25 months, with the most common (54.17 percent) being 12 months. In 91.67 percent of cases, all follow-ups are successful. The most common recurrence level is 1 (25%). A surgical complication is a subconjunctival hemorrhage (33.33 percent). Comparing the surgeries done on people with recurrent pterygium didn't show anything important (F = 1.13, p = 0.339). Age significantly affected the recurrence of pterygium (95% CI, 6.79-63.56; OR = 20.78, P 0.001). Conclusion: This study discovered a 14.6% rate of pterygium recurrence after pterygium surgery. Across all surgeries and patients, the rate of recurrence was four times higher with the bare sclera method than with conjunctival autograft. The researchers advise selecting a more conventional surgical technique to avoid a recurrence.

Keywords: pterygium, recurrence pterygium, pterygium surgery, excision pterygium

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Authors: Babajide Olufemi Diyaolu

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The opportunity provided by advances in technology as regards sports betting is so numerous that even at one's comfort, with the use of a phone, Nigerian youth are found engaging in all kinds of betting. Today it is more difficult to differentiate a true fan as there are quite a number of them that became fans as a result of betting on live games. This study investigated the influence of online sports events on betting among Nigerian youth. A descriptive survey research design was used, and the population consists of all Nigerian youth that engages in betting and live within the southwest zone of Nigeria. A simple random sampling technique was used to pick three states from the southwest zone of Nigeria. Two thousand five hundred respondents comprising males and female were sampled from the three states. A structured questionnaire on online sports event contribution to sports betting (OSECSB) was used. The Instrument consists of three sections. Section A seeks information on the demographic data of the respondents. Section B seeks information on online sports events, while section C is used to extract information on sports betting. The modified instrument, which consists of 14 items, has a reliability coefficient of 0.74. The hypothesis was tested at 0.05 significance level. The completed questionnaire was collated, coded, and analyzed using descriptive statistics of frequency counts, percentage and pie chart, and inferential statistics of multiple regressions. The findings of this study revealed that online sports betting is a significant predictor of an increase in sports betting among Nigerian youth. The media and television, as well as globalization and the internet coupled with social media and various online platforms, have all contributed to the immense increase in sports betting. The increase in the advertisement of the betting platform during live matches, especially football, is becoming more alarming. In most organized international events, the media attention, as well as sponsorship right, are now been given to one or two betting platforms. There is a need for all stakeholders to put in place school-based intervention programs to reorientate our youth about the consequences of addiction to betting. Such programs must include meta-analyses and emotional control towards sports betting.

Keywords: betting platform, Nigerian fans, Nigerian youth, sports betting

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Authors: Mohit Wadhawan, Sushma Rathaur

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Lymphatic filariasis, also called elephantiasis is a tropical disease afflicting over 120 million people in 81 countries worldwide. Existing anti filarial drugs are effective against the larval stages of filarial parasites which call for an urgent need of drugs which are macrofilaricidal. Identification of molecular targets crucial for survival of filarial parasites is a prerequisite for drug designing. Prolyl oligopeptidase (POP) is one such crucial enzyme involved in the maturation and degradation of neuropeptides and peptide hormones. We have identified this peptidase in the bovine filarial parasite, Setaria cervi. Effect of inhibition of POP on the proteome profile of filarial parasite has been discussed in this study. Filarial parasites were exposed to Z-pro-prolinal (ZPP), a specific POP inhibitor for 8 h and the motility and viability of the parasites was observed. It significantly reduced the motility and viability of the parasites. To study the proteome profile, the cytosolic, endoplasmic reticulum (ER) and mitochondrial extracts of the adult female parasites were subjected to 2-dimensional electrophoresis. As analyzed by the PD-Quest software, the ZPP caused the alteration in the different subcellular proteins, and the significantly altered proteins were identified using MALDI-MS/MS spectrometry. The major proteins identified were found to play important role in diverse biological functions like signaling, redox regulation, energy metabolism, stress response, and cytoskeleton formation. Moreover, we found upregulation in the calcium binding proteins such as calreticulin, calponin, and calpain-6 suggesting that POP inhibition regulates calcium release. This relates to earlier reports that POP plays non-catalytic role in inositol 1,4,5-trisphosphate (IP3) signaling inducing release of calcium from ER. Taken together, the data demonstrated that inhibition of prolyl oligopeptidase alter the overall proteome signifying its role in survival of the filarial parasites. Thus this study provides a basis for the use of POP as a chemotherapeutic target for the treatment of lymphatic filariasis.

Keywords: lymphatic filariasis, setaria cervi, prolyl oligopeptidase, proteomics

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Authors: A. A. Md. Ryhan Uddin, Swarup Das, Rajesh Barua, Joheb Hasan, Rashedul Islam

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Background: The herbicide has toxicological importance because some of them are associated with high mortality rates due to respiratory failure. Organophosphate poisoning (OPC) & Paraquat self-poisoning is a major clinical and public health problems in low and middle-income countries across much of South Asia. Paraquat was not used as a common suicidal agent previously in Bangladesh. We report a case of 15 years old female admitted to the ER with a history of nausea & vomiting after ingestion of an unknown substance in a suicidal attempt, later identified as mixed poisoning- OPC & Paraquat. She was initially asymptomatic but later developed renal shutdown & lung injuries as well as pneumothorax, referred to as Daisley Barton Syndrome. Objective: This case report aims to alert spontaneous pneumothorax in mixed poisoning on uncommon forms of presentation. Pneumothorax in a patient with paraquat poisoning is a less unusual but underdiagnosed finding. It has a high index of early mortality. Case history: The patient's attendant complained about nausea followed by vomiting, which was nonprojectile & contains undigested food materials first, then gastric juice later. After a few hours, she also complains of urinary retention. Her family members treated her with some home remedies for her initial symptoms, but all attempts failed. After admission, the patient was initially asymptomatic. Through repeated history taking, her attendant showed a bottle of OPC in liquid form, which they suspected that she may have ingested some of the liquid from that bottle accidentally or attempted Suicide. So, management started for OPC poisoning. She responded well initially, but on 4th day of admission, the patient's condition became deteriorating. After the workout with the family member, 2nd bottle of Pesticide was discovered, which was Paraquat. Conclusion: Physicians should be aware of the symptoms of mixed poisoning and the timely use of urine dithionate testing for early detection and treatment. Pneumothorax is an early predictor of mortality in patients with paraquat poisoning.

Keywords: pneumothorax, suicide, dithionate, OPC, herbicide

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Authors: Pierre Mintom, William Djeukeu Asongni, Michelle Moni, William Dakam, Christine Fernande Nyangono Biyegue.

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Background: In order to prevent congestive heart failure, control of hypertension and hypercholesterolemia is necessary because those risk factors frequently occur in combination. Objective: The aim of the study is to determine the prevalence and risk factors of hypertension, hypercholesterolemia and double burden HTA-Hypercholesterolemia in patients with congestive heart failure. Methodology: A database of 98 patients suffering from congestive heart failure was used. The latter were recruited from August 15, 2017, to March 5, 2018, in the Cardiology department of Deido District Hospital of Douala. This database provides information on sociodemographic parameters, biochemical examinations, characteristics of heart failure and food consumption. ESC/ESH and NCEP-ATPIII definitions were used to define Hypercholesterolemia (total cholesterol ≥200mg/dl), Hypertension (SBP≥140mmHg and/or DBP≥90mmHg). Double burden hypertension-hypercholesterolemia was defined as follows: total cholesterol (CT)≥200mg/dl, SBP≥140mmHg and DBP≥90mmHg. Results: The prevalence of hypertension (HTA), hypercholesterolemia (hyperchol) and double burden HTA-Hyperchol were 61.2%, 66.3% and 45.9%, respectively. No sociodemographic factor was associated with hypertension, hypercholesterolemia and double burden, but Male gender was significantly associated (p<0.05) with hypercholesterolemia. HypoHDLemia significantly increased hypercholesterolemia and the double burden by 19.664 times (p=0.001) and 14.968 times (p=0.021), respectively. Regarding dietary habits, the consumption of rice, peanuts and derivatives and cottonseed oil respectively significantly (p<0.05) exposed to the occurrence of hypertension. The consumption of tomatoes, green bananas, corn and derivatives, peanuts and derivatives and cottonseed oil significantly exposed (p<0.05) to the occurrence of hypercholesterolemia. The consumption of palm oil and cottonseed oil exposed the occurrence of the double burden of hypertension-hypercholesterolemia. Consumption of eggs protects against hypercholesterolemia, and consumption of peanuts and tomatoes protects against the double burden. Conclusion: hypercholesterolemia associated with hypertension appears as a complicating factor of congestive heart failure. Key risk factors are mainly diet-based, suggesting the importance of nutritional education for patients. New management protocols emphasizing diet should be considered.

Keywords: risk factors, hypertension, hypercholesterolemia, congestive heart failure

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Authors: Hala M. El-hanbuli, Mohammed F. Darweesh

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The incidence rates of any tumor vary hugely with geographical location. Basal Cell Carcinoma (BCC) is one of the most common skin cancer that has many histopathologic subtypes. Objective: The aim was to study the histopathological features of BCC cases that were received in the Pathology Department, Kasr El-Aini hospital, Cairo University, Egypt during the period from Jan 2004 to Dec 2013 and to evaluate the clinical characters through the patient data available in the request sheets. Methods: Slides and data of BCC cases were collected from the archives of the pathology department, Kasr El-Aini hospital. Revision of all available slides and histological classification of BCC according to WHO (2006) was done. Results: A total number of 310 cases of BCC representing about 65% from the total number of malignant skin tumors examined during the 10-years duration in the department. The age ranged from 8 to 84 years, the mean age was (55.7 ± 15.5). Most of the patients (85%) were above the age of 40 years. There was a slight male predominance (55%). Ulcerated BCC was the most common gross picture (60%), followed by nodular lesion (30%) and finally the ulcerated nodule (10%). Most of the lesions situated in the high-risk sites (77%) where the nose was the most common site (35%) followed by the periocular area (22%), then periauricular (15%) and finally perioral (5%). No lesion was reported outside the head. The tumor size was less than 2 centimeters in 65% of cases, and from 2-5 centimeters in the lesions' greatest dimension in the rest of cases. Histopathological reclassification revealed that the nodular BCC was the most common (68%) followed by the pigmented nodular (18.75%). The histologic high-risk groups represented (7.5%) about half of them (3.75%) being basosquamous carcinoma. The total incidence for multiple BCC and 2nd primary was 12%. Recurrent BCC represented 8%. All of the recurrent lesions of BCC belonged to the histologic high-risk group. Conclusion: Basal Cell Carcinoma is the most common skin cancer in the 10-year survey. Histopathological diagnosis and classification of BCC cases are essential for the determination of the tumor type and its biological behavior.

Keywords: basal cell carcinoma, high risk, histopathological features, statistical analysis

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Authors: Jane N. O'Sullivan

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In most studies relating change in fertility to potentially causal factors (such as girls’ educational attainment, infant mortality or urbanization), the presence or nature of family planning efforts are not examined, potentially misattributing their contributions. Modest impacts of voluntary family planning programs on fertility change have been claimed, citing the near-term effects of historical quasi-experimental projects – notably in Bangladesh and in Ghana – where recipients and non-recipients could be contrasted. By their nature, such experiments lacked the wider cultural impacts of national programs. Concurrently, analyses relating population growth with economic advancement have been equivocal, discrediting previous widespread concern which prevailed before the 1980s. This neutral view has been revised more recently with demographic dividend theory crediting higher working-age proportion with some economic stimulus if supported by sufficient institutional and human capacity. In this study of country-level data, cross-country comparisons spanning six decades relate fertility decline with family planning effort, GDP per capita and female education, finding that the timing of rapid fertility decline aligns with commencement of voluntary family planning programs, while economic betterment came after substantial fertility fall. The relationship between fertility and primary education completion was inconsistent, with potential channels of causation operating in both directions. GDP per capita was unrelated to rate of fertility decline, but total fertility rates above three children per woman strongly impeded enrichment. By synchronizing countries with respect to their fertility transition, strong relationships are revealed which suggest lower fertility enables economic betterment, rather than the other way around. These results argue in favour of elevating voluntary family planning as a development priority.

Keywords: economic advance, family planning effort, fertility decline, population growth rate

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Authors: Seyyed Payman Ziapour, Ahmadali Enayati, Sadegh Kheiri, Farzaneh Sahraei-Rostami, Reza Ali Mohammadpour, Mahmoud Fazeli-Dinan, Mohsen Aarabi, Fatemeh Asgarian, Seyed Hassan Nikookar, Mohammad Sarafrazi

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Rhipicephalus bursa (R. bursa) is a two-host ixodid tick with wide distribution in north of Iran especially in domestic animals of Mazandaran Province. The prolonged or incorrect use of chemical insecticides has led to build up of resistance in hard ticks in many areas of the world. Lack of basic information on resistance status of R. bursa was the reason behind this study to determine the susceptibility status of the species to lambda-cyhalothrin insecticide in Mazandaran Province. From May 2013 to March 2014, R. bursa ticks were collected on sheep, goat and cattle in different districts of Mazandaran Province. The engorged female ticks were reared in a controlled insectary for producing 12-18 days old larvae for larval packet test (LPT) bioassay against discriminant doses of lambda-cyhalothrin 5% EC (MAC SILAT®). 80% of ten pooled tick populations were susceptible to lambda-cyhalothrin as resistance ratios (RR50s) varied from 1 to 2.94 when compared with the most susceptible population NH-16. Only GK-12 and BF-6 populations (from plain areas of Galugah and Fereydunkenar Counties, respectively) were classified as resistant level I at LC50 level. Population NK-2 (from woodland areas of Kojour district in Nowshahr County) showed the highest resistance ratio of RR99 = 4.32 and 30% of tick populations were resistant at LC99 level. Our research showed initiation of lambda-cyhalothrin resistance in Rhipicephalus bursa populations in Mazandaran Province, Northern Iran. This is considered a warning to policy makers for disease control in the study area. This research is a part of the PhD thesis of SP. Ziapour by grant No. 92-89 in Student Research Committee, Mazandaran University of Medical Sciences, Iran.

Keywords: Rhipicephalus bursa, hard tick, lambda-cyhalothrin resistance, Iran

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Authors: Kinda AlSamara

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The nineteenth century was characterized by major educational reforms in the Arab World. One of the unintended outcomes of colonization in Arab countries was the initiation of women liberation as well as the introduction of modern education and its application in sensitizing people on the rights of women and their liberation. The reforms were often attributed to various undercurrents that took place at different levels within the Ottoman Empire, and particularly the arrival and influence of the Christian missionaries were supported by the American and European governments. These trends were also significantly attributed to the increase in the presence of Europeans in the region, as well as the introduction of secular ideas and approaches related to the meaning of modernity. Using literary analysis as a method, this paper examines the role of an important male figure like the political activist and writer Qāsim Amīn and the religious reformer Muḥammad ʻAbduh in starting this discourse and shows their impact on the emancipation of women movement (Taḥrīr), and how later women led the movement with their published work. This paper explores Arab Salons and the initiation of women’s literary circles. Women from wealthy families in Egypt and Syria who had studied in Europe or interacted with European counterparts began these circles. These salons acted as central locations where people could meet and hold discussions on political, social, and literary trends as they happened each day. The paper concludes with a discussion of current debates between the Islamist and the secularist branches of the movement today. While the Islamists believe that adhering to the core of Islam with some of its contested position on women is a modern ideology of liberation that fits the current culture of modern time Egypt; the secularists argue that the influence that Islam has on the women’s liberation movement in Egypt has been a threat to the natural success and progress of the movement, which was initiated in the early nineteenth century independent of the more recent trends towards religiosity in the country.

Keywords: educational model, crisis of terminologies, Arab awakening, nineteenth century

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Authors: Hela Ghali, Oumayma Ben Amor, Salwa Khefacha, Mohamed Ben Rejeb, Sirine Frigui, Meriam Tourki Dhidah, Lamine Dhidah, Houyem Said Laatiri

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Background: Blood exposure accidents are the most common problem in hospitals that threaten healthcare professionals with a high risk of infectious complications which weighs heavily on health systems worldwide. Paramedics are the highest risk group due to the nature of their daily activities. We aimed to determine knowledge and attitudes about the management of blood-exposure accidents among nurses and technicians in two pediatric departments. Materials/Methods: This is a cross-sectional descriptive study conducted on March 2017, carried out with the care staff of the pediatric ward of the Farhat Hached Teaching Hospital of Sousse and pediatric surgery of the Fattouma Bourguiba University Hospital in Monastir, using a pre- tested and self-administered questionnaire. Data entry and analysis were performed using Excel software. Results: The response rate was 85.1%. A female predominance (82.5%) was reported among respondents with a sex ratio of 0.21. 80% of the participants were under 35 years old. Seniority of less than 10 years was found in 77.5% of respondents. Only 22.5% knew the definition of a blood- exposure accident. 100% and 95% of participants reported the relative risk, respectively, to hepatitis and AIDS viruses. However, only 15% recognized the severity factors of a blood-exposure accident. Hygiene compliance was the most important dimension for almost the entire population for the prevention. On the other hand, only 12.5% knew the meaning of 'standard precautions' and ¼ considered them necessary for at-risk patients only. 40% reported being exposed at least once, among them, 87.5% used betadine, and 77.5% said that anti-infectious chemoprophylaxis is necessary regardless of the patient's serological status. However, 52.5% did not know the official reporting circuit of management of blood-exposure accident in their institutions. Conclusion: For better management of risks in hospitals and an improvement of the safety of the care, a reinforcement of the sensibilization of the caregivers with regard to the risks of blood exposure accident is necessary, while developing their knowledge to act in security.

Keywords: attitudes, blood-exposure accident, knowledge, pediatric department

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Authors: Rita Alfattal, Maryam Alfarhan, Adeeb M. Algaith, Buthaina Albash, Reem M. Elshafie, Asma Alshammari, Ahmad Alahmad, Fatima Dashti, Rasha Alsafi, Hind Alsharhan

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Defects of respiratory chain complex III (CIII) result in characteristic but rare mitochondrial disorders associated with distinct neuroradiological findings. The underlying molecular defects affecting mitochondrial CIII assembly factors are few and yet to be identified. LYRM7 assembly factor is required for proper CIII assembly where it acts as a chaperone for the Rieske iron‐sulfur (UQCRFS1) protein in the mitochondrial matrix and stabilizing it. We present here the seventeenth individual with LYRM7-associated mitochondrial leukoencephalopathy harboring a previously reported rare pathogenic homozygous LYRM 7 variant, c.2T>C, (p.Met1?). Like previously reported individuals, our 4-year-old male proband presented with recurrent metabolic and lactic acidosis, encephalopathy, and myopathy. Further, he has additional, previously unreported features, including an acute stroke like episode with bilateral central blindness and optic neuropathy, recurrent hyperglycemia and hypertension associated with metabolic crisis. However, he has no signs of psychomotor regression. He has been stable clinically with residual left-sided reduced visual acuity and amblyopia, and no more metabolic crises for 2-year-period while on the mitochondrial cocktail. Although the reported brain MRI findings in other affected individuals are homogenous, it is slightly different in our index, revealing evidence of bilateral almost symmetric multifocal periventricular T2 hyperintensities with hyperintensities of the optic nerves, optic chiasm, and corona radiata but with no cavitation or cystic changes. This report describes new clinical and radiological findings of LYRM7-associated disease. The report also summarizes the clinical and molecular data of previously reported individuals describing the full phenotypic spectrum.

Keywords: LYRM7 gene defect, mitochondrial disease, , lactic acidosis, , genetic disorder

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Authors: Nazli Kazanoglu

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Reconciliation of work and family life has been an area of interest within the academic as well as in the political debate for more than three decades. With the dramatic changes in the extent to which women and men contribute to unpaid domestic work and paid employment, the reconciliation of work and family life issues have become more prominent than ever before. And they have begun to enjoy an increased attention of policy makers both at the EU and national levels. Over the last three decades the EU has initiated numerous equality programs and strategies and roadmaps regarding reconciliation of work and family life, though particularly because of the crisis and increasing willingness of achieving the EUs target of seventy five per cent of men and women in employment by 2020, those programs, strategies and roadmaps emphasized on eradicating womens familial burdens while entering labor market and providing them as equal opportunities as their male counterparts have. Reconciliation of work and family life policies thus bit by bit moved away from the objectives with a strong commitment to ensuring gender equality towards employment objectives. This paper is thus an endeavor to look at the nature of EU reconciliation of work and family life policies from the angle of gender equality. More precisely relying on the feminist literature, this paper rests on the assumption that reconciliation of work and family policies should provide the sufficient measures indeed with a more emphasis on endorsing gender equality rather than economic concerns and prioritizes two inter-related aspects while evaluating the gender equality of reconciliation of work and family life policies. First providing free choice to women in terms of their family and work lives and second challenge the unequal division of labor at home. In that sense, it investigates the nature of the changing uses and meanings of gender equality in reconciliation of work and family life policies in different stages of the EU social policy development particularly after the introduction of European Employment Strategy which gave a tremendous importance to reconciliation of work and family life during their collaborations with other issues on the EU agenda as well as the major rationale behind their development and implementation and locates them in terms of two inter-related parameters mentioned above.

Keywords: European Union, division of unpaid work, gender equality, rhetoric of free choice

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Authors: Wan-Ting Kuo, Yi-Wen Liu, Hsiao-Sheng Liu

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Annual incidence of bladder cancer increases in the world and occurs frequently in the male. Most common type is transitional cell carcinoma (TCC) which is treated by transurethral resection followed by intravesical administration of agents. In clinical treatment of bladder cancer, chemotherapeutic drugs-induced apoptosis is always used in patients. However, cancers usually develop resistance to chemotherapeutic drugs and often lead to aggressive tumors with worse clinical outcomes. Approximate 70% TCC recurs and 30% recurrent tumors progress to high-grade invasive tumors, indicating that new therapeutic agents are urgently needed to improve the successful rate of overall treatment. Nonapoptotic program cell death may assist to overcome worse clinical outcomes. Autophagy which is one of the nonapoptotic pathways provides another option for bladder cancer patients. Autophagy is reported as a potent anticancer therapy in some cancers. First of all, we established a mouse orthotopic bladder tumor formation model in order to create a similar tumor microenvironment. IVIS system and micro-ultrasound were utilized to noninvasively monitor tumor formation. In addition, we carried out intravesical treatment in our animal model to be consistent with human clinical treatment. In our study, we carried out intravesical instillation of the autophagy inducer in mouse orthotopic bladder tumor to observe tumor formation by noninvasive IVIS system and micro-ultrasound. Our results showed that bladder tumor formation is suppressed by the autophagy inducer, and there are no significant side effects in the physiology of mice. Furthermore, the autophagy inducer upregulated autophagy in bladder tissues of the treated mice was confirmed by Western blot, immunohistochemistry, and immunofluorescence. In conclusion, we reveal that a novel autophagy inducer with low side effects suppresses bladder tumor formation in our mouse orthotopic bladder tumor model, and it provides another therapeutic approach in bladder cancer patients.

Keywords: bladder cancer, transitional cell carcinoma, orthotopic bladder tumor formation model, autophagy

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Authors: Daly M. J, Condron C, Mulhall C, Eppich W, O'Neill J.

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Introduction: In contemporary clinical cardiology, comprehensive and holistic bedside evaluation including accurate cardiac auscultation is in decline despite having positive effects on patients and their outcomes. Methods: Scripted histories and scoring checklists for three clinical scenarios in cardiology were co-created and refined through iterative consensus by a panel of clinical experts; these were then paired with recordings of auscultatory findings from three actual patients with known valvular heart disease. A wearable vest with embedded pressure-sensitive panel speakers was developed to transmit these recordings when examined at the standard auscultation points. RCSI medical students volunteered for a series of three formative long case examinations in cardiology (LC1 – LC3) using this hybrid simulation. Participants were randomised into two groups: Group 1 received individual teaching from an expert trainer between LC1 and LC2; Group 2 received the same intervention between LC2 and LC3. Each participant’s long case examination performance was recorded and blindly scored by two peer participants and two RCSI examiners. Results: Sixty-eight participants were included in the study (age 27.6 ± 0.1 years; 74% female) and randomised into two groups; there were no significant differences in baseline characteristics between groups. Overall, the median total faculty examiner score was 39.8% (35.8 – 44.6%) in LC1 and increased to 63.3% (56.9 – 66.4%) in LC3, with those in Group 1 showing a greater improvement in LC2 total score than that observed in Group 2 (p < .001). Using the novel checklist, intraclass correlation coefficients (ICC) were excellent between examiners in all cases: ICC .994 – .997 (p < .001); correlation between peers and examiners improved in LC2 following peer grading of LC1 performances: ICC .857 – .867 (p < .001). Conclusion: Hybrid simulation and quantitative grading improve learning, standardisation of assessment, and direct comparisons of both performance and acumen in clinical cardiology.

Keywords: cardiology, clinical skills, long case examination, hybrid simulation, checklist

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Authors: Parastoo Kazemiyan

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Over the past 80 years, in compliance with the advent of modernity in Iran and Turkey, the presence of women in economic and social arenas has creates serious challenges in the capacity of urban spaces to respond to their presence and transport because urban spaces up until then were based on masculine criteria and therefore, women could use such spaces in the company of their fathers or husbands. However, as modernity expanded by Reza Shah and Ataturk, women found the opportunity to work and be present in urban spaces alongside men and their presence in economic and social domains resulted in their presence in these spaces in the early and late hours of the day. Therefore, the city had to be transformed in structural, social, and environmental terms to accommodate women's activities and presence in various urban arenas, which was a huge step in transition from a masculine man-based culture to an all-inclusive human-based culture in these two countries. However, the optimization of urban space was subject to political changes in the two countries, leading to significant differences in designing urban spaces in Tehran and Istanbul. What shows the importance and novelty of the present study lie in the differences in urban planning and optimization in the two capital cities, which gave rise to different outcomes in desirability and quality of living in these two capital cities. Due to the importance of the topic, one of the most significant factors in desirability and acceptability of urban space for women was examined using a descriptive-analytic method based on qualitative methodology in Tehran and Istanbul. The results showed that the infrastructural factors in Istanbul, including safety of access, variety, and number of public transport modes, transparency, and supervision over public spaces have provided women with a safer and more constant presence compared to Tehran. It seems that challenges involved in providing access to urban spaces in Tehran in terms of infrastructure and function have made Tehran unable to respond to the most basic needs of its female citizens.

Keywords: gender differences, urban space security, access to transportation systems, women's challenges

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