Search results for: attachment-based family therapy

Authors: Policarpio Jr. Joves

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Physicians in most teaching hospitals are commonly promoted into managerial roles, yet their training is mostly in clinical and scientific skills but not in leadership competencies. When they shift into roles of physician leadership, the majority hold on to their primary identity of physicians. These conflicting roles affect their identity and eventually their work. The physician leaders also face additional challenges related to academics which include incorporation of new knowledge into the existing curriculum, use of technology in the delivery of teaching, the need to train medical students outside of hospital wards, etc. The study aims to explore how physician leaders in teaching hospitals of private medical schools enact their leadership roles and how they face the challenges as physician leaders. The study setting shall be teaching hospitals of three private medical schools situated in the National Capital Region, Philippines. A multiple case study design shall be adopted in this research. Physicians shall be eligible to participate in the study if they are practicing clinicians limited to the five major clinical specialty: Internal Medicine, Pediatrics, Family Medicine, Surgery, Obstetrics and Gynecology. They must be teaching in the College of Medicine prior to their appointments as physician leaders in both medical school and teaching hospital. Semi-structured face-to-face interviews shall be utilized as a means of data collection, with open-ended questions, enabling physician leaders to present narratives about their identity, role enactment, conflicts, reaction of colleagues, and the challenges encountered in their day-to-day work as physician leaders. Interviews shall be combined with observations and review of records to gain more insights into how the physician leaders are 'doing' management. Within-case analysis shall be done initially followed by a thematic analysis across the cases, referred to as cross–case analysis or cross-case synthesis.

Keywords: academic leaders, academic managers, physician leaders, physician managers

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Authors: Yung Yau

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'Little people' are those who have extremely short stature as they suffer from rare bone diseases. They are commonly known as 'dwarves' or 'people with dwarfism'. Dwarfism is generally regarded as a type of rare disease for its extremely small odds (~1 in 15,000). On account of its rarity, dwarfism, unlike other types of disability, has attracted relatively little attention from the general public and in various academic fields (e.g. architecture, psychology and sociology) except medical science. In view of the extant research gaps, this study aims to investigate the physical barriers facing the little people in the built environment in Hong Kong. Between November 2017 and July 2018, ten little people or their family members participated in in-depth interviews. Responses of the interviewees were transcribed (i.e., speech being converted to text word for word). Interview data were then analyzed using the interpretative phenomenological analysis methodology developed by J. Smith and others in 2009. The findings of the project reveal that although Hong Kong's built environment has been designed barrier-free pursuant to the prevailing building standards, those standards do not cater to the special anthropometric characteristics of little people. As a result, little people face a lot of challenges when using built facilities. For example, most water closets, urinals, and wash hand basins are not fit for little people's use. As indicated by the project findings, we are still far away from providing a discrimination-free and barrier-free living environment for the little people in Hong Kong. To make Hong Kong society more inclusive to the little people, there is a need for further tailored building design. A set of building design principles for better inclusion of the little people in our society are highlighted. These principles include 'the building design should accommodate individuals with different heights' and 'the building design should allow individuals to use comfortably and efficiently with a minimum of fatigue'. At the end of the paper, the author also calls for an agenda for further studies. For instance, we need an anthropometric study on little people for developing practical building design guidelines.

Keywords: dwarfism, little people, inclusive buildings, people with disabilities, social sustainability

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Authors: Lucie Matricon, Anne Roubaud, Geert Haarlemmer, Christophe Geantet

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Introduction: This case discusses the management of two floor of mouth (FOM) Squamous Cell Carcinomas (SCC) not identified upon initial biopsy. Case Report: A 51 year-old male presented with right FOM erythroleukoplakia. Relevant medical history included alcoholic dependence syndrome and alcoholic liver disease. Relevant drug therapy encompassed acamprosate, folic acid, hydroxocobalamin and thiamine. The patient had a 55.5 pack-year smoking history and alcohol dependence from age 14, drinking 16 units/day. FOM incisional biopsy and histopathological analysis diagnosed Carcinoma in situ. Treatment involved wide local excision. Specimen analysis revealed two separate foci of pT1 moderately differentiated SCCs. Carcinoma staging scans revealed no pathological lymphadenopathy, no local invasion or metastasis. SCCs had been excised in completion with narrow margins. MDT discussion concluded that in view of the field changes it would be difficult to identify specific areas needing further excision, although techniques such as Lugol’s Iodine were considered. Further surgical resection, surgical neck management and sentinel lymph node biopsy was offered. The patient declined intervention, primary management involved close monitoring alongside alcohol and smoking cessation referral. Discussion: Narrow excisional margins can increase carcinoma recurrence risk. Biopsy failed to identify SCCs, despite sampling an area of clinical concern. For gross field change multiple incisional biopsies should be considered to increase chance of accurate diagnosis and appropriate treatment. Coupling of tobacco and alcohol has a synergistic effect, exponentially increasing the relative risk of oral carcinoma development. Tobacco and alcoholic control is fundamental in reducing treatment‑related side effects, recurrence risk, and second primary cancer development.

Keywords: microalgae, biofuels, hydrothermal liquefaction, biomass

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Authors: Nuo Xu, Sijing Chen

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Background: Childbirth is considered a critical traumatic event throughout our lives, positively or negatively impacting the mother's physiology, psychology, and even the whole family. Adverse birth experiences, such as labor pain, anxiety, and fear can negatively impact the mother. Studies had shown that the immersive nature of VR can distract attention from pain and increase focus on interventions for pain relief. However, the existing studies that applied VR to maternal delivery were still in their infancy and showed disparate results, and the small sample size is not representative, so this review analyzed the effects of VR in labor, such as on maternal pain and anxiety, with a view to providing a basis for future applications. Search strategy: We searched Pubmed, Embase, Web of Science, the Cochrane Library, CINAHL, China National Knowledge Infrastructure, Wan-Fang database from the building to November 17, 2021. Selection Criteria: Randomized controlled trials (RCTs) that intervened the pregnant women aged 18-35 years with gestational >34 weeks and without complications with VR technology were contained within this review. Data Collection and Analysis: Two researchers completed the study selection, data extraction, and assessment of study quality. For quantitative data we used MD or SMD, and RR (risk ratio) for qualitative data. Random-effects model and 95% confidence interval (95% CI) were used. Main Results: 12 studies were included. Using VR could relieve pain during labor (MD=-1.81, 95% CI (-2.04, -1.57), P< 0.00001) and active period (SMD=-0.41, 95% CI (-0.68, -0.14), P= 0.003), reduce anxiety (SMD=-1.39, 95% CI (-1.99, -0.78), P< 0.00001) and improve satisfaction (RR = 1.32; 95% CI (1.10, 1.59); P = 0.003), but the effect on the duration of first (SMD=-1.12, 95% CI (-2.38, 0.13), P=0.08) and second (SMD=-0.22, 95% CI (-0.67, 0.24), P=0.35) stage of labor was not statistically significant. Conclusions: Compared with conventional care, VR technology can relieve labor pain and anxiety and improve satisfaction. However, extensive experimental validation is still needed.

Keywords: virtual reality, delivery, labor pain, anxiety, meta-analysis, systematic review

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Authors: Hassan Sher

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Agriculture has a pivotal role in Pakistan’s economy, accounting for about one-fourth of the GDP and employing almost half the population. However, the competitiveness, productivity, growth, employment potential, export opportunity, and contribution to GDP of the sector is significantly hampered by agriculture marketing laws/regulations at the provincial level that reward rent seeking behavior, promote monopoly power, artificially reduce farmer incomes while inflating prices to consumers, and act as disincentives to investment. Although of more recent vintage than some other provincial agricultural marketing laws, the NWFP Agricultural and Livestock Produce Markets Act, 2007 is a throwback to a colonial paradigm, where restrictions on agricultural produce marketing and Government control of distribution channels is the norm. The Swat Valley (in which we include its tributary valleys) is an area of Pakistan in which there is poverty is both extreme and pervasive. For many, a significant portion of the family’s income comes from selling plants that are used as herbs, medicines, and perfumes. Earlier studies have shown that the benefit they derive from this work is less than they might because of: Lack of knowledge concerning which plants and which plant parts are valuable, Lack of knowledge concerning optimal preservation and storage of material, illiteracy. Another concern that much of the plant material sold from the valley is collected in the wild, without an appreciation of the negative impact continued collecting has on wild populations. We propose: Creating colored cards to help inhabitants recognize the 25 most valuable plants in their area; Developing and sharing protocols for growing the 25 most valuable plants in a home garden; Developing and sharing efficient mechanisms for drying plants so they do not lose value; Encouraging increased literacy by incorporating numbers and a few words in the handouts.

Keywords: food security, medicinal plants, industrial plants, economic development

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Authors: Abir Mohamed Mohamed Ibrahim, Amina Titouche, Mohamed Hazzit

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Phytotherapy is based on use of plant natural products holding the main sources of drugs with healing properties for the treatment of human, animal or vegetable diseases. With these aims, and to replace chemical preservatives in natural products, we are interested to use essential oils from Algerian endemic plants belonging to the Asteraceae family: Artemisia herba alba Asso, which was undergoes a hydro-distillation after its irradiation by Gamma rays at frequencies: 10, 20, and 30 KGray which gave respectively the following essential oil yields: 1.087%, 1.087%, 1.085%, compared with that of the untreated sample giving a yield of 1.27 %. Evaluation of the antioxidant activity in vitro of essential oil for A. herba alba has been assessed by two different methods: inhibition of DPPH radical and measurement of reducing power. The first method has not revealed a very big difference regardless of the dose of irradiation, the IC50 is about 4000 mg/l, the maximum of inhibition was around 49.4%, likewise, the test of reducing power awarded us a maximum reducing capacity was of 0.76%; both of results were registered by the specimen irradiated at 20 KGy, it has a more better antioxidant power than no irradiated sample but slightly. To combat Fusarium culmorum, causing the wilts and rots, we are focused on the antifungal screening of this aromatic plant. The results obtained, followed by measurements of Minimal Inhibitory Concentrations (MIC); showed promising inhibitory effect against pathogen tested. With a yield superior to l%, the essential oil has shown a remarkable efficiency on the stump, mainly for sample irradiate at 30KGray (MICs= 625 µg/ml; MICc= 1250 µg/ml) with MIC of 2%. These results demonstrate a good antifungal activity, to limit and even to stop the development of the pathogenic microorganism and also the positive effect of dose of irradiation to upgrade this capacity as well, to uphold the antioxidant capacity.

Keywords: artemisia herba alba Asso, essential oil yield, gamma ray, antioxidant activity, antifungal activity

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Authors: L. Meers, L. Contalbrigo, V. Stevens, O. Ulitina, S. Laufer, W. E. Samuels, S. Normando

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Since the COVID-19 pandemic started, there has been concern that domestic animals may help spread SARS-Cov-2. This concern also greatly affected human-animal interaction projects such as animal-assisted interventions (AAI). As a result, institutions and AAI practitioners developed new safety protocols and procedures to control the spread of the SARS-Cov-2 virus during AAI sessions and to guarantee safety for their clients and animals. However, little is known yet about the impact on animals' needs and the possible welfare issues due to these lifestyle adaptions. Fifteen therapists in Flanders, Belgium, who were currently conducting canine-assisted interventions, conducted unstructured observations on how their dogs' (11 mixed breeds, 3 Labradors, 1 terrier aged 2 – 12 years) behaviors changed due to institutional COVID-19 safety protocols. Most (80%) of the respondents reported that their dogs showed sniffing or sneezing after smelling disinfected areas. Two (13%) dogs responded with vomiting and gagging, and three (20%) dogs urinated over disinfected areas. All protocols advise social distancing between participants and animals. When held back, eight (53%) dogs showed self-calming behaviors. Respondents reported that most (73%) dogs responded with flight reactions when seeing humans wearing facial masks. When practitioners threw their used masks in open dustbins, five (33%) dogs tried to take them out with their mouths and play with them; two (13%) Labradors tried to eat them. Taking the dogs' temperatures was the most frequently (53%) used method to supervise their health. However, all dogs showed behaviors as ducking the tail, trying to escape, or biting the animal handler during this procedure. We interpret these results to suggest that dogs tended to react with stress and confusion to the changes in AAI practices they're part of. The health and safety protocols that institutions used were largely borne from recommendations made to protect humans. The participating practitioners appeared to use their knowledge of dog behavior and safety to modify them as best they could—but with more significant concern directed towards the other humans. Given their inter-relatedness and mutual importance for welfare, we advocate for integrated human and animal health and welfare assessments and protocols to provide a framework for "One health" approaches in animal-assisted interventions.

Keywords: animal-assisted therapy, COVID-19 protocol, one health, welfare

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Authors: Victorine Mbong Shu

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Very little research exists on family sex and sexuality communication and identity formation and how communication is helping adolescents in forming their sexual identities in South Africa. This study is designed to explore the impact of sexual communication in African families and the dynamics that influence the openness or closedness of adolescent sexual identities. The primary objectives of this study are threefold; to understand how sexuality communication in African families impacts the closedness and/or openness of adolescent African identities; to explore the nature of African children's sexuality given the status of their families’ communications on sex; to describe how parental or adult sexual knowledge, attitudes, values of sex, etc. are translated to children in African families, if at all. This study seeks answers to challenges faced by African parents and caregivers of adolescent children in South Africa regarding sex-sexuality communication and their shifting identities in different spaces. Its outcome seeks to empower these families on how to continue to effectively communicate sex and sexuality at different stages and circumstances. Two sets of people are interviewed separately in order to explore issues of familial communication and how to understand how together with religion and culture, adolescents are socialised to form the social and gender identities that they take to adulthood. They were parents of adolescents and young adult children who spoke in retrospect on when they were adolescents. The results of this study will fill knowledge gaps considering the chosen theory of communication that gives clarity to the topic of sex and sexuality communication in African families in South Africa and the dynamics of privacy that influence identity formation. A subset of the 40 conversations, 5 female parents, 5 male parents, 5 young female adults, and 5 male young adults, was used for this analysis. The preliminary results revealed five emergent themes informed by research questions and the theoretical framework of this study: Open communication, Discomfort discussing sex and sexuality, The importance of sex communication to African parents, Factors influencing African families’ communication about sex and sexuality and Privacy and boundaries.

Keywords: sex, sexuality, communication, African families, adolescents

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Authors: Ozen Asut, Gulifeiya Abuduxike, Imge Begendi, Mustafa O. Canatan, Merve Colak, Gizem Ozturk, Lara Tasan, Ahmed Waraiet, Songul A. Vaizoglu, Sanda Cali

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Obesity among children and adolescents is one of the critical public health problems worldwide. Internet addiction is one of the sedentary behaviors that cause obesity due to the excessive screen time and reduced physical activities. We aimed to examine the relationships between the screen time, internet addiction and other lifestyle behaviors with obesity among high school students in the Near East College in Nicosia, Northern Cyprus. A cross-sectional study conducted among 469 secondary school students, mean age 11.95 (SD, 0.81) years. A self-administrated questionnaire was applied to assess the screen time and lifestyle behaviors. The Turkish adopted version of short-form of internet addiction test was used to assess internet addiction problems. Height and weight were measured to calculate BMI and classified based on the BMI percentiles for sex and age. Descriptive analysis, Chi-Square test, and multivariate regression analysis were done. Of all, 17.2% of the participants were overweight and obese, and 18.1% had internet addictions, while 40.7% of them reported having screen time more than two hours. After adjusting the analysis for age and sex, eating snacks while watching television (OR, 3.04; 95% CI, 1.28-7.21), self- perceived body weight (OR, 24.9; 95% CI, 9.64-64.25) and having a play station in the room (OR, 4.6; 95% CI, 1.85 - 11.42) were significantly associated with obesity. Screen time (OR, 4.68; 95% CI, 2.61-8.38; p=0.000) and having a computer in bedroom (OR, 1.7; 95% CI, 1.01- 2.87; p=0.046) were significantly associated with internet addiction, whereas parent’s compliant regarding the lengthy technology use (OR, 0.23; 95% CI, 0.11-0.46; p=0.000) was found to be a protective factor against internet addiction. Prolonged screen time, internet addiction, sedentary lifestyles, and reduced physical and social activities are interrelated, multi-dimensional factors that lead to obesity among children and adolescents. A family - school-based integrated approach should be implemented to tackle obesity problems.

Keywords: adolescents, internet addiction, lifestyle, Northern Cyprus, obesity, screen time

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Authors: C. Catalina Zapata, Z. Claudia Montoya

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Transplant from hematopoietic parents (THP) or medulla (MT) is a procedure used to replace the medulla that does not work as part of a disease or when it is destroyed either by a treatment of high medication doses against cancer or by radiation. The transplant process has three stages, a stage prior to transplant, during and after the transplant. It is held with the help of an interdisciplinary team, including nursing, carrying out mainly educative procedures to warrant the adhesion and the changes in lifestyles needed to whom will undergo this procedure. The aim of the study was to assess the results of an educative procedure by nursing, on adult patients subjected to a transplant from hematopoietic parents at a high complexity institution of Medellin city, Colombia. This study had an observational longitudinal design. According to the rules of protocol, the educative activity must be held on all patients joining the procedure. Four instruments were designed in order to collect all the information. One of them to measure the sociodemographic variables, another one to measure self-care practices, another one to measure transplant knowledge and its cares and the other one to measure the 30-day post-transplant complications. The last three instruments were applied before and after the educative procedure. A univaried analysis was carried out but the bivaried analysis was not carried out since there were not statistically meaningful differences before and after. Within the results, ten patients were evaluated. The average age was 38.2 (13.38 SD – standard deviation), 8/10 were men. Some self-care practices such us having pets and plants and consuming some specific food as well as little use of UV protection are all present in this type of patients and are not modified after the procedure. In measuring the knowledge, something stands out among the answers. It is the fact that some patients do not know what the medulla is, the nature of separating wastes at home and the need to consult about vomit and nausea. The most frequent complications during the first thirty days were: nausea, vomit, fever, and rash. They are considered to be expected within this period. Patients do not exhibit differences in their level of knowledge before and after the educative procedure by nursing. The patients’ self-care practices do not involve all the necessary ones to avoid complications. During the first 30 days, most of the complications are typical of the transplant process from hematopoietic parents.

Keywords: bone marrow transplant, education, family, nursing, patients, Transplantation of hematopoietic progenitors

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Authors: Swati Gautam, Amita Jain, Shyampyari Jaiswar

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Objective: To elucidate the role of (ApaI&TaqI) VDR gene polymorphism in the pathogenesis of female genital tuberculosis (FGTB) cases. Background: Female genital TB represents about 15-20% of total extra-pulmonary TB (EPTB). Female subjects with vitamin D deficiency have been shown to be at higher risk of pulmonary TB as well as FGTB. In same context few functional polymorphism in vitamin D receptor (VDR) gene has been considered as an important genetic risk factor that modulate the development of FGTB. Therefore we aimed, to elucidate the role of (ApaI&TaqI) VDR gene polymorphism in the pathogenesis of FGTB. Study design: Case-Control study. Sample size: Cases (60) and Controls (60). Study site: Department of Obstetrics & Gynecology & Department of Microbiology, K.G.M.U. Lucknow, (UP). Inclusion criteria: Cases: Women with age group 20-35 years, premenstrual endometrial aspiration collected and included in the study, those were positive with acid-fast bacilli (AFB)/ TB-PCR/ LJ culture/ liquid culture. Controls: Women with age group 20-35 years having no history of ATT and all test negative for TB recruited as control. Exclusion criteria: -Women with endometriosis, polycystic ovaries (PCOD), positive on Chlamydia & gonorrhea, already on anti-tubercular therapy (ATT) excluded. Materials and Methods: Blood samples were collected in EDTA tubes from cases and controls stored at -20ºC. Genomic DNA extraction was carried out by salting-out method. Genotyping of VDR gene (ApaI&TaqI) polymorphism was performed by using single amplification refractory mutation system (ARMS) PCR technique. PCR products were analyzed by electrophoresis on 2% agarose gel. Statistical analysis was done by SPSS16.3 software & computing odds ratio (OR) with 95% CI. Results: Increased risk of female genital tuberculosis was observed in AA genotype (OR =1.1419-6.212 95% CI, P*<0.036) and A allele (OR =1.255-3.518, 95% CI, P* < 0.006) in FGTB as compared to controls. Moreover A allele was found more frequent in FGTB patients. No significant difference was observed in TaqI gene polymorphism of VDR gene. Conclusion: The ApaI polymorphism is significantly associated with etiology of FGTB and plays an important role as a genetic risk factor in FGTB women.

Keywords: ARMS, ATT, EPTB, FGTB, VDR

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Authors: Sourav Ghosh, Antony Gomes

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Since 1894 anti-snake venom serum (ASVS) is the only available treatment against snake envenomation, although there are many side effects and limitations. The need for a supportive treatment was felt for a long time to overcome the side effects and limitations of ASVS. Andrographolide conjugated with gold nanoparticle (A-GNP) has been found to antagonize viper venom-induced local damages. The present study was aimed to study the protective efficacy of A-GNP against Viper venom-induced inflammatory response and organ toxicity in animal model. Ethical clearance was obtained from animal experiments. Physico-chemical characterization of A-GNP was done by DLS (diameter and zeta potential), FE-SEM and XRD. Swiss albino male mice were divided into 4 groups: Gr.1-Sham control, Gr.2- Russell’s Viper venom (RVV) control, Gr.3- andrographolide treated and Gr.4- A-GNP treated. The 1/5th minimum lethal dose of RVV (500µg/kg, s.c.) was induced in animals of group 2, 3 & 4 animals, followed by treatment with andrographolide (100mg/kg, i.p.) and A-GNP (100mg/kg, i.v.) in group 3 & 4 animals, respectively. Blood was collected after 18 h, serum was prepared, and inflammatory markers (IL 1β, 6, 17a, 10, TNF α) and biochemical markers (AST, ACP, LDH, urea, creatinine) were assessed. Values were expressed as mean±SEM (n=4), one way ANOVA was done, P<0.05 was considered as statistically significant. DLS size showed the hydrodynamic diameter of A-GNP to be 230-260nm with polydispersity index of 0.103 and zeta potential was -18.32mV. XRD data confirmed the presence of crystalline gold in A-GNP, and FESEM indicated the presence of nearly spherical particle with size18-24nm.Treatment with A-GNP significantly decreased viper venom-induced proinflammatory markers (IL 1β, 6, 17, TNF α) increased anti-inflammatory markers (IL 10) and decreased organ toxicity markers (AST, ACP, LDH, urea, creatinine) in animal model. Venom neutralization efficacy of A-GNP was > andrographolide, which confirmed the increased efficacy of andrographolide after gold nanoparticle conjugation. Venom neutralization by A-GNP was due to anti-oxidant/anti-inflammatory activity of andrographolide, which showed increased efficacy after gold nanoparticle tagging. Thus, A-GNP may serve as a supportive therapy in snake-bite (against inflammatory response and organ toxicity) subject to further detail studies.

Keywords: andrographolide, gold nanoparticle, inflammatory response, organ toxicity, snake venom, snake venom neutralization, viper venom

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Authors: Tara Hunter, Kristine Concepcion, Wendy Cheng, Brianna Pike, Jane Estoesta, Anne Stuart

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In 2015, Family Planning NSW was contracted by the NSW Ministry of Health to design and deliver Sexual Safety Policy training (SSPT) to mental health professionals across NSW. The training was based on their current guidelines and developed in consultation with an expert reference group. From October 2015 to April 2017 it was delivered to over 2,400 mental health professionals with a view to supporting implementation of consistent prevention and intervention related to sexual safety in the mental health setting. An evaluation was undertaken to determine the knowledge and confidence of participants related to sexual safety before and after the training, and whether any improvements were translated into changes in practice. Participants were invited to complete a survey prior to the training, upon completion and three to six months thereafter. Telephone interviews were conducted among service managers and mental health champions six months post-training. Prior to training, the majority of mental health professionals reported being slightly to moderately confident in identifying a sexual safety incident. When asked on their understanding of sexual safety, gender sensitive practice and trauma informed care, they reported no confidence, slight confidence and moderate confidence. Immediately after the training, 54.5% reported being very confident and 10.9% extremely confident in identifying a sexual safety incident. More than half felt very confident or extremely confident in their understanding of sexual safety principles. The impact survey (six months later) found that the majority of participants (91%) were highly confident in identifying a sexual safety incident. Telephone interviewees reported a change in workplace culture and increased awareness after the training. Mental health professionals experienced increased knowledge and confidence about sexual safety principles following the training and were able to implement positive changes and concrete actions to better address sexual safety issues in their workplace.

Keywords: sexual safety, mental health professionals, trauma informed care, policy training

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Authors: Amar Ranjan, Julieana Durai, Pranay Tanwar

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Background &Introduction: Ovarian cancer is one of the most common malignant tumor in the female. 70% of the cases of ovarian cancer are diagnosed at an advanced stage. The five-year survival rate associated with ovarian cancer is less than 30%. The early diagnosis of ovarian cancer becomes a key factor in improving the survival rate of patients. Presently, CAl25 (carbohydrate antigen125) is used for the diagnosis and therapeutic monitoring of ovarian cancer, but its sensitivity and specificity is not ideal. The introduction of HE4, human epididymis protein 4 has attracted much attention. HE4 has a sensitivity and specificity of 72.9% and 95% for differentiating between benign and malignant adnexal masses, which is better than CA125 detection.  Methods: Serum HE4 and CA -125 were estimated using the chemiluminescence method. Our cases were 40 epithelial ovarian cancer, 9 benign ovarian tumor, 29 benign gynaecological diseases and 13 healthy individuals. This group include healthy woman those who have undergoing family planning and menopause-related medical consultations and they are negative for ovarian mass. Optimal cut off values for HE4 and CA125 were 55.89pmol/L and 40.25U/L respectively (determined by statistical analysis). Results: The level of HE4 was raised in all ovarian cancer patients (n=40) whereas CA125 levels were normal in 6/40 ovarian cancer patients, which were the cases of OC confirmed by histopathology. There is a significant decrease in the level of HE4 with comparison to CA125 in benign ovarian tumor cases. Both the levels of HE4 and CA125 were raised in the nonovarian cancer group, which includes cancer of endometrium and cervix. In the healthy group, HE4 was normal in all patients except in one case of the rudimentary horn, and the reason for this raised HE4 level is due to the incomplete development of uterus whereas CA125 was raised in 3 cases. Conclusions: Findings showed that the serum level of HE4 is an important indicator in the diagnosis of ovarian cancer, and it also distinguishes between benign and malignant pelvic masses. However, a combination of HE4 and CA125 panel will be extremely valuable in improving the diagnostic efficiency of ovarian cancer. These findings of our study need to be validated in the larger cohort of patients.

Keywords: human epididymis protein 4, ovarian cancer, diagnosis, benign lesions

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Authors: Fatemeh Zeinali Sehrig

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Background: miRNAs play an important role in the post-transcriptional regulation of genes, including genes involved in DNA methylation (DNMTs), and are also important regulators of oncogenic pathways. The study of microRNAs and DNMTs in breast cancer allows the development of targeted treatments and early detection of this cancer. Methods and Materials: Clinical Patients and Samples: Institutional guidelines, including ethical approval and informed consent, were followed by the Ethics Committee (Ethics code: IR.IAU.TABRIZ.REC.1401.063) of Tabriz Azad University, Tabriz, Iran. In this study, tissues of 100 patients with breast cancer and tissues of 100 healthy women were collected from Noor Nejat Hospital in Tabriz. The basic characteristics of the patients with breast cancer included: 1)Tumor grade(Grade 3 = 5%, Grade 2 = 87.5%, Grade 1 = 7.5%), 2)Lymph node(Yes = 87.5%, No = 12.5%), 3)Family cancer history(Yes = 47.5%, No = 41.3%, Unknown = 11.2%), 4) Abortion history(Yes = 36.2%).In silico methods (data gathering, process, and build networks): Gene Expression Omnibus (GEO), a high-throughput genomic database, was queried for miRNAs expression profiles in breast cancer. For Experimental protocol Tissue Processing, Total RNA isolation, complementary DNA(cDNA) synthesis, and quantitative real time PCR (QRT-PCR) analysis were performed. Results: In the present study, we found significant (p.value<0.05) changes in the expression level of miRNAs and DNMTs in patients with breast cancer. In bioinformatics studies, the GEO microarray data set, similar to qPCR results, showed a decreased expression of miRNAs and increased expression of DNMTs in breast cancer. Conclusion: According to the results of the present study, which showed a decrease in the expression of miRNAs and DNMTs in breast cancer, it can be said that these genes can be used as important diagnostic and therapeutic biomarkers in breast cancer.

Keywords: gene expression omnibus, microarray dataset, breast cancer, miRNA, DNMT (DNA methyltransferases)

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Authors: Georgios Pardalis, Krushna Mahapatra, Brijesh Mainali

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Compared to other sectors, the residential and service sector in Sweden is responsible for almost 40% of the national final energy use and faces great challenges towards achieving reduction of energy intensity. The one- and two-family (henceforth 'detached') houses, constituting 60% of the residential floor area and using 32 TWh for space heating and hot water purposes, offers significant opportunities for improved energy efficiency. More than 80% of those houses are more than 35 years of old and a large share of them need major renovations. However, the rate of energy renovations for such houses is significantly low. The renovation market is dominated by small and medium-sized local companies (SMEs), who mostly offer individual solutions. A one-stop-shop business framework, where a single actor collaborates with other actors and coordinates them to offer a full package for holistic renovations, may speed up the rate of renovation. Such models are emerging in some European countries. This paper aims to understand the willingness of the SMEs to adopt a one-stop-shop business framework. Interviews were conducted with 13 SMEs in Kronoberg county in Sweden, a geographic region known for its initiatives towards sustainability and energy efficiency. The examined firms seem reluctant to adopt one-stop-shop for nonce due to the perceived risks they see in such a business move and due to their characteristics, although they agree that such a move will advance their position in the market and their business volume. By using threat-rigidity and prospect theory, we illustrate how this type of companies can move from being reluctant to adopt one-stop-shop framework to its adoption. Additionally, with the use of behavioral theory, we gain deeper knowledge on those exact reasons preventing those firms from adopting the one-stop-shop framework.

Keywords: construction SMEs, innovation adoption, one-stop-shop, perceived risks

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Authors: Adel Khorramrouz, Monireh Ahmadi Bani, Ehsan Norouzi

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Background:-Due to the essential role of the foot in movement, foot disorders (FDs) have significant impacts on activity and quality of life. Many studies confirmed the association between FDs and demographic characteristics. On the other hand, recent advances in data collection and statistical analysis led to an increase in the volume of databases. Analysis of patient’s data through the decision tree can be used to explore the relationship between demographic characteristics and FDs. Significance of the study: This study aimed to investigate the relationship between demographic characteristics with common FDs. The second purpose is to better inform foot intervention, we classify FDs based on demographic variables. Methodologies: We analyzed 2323 subjects with pes-planus (PP), pes-cavus (PC), hallux-valgus (HV) and plantar-fasciitis (PF) who were referred to a foot therapy clinic between 2015 and 2021. Subjects had to fulfill the following inclusion criteria: (1) weight between 14 to 150 kilogram, (2) height between 30 to 220, (3) age between 3 to 100 years old, and (4) BMI between 12 to 35. Medical archives of 2323 subjects were recorded retrospectively and all the subjects examined by an experienced physician. Age and BMI were classified into five and four groups, respectively. 80% of the data were randomly selected as training data and 20% tested. We build a decision tree model to classify FDs using demographic characteristics. Findings: Results demonstrated 981 subjects from 2323 (41.9%) of people who were referred to the clinic with FDs were diagnosed as PP, 657 (28.2%) PC, 628 (27%) HV and 213 (9%) identified with PF. The results revealed that the prevalence of PP decreased in people over 18 years of age and in children over 7 years. In adults, the prevalence depends first on BMI and then on gender. About 10% of adults and 81% of children with low BMI have PP. There is no relationship between gender and PP. PC is more dependent on age and gender. In children under 7 years, the prevalence was twice in girls (10%) than boys (5%) and in adults over 18 years slightly higher in men (62% vs 57%). HV increased with age in women and decreased in men. Aging and obesity have increased the prevalence of PF. We conclude that the accuracy of our approach is sufficient for most research applications in FDs. Conclusion:-The increased prevalence of PP in children is probably due to the formation of the arch of the foot at this age. Increasing BMI by applying high pressure on the foot can increase the prevalence of this disorder in the foot. In PC, the Increasing prevalence of PC from women to men with age may be due to genetics and innate susceptibility of men to this disorder. HV is more common in adult women, which may be due to environmental reasons such as shoes, and the prevalence of PF in obese adult women may also be due to higher foot pressure and housekeeping activities.

Keywords: decision tree, demographic characteristics, foot disorders, machine learning

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Authors: Folajinmi Oluwasina, Magbagbeola Dairo, Ikeoluwapo Ajayi

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Contraception has proven to be an effective way of controlling fertility and spacing births. Studies have shown that contraception can avert the high-risk pregnancies and consequently reduce maternal deaths up to 32%. Uptake of modern contraception is promoted as a mechanism to address the reproductive health needs of men and women, as well as the crucial challenge of rapid population increase. A cross- sectional descriptive study using a two- stage systematic sampling technique was used to select 530 women of reproductive age out of 20,000 households. Respondents were interviewed using a semi-structured questionnaire. Knowledge was assessed on a 5 point score in which a score of ≤ 2 rated poor while perception was scored on 36 points score in which a score of ≤ 18 was rated low. Data were analyzed using descriptive statistics, Chi-square test and logistic regression at p< 0.05. There were 530 respondents. Age of respondents was 30.3 ±7.8 years, and 73.0% were married. About 90% had good knowledge of contraception while 60.8% had used contraceptives. The commonest source of information about contraception was mass media (72.8%). Minority (26.1%) obtained husbands approval before using contraceptive while 20.0% had used modern contraceptives before the first birth. Many (54.5%) of the respondents agreed that contraception helps in improving standard of living and 64.7% had good perception about contraception. Factors that hindered effective uptake of contraception services included poor service provider’s attitude (33.3%) and congestion at the service centers (4.5%). Respondents with nonuse of contraceptive before first birth are less likely to subsequently use contraceptives (OR= 0.324, 95% CI= 0.1-0.5). Husband approval of contraceptives use was the major determinant of women’s contraceptive use (OR = 3.4, 95% CI = 1.3-8.7). Respondents who had family planning centers not more than 5 kilometers walking distance to their residence did not significantly use contraception services (41.5%) more than 21.1% of those who had to take means of transportation to the service venues. This study showed that majority of the respondents were knowledgeable and aware of contraception services, but husband’s agreement on the use of modern contraceptives remains poor. Programmes that enhances husbands approval of modern contraception is thus recommended.

Keywords: contraception services, service provider’s attitude, uptake, husbands approval

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Authors: Muntanavadee Maytapattana

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This research aims to study the effects of the Parent Training Program for Obesity Reduction (PTPOR) on child waist circumference and health behaviors of pre-school children at the Samut-Songkhram kindergarten school, Samut-Songkhram province, Thailand. The objective of this research is to evaluate the effectiveness of the PTPOR on child waist circumference and health behaviors of the pre-school children. The conceptual framework of this study is developed on the basis of the Ecological Systems Theory (EST), not only do the individual factors such as child characteristics and child risk factors contribute to the child’s weight status, but also other factors such as parenting style and family characteristics, as well as community and demographic factors. This research is a quasi-experimental study. Participants were pre-school overweight and obese children and their parents. Forty-one parent-child dyads were recruited into the program. Parents participated in two sessions including an educational session and a group discussion session. Research methodology uses Paired-Samples t-test to determine the difference between groups in the mean scores of the outcome variables of the children and parents. The research results show that there was significant difference between child waist circumferences mean score at the baseline and finishing the program at the 0.01 level (p = 0.001), mean score of the child waist circumference was decrease after finishing the program. And there was no significant difference between child exercise health behaviors mean score at the baseline and finishing the program at the 0.05 level; however, mean score of the child exercise behavior was increase after finishing the program. Meanwhile, there was significant difference between child dietary health behavior mean score at the baseline and finishing the program at the 0.01 level (p = 0.001), mean score of the child dietary was increase after finishing the program.

Keywords: PTPOR, child waist circumference, child health behaviors, pre-school children

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Authors: Varsha Salian, Shama Rao, N. Narendra, B. Mohana Kumar

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Evolving evidence proposes the existence of a highly tumorigenic subpopulation of undifferentiated, self-renewing cancer stem cells, responsible for exhibiting resistance to conventional anti-cancer therapy, recurrence, metastasis and heterogeneous tumor formation. Importantly, the mechanisms exploited by cancer stem cells to resist chemotherapy are very less understood. Oral squamous cell carcinoma (OSCC) is one of the most regularly diagnosed cancer types in India and is associated commonly with alcohol and tobacco use. Therefore, the isolation and in vitro characterization of cancer stem-like cells from patients with OSCC is a critical step to advance the understanding of the chemoresistance processes and for designing therapeutic strategies. With this, the present study aimed to establish and characterize cancer stem-like cells in vitro from OSCC. The primary cultures of cancer stem-like cell lines were established from the tissue biopsies of patients with clinical evidence of an ulceroproliferative lesion and histopathological confirmation of OSCC. The viability of cells assessed by trypan blue exclusion assay showed more than 95% at passage 1 (P1), P2 and P3. Replication rate was performed by plating cells in 12-well plate and counting them at various time points of culture. Cells had a more marked proliferative activity and the average doubling time was less than 20 hrs. After being cultured for 10 to 14 days, cancer stem-like cells gradually aggregated and formed sphere-like bodies. More spheroid bodies were observed when cultured in DMEM/F-12 under low serum conditions. Interestingly, cells with higher proliferative activity had a tendency to form more sphere-like bodies. Expression of specific markers, including membrane proteins or cell enzymes, such as CD24, CD29, CD44, CD133, and aldehyde dehydrogenase 1 (ALDH1) is being explored for further characterization of cancer stem-like cells. To summarize the findings, the establishment of OSCC derived cancer stem-like cells may provide scope for better understanding the cause for recurrence and metastasis in oral epithelial malignancies. Particularly, identification and characterization studies on cancer stem-like cells in Indian population seem to be lacking thus provoking the need for such studies in a population where alcohol consumption and tobacco chewing are major risk habits.

Keywords: cancer stem-like cells, characterization, in vitro, oral squamous cell carcinoma

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Authors: A. Kourou, A. Ioakeimidou, E. Bafa, C. Fassoulas, M. Panoutsopoulou

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The role of volunteers in disaster management is of decisive importance and the need of their involvement is well recognized, both for prevention measures and for disaster management. During major catastrophes, whereas professional personnel are outsourced, the role of volunteers is crucial. In Greece experience has shown that various groups operating in the civil protection mechanism like local administration staff or volunteers, in many cases do not have the necessary knowledge and information on best practices to act against natural disasters. One of the major problems is the lack of volunteers’ education and training. In the above given framework, this paper presents the results of a survey aimed to identify the level of education and preparedness of civil protection volunteers in Greece. Furthermore, the implementation of earthquake protection measures at individual, family and working level, are explored. More specifically, the survey questionnaire investigates issues regarding pre-earthquake protection actions, appropriate attitudes and behaviors during an earthquake and existence of contingency plans in the workplace. The questionnaires were administered to citizens from different regions of the country and who attend the civil protection training program: “Protect Myself and Others”. A closed-form questionnaire was developed for the survey, which contained questions regarding the following: a) knowledge of self-protective actions; b) existence of emergency planning at home; c) existence of emergency planning at workplace (hazard mitigation actions, evacuation plan, and performance of drills); and, d) respondents` perception about their level of earthquake preparedness. The results revealed a serious lack of knowledge and preparedness among respondents. Taking into consideration the aforementioned gap and in order to raise awareness and improve preparedness and effective response of volunteers acting in civil protection, the EVANDE project was submitted and approved by the European Commission (EC). The aim of that project is to educate and train civil protection volunteers on the most serious natural disasters, such as forest fires, floods, and earthquakes, and thus, increase their performance.

Keywords: civil protection, earthquake, preparedness, volunteers

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Authors: Kabrambam D. Singh, Dinabandhu Sahoo, Yallappa Rajashekar

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Evolution has caused many insects to develop resistance to several synthetic insecticides. This problem along with the persisting concern regarding the health and environmental safety issues of the existing synthetic insecticides has urged the scientific fraternity to look for a new plant-based natural insecticide with inherent eco-friendly nature. Colocasia esculenta var. esculenta (L.) Schott (Araceae family) is widely grown throughout the South- East Asian Countries for its edible corms and leaves. Various physico-chemical and spectroscopic techniques (IR, 1H NMR, 13C NMR and Mass) were used for the isolation and characterization of isolated bioactive molecule named 2, 3-dimethylmaleic anhydride (3, 4-dimethyl-2, 5-furandione). This compound was found to be highly toxic, even at low concentration, against several storage grain pests when used as biofumigant. Experimental studies on the mode of action of 2, 3-dimethylmaleic anhydride revealed that the biofumigant act as inhibitor of acetylcholinesterase enzyme in cockroach and stored grain insects. The knockdown activity of bioactive compound is concurrent with in vivo inhibition of AChE; at KD99 dosage of bioactive molecule showed more than 90% inhibition of AChE activity in test insects. The molecule proved to affect the antioxidant enzyme system; superoxide dismutase (SOD), and catalase (CAT) and also found to decrease reduced glutathione (GSH) level in the treated insects. The above results indicate involvement of inhibition of AChE activity and oxidative imbalance as the potential mode of action of 2, 3-dimethylmaleic anhydride. In addition, the study reveals computational docking programs elaborate the possible interaction of 2, 3-dimethylmaleic anhydride with enzyme acetylcholinesterase (AChE) of Periplaneta americana. Finally, the results represent that toxicity of 2, 3-dimethylmaleic anhydride might be associated with inhibition of AChE activity and oxidative imbalance.

Keywords: 2, 3-dimethylmaleic anhydride, Colocasia esculenta var. esculenta (L.) Schott, Biofumigant, acetylcholinesterase, antioxidant enzyme, molecular docking

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Authors: Danilo A. F. Fontes, Magaly A. M.Lyra, Maria L. C. Moura, Leslie R. M. Ferraz, Salvana P. M. Costa, Amanda C. Q. M. Vieira, Larissa A. Rolim, Giovanna C. R. M. Schver, Ping I. Lee, Severino Alves-Júnior, José L. Soares-Sobrinho, Pedro J. Rolim-Neto

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Efavirenz (EFV) is a first-choice drug in antiretroviral therapy with high efficacy in the treatment of infection by Human Immunodeficiency Virus, which causes Acquired Immune Deficiency Syndrome (AIDS). EFV has low solubility in water resulting in a decrease in the dissolution rate and, consequently, in its bioavailability. Among the technological alternatives to increase solubility, the Lamellar Double Hydroxides (LDH) have been applied in the development of systems with poorly water-soluble drugs. The use of analytical techniques such as X-Ray Diffraction (XRD), Infrared Spectroscopy (IR) and Differential Scanning Calorimetry (DSC) allowed the elucidation of drug interaction with the lamellar compounds. The objective of this work was to characterize and develop the binary systems with EFV and LDH in order to increase the solubility of the drug. The LDH-CaAl was synthesized by the method of co-precipitation from salt solutions of calcium nitrate and aluminum nitrate in basic medium. The systems EFV-LDH and their physical mixtures (PM) were obtained at different concentrations (5-60% of EFV) using the solvent technique described by Takahashi & Yamaguchi (1991). The characterization of the systems and the PM’s was performed by XRD techniques, IR, DSC and dissolution test under non-sink conditions. The results showed improvements in the solubility of EFV when associated with LDH, due to a possible change in its crystal structure and formation of an amorphous material. From the DSC results, one could see that the endothermic peak at 173°C, temperature that correspond to the melting process of EFZ in the crystal form, was present in the PM results. For the EFZ-LDH systems (with 5, 10 and 30% of drug loading), this peak was not observed. XRD profiles of the PM showed well-defined peaks for EFV. Analyzing the XRD patterns of the systems, it was found that the XRD profiles of all the systems showed complete attenuation of the characteristic peaks of the crystalline form of EFZ. The IR technique showed that, in the results of the PM, there was the appearance of one band and overlap of other bands, while the IR results of the systems with 5, 10 and 30% drug loading showed the disappearance of bands and a few others with reduced intensity. The dissolution test under non-sink conditions showed that systems with 5, 10 and 30% drug loading promoted a great increase in the solubility of EFV, but the system with 10% of drug loading was the only one that could keep substantial amount of drug in solution at different pHs.

Keywords: Efavirenz, Lamellar Double Hydroxides, Pharmaceutical Techonology, Solubility

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Authors: Sasibhushan Yengala, Nelson Muthu, Subramani Kanagaraj

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The abstract reports on the design related to a modular and affordable standing cum sitting device to meet the requirements of paraplegic patients of the different physiques. Paraplegic patients need the assistance of an external arrangement to the lower limbs and trunk to help patients adopt the correct posture while standing abreast gravity. This support can be from a tilt table or a standing frame which the patient can use to stay in a vertical posture. Standing frames are devices fitting to support a person in a weight-bearing posture. Commonly, these devices support and lift the end-user in shifting from a sitting position to a standing position. The merits of standing for a paraplegic patient with a spinal injury are numerous. Even when there is limited control on muscles that ordinarily support the user using the standing frame in a vertical position, the standing stance improves the blood pressure, increases bone density, improves resilience and scope of motion, and improves the user's feelings of well-being by letting the patient stand. One limitation with standing frames is that these devices are typically function definitely; cannot be used for different purposes. Therefore, users are often compelled to purchase more than one of these devices, each being purposefully built for definite activities. Another concern frequent in standing frames is manoeuvrability; it is crucial to provide a convenient adjustment scope for all users. Thus, there is a need to provide a standing frame with multiple uses that can be economical for a larger population. There is also a need to equip added readjustment means in a standing frame to lessen the shear and to accommodate a broad range of users. The proposed Versatile Standing cum Sitting Device (VSD) is designed to change from standing to a comfortable sitting position using a series of mechanisms. First, a locking mechanism is provided to lock the VSD in a standing stance. Second, a dampening mechanism is provided to make sure that the VSD shifts from a standing to a sitting position gradually when the lock mechanism gets disengaged. An adjustment option is offered for the height of the headrest via the use of lock knobs. This device can be used in clinics for rehabilitation purposes irrespective of patient's anthropometric data due to its modular adjustments. It can facilitate the patient's daily life routine while in therapy and giving the patient the comfort to sit when tired. The device also provides the availability of rehabilitation to a common person.

Keywords: paraplegic, rehabilitation, spinal cord injury, standing frame

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Authors: Laleh Golamrej Eliasi

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Finland is the second most violent country for women in the European Union (EU). 47% of women in Finland claimed to have experienced domestic violence against women (DVAW), compared to an average of 33% in the EU. Although the statistics in Finland are transparent, to the author’s best knowledge, there are no statisticsonDV by nationality in Finland. On the other hand, being a Muslim woman in a non-Muslim-majority country represents a position of double vulnerability to violence. There are 10404 Afghan refugees in Finland who are Muslim. Barriers such as unfamiliarity with support services, fear of the police, racism, language, economic and practical dependence, social isolation, and family commitments all lead to a lack of reporting of DVAW among migrants. Although witnessing and experiencing DV have devastating effects on women’s and children’s health and well-being, there is a lack of studies about DVAW among Afghan families in Finland. To fill this knowledge gap, Afghan women living in Finland are selected as the target group to assess their views on DVAW and child protection. This study is implemented in the socio-ecological approach framework to assess the impacts of individual characteristics, interpersonal relationships, community, and society components on DVAW in Afghan families. Interviews with Afghan women and content analysis are used to find out participants' views on DVAW, its risk factors, and approaches and methods to improve protection for women and children. Main purpose is to obtain information about participants' views on the subject. The findings can be used to improve culturally safe social work knowledge and practices with a bottom-up approach to reduce DV and increase child protection. Therefore, this research can have important effects on the sustainable development of services and supports the welfare and inclusion of immigrant families. The expected results will contribute to sustainable gender equality, which is in line with the fifth goal of the Sustainable Development Goals.

Keywords: domestic violence, immigrant women, immigrant child protection, social work

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Authors: Leticia Leandro Rade, Amanda Silva de Sousa, Suman Das, Wesley Generoso, Mayara Chagas Ávila, Plinio Salmazo Vieira, Antonio Bonomi, Gabriela Persinoti, Mario Tyago Murakami, Thomas Michael Makris, Leticia Maria Zanphorlin

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Alkenes have an economic appeal, especially in the biofuels field, since they are precursors for drop-in biofuels production, which have similar chemical and physical properties to the conventional fossil fuels, with no oxygen in their composition. After the discovery of the first P450 CYP152 OleTJE in 2011, reported with its unique property of decarboxylating fatty acids (FA), by using hydrogen peroxide as a cofactor and producing 1-alkenes as the main product, the scientific and technological interest in this family of enzymes vastly increased. In this context, the present work presents a new decarboxylase (OleTRN) with low similarity with OleTJE (32%), its biochemical characterization, and structure elucidation. As main results, OleTRN presented a high yield of expression and purity, optimum reaction conditions at 35 °C and pH from 6.5 to 8.0, and higher specificity for oleic acid. Besides that, structure-guided mutations were performed and according to the functional characterizations, it was observed that some mutations presented different specificity and chemoselectivity by varying the chain-length of FA substrates from 12 to 20 carbons. These results are extremely interesting from a biotechnological perspective as those characteristics could diversify the applications and contribute to designing better cytochrome P450 decarboxylases. Considering that peroxygenases have the potential activity of decarboxylating and hydroxylating fatty acids and that the elucidation of the intriguing mechanistic involved in the decarboxylation preferential from OleTJE is still a challenge, the elucidation of OleTRN structure and the functional characterizations of OleTRN and its mutants contribute to new information about CYP152. Besides that, the work also contributed to the discovery of a new decarboxylase with a different selectivity profile from OleTJE, which allows a wide range of applications.

Keywords: P450, decarboxylases, alkenes, biofuels

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Authors: Tracey Lion-Cachet

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Eating disorders typically manifest in adolescence and are notoriously difficult to treat. There are two notable reasons for this. Firstly, research consistently demonstrates that early intervention is a critical mediator of prognosis, with early intervention leading to a better prognosis. However, because eating disorders do not originate as full-syndrome diagnoses but rather as prodromal cases, they often go undetected; by the time symptoms meet diagnostic criteria, they have become recalcitrant. Another interrelated issue is motivation to change. Research demonstrates that in the early stages of an eating disorder, adolescents are highly resistant to change, and motivation increases only once symptoms have shifted from egosyntonic to egodystonic in nature. The purpose of this project was to design a prevention model based on the social psychology paradigm of Entertainment-Education, which embeds messages within the genre of film as a means of affecting change. The resulting project was a narrative screenplay targeting teenagers/young adults from diverse backgrounds. The goals of the project were to create a film script that, if ultimately made into a film, could serve to: 1) interrupt symptom progression and improve prognosis through early intervention; 2) incorporate techniques from third-wave cognitive behavioral treatment models, acceptance and commitment therapy (ACT) and rational recovery (RR), with a focus on the effects of mindfulness as a means of informing recovery; 3) target issues to do with motivation to change by shifting the perception of eating disorders from culturally specific psychiatric illnesses to habit-based brain wiring issues. Nine licensed clinicians were asked to evaluate two excerpts taken from the final script. They subsequently provided feedback on a Likert-scale, which assessed whether the script had achieved its goals. Overall, evaluators agreed that the project’s etiological and intervention models have the potential to inspire change and serve as an effective means of prevention and treatment of eating disorders. However, one-third of the evaluators did not find the content developmentally appropriate. This is a notable limitation to the study and will need to be addressed in the larger script before the final project can potentially be targeted to a teenage and young adult audience.

Keywords: adolescents, eating disorders, pediatrics, entertainment-education, mindfulness-based intervention, prevention

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Authors: Maria Ashitko

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The Constitution of the Republic of Belarus is based on the principle of the unity of rights and obligations, including those of the child. The constitutional status of the child is aspecific system of constitutional elements established and guaranteed by the state through the current legislation and regulatory acts that ensure the special legal status of the child, his or her constitutional legal capacity, implementation of the principles of the constitutional and legal status of the child, constitutional rights of the child and their safeguards. Under the principles of the constitutional status of the child, we consider the general, normative, social-volitional rules of behavior established by the Constitution of the Republic of Belarus, laws and other regulatory acts that determine the content and social purpose of the legal status of the child. The constitutional and legal status of the child is characterized by the following special principles, which form a feature of the state legal system:1) Ensuring the interests of the child means providing for the child in accordance with his or her age, state of health, characteristics of development, life experience, family life, cultural traditions, ethnicity. 2) The principle of equal responsibility of both parents or their substitutes characterized by caring for the next generation as one of the priority tasks of the state and society, and all issues related to the implementation of children’s rights should be addressed at the constitutional level. 3) We would like to highlight such a special principle as the subprinciple of safeguards, which is the principle of ensuring the safety of the child. It is also worth noting that in legal studies, there is no relationship between safety and constitutional rights as general safeguards of individual rights and freedoms, and as special safeguards for the right to life. 4) The principle of justice is expressed by the fact that in modern conditions, the quality of life is determined not only by material wealth but also by the ability of the state to ensure the harmonization of social relations and social harmony on the basis of humanism and justice. Thus, the specificity of the constitutional status of the child is the age boundary between adulthood and minority; therefore, we propose to highlight the age characteristics of the child as an additional element. It is advisable to highlight such a special principle as the subprinciple of safeguards, which is the principle of ensuring the safety of the child.

Keywords: children’s rights, constitutional status, constitutional principles, constitutional rights

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Authors: Dusanee Suwankhong, Pranee Liamputtong

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Mothers living with HIV tend to experience stigma and discrimination which has an impact on their psychological and social well-being and their human rights. This paper explores the lived experience of Thai mothers with HIV in their family. In-depth interviewing and drawing methods were employed to gain a deep understanding on the experience of 30 HIV-positive mothers in the southern community of Thailand. The data was analyzed using thematic analysis method. We found that the majority of HIV-positive mothers learned about their HIV status through blood test services during their antenatal care, but some decided to visit a doctor when their partner became chronically frail and showed some signs indicating HIV/AIDS. Learning about their HIV gave them a great shock, and they could not believe that they were infected with HIV/AIDS. They feared that their illness would be disclosed and hence attempted to keep their HIV secret. This was due to the fact that people in their community would blame and labeled them as a ‘disgusting person’. Besides, they would be separated from social contacts and networks, their individual rights would be disregarded, and their potential roles would be restricted. Although participants suggested that people had more positive view on HIV-infected person nowadays, all still wanted to keep it secret because of fear of stigma and discrimination. Thai health care has provided various kinds of support programs, but many mothers chose not to participate due to the fear of disclosure. However, the women attempted to seek some strategies to live a life which would be more acceptable by the community. We conclude that HIV is still seen as a stigmatised disease in rural community of southern Thailand. Local health care providers and relevant sectors in the locality should create suitable programs to enhance self-worth among those HIV-positive mothers because this could increase a quality of life of this vulnerable mothers. Providing sufficient and appropriate supports for better emotional wellbeing is an essential role of health professionals so that the feeling of isolation among these women could be eliminated and positive social justice can be achieved.

Keywords: HIV-positive mothers, lived experience, southern Thailand, stigma and discrimination

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Authors: Ajay Gogia, Svs Deo, Dn Sharma, Atul Batra, Ashutash Mishra

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Background and Aims: Breast cancer in women aged less than 25 years (defined as very young breast cancer, VYBC) is rare and accounts for 0.25% of all breast cancer in the West. There is no data available on VYBC from developing countries. The aim of this study was to analyze the clinical, pathological, and prognostic factors and outcomes in VYBC. Methods: This retrospective analysis was performed on 80 patients aged 25 years or less (screened 8000 files of female BC) who were registered at All India Institute of Medical Sciences (AIIMS), New Delhi, India, over a 15-year period between 2011 and 2023. Results: The median age was 21.5 years (range 16-25). A positive family history (siblings and parents) was elicited in 30% of cases, and breast cancer gene (BRCA1/2) mutation was found in 33% of cases patients. Ten patients (12.5%) patients have pregnancy-associated breast cancer (BC detected during pregnancy or 1 year after postpartum period). The TNM stage distribution was Stage I was 0, stage II -30%, stage III –60% and Stage IV -10 %patients. Seventy percent of tumors were high grade, and 90% had pathological node-positive disease. Estrogen, Progesterone, and human epidermal growth factor receptor 2 (HER2)/neu positivity were 25%,25% and 35%, respectively. Triple-negative breast cancer constituted 40% of patients. With a median follow-up of 42 months, 3 years, relapse-free survival (nonmetastatic disease), progression-free survival (metastatic disease) and overall survival were 30%, 15% and 50%, respectively. Conclusions: Very young women constituted 1% of all breast cancer cases. Advanced disease at presentation and high-risk pathological features result in poor outcomes. One-third of VYBCs are associated with BRCA mutation, which requires genetic counseling and risk reduction surgery if required. Due to the aggressive behavior of BC in this age group, need early diagnosis and prompt treatment

Keywords: very young, breast cancer, outcome, developing country, India

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