Search results for: intrauterine fetal death

Authors: Hashem M. Alargha, Mohammad O. Hamdan, Waseem H. Aziz

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Aerobatic and military pilots are subjected to high gravitational forces that could cause blackout, physical injuries or death. A CFD simulation using fluid-solid interactions scheme has been conducted to investigate the gravitational effects and hazards inside cerebral aneurysms. Medical data have been used to derive the size and geometry of a simple aneurysm on a T-shaped bifurcation. The results show that gravitational force has no effect on maximum Wall Shear Stress (WSS); hence, it will not cause aneurysm initiation/formation. However, gravitational force cause causes hypertension which could contribute to aneurysm rupture.

Keywords: aneurysm, cfd, wall shear stress, gravity, fluid dynamics, bifurcation artery

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Authors: Diwei Lin, Amanda Jia Hui Tan

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In 2012, testicular cancer was estimated to account for 940 disability adjusted life years in Australia; of these, 450 were years lost due to premature death and 500 were years of healthy life lost due to disease, disability or injury. Testicular choriocarcinoma is one of the rarest variants of testicular germ cell tumours, accounting for less than 1% of testicular germ cell tumours and only about 0.19% of all testicular tumours. Management involves radical orchiectomy followed by chemotherapy. Even then, the prognosis is extremely poor. This case report describes a 20-year-old male with pure testicular choriocarcinoma with pulmonary metastases.

Keywords: testicular cancer, choriocarcinoma, cryptorchidism, chemotherapy, metastatic testicular cancer

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Authors: Maryam Nazari, Atefeh Ghanbari, Saghar Noorinia

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Obesity, as an abnormal or excessive accumulation of fat, is caused by genetic, behavioral and environmental factors. Recently, obesity surgeries, such as bariatric surgery, as the last measure to control obesity, have attracted experts and society, especially women, attention, so knowing the possible complications of this major surgery and their control in reproductive age is of particular importance due to its effects on pregnancy outcomes. Bariatric surgery reduces the risk of diabetes and high blood pressure associated with pregnancy, premature birth, macrosomia, stillbirth and dumping syndrome. Although in the first months after surgery, nausea and vomiting caused by changes in intra-abdominal pressure are associated with an increased risk of malabsorption of micronutrients such as folic acid, iron, vitamin B1, D, calcium, selenium and phosphorus and finally, fetal growth disorder. Moreover, serum levels of micronutrients such as vitamin D, calcium, and iron in mothers who used to have bariatric surgery and their babies have been shown to be lower than in mothers without a history of bariatric surgery. Moreover, vitamin A deficiency is shown to be more widespread in pregnancies after bariatric surgery, which leads to visual problems in newborns and premature delivery. However, complications such as the duration of hospitalization of newborns in the NICU, disease rate in the first 28 days of life and congenital anomalies are not significantly different in babies born to mothers undergoing bariatric surgery compared to the control group. In spite of the vast advantages following obesity surgeries, due to the catabolic conditions and severe weight loss followed by such major intervention and the probability of nutrients malnutrition in a pregnant woman and her baby, after having surgery, at least 12 to 18 months should be considered to get pregnant as a recovery period. In addition, taking essential supplements before and at least 6 months after this approach is recommended.

Keywords: bariatric surgery, pregnancy, malnutrition, vitamin and mineral deficiency

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Authors: Oluwaponmile David Alao

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Due to an increase in the death rate as a result of heart attack. There is need to develop a system that can be useful in the diagnosis of the disease at the medical centre. This system will help in preventing misdiagnosis that may occur from the medical practitioner or the physicians. In this research work, heart disease dataset obtained from UCI repository has been used to develop an intelligent prediction diagnosis system. The system is modeled on a feedforwad neural network and trained with back propagation neural network. A recognition rate of 86% is obtained from the testing of the network.

Keywords: heart disease, artificial neural network, diagnosis, prediction system

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Authors: Arlan S. Freitas, Leila M. Carvalho, Adriana L. Soares, Arnoud Neto, Marta S. Madruga, Elza I. Ida, Massami Shimokomaki

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The objective of this work was to evaluate the influence of microclimatic profile of broiler transport trucks under commercial conditions over the breast meat quality and DOA (Death On Arrival) in a tropical Brazilian regions as the North East where routinely the season is divided into dry and wet seasons. The temperature remains fairly constant and obviously the relative humidity changes accordingly. Three loads of 4,100 forty seven days old broiler were monitored from farm to slaughterhouse in a distance of 4.3 km, morning period of October 2015 rainy days. The profile of the environmental variables inside the container truck throughout the journey was obtained by the installation of thermo anemometers in 6 different locations by monitoring the heat index (HI), air velocity (AV), temperature (T), and relative humidity (RH). Meat qualities were evaluated by determining the occurrence of PSE (pale, soft, exudative) meat and DFD (dark, firm dry) meat. The percentage of birds DOA per loaded truck was determined by counting the dead broiler during the hanging step at the slaughtering plant. The analysis of variance was performed using statistical software (Statistica 8 for windows, Statsoft 2007, Tulsa, OK, USA). The Tukey significance test (P<0.05) was applied to compare means from microenvironmental data, PSE, DFD and DOA. Fillet samples were collected at 24h post mortem for pH e color (L*, a* e b*) determination through the CIELAB system. Results showed the occurrence of 2.98% of PSE and 0.66% de DFD and only 0.016% of DOA and overall the most uncomfortable container location was at the truck frontal inferior presenting 6.25% of PSE. DFD of 2.0% were obtained from birds located at central and inferior rear locations. These values were unexpected in comparison to other results obtained in our laboratories in previous experiments carried out within the country south state. The results reported herein were lower in every aspect. Reasonable explanation would be the shorter distance, wet conditions throughout around 15-20 min journeys and lower T and RH values as observed in samples taken from the rear location as higher DFD values were obtained. These facts mean the animals were not under heat stressful condition but in fact under cold stress conditions as the result of DFD suggested in association to the lower number of DOA.

Keywords: cold stress, DFD, microclimatic profile, PSE

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Authors: Y. S. Yusoff, G. Streftaris, H. R Waters

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Death within 30 days is an important factor to be looked into, as there is a significant risk of deaths immediately following or soon after, Myocardial Infarction (MI) or stroke. In this paper, we will model the deaths within 30 days following a Myocardial Infarction (MI) or stroke in the UK. We will see how the probabilities of sudden deaths from MI or stroke have changed over the period 1981-2000. We will model the sudden deaths using a Generalized Linear Model (GLM), fitted using the R statistical package, under a Binomial distribution for the number of sudden deaths. We parameterize our model using the extensive and detailed data from the Framingham Heart Study, adjusted to match UK rates. The results show that there is a reduction for the sudden deaths following a MI over time but no significant improvement for sudden deaths following a stroke.

Keywords: sudden deaths, myocardial infarction, stroke, ischemic heart disease

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Authors: John Hang Leung, Shyh-Yau Wang, Hei-Tung Yip, Fion, Ho Tsung-chin, Agnes LF Chan

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Objectives: Platinum-resistant ovarian cancer has a short overall survival of 9–12 months and limited treatment options. The combination of immunotherapy and targeted therapy appears to be a promising treatment option for patients with ovarian cancer, particularly to patients with platinum-resistant recurrent ovarian cancer (PRrOC). However, there are no direct head-to-head clinical trials comparing their efficacy and toxicity. We, therefore, used a network to directly and indirectly compare seven newer immunotherapies or targeted therapies combined with chemotherapy in platinum-resistant relapsed ovarian cancer, including antibody-drug conjugates, PD-1 (Programmed death-1) and PD-L1 (Programmed death-ligand 1), PARP (Poly ADP-ribose polymerase) inhibitors, TKIs (Tyrosine kinase inhibitors), and antiangiogenic agents. Methods: We searched PubMed (Public/Publisher MEDLINE), EMBASE (Excerpta Medica Database), and the Cochrane Library electronic databases for phase II and III trials involving PRrOC patients treated with immunotherapy or targeted therapy plus chemotherapy. The quality of included trials was assessed using the GRADE method. The primary outcomes compared were progression-free survival, the secondary outcomes were overall survival and safety. Results: Seven randomized controlled trials involving a total of 2058 PRrOC patients were included in this analysis. Bevacizumab plus chemotherapy showed statistically significant differences in PFS (Progression-free survival) but not OS (Overall survival) for all interested targets and immunotherapy regimens; however, according to the heatmap analysis, bevacizumab plus chemotherapy had a statistically significant risk of ≥grade 3 SAEs (Severe adverse effects), particularly hematological severe adverse events (neutropenia, anemia, leukopenia, and thrombocytopenia). Conclusions: Bevacizumab plus chemotherapy resulted in better PFS as compared with all interested regimens for the treatment of PRrOC. However, statistical differences in SAEs as bevacizumab plus chemotherapy is associated with a greater risk for hematological SAE.

Keywords: platinum-resistant recurrent ovarian cancer, network meta-analysis, immune checkpoint inhibitors, target therapy, antiangiogenic agents

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Authors: James Boylan, Denny Meyer, Won Sun Chen

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Background: Globally, there is an increasing trend of road traffic deaths, reaching 1.35 million in 2016 in comparison to 1.3 million a decade ago, and overall, road traffic injuries are ranked as the eighth leading cause of death for all age groups. The reported death rate for younger drivers aged 16-19 years is almost twice the rate reported for older drivers aged 25 and above, with a rate of 3.5 road traffic fatalities per annum for every 10,000 licenses held. Telematics refers to a system with the ability to capture real-time data about vehicle usage. The data collected from telematics can be used to better assess a driver's risk. It is typically used to measure acceleration, turn, braking, and speed, as well as to provide locational information. With the Australian government creating the National Telematics Framework, there has been an increase in the government's focus on using telematics data to improve road safety outcomes. The purpose of this study is to test the hypothesis that improvements in telematics measured driving behaviour to relate to improvements in road safety attitudes measured by the Driving Behaviour Questionnaire (DBQ). Methodology: 28 participants were recruited and given a telematics device to insert into their vehicles for the duration of the study. The participant's driving behaviour over the course of the first month will be compared to their driving behaviour in the second month to determine whether feedback from telematics devices improves driving behaviour. Participants completed the DBQ, evaluated using a 6-point Likert scale (0 = never, 5 = nearly all the time) at the beginning, after the first month, and after the second month of the study. This is a well-established instrument used worldwide. Trends in the telematics data will be captured and correlated with the changes in the DBQ using regression models in SAS. Results: The DBQ has provided a reliable measure (alpha = .823) of driving behaviour based on a sample of 23 participants, with an average of 50.5 and a standard deviation of 11.36, and a range of 29 to 76, with higher scores, indicating worse driving behaviours. This initial sample is well stratified in terms of gender and age (range 19-27). It is expected that in the next six weeks, a larger sample of around 40 will have completed the DBQ after experiencing in-vehicle telematics for 30 days, allowing a comparison with baseline levels. The trends in the telematics data over the first 30 days will be compared with the changes observed in the DBQ. Conclusions: It is expected that there will be a significant relationship between the improvements in the DBQ and the trends in reduced telematics measured aggressive driving behaviours supporting the hypothesis.

Keywords: telematics, driving behavior, young drivers, driving behaviour questionnaire

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Authors: Juneseok You, Kuewhan Jang, Chanho Park, Jaeyeong Choi, Hyunjun Park, Sehyun Shin, Changsoo Han, Sungsoo Na

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Nanomaterials occur toxic effects to human being or ecological systems. Some sensors have been developed to detect toxic materials and the standard for toxic materials has been established. Zinc oxide nanowire (ZnO NW) is known for toxic material. By ionizing in cell body, ionized Zn ions are overexposed to cell components, which cause critical damage or death. In this paper, we detected ZnO NW in water using QCM (Quartz Crystal Microbalance) and ssDNA (single strand DNA). We achieved 30 minutes of response time for real time detection and 100 pg/mL of limit of detection (LOD).

Keywords: zinc oxide nanowire, QCM, ssDNA, toxic material, biosensor

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Authors: Danielle G. Saique

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Introduction: Promoting Gender Equality, Equity and Empowerment of Women (GEE&EW) can be attained by practicing thereby exercising Sexual and Reproductive Health and Rights (SRHR). Gender Inequality is manifested thru Violence Against Women (VAW). Objectives: This study presents causes, prevalence, effects of Gender Inequality for not practicing and violating SRHR. This proposes Action Plan by promoting, integrating SRHR in the “holistic approach” of Social Work education, practice and service-delivery in any work-set-ups. Limitations: VAW cases showed victim and violator are known, related and living together. Cases transpired at home, reported, investigated in the police and filed in the legal court of law for the year 2013. Methods: Data from blotters, reports, filed cases, case studies gathered by the Social Worker (SWr). Qualitative analysis identified cause, prevalence of VAW related in violating SRHR. SWr serves innovative interventions in any work settings by applying SRHR background, skills in educating, counseling client-victims. Results: 65 VAW cases on non-negotiation or refusal of practicing SRHR. Non-acceptance of Family Planning yielded unwanted, unplanned pregnancies, abandoned children, battered women. Neglected pre-post natal maternal care caused complications or death. Rape, incest led trauma or death. Unsafe, unprotected sex transmitted STDs. Conclusions: Non-availing SRHR from health facilities, from Medical Health SWr concluded to non-practicing or violating rights to life, health care, protection, rights to information, education, rights to plan family, rights from torture, ill-treatment. VAW brings undesirable effects to the well-being, wellness and humaneness of the victim. Recommendations: The innovative intervention services on SRHR of a SWr and the findings, results in violating SRHR are recommendations in Action Planning by adding “The SRHR Concepts” in Social Work thereby preventing VAW; empowering women’s rights to development, gender equality, equity liberty, security, freedom; resilience and involvement in promoting, practicing, exercising SRHR at home. Recommended therefore to duplicate this innovative practice and experience on SRHR as implemented by the SWr in any work setting.

Keywords: women development, promoting gender equality, equity, empowerment of women

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Authors: Messaouda Belaid, Salima Kebbouche-Gana

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The negative effect of the Varroa bee colony is very important. They cause morphological and physiological changes, causing a decrease in performance of individuals and long-term death of the colony. Indirectly, they weaken the bees become much more sensitive to the different pathogenic organisms naturally present in the colony. This work aims to research secondary infections of microbial origin occurred in the worker bee nurse due to parasitism by Varroa destructor. The feeding behaviour of Varroa may causes damaging host integument. The results show that the microbial contamination enable to be transmitted into honeybee heamocoel are Bacillus sp, Pseudomonas sp, Enterobacter, Aspergillus.

Keywords: honeybee, Apis mellifera intermissa, microbial contamination, Varroa destructor

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Authors: Ortega Ivan, De La Plaza Edurne

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Background: Spain and other European countries have implemented Uncontrolled Donation after Cardiac Death (uDCD) programs. After 15 years of experience in Spain, many things have changed. Recent evidence and technical breakthroughs achieved in resuscitation are relevant for uDCD programs and raise some ethical concerns related to these protocols. Aim: To rethink current uDCD programs in the light of recent evidence on available therapeutic procedures applicable to victims of out-of-hospital cardiac arrest (OHCA). To address the following question: What is the current standard of treatment owed to victims of OHCA before including them in an uDCD protocol? Materials and Methods: Review of the scientific and ethical literature related to both uDCD programs and innovative resuscitation techniques. Results: 1) The standard of treatment received and the chances of survival of victims of OHCA depend on whether they are classified as Non-Heart Beating Patients (NHBP) or Non-Heart-Beating-Donors (NHBD). 2) Recent studies suggest that NHBPs are likely to survive, with good quality of life, if one or more of the following interventions are performed while ongoing CPR -guided by suspected or known cause of OHCA- is maintained: a) direct access to a Cath Lab-H24 or/and to extra-corporeal life support (ECLS); b) transfer in induced hypothermia from the Emergency Medical Service (EMS) to the ICU; c) thrombolysis treatment; d) mobile extra-corporeal membrane oxygenation (mini ECMO) instituted as a bridge to ICU ECLS devices. 3) Victims of OHCA who cannot benefit from any of these therapies should be considered as NHBDs. Conclusion: Current uDCD protocols do not take into account recent improvements in resuscitation and need to be adapted. Operational criteria to distinguish NHBDs from NHBP should seek a balance between the technical imperative (to do whatever is possible), considerations about expected survival with quality of life, and distributive justice (costs/benefits). Uncontrolled DCD protocols can be performed in a way that does not hamper the legitimate interests of patients, potential organ donors, their families, the organ recipients, and the health professionals involved in these processes. Families of NHBDs’ should receive information which conforms to the ethical principles of respect of autonomy and transparency.

Keywords: uncontrolled donation after cardiac death resuscitation, refractory cardiac arrest, out of hospital cardiac, arrest ethics

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Authors: Mauricio Quintero Angel, Alexander Pereira, Selene Alarcón

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One of the elements of greatest importance in agricultural production is the harvesting; an activity associated to different occupational health risks such as harvesting in high altitudes, the transport of heavy materials and the application of excessive muscle strain that leads to muscular-bone disorders. Therefore, there is an urgent necessity to improve and validate interventions to reduce exposition and risk to harvesters. This article has the objective of describing the co-development under the ergonomic analysis framework of an assisted manual harvesting tool for peach palm oriented to reduce the risk of death and accidents as it avoid the harvest in heights. The peach palm is a palm tree that is cultivated in Colombia, Perú, Brasil, Costa Rica, among others and that reaches heights of over 20 m, with stipes covered with spines. The fruits are drupes of variable size. For the harvesting of peach palm, in Colombia farmers use the “Marota” or “Climber”, a tool in a closed X shape built in wood, that has two supports adjusted at the stipe, that elevate alternately until reaching a point high enough to grab the bunch that is brought down using a rope. An activity of high risk since it is done at a high altitude without any type of protection and safety measures. The Marota is alternated with a rod, which as variable height between 5 and 12 Meters with a harness system at one end to hold the bunch that is lowered with the whole system (bamboo bunch). The rod is used from the ground or from the Marota in height. As an alternative to traditional tools, the Bajachonta was co-developed with farmers, a tool that employs a traditional bamboo hook system with modifications, to be able to hold it with a rope that passes through a pulley. Once the bunch is hitched, the hook system is detached and this stays attached to the peduncle of the palm tree, afterwards through a pulling force being exerted towards the ground by tensioning the rope, the bunch comes loose to be taken down using a rope and the pulley system to the ground, reducing the risk and efforts in the operation. The bajachonta was evaluated in tree productive zones of Colombia, with innovative farmers, were the adoption is highly probable, with some modifications to improve its efficiency and effectiveness, keeping in mind that the farmers perceive in it an advantage in the reduction of death and accidents by not having to harvest in heights.

Keywords: assisted harvesting, ergonomics, harvesting in high altitudes, participative design, peach palm

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Authors: Qamar J. A. Khan, Fatma Ahmed Al Kharousi

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A prey-predator eco-epidemiological model is studied where transmission of the disease between infected and uninfected prey is nonlinear. The interaction of the predator with infected and uninfected prey species depend on their numerical superiority. Harvesting of both uninfected and infected prey is considered. Stability analysis is carried out for equilibrium values. Using the parameter µ, the death rate of infected prey as a bifurcation parameter it is shown that Hopf bifurcation could occur. The theoretical results are compared with numerical results for different set of parameters.

Keywords: bifurcation, optimal harvesting, predator, prey, stability

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Authors: Ainur Mukhambetova, Miras Karzhauov, Vyacheslav Ogay

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Introduction: Mesenchymal stem cells (MSCs) have the capacity to be differentiated into several cell lineages and are a promising source for cell therapy and tissue engineering. However, currently most MSCs culturing protocols use media supplemented with fetal bovine serum (FBS), which limits their application in clinic due to the possibility of zoonotic infections, contamination and immunological reactions. Consequently, formulating effective serum free culture medium becomes one of the important problems in contemporary cell biotechnology. Objectives: The aim of this study was to define an optimal serum-free medium for culturing of periosteum derived MSCs. Materials and methods: The MSCs were extracted from human periosteum and transferred to the culture flasks pretreated with CELLstart™. Immunophenotypic characterization, proliferation and in vitro differentiation of cells grown on STEM PRO® MSC SFM were compared to the cells cultured in the standard FBS containing media. Chromosome analysis and flow cytometry were also performed. Results: We have shown that cells were grown on STEM PRO® MSC SFM retained all the morphological, immunophenotypic (CD73, CD90, CD105, vimentin and Stro-1) and cell differentiation characteristics specific to MSCs. Chromosome analysis indicated no anomalies in the chromosome structure. Flow cytometry showed a high expression of cell adhesion molecules CD44 (98,8%), CD90 (97,4%), CD105 (99,1%). In addition, we have shown that cell is grown on STEM PRO® MSC SFM have higher proliferation capacity compared to cell expanded on standard FBS containing the medium. Conclusion: We have shown that STEM PRO® MSC SFM is optimal for culturing periosteum derived human MSCs which subsequently can be safely used in cell therapy.

Keywords: cell technologies, periosteum-derived MSCs, regenerative medicine, serum-free medium

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Authors: José Ramón López-Mínguez, Estrella Suárez-Corchuelo, Sergio López-Tejero, Luis Nombela-Franco, Xavier Freixa-Rofastes, Guillermo Bastos-Fernández, Xavier Millán-Álvarez, Raúl Moreno-Gómez, José Antonio Fernández-Díaz, Ignacio Amat-Santos, Tomás Benito-González, Fernando Alfonso-Manterola, Pablo Salinas-Sanguino, Pedro Cepas-Guillén, Dabit Arzamendi, Ignacio Cruz-González, Juan Manuel Nogales-Asensio

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Background and objectives: The treatment of patients with non-valvular atrial fibrillation (NVAF) who need coronary stenting is challenging. The objective of the study was to determine whether left atrial appendage occlusion (LAAO) could be a feasible option and benefit these patients. To this end, we studied the impact of LAAO plus antiplatelet drugs vs oral anticoagulants (OAC) (including direct OAC) plus antiplatelet drugs in these patients’ long-term outcomes. Methods: The results of 207 consecutive patients with NVAF who underwent coronary stenting were analyzed. A total of 146 patients were treated with OAC (75 with acenocoumarol, 71 with direct OAC) while 61 underwent LAAO. The median follow-up was 35 months. Patients also received antiplatelet therapy as prescribed by their cardiologist. The study received the proper ethical oversight. Results: Age (mean 75.7 years), and the past medical history of stroke were similar in both groups. However, the LAAO group had more unfavorable characteristics (history of coronary artery disease [CHA2DS2-VASc], and significant bleeding [BARC ≥ 2] and HAS-BLED). The occurrence of major adverse events (death, stroke/transient ischemic events, major bleeding) and major cardiovascular events (cardiac death, stroke/transient ischemic attack, and myocardial infarction) were significantly higher in the OAC group compared to the LAAO group: 19.75% vs 9.06% (HR, 2.18; P = .008) and 6.37% vs 1.91% (HR, 3.34; P = .037), respectively. Conclusions: In patients with NVAF undergoing coronary stenting, LAAO plus antiplatelet therapy produced better long-term outcomes compared to treatment with OAC plus antiplatelet therapy despite the unfavorable baseline characteristics of the LAAO group.

Keywords: stents, atrial fibrillation, anticoagulants, left atrial appendage occlusion

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Authors: Jan Gayl Barcelon, N. Gorgonio

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Renal tubular acidosis, a medical condition that involves the accumulation of acid in the body due to failure of the kidneys to maintain normal urine and blood pH, is rarely encountered in pregnancy. The effect of renal tubular acidosis in pregnancy is not fully established. It may worsen during pregnancy and cause maternal and fetal morbidity. A 30-year-old primigravida was diagnosed with renal tubular acidosis at age 7, but due to uncontrolled disease progression, she developed rickets at age 10. She was first seen in our institution at eight weeks gestation and maintained on bicarbonate and potassium supplementation. At 26 weeks gestation, she was diagnosed with polyhydramnios, causing on and off irregular uterine contractions. At 30 weeks gestation, despite oral Nifedipine, premature labor was uncontrolled; hence she was admitted for tocolysis. With elevated creatinine (123 umol/L) and a normal blood urea nitrogen level (6.70 mmol/L), she was referred to Nephrology Service, which cleared the patient prior to MgSO₄ drip. Dosing of 4g MgSO₄ over 20 minutes followed by a maintenance of 2g/hour x 24 hours for neuroprotection and tocolysis was ordered. Two hours after MgSO₄ drip initiation, hematuria developed with adequate urine output. The infusion was immediately stopped. The serum magnesium level was high normal at 6.7 mEq/L. After 4 hours of renal clearance, the repeat serum magnesium level was normal (2.7 mEq/L) and with clear urine output. The patient was then given Nifedipine 30mg/tab, 3x a day which controlled the uterine contractions. At 37 weeks gestation, the patient delivered via primary low transverse Cesarean Section to a live female with a birthweight of 2470gm, appropriate for gestational age. The use of MgSO₄ for the control of premature labor in patients with chronic renal disease secondary to renal tubular can cause hematuria.

Keywords: hematuria, magnesium sulfate, premature labor, renal tubular acidosis

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Authors: Desjardin, Michaels, Martinez, Ulmann

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Copper IUD is one of the most efficient and cost-effective contraception. However, pain at insertion hampers the use of this method. This is especially unfortunate in nulliparous women, often younger, who are excellent candidates for this contraception, including Emergency Contraception. Standard insertion procedure of a copper IUD usually involves measurement of uterine cavity with an hysterometer and the use of a tenaculum in order to facilitate device insertion. Both procedures lead to patient pain which often constitutes a limitation of the method. To overcome these issues, we have developed a modified insertor combined with a copper IUD. The singular design of the inserter includes a flexible inflatable membrane technology allowing an easy access to the uterine cavity even in case of abnormal uterine positions or narrow cervical canal. Moreover, this inserter makes possible a direct IUD insertion with no hysterometry and no need for tenaculum. To assess device effectiveness and patient-reported pain, a study was conducted at two clinics in Fance with 31 individuals who wanted to use a copper IUD as contraceptive method. IUD insertions have been performed by four healthcare providers. Operators completed questionnaire and evaluated effectiveness of the procedure (including IUD correct fundal placement and other usability questions) as their satisfaction. Patient also completed questionnaire and pain during procedure was measured on a 10-cm Visual Analogue Scale (VAS). Analysis of the questionnaires indicates that correct IUD placement took place in more than 93% of women, which is a standard efficacy rate. It also demonstrates that IUD insertion resulted in no, light or moderate pain predominantly in nulliparous women. No insertion resulted in severe pain (none above 6cm on a 10-cm VAS). This translated by a high level of satisfaction from both patients and practitioners. In addition, this modified inserter allowed a simplification of the insertion procedure: correct fundal placement was ensured with no need for hysterometry (100%) prior to insertion nor for cervical tenaculum to pull on the cervix (90%). Avoidance of both procedures contributed to the decrease in pain during insertion. Taken together, the results of the study demonstrate that this device constitutes a significant advance in the use of copper IUDs for any woman. It allows a simplification of the insertion procedure: there is no need for pre-insertion hysterometry and no need for traction on the cervix with tenaculum. Increased comfort during insertion should allow a wider use of the method for nulliparous women and for emergency contraception. In addition, pain is often underestimated by practitioners, but fear of pain is obviously one of the blocking factors as indicated by the analysis of the questionnaire. This evaluation brings interesting information on the use of this modified inserter for standard copper IUD and promising perspectives to set up a changement in the standard of IUD insertion procedure.

Keywords: contraceptio, IUD, innovation, pain

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Authors: Nneka U. Igboeli, Maxwell O. Adibe

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Iron and folate supplementation in pregnancy are important interventions that prevent maternal anaemia and fetal anomaly. Thus, daily oral doses of iron and folic acid are recommended throughout pregnancy as part of antenatal care. However, low adherence has been a major drawback leading to low effectiveness of these programs. The effect of mobile text message reminders to pregnant women to take their routine medications on adherence was evaluated in this study. The first 100 women who consented to the study were recruited and randomized to either receive a text message reminder on adherence to routine medications or not. Adherence was assessed using the 8-item Modified Morisky Adherence Scale (8-MMAS). The folders of successfully recruited women were tagged with the a study number assigned to each of them. The womens’ phone numbers were collected and these were used to send text messages reminders on adhering to routine drugs only to women in the intervention group. The text messages were sent three times per week for a period of four weeks with an adherence reassessment at the one month follow-up antenatal visit for recruited women. At one month follow-up, the lost to follow-up were 6 (16%) women for the intervention group and 17 (34%) for the control group. The across group mean difference in adherence score was 0.07 (-0.96 – 1.10) at baseline and 0.3 (-0.31 – 0.92) after intervention, both insignificant at p > 0.05. The within group change were increases of 0.58 (0.00 – 1.16) (p = 0.05) from baseline for the intervention group and a 0.35 (-0.51 – 1.20) (p = 0.395) for the control group. Non-significant increase in adherence scores were recorded for both groups. However, the increase in adherence scores of women in the intervention group was greater and may be potentially transformed into more positive results if the study period is increased with possibly reduced study drop-outs shows great promise for more positive results.

Keywords: adherence, mobile phone, pregnant women, reminders

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Authors: Maria Cherepanova, Svetlana Maximova

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Background And Aims: Suicide is among ten most common causes of death of the working-age population in the world. According to the WHO forecasts, by 2025 suicide will be the third leading cause of death, after cardiovascular diseases and cancer. In 2019, the global suicide rate in the world was 10,5 per 100,000 people. In Russia, the average figure was 11.6. However, in some depressed regions of Russia, such as Buryatia and Altai, it reaches 35.3. The aim of this study was to develop models based on the regional factors of social well-being deprivation that provoke the suicidal risk of various age groups of Russian population. We also investigated suicidal risk prevention in modern Russia, analyzed its efficacy, and developed recommendations for suicidal risk prevention improvement. Methods: In this study, we analyzed the data from sociological surveys from six regions of Russia. Totally we interviewed 4200 people, the age of the respondents was from 16 to 70 years. The results were subjected to factorial and regression analyzes. Results: The results of our study indicate that young people are especially socially vulnerable, which result in ineffective patterns of self-preservation behavior and increase the risk of suicide. That is due to lack of anti-suicidal barriers formation; low importance of vital values; the difficulty or impossibility to achieve basic needs; low satisfaction with family and professional life; and decrease in personal unconditional significance. The suicidal risk of the middle-aged population is due to a decrease in social well-being in the main aspects of life, which determines low satisfaction, decrease in ontological security, and the prevalence of auto-aggressive deviations. The suicidal risk of the elderly population is due to increased factors of social exclusion which result in narrowing the social space and limiting the richness of life. Conclusions: The existing system for lowering suicide risk in modern Russia is predominantly oriented to a medical treatment, which provides only intervention to people who already committed suicide, that significantly limits its preventive effectiveness and social control of this deviation. The national strategy for suicide risk reduction in modern Russian society should combine medical and social activities, designed to minimize possible situations resulting to suicide. The strategy for elimination of suicidal risk should include a systematic and significant improvement of the social well-being of the population and aim at overcoming the basic aspects of social disadvantages such as poverty, unemployment as well as implementing innovative mental health improvement, developing life-saving behavior that will help to counter suicides in Russia.

Keywords: social factors, suicide, prevention, Russia

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Authors: Ya-Ching Fu, An-Kuo Chou, Boon-Fatt Tan, Chi-Nien Chen, Wen-Chien Yang, Pou-Leng Cheong

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Blind oro-/naso-pharyngeal suction and feeding tube placement are very common practices in neonatal intensive care unit. Though esophageal perforation is a rare complication of these instrumentations, its prevalence is highest in extremely premature neonates. Due to its association with significant morbidity (including respiratory deterioration, pneumothorax, and sepsis) and even mortality, it is an important issue to prevent this iatrogenic complication in the field of premature care. We demonstrate an esophageal perforation in an extreme-low-birth-weight neonate after oro-gastric tube placement. This female baby weighing 680 grams was delivered by caesarean section at 25 weeks of gestational age. She initially received oro-tracheal intubation with mechanical ventilation which was smoothly weaned to non-invasive positive-pressure ventilation at 7-day-old. However, after insertion of a 5-French oro-gastric tube, the baby’s condition suddenly worsened with apnea requiring mechanical ventilation. Her chest radiogram showed the oro-gastric tube in right pleural space, and thus another oro-gastric tube was replaced, and its position was radiographically confirmed. The malpositioned tube was then removed. The baby received 2-week course of intravenous antibiotics for her esophageal perforation. Feeding was then reintroduced and increased to full feeds in a smooth course. She was discharged at 107-day-old. Esophageal perforation in newborn is very rare. Sudden respiratory deterioration in a neonate after naso-/oro-gastric tube placement should alarm us to consider esophageal perforation, and further radiological investigation is required for the diagnosis. Tube materials, patient condition, and age are major risk factors of esophageal perforation. The use of softer tube material, such as silicone, in extreme premature baby might prevent this fetal complication.

Keywords: esophageal perforation, preterm, newborn, feeding tube

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Authors: Krishna Dahiya

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Introduction: Labour pain has been described as the most severe pain experienced by women in their lives. Pain management in labour is one of the most important challenges faced by the obstetrician. The opioids are the primary treatment for patients with moderate and severe pain but these drugs are not always tolerated and are associated with dose-dependent side effects. Nonsteroidal anti-inflammatory drugs, too, are associated with variable adverse effects. Considering these factors, our study compared the efficacy and side effect of intravenous tramadol and paracetamol. Objective: To evaluate the efficacy and adverse effects of an intravenous infusion of 1000 mg of paracetamol as compared with an intravenous injection of 50mg of tramadol for intrapartum analgesia. Methods: In a randomized prospective study at Pt. BDS PGIMS, 200 women in active labor were allocated to received either paracetamol (n=100) or tramadol (n=100). The primary outcome was the efficacy of the drug to supply adequate analgesia as measured by a change in the visual analog scale (VAS) pain intensity score at various times after drug administration. The secondary outcomes included the need for additional rescue analgesia and the presence of adverse maternal or fetal events. Results: The mean age of cases were 25.55 ± 3.849 years and 25.60 ± 3.655 years respectively As recorded by the VAS score, there was significant pain reduction at 30 minutes, and at 1 and 2 hours in both groups (P<0.01). In comparison, between group I and II, a significantly higher rate of nausea and vomiting in tramadol group (14% vs 8%; P < 0.03) patients. Similarly, drowsiness (0% vs 11%; P<0.01), dry mouth (0% vs 8%; P<0.04) and dizziness (0% vs 9%; P<0.02) was also significant in group II. Conclusion: Due to difficulty in administering epidural analgesia to all parturients, administration of paracetamol and tramadol infusion for analgesia is simple and less invasive alternative. In the present study, both paracetamol and tramadol were equally effective for labour analgesia but paracetamol has emerged as safe alternative as compared to tramadol due to a low incidence of side effects.

Keywords: paracetamol, tramadol, labor, analgesia

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Authors: Lydia Ouma Radoli

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The paradox of documenting history through visuals that objectify gruesome images to depict the prominence of stories intrigues media researchers. In East Africa, the topic has been captured in a variety of media frames, but scantly in scholarly work. This paper adopts Visual Rhetoric and Framing Theories to tease out the drivers behind the criteria for the selection of violent visuals. The paper projects that quantitative and qualitative literature regarding journalists’ personal and work-related exposure to PSTD will give insights into the concept of trauma journalism - reporting of horrific events, e.g., violent crime and terror. The data will be collected through methods such as document analysis (photographs and videos) and in-depth interviews to summarize the informational contents with respect to the research objectives and questions. The study is hinged on the background that the criterion for news production is constructed from the idea that ‘if there’s violence, conflict, and death involved, the story gets top priority.’ The anticipated outcome is to establish trauma experiences of visual rhetors, suggest mitigations, and address gaps in academic research. The findings of the study will sustain the critical role of visual rhetors. Further, media practitioners may find the study useful in assessing the effects and values of visual witnessing. Historically, the criterion for visual news production has been that if there’s violence, conflict, and death involved, the story gets top priority. To capture the goriness of the images, media theorists and sociologists have used the expression: “If it bleeds, it leads.” The statement assumes that audiences are attracted to pictures that show violent images. Further, research on visual aspects of Television news has shown its ability to hold viewers’ attention and cause aggression. This paper samples images and narratives from Journalists who have covered trauma-related events. The samples are indicative of the problem under study, which depicts journalists exposed to traumatic events as not receiving any Psycho-social support within newsrooms. It is hoped that the study could inform policy and practice within developing countries through the interpretations of theoretical and empirical explanations of existing trauma phenomena among journalists.

Keywords: visual-witnessing, media culture, visual rhetoric, imaging violence in East Africa

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Authors: Jae-Hyeon Kim, Michael Lee

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Intrinsic and acquired resistance limits the therapeutic benefits of oncogenic BRAF inhibitors in melanoma. MicroRNAs (miRNA) regulate the expression of target mRNAs by repressing their translation. Thus, we investigated miRNA expression patterns in melanoma cell lines to identify candidate biomarkers for acquired resistance to BRAF inhibitor. Here, we used Affymetrix miRNA V3.0 microarray profiling platform to compare miRNA expression levels in three cell lines containing BRAF inhibitor-sensitive A375P BRAF V600E cells, their BRAF inhibitor-resistant counterparts (A375P/Mdr), and SK-MEL-2 BRAF-WT cells with intrinsic resistance to BRAF inhibitor. The miRNAs with at least a two-fold change in expression between BRAF inhibitor-sensitive and –resistant cell lines, were identified as differentially expressed. Averaged intensity measurements identified 138 and 217 miRNAs that were differentially expressed by 2 fold or more between: 1) A375P and A375P/Mdr; 2) A375P and SK-MEL-2, respectively. The hierarchical clustering revealed differences in miRNA expression profiles between BRAF inhibitor-sensitive and –resistant cell lines for miRNAs involved in intrinsic and acquired resistance to BRAF inhibitor. In particular, 43 miRNAs were identified whose expression was consistently altered in two BRAF inhibitor-resistant cell lines, regardless of intrinsic and acquired resistance. Twenty five miRNAs were consistently upregulated and 18 downregulated more than 2-fold. Although some discrepancies were detected when miRNA microarray data were compared with qPCR-measured expression levels, qRT-PCR for five miRNAs (miR-3617, miR-92a1, miR-1246, miR-1936-3p, and miR-17-3p) results showed excellent agreement with microarray experiments. To further investigate cellular functions of miRNAs, we examined effects on cell proliferation. Synthetic oligonucleotide miRNA mimics were transfected into three cell lines, and proliferation was quantified using a colorimetric assay. Of the 5 miRNAs tested, only miR-1246 altered cell proliferation of A375P/Mdr cells. The transfection of miR-1246 mimic strongly conferred PLX-4720 resistance to A375P/Mdr cells, implying that miR-1246 upregulation confers acquired resistance to BRAF inhibition. We also found that PLX-4720 caused much greater G2/M arrest in A375P/Mdr cells transfected with miR-1246mimic than that seen in scrambled RNA-transfected cells. Additionally, miR-1246 mimic partially caused a resistance to autophagy induction by PLX-4720. These results indicate that autophagy does play an essential death-promoting role inPLX-4720-induced cell death. Taken together, these results suggest that miRNA expression profiling in melanoma cells can provide valuable information for a network of BRAF inhibitor resistance-associated miRNAs.

Keywords: microRNA, BRAF inhibitor, drug resistance, autophagy

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Authors: Elsie M. Nolte, Annie M. Joubert, Roy Lakier, Maryke Etsebeth, Jolene M. Helena, Marcel Verwey, Laurence Lafanechere, Anne E. Theron

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Treatment regimens for breast- and lung cancers may include both radiation- and chemotherapy. Ideally, a pharmaceutical agent which selectively sensitizes cancer cells to gamma (γ)-radiation would allow administration of lower doses of each modality, yielding synergistic anti-cancer benefits and lower metastasis occurrence, in addition to decreasing the side-effect profiles. A range of 2-methoxyestradiol (2-ME) analogues, namely 2-ethyl-3-O-sulphamoyl-estra-1,3,5 (10) 15-tetraene-3-ol-17one (ESE-15-one), 2-ethyl-3-O-sulphamoyl-estra-1,3,5(10),15-tetraen-17-ol (ESE-15-ol) and 2-ethyl-3-O-sulphamoyl-estra-1,3,5(10)16-tetraene (ESE-16) were in silico-designed by our laboratory, with the aim of improving the parent compound’s bioavailability in vivo. The main effect of these compounds is the disruption of microtubule dynamics with a resultant mitotic accumulation and induction of programmed cell death in various cancer cell lines. This in vitro study aimed to determine the cellular responses involved in the radiation sensitization effects of these analogues at low doses in breast- and lung cancer cell lines. The oestrogen receptor positive MCF-7-, oestrogen receptor negative MDA-MB-231- and triple negative BT-20 breast cancer cell lines as well as the A549 lung cancer cell line were used. The minimal compound- and radiation doses able to induce apoptosis were determined using annexin-V and cell cycle progression markers. These doses (cell line dependent) were used to pre-sensitize the cancer cells 24 hours prior to 6 gray (Gy) radiation. Experiments were conducted on samples exposed to the individual- as well as the combination treatment conditions in order to determine whether the combination treatment yielded an additive cell death response. Morphological studies included light-, fluorescence- and transmission electron microscopy. Apoptosis induction was determined by flow cytometry employing annexin V, cell cycle analysis, B-cell lymphoma 2 (Bcl-2) signalling, as well as reactive oxygen species (ROS) production. Clonogenic studies were performed by allowing colony formation for 10 days post radiation. Deoxyribonucleic acid (DNA) damage was quantified via γ-H2AX foci and micronuclei quantification. Amplification of the p53 signalling pathway was determined by western blot. Results indicated that exposing breast- and lung cancer cells to nanomolar concentrations of these analogues 24 hours prior to γ-radiation induced more cell death than the compound- and radiation treatments alone. Hypercondensed chromatin, decreased cell density, a damaged cytoskeleton and an increase in apoptotic body formation were observed in cells exposed to the combination treatment condition. An increased number of cells present in the sub-G1 phase as well as increased annexin-V staining, elevation of ROS formation and decreased Bcl-2 signalling confirmed the additive effect of the combination treatment. In addition, colony formation decreased significantly. p53 signalling pathways were significantly amplified in cells exposed to the analogues 24 hours prior to radiation, as was the amount of DNA damage. In conclusion, our results indicated that pre-treatment of breast- and lung cancer cells with low doses of 2-ME analogues sensitized breast- and lung cancer cells to γ-radiation and induced apoptosis more so than the individual treatments alone. Future studies will focus on the effect of the combination treatment on non-malignant cellular counterparts.

Keywords: cancer, microtubule dynamics, radiation therapy, radiosensitization

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Authors: Shantol McIntosh

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Due to environmental and underlying health disparities, the COVID-19 pandemic has caused an added set of economic implications worldwide. Black and Hispanic individuals are more susceptible to contract COVID-19, and if they do, they are more likely to have a severe case that necessitates hospitalization or results in death (Altarum et al., 2020). The literature shows that disparities in health and health treatment are nothing new as they have been recorded for decades and indicate systemic and structural imbalances rooted in racism and discrimination. The purpose of this study is to determine the frequency with which these populations have access to healthcare and treatment. The study will also highlight the key drivers of health disparities. Findings and implications for research and policy will be discussed.

Keywords: COVID-19, racial and ethnic disparities, discrimination, policy

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Authors: Angelos Mavropoulos

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Apostle Paul repeatedly mentioned the bodily sufferings that he voluntarily went through for Christ, as his body was in chains for the ‘mystery of Christ’ (Col 4:3), while on his flesh he gladly carried the ‘thorn’ and all his pains and weaknesses, which prevent him from being proud (2 Cor 12:7). In his view, God’s power ‘is made perfect in weakness’ and when we are physically weak, this is when we are spiritually strong (2 Cor 12:9-10). In addition, we all bear the death of Jesus in our bodies so that His life can be ‘revealed in our mortal body’ (2 Cor 4:10-11), and if we indeed share in His sufferings, we will share in His glory as well (Rom 8:17). Based on these passages, several Christian writers projected bodily suffering, pain, death, and martyrdom, in general, as the means to a noble Christian life and the way to attain God. Even more, Christian tradition is full of instances of voluntary self-harm, mortification of the flesh, and body mutilation for the sake of the soul by several pious men and women, as an imitation of Christ’s earthly suffering. It is a fact, therefore, that, for Christianity, he or she who not only endures but even inflicts earthly pains for God is highly appreciated and will be rewarded in the afterlife. Nevertheless, more recently, Gaudium et Spes and Veritatis Splendor decisively and totally overturned the Catholic Church’s view on the matter. The former characterised the practices that violate ‘the integrity of the human person, such as mutilation, torments inflicted on body or mind’ as ‘infamies’ (Gaudium et Spes, 27), while the latter, after confirming that there are some human acts that are ‘intrinsically evil’, that is, they are always wrong, regardless of ‘the ulterior intentions of the one acting and the circumstances’, included in this category, among others, ‘whatever violates the integrity of the human person, such as mutilation, physical and mental torture and attempts to coerce the spirit.’ ‘All these and the like’, the encyclical concludes, ‘are a disgrace… and are a negation of the honour due to the Creator’ (Veritatis Splendor, 80). For the Catholic Church, therefore, willful bodily sufferings and mutilations infringe human integrity and are intrinsically evil acts, while intentional harm, based on the principle that ‘evil may not be done for the sake of good’, is always unreasonable. On the other hand, many saints who engaged in these practices are still honoured for their ascetic and noble life, while, even today, similar practices are found, such as the well-known Good Friday self-flagellation and nailing to the cross, performed in San Fernando, Philippines. So, the viewpoint of modern Theology about these practices and the question of whether Christians should hurt their body for the salvation of their soul is the question that this paper will attempt to answer.

Keywords: human body, human soul, torture, pain, salvation

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Authors: Lise P. Labéjof, Ivna Mororó, Raquel G. Bastos, Maria Isabel G. Severo, Arno H. de Oliveira

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This work presents an alternative mode of intestine mucosa renewal that may allow to better understand the total loss of villi after irradiation. It was tested a morphological method of 3d reconstruction using micrographs of serial sections of rat duodenum. We used hundreds of sections of each specimen of duodenum placed on glass slides and examined under a light microscope. Those containing the detachment, approximately a dozen, were chosen for observation under a transmission electron microscope (TEM). Each of these sections was glued on a block of epon resin and recut into a hundred of 60 nm-thick sections. Ribbons of these ultrathin sections were distributed on a series of copper grids in the same order of appearance than during the process of microstomia. They were then stained by solutions of uranyl and lead salts and observed under a TEM. The sections were pictured and the electron micrographs showing signs of cells detachment were transferred into two softwares, ImageJ to align the cellular structures and Reconstruct to realize the 3d reconstruction. It has been detected epithelial cells that exhibited all signs of programmed cell death and localized at the villus-crypt junction. Their nucleus was irregular in shape with a condensed chromatin in clumps. Their cytoplasm was darker than that of neighboring cells, containing many swollen mitochondria. In some places of the sections, we could see intercellular spaces enlarged by the presence of shrunk cells which displayed a plasma membrane with an irregular shape in thermowell as if the cell interdigitations would distant from each other. The three-dimensional reconstruction of the crypts has allowed observe gradual loss of intercellular contacts of crypt cells in the longitudinal plan of the duodenal mucosa. In the transverse direction, there was a gradual increase of the intercellular space as if these cells moved away from one another. This observation allows assume that the gradual remoteness of the cells at the villus-crypt junction is the beginning of the mucosa detachment. Thus, the shrinking of cells due to apoptosis is the way that they detach from the mucosa and progressively the villi also. These results are in agreement with our initial hypothesis and thus have demonstrated that the villi become detached from the mucosa at the villus-crypt junction by the programmed cell death process. This type of loss of entire villus helps explain the rapid denudation of the intestinal mucosa in case of irradiation.

Keywords: 3dr, transmission electron microscopy, ionizing radiations, rat small intestine, apoptosis

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Authors: Rich Murphy

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‘The Racism Found in Capitalism’s Poetry’ claims that since the death of philosophy and the end of art modern poetry has been upstaged by capitalist poetry using similar strategies and techniques; while both sublime moments use spectacle one is more effective. The essay also claims that capitalist poetry is open to racism and analyzes KFC advertising campaign to produce evidence of wide spread acceptance in an era of ‘micro-aggressions’ and confederate flag removals. The essay spends considerable time outlining the history of advertising and the weak literary counters to it that inevitably lent its assistance in education. The essay also suggests that the concept of ‘Enormous Irony’ may be the only way to counter. However, as long as capitalism is the method of the economy and governance, the essay suggests, there was little hope in spite of Obama’s election.

Keywords: modern poetry, advertising, Kentucky fried chicken, capitalism, poetry

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Authors: Taiyo Matsumura, Kota Funabashi, Nobumichi Sakai, Takashi Ono

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The purpose of this research is to construct a watching system that monitors human activity in a room and detects abnormalities at an early stage to prevent unattended deaths of people living alone. In this article, we propose a method whereby highly urgent abnormal conditions of a person are determined by changes in the concentration of CO₂ generated from activity and respiration in a room. We also discussed the effects the amount of activity has on the determination. The results showed that this discrimination method is not dependent on the amount of activity and is effective in judging highly urgent abnormal conditions.

Keywords: abnormal conditions, multiple sensors, people living alone, respiratory arrest, unattended death, watching system

Procedia PDF Downloads 137