Search results for: rural women

Authors: Tin Yee Ling, Kavita Maravar, Ruzica Ardalic

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Background: Uterine torsion (UT) in pregnancy of more than 45-degree along the longitudinal axis is a rare occurrence, and the aetiology remains unclear. Case: A 34-year-old G2P1 woman with a history of one previous caesarean section presented at 36+2 weeks with sudden onset lower abdominal pain, syncopal episode, and tender abdomen on examination. She was otherwise haemodynamically stable. Cardiotocography showed a pathological trace with initial prolonged bradycardia followed by a subsequent tachycardia with reduced variability. An initial diagnosis of uterine dehiscence was made, given the history and clinical presentation. She underwent an emergency caesarean section which revealed a 180-degree UT along the longitudinal axis, with oedematous left round ligament lying transverse anterior to the uterus and a segment of large bowel inferior to the round ligament. Detorsion of uterus was performed prior to delivery of the foetus, and anterior uterine wall was intact with no signs of rupture. There were no anatomical uterine abnormalities found other than stretched left ovarian and round ligaments, which were repaired. Delivery was otherwise uneventful, and she was discharged on day 2 postpartum. Discussion: UT is rare as the number of reported cases is within the few hundreds worldwide. Generally, the uterus is supported in place by uterine ligaments, which limit the mobility of the structure. The causes of UT are unknown, but risk factors such as uterine abnormalities, increased uterine ligaments’ flexibility in pregnancy, and foetal malposition has been identified. UT causes occlusion of uterine vessels, which can lead to ischaemic injury of the placenta causing premature separation of the placenta, preterm labour, and foetal morbidity and mortality if delivery is delayed. Diagnosing UT clinically is difficult as most women present with symptoms similar to placenta abruption or uterine rupture (abdominal pain, vaginal bleeding, shock), and one-third are asymptomatic. The management of UT involves surgical detorsion of the uterus and delivery of foetus via caesarean section. Extra vigilance should be taken to identify the anatomy of the uterus experiencing torsion prior to hysterotomy. There have been a few cases reported with hysterotomy on posterior uterine wall for delivery of foetus as it may be difficult to identify and reverse a gravid UT when foetal well-being is at stake. Conclusion: UT should be considered a differential diagnosis of acute abdominal pain in pregnancy. It is crucial that the torsion is addressed immediately as it is associated with maternal and foetal morbidity and mortality.

Keywords: uterine torsion, pregnancy complication, abdominal pain, torted uterus

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Authors: Marine Agogue, Beatrice Parguel, Emilie Canet

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Defined as receptive attention to and awareness of present events and experience, mindfulness has grown in popularity over the past 30 years to become a trendy buzzword in business media, which regularly reports on its organizational benefits. Mindfulness would enhance or impede creative thinking depending on the type of meditation. Specifically, focused-attention meditation (focusing attention on one object instead of being open to perceive and observe any sensation or thought) would not be or negatively correlated to creativity. This research explores whether mood, in its two dimensions (i.e., hedonic tone, activation level), could mediate this potentially negative effect. The rationale is that focused-attention meditation is likely to improve hedonic tone but, in the meantime, damage activation level, resulting in opposite effects on creativity through the mediation effect of creative self-efficacy, i.e., the belief that one can perform successfully in an ideation setting. To test this conceptual model, a survey was administered to 97 subjects (53% women, mean age: 25 years), randomly assigned to three conditions (a 10-minute focused-attention meditation session vs. a 10-minute psychometric tests session vs. a control condition) and asked to participate in the egg creative task. Creativity was measured in terms of fluency, expansivity, and originality, the other variables using existing scales: hedonic tone (e.g., joyful, happy), activation level (e.g., passive, sluggish), creative self-efficacy (e.g., ‘I felt confident in my ability to do the task effectively’) and self-perceived creativity (e.g., ‘I have lots of original ideas’). The chains of mediation were tested using PROCESS macro (model 6) and controlled for subjects’ gender, age, and self-perceived creativity. Comparing the mindfulness and the control conditions, no difference appeared in terms of creativity, nor any mediation chain by hedonic tone. However, subjects who participated in the meditation session felt less active than those in the control condition, which decreased their creative self-efficacy, and creativity (whatever the indicator considered). Comparing the mindfulness and the psychometric tests conditions, analyses showed that creativity was higher in the psychometric tests condition. As previously, no mediation chain appeared by hedonic tone. However, subjects who participated in the meditation session felt less active than those in the psychometric tests condition, which decreased their creative self-efficacy, and creativity. These findings confirm that focused-attention meditation does not enhance creativity. They demonstrate an emotional underlying mechanism based on activation level and suggest that both positive and active mood states have the potential to enhance creativity through creative self-efficacy. In the end, they should discourage organizations from trying to nudge creativity using mindfulness ad hoc devices.

Keywords: creativity, mindfulness, creative self-efficacy, experiment

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Authors: Pushp Lata Sankhwar

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INTRODUCTION: Maternal Hypothyroidism is the most frequent endocrine disorder in pregnancy and varies from 2.5% in the west to 11.0% in India. Maternal Hypothyroidism can have detrimental maternal effects like increased risk of preterm labor, PPROM leading to increased maternal morbidity and also on the neonate in the form of prematurity and its complications, prolonged hospital stay, neurological developmental problems, delayed milestones and mental retardation etc. Henceforth, the study was planned to evaluate the role of Hypothyroidism in preterm labor and its effect on neonates. AIMS AND OBJECTIVES: To Correlate Overt Hypothyroidism, Subclinical Hypothyroidism and Isolated Hypothyroxinemia With Preterm Labor and the neonatal outcome. Material and Methods: A case-control study of singleton pregnancy was performed over a year, in which a total of 500 patients presenting in the emergency with preterm labor were enrolled. The thyroid profile of these patients was sent at the time of admission, on the basis of which they were divided into Cases – Hypothyroidic mothers and Controls – Euthyroid mothers. The cases were further divided into subclinical, overt Hypothyroidism and isolated hypothyroxinemia. The neonatal outcome of these groups was also compared on the basis of the incidence and severity of neonatal morbidity, neonatal respiratory distress, the incidence of neonatal Hypothyroidism and early complications. The feto-maternal data was collected and analysed. RESULTS: In the study, a total of 500 antenatal patients with a history of preterm labor were enrolled, out of which 67 (13.8%) patients were found to be hypothyroid. The majority of the mothers had Subclinical Hypothyroidism (12.2%), followed by Overt Hypothyroidism seen in 1% of the mothers and isolated hypothyroxinemia in 0.6% of cases. The neonates of hypothyroid mothers had higher levels of cord blood TSH, and the mean cord blood TSH levels were highest in the case of neonates of mothers with Overt Hypothyroidism. The need for resuscitation of the neonates at the time of birth was higher in the case of neonates of hypothyroid mothers, especially with Subclinical Hypothyroidism. Also, it was found that the requirement of oxygen therapy in the form of oxygen by nasal prongs, oxygen by a hood, CPAP, CPAP along with surfactant therapy and mechanical ventilation along with surfactant therapy was significantly higher in the case of neonates of hypothyroid mothers. CONCLUSION: The results of our study imply that uncontrolled and untreated maternal Hypothyroidism may also lead to preterm delivery. The neonates of mothers with Hypothyroidism have higher cord blood TSH levels. The study also shows that there is an increased incidence and severity of respiratory distress in the neonates of hypothyroid mothers with untreated subclinical Hypothyroidism. Hence, we propose that routine screening for thyroid dysfunction in pregnant women should be done to prevent thyroid-related feto-maternal complications.

Keywords: high-risk pregnancy, thyroid, dysfunction, hypothyroidism, Preterm labor

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Authors: Adesuwa Omorede, Karin Axelsson

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The war and violence around the world today has brought a mass increase of forcibly displaced individuals to seek refuge in the European Union, where they have to leave their homes and restart a new life built on other cultural, social, economic and legal premises than they are used to. Since 2014, the EU has accepted to help with the crisis by providing protection and refuge, and countries like Germany, Hungary, Austria, and Sweden accepted around two-thirds of EU’s asylum seekers. In 2015 for instance, Sweden harbored large numbers of refugees, which lead to a drastic rise in population. This drastic rise brought an overwhelming challenge to Sweden since they needed to find quick and suitable solutions to accommodate these thousands of refugees. Further, it posed a challenge for Sweden to immediately tackle the problem of integrating the new arrivals in the labor market. With an unstable societal integration and little or no skills to connect to the workforce, these immigrants faced a shaky beginning, as they had to struggle with not just integrating into a new society but also to get suitable jobs. These uncertainties brought pressure on the immigrants, which drove a number of them to move from city to city seeking for a place and alternatives for their well-being, safe haven, and self-provision. As a result, they brought in their own skills, experiences, and cultural orientation into exploring and exploiting new opportunities and filling the gaps in their new environment. In so doing, immigrants contributing with multidisciplinary collaborations, insights, international relations and national growth through the exploitation of entrepreneurial opportunities. The study, seek to understand how these uncertainties led migrant entrepreneurs towards entrepreneurial activities. Furthermore, it contributes to understanding their processes towards exploring and exploiting opportunities for entrepreneurship as well as their role in contributing to local and national growth. To reach these aims, an inductive qualitative study was conducted using semi-structured interviews of several migrant entrepreneurs – both female and male – that took part in two different entrepreneurial projects in mid-Sweden. The first project was a business program for African women; the other was an entrepreneurship hub for immigrants. Both were focused on inspiring and coaching immigrants during their entrepreneurial process. An integrated part was to work with the participants’ entrepreneurial skills and abilities. In addition, archival documents were collected. The data was analyzed using content analysis for qualitative research. The study aims to contribute to the entrepreneurship literature by understanding the influences of cognitive and environmental factors towards entrepreneurial activities. This study also provides several suggestions for policymakers on how they can better integrate migrants into becoming contributors to the society.

Keywords: entrepreneurial intentions, entrepreneurial processes, migrant entrepreneurship, uncertainty

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Authors: Sara Assi, Berthe Hayar, Claudio Pisano, Nadine Darwiche, Walid Saad

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Nanomedicine, the application of nanotechnology to medicine, is an emerging discipline that has gained significant attention in recent years. Current breakthroughs in nanomedicine have paved the way to develop effective drug delivery systems that can be used to target cancer. The use of nanotechnology provides effective drug delivery, enhanced stability, bioavailability, and permeability, thereby minimizing drug dosage and toxicity. As such, the use of nanoparticle (NP) formulations in drug delivery has been applied in various cancer models and have shown to improve the ability of drugs to reach specific targeted sites in a controlled manner. Cancer is one of the major causes of death worldwide; in particular, colorectal cancer (CRC) is the third most common type of cancer diagnosed amongst men and women and the second leading cause of cancer related deaths, highlighting the need for novel therapies. Retinoids, consisting of natural and synthetic derivatives, are a class of chemical compounds that have shown promise in preclinical and clinical cancer settings. However, retinoids are limited by their toxicity and resistance to treatment. To overcome this resistance, various synthetic retinoids have been developed, including the adamantyl retinoid ST1926, which is a potent anti-cancer agent. However, due to its limited bioavailability, the development of ST1926 has been restricted in phase I clinical trials. We have previously investigated the preclinical efficacy of ST1926 in CRC models. ST1926 displayed potent inhibitory and apoptotic effects in CRC cell lines by inducing early DNA damage and apoptosis. ST1926 significantly reduced the tumor doubling time and tumor burden in a xenograft CRC model. Therefore, we developed ST1926-NPs and assessed their efficacy in CRC models. ST1926-NPs were produced using Flash NanoPrecipitation with the amphiphilic diblock copolymer polystyrene-b-ethylene oxide and cholesterol as a co-stabilizer. ST1926 was formulated into NPs with a drug to polymer mass ratio of 1:2, providing a stable formulation for one week. The contin ST1926-NP diameter was 100 nm, with a polydispersity index of 0.245. Using the MTT cell viability assay, ST1926-NP exhibited potent anti-growth activities as naked ST1926 in HCT116 cells, at pharmacologically achievable concentrations. Future studies will be performed to study the anti-tumor activities and mechanism of action of ST1926-NPs in a xenograft mouse model and to detect the compound and its glucuroconjugated form in the plasma of mice. Ultimately, our studies will support the use of ST1926-NP formulations in enhancing the stability and bioavailability of ST1926 in CRC.

Keywords: nanoparticles, drug delivery, colorectal cancer, retinoids

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Authors: Itze Coronel Salomon

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The rise of organized crime and violence related to drug cartels in Mexico has created serious challenges for the authorities to provide security to those who live within its borders. However, to achieve a significant improvement in security is absolute respect for fundamental human rights by the authorities. Irregular migrants in Mexico are at serious risk of abuse. Research by Amnesty International as well as reports of the NHRC (National Human Rights) in Mexico, have indicated the major humanitarian crisis faced by thousands of migrants traveling in the shadows. However, the true extent of the problem remains invisible to the general population. The fact that federal and state governments leave no proper record of abuse and do not publish reliable data contributes to ignorance and misinformation, often spread by the media that portray migrants as the source of crime rather than their victims. Discrimination and intolerance against irregular migrants can generate greater hostility and exclusion. According to the modus operandi that has been recorded criminal organizations and criminal groups linked to drug trafficking structures deprive migrants of their liberty for forced labor and illegal activities related to drug trafficking, even some have been kidnapped for be trained as murderers . If the victim or their family cannot pay the ransom, the kidnapped person may suffer torture, mutilation and amputation of limbs or death. Migrant women are victims of sexual abuse during her abduction as well. In 2011, at least 177 bodies were identified in the largest mass grave found in Mexico, located in the town of San Fernando, in the border state of Tamaulipas, most of the victims were killed by blunt instruments, and most seemed to be immigrants and travelers passing through the country. With dozens of small graves discovered in northern Mexico, this may suggest a change in tactics between organized crime groups to the different means of obtaining revenue and reduce murder profile methods. Competition and conflict over territorial control drug trafficking can provide strong incentives for organized crime groups send signals of violence to the authorities and rival groups. However, as some Mexican organized crime groups are increasingly looking to take advantage of income and vulnerable groups, such as Central American migrants seem less interested in advertising his work to authorities and others, and more interested in evading detection and confrontation. This paper pretends to analyze the introduction of this new trend of kidnapping migrants for forced labors by drug cartels in Mexico into the forms of contemporary slavery and its implications.

Keywords: international law, migration, transnational organized crime

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Authors: Karthick Dharmalingam, Stalin Ramakrishnan, Haseena Banu Hedayathullah Khan, Sachidanandanam Thiruvaiyaru Panchanadham, Shanthi Palanivelu

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Background: Breast cancer is arising as the most dreadful cancer affecting women worldwide. Hence, there arises a need to search and test for new drugs. Herbal formulations used in Siddha preparations are proved to be effective against various types of cancer. They also offer advantage through synergistic amplification and diminish any possible adverse effects. Tridham (TD) is a herbal formulation prepared in our laboratory consisting of Terminalia chebula, Elaeocarpus ganitrus and Prosopis cineraria in a definite ratio and has been used for the treatment of mammary carcinoma. Objective: To study the restorative effect of Tridham and penta galloyl glucose (a component of TD) on DMBA induced mammary carcinoma in female Sprague Dawley rats. Materials and Methods: Rats were divided into seven groups of six animals each. Group I (Control) received corn oil. Group II– mammary carcinoma was induced by DMBA dissolved in corn oil single dose orally. Group III and Group IV were induced with DMBA and subsequently treated with Tridham and penta galloyl glucose, respectively for 48 days. Group V was treated with DMBA and subsequently with a standard drug, cyclophosphamide. Group VI and Group VII were given Tridham and penta galloyl glucose alone, respectively for 48 days. After the experimental period, the animals were sacrificed by cervical decapitation. The mammary gland tissue was excised and levels of antioxidants were determined by biochemical assay. p53 and PCNA expression were accessed using immunohistochemistry. Nrf-2, Cox-2 and caspase-3 protein expression were studied by Western Blotting analysis. p21, Bcl-2, Bax, Bad and caspase-8 gene expression were studied by RT-PCR. Results: Histopathological studies confirmed induction of mammary carcinoma in DMBA induced rats and treatment with TD and PGG resulted in regression of tumour. The levels of enzymic and non-enzymic antioxidants were decreased in DMBA induced rats when compared to control rats. The levels of cell cycle inhibitory markers and apoptotic markers were decreased in DMBA induced rats when compared to control rats. These parameters were restored to near normal levels on treatment with Tridham and PGG. Conclusion: The results of the present study indicate the antineoplastic effect of Tridham and PGG are exerted through the modulation of antioxidant status and expression of cell cycle regulatory markers as well as apoptotic markers. Acknowledgment: Financial assistance provided in the form of ICMR-SRF by Indian Council of Medical Research (ICMR), India is gratefully acknowledged here.

Keywords: antioxidants, Mammary carcinoma, pentaGalloyl glucose, Tridham

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Authors: Arina V. Tankanag, Gennady V. Krasnikov, Nikolai K. Chemeris

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The development of respiration-dependent oscillations in the peripheral blood flow may occur by at least two mechanisms. The first mechanism is related to the change of venous pressure due to mechanical activity of lungs. This phenomenon is known as ‘respiratory pump’ and is one of the mechanisms of venous return of blood from the peripheral vessels to the heart. The second mechanism is related to the vasomotor reflexes controlled by the respiratory modulation of the activity of centers of the vegetative nervous system. Early high phase synchronization of respiration-dependent blood flow oscillations of left and right forearm skin in healthy volunteers at rest was shown. The aim of the work was to study the effect of deep controlled breathing on the phase synchronization of skin blood flow oscillations. 29 normotensive non-smoking young women (18-25 years old) of the normal constitution without diagnosed pathologies of skin, cardiovascular and respiratory systems participated in the study. For each of the participants six recording sessions were carried out: first, at the spontaneous breathing rate; and the next five, in the regimes of controlled breathing with fixed breathing depth and different rates of enforced breathing regime. The following rates of controlled breathing regime were used: 0.25, 0.16, 0.10, 0.07 and 0.05 Hz. The breathing depth amounted to 40% of the maximal chest excursion. Blood perfusion was registered by laser flowmeter LAKK-02 (LAZMA, Russia) with two identical channels (wavelength 0.63 µm; emission power, 0.5 mW). The first probe was fastened to the palmar surface of the distal phalanx of left forefinger; the second probe was attached to the external surface of the left forearm near the wrist joint. These skin zones were chosen as zones with different dominant mechanisms of vascular tonus regulation. The degree of phase synchronization of the registered signals was estimated from the value of the wavelet phase coherence. The duration of all recording was 5 min. The sampling frequency of the signals was 16 Hz. The increasing of synchronization of the respiratory-dependent skin blood flow oscillations for all controlled breathing regimes was obtained. Since the formation of respiration-dependent oscillations in the peripheral blood flow is mainly caused by the respiratory modulation of system blood pressure, the observed effects are most likely dependent on the breathing depth. It should be noted that with spontaneous breathing depth does not exceed 15% of the maximal chest excursion, while in the present study the breathing depth was 40%. Therefore it has been suggested that the observed significant increase of the phase synchronization of blood flow oscillations in our conditions is primarily due to an increase of breathing depth. This is due to the enhancement of both potential mechanisms of respiratory oscillation generation: venous pressure and sympathetic modulation of vascular tone.

Keywords: deep controlled breathing, peripheral blood flow oscillations, phase synchronization, wavelet phase coherence

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Authors: Tatyana Savchuk, Yelena Grinvald, Mohamed Ali, Ramune Sepetiene, Dinara Sadvakassova, Saniya Saussakova, Kuralay Zhangazieva, Dulat Imashpayev

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Introduction. The problem of viral hepatitis B (HBV) takes a vital place in the global health system. The existing risk of HBV transmission through blood transfusions is associated with transfusion of blood taken from infected individuals during the “serological window” period or from patients with latent HBV infection, the marker of which is anti-HBcore. In the absence of information about other markers of hepatitis B, the presence of anti-HBcore suggests that a person may be actively infected or has suffered hepatitis B in the past and has immunity. Aim. To study the risk factors influencing the positive anti-HBcore indicators among the donor population. Materials and Methods. The study was conducted in 2021 in the Scientific and Production Center of Transfusiology of the Ministry of Healthcare in Kazakhstan. The samples taken from blood donors were tested for anti-HBcore, by CLIA on the Architect i2000SR (ABBOTT). A special questionnaire was developed for the blood donors’ socio-demographic characteristics. Statistical analysis was conducted by the R software (version 4.1.1, USA, 2021). Results.5709 people aged 18 to 66 years were included in the study, the proportion of men and women was 68.17% and 31.83%, respectively. The average age of the participants was 35.7 years. A weighted multivariable mixed effects logistic regression analysis showed that age (p<0.001), ethnicity (p<0.05), and marital status (p<0.05) were statistically associated with anti-HBcore positivity. In particular, analysis adjusting for gender, nationality, education, marital status, family history of hepatitis, blood transfusion, injections, and surgical interventions, with a one-year increase in age (adjOR=1.06, 95%CI:1.05-1.07), showed an 6% growth in odds of having anti-HBcore positive results. Those who were russian ethnicity (adjOR=0.65, 95%CI:0.46-0.93) and representatives of other nationality groups (adjOR=0.56, 95%CI:0.37-0.85) had lower odds of having anti-HBcore when compared to Kazakhs when controlling for other covariant variables. Among singles, the odds of having a positive anti-HBcore were lower by 29% (adjOR = 0.71, 95%CI:0.57-0.89) compared to married participants when adjusting for other variables. Conclusions.Kazakhstan is one of the countries with medium endemicity of HBV prevalence (2%-7%). Results of the study demonstrated the possibility to form a profile of risk factors (age, nationality, marital status). Taking into account the data, it is recommended to increase attention to donor questionnaires by adding leading questions and to improve preventive measures to prevent HBV. Funding. This research was supported by a grant from Abbott Laboratories.

Keywords: anti-HBcore, blood donor, donation, hepatitis B virus, occult hepatitis

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Authors: Cátia Gonçalves, Teresa Nunes, Inês Pina, Ana Vicente, C. Alves, Felix Charvet, Daniel Neves, A. Matos

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The production of charcoal relies on rudimentary technologies using traditional brick kilns. Charcoal is produced under pyrolysis conditions: breaking down the chemical structure of biomass under high temperature in the absence of air. The amount of the pyrolysis products (charcoal, pyroligneous extract, and flue gas) depends on various parameters, including temperature, time, pressure, kiln design, and wood characteristics like the moisture content. This activity is recognized for its inefficiency and high pollution levels, but it is poorly characterized. This activity is widely distributed and is a vital economic activity in certain regions of Portugal, playing a relevant role in the management of woody residues. The location of the units establishes the biomass used for charcoal production. The Portalegre district, in the Alto Alentejo region (Portugal), is a good example, essentially with rural characteristics, with a predominant farming, agricultural, and forestry profile, and with a significant charcoal production activity. In this district, a recent inventory identifies almost 50 charcoal production units, equivalent to more than 450 kilns, of which 80% appear to be in operation. A field campaign was designed with the objective of determining the composition of the emissions released during a charcoal production cycle. A total of 30 samples of particulate matter and 20 gas samples in Tedlar bags were collected. Particulate and gas samplings were performed in parallel, 2 in the morning and 2 in the afternoon, alternating the inlet heads (PM₁₀ and PM₂.₅), in the particulate sampler. The gas and particulate samples were collected in the plume as close as the emission chimney point. The biomass (dry basis) used in the carbonization process was a mixture of cork oak (77 wt.%), holm oak (7 wt.%), stumps (11 wt.%), and charred wood (5 wt.%) from previous carbonization processes. A cylindrical batch kiln (80 m³) with 4.5 m diameter and 5 m of height was used in this study. The composition of the gases was determined by gas chromatography, while the particulate samples (PM₁₀, PM₂.₅) were subjected to different analytical techniques (thermo-optical transmission technique, ion chromatography, HPAE-PAD, and GC-MS after solvent extraction) after prior gravimetric determination, to study their organic and inorganic constituents. The charcoal production cycle presents widely varying operating conditions, which will be reflected in the composition of gases and particles produced and emitted throughout the process. The concentration of PM₁₀ and PM₂.₅ in the plume was calculated, ranging between 0.003 and 0.293 g m⁻³, and 0.004 and 0.292 g m⁻³, respectively. Total carbon, inorganic ions, and sugars account, in average, for PM10 and PM₂.₅, 65 % and 56 %, 2.8 % and 2.3 %, 1.27 %, and 1.21 %, respectively. The organic fraction studied until now includes more than 30 aliphatic compounds and 20 PAHs. The emission factors of particulate matter to produce charcoal in the traditional kiln were 33 g/kg (wooddb) and 27 g/kg (wooddb) for PM₁₀ and PM₂.₅, respectively. With the data obtained in this study, it is possible to fill the lack of information about the environmental impact of the traditional charcoal production in Portugal. Acknowledgment: Authors thanks to FCT – Portuguese Science Foundation, I.P. and to Ministry of Science, Technology and Higher Education of Portugal for financial support within the scope of the project CHARCLEAN (PCIF/GVB/0179/2017) and CESAM (UIDP/50017/2020 + UIDB/50017/2020).

Keywords: brick kilns, charcoal, emission factors, PAHs, total carbon

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Authors: Sarah Crawford, Gerry Lesley

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This research is a pre-clinical assessment of anti-cancer effects of novel non-steroidal diethyl stilbestrol-like estrogen analogs in estrogen-receptor positive/ progesterone-receptor positive human breast cancer microtumors of MCF 7 cell line. Tamoxifen analog formulation (Tam A1) was used as a single agent or in combination with therapeutic concentrations of 4-hydroxytamoxifen, currently used as a long-term treatment for the prevention of breast cancer recurrence in women with estrogen receptor positive/ progesterone receptor positive malignancies. At concentrations ranging from 30-50 microM, Tam A1 induced microtumor disaggregation and cell death. Incremental cytotoxic effects correlated with increasing concentrations of Tam A1. Live tumor microscopy showed that microtumos displayed diffuse borders and substrate-attached cells were rounded-up and poorly adherent. A complete cytotoxic effect was observed using 40-50 microM Tam A1 with time course kinetics similar to 4-hydroxytamoxifen. Combined treatment with TamA1 (30-50 microM) and 4-hydroxytamoxifen (10-15 microM) induced a highly cytotoxic, synergistic combined treatment response that was more rapid and complete than using 4-hydroxytamoxifen as a single agent therapeutic. Microtumors completely dispersed or formed necrotic foci indicating a highly cytotoxic combined treatment response. Moreover, breast cancer microtumors treated with both 4-hydroxytamoxifen and Tam A1 displayed lower levels of long-term post-treatment regrowth, a critical parameter of primary drug resistance, than observed for 4-hydroxytamoxifen when used as a single agent therapeutic. Tumor regrowth at 6 weeks post-treatment with either single agent 4-hydroxy tamoxifen, Tam A1 or a combined treatment was assessed for the development of drug resistance. Breast cancer cells treated with both 4-hydroxytamoxifen and Tam A1 displayed significantly lower levels of post-treatment regrowth, indicative of decreased drug resistance, than observed for either single treatment modality. The preclinical data suggest that combined treatment involving the use of tamoxifen analogs may be a novel clinical approach for long-term maintenance therapy in patients with estrogen-receptor positive/progesterone-receptor positive breast cancer receiving hormonal therapy to prevent disease recurrence. Detailed data on time-course, IC50 and tumor regrowth assays post- treatment as well as a proposed mechanism of action to account for observed synergistic drug effects will be presented.

Keywords: 4-hydroxytamoxifen, tamoxifen analog, drug-resistance, microtumors

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Authors: Itee Chowdhury, Shikha Modi

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Introduction: Cancer is beginning to outpace cardiovascular disease as a cause of death affecting every major organ system with profound implications for perioperative management. Breast cancer is the most common cancer in women in India, accounting for 27% of all cancers. The small changes in analgesic management of cancer patients can greatly improve prognosis and reduce the risk of postsurgical cancer recurrence as opioid-based analgesia has a deleterious effect on cancer outcomes. Shortened postsurgical recovery time facilitates earlier return to intended oncological therapy maximising the chance of successful treatment. Literature reveals that the role of BIS since FDA approval has been assessed in various types of surgeries, but clinical data on its use in oncosurgical patients are scanty. Our study focuses on the role of BIS-guided anaesthesia for breast cancer surgery patients. Methods: A prospective randomized controlled study in patients aged 36-55years scheduled for modified radical mastectomy was conducted in 51 patients in each group who met the inclusion and exclusion criteria, and randomization was done by sealed envelope technique. In BIS guided anaesthesia group (B), sevoflurane was titrated to keep the BIS value 45-60, and thereafter if the patient showed hypertension/tachycardia, an opioid was given. In standard anaesthesia care (group C), sevoflurane was titrated to keep MAC in the range of 0.8-1, and fentanyl was given if the patient showed hypertension/tachycardia. Intraoperative opioid consumption was calculated. Postsurgery recovery characteristics, including Aldrete score, were assessed. Patients were questioned for pain, PONV, and recall of the intraoperative event. A comparison of age, BMI, ASA, recovery characteristics, opioid, and VAS score was made using the non-parametric Mann-Whitney U test. Categorical data like intraoperative awareness of surgery and PONV was studied using the Chi-square test. A comparison of heart rate and MAP was made by an independent sample t-test. #ggplot2 package was used to show the trend of the BIS index for all intraoperative time points for each patient. For a statistical test of significance, the cut-off p-value was set as <0.05. Conclusions: BIS monitoring led to reduced opioid consumption and early recovery from anaesthesia in breast cancer patients undergoing MRM resulting in less postoperative nausea and vomiting and less pain intensity in the immediate postoperative period without any recall of the intraoperative event. Thus, the use of a Bispectral index monitor allows for tailoring of anaesthesia administration with a good outcome.

Keywords: bispectral index, depth of anaesthesia, recovery, opioid consumption

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Authors: Aminul Haque, Quazi Zahangir Hossain, Dilshad Sharmin Chowdhury

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The human migration is getting growing concern around the world, and recurrent disasters and climate change impact have great influence on migration. Bangladesh is one of the disaster prone countries that/and has greater susceptibility to stress migration by recurrent disasters and climate change. The study was conducted to investigate the factors that have a strong influence on current migration and changing pattern of life and livelihood means of the southwest coastal part of Bangladesh. Moreover, the study also revealed a strong relationship between disasters and migration and appropriate policy concern. To explore this relation, both qualitative and quantitative methods were applied to a questionnaire survey at household level and simple random sampling technique used in the sampling process along with different secondary data sources for understanding policy concern and practices. The study explores the most influential driver of migration and its relationship with social, economic and environmental drivers. The study denotes that, the environmental driver has a greater effect on the intention of permanent migration (t=1.481, p-value=0.000) at the 1 percent significance level. The significant number of respondents denotes that abrupt pattern of cyclone, flood, salinity intrusion and rainfall are the most significant environmental driver to make a decision on permanent migration. The study also found that the temporary migration pattern has 2-fold increased compared to last ten (10) years. It also appears from the study that environmental factors have a great implication on the changing pattern of the occupation of the study area and it has reported that about 76% of the respondent now in the changing modality of livelihood compare to their traditional practices. The study bares that the migration has foremost impact on children and women by increasing hardship and creating critical social security. The exposure-route of permanent migration is not smooth indeed, these migrations creating urban and conflict in Chittagong hill tracks of Bangladesh. The study denotes that there is not any safeguard of the stress migrant on existing policy and not have any measures for safe migration and resettlement rather considering the emergency response and shelter. The majority of (98%) people believes that migration is not to be the adoption strategies, but contrary to this young group of respondent believes that safe migration could be the adaptation strategy which could bring a positive result compare to the other resilience strategies. On the other hand, the significant number of respondents uttered that appropriate policy measure could be an adaptation strategy for being the formation of a resilient community and reduce the migration by meaningful livelihood options with appropriate protection measure.

Keywords: environmental driver, livelihood, migration, resilience

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Authors: Neusa Fernanda Torres, Buyisile Chibi, Lyn E. Middleton, Vernon P. Solomon, Tivani P. Mashamba-Thompson

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Background: Self-medication with antibiotics (SMA) is a global concern, with a higher incidence in low and middle-income countries (LMICs). Despite intense world-wide efforts to control and promote the rational use of antibiotics, continuing practices of SMA systematically exposes individuals and communities to the risk of antibiotic resistance and other undesirable antibiotic side effects. Moreover, it increases the health systems costs of acquiring more powerful antibiotics to treat the resistant infection. This review thus maps evidence on the factors influencing self-medication with antibiotics in these settings. Methods: The search strategy for this review involved electronic databases including PubMed, Web of Knowledge, Science Direct, EBSCOhost (PubMed, CINAHL with Full Text, Health Source - Consumer Edition, MEDLINE), Google Scholar, BioMed Central and World Health Organization library, using the search terms:’ Self-Medication’, ‘antibiotics’, ‘factors’ and ‘reasons’. Our search included studies published from 2007 to 2017. Thematic analysis was performed to identify the patterns of evidence on SMA in LMICs. The mixed method quality appraisal tool (MMAT) version 2011 was employed to assess the quality of the included primary studies. Results: Fifteen studies met the inclusion criteria. Studies included population from the rural (46,4%), urban (33,6%) and combined (20%) settings, of the following LMICs: Guatemala (2 studies), India (2), Indonesia (2), Kenya (1), Laos (1), Nepal (1), Nigeria (2), Pakistan (2), Sri Lanka (1), and Yemen (1). The total sample size of all 15 included studies was 7676 participants. The findings of the review show a high prevalence of SMA ranging from 8,1% to 93%. Accessibility, affordability, conditions of health facilities (long waiting, quality of services and workers) as long well as poor health-seeking behavior and lack of information are factors that influence SMA in LMICs. Antibiotics such as amoxicillin, metronidazole, amoxicillin/clavulanic, ampicillin, ciprofloxacin, azithromycin, penicillin, and tetracycline, were the most frequently used for SMA. The major sources of antibiotics included pharmacies, drug stores, leftover drugs, family/friends and old prescription. Sore throat, common cold, cough with mucus, headache, toothache, flu-like symptoms, pain relief, fever, running nose, toothache, upper respiratory tract infections, urinary symptoms, urinary tract infection were the common disease symptoms managed with SMA. Conclusion: Although the information on factors influencing SMA in LMICs is unevenly distributed, the available information revealed the existence of research evidence on antibiotic self-medication in some countries of LMICs. SMA practices are influenced by social-cultural determinants of health and frequently associated with poor dispensing and prescribing practices, deficient health-seeking behavior and consequently with inappropriate drug use. Therefore, there is still a need to conduct further studies (qualitative, quantitative and randomized control trial) on factors and reasons for SMA to correctly address the public health problem in LMICs.

Keywords: antibiotics, factors, reasons, self-medication, low and middle-income countries (LMICs)

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Authors: Claire Limoge Schraen, Philippe Gueguen, Cedric Giry, Cedric Desprez, Frédéric Ragueneau

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Mediterranean area is characterized by numerous monumental or vernacular masonry structures illustrating old ways of build and live. Those precious buildings are often poorly documented, present complex shapes and loadings, and are protected by the States, leading to legal constraints. This area also presents a moderate to high seismic activity. Even moderate earthquakes can be magnified by local site effects and cause collapse or significant damage. Moreover the structural resistance of masonry buildings, especially when less famous or located in rural zones has been generally lowered by many factors: poor maintenance, unsuitable restoration, ambient pollution, previous earthquakes. Recent earthquakes prove that any damage to these architectural witnesses to our past is irreversible, leading to the necessity of acting preventively. This means providing preventive assessments for hundreds of structures with no or few documents. In this context we want to propose a general method, based on hierarchized numerical models, to provide preliminary structural diagnoses at a regional scale, indicating whether more precise investigations and models are necessary for each building. To this aim, we adapt different tools, being developed such as photogrammetry or to be created such as a preprocessor starting from pictures to build meshes for a FEM software, in order to allow dynamic studies of the buildings of the panel. We made an inventory of 198 baroque chapels and churches situated in the French Alps. Then their structural characteristics have been determined thanks field surveys and the MicMac photogrammetric software. Using structural criteria, we determined eight types of churches and seven types for chapels. We studied their dynamical behavior thanks to CAST3M, using EC8 spectrum and accelerogramms of the studied zone. This allowed us quantifying the effect of the needed simplifications in the most sensitive zones and choosing the most effective ones. We also proposed threshold criteria based on the observed damages visible in the in situ surveys, old pictures and Italian code. They are relevant in linear models. To validate the structural types, we made a vibratory measures campaign using vibratory ambient noise and velocimeters. It also allowed us validating this method on old masonry and identifying the modal characteristics of 20 churches. Then we proceeded to a dynamic identification between numerical and experimental modes. So we updated the linear models thanks to material and geometrical parameters, often unknown because of the complexity of the structures and materials. The numerically optimized values have been verified thanks to the measures we made on the masonry components in situ and in laboratory. We are now working on non-linear models redistributing the strains. So we validate the damage threshold criteria which we use to compute the vulnerability curves of each defined structural type. Our actual results show a good correlation between experimental and numerical data, validating the final modeling simplifications and the global method. We now plan to use non-linear analysis in the critical zones in order to test reinforcement solutions.

Keywords: heritage structures, masonry numerical modeling, seismic vulnerability assessment, vibratory measure

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Authors: Rahimi-Movaghar Vafa, Mansouri Pejman, Chardoli Mojtaba, Rezvani Samina

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Introduction: Blunt abdominal trauma is one of the leading causes of morbidity and mortality in all age groups, but diagnosis of serious intra-abdominal pathology is difficult and most of the damages are obscure in the initial investigation. There is still controversy about which patients should undergo abdomen/pelvis CT, which patients needs more observation and which patients can be discharged safely The aim of this study was to determine that is it safe to discharge patients with blunt abdominal trauma with normal initial findings. Methods: This non-randomized cross-sectional study was conducted from September 2013 to September 2014 at two levels I trauma centers, Sina hospital and Rasoul-e-Akram hospital (Tehran, Iran). Our inclusion criteria were all patients were admitted for suspicious BAT and our exclusion criteria were patients that have serious head and neck, chest, spine and limb injuries which need surgical intervention, those who have unstable vital signs, pregnant women with a gestational age over 3 months and homeless or without exact home address. 390 patients with blunt trauma abdomen examined and the necessary data, including demographic data, the abdominal examination, FAST result, patients’ lab test results (hematocrit, base deficit, urine analysis) on admission and at 6 and 12 hours after admission were recorded. Patients with normal physical examination, laboratory tests and FAST were discharged from the ED during 12 hours with the explanation of the alarm signs and were followed up after 24 hours and 1 week by a telephone call. Patients with abnormal findings in physical examination, laboratory tests, and FAST underwent abdomino-pelvic CT scan. Results: The study included 390 patients with blunt abdominal trauma between 12 and 80 years of age (mean age, 37.0 ± 13.7 years) and the mean duration of hospitalization in patients was 7.4 ± 4.1 hours. 88.6% of the patients were discharged from hospital before 12 hours. Odds ratio (OR) for having any symptoms for discharge after 6 hours was 0.160 and after 12 hours was 0.117 hours, which is statistically significant. Among the variables age, systolic and diastolic blood pressure, heart rate, respiratory rate, hematocrit and base deficit at admission, 6 hours and 12 hours after admission showed no significant statistical relationship with discharge time. From our 390 patients, 190 patients have normal initial physical examination, lab data and FAST findings that didn’t show any signs or symptoms in their next assessment and in their follow up by the phone call. Conclusion: It is recommended that patients with no symptoms at admission (completely normal physical examination, ultrasound, normal hematocrit and normal base deficit and lack of microscopic hematuria) and good family and social status can be safely discharged from the emergency department.

Keywords: blunt abdominal trauma, patient discharge, emergency department, FAST

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Authors: Magdalena B. Kaziuk, Waldemar Kosiba, Marek J. Kuzniewski

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Introduction: Adipose tissue is a typical place for storage water-insoluble toxins in the body. It's connective tissue, where the intercellular substance consist of fat, which level in people with low physical activity should be 18-25% for women and 13-18% for men. Due to the fat distribution in the body we distinquish two types of obesity: android (visceral, abdominal) and gynoidal (gluteal-femoral, peripheral). Abdominal obesity increases the risk of complications of the cardiovascular system diseases, and impaired renal and liver function. Through the influence on disorders of metabolism, lipid metabolism, diabetes and hypertension, leading to emergence of the metabolic syndrome. So thus, obesity will especially overload kidney function in patients after transplantation. Aim: An attempt was made to estimate the impact of amount fat tissue on transplanted kidney function and excretory function of the liver in patients after Ktx. Material and Methods: The study included 108 patients (50 females, 58 male, age 46.5 +/- 12.9 years) with active kidney transplant after more than 3 months from the transplantation. An analysis of body composition was done by using electrical bioimpedance (BIA) and anthropometric measurements. Estimated basal metabolic rate (BMR), muscle mass, total body water content and the amount of body fat. Information about physical activity were obtained during clinical examination. Nutritional status, and type of obesity were determined by using indicators: Waist to Height Ratio (WHR) and Waist to Hip Ratio (WHR). Excretory functions of the transplanted kidney was rated by calculating the estimated renal glomerular filtration rate (eGFR) using the MDRD formula. Liver function was rated by total bilirubin and alanine aminotransferase levels ALT concentration in serum. In our patients haemolitic uremic syndrome (HUS) was excluded. Results: In 19.44% of patients had underweight, 22.37% of the respondents were with normal weight, 11.11% had overweight, and the rest were with obese (49.08%). People with android stature have a lower eGFR compared with those with the gynoidal stature (p = 0.004). All patients with obesity had higher amount of body fat from a few to several percent. The higher amount of body fat percentage, the lower eGFR had patients (p <0.001). Elevated ALT levels significantly correlated with a high fat content (p <0.02). Conclusion: Increased amount of body fat, particularly in the case of android obesity can be a predictor of kidney and liver damage. Due to that obese patients should have more frequent control of diagnostic functions of these organs and the intensive dietary proceedings, pharmacological and regular physical activity adapted to the current physical condition of patients after transplantation.

Keywords: obesity, body fat, kidney transplantation, glomerular filtration rate, liver function

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Authors: Mansur Agzamov, Valery Bersnev, Natalia Ivanova, Istam Agzamov, Timur Khayrullaev, Yulduz Agzamova

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Objectives. Treatment of hypertensive intracerebral hematoma (ICH) is controversial. Advantage of one surgical method on other has not been established. Recent reports suggest a favorable effect of minimally invasive surgery. We conducted a small comparative study of different surgical methods. Methods. We analyzed the result of surgical treatment of 176 patients with intracerebral hematomas at the age from 41 to 78 years. Men were been113 (64.2%), women - 63 (35.8%). Level of consciousness: conscious -18, lethargy -63, stupor –55, moderate coma - 40. All patients on admission and in the dynamics underwent computer tomography (CT) of the brain. ICH was located in the putamen in 87 cases, thalamus in 19, in the mix area in 50, in the lobar area in 20. Ninety seven patients of them had an intraventricular hemorrhage component. The baseline volume of the ICH was measured according to a bedside method of measuring CT intracerebral hematomas volume. Depending on the intervention of the patients were divided into three groups. Group 1 patients, 90 patients, operated open craniotomy. Level of consciousness: conscious-11, lethargy-33, stupor–18, moderate coma -18. The hemorrhage was located in the putamen in 51, thalamus in 3, in the mix area in 25, in the lobar area in 11. Group 2 patients, 22 patients, underwent smaller craniotomy with endoscopic-assisted evacuation. Level of consciousness: conscious-4, lethargy-9, stupor–5, moderate coma -4. The hemorrhage was located in the putamen in 5, thalamus in 15, in the mix area in 2. Group 3 patients, 64 patients, was conducted minimally invasive removal of intracerebral hematomas using the original device (patent of Russian Federation № 65382). The device - funnel cannula - which after the special markings introduced into the hematoma cavity. Level of consciousness: conscious-3, lethargy-21, stupor–22, moderate coma -18. The hemorrhage was located in the putamen in 31, in the mix area in 23, thalamus in 1, in the lobar area in 9. Results of treatment were evaluated by Glasgow outcome scale. Results. The study showed that the results of surgical treatment in three groups depending on the degree of consciousness, the volume and localization of hematoma. In group 1, good recovery observed in 8 cases (8.9%), moderate disability in 22 (24.4%), severe disability - 17 (18.9%), death-43 (47.8%). In group 2, good recovery observed in 7 cases (31.8%), moderate disability in 7 (31.8%), severe disability - 5 (29.7%), death-7 (31.8%). In group 3, good recovery was observed in 9 cases (14.1%), moderate disability-17 (26.5%), severe disability-19 (29.7%), death-19 (29.7%). Conclusions. The method of using cannulae allowed to abandon from open craniotomy of the majority of patients with putaminal hematomas. Minimally invasive technique reduced the postoperative mortality and improves treatment outcomes of these patients.

Keywords: nontraumatic intracerebral hematoma, minimal invasive surgical technique, funnel canula, differentiated surcical treatment

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Authors: Laura Lee Prather

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A functioning democracy is defined by various characteristics, including freedom of speech, equality, human rights, rule of law and many more. Lawsuits brought to intimidate speakers, drain the resources of community members, and silence journalists and others who speak out in support of matters of public concern are an abuse of the legal system and an encroachment of human rights. The impact can have a broad chilling effect, deterring others from speaking out against abuse. This article aims to suggest ways to address this form of judicial harassment. In 1988, University of Denver professors George Pring and Penelope Canan coined the term “SLAPP” when they brought to light a troubling trend of people getting sued for speaking out about matters of public concern. Their research demonstrated that thousands of people engaging in public debate and citizen involvement in government have been and will be the targets of multi-million-dollar lawsuits for the purpose of silencing them and dissuading others from speaking out in the future. SLAPP actions chill information and harm the public at large. Professors Pring and Canan catalogued a tsunami of SLAPP suits filed by public officials, real estate developers and businessmen against environmentalists, consumers, women’s rights advocates and more. SLAPPs are now seen in every region of the world as a means to intimidate people into silence and are viewed as a global affront to human rights. Anti-SLAPP laws are the antidote to SLAPP suits and while commonplace in the United States are only recently being considered in the EU and the UK. This researcher studied more than thirty years of Anti-SLAPP legislative policy in the U.S., the call for evidence and resultant EU Commission’s Anti-SLAPP Directive and Member States Recommendations, the call for evidence by the UK Ministry of Justice, response and Model Anti-SLAPP law presented to UK Parliament, as well as, conducted dozens of interviews with NGO’s throughout the EU, UK, and US to identify varying approaches to SLAPP lawsuits, public policy, and support for SLAPP victims. This paper identifies best practices taken from the US, EU and UK that can be implemented globally to help combat SLAPPs by: (1) raising awareness about SLAPPs, how to identify them, and recognizing habitual abusers of the court system; (2) engaging governments in the policy discussion in combatting SLAPPs and supporting SLAPP victims; (3) educating judges in recognizing SLAPPs an general training on encroachment of human rights; (4) and holding lawyers accountable for ravaging the rule of law.

Keywords: Anti-SLAPP Laws and Policy, Comparative media law and policy, EU Anti-SLAPP Directive and Member Recommendations, International Human Rights of Freedom of Expression

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Authors: Ho Sy Nam, Tang Ha Nam Anh

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Background: Rotator cuff tears are a common problem in the aging population. The prevalence of massive rotator cuff tears varies in some studies from 10% to 40%. Of irreparable rotator cuff tears (IRCTs), which are mostly associated with massive tear size, 79% are estimated to have recurrent tears after surgical repair. Recent studies have shown that superior capsule reconstruction (SCR) in massive rotator cuff tears can be an efficient technique with optimistic clinical scores and preservation of stable glenohumeral stability. Superior capsule reconstruction techniques most commonly use either fascia lata autograft or dermal allograft, both of which have their own benefits and drawbacks (such as the potential for donor site issues, allergic reactions, and high cost). We propose a simple technique for superior capsule reconstruction that involves using the long head of the biceps tendon as a local autograft; therefore, the comorbidities related to graft harvesting are eliminated. The long head of the biceps tendon proximal portion is relocated to the footprint and secured as the SCR, serving to both stabilize the glenohumeral joint and maintain vascular supply to aid healing. Objective: The purpose of this study is to assess the clinical outcomes of patients with large to massive RCTs treated by SCR using LHBT. Materials and methods: A study was performed of consecutive patients with large to massive RCTs who were treated by SCR using LHBT between January 2022 and December 2022. We use one double-loaded suture anchor to secure the long head of the biceps to the middle of the footprint. Two more anchors are used to repair the rotator cuff using a single-row technique, which is placed anteriorly and posteriorly on the lateral side of the previously transposed LHBT. Results: The 3 men and 5 women had an average age of 61.25 years (range 48 to 76 years) at the time of surgery. The average follow-up was 8.2 months (6 to 10 months) after surgery. The average preoperative ASES was 45.8, and the average postoperative ASES was 85.83. The average postoperative UCLA score was 29.12. VAS score was improved from 5.9 to 1.12. The mean preoperative ROM of forward flexion and external rotation of the shoulder was 720 ± 160 and 280 ± 80, respectively. The mean postoperative ROM of forward flexion and external rotation were 1310 ± 220 and 630 ± 60, respectively. There were no cases of progression of osteoarthritis or rotator cuff muscle atrophy. Conclusion: SCR using LHBT is considered a treatment option for patients with large or massive RC tears. It can restore superior glenohumeral stability and function of the shoulder joint and can be an effective procedure for selected patients, helping to avoid progression to cuff tear arthropathy.

Keywords: superior capsule reconstruction, large or massive rotator cuff tears, the long head of the biceps, stabilize the glenohumeral joint

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Authors: Merle Talvik, Taimi Tulva, Kristi Puusepp, Ulle Ernits

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Background data. This is a study in the field of health humanities. The 1930s were years of rapid cultural and economic development in Europe and in Estonia. The urban way of life the glamorous lifestyle gained popularity, although the society of Estonia in the 1930s had traditionally been agrarian. People's free time increased, which needed to be filled with activities either at home or outside the home. Therefore, the number of popular magazines aimed at housewives increased. More than 200 magazines and bulletins were published in the Republic of Estonia before the Second World War (in 1934, the population of Estonia was 1,126,000). In the 1930s, the Republic of Estonia faced several challenges in healthcare. Infectious diseases, alcoholism, prostitution and child mortality had to be dealt with. Healers without medical education operated in the villages. For the average person, medical care was quite expensive, and despite efforts, by 1940, only 20% of the population was covered by health insurance. Advice published in popular family magazines provided help in solving, understanding and preventing health problems. Aim. The aim of the study is to analyze the health counseling through magazines during the Republic of Estonia (1930-1940) in historical and cultural context. Method. In total, 420 magazine issues were processed. An extensive textual analysis, as well as an analysis of photographs and illustrations from the aspect of health advice was carried out to achieve the research objective. Results. Health counseling was written by well-known doctors of the time, leaders of the abstinence movement and others. There was advice in various areas: prevention of infectious and non-infectious diseases and their treatment with simple methods, first aid, combating sexually transmitted diseases, women's and children's health, mental health, folk medicine techniques, abstinence, healthy eating, skin care, hygiene, introducing pharmacy products. Advice was offered in both written and visual form. Photos and illustrations helped to empower the health advice. Folk heritage and health knowledge of the time were relied upon, and a scientific point of view was popularized. Aspirations towards a European lifestyle were reflected in articles and illustrations. Contribution. The article has an ethnological attitude, and its impact comes down to understanding the history of health care in its socio-cultural context. The health counseling topics of the 1930s are also applicable in today's health education and research. Health counseling builds on the legacy of the past, and it helps to understand that the past is in the future and the main principles of health counseling arise from our history and background.

Keywords: estonian republic, health counseling, lifestyle, magazines, media

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Authors: Mira Karnieli, Shosh Veitzman

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In recent years, due to transitions in teacher education, professional identities are changing. In many countries, the education system is absorbing ex-military personnel. The aim of this research is to investigate the phenomenon of retired officers in Israel who choose education as a second career and the training provided. The phenomenon of retired military permanent-service officers pursuing a career in education is not unique to Israel. In the United States and the United Kingdom, for example, government-supported accelerated programs (Troops to Teachers) are run for ex-military personnel (soldiers and officers) with a view to their entry into the education system. These programs direct the ex-military personnel to teacher education and training courses to obtain teaching certification. The present study, however, focused specifically on senior officers who have a full academic education, most of the participants hold second degrees in a variety of fields. They all retired from a rich military career, including roles in command, counseling, training, guidance, and management. The research included 80 participants' men and women. Data was drowning from in-depth interviews and questioner. The conceptual framework which guided this study was mixed methods. The qualitative-phenomenological methodology, using in-depth interviews, and a questioner. The study attempted to understand the motives and personal perceptions behind the choice of teaching. Were they able to identify prior skills that they had accumulated throughout their years of service? What were these skills? In addition, which (if any) would stand them in good stead for a career in teaching? In addition, they were asked how they perceived the training program’s contribution to their professionalization and integration in the education system. The data was independently coded by the researchers. Subsequently, the data was discussed by both researchers, codes were developed, and conceptual categories were formed. Analysis of the data shows this population to be characterized by the high motivation for studying, professionalization, contribution to society and a deep sense of commitment to education. All of them had a profession which they acquired in the past which is not related to education. However, their motives for choosing to teach are related to their wish to give expression to their leadership experience and ability, the desire to have an influence and to bring about change. This is derived from personal commitment, as well as from a worldview and value system that are supportive of education. In other words, they feel committed and act out of a sense of vocation. In conclusion, it will emphasize that all the research participants began working in education immediately upon completing the training program. They perceived this path as a way of realizing a mission despite the low status of the teaching profession in Israel and low teacher salaries.

Keywords: cross-boundary skills, lifelong learning, professional identities, teaching as a second career, training program

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Authors: K. Karapetyan, F. Tkhruni, A. Aghajanyan, T. S. Balabekyan, L. Arstamyan

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Introduction: Globalization of the food supply has created the conditions favorable for the emergence and spread of food-borne and especially dangerous pathogens (EDP) in developing countries. The fresh-cut fruit and vegetable industry is searching for alternatives to replace chemical treatments with biopreservative approaches that ensure the safety of the processed foods product. Antimicrobial compounds of lactic acid bacteria (LAB) possess bactericidal or bacteriostatic activity against intestinal pathogens, spoilage organisms and food-borne pathogens such as Listeria monocytogenes, Staphylococcus aureus and Salmonella. Endemic strains of LAB were isolated. The strains, showing broad spectrum of antimicrobial activity against food spoiling microorganisms, were selected. The genotyping by 16S rRNA sequencing, GS-PCR, RAPD PCR methods showed that they were presented by Lactobacillus rhamnosus109, L.plantarum 65, L.plantarum 66 and Enterococcus faecium 64 species. LAB are deposited in "Microbial Depository Center" (MDC) SPC "Armbiotechnology". Methods: LAB strains were isolated from different dairy products from rural households from the highland regions of Armenia. Serially diluted samples were spread on MRS (Merck, Germany) and hydrolyzed milk agar (1,2 % w/v). Single colonies from each LAB were individually inoculated in liquid MRS medium and incubated at 37oC for 24 hours. Culture broth with biomass was centrifuged at 10,000 g during 20 min for obtaining of cell free culture broth (CFC). The antimicrobial substances from CFC broth were purified by the combination of adsorption-desorption and ion-exchange chromatography methods. Separation of bacteriocins was performed using a HPLC method on "Avex ODS" C18 column. Mass analysis of peptides recorded on the device API 4000 in the electron ionization mode. The spot-on-lawn method on the test culture plated in the solid medium was applied. The antimicrobial activity is expressed in arbitrary units (AU/ml). Results. Purification of CFC broth of LAB allowed to obtain partially purified antimicrobial preparations which contains bacteriocins with broad spectrum of antimicrobial activity. Investigation of their main biochemical properties shown, that inhibitory activity of preparations is partially reduced after treatment with proteinase K, trypsin, pepsin, suggesting a proteinaceous nature of bacteriocin-like substances containing in CFC broth. Preparations preserved their activity after heat treatment (50-121 oC, 20 min) and were stable in the pH range 3–8. The results of SDS PAAG electrophoresis show that L.plantarum 66 and Ent.faecium 64 strains have one bacteriocin (BCN) with maximal antimicrobial activity with approximate molecular weight 2.0-3.0 kDa. From L.rhamnosus 109 two BCNs were obtained. Mass spectral analysis indicates that these bacteriocins have peptide bonds and molecular weight of BCN 1 and BCN 2 are approximately 1.5 kDa and 700 Da. Discussion: Thus, our experimental data shown, that isolated endemic strains of LAB are able to produce bacteriocins with high and different inhibitory activity against broad spectrum of microorganisms of different taxonomic group, such as Salmonella sp., Esherichia coli, Bacillus sp., L.monocytogenes, Proteus mirabilis, Staph. aureus, Ps. aeruginosa. Obtained results proved the perspectives for use of endemic strains in the preservation of foodstuffs. Acknowledgments: This work was realized with financial support of the Project Global Initiatives for Preliferation Prevention (GIPP) T2- 298, ISTC A-1866.

Keywords: antimicrobial activity, bacteriocins, endemic strains, food safety

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Authors: Josie West

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This paper focuses on the conflicts and utility of Marxist Feminist frames for sex work research, drawing on findings uncovered through in-depth interviews with online sex workers, alongside critical discourse analysis of media and political commentary. It brings the critical perspective of women into digital workerism and gig economy dialogue who, despite their significant presence within online work, have been overlooked. The autonomist Marxist concept of class composition is adopted to unpack the social, technical and political composition of this often-invisible segment of the service sector. Autonomism makes visible the perspective of workers engaged in processes of mobilization and demobilizaiton. This allows researchers to find everyday forms of resistance which occur within and outside trade unions. On the other hand, Marxist feminist arguments about invisibility politics can generate unhelpful allegories about sex work as domestic labour within the reproductive sphere. Nick Srnicek’s development of Marx’s notion of infrastructure rents helps theorize experiences of unpaid labour within online sex work. Moreover, debates about anti-work politics can cause conflict among sex workers fighting for the labour movement and those rejecting the capitalist work ethic. This illuminates’ tensions caused by white privilege and differing experiences of sex work. The monopolistic and competitive nature of sex work platforms within platform capitalism, and the vulnerable position of marginalised workers within stigmatized/criminalised markets, complicates anti-work politics further. This paper is situated within the feminist sex wars and the intensely divisive question of whether sex workers are victims of the patriarchy or symbols of feminist resistance. Camgirls are shown to engage in radical tactics of resistance against their technical composition on popular sex work platforms. They also engage in creative acts of resistance through performance art, in an attempt to draw attention to stigma and anti-criminalization politics. This sector offers a fascinating window onto grassroots class-action, alongside education about ‘whorephobia.’ A case study of resistance against Only Fans, and a small workers co-operative which emerged during the pandemic, showcases how workers engage in socialist and political acts without the aid of unions. Workers are victims of neoliberalism and simultaneous adopters of neoliberal strategies of survival. The complex dynamics within unions are explored, including tensions with grass-roots resistance, financial pressures and intersecting complications of class, gender and race.

Keywords: autonomist marxism, digital labor, feminism, neoliberalism, sex work, platform capitalism

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Authors: Purnima Anjali Mohanty, Mousumi Padhi

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Background of the study: In the background of the passage of the Transgender Bill 2016, which is the first such step of formal recognition of the rights of transgender, the Hijras have been recognized under the wider definition of Transgender. Fascinatingly, in the Hindu social context, Hijras have a long social standing during marriages and childbirths. Other than this ironically, they live an ostracized life. The Bill rather than recognizing their unique characteristics and needs, reinforces the societal dualism through a parallelism of their legal rights with rights available to women. Purpose of the paper: The research objective was to probe why and to what extent did they identify themselves with the feminine gender roles. Originality of the paper: In the Indian context, the subject of eunuch has received relatively little attention. Among the studies that exist, there has been a preponderance of studies from the perspective of social exclusion, rights, and physical health. There has been an absence of research studying the self-identity of Hijras from the gender perspective. Methodology: The paper adopts the grounded theory method to investigate and discuss the underlying gender identity of transgenders. Participants in the study were 30 hijras from various parts of Odisha. 4 Focus group discussions were held for collecting data. The participants were approached in their natural habitat. Following the methodological recommendations of the grounded theory, care was taken to select respondents with varying experiences. The recorded discourses were transcribed verbatim. The transcripts were analysed sentence by sentence, and coded. Common themes were identified, and responses were categorized under the themes. Data collected in the latter group discussions were added till saturation of themes. Finally, the themes were put together to prove that despite the demand for recognition as third gender, the eunuchs of Odisha identify themselves with the feminine roles. Findings: The Hijra have their own social structure and norms which are unique and are in contrast with the mainstream culture. These eunuchs live and reside in KOTHIS (house), where the family is led by a matriarch addressed as Maa (mother) with her daughters (the daughters are eunuchs/effeminate men castrated and not castrated). They all dress up as woman, do womanly duties, expect to be considered and recognized as woman and wife and have the behavioral traits of a woman. Looking from the stance of Feminism one argues that when the Hijras identify themselves with the gender woman then on what grounds they are given the recognition as third gender. As self-identified woman; their claim for recognition as third gender falls flat. Significance of the study: Academically it extends the study of understanding of gender identity and psychology of the Hijras in the Indian context. Practically its significance is far reaching. The findings can be used to address legal and social issues with regards to the rights available to the Hijras.

Keywords: feminism, gender perspective, Hijras, rights, self-identity

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Authors: Jemely M. Punzalan, Christine B. Bernal, Beatrice B. Canonigo, Maria Rosario F. Cabansag, Dennis S. Flores, Paul Joseph T. Galutira, Remedios D. Chan

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Background: Systemic lupus erythematosus (SLE) is one of the most common autoimmune disorders predominates in women of childbearing age. Simple Measure of Impact of Lupus Erythematosus in Youngsters (SMILEY) is the only health specific quality of life tool for pediatric SLE, which has been translated to different languages except in Filipino. Objective: The primary objective of this study was to develop a Filipino translation of the SMILEY and to examine the validity and reliability of this translation. Methodology: The SMILEY was translated into Filipino by a bilingual individual and back-translated by another bilingual individual blinded from the original English version. The translation was evaluated for content validity by a panel of experts and subjected to pilot testing. The pilot-tested translation was used in the validity and reliability testing proper. The SMILEY, together with the previously validated PEDSQL 4.0 Generic Core Scale was administered to lupus pediatric patients and their parent at two separate occasions: a baseline and a re-test seven to fourteen days apart. Tests for convergent validity, internal consistency, and test-retest reliability were performed. Results: A total of fifty children and their parent were recruited. The mean age was 15.38±2.62 years (range 8-18 years), mean education at high school level. The mean duration of SLE was 28 months (range 1-81 months). Subjects found the questionnaires to be relevant, easy to understand and answer. The validity of the SMILEY was demonstrated in terms of content validity, convergent validity, internal consistency, and test-retest reliability. Age, socioeconomic status and educational attainment did not show a significant effect on the scores. The difference between scores of child and parent report was showed to be significant with SMILEY total (p=0.0214), effect on social life (p=0.0000), and PEDSQL physical function (p=0.0460). Child reports showed higher scores for the following domains compared to their parent. Conclusion: SMILEY is a brief, easy to understand, valid and reliable tool for assessing pediatric SLE specific HRQOL. It will be useful in providing better care, understanding and may offer critical information regarding the effect of SLE in the quality of life of our pediatric lupus patients. It will help physician understands the needs of their patient not only on treatment of the specific disease but as well as the impact of the treatment on their daily lives.

Keywords: systemic lupus erythematosus, pediatrics, quality of life, Simple Measure of Impact of Lupus Erythematosus in Youngsters (SMILEY)

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Authors: Lya Porto, Giulia Giacchè, Mario Aquino Alves

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The paper aims to describe the linkage between government and civil society proposing a study on agro-ecological agriculture policy and urban action in São Paulo city underling the main achievements obtained. The negotiation processes between social movements and the government (inputs) and its results on political regulation and public action for Urban Agriculture (UA) in São Paulo city (outputs) have been investigated. The method adopted is qualitative, with techniques of semi-structured interviews, participant observation, and documental analysis. The authors conducted 30 semi-structured interviews with organic farmers, activists, governmental and non-governmental managers. Participant observation was conducted in public gardens, urban farms, public audiences, democratic councils, and social movements meetings. Finally, public plans and laws were also analyzed. São Paulo city with around 12 million inhabitants spread out in a 1522 km2 is the economic capital of Brazil, marked by spatial and socioeconomic segregation, currently aggravated by environmental crisis, characterized by water scarcity, pollution, and climate changes. In recent years, Urban Agriculture (UA) social movements gained strength and struggle for a different city with more green areas, organic food production, and public occupation. As the dynamics of UA occurs by the action of multiple actresses and institutions that struggle to build multiple senses on UA, the analysis will be based on literature about solidarity economy, governance, public action and networks. Those theories will mark out the analysis that will emphasize the approach of inter-subjectivity built between subjects, as well as the hybrid dynamics of multiple actors and spaces in the construction of policies for UA. Concerning UA we identified four main typologies based on land ownership, main function (economic or activist), form of organization of the space, and type of production (organic or not). The City Hall registers 500 productive unities of agriculture, with around 1500 producers, but researcher estimated a larger number of unities. Concerning the social movements we identified three categories that differ in goals and types of organization, but all of them work by networks of activists and/or organizations. The first category does not consider themselves as a movement, but a network. They occupy public spaces to grow organic food and to propose another type of social relations in the city. This action is similar to what became known as the green guerrillas. The second is configured as a movement that is structured to raise awareness about agro-ecological activities. The third one is a network of social movements, farmers, organizations and politicians that work focused on pressure and negotiation with executive and legislative government to approve regulations and policies on organic and agro-ecological Urban Agriculture. We conclude by highlighting how the interaction among institutions and civil society produced important achievements for recognition and implementation of UA within the city. Some results of this process are awareness for local production, legal and institutional recognition of the rural zone around the city into the planning tool, the investment on organic school public procurements, the establishment of participatory management of public squares, the inclusion of UA on Municipal Strategic Plan and Master Plan.

Keywords: public action, policies, agroecology, urban and peri-urban agriculture, Sao Paulo

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Authors: Nermeen Elbeltagy, Helmy abd Elsatar, Sara Hassan, Mohamed Darwish

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Introduction: with the inial appearance in Wuhan, China, in December 2019, the coronavirus disease-related respiratory infection (COVID-19) has rapidly spread among people all over the world. The WHO considered it a pandemic in March 2020. The severe acute respiratory syndrome coronavirus (SARS-CoV) and the Middle East respiratory syndrome coronavirus (MERS-CoV) outbreaks have proved that pregnant females as well as their fetuses are exposed to adverse outcomes, including high rates of intensive care unit (ICU) admission and case fatality. Physiological changes occurring during pregnancy such as the increased transverse diameter of the thoracic cage as well as the elevation of the diaphragm can expose the mother to severe infections because of her decreased tolerance for hypoxia. Furthermore, vasodilation and changes in lung capacity can cause mucosal edema and an increase in upper respiratory tract secretions. In addition, the increased susceptibility to infection is enhanced by changes in cellmediated immunity. Aim of the work: to study the effect of COVID-19 on pregnant females admitted to El-Shatby Maternity University Hospital regarding maternal antepartum, intrapartum and postpartum adverse effects on the mothers and their neonates. Method: A retrospective cohort study was done between October 2020 and October 2022. Maternal characteristics and associated health conditions of COVID-19 positive parents were investigated. Also, the severity of their conditions and me of infection (first or second or third trimester)were explored. Cases were diagnosed based on presence of symptoms suggestive of COVID-19, laboratory tests (other than PCR) and radiological findings.all cases were confirmed by positive PCR test results. Results: The most common adverse maternal outcomes were pre-term labor (11.6%) followed by premature rupture of membranes (5.7%), post-partum hemorrhage (5.4%), preeclampsia (5.0%) and placental abrupon (4.3%). One sixth of the neonates of the studied paents were admied to NICUs and 6.5% of them had respiratory distress with no neonatal deaths. The majority of neonates (85.4%) had a birth weight of 2500- 4000g (normal range). Most of the neonates (77.9%) had an APGAR score of equal or more than 7 in 5 minutes. Conclusion: the most common comorbidity that might increase the incidence of COVID-19 before pregnancy were diabetes, cardiac disorders/ chronic hypertension and chronic obstructive lung diseases (non-asthma). During pregnancy, anemia followed by gestational diabetes and pre-eclampsia/gestational hypertension were the most prevalent comorbidity. So, severity of infection can be reduced by good antenatal care.

Keywords: COVID-19, pregnancy outcome, complicated pregnancy., COVID in Egypt

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Authors: Obasanjo Afolabi Bolarinwa

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This study assesses the levels of knowledge of sexually transmitted infections among unmarried youths in Nigeria; examines the pattern of high risk sex among unmarried youths in Nigeria; investigate the socio-demographic factors (age, place of residence, religion, level of education, wealth index and employment status) affecting the practice of high-risk sexual behaviour and ascertain the relationships between knowledge of sexually transmitted infections and practice of high risk sex. The goal of the study is to identify the factors associated with the practice of high risk sex among youth. These were with a view to identifying critical actions needed to reduce high risk sexual behaviour among youths. The study employed secondary data. The data for the study were extracted from the 2013 Nigeria Demographic and Health Survey (NDHS). The 2013 NDHS collected information from 38,948 Women ages 15-49 years and 17,359 men ages 15-49. A total of 7,744 female and 6,027 male respondents were utilized in the study. In order to adjust for the effect of oversampling of the population, the weighting factor provided by Measure DHS was applied. The data were analysed using frequency distribution and logistic regression. The results show that both male (92.2%) and female (93.6%) have accurate knowledge of sexually transmitted infections. The study also revealed that prevalence of high risk sexual behavior is high among Nigerian youths; this is evident as 77.7% (female) and 78.4% (male) are engaging in high risk sexual behavior. The bivariate analysis shows that age of respondent (χ2=294.2; p < 0.05), religion (χ2=136.64; p < 0.05), wealth index (χ2=17.38; p < 0.05), level of education (χ2=34.73; p < 0.05) and employment status (χ2=94.54; p < 0.05) were individual factors significantly associated with high risk sexual behaviour among male while age of respondent (χ2=327.07; p < 0.05), place of residence (χ2=6.71; p < 0.05), religion (χ2=81.04; p < 0.05), wealth index (χ2=7.41; p < 0.05), level of education (χ2=18.12; p < 0.05) and employment status (χ2=51.02; p < 0.05) were individual factors significantly associated with high risk sexual behaviour among female. Furthermore, the study shows that there is a relationship between knowledge of sexually transmitted infections and high risk sex among male (χ2=38.32; p < 0.05) and female (χ2=18.37; p < 0.05). At multivariate level, the study revealed that individual characteristics such as age, religion, place of residence, wealth index, levels of education and employment status were statistically significantly related with high risk sexual behaviour among male and female (p < 0.05). Lastly, the study shows that knowledge of sexually transmitted infection was significantly related to high risk sexual behaviour among youths (p < 0.05). The study concludes that there is a high level of knowledge of sexually transmitted infections among unmarried youths in Nigeria. The practice of high risk sex is high among unmarried youths but higher among male youths. The prevalence of high risk sexual activity is higher for males when they are at disadvantage and higher for females when they are at advantage. Socio-demographic factors like age of respondents, religion, wealth index, place of residence, employment status and highest level of education are factors influencing high risk sexual behaviour among youths.

Keywords: high risk sex, wealth index, sexual behaviour, knowledge

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Authors: Tzipi Eshet

Abstract:

The importance of environmental education as part of a national strategy to promote the environment is recognized around the world. Lecturers at colleges of teacher education have considerable responsibility, directly and indirectly, for the environmental literacy of students who will end up teaching in the school system. This study examined whether lecturers in colleges of teacher education and teacher training in Israel, are able and willing to develop among the students, environmental literacy. Capability and readiness is assessed by evaluating the level of environmental literacy dimensions that include knowledge on environmental issues, positions related to the environmental agenda and "green" patterns of behavior in everyday life. The survey included 230 lecturers from 22 state colleges coming from various sectors (secular, religious, and Arab), from different academic fields and different personal backgrounds. Firstly, the results show that the higher the commitment to environmental issues, the lower the satisfaction with the current situation. In general, the respondents show positive environmental attitudes in all categories examined, they feel that they can personally influence responsible environmental behavior of others and are able to internalize environmental education in schools and colleges; they also report positive environmental behavior. There are no significant differences between teachers of different background characteristics when it comes to behavior patterns that generate personal income funds (e.g. returning bottles for deposit). Women show a more responsible environmental behavior than men. Jewish lecturers, in most categories, show more responsible behavior than Druze and Arab lecturers; however, when referring to positions, Arabs and Druze have a better sense in their ability to influence the environmental agenda. The Knowledge test, which included 15 questions, was mostly based on basic environmental issues. The average score was adequate - 83.6. Science lecturers' environmental literacy is higher than the other lecturers significantly. The larger the environmental knowledge base is, they are more environmental in their attitudes, and they feel more responsible toward the environment. It can be concluded from the research findings, that knowledge is a fundamental basis for developing environmental literacy. Environmental knowledge has a positive effect on the development of environmental commitment that is reflected in attitudes and behavior. This conclusion is probably also true of the general public. Hence, there is a great importance to the expansion of knowledge among the general public and teacher educators in particular on environmental. From the open questions in the survey, it is evident that most of the lecturers are interested in the subject and understand the need to integrate environmental issues in the colleges, either directly by teaching courses on the environment or indirectly by integrating environmental issues in different professions as well as asking the students to set an example (such as, avoid unnecessary printing, keeping the environment clean). The curriculum at colleges should include a variety of options for the development and enhancement of environmental literacy of student teachers, but first there must be a focus on bringing their teachers to a high literacy level so they can meet the difficult and important task they face.

Keywords: colleges of teacher education, environmental literacy, environmental education, teacher's teachers

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