Search results for: female images

Authors: Jianwei Qian, Rob Law

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With the expansion of globalization and the increment of market competition, the festival, especially the traditional one, has demonstrated its vitality under the new context. As a new tourist attraction, festivals play a critically important role in promoting the tourism economy, because the organization of a festival can engage more tourists, generate more revenues and win a wider media concern. However, in the current stage of China, traditional festivals as a way to disseminate national culture are undergoing the challenge of foreign festivals and the related culture. Different from those special events created solely for developing economy, traditional festivals have their own culture and connotation. Therefore, it is necessary to conduct a study on not only protecting the tradition, but promoting its development as well. This study conducts a comparative study of the development of China’s Valentine’s Day and Western Valentine’s Day under the Chinese context and centers on newspaper reports in China from 2000 to 2016. Based on the literature, two main research focuses can be established: one is concerned about the festival’s impact and the other is about tourists’ motivation to engage in a festival. Newspaper reports serve as the research discourse and can help cover the two focal points. With the assistance of content mining techniques, semantic networks for both Days are constructed separately to help depict the status quo of these two festivals in China. Based on the networks, two models are established to show the key component system of traditional festivals in the hope of perfecting the positive role festival tourism plays in the promotion of economy and culture. According to the semantic networks, newspaper reports on both festivals have similarities and differences. The difference is mainly reflected in its cultural connotation, because westerners and Chinese may show their love in different ways. Nevertheless, they share more common points in terms of economy, tourism, and society. They also have a similar living environment and stakeholders. Thus, they can be promoted together to revitalize some traditions in China. Three strategies are proposed to realize the aforementioned aim. Firstly, localize international festivals to suit the Chinese context to make it function better. Secondly, facilitate the internationalization process of traditional Chinese festivals to receive more recognition worldwide. Finally, allow traditional festivals to compete with foreign ones to help them learn from each other and elucidate the development of other festivals. It is believed that if all these can be realized, not only the traditional Chinese festivals can obtain a more promising future, but foreign ones are the same as well. Accordingly, the paper can contribute to the theoretical construction of festival images by the presentation of the semantic network. Meanwhile, the identified features and issues of festivals from two different cultures can enlighten the organization and marketing of festivals as a vital tourism activity. In the long run, the study can enhance the festival as a key attraction to keep the sustainable development of both the economy and the society.

Keywords: Chinese context, comparative study, festival tourism, semantic network analysis, valentine’s day

Procedia PDF Downloads 219

Authors: Benyam Zenebe, Tesfaye Sisay, Gurja Belay, Workabeba Abebe

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Background: The prevalence and antibiogram of pathogenic E. coli strains, which cause diarrhea vary from region to region, and even within countries in the same geographical area. In Ethiopia, diagnostic approaches to E. coli induced diarrhea in children less than five years of age are not standardized. The aim of this study was to determine the involvement of pathogenic E. coli strains in child diarrhea and determine the antibiograms of the isolates in children less than 5 years of age with diarrhea at Addis Ababa University College of Health Sciences TikurAnbessa Specialized Hospital, Addis Ababa, Ethiopia. Methods: A purposive study that included 98 diarrheic children less than five years of age was conducted at Addis Ababa University College of Health Sciences, TikurAnbessa Specialized Hospital, Addis Ababa, Ethiopia to detect pathogenic E. coli biotypes. Stool culture was used to identify presumptive E. coliisolates. Presumptive isolates were confirmed by biochemical tests, and antimicrobial susceptibility tests were performed on confirmed E. coli isolates by the disk diffusion method. DNA was extracted from confirmed isolates by a heating method and subjected to Polymerase Chain Reaction or the presence of virulence genes. Amplified PCR products were analyzed by agarose gel electrophoresis. Data were collected on child demographics and clinical conditions using administered questionnaires. The prevalence of E. coli strains from the total diarrheic children, and the prevalence of pathogenic strains from total E. coli isolates along with their susceptibility profiles; the distribution of pathogenic E.coli biotypes among different age groups and between the sexes were determined by using descriptive statistics. Result: Out of 98 stool specimens collected from diarrheic children less than 5 years of age, 75 presumptive E. coli isolates were identified by culture; further confirmation by biochemical tests showed that only 56 of the isolates were E. coli; 29 of the isolates were found in male children and 27 of them in female children. Out of the 58 isolates of E. coli, 25 pathotypes belonging to different classes of pathogenic strains: STEC, EPEC, EHEC, EAEC were detected by using the PCR technique. Pathogenic E. coli exhibited high rates of antibiotic resistance to many of the antibiotics tested. Moreover, they exhibited multiple drug resistance. Conclusion: This study found that the isolation rate of E. coli and the involvement of antibiotic-resistant pathogenic E. coli in diarrheic children is prominent, and hence focus should be given on the diagnosis and antimicrobial sensitivity testing of pathogenic E. coli at Addis Ababa University College of Health Sciences TikurAnbessa Specialized Hospital. Among antibiotics tested, Cefotitan could be a drug of choice to treat E. coli.

Keywords: antibiotic susceptibility profile, children, diarrhea, E. coli, pathogenic

Procedia PDF Downloads 218

Authors: M. H. A. D. de Silva, R. P. Hewawasam, M. A. G. Iresha

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Macrosomia is common in infants born to not only women diagnosed with gestational diabetes mellitus but also non-diabetic obese women. Maternal Body Mass Index (BMI) correlates with the incidence of large for gestational age infants. Obesity has reached epidemic levels in modern societies. During the past two decades, obesity in children and adolescents has risen significantly in Asian populations including Sri Lanka. There is increasing evidence to believe that infants who are born large for gestational age are more likely to be obese in childhood and adolescence and are at risk of cardiovascular and metabolic complications later in life. It is also established that Asians have lower skeletal muscle mass, low bone mineral content and excess body fat for a given BMI indicating a genetic predisposition in the occurrence of obesity. The objective of this study is to determine the effect of maternal weight, weight gain during pregnancy, c-peptide and insulin concentrations in the cord blood on the birth of appropriate for and large for gestational age infants in a tertiary care center in Southern Sri Lanka. Umbilical cord blood was collected from 90 newborns (Male 40, Female 50; gestational age 35-42 weeks) after double clamping the umbilical cord before separation of the placenta and the concentration of insulin and C-peptide were measured by ELISA technique. Anthropometric parameters of the newborn such as birth weight, length, ponderal index, occipital frontal, chest, hip and calf circumferences were measured, and characteristics of the mother were collected. The relationship between insulin, C-peptide and anthropometrics were assessed by Spearman correlation. The multiple logistic regression analysis examined influences of maternal weight, weight gain during pregnancy, C-peptide and insulin concentrations in cord blood as covariates on the birth of large for gestational age infants. A significant difference (P<0.001) was observed between the insulin levels of infants born large for gestational age (18.73 ± 0.52 µlU/ml) and appropriate for gestational age (13.08 ± 0.56 µlU/ml). Consistently, A significant decrease in concentration (41.68%, P<0.001) was observed between C-peptide levels of infants born large for gestational age and appropriate for gestational age. Cord blood insulin and C-peptide levels had a significant correlation with birth weight (r=0.35, P<0.05) of the newborn at delivery. Maternal weight and BMI which are indicators of maternal nutrition were proven to be directly correlated with birth weight and length. To our knowledge, this relationship was investigated for the first time in a Sri Lankan setting and was also evident in our results. This study confirmed the fact that insulin and C-peptide play a major role in regulating fetal growth. According to the results obtained in this study, we can suggest that the increased BMI of the mother has a direct influence on increased maternal insulin secretion, which may subsequently affect cord insulin and C-peptide levels and also birth weight of the infant.

Keywords: C-peptide, insulin, large for gestational age, maternal weight

Procedia PDF Downloads 154

Authors: Taurino S. R. Neto, Epitácio D. S. Neto, Flávio Signorelli, Gustavo G. M. Balbi, Alex H. Higashi, Mário Luiz R. Monteiro, Eloisa Bonfá, Danieli C. O. Andrade, Leandro C. Zacharias

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Purpose: To perform a multimodal evaluation, including the use of Optical Coherence Angiotomography (OCTA), in patients with primary antiphospholipid syndrome (PAPS) without ocular complaints and to compare them with healthy individuals. Methods: A complete structural and functional ophthalmological evaluation using OCTA and microperimetry (MP) exam in patients with PAPS, followed at a tertiary rheumatology outpatient clinic, was performed. All ophthalmologic manifestations were recorded and then statistical analysis was performed for comparative purposes; p <0.05 was considered statistically significant. Results: 104 eyes of 52 subjects (26 patients with PAPS without ocular complaints and 26 healthy individuals) were included. Among PAPS patients, 21 were female (80.8%) and 21 (80.8%) were Caucasians. Thrombotic PAPS was the main clinical criteria manifestation (100%); 65.4% had venous and 34.6% had arterial thrombosis. Obstetrical criteria were present in 34.6% of all thrombotic PAPS patients. Lupus anticoagulant was present in all patients. 19.2% of PAPS patients presented ophthalmologic findings against none of the healthy individuals. The most common retinal change was paracentral acute middle maculopathy (PAMM) (3 patients, 5 eyes), followed by drusen-like deposits (1 patient, 2 eyes) and pachychoroid pigment epitheliopathy (1 patient, 1 eye). Systemic hypertension and hyperlipidaemia were present in 100% of the PAPS patients with PAMM, while only six patients (26.1%) with PAPS without PAMM presented these two risk factors together. In the quantitative OCTA evaluation, we found significant differences between PAPS patients and controls in both the superficial vascular complex (SVC) and deep vascular complex (DVC) in the high-speed protocol, as well as in the SVC in the high-resolution protocol. In the analysis of the foveal avascular zone (FAZ) parameters, the PAPS group had a larger area of FAZ in the DVC using the high-speed method compared to the control group (p=0.047). In the quantitative analysis of the MP, the PAPS group had lower central (p=0.041) and global (p<0.001) retinal sensitivity compared to the control group, as well as in the sector analysis, with the exception of the inferior sector. In the quantitative evaluation of fixation stability, there was a trend towards worse stability in the PAPS subgroup with PAMM in both studied methods. Conclusions: PAMM was observed in 11.5% of PAPS patients with no previous ocular complaints. Systemic hypertension concomitant with hyperlipidemia was the most commonly associated risk factor for PAMM in patients with PAPS. PAPS patients present lower vascular density and retinal sensitivity compared to the control group, even in patients without PAMM.

Keywords: antiphospholipid syndrome, optical coherence angio tomography, optical coherence tomography, retina

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Authors: Nouha Bouayed Abdelmoula, Rim Louati, Nawel Abdellaoui, Balkiss Abdelmoula, Oldez Kaabi, Walid Smaoui, Samir Aloulou

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Background and Aims: Cardiofaciocutaneous syndrome (CFC) is an autosomal dominant disorder with the vast majority of cases arising by a new mutation of BRAF, MEK1, MEK2, or rarely, KRAS genes. Here, we report a rare Tunisian case of CFC syndrome for whom we identify SOS1 mutation. Methods: Genomic DNA was obtained from peripheral blood collected in an EDTA tube and extracted from leukocytes using the phenol/chloroform method according to standard protocols. High resolution melting (HRM) analysis for screening of mutations in the entire coding sequence of PTPN11 was conducted first. Then, HRM assays to look for hot spot mutations coding regions of the other genes of the RAS-MAPK pathway (RAt Sarcoma viral oncogene homolog Mitogen-Activated Protein Kinases Pathway): SOS1, SHOC2, KRAS, RAF1, KRAS, NRAS, CBL, BRAF, MEK1, MEK2, HRAS, and RIT1, were applied. Results: Heterozygous SOS1 point mutation clustered in exon 10, which encodes for the PH domain of SOS1, was identified: c.1655 G > A. The patient was a 9-year-old female born from a consanguineous couple. She exhibited pulmonic valvular stenosis as congenital heart disease. She had facial features and other malformations of Noonan syndrome, including macrocephaly, hypertelorism, ptosis, downslanting palpebral fissures, sparse eyebrows, a short and broad nose with upturned tip, low-set ears, high forehead commonly associated with bitemporal narrowing and prominent supraorbital ridges, short and/or webbed neck and short stature. However, the phenotype is also suggestive of CFC syndrome with the presence of more severe ectodermal abnormalities, including curly hair, keloid scars, hyperkeratotic skin, deep plantar creases, and delayed permanent dentition with agenesis of the right maxillary first molar. Moreover, the familial history of the patient revealed recurrent brain malignancies in the paternal family and epileptic disease in the maternal family. Conclusions: This case report of an overlapping RASopathy associated with SOS1 mutation and familial history of brain tumorigenesis is exceptional. The evidence suggests that RASopathies are truly cancer-prone syndromes, but the magnitude of the cancer risk and the types of cancer partially overlap.

Keywords: cardiofaciocutaneous syndrome, CFC, SOS1, brain cancer, germline mutation

Procedia PDF Downloads 143

Authors: Sahar Heidary

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Radiography and radiotherapy have emerged as crucial pillars of modern medical practice, revolutionizing diagnostics and treatment for a myriad of health conditions. This abstract highlights the pivotal role of radiography and radiotherapy in favor of healthcare and society. Radiography, a non-invasive imaging technique, has significantly advanced medical diagnostics by enabling the visualization of internal structures and abnormalities within the human body. With the advent of digital radiography, clinicians can obtain high-resolution images promptly, leading to faster diagnoses and informed treatment decisions. Radiography plays a pivotal role in detecting fractures, tumors, infections, and various other conditions, allowing for timely interventions and improved patient outcomes. Moreover, its widespread accessibility and cost-effectiveness make it an indispensable tool in healthcare settings worldwide. On the other hand, radiotherapy, a branch of medical science that utilizes high-energy radiation, has become an integral component of cancer treatment and management. By precisely targeting and damaging cancerous cells, radiotherapy offers a potent strategy to control tumor growth and, in many cases, leads to cancer eradication. Additionally, radiotherapy is often used in combination with surgery and chemotherapy, providing a multifaceted approach to combat cancer comprehensively. The continuous advancements in radiotherapy techniques, such as intensity-modulated radiotherapy and stereotactic radiosurgery, have further improved treatment precision while minimizing damage to surrounding healthy tissues. Furthermore, radiography and radiotherapy have demonstrated their worth beyond oncology. Radiography is instrumental in guiding various medical procedures, including catheter placement, joint injections, and dental evaluations, reducing complications and enhancing procedural accuracy. On the other hand, radiotherapy finds applications in non-cancerous conditions like benign tumors, vascular malformations, and certain neurological disorders, offering therapeutic options for patients who may not benefit from traditional surgical interventions. In conclusion, radiography and radiotherapy stand as indispensable tools in modern medicine, driving transformative improvements in patient care and treatment outcomes. Their ability to diagnose, treat, and manage a wide array of medical conditions underscores their favor in medical practice. As technology continues to advance, radiography and radiotherapy will undoubtedly play an ever more significant role in shaping the future of healthcare, ultimately saving lives and enhancing the quality of life for countless individuals worldwide.

Keywords: radiology, radiotherapy, medical imaging, cancer treatment

Procedia PDF Downloads 57

Authors: Rozelle Labuschagne, Ronel Roos

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Individuals often experience a reduction in physical function, quality of life and basic activities of daily living after surgery. This is exponentially true for high-risk patients, especially the elderly and frail individuals. Not much is known about the physical function, physical activity preferences and factors associated with the six-minute walk test of elderly individuals who would undergo elective abdominal surgery in South Africa. Such information is important to design effective prehabilitation physiotherapy programs prior to elective surgery. The purpose of the study was to describe the demographic profile and physical function of elderly patients who would undergo elective surgery and to determine factors associated with their six-minute walk test distance findings. A cross-sectional descriptive study in elderly patients older than 60 years of age who would undergo elective abdominal surgery were consecutively sampled at a private hospital in Pretoria, South Africa. Participants’ demographics were collected and physical function assessed with the Functional Comorbidity Index (FCI), DeMorton Mobility Index (DEMMI), Lawton-Brody Instrumental Activities of Daily Living Scale (IADL) and six-minute walk test (6MWT). Descriptive and inferential statistics were used for data analysis with IBM SPSS 25. A p-value ≤ 0.05 were deemed statistically significant. The pilot study consisted of 12 participants (female (n=11, 91.7%), male (n=1, 8.3%) with a mean age of 65.8 (±4.5) years, body mass index of 28 (±4.2) kg.m2 with one (8.3%) participant being a current smoker and four (33.3%) participants having a smoking history. Nine (75%) participants lived independently at home and three (25%) had caregivers. Participants reported walking (n=6, 50%), stretching exercises (n=1, 8.3%), household chores & gardening (n=2, 16.7%), biking/swimming/running (n=1, 8.3%) as physical activity preferences. Physical function findings of the sample were: mean FCI score 3 (±1.1), DEMMI score 81.1 (±14.9), IADL 95 (±17.3), 6MWT 435.50 (IQR 364.75-458.50) with percentage 6MWT distance achieved 81.8% (IQR 64.4%-87.5%). A strong negative correlation was observed between 6MWT distance walked and FCI (r = -0.729, p=0.007). The majority of study participants reported incorporating some form of physical activity into their daily life as form of exercise. Most participants did not achieve their predicted 6MWT distance indicating less than optimal levels of physical function capacity. The number of comorbidities as determined by the FCI was associated with the distance that participants could walk with the 6MWT. The results of this pilot study could be used to indicate which elderly individuals would benefit most from a pre-surgical rehabilitation program. The main goal of such a program would be to improve physical function capacity as measured by the 6MWT. Surgeons could refer patients based on age and number of comorbidities, as determined by the FCI, to potentially improve surgical outcomes.

Keywords: abdominal surgery, elderly, physical function, six-minute walk test

Procedia PDF Downloads 184

Authors: Claire Tranter, Coral Dando

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Gathering information from others is a fundamental goal for those concerned with investigating crime, and protecting national and international security. Persuading an individual to move from an opposing to converging viewpoint, and an understanding on the cognitive style behind this change can serve to increase understanding of traditional face-to-face interactions, as well as synthetic environments (SEs) often used for communication across varying geographical locations. SEs are growing in usage, and with this increase comes an increase in crime being undertaken online. Communication technologies can allow people to mask their real identities, supporting anonymous communication which can raise significant challenges for investigators when monitoring and managing these conversations inside SEs. To date, the psychological literature concerning how to maximise information-gain in SEs for real-world interviewing purposes is sparse, and as such this aspect of social cognition is not well understood. Here, we introduce an overview of a novel programme of PhD research which seeks to enhance understanding of cross-cultural and cross-gender communication in SEs for maximising information gain. Utilising a dyadic jury paradigm, participants interacted with a confederate who attempted to persuade them to the opposing verdict across three distinct environments: face-to-face, instant messaging, and a novel virtual reality environment utilising avatars. Participants discussed a criminal scenario, acting as a two-person (male; female) jury. Persuasion was manipulated by the confederate claiming an opposing viewpoint (guilty v. not guilty) to the naïve participants from the outset. Pre and post discussion data, and observational digital recordings (voice and video) of participant’ discussion performance was collected. Information regarding cognitive style was also collected to ascertain participants need for cognitive closure and biases towards jumping to conclusions. Findings revealed that individuals communicating via an avatar in a virtual reality environment reacted in a similar way, and thus equally persuasive, when compared to individuals communicating face-to-face. Anonymous instant messaging however created a resistance to persuasion in participants, with males showing a significant decline in persuasive outcomes compared to face to face. The findings reveal new insights particularly regarding the interplay of persuasion on gender and modality, with anonymous instant messaging enhancing resistance to persuasion attempts. This study illuminates how varying SE can support new theoretical and applied understandings of how judgments are formed and modified in response to advocacy.

Keywords: applied cognition, persuasion, social media, virtual reality

Procedia PDF Downloads 138

Authors: Mohamed Hendawy Mousa, Warda Youssef Mohamed Morsy

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Background: Sepsis is a major cause of mortality and morbidity in trauma patients. Body mass index as an indicator of nutritional status was reported as a predictor of injury pattern and complications among critically ill injured patients. Aim: The aim of this study is to investigate the relationship between body mass index and the development of sepsis, systemic inflammatory response syndrome among adult trauma patients at emergency hospital - Cairo University. Research design: Descriptive correlational research design was utilized in the current study. Research questions: Q1. What is the body mass index profile of adult trauma patients admitted to the emergency hospital at Cairo University over a period of 6 months?, Q2. What is the frequency of systemic inflammatory response syndrome and sepsis among adult trauma patients admitted to the emergency hospital at Cairo University over a period of 6 months?, and Q3. What is the relationship between the development of sepsis, systemic inflammatory response syndrome and body mass index among adult trauma patients admitted to the emergency hospital at Cairo University over a period of 6 months?. Sample: A purposive sample of 52 adult male and female trauma patients with revised trauma score 10 to 12. Setting: The Emergency Hospital affiliated to Cairo University. Tools: Four tools were utilized to collect data pertinent to the study: Socio demographic and medical data tool, Systemic inflammatory response syndrome assessment tool, Revised Trauma Score tool, and Sequential organ failure assessment tool. Results: The current study revealed that, (61.5 %) of the studied subjects had normal body mass index, (25 %) were overweight, and (13.5 %) were underweight. 84.6% of the studied subjects had systemic inflammatory response syndrome and 92.3% were suffering from mild sepsis. No significant statistical relationship was found between body mass index and occurrence of Systemic inflammatory response syndrome (2= 2.89 & P = 0.23). However, Sequential organ failure assessment scores were affected significantly by body mass index was found mean of initial and last Sequential organ failure assessment score for underweight, normal and obese where t= 7.24 at p = 0.000, t= 16.49 at p = 0.000 and t= 9.80 at p = 0.000 respectively. Conclusion: Underweight trauma patients showed significantly higher rate of developing sepsis as compared to patients with normal body weight and obese. Recommendations: based on finding of this study the following are recommended: replication of the study on a larger probability sample from different geographical locations in Egypt; Carrying out of further studies in order to assess the other risk factors influencing trauma outcome and incidence of its complications; Establishment of standardized guidelines for managing underweight traumatized patients with sepsis.

Keywords: body mass index, sepsis, systemic inflammatory response syndrome, adult trauma

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Authors: Marina Fuertes

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Introduction: In everyday life experiences, children are solicited to cooperate with others. Often they perform cooperative tasks with their parents (e.g., setting the table for dinner) or in school. These tasks are very significant since children may learn to turn taking in interactions, to participate as well to accept others participation, to trust, to respect, to negotiate, to self-regulate their emotions, etc. Indeed, cooperative tasks contribute to children social, motor, cognitive and linguistic development. Therefore, it is important to study what learning, social and affective experiences are provided to children during these tasks. In this study, we included parents and preschool educators. Parents and educators are both significant: educative, interactive and affective figures. Rarely parents and educators behavior have been compared in studies about cooperative tasks. Parents and educators have different but complementary styles of interaction and communication. Aims: Therefore, this study aims to compare parents and educators' (of both genders) interactive behavior (cooperativity, empathy, ability to challenge the child, reciprocity, elaboration) during a play/individualized situation involving a cooperative task. Moreover, to compare parents and educators' behavior with girls and boys. Method: A quasi-experimental study with 45 dyads educators-children and 45 dyads with parents and their children. In this study, participated children between 3 and 5 years old and with age appropriate development. Adults and children were videotaped using a variety of materials (e.g., pencils, wood, wool) and tools (e.g., scissors, hammer) to produce together something of their choice during 20-minutes. Each dyad (one adult and one child) was observed and videotaped independently. Adults and children agreed and consented to participate. Experimental conditions were suitable, pleasant and age appropriated. Results: Findings indicate that parents and teachers offer different learning experiences. Teachers were more likely to challenged children to explore new concepts and to accept children ideas. In turn, parents gave more support to children actions and were more likely to use their own example to teach children. Multiple regression analysis indicates that parent versus educator status predicts their behavior. Gender of both children and adults affected the results. Adults acted differently with girls and boys (e.g., adults worked more cooperatively with girls than boys). Male participants supported more girls participation rather than boys while female adults allowed boys to make more decisions than girls. Discussion: Taking our results and past studies, we learn that different qualitative interactions and learning experiences are offered by parents, educators according to parents and children gender. Thus, the same child needs to learn different cooperative strategies according to their interactive patterns and specific context. Yet, cooperative play and individualized activities with children generate learning opportunities and benefits children participation and involvement.

Keywords: early childhood education, parenting, gender, cooperative tasks, adult-child interaction

Procedia PDF Downloads 315

Authors: Peter J. Fusco, Dave M. Mathew, Chris Mathew, Kenneth H. Levy, Kathryn S. Varghese, Stephanie Salazar-Restrepo, Serena M. Mathew, Sofia Khaja, Eamon Vega, Mia Polizzi, Alyssa Mullane, Adham Ahmed

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Background: Laparoscopic (LS) removal of neuroblastomas in children has been reported to offer favorable outcomes compared to the conventional open thoracotomy (OT) procedure. Critical perioperative measures such as blood loss, operative time, length of stay, and time to postoperative chemotherapy have all supported laparoscopic use rather than its more invasive counterpart. Herein, a pairwise meta-analysis was performed comparing perioperative outcomes between LS and OT in thoracoabdominal neuroblastoma cases. Methods: A comprehensive literature search was performed on PubMed, Ovid EMBASE, and Scopus databases to identify studies comparing the outcomes of pediatric patients with thoracoabdominal neuroblastomas undergoing resection via OT or LS. After deduplication, 4,227 studies were identified and subjected to initial title screening with exclusion and inclusion criteria to ensure relevance. When studies contained overlapping cohorts, only the larger series were included. Primary outcomes include estimated blood loss (EBL), hospital length of stay (LOS), and mortality, while secondary outcomes were tumor recurrence, post-operative complications, and operation length. The “meta” and “metafor” packages were used in R, version 4.0.2, to pool risk ratios (RR) or standardized mean differences (SMD) in addition to their 95% confidence intervals in the random effects model via the Mantel-Haenszel method. Heterogeneity between studies was assessed using the I² test, while publication bias was assessed via funnel plot. Results: The pooled analysis included 209 patients from 5 studies (141 OT, 68 LS). Of the included studies, 2 originated from the United States, 1 from Toronto, 1 from China, and 1was from a Japanese center. Mean age between study cohorts ranged from 2.4 to 5.3 years old, with female patients occupying between 30.8% to 50% of the study populations. No statistically significant difference was found between the two groups for LOS (SMD -1.02; p=0.083), mortality (RR 0.30; p=0.251), recurrence(RR 0.31; p=0.162), post-operative complications (RR 0.73; p=0.732), or operation length (SMD -0.07; p=0.648). Of note, LS appeared to be protective in the analysis for EBL, although it did not reach statistical significance (SMD -0.4174; p= 0.051). Conclusion: Despite promising literature assessing LS removal of pediatric neuroblastomas, results showed it was non-superior to OT for any explored perioperative outcomes. Given the limited comparative data on the subject, it is evident that randomized trials are necessary to further the efficacy of the conclusions reached.

Keywords: laparoscopy, neuroblastoma, thoracoabdominal, thoracotomy

Procedia PDF Downloads 122

Authors: Jean Akiana, Digne Merveille Nganga Bouanga, Nardiouf Sjelin Nsana, Wilfrid Sapromet Ngoubili, Chyvanelle Ndous Akiridzo, Vishnou Reize Ampiri, Henri-Joseph Parra, Florence Fenollar, Didier Raoult, Oleg Mediannikov, Cheikh Sadhibou Sokhna

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Schistosoma haematobium schistosomiasis is an endemic disease in which the level of human exposure, incidence, and fatality attributed to it remains, unfortunately, high worldwide. The erection of hydroelectric infrastructures constitute a major factor in the emergence of this disease. In the context of the Republic of the Congo, which considers industrialization and modernization as two essential pillars of development, building the hydroelectric dams of Liouesso (19 Mw) and the feasibility studies of the dams of Chollet (600MW) in the Sangha, of Sounda (1000MW) in Kouilou and Kouembali (150MW) on Lefini is necessary to increase the country's energy capacities. Likewise, the urbanization of former endemic localities should take into account the maintenance of contamination points. However, health impact studies on schistosomiasis epidemiology in general and urinary bilharzia, in particular, have never been carried out in these areas, neither before nor after the erection of those dams. Participants benefited from an investigative questionnaire, urinalysis both by dipstick and urine filtrate examined under a microscope. Assessment of the genetic diversity of schistosoma species populations was considered as well as PCR analysis to confirm the test strip and microscopy tests. 405 participants were registered in five localities. The sampling was made up of a balanced population in terms of male/female ratio, which is around 1. The prevalence rate was 45% (55/123) in Nkayi, 10.40% (11/106) in Loudima, 1 case in Mbomo (West Cuvette), which would probably be imported, zero in Liouesso and Kabo. The highest oviuria (number of eggs per volume of urine) is 150 S. haematobium eggs/10ml in Nkayi, apart from the case of imported Mbomo, imported from Gabon, which has 160 S. haematobium eggs/10ml. The lowest oviuria was 2 S. haematobium eggs/10ml. Prevalence rates are still high in semi-urban areas (Nkayi). As praziquantel treatments are available and effective, it is important to step up mass treatment campaigns in high risk areas already largely initiated by the National Schistosomiasis Control Program. Prevalence rates are still high in semi-urban areas (Nkayi). As praziquantel treatments are available and effective, it is important to step up mass treatment campaigns in high risk areas already largely initiated by the National Schistosomiasis Control Program.

Keywords: Bilharzia, Schistosoma haematobium, oviuria, urbanization, Congo

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Authors: Johan Buermans, Kristel Crombé, Niek Desmet, Laura Dittrich, Andrei Goriaev, Yurii Kovtun, Daniel López-Rodriguez, Sören Möller, Per Petersson, Maja Verstraeten

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The International Thermonuclear Experimental Reactor (ITER) will rely on three sources of external heating to produce and sustain a plasma; Neutral Beam Injection (NBI), Ion Cyclotron Resonance Heating (ICRH), and Electron Cyclotron Resonance Heating (ECRH). ECRH is a way to heat the electrons in a plasma by resonant absorption of electromagnetic waves. The energy of the electrons is transferred indirectly to the ions by collisions. The electron cyclotron heating system can be directed to deposit heat in particular regions in the plasma (https://www.iter.org/mach/Heating). Electron Cyclotron Resonance Heating (ECRH) at the fundamental resonance in X-mode is limited by a low cut-off density. Electromagnetic waves cannot propagate in the region between this cut-off and the Upper Hybrid Resonance (UHR) and cannot reach the Electron Cyclotron Resonance (ECR) position. Higher harmonic heating is hence preferred in heating scenarios nowadays to overcome this problem. Additional power deposition mechanisms can occur above this threshold to increase the plasma density. This includes collisional losses in the evanescent region, resonant power coupling at the UHR, tunneling of the X-wave with resonant coupling at the ECR, and conversion to the Electron Bernstein Wave (EBW) with resonant coupling at the ECR. A more profound knowledge of these deposition mechanisms can help determine the optimal plasma production scenarios. Several ECRH experiments are performed on the TOroidally MAgnetized System (TOMAS) to identify the conditions for Electron Bernstein Wave (EBW) heating. Density and temperature profiles are measured with movable Triple Langmuir Probes in the horizontal and vertical directions. Measurements of the forwarded and reflected power allow evaluation of the coupling efficiency. Optical emission spectroscopy and camera images also contribute to plasma characterization. The influence of the injected power, magnetic field, gas pressure, and wave polarization on the different deposition mechanisms is studied, and the contribution of the Electron Bernstein Wave is evaluated. The TOMATOR 1D hydrogen-helium plasma simulator numerically describes the evolution of current less magnetized Radio Frequency plasmas in a tokamak based on Braginskii’s legal continuity and heat balance equations. This code was initially benchmarked with experimental data from TCV to determine the transport coefficients. The code is used to model the plasma parameters and the power deposition profiles. The modeling is compared with the data from the experiments.

Keywords: electron Bernstein wave, Langmuir probe, plasma characterization, TOMAS

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Authors: Y. Z. Gad

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Disorders of Sex Development (DSD) are defined as congenital conditions in which development of chromosomal, gonadal or anatomical sex is atypical. The DSD are relatively prevalent in Egypt. In spite of that, the relative rarity of the individual disease types or their molecular pathologies frequently resulted in reporting on single or few cases. This augmented the challenging nature of phenotype-genotype correlation in this disease group and its utilization in the management of such medical emergency. Through critical assessment of the published DSD reports, the current review aims at analyzing the clinical characteristics of the various DSD forms in relation to the underlying molecular pathologies. A systematic literature search was done in Pubmed, using relevant keywords (Egypt versus DSD, genital ambiguity or ambiguous genitalia, the old terms of 'intersex, hermaphroditism and pseudohermaphroditism', and a list of the DSD entities and their related genes). The search yielded 24 reports of molecular data in Egyptian patients presenting with ambiguous genitalia. However, only 21 publications fulfilled the criteria of inclusion of detailed clinical descriptions and definitive molecular diagnoses of individual patients. Curation of the data yielded a total of 53 cases that were ascertained from 40 families. Fifty-one patients present with ambiguous genitalia only while 2 had multiple congenital anomalies. Parental consanguinity was noted in 60% of cases. Sex of rearing at initial presentation was female in 75% and 60% in 46,XY and 46,XX DSD cases, respectively. The external genital phenotype in 2/3 of the 46,XY DSD cases showed moderate undermasculinization [Quigley scores 3 & 4] and 1/3 had severe presentations [scores 5 & 6]. For 46,XX subjects, 1 had severe virilization of the external genitalia while 8 had moderate phenotype. Hormonal data were inconclusive or contradictory to final diagnosis in a forth of cases. Collectively, 31 families [31/40, 77.5%] with 46,XY DSD had molecular defects in the genes, 5 alpha reductase 2 (SRD5A2) [12/31], 17 beta-hydroxysteroid dehydrogenase 3 [8/31], androgen receptor [7/31], Steroidogenic factor 1 [2/31], luteinizing hormone receptor [1/31], and fibroblast growth factor receptor 1 [1/31]. In a multiethnic study, 9 families afflicted with 46,XX DSD due to 11 beta hydroxylase (CYP11B1) deficiency were documented. Two recurrent mutations, G34R and N160D, in SRD5A2 were present, respectively, in 42 and 17% of cases. Similarly, 4 recurrent mutations resulted in 89% of the CYP11B1 presentations. In conclusion, this analysis highlights the importance of autosomal recessive inheritance and inbreeding among DSD presentations, the importance of founder effect in at least 2 disorders, the difficulties in relating the genotype with the indeterminate genital phenotype, the under-reporting of some DSD subtypes, and the notion that the reported mutational profiles among Egyptian DSD cases are relatively different from those reported in other ethnic groups.

Keywords: disorders of sex development, genital ambiguity, mutation, molecular diagnosis, Egypt

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Authors: Junze Li, M. Li

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Laser diodes fabricated from the III-nitride material system are emerging solutions for the next generation telecommunication systems and optical clocks based on Ca at 397nm, Rb at 420.2nm and Yb at 398.9nm combined 556 nm. Most of the applications require single longitudinal optical mode lasers, with very narrow linewidth and compact size, such as communication systems and laser cooling. In this case, the GaN based distributed feedback (DFB) laser diode is one of the most effective candidates with gratings are known to operate with narrow spectra as well as high power and efficiency. Given the wavelength range, the period of the first-order diffraction grating is under 100 nm, and the realization of such gratings is technically difficult due to the narrow line width and the high quality nitride overgrowth based on the Bragg grating. Some groups have reported GaN DFB lasers with high order distributed feedback surface gratings, which avoids the overgrowth. However, generally the strength of coupling is lower than that with Bragg grating embedded into the waveguide within the GaN laser structure by two-step-epitaxy. Therefore, the overgrowth on the grating technology need to be studied and optimized. Here we propose to fabricate the fine step shape structure of first-order grating by the nanoimprint combined inductively coupled plasma (ICP) dry etching, then carry out overgrowth high quality AlGaN film by metalorganic chemical vapor deposition (MOCVD). Then a series of gratings with different period, depths and duty ratios are designed and fabricated to study the influence of grating structure to the nano-heteroepitaxy. Moreover, we observe the nucleation and growth process by step-by-step growth to study the growth mode for nitride overgrowth on grating, under the condition that the grating period is larger than the mental migration length on the surface. The AFM images demonstrate that a smooth surface of AlGaN film is achieved with an average roughness of 0.20 nm over 3 × 3 μm2. The full width at half maximums (FWHMs) of the (002) reflections in the XRD rocking curves are 278 arcsec for the AlGaN film, and the component of the Al within the film is 8% according to the XRD mapping measurement, which is in accordance with design values. By observing the samples with growth time changing from 200s, 400s to 600s, the growth model is summarized as the follow steps: initially, the nucleation is evenly distributed on the grating structure, as the migration length of Al atoms is low; then, AlGaN growth alone with the grating top surface; finally, the AlGaN film formed by lateral growth. This work contributed to carrying out GaN DFB laser by fabricating grating and overgrowth on the nano-grating patterned substrate by wafer scale, moreover, growth dynamics had been analyzed as well.

Keywords: DFB laser, MOCVD, nanoepitaxy, III-niitride

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Authors: Andrea Fiorista

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The learning of prepositions is a quite problematic aspect in foreign language instruction, and Italian is certainly not an exception. In their prototypical function, prepositions express schematic relations of two entities in a highly abstract, typically image-schematic way. In other terms, prepositions assume concepts such as directionality, collocation of objects in space and time and, in Cognitive Linguistics’ terms, the position of a trajector with respect to a landmark. Learners of different native languages may conceptualize them differently, implying that they are supposed to operate a recategorization (or create new categories) fitting with the target language. However, most current Italian Foreign/Second Language handbooks and didactic grammars do not facilitate learners in carrying out the task, as they tend to provide partial and idiosyncratic descriptions, with the consequent learner’s effort to memorize them, most of the time without success. In their prototypical meaning, prepositions are used to specify precise topographical positions in the physical environment which become less and less accurate as they radiate out from what might be termed a concrete prototype. According to that, the present study aims to elaborate a cognitive and conceptually well-grounded analysis of some extensive uses of the Italian preposition a, in order to propose effective pedagogical solutions in the Teaching/Learning process. Image schemas, cognitive metaphors and embodiment represent efficient cognitive tools in a task like this. Actually, while learning the merely spatial use of the preposition a (e.g. Sono a Roma = I am in Rome; vado a Roma = I am going to Rome,…) is quite straightforward, it is more complex when a appears in constructions such as verbs of motion +a + infinitive (e.g. Vado a studiare = I am going to study), inchoative periphrasis (e.g. Tra poco mi metto a leggere = In a moment I will read), causative construction (e.g. Lui mi ha mandato a lavorare = He sent me to work). The study reports data from a teaching intervention of Focus on Form, in which a basic cognitive schema is used to facilitate both teachers and students to respectively explain/understand the extensive uses of a. The educational material employed translates Cognitive Linguistics’ theoretical assumptions, such as image schemas and cognitive metaphors, into simple images or proto-scenes easily comprehensible for learners. Illustrative material, indeed, is supposed to make metalinguistic contents more accessible. Moreover, the concept of embodiment is pedagogically applied through activities including motion and learners’ bodily involvement. It is expected that replacing rote learning with a methodology that gives grammatical elements a proper meaning, makes learning process more effective both in the short and long term.

Keywords: cognitive approaches to language teaching, image schemas, embodiment, Italian as FL/SL

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Authors: Minghui Zhang, Sirine Fkaier, Sabri Fernana, Svetlana Kiseleva, Denis Kiselev

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The real-time identification of bacteria and fungi is difficult because they emit much weaker signals than pollen. In 2020, Plair developed Rapid-E+, which extends abilities of Rapid-E to detect smaller bioaerosols such as bacteria and fungal spores with diameters down to 0.3 µm, while keeping the similar or even better capability for measurements of large bioaerosols like pollen. Rapid-E+ enables simultaneous measurements of (1) time-resolved, polarization and angle dependent Mie scattering patterns, (2) fluorescence spectra resolved in 16 channels, and (3) fluorescence lifetime of individual particles. Moreover, (4) it provides 2D Mie scattering images which give the full information on particle morphology. The parameters of every single bioaerosol aspired into the instrument are subsequently analysed by machine learning. Firstly, pure species of microbes, e.g., Bacillus subtilis (a species of bacteria), and Penicillium chrysogenum (a species of fungal spores), were aerosolized in a bioaerosol chamber for Rapid-E+ training. Afterwards, we tested microbes under different concentrations. We used several steps of data analysis to classify and identify microbes. All single particles were analysed by the parameters of light scattering and fluorescence in the following steps. (1) They were treated with a smart filter block to get rid of non-microbes. (2) By classification algorithm, we verified the filtered particles were microbes based on the calibration data. (3) The probability threshold (defined by the user) step provides the probability of being microbes ranging from 0 to 100%. We demonstrate how Rapid-E+ identified simultaneously microbes based on the results of Bacillus subtilis (bacteria) and Penicillium chrysogenum (fungal spores). By using machine learning, Rapid-E+ achieved identification precision of 99% against the background. The further classification suggests the precision of 87% and 89% for Bacillus subtilis and Penicillium chrysogenum, respectively. The developed algorithm was subsequently used to evaluate the performance of microbe classification and quantification in real-time. The bacteria and fungi were aerosolized again in the chamber with different concentrations. Rapid-E+ can classify different types of microbes and then quantify them in real-time. Rapid-E+ enables classifying different types of microbes and quantifying them in real-time. Rapid-E+ can identify pollen down to species with similar or even better performance than the previous version (Rapid-E). Therefore, Rapid-E+ is an all-in-one instrument which classifies and quantifies not only pollen, but also bacteria and fungi. Based on the machine learning platform, the user can further develop proprietary algorithms for specific microbes (e.g., virus aerosols) and other aerosols (e.g., combustion-related particles that contain polycyclic aromatic hydrocarbons).

Keywords: bioaerosols, laser-induced fluorescence, Mie-scattering, microorganisms

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Authors: Sadandaula Rose Muheriwa Matemba, Alexander Glazier, Natalie M. LeBlanc

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In the United States, up to 10% of girls and 22 % of boys 10-14 years have had sex, 5% of them had their first sex before 11 years, and the age of first sexual encounter is reported to be 8 years. Over 4,000 adolescent girls, 10-14 years, become pregnant every year, and 2.6% of the abortions in 2019 were among adolescents below 15 years. Despite these negative outcomes, little research has been conducted to understand the sexual health education offered to young adolescents ages 10-14. Early sexual health education is one of the most effective strategies to help lower the rate of early pregnancies, HIV infections, and other sexually transmitted. Such knowledge is necessary to inform best practices for supporting the healthy sexual development of young adolescents and prevent adverse outcomes. This qualitative descriptive study was conducted to explore the community stakeholders’ experiences in sexual health education for young adolescents ages 10-14 and ascertain the young adolescents’ sexual health support needs. Maximum variation purposive sampling was used to recruit a total sample of 13 community stakeholders, including health education teachers, members of youth-based organizations, and Adolescent Clinic providers in Rochester, New York State, in the United States of America from April to June 2022. Data were collected through semi-structured individual in-depth interviews and were analyzed using MAXQDA following a conventional content analysis approach. Triangulation, team analysis, and respondent validation to enhance rigor were also employed to enhance study rigor. The participants were predominantly female (92.3%) and comprised of Caucasians (53.8%), Black/African Americans (38.5%), and Indian-American (7.7%), with ages ranging from 23-59. Four themes emerged: the perceived need for early sexual health education, preferred timing to initiate sexual health conversations, perceived age-appropriate content for young adolescents, and initiating sexual health conversations with young adolescents. The participants described encouraging and concerning experiences. Most participants were concerned that young adolescents are living in a sexually driven environment and are not given the sexual health education they need, even though they are open to learning sexual health materials. There was consensus on the need to initiate sexual health conversations early at 4 years or younger, standardize sexual health education in schools and make age-appropriate sexual health education progressive. These results show that early sexual health education is essential if young adolescents are to delay sexual debut, prevent early pregnancies, and if the goal of ending the HIV epidemic is to be achieved. However, research is needed on a larger scale to understand how best to implement sexual health education among young adolescents and to inform interventions for implementing contextually-relevant sexuality education for this population. These findings call for increased multidisciplinary efforts in promoting early sexual health education for young adolescents.

Keywords: community stakeholders’ perspectives, sexual development, sexual health education, young adolescents

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Authors: Hamdan Hamood Aldumaini, Amjad Hussein Meqdam, Shamsaldeen kassim Ali, Hamed Mohammed Al-Yousefi, Haron Ahmed Al-Badawi

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Background: Autism Spectrum Disorder (ASD) is a complex developmental challenge characterized by significant impairments in social interaction, communication, and behavioral patterns. Diagnosing ASD is challenging due to the lack of definitive medical tests, making early identification crucial. Therefore, increasing people's awareness about autism leads to early diagnosis and better prognosis. Objective: Our study aims to identify the initial symptoms prompting families to seek medical advice, determine the timeline between symptom onset and formal diagnosis, and explore methods for assessing the severity of ASD. Subjects and Methods: The study design employed was a descriptive cross-sectional design, which was suitable for the nature of the research. The data collection took place from March 5, 2022, to April 5, 2022, in Autism Rehabilitation Centers in Sana'a, Yemen. The study population consisted of all children who were diagnosed with autism and visited Autism rehabilitation centers in Sana'a city. The sample size was determined using Epi info version 7, and a total population of 587 autistic children attending the treatment was calculated, but only 250 children were included in this study (176 were male vs. 74 female). Result: In terms of sociability problems, it was found that a significant proportion of Yemeni children with autism experienced difficulties in this area. Specifically, 39.6% were classified as having severe sociability problems, while 28.4% were classified as having moderate issues. Sensory-cognitive awareness problems were also prevalent among the respondents, with 29.6% exhibiting severe difficulties in this domain. Health and physical problems were identified as significant concerns for Yemeni children with autism. The results indicated that 38.4% of the participants experienced severe health and physical issues. Identifying the first symptoms of autism is crucial for early detection and intervention. According to the study, speech delay was the most commonly observed first abnormality, reported by 71.3% of parents. Communication difficulties with others were the second most noticed abnormality, reported by 54.9% of parents. Repetitive movements were the third most commonly observed abnormality, reported by 18% of parents. Regarding the awareness among parents of ASD, our study showed that a significant portion (62%) of parents lack awareness about Autism Spectrum Disorder (ASD) and its causes. Surprisingly, a majority of these parents (over 80%) believe that autism is a curable condition. Additionally, more than half (51.2%) of the parents surveyed reported insufficient knowledge about medication options available to support therapy and rehabilitation for their autistic children.

Keywords: autism characteristics, rehabilitation centres, yemen, children

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Authors: Sunil Kumar, Rajesh Sharma

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Toxic epidermal necrolysis, pruritis, rashes, lichen planus like eruption, hyper pigmentation of skin are rare toxic effects of choloroquine used over a long time. Skin and mucus membrane hyper pigmentation is generally of a bluish black or grayish color and irreversible after discontinuation of the drug. According to Ayurveda, Dushivisha is the name given to any poisonous substance which is not fully endowed with the qualities of poison by nature (i.e. it acts as an impoverished or weak poison) and because of its mild potency, it remains in the body for many years causing various symptoms, one among them being discoloration of skin.The objective of this case report is to investigate the effect of Ayurvedic management of chloroquine induced hyper-pigmentation on the line of treatment of Dushivisha. Case Report: A 26-year-old female was suffering from hyper-pigmentation of the skin over the neck, forehead, temporo-mandibular joints, upper back and posterior aspect of both the arms since 8 years had history of taking Chloroquine came to Out Patient Department of National Institute of Ayurveda, Jaipur, India in Jan. 2015. The routine investigations (CBC, ESR, Eosinophil count) were within normal limits. Punch biopsy skin studied for histopathology under hematoxylin and eosin staining showed epidermis with hyper-pigmentation of the basal layer. In the papillary dermis as well as deep dermis there were scattered melanophages along with infiltration by mononuclear cells. There was no deposition of amyloid-like substances. These histopathological findings were suggestive of Chloroquine induced hyper-pigmentation. The case was treated on the line of treatment of Dushivisha and was given Vamana and Virechana (therapeutic emesis and purgation) every six months followed by Snehana karma (oleation therapy) with Panchatikta Ghrit and Swedana (sudation). Arogyavardhini Vati -1 g, Dushivishari Vati 500 mg, Mahamanjisthadi Quath 20 ml were given twelve hourly and Aragwadhadi Quath 25 ml at bed time orally. The patient started showing lightening of the pigments after six months and almost complete remission after 12 months of the treatment. Conclusion: This patient presented with the Dushivisha effect of Chloroquineandwas administered two relevant procedures from Panchakarma viz. Vamana and Virechana. Both Vamana and Virechanakarma here referred to Shodhana karma (purification procedures) eliminates accumulated toxins from the body. In this process, oleation dislodge the toxins from the tissues and sudation helps to bring them to the alimentary tract. The line of treatment did not target direct hypo pigmentary effects; rather aimed to eliminate the Dushivisha. This gave promising results in this condition.

Keywords: Ayurveda, chloroquine, Dushivisha, hyper-pigmentation

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Authors: Afsaneh Ghanbari Panah, Elyaz Bornak, Shiva Ghadiri Karizi, Amna Ahmad, Burcu Yildirim

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This study explores domestic violence (DV) and coping strategies among married women in Iran, Pakistan, and Turkey. DV is a universal issue characterized by physical, psychological, or economic abuse by male family members towards female partners. The study aims to examine the prevalence of DV and the coping mechanisms employed by women in these three countries. The research highlights the significant impact of DV globally, transcending cultural, social, and economic boundaries. Despite the lack of comprehensive state-sponsored reports on Violence Against Women (VAW) in South Asia, fragmented reports by non-governmental agencies indicate high rates of self-reported intimate partner violence (IPV), including sexual violence, across these regions. The study emphasizes the urgent need for effective measures to address VAW, as existing laws often exclude unregistered and unmarried intimate partners. Coping mechanisms play a crucial role in responding to and managing the consequences of DV. The study defines coping as cognitive and behavioral responses to environmental stressors. Common coping strategies identified in the literature include spirituality, temporary or permanent separation, silence, submission, minimizing violence, denial, and seeking external support. Understanding these coping mechanisms is crucial for developing effective prevention and management strategies. The study presents findings from Iran, Pakistan, and Turkey, indicating varying prevalence rates of different forms of violence. Turkish respondents reported higher rates of emotional, physical, economic, and sexual violence, while Iranian respondents reported high levels of psychological, physical, and sexual violence. In Karachi, Pakistan, physical, sexual, and psychological violence were prevalent among women. The study highlights the importance of cross-cultural research and the need to consider individual and collective coping mechanisms in different societal contexts. Factors such as personal ideologies, political agendas, and economic stability influence societal support and cultural acceptance of IPV. To develop sustainable strategies, an in-depth exploration of coping mechanisms is necessary. In conclusion, this comparative study provides insights into DV and coping strategies among married women in Iran, Pakistan, and Turkey. The findings underscore the urgent need for comprehensive measures to address VAW, considering cultural, social, and economic factors. By understanding the prevalence and coping mechanisms employed by women, policymakers can develop effective interventions to support DV survivors and prevent further violence.

Keywords: domestic violence, coping styles, cultural study, violence against women

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Authors: Leonardo Costa Pereira, Frederico Santos Santana, Mauro Karnikowski, Luís Sinésio Silva Neto, Aline Oliveira Gomes, Marisete Peralta Safons, Margô Gomes De Oliveira Karnikowski

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In Brazil, projections of population aging follow all world projections, the birth rate tends to be surpassed by the mortality rate around the year 2045. Historically, the population of Brazilian blacks suffered for several centuries from the oppression of dominant classes. A group, especially of blacks, stands out in relation to territorial, historical and social aspects, and for centuries they have isolated themselves in small communities, in order to maintain their freedom and culture. The isolation of the Quilombola communities generated socioeconomic effects as well as the health of these blacks. Thus, the objective of the present study is to verify the association of body composition parameters with lower and upper limb strength and functional capacity in Quilombola remnants. The research was approved by ethics committee (1,771,159). Anthropometric evaluations of hip and waist circumference, body mass and height were performed. In order to verify the body composition, the relationship between stature and body mass (BM) was performed, generating the body mass index (BMI), as well as the dual-energy X-ray absorptiometry (DEXA) test. The Time Up and Go (TUG) test was used to evaluate the functional capacity, and a maximum repetition test (1MR) for knee extension and handgrip (HG) was applied for strength magnitude analysis. Statistical analysis was performed using the statistical package SPSS 22.0. Shapiro Wilk's normality test was performed. For the possible correlations, the suggestions of the Pearson or Spearman tests were adopted. The results obtained after the interpretation identified that the sample (n = 18) was composed of 66.7% of female individuals with mean age of 66.07 ± 8.95 years. The sample’s body fat percentage (%BF) (35.65 ± 10.73) exceeds the recommendations for age group, as well as the anthropometric parameters of hip (90.91 ± 8.44cm) and waist circumference (80.37 ± 17.5cm). The relationship between height (1.55 ± 0.1m) and body mass (63.44 ± 11.25Kg) generated a BMI of 24.16 ± 7.09Kg/m2, that was considered normal. The TUG performance was 10.71 ± 1.85s. In the 1MR test, 46.67 ± 13.06Kg and in the HG 23.93±7.96Kgf were obtained, respectively. Correlation analyzes were characterized by the high frequency of significant correlations for height, dominant arm mass (DAM), %BF, 1MR and HG variables. In addition, correlations between HG and BM (r = 0.67, p = 0.005), height (r = 0.51, p = 0.004) and DAM (r = 0.55, p = 0.026) were also observed. The strength of the lower limbs correlates with BM (r = 0.69, p = 0.003), height (r = 0.62, p = 0.01) and DAM (r = 0.772, p = 0.001). In this way, we can conclude that not only the simple spatial relationship of mass and height can influence in predictive parameters of strength or functionality, being important the verification of the conditions of the corporal composition. For this population, height seems to be a good predictor of strength and body composition.

Keywords: African Continental Ancestry Group, body composition, functional capacity, strength

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Authors: Apurva Singh, S. P. Jaiswar, Apala Priyadarshini, Akancha Pandey

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Objective: The aim of this study is to find the association of PON1 gene polymorphism with pesticides In RPL subjects. Background: Recurrent pregnancy loss (RPL) is defined as three or more sequential abortions before the 20th week of gestation. Pesticides and its derivatives (organochlorine and organophosphate) are proposed to accommodate a ruler chemical for RPL in the sub-humid region of India. The paraoxonase-1 enzyme (PON1) plays an important role in the toxicity of some organophosphate pesticides, with low PON1 activity being associated with higher pesticide sensitivity Methodology: This is a case-control study done in Department of Obstetrics & Gynaecology & Department of Biochemistry, K.G.M.U, Lucknow, India. The subjects were enrolled after fulfilling the inclusion & exclusion criteria. Inclusion criteria: Cases- Subject having two or more spontaneous abortions & Control- Healthy female having one or more alive child was selected. Exclusion criteria: Cases & Control- Subject having the following disease will be excluded from the study Diabetes mellitus, Hypertension, Tuberculosis, Immunocompromised patients, any endocrine disorder and genital, colon or breast cancer any other malignancies. Blood samples were collected in EDTA tubes from cases & healthy control women & genomic DNA was extracted by phenol-chloroform method. The estimation of pesticides residue from blood was done by HPLC. Biochemical estimation was also performed. Genotyping of PON1 gene polymorphism was performed by RFLP. Statistical analysis of the data was performed using the SPSS16.3 software. Results: A sum of total 14 pesticides (12 organochlorine and 2 organophosphate) selected on the basis of their persistent nature and consumption rate. The significant level of pesticide (ppb) estimated by the Mann whiney test and it was found to be significant at higher level of β-HCH (p:0.04), γ-HCH (p:0.001), δ-HCH (p: 0.002), chloropyrifos (p:0.001), pp-DDD (p:0.001) and fenvalrate (p: 0.001) in case group compare to its control. The level of antioxidant enzymes were found to be significantly decreased among the cases. Wild homozygous TT was more frequent and prevalent among control groups. However, heterozygous group (Tt) was more in cases than control groups (CI-0.3-1.3) (p=0.06). Conclusion: Higher levels of pesticides with endocrine disrupting potential in cases indicate the possible role of these compounds as one of the causes of recurrent pregnancy loss. Possibly, increased pesticide level appears to indicate increased levels of oxidative damage that has been associated with the possible cause of Recurrent Miscarriage, it may reflect indirect evidence of toxicity rather than the direct cause. Since both factors are reported to increase risk, individuals with higher levels of these 'Toxic compounds' especially in 'high-risk genotypes' might be more susceptible to recurrent pregnancy loss.

Keywords: paraoxonase, pesticides, PON1, RPL

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Authors: Dana R. Thomson, Catherine Linard, Sabine Vanhuysse, Jessica E. Steele, Michal Shimoni, Jose Siri, Waleska Caiaffa, Megumi Rosenberg, Eleonore Wolff, Tais Grippa, Stefanos Georganos, Helen Elsey

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The Sustainable Development Goals (SDGs) and Urban Health Equity Assessment and Response Tool (Urban HEART) identify dozens of key indicators to help local decision-makers prioritize and track inequalities in health outcomes. However, presentations and discussions at the International Conference on Urban Health (ICUH) 2017 suggested that additional indicators are needed to make decisions and policies. A local decision-maker may realize that malaria or road accidents are a top priority. However, s/he needs additional health determinant indicators, for example about standing water or traffic, to address the priority and reduce inequalities. Health determinants reflect the physical and social environments that influence health outcomes often at community- and societal-levels and include such indicators as access to quality health facilities, access to safe parks, traffic density, location of slum areas, air pollution, social exclusion, and social networks. Indicator identification and disaggregation are necessarily constrained by available datasets – typically collected about households and individuals in surveys, censuses, and administrative records. Continued advancements in earth observation, data storage, computing and mobile technologies mean that new sources of health determinants indicators derived from 'big data' are becoming available at fine geographic scale. Big data includes high-resolution satellite imagery and aggregated, anonymized mobile phone data. While big data are themselves not representative of the population (e.g., satellite images depict the physical environment), they can provide information about population density, wealth, mobility, and social environments with tremendous detail and accuracy when combined with population-representative survey, census, administrative and health system data. The aim of this paper is to (1) flag to data scientists important indicators needed by health decision-makers at the city and sub-city scale - ideally free and publicly available, and (2) summarize for local decision-makers new datasets that can be generated from big data, with layperson descriptions of difficulties in generating them. We include SDGs and Urban HEART indicators, as well as indicators mentioned by decision-makers attending ICUH 2017.

Keywords: health determinant, health outcome, mobile phone, remote sensing, satellite imagery, SDG, urban HEART

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Authors: Anastasia Beketova, Emmanouil-George C. Tzanakakis, Ioannis G. Tzoutzas, Eleana Kontonasaki

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In restorative dentistry, yttria-stabilized zirconia (YSZ) nanoparticles can be applied as fillers to improve the mechanical properties of various resin-based materials. Using sol-gel based synthesis as simple and cost-effective method, nano-sized YSZ particles with high purity can be produced. The aim of this study was to synthesize YSZ nanoparticles by the Pechini sol-gel method at different temperatures and to investigate their composition, structure, and morphology. YSZ nanopowders were synthesized by the sol-gel method using zirconium oxychloride octahydrate (ZrOCl₂.8H₂O) and yttrium nitrate hexahydrate (Y(NO₃)₃.6H₂O) as precursors with the addition of acid chelating agents to control hydrolysis and gelation reactions. The obtained powders underwent TG_DTA analysis and were sintered at three different temperatures: 800, 1000, and 1200°C for 2 hours. Their composition and morphology were investigated by Fourier Transform Infrared Spectroscopy (FTIR), X-Ray Diffraction Analysis (XRD), Scanning Electron Microscopy with associated with Energy Dispersive X-ray analyzer (SEM-EDX), Transmission Electron Microscopy (TEM) methods, and Dynamic Light Scattering (DLS). FTIR and XRD analysis showed the presence of pure tetragonal phase in the composition of nanopowders. By increasing the calcination temperature, the crystallinity of materials increased, reaching 47.2 nm for the YSZ1200 specimens. SEM analysis at high magnifications and DLS analysis showed submicron-sized particles with good dispersion and low agglomeration, which increased in size as the sintering temperature was elevated. From the TEM images of the YSZ1000 specimen, it can be seen that zirconia nanoparticles are uniform in size and shape and attain an average particle size of about 50 nm. The electron diffraction patterns clearly revealed ring patterns of polycrystalline tetragonal zirconia phase. Pure YSZ nanopowders have been successfully synthesized by the sol-gel method at different temperatures. Their size is small, and uniform, allowing their incorporation of dental luting resin cements to improve their mechanical properties and possibly enhance the bond strength of demanding dental ceramics such as zirconia to the tooth structure. This research is co-financed by Greece and the European Union (European Social Fund- ESF) through the Operational Programme 'Human Resources Development, Education and Lifelong Learning 2014- 2020' in the context of the project 'Development of zirconia adhesion cements with stabilized zirconia nanoparticles: physicochemical properties and bond strength under aging conditions' (MIS 5047876).

Keywords: dental cements, nanoparticles, sol-gel, yttria-stabilized zirconia, YSZ

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Authors: Reham Algheshairy, Khaled Tayeb, Christopher Smith, Rebecca Gregg, Haruna Musa

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Background: Diabetes is a medical condition that refers to the pancreas’ inability to secrete sufficient insulin levels, a hormone responsible for controlling glucose levels in the body. Any surplus glucose in the blood stream is excreted through the urinary system. Insulin resistance in blood cells can also cause this condition despite the fact that the pancreas is producing the required amount of insulin A number of researchers claim that the prevalence of diabetes in Saudi Arabia has reached epidemic proportions, although one study did observe one positive in the rise in the awareness of diabetes, possibly indicative of Saudi Arabia’s improving healthcare system. While a number of factors can cause diabetes, the ever-increasing incidence of the disease in Saudi Arabia has been blamed primarily on low levels of physical activity and high levels of obesity. Objectives: The project has two aims. The first aim of the project is to investigate the regulatory effects of consumption of Nigella seeds and Ajwah dates on blood glucose levels in diabetic patients with type 2 diabetes. The second aim of the project is to investigate whether these dietary factors may have potentially beneficial effects in controlling the complications that associated with type 2 diabetes. Methods: This use a random-cross intervention trail of 75 Saudi male and female with type 2 diabetes in Al-Noor hospital in Makkah ( KSA) aged between 18 and 70 years were divided into 3 groups. Group 1 will consume 2g of Nigella Sativa seeds daily along with a modified diet for 12 weeks, group 2 will be given Ajwah dates daily with a modified diet for 12 weeks and group 3 will follow a modified diet for 12 weeks. Anthropometric measurements were taken at baseline, along with bloods for HbA1c, fasting blood sugar and at the end of 12 weeks. Results: This study found significant decrease in blood level (FBG & 2PPBG) and HbA1c in the groups with diet and Nigella seeds) compared to Ajwa date. However, there is no significant change were found in HbA1c, FBG and 2hrpp regarding Ajwa group. Conclusion: This study illustrated a significant improvement in some markers of glycaemia following 2 g of Ns and diet for 12 weeks. The dose of 2g/day of consumed Nigella seeds was found to be more effective in controlling BGL and HbA1c than control and Ajwa groups. This suggests that Nigella seeds and following a diet may have a potential effect (a role in controlling outcomes for type 2 diabetes and controlling the disease). Further research is needed on a large scale to determine the optimum dose and duration of Nigella and Ajwa in order to achieve the desired results.

Keywords: type 2 diabetes, Nigella seeds, Ajwa dates, fasting blood glucose, control

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Authors: Rune Bjerke

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Psychologists incline to see creativity as a mental and psychological process. However, creativity is as well results of cultural and social interactions. Therefore, creativity is not a product of individuals in isolation, but of social systems. Creative people get ideas from the influence of others and the immediate cultural environment – a space of knowledge, situations, and practices. Therefore, in this study we apply the systems theory in practice to activate creativity processes in the production of our novel and screenplay writing. We, as storytellers actively seek to get into situations in our everyday lives, our systems, to generate ideas. Within our personal systems, we have the potential to induce situations to realise ideas to our texts, which may be accepted by our gate-keepers and can become socially validated. This is our method of writing – get into situations, get ideas to texts, and test them with family and friends in our social systems. Example of novel text as an outcome of our method is as follows: “Is it a matter of obviousness or had I read it somewhere, that the one who increases his knowledge increases his pain? And also, the other way around, with increased pain, knowledge increases, I thought. Perhaps such a chain of effects explains why the rebel August Strindberg wrote seven plays in ten months after the divorce with Siri von Essen. Shortly after, he tried painting. Neither the seven theatre plays were shown, nor the paintings were exhibited. I was standing in front of Munch's painting Women in Three Stages with chaotic mental images of myself crumpled in a church and a laughing x-girlfriend watching my suffering. My stomach was turning at unpredictable intervals and the subsequent vomiting almost suffocated me. Love grief at the worst. Was it this pain Strindberg felt? Despite the failure of his first plays, the pain must have triggered a form of creative energy that turned pain into ideas. Suffering, thoughts, feelings, words, text, and then, the reader experience. Maybe this negative force can be transformed into something positive, I asked myself. The question eased my pain. At that moment, I forgot the damp, humid air in the Munch Museum. Is it the similar type of Strindberg-pain that could explain the recurring, depressive themes in Munch's paintings? Illness, death, love and jealousy. As a beginning art student at the master's level, I had decided to find the answer. Was it the same with Munch's pain, as with Strindberg - a woman behind? There had to be women in the case of Munch - therefore, the painting “Women in Three Stages”? Who are they, what personality types are they – the women in red, black and white dresses from left to the right?” We, the writers, are using persons, situations and elements in our systems, in a systems theory perspective, to prompt creative ideas. A conceptual model is provided to advance creativity theory.

Keywords: creativity theory, systems theory, novel writing, screenplay writing, sources of creativity in social systems

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Authors: F. O’Dowd, G. Murphy, M. Roche, E. Shudell, F. Keane, M. O’Kane

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Intoduction: Apremilast (Otezla®) is an oral phosphodiesterase-4 (PDE4) inhibitor indicated for treatment of adult patients with moderate to severe plaque psoriasis who have contraindications to have failed or intolerant of standard systemic therapy and/or phototherapy; and adult patients with active psoriatic arthritis. Apremilast influences intracellular regulation of inflammatory mediators. Two randomized, placebo-controlled trials evaluating apremilast in 1426 patients with moderate to severe plague psoriasis (ESTEEM 1 and 2) demonstrated that the commonest adverse reactions (AE’s) leading to discontinuation were nausea (1.6%), diarrhoea (1.0%), and headaches (0.8%). The overall proportion of subjects discontinuing due to adverse reactions was 6.1%. At week 16 these trials demonstrated significant more apremilast-treated patients (33.1%) achieved the primary end point PASI-75 than placebo (5.3%). We began prescribing apremilast in July 2015. Aim: To evaluate efficacy and tolerability of apremilast in an Irish teaching hospital psoriasis population. Methods: A proforma documenting clinical evaluation parameters, prior treatment experience and AE’s; was completed prospectively on all patients commenced on apremilast since July 2015 – July 2017. Data was collected at week 0,6,12,24,36 and week 52 with 20/71 patients having passed week 52. Efficacy was assessed using Psoriasis Area and Severity Index (PASI) and Dermatology Life Quality Index (DLQI). AE’s documented included GI effects, infections, changes in weight and mood. Retrospective chart review and telephone review was utilised for missing data. Results: A total of 71 adult subjects (38 male, 33 female; age range 23-57), with moderate to severe psoriasis, were evaluated. Prior treatment: 37/71 (52%) were systemic/biologic/phototherapy naïve; 14/71 (20%) has prior phototherapy alone;20/71 (28%) had previous systemic/biologic exposure; 12/71 (17%) had both psoriasis and psoriatic arthritis. PASI responses: mean baseline PASI was 10.1 and DLQI was 15.Week 6: N=71, n=15 (21%) achieved PASI 75. Week 12: N= 48, n=6 (13%) achieved a PASI 100%; n=16 (34.5%) achieved a PASI 75. Week 24: N=40, n=10 (25%) achieved a PASI 100; n=15 (37.5%) achieved a PASI 75. Week 52: N= 20, n=4 (20%) achieved a PASI 100; n= 16 (80%) achieved a PASI 75. (N= number of pts having passed the time point indicated, n= number of pts (out of N) achieving PASI or DLQI responses at that time). DLQI responses: week 24: N= 40, n=30 (75%) achieved a DLQI score of 0; n=5 (12.5%) achieved a DLQI score of 1; n=1 (2.5%) achieved a DLQI score of 10 (due to lack of efficacy). Adverse Events: The proportion of patients that discontinued treatment due to AE’s was n=7 (9.8%). One patient experienced nausea alleviated by dose reduction; another developed significant dysgeusia for certain foods, both continued therapy. Two patients lost 2-3 kg. Conclusion: Initial Irish patient experience of Apremilast appears comparable to that observed in trials with good efficacy and tolerability.

Keywords: Apremilast, introduction, Ireland, clinical audit

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Authors: Carmen Noheda

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This text provides a reflection on the way of thinking about the study of the history of music by examining the production of historiography in Spain at the turn of the century. Based on concepts developed by the historical theorist Jörn Rüsen, the article focuses on the following aspects: the theoretical artifacts that structure the interpretation of the limits of writing the history of music, the narrative patterns used to give meaning to the discourse of history, and the orientation context that functions as a source of criteria of significance for both interpretation and representation. This analysis intends to show that historical music theory is not only a means to abstractly explore the complex questions connected to the production of historical knowledge, but also a tool for obtaining concrete images about the intellectual practice of professional musicologists. Writing about the historiography of contemporary Spanish music is a task that requires both a knowledge of the history that is being written and investigated, as well as a familiarity with current theoretical trends and methodologies that allow for the recognition and definition of the different tendencies that have arisen in recent decades. With the objective of carrying out these premises, this project takes as its point of departure the 'immediate historiography' in relation to Spanish music at the beginning of the 21st century. The hesitation that Spanish musicology has shown in opening itself to new anthropological and sociological approaches, along with its rigidity in the face of the multiple shifts in dynamic forms of thinking about history, have produced a standstill whose consequences can be seen in the delayed reception of the historiographical revolutions that have emerged in the last century. Methodologically, this essay is underpinned by Rüsen’s notion of the disciplinary matrix, which is an important contribution to the understanding of historiography. Combined with his parallel conception of differing paradigms of historiography, it is useful for analyzing the present-day forms of thinking about the history of music. Following these theories, the article will in the first place address the characteristics and identification of present historiographical currents in Spanish musicology to thereby carry out an analysis based on the theories of Rüsen. Finally, it will establish some considerations for the future of musical historiography, whose atrophy has not only fostered the maintenance of an ingrained positivist tradition, but has also implied, in the case of Spain, an absence of methodological schools and an insufficient participation in international theoretical debates. An update of fundamental concepts has become necessary in order to understand that thinking historically about music demands that we remember that subjects are always linked by reciprocal interdependencies that structure and define what it is possible to create. In this sense, the fundamental aim of this research departs from the recognition that the history of music is embedded in the conditions that make it conceivable, communicable and comprehensible within a society.

Keywords: historiography, Jörn Rüssen, Spanish musicology, theory of history of music

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Authors: Daniel Thompson, Muhammad Peerbux, Sophie Cerutti, Hansraj Bookun

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Introduction: Dialysis access is a key component of the care of patients with end stage renal failure. In our institution, a combined service of vascular surgeons and nephrologists are responsible for the creation and maintenance of arteriovenous fisultas (AVF), tenckhoff cathethers and Hickman/permcath lines. This poster investigates the last 10 years of dialysis access surgery conducted at St. Vincent’s Hospital Melbourne. Method: A cross-sectional retrospective analysis was conducted of patients of St. Vincent’s Hospital Melbourne (Victoria, Australia) utilising data collection from the Australasian Vascular Audit (Australian and New Zealand Society for Vascular Surgery). Descriptive demographic analysis was carried out as well as operation type, length of hospital stays, postoperative deaths and need for reoperation. Results: 2085 patients with renal failure were operated on between the years of 2011 and 2020. 1315 were male (63.1%) and 770 were female (36.9%). The mean age was 58 (SD 13.8). 92% of patients scored three or greater on the American Society of Anesthiologiests classification system. Almost half had a history of ischaemic heart disease (48.4%), more than half had a history of diabetes (64%), and a majority had hypertension (88.4%). 1784 patients had a creatinine over 150mmol/L (85.6%), the rest were on dialysis (14.4%). The most common access procedure was AVF creation, with 474 autologous AVFs and 64 prosthetic AVFs. There were 263 Tenckhoff insertions. We performed 160 cadeveric renal transplants. The most common location for AVF formation was brachiocephalic (43.88%) followed by radiocephalic (36.7%) and brachiobasilic (16.67%). Fistulas that required re-intervention were most commonly angioplastied (n=163), followed by thrombectomy (n=136). There were 107 local fistula repairs. Average length of stay was 7.6 days, (SD 12). There were 106 unplanned returns to theatre, most commonly for fistula creation, insertion of tenckhoff or permacath removal (71.7%). There were 8 deaths in the immediately postoperative period. Discussion: Access to dialysis is vital for patients with end stage kidney disease, and requires a multidisciplinary approach from both nephrologists, vascular surgeons, and allied health practitioners. Our service provides a variety of dialysis access methods, predominately fistula creation and tenckhoff insertion. Patients with renal failure are heavily comorbid, and prolonged hospital admission following surgery is a source of significant healthcare expenditure. AVFs require careful monitoring and maintenance for ongoing utility, and our data reflects a multitude of operations required to maintain usable access. The requirement for dialysis is growing worldwide and our data demonstrates a local experience in access, with preferred methods, common complications and the associated surgical interventions.

Keywords: dialysis, fistula, nephrology, vascular surgery

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