Search results for: obstetrical risk factor

Authors: Feifei Wu, Pius Babuna, Xiaohua Yang

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The suitability evaluation of human settlements over time and space is essential to track potential challenges towards suitable human settlements and provide references for policy-makers. This study established a theoretical framework of human settlements based on the nature, human, economy, society and residence subsystems. Evaluation indicators were determined with the consideration of the coupling effect among subsystems. Based on the extended Fourier amplitude sensitivity test algorithm, the global sensitivity analysis that considered the coupling effect among indicators was used to determine the weights of indicators. The human settlement suitability was evaluated at both subsystems and comprehensive system levels in 30 provinces of China between 2000 and 2016. The findings were as follows: (1) human settlements suitability index (HSSI) values increased significantly in all 30 provinces from 2000 to 2016. Among the five subsystems, the suitability index of the residence subsystem in China exhibited the fastest growinggrowth, fol-lowed by the society and economy subsystems. (2) HSSI in eastern provinces with a developed economy was higher than that in western provinces with an underdeveloped economy. In con-trast, the growing rate of HSSI in eastern provinces was significantly higher than that in western provinces. (3) The inter-provincial difference of in HSSI decreased from 2000 to 2016. For sub-systems, it decreased for the residence system, whereas it increased for the economy system. (4) The suitability of the natural subsystem has become a limiting factor for the improvement of human settlements suitability, especially in economically developed provinces such as Beijing, Shanghai, and Guangdong. The results can be helpful to support decision-making and policy for improving the quality of human settlements in a broad nature, human, economy, society and residence context.

Keywords: human settlements, suitability evaluation, extended fourier amplitude, human settlement suitability

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Authors: Dujrudee Chinwong, Chanida Prompantakorn, Ubonphan Chaichana, Surarong Chinwong

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Objective: Understanding the university students’ perceptions on smoking caused lung cancer based on the Health Belief Model should help health care providers in assisting them to quit smoking. Thus, this study aimed to investigate the University students’ health belief in smoking behaviors caused lung cancer, which based on the Health Belief Model. Methods: Data were collected from voluntary participants using a self-administered questionnaire. Participants were students studying at a University in northern Thailand who were current smokers; they were selected using snowball sampling. Results: Of 361 students, 84% were males; 78% smoked not more than 10 cigarettes a day; 68% intended to quit smoking. Our findings, based on the health belief model, showed that 1) perceived susceptibility: participants strongly believed that if they did not stop smoking, they were at high risk of lung cancer (88%); 2) perceived severity: they strongly believed that they had a high chance of death from lung cancer if they continued smoking (84%); 3) perceived benefits: they strongly believed that quitting smoking could reduce the chance of developing lung cancer; 4) perceived barriers of quitting smoking: they strongly believed in the difficulty of quitting smoking because it needed a high effort and strong intention (69%); 5) perceived self-efficacy: however, they strongly believed that they can quit smoking right away if they had a strong intention to quit smoking (70%); 6) cues to action: they strongly believed in the support of parents (85%) and lovers (78%) in helping them to quit smoking. Further, they believed that limitation on smoking area in the University and smoking cessation services provided by the University can assist them to quit smoking. Conclusion: The Health Belief Model helps us to understand students’ smoking behaviors caused lung cancer. This could lead to designing a smoking cessation program to assist students to quit smoking.

Keywords: health belief model, lung cancer, smoking, Thailand

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Authors: Riddhi Chopra

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While China’s friendship with a number of countries has waxed and waned over the decades, Sino-Pak relationship is said to have withstood the vicissitudes of larger international politics as well as changes in regional and domestic currents. Pakistan, one of the first countries to recognize the People’s Republic of China, thus providing China with a corridor into the energy rich Muslim states which was reciprocated with a continual stream of no-strings-attached military hardware and defense-related assistance from Beijing. The joint enmity towards India also provided the initial thrust to a burgeoning Sino-Pak friendship. This paper intends to provide a profound analysis of the strategic relation between China-Pakistan and examine India as a determining factor. The Pakistan-China strategic relationship has been conventionally viewed by India as a zero sum game, wherein any gains accrued by Pakistan or China through their partnership is seen as a direct detriment to the evolution of India-Pakistan or India-China relation. The paper evaluates various factors which were crucial for the synthesis of such a strong relation and presents a comprehensive study of the various policies and programs that have been undertaken by the two countries to tie India to South Asia and reduce its sphere of influence. The geographic dynamics is said to breed a natural coalition, dominating the strategic ambitions of both Beijing and Islamabad hence directing their relationship. In addition to the obvious geopolitical factors, there are several dense collaborations between the two nations knitting a relatively close partnership. Moreover, an attempt has been made to assess the irritants in China-Pak relations and the initiatives taken by the two to further strengthen it. Current trends in diplomatic, economic and defense cooperation – along with the staunch affinity rooted in history and consistent geo-strategic interests – points to a strong and strengthening relationship, significant in directing India’s foreign and security policies. This paper seeks to analyze the changing power dynamics of the China-Pak nexus with external actors such as US and India with an ulterior motive of their own and predict the change in power dynamics between the four countries.

Keywords: China, Pakistan, India, strategy

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Authors: Wei-Ting Hung

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Inbound tourist expenditure might not only have influenced by individual tourist characteristics but may also be affected by nationality characteristics. The cross national distance effects on tourist consumption behavior should be incorporated in the analytical framework. Additionally, the often used factor analysis, cluster analysis and regression analysis overlook the hierarchical tourist consumption data structure and may lead to misleading results. The objectives of the present study were twofold. First, we propose a multilevel model that takes individual and cross-national differences into account under a hierarchical framework. Second, we further sought to determine the types of cross-national differences affecting tourist expenditure. Thus, this study incorporates the individual tourist effects and cross national distance effects simultaneously, uses the data of 2010 Annual Survey Report on Visitors’ Expenditure and Trends in Taiwan to investigate the determinants of inbound tourist expenditure. Multilevel analysis was used to investigate the influence of individual tourist effects and cross national distance effects on inbound tourist expenditure. The empirical results show that cross national distance plays a crucial role in tourist consumption behavior. Our findings also indicate age and income have positive influence on tourism expenditure., whereas education and gender do not have significant impact. Regarding macro-level factors, geographic and cultural differences exhibited significant positive relationships on tourism expenditure, while economic differences did not. Based on the above empirical results, it is suggested that tour operators should take tourists’ individual attributes, particularly their income and age, into consideration when arranging tours. In addition, nationality holds sway over tourists’ consumption behavior, of which geographic and cultural differences are the two major factors at play. The empirical results of this study serve as practical suggestions for tourism marketing strategies and policy implications for government policies.

Keywords: cross national distance, inbound tourist, multilevel analysis, tourist expenditure

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Authors: Atitallah Sofien, Bouyahia Olfa, Krifi Farah, Missaoui Nada, Ben Rabeh Rania, Yahyaoui Salem, Mazigh Sonia, Boukthir Samir

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Introduction: Cutis marmorata telangiectatica congenita (CMTC) is a rare cutaneous vascular malformation. It most often appears at birth or during the first days of life. Its origin is still unknown. It associates a livedo with telangiectasias of diffuse or segmental topography. In rare cases, it can be associated with neurological disorders such as macrocephaly and, less frequently, with epilepsy. Methodology: We report a case of an infant with Macrocephaly- Cutis marmorata telangiectatica congenita syndrome associated with epilepsy. Results: This is the case of a one month and 15 days old female infant from a non-consanguineous marriage, admitted for a status epilepticus in the context of apyrexia. Infectious and metabolic causes had been eliminated. Physical examination had shown non-infiltrated and reticular livedoid erythematous patches affecting the left upper limb and atrophic on the back of the left hand. Cerebral magnetic resonance imaging (MRI) showed thin layers of bifrontal, temporal, and left parietal hygromas associated with the widening of the bifrontal subarachnoid spaces. The electroencephalogram showed a well-organized sleep tracing with a single right occipital paroxysmal abnormality. Antiepileptic treatment has been administered with good clinical evolution and regression of the skin lesion and a control electroencephalogram without abnormality. Conclusion: This observation illustrates an association of CMTC with both macrocephaly and epilepsy. This pathology, which is relatively benign and has a good prognosis, generally does not require treatment. However, a detailed examination must be carried out, and a follow-up plan must be put in place for each patient presenting with CMTC, given the risk of association with other abnormalities, which can be potentially serious.

Keywords: cutis marmorata telangiectatica congenita, macrocephaly, epilepsy, children

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Authors: Nasiruddin Khan, Nasser M. Al-Daghri, Dara A. Al-Disi, Asim Al-Fadda, Mohamed Al-Seif, Gyanendra Tripathi, A. L. Harte, Philip G. Mcternan

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For the last few decades, the prevalence of type 2 diabetes mellitus (T2DM) in the Kingdom of Saudi Arabia (KSA) is increasing alarmingly high and is unprecedented at 31.6 %. Preventive measures should be taken to curb down the increasing incidence. In this prospective, 3-month study, we aimed to determine whether dietary modification program would confer favorable affects among overweight and obese adult Saudi women with or without T2DM. A total of 92 Saudi women [18 healthy controls, 24 overweight subjects and 50 overweight or obese patients with early onset T2DM were included in this prospective study. Baseline anthropometrics and fasting blood samples were taken at baseline and after 3 months. Fasting blood sugar and lipid profile were measured routinely. A 500 Kcal deficit energy diet less than their daily recommended dietary allowances were prescribed to all participants. After 3 months of follow-up visit, significant improvements were observed in both the overweight and DMT2 group as compared to baseline with decreased mean BMI [Overweight Group 28.54±1.49 versus 27.95±2.25, p<0.05; DMT2 group 35.24±7.67 versus 35.04±8.07, p<0.05] and hip circumference [Overweight group 109.67±5.01 versus 108.07±4.07, p<0.05; DMT2 group 112.3±13.43 versus 109.21±12.71, p<0.01]. Moreover, in the overweight group, baseline HDL-cholesterol was significantly associated with protein intake and inversely associated with carbohydrate intake in controls. In the DMT2 group, carbohydrate intake at baseline was significantly associated with BMI. A 3-month 500kcal/day deficit dietary modification alone is probably effective among adult overweight or obese Saudi females without or with T2DM. Longer prospective studies are to determine whether the dietary intervention alone can reduce progression of T2DM among high-risk adult Arabs.

Keywords: diet, lipid, obesity, T2DM

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Authors: Jasna Čanadanović-Brunet, Gordana Ćetković, Sonja Djilas, Vesna Tumbas-Šaponjac, Jelena Vulić, Sladjana Stajčić

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Honey, produced by the honeybee, is a natural saturated sugar solution, which is mainly composed of a complex mixture of carbohydrates. Besides this, it also contains certain minor constituents, proteins, enzymes, amino and organic acids, lipids, vitamins, phenolic acids, flavonoids and carotenoids. Honey serves as a source of natural antioxidants, which are effective in reducing the risk of heart disease, cancer, immune-system decline, cataracts, and different inflammatory processes. Honey is consumed in its natural form alone, but also in combination with nuts and various kinds of dried fruits (plums, figs, cranberries, apricots etc.). The aim of this research was to investigate the contribution of dried apricot addition to polyphenols and flavonoids contents and antioxidant activities of honey. Some individual phenolic compounds in Serbian polyfloral honey (PH), linden honey (LH) and also in their mixtures with dried apricot, in 40% mass concentrations (PH40; LH40), were identified and quantified by HPLC. The most dominant phenolic compound was: gallic acid in LH (11.14 mg/100g), LH40 (42.65 mg/100g), PH (7.24 mg/100g) and catehin in PH40 (11.83 mg/100g). The antioxidant activity of PH, LH, PH40 and LH40 was tested by measuring their ability to scavenge hydroxyl radicals (OH) by electron spin resonance spectroscopy (ESR). Honey samples with 40% dried apricot exhibited better antioxidant activity measured by hydroxyl radical scavenging activity. The EC50 values, the amount of antioxidant necessary to decrease the initial concentration of OH radicals by 50%, were: EC50PH=3.36 mg/ml, EC50LH=13.36 mg/ml, EC50PH40=2.29 mg/ml, EC50 LH40=7.78 mg/ml. Our results indicate that supplementation of polyfloral honey and linden honey with dried apricots improves antioxidant activity of honey by enriching the phenolic composition.

Keywords: honey, dried apricot, HPLC, hydroxyl radical

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Authors: Shasline Gedeon, Tiffany W. Ardley, Ying Wang, Nathan J. Gesmundo, Katarina A. Sarris, Ana L. Aguirre

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Drug discovery and delivery involve drug targeting, an approach that helps find a drug against a chosen target through high throughput screening and other methods by way of identifying the physical properties of the potential lead compound. Physical properties of potential drug candidates have been an imperative focus since the unveiling of Lipinski's Rule of 5 for oral drugs. Throughout a compound's journey from discovery, clinical phase trials, then becoming a classified drug on the market, the desirable properties are optimized while minimizing/eliminating toxicity and undesirable properties. In the pharmaceutical industry, the ability to generate molecules in parallel with maximum efficiency is a substantial factor achieved through sp²-sp² carbon coupling reactions, e.g., Suzuki Coupling reactions. These reaction types allow for the increase of aromatic fragments onto a compound. More recent literature has found benefits to decreasing aromaticity, calling for more sp³-sp² carbon coupling reactions instead. The objective of this project is to provide a comparison between various sp³-sp² carbon coupling methods and reaction conditions, collecting data on production of the desired product. There were four different coupling methods being tested amongst three cores and 4-5 installation groups per method; each method ran under three distinct reaction conditions. The tested methods include the Photoredox Decarboxylative Coupling, the Photoredox Potassium Alkyl Trifluoroborate (BF3K) Coupling, the Photoredox Cross-Electrophile (PCE) Coupling, and the Weix Cross-Electrophile (WCE) Coupling. The results concluded that the Decarboxylative method was very difficult in yielding product despite the several literature conditions chosen. The BF3K and PCE methods produced competitive results. Amongst the two Cross-Electrophile coupling methods, the Photoredox method surpassed the Weix method on numerous accounts. The results will be used to build future libraries.

Keywords: drug discovery, high throughput chemistry, photoredox chemistry, sp³-sp² carbon coupling methods

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Authors: Emmanuel Abayomi Rotimi

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Context: Rabbits production plays important role in increasing animal protein supply in Nigeria. Rabbit production provides a cheap, affordable, and healthy source of meat. The growth of animals involves an increase in body weight, which can change the conformation of various parts of the body. Live weight and linear measurements are indicators of growth rate in rabbits and other farm animals. Aims: This study aimed to define the body dimensions of New Zealand rabbits and also to investigate the morphometric traits variables that contribute to body conformation by the use of principal component analysis (PCA). Methods: Data were obtained from 80 New Zealand rabbits (40 bucks and 40 does) raised in Livestock Teaching and Research Farm, Federal University Dutsinma. Data were taken on body weight (BWT), body length (BL), ear length (EL), tail length (TL), heart girth (HG) and abdominal circumference (AC). Data collected were subjected to multivariate analysis using SPSS 20.0 statistical package. Key results: The descriptive statistics showed that the mean BWT, BL, EL, TL, HG, and AC were 0.91kg, 27.34cm, 10.24cm, 8.35cm, 19.55cm and 21.30cm respectively. Sex showed significant (P<0.05) effect on all the variables examined, with higher values recorded for does. The phenotypic correlation coefficient values (r) between the morphometric traits were all positive and ranged from r = 0.406 (between EL and BL) to r = 0.909 (between AC and HG). HG is the most correlated with BWT (r = 0.786). The principal component analysis with variance maximizing orthogonal rotation was used to extract the components. Two principal components (PCs) from the factor analysis of morphometric traits explained about 80.42% of the total variance. PC1 accounted for 64.46% while PC2 accounted for 15.97% of the total variances. Three variables, representing body conformation, loaded highest in PC1. PC1 had the highest contribution (64.46%) to the total variance, and it is regarded as body conformation traits. Conclusions: This component could be used as selection criteria for improving body weight of rabbits.

Keywords: conformation, multicollinearity, multivariate, rabbits and principal component analysis

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Authors: Arash Rafiei, Carroll Moore

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Leaching process as the first stage of hydrometallurgy is a multidisciplinary system including material properties, chemistry, reactor design, mechanics and fluid dynamics. Therefore, doing leaching system optimization by pure scientific methods need lots of times and expenses. In this work, a mixture of two titanium ores and one titanium slag are used for extracting titanium for leaching stage of TiO2 pigment production procedure. Optimum titanium extraction can be obtained from following strategies: i) Maximizing titanium extraction without selective digestion; and ii) Optimizing selective titanium extraction by balancing between maximum titanium extraction and minimum impurity digestion. The main difference between two strategies is due to process optimization framework. For the first strategy, the most important stage of production process is concerned as the main stage and rest of stages would be adopted with respect to the main stage. The second strategy optimizes performance of more than one stage at once. The second strategy has more technical complexity compared to the first one but it brings more economical and technical advantages for the leaching system. Obviously, each strategy has its own optimum operational zone that is not as same as the other one and the best operational zone is chosen due to complexity, economical and practical aspects of the leaching system. Experimental design has been carried out by using Taguchi method. The most important advantages of this methodology are involving different technical aspects of leaching process; minimizing the number of needed experiments as well as time and expense; and concerning the role of parameter interactions due to principles of multifactor-at-time optimization. Leaching tests have been done at batch scale on lab with appropriate control on temperature. The leaching tank geometry has been concerned as an important factor to provide comparable agitation conditions. Data analysis has been done by using reactor design and mass balancing principles. Finally, optimum zone for operational parameters are determined for each leaching strategy and discussed due to their economical and practical aspects.

Keywords: titanium leaching, optimization, experimental design, performance analysis

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Authors: Nam-Hee Kim, Jang-Hoon Ko, Kwon-Hee Lee

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A relief valve is a mechanical element to keep safety by controlling high pressure. Usually, the high pressure is relieved by using the spring force and letting the fluid to flow from another way out of system. When its normal pressure is reached, the relief valve can return to initial state. The relief valve in this study has been applied for pressure vessel, evaporator, piping line, etc. The relief valve should be designed for smooth operation and should satisfy the structural safety requirement under operating condition. In general, the structural analysis is performed by following fluid flow analysis. In this process, the FSI (Fluid-Structure Interaction) is required to input the force obtained from the output of the flow analysis. Firstly, this study predicts the velocity profile and the pressure distribution in the given system. In this study, the assumptions for flow analysis are as follows: • The flow is steady-state and three-dimensional. • The fluid is Newtonian and incompressible. • The walls of the pipe and valve are smooth. The flow characteristics in this relief valve does not induce any problem. The commercial software ANSYS/CFX is utilized for flow analysis. On the contrary, very high pressure may cause structural problem due to severe stress. The relief valve is made of body, bonnet, guide, piston and nozzle, and its material is stainless steel. To investigate its structural safety, the worst case loading is considered as the pressure of 700 bar. The load is applied to inside the valve, which is greater than the load obtained from FSI. The maximum stress is calculated as 378 MPa by performing the finite element analysis. However, the value is greater than its allowable value. Thus, an alternative design is suggested to improve the structural performance through case study. We found that the sensitive design variable to the strength is the shape of the nozzle. The case study is to vary the size of the nozzle. Finally, it can be seen that the suggested design satisfy the structural design requirement. The FE analysis is performed by using the commercial software ANSYS/Workbench.

Keywords: relief valve, structural analysis, structural design, strength, safety factor

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Authors: Shannon Rappe, Elizabeth Morse, David Phillippi

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Postpartum women with an opioid use disorder (OUD) are at high risk for treatment disengagement, leaving them vulnerable to overdose and death between seven and twelve months postpartum. Intensive case management programs have been proposed as an effective strategy to reduce barriers and increase treatment engagement among postpartum women. The purpose of this project is to determine the effects of early engagement in an intensive case management program on postpartum engagement and infant health outcomes among postpartum women with opioid use. This retrospective review of secondary data was collected on 225 infants, and 221 postpartum women enrolled in an intensive case management program in Tennessee between May 1, 2019, and May 5, 2020. Chi-squares were computed to examine the timing of engagement during pregnancy, maternal treatment outcomes, and infant health outcomes, including neonatal abstinence syndrome (NAS), birth weight, gestational age, and length of stay. The mean prenatal program engagement was 109 days (SD = 67.6); 16.7% (n = 37) enrolled during the first trimester, 37.6% (n = 83) in the second trimester, and 45.7% (n = 101) in the third trimester. Of the 221 women engaged, 45.2% (n = 100) remained engaged in the case of management at the time of data collection, and 40% (n = 89) remained engaged in MAT at the time of data collection. Twenty- five percent (n = 25) of mothers who graduated sustained engagement in MAT. Of 225 infants 28.9% (n = 65) had a positive NAS status, mean birth weight was 6.5 lbs. (SD = 19.3); mean gestational age was 38.3 weeks (SD = 19.3) and mean length of stay was 8.19 days (SD = 9.8). This study's findings identified that engaging mothers during pregnancy in a program designed to meet their unique challenges positively impacts both the mother and infant outcomes, regardless of their timing.

Keywords: intensive case management, neonatal abstinence syndrome, opioid addiction, opioid crisis, opioid use in pregnant women, postpartum addiction

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Authors: Arkadiusz Zurek

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The potential of using drones is visible in many areas of logistics, especially in terms of their use for monitoring and control of many processes. The technologies implemented in the last decade concern new possibilities for companies that until now have not even considered them, such as warehouse inventories. Unmanned aerial vehicles are no longer seen as a revolutionary tool for Industry 4.0, but rather as tools in the daily work of factories and logistics operators. The research problem is to develop a method for measuring the weight of goods in a selected link of the clothing supply chain by drones. However, the purpose of this article is to analyze the causes of errors in traditional measurements, and then to identify adverse events related to the use of drones for the inventory of a heap of textiles intended for production purposes. On this basis, it will be possible to develop guidelines to eliminate the causes of these events in the measurement process using drones. In a real environment, work was carried out to determine the volume and weight of textiles, including, among others, weighing a textile sample to determine the average density of the assortment, establishing a local geodetic network, terrestrial laser scanning and photogrammetric raid using an unmanned aerial vehicle. As a result of the analysis of measurement data obtained in the facility, the volume and weight of the assortment and the accuracy of their determination were determined. In this article, this work presents how such heaps are currently being tested, what adverse events occur, indicate and describes the current use of photogrammetric techniques of this type of measurements so far performed by external drones for the inventory of wind farms or construction of the station and compare them with the measurement system of the aforementioned textile heap inside a large-format facility.

Keywords: drones, unmanned aerial system, UAS, indoor system, security, process automation, cost optimization, photogrammetry, risk elimination, industry 4.0

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Authors: Min Wang, Sergey Utev

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The lessons from the 2007-09 global financial crisis have driven scientific research, which considers the design of new methodologies and financial models in the global market. The quantum mechanics approach was introduced in the unpredictable stock market modeling. One famous quantum tool is Feynman path integral method, which was used to model insurance risk by Tamturk and Utev and adapted to formalize the path-dependent option pricing by Hao and Utev. The research is based on the path-dependent calculation method, which is motivated by the Feynman path integral method. The path calculation can be studied in two ways, one way is to label, and the other is computational. Labeling is a part of the representation of objects, and generating functions can provide many different ways of representing share price paths. In this paper, the recent works on graphical theoretical construction of individual share price path via matroid is presented. Firstly, a study is done on the knowledge of matroid, relationship between lattice path matroid and Tutte polynomials and ways to connect points in the lattice path matroid and Tutte polynomials is suggested. Secondly, It is found that a general binary tree can be validly constructed from a connected lattice path matroid rather than general lattice path matroid. Lastly, it is suggested that there is a way to represent share price paths via a general binary tree, and an algorithm is developed to construct share price paths from general binary trees. A relationship is also provided between lattice integer points and Tutte polynomials of a transversal matroid. Use this way of connection together with the algorithm, a share price path can be constructed from a given connected lattice path matroid.

Keywords: combinatorial construction, graphical representation, matroid, path calculation, share price, Tutte polynomial

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Authors: Ibrahim Alreshidi, Aseel Albrekeit, Ruaa Alharthi

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Background: As a result of the spread of COVID-19 at the beginning of 2020, many governments, including Saudi Arabia, have suspended operations in many agencies. Most dermatologists have restricted their practice, including cosmetic procedures, to ensure social distancing. On the 7th of May 2020, Saudi authorities reduced the restriction of COVID-19 virus preventative measures, allowing clinics to start accepting patients following the ministry of health protocols. Objectives: Evaluation of the public's perception and willingness to undergo cosmetic procedures during COVID-19 outbreaks in Saudi Arabia. Materials and methods: A descriptive, cross-sectional, questionnaire-based study was carried out among the individuals who lack typical symptoms of COVID-19 infection in Saudi Arabia. A self-designed web-based questionnaire was developed; content face validity and a pilot study were done. The questionnaire was distributed electronically from the 8th of May until the 31st of May 2020. Results: A total of 656 individuals who lack typical symptoms of COVID-19 infection were included in this analysis. Only 10.5% of participants expressed their will to do cosmetic procedures during the COVID-19 pandemic. More than 90% of the participants believed that the COVID-19 pandemic was either somewhat serious (52.9%) or very serious (38.7%). The willingness to do cosmetic procedures during the COVID-19 pandemic remained unaltered when the price was discounted (p<0.001) and when infection control measures were ensured (p<0.001). Conclusion: The COVID-19 pandemic had a negative impact on the practice of cosmetic dermatology. Fear of transferring the infection to a beloved home member is the main reason to avoid these procedures. Generating well-structured safety guidelines to decrease the risk of this unusual virus transmission in dermatology practice and creating financial incentives may help increase the public willingness to do these cosmetic procedures during this pandemic.

Keywords: COVID-19 pandemic, cosmetic procedures, questionnaire, dermatology

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Authors: Seungho Shin, Keunwoo Choi, Ali Akbar, Sukkee Um

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In this study, the nanoscale transport properties and catalyst utilization of vertically aligned carbon nanotube (VACNT) catalyst layers are computationally predicted by the three-dimensional lattice Boltzmann simulation based on the quasi-random nanostructural model in pursuance of fuel cell catalyst performance improvement. A series of catalyst layers are randomly generated with statistical significance at the 95% confidence level to reflect the heterogeneity of the catalyst layer nanostructures. The nanoscale gas transport phenomena inside the catalyst layers are simulated by the D3Q19 (i.e., three-dimensional, 19 velocities) lattice Boltzmann method, and the corresponding mass transport characteristics are mathematically modeled in terms of structural properties. Considering the nanoscale reactant transport phenomena, a transport-based effective catalyst utilization factor is defined and statistically analyzed to determine the structure-transport influence on catalyst utilization. The tortuosity of the reactant mass transport path of VACNT catalyst layers is directly calculated from the streaklines. Subsequently, the corresponding effective mass diffusion coefficient is statistically predicted by applying the pre-estimated tortuosity factors to the Knudsen diffusion coefficient in the VACNT catalyst layers. The statistical estimation results clearly indicate that the morphological structures of VACNT catalyst layers reduce the tortuosity of reactant mass transport path when compared to conventional catalyst layer and significantly improve consequential effective mass diffusion coefficient of VACNT catalyst layer. Furthermore, catalyst utilization of the VACNT catalyst layer is substantially improved by enhanced mass diffusion and electric current paths despite the relatively poor interconnections of the ion transport paths.

Keywords: Lattice Boltzmann method, nano transport phenomena, polymer electrolyte fuel cells, vertically aligned carbon nanotube

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Authors: Saeed M. Alshahrani

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This research integrated blockchain technology to reform medical records management in healthcare informatics. It was aimed at resolving the limitations of centralized systems by establishing a secure, decentralized, and user-centric platform. The system was architected with a sophisticated three-tiered structure, integrating advanced cryptographic methodologies, consensus algorithms, and the Fast Healthcare Interoperability Resources (HL7 FHIR) standard to ensure data security, transaction validity, and semantic interoperability. The research has profound implications for healthcare delivery, patient care, legal compliance, operational efficiency, and academic advancements in blockchain technology and healthcare IT sectors. The methodology adapted in this research comprises of Preliminary Feasibility Study, Literature Review, Design and Development, Cryptographic Algorithm Integration, Modeling the data and testing the system. The research employed a permissioned blockchain with a Practical Byzantine Fault Tolerance (PBFT) consensus algorithm and Ethereum-based smart contracts. It integrated advanced cryptographic algorithms, role-based access control, multi-factor authentication, and RESTful APIs to ensure security, regulate access, authenticate user identities, and facilitate seamless data exchange between the blockchain and legacy healthcare systems. The research contributed to the development of a secure, interoperable, and decentralized system for managing medical records, addressing the limitations of the centralized systems that were in place. Future work will delve into optimizing the system further, exploring additional blockchain use cases in healthcare, and expanding the adoption of the system globally, contributing to the evolution of global healthcare practices and policies.

Keywords: healthcare informatics, blockchain, medical records management, decentralized architecture, data security, cryptographic algorithms

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Authors: Jill Villarreal, Kristalyn Cooksey, Kai Lloyd, Daniel Ha

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Little research has been conducted to examine college students' reading attitudes, including students' perceptions of reading behaviors and reading abilities. This is problematic, as reading assigned course material is a critical component to an undergraduate student's academic success. For this study, flyers were electronically disseminated to instructors at 24 public and 10 private U.S. institutions in “Reading-Intensive Departments” including Psychology, Sociology, Education, Business, and Communications. We requested the online survey be completed as an in-class activity during the fall 2019 and spring 2020 semesters. All participants voluntarily completed the questionnaire anonymously. Of the participants, 280 self-identified their race as Black and 280 self-identified their race as White. Of the participants, 177 self-identified their gender as Male and 383 self-identified their Gender as Female. Participants ranged in age from 18-24. Factor analysis found four dimensions resulting from the questions regarding reading. The first we interpret as “Reading Proficiency”, accounted for 19% of the variability. The second dimension was “Reading Anxiety” (15%), the third was “Textbook Reading Ability” (9%), and the fourth was “Reading Enjoyment” (8%). Linear models on each of these dimensions revealed no effect of Age, Gender, Race, or Income on “Reading proficiency”. The linear model of “Reading Anxiety” showed a significant effect of race (p = 0.02), with higher anxiety in white students, as well as higher reading anxiety in female students (p < 0.001). The model of “Textbook Reading Ability” found a significant effect of race (p < 0.001), with higher textbook problems in white students. The model of “Reading Enjoyment” showed significant effects of race (p = 0.013) with more enjoyment for white students, gender (p = 0.001) with higher enjoyment for female students, and age (p = 0.033) with older students showing higher enjoyment. These findings suggest that gender, age, and race are important factors in many aspects of college students' reading attitudes. Further research will investigate possible causes for these differences. In addition, the effectiveness of college-level programs to reduce reading anxiety, promote the reading of textbooks, and foster a love of reading will be assessed.

Keywords: age, college, gender, race, reading

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

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

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

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Authors: Frederick Anlimah, Vinod Gopaldasani, Catherine MacPhail, Brian Davies

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The construction industry, particularly tunnel construction, exposes workers to respirable crystalline silica (RCS), which can cause incurable illnesses such as silicosis and lung cancer. Despite various control measures, exposures remain inadequately controlled. This research aimed to identify the barriers and challenges hindering the implementation of effective controls and the adoption of safe work practices to protect workers from RCS exposure in tunnelling. A mixed-method approach was employed for this research. Tunnel construction workers were observed, surveyed and interviewed to gauge their knowledge and attitudes and understand their challenges in reducing RCS exposure. The preliminary analysis of the data reveals a diverse array of sociotechnical factors interacting to influence RCS exposure. It is noteworthy that participants consistently emphasised the project as the most exemplary one they have been involved in, although there is room for improvement. While there is a commendable level of knowledge about RCS exposure and control in tunnelling, there is a striking lack of perceived satisfaction regarding dust control. Several factors were identified as interacting to prevent the effective management of dust. These include perceived time pressure, absence of on-tool dust controls, low risk perceptions among workers, and inadequate enforcement of controls. Moreover, participants highlighted communication and heat-related challenges as hindrances to the continuous wear of respirators. This research highlights the need for a paradigm shift in tunnel construction to address the barriers associated with RCS exposure reduction. It emphasises the importance of collaboration among various stakeholders, advocating for more effective controls and enforcement strategies and enhanced worker education through knowledge sharing.

Keywords: respirable crystalline silica, dust control, worker practices, exposure prevention, silicosis

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Authors: Choonoh Lee, Seyeon Park, Dongyun Kang, Jaehyeong Choi, Soojee Kim, Younggeun Kim

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Market Kurly is the first South Korean online grocery retailer that guarantees same-day, overnight shipping. More than 1.6 million customers place an average of 4.7 million orders and add 3 to 14 products into a cart per month. The company has sold almost 30,000 kinds of various products in the past 6 months, including food items, cosmetics, kitchenware, toys for kids/pets, and even flowers. The company is operating and expanding multiple dry, cold, and frozen fulfillment centers in order to store and ship these products. Due to the scale and complexity of the fulfillment, pick-pack-ship processes are planned and operated in batches, and thus, the planning that decides the batch of the customers’ orders is a critical factor in overall productivity. This paper introduces a metaheuristic optimization method that reduces the complexity of batch processing in a fulfillment center. The method is an iterative genetic algorithm with heuristic creation and evolution strategies; it aims to group similar orders into pick-pack-ship batches to minimize the total number of distinct products. With a well-designed approach to create initial genes, the method produces streamlined plans, up to 13.5% less complex than the actual plans carried out in the company’s fulfillment centers in the previous months. Furthermore, our digital-twin simulations show that the optimized plans can reduce 3% of operation time for packing, which is the most complex and time-consuming task in the process. The optimization method implements a multithreading design on the Spring framework to support the company’s warehouse management systems in near real-time, finding a solution for 4,000 orders within 5 to 7 seconds on an AWS c5.2xlarge instance.

Keywords: fulfillment planning, genetic algorithm, online grocery retail, optimization

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Authors: Jean Paul Hategekimana, Josiane Irakoze, Eugene Niyonzima, Annick Ndekezi

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Cassava (Manihot esculenta Crantz) is a root crop comprising an anti-nutritive factor known as cyanide. The compound can be removed by numerous processing methods such as boiling, fermentation, blanching, and sun drying to avoid the possibility of cyanide poisoning. Inappropriate processing mean can lead to disease and death. Cassava-based dishes are consumed in different ways, where cassava is cultivated according to their culture and preference. However, they have been shown to be unsafe based on high cyanide levels. The current study targeted to resolve the problem of high cyanide in cassava consumed in Rwanda. This study was conducted to determine the effect of slicing, blanching, and soaking time to reduce the fermentation duration of cassava for hydrogen cyanide (HCN) in mg/g removal. Cassava was sliced into three different portions (1cm, 2cm, and 5cm). The first portions were naturally fermented for seven days, where each portion was removed every 24 hours from soaking tanks and then oven dried at a temperature of 60°C and then milled to obtain naturally fermented cassava flours. Other portions of 1cm, 2cm, and 5cm were blanched for 2, 5, 10 min, respectively, and each similarly dried at 60°C and milled to produce blanched cassava flour. Other blanched portions were used to follow the previous fermentation steps. The last portions, which formed the control, were simply chopped. Cyanide content and starch content in mg/100g were investigated. According to the conducted analysis on different cassava treatments for detoxification, found that usual fermentation can be used, but for sliced portions aimed to size reduction for the easy hydrogen cyanide diffuse out and it takes four days to complete fermentation, which has reduced at 94.44% with significantly different (p<0.05)of total hydrogen cyanide contained in cassava to safe level of consumption, and what is recommended as more effective is to apply blanching combined with fermentation due to the fact that, it takes three days to complete hydrogen cyanide removal at 95.56% on significantly different (p<0.05) of reduction to the safe level of consumption.

Keywords: cassava, cyanide, blanching, drying, fermentation

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Authors: M. Inmaculada Alvarez-Fernández, Celestino González-Nicieza, M. Belén Prendes-Gero, Fernando López-Gayarre

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Among many factors affecting the stability of mining excavations, rock-bursts and tremors play a special role. These dynamic loads occur practically always and have different sources of generation. The most important of them is the commonly used mining technique, which disintegrates a certain area of the rock mass not only in the area of the planned mining, but also creates waves that significantly exceed this area affecting the structural elements. In this work it is analysed the consequences of dynamic loads over the structural elements in an underground room and pillar mine to avoid roof instabilities. With this end, dynamic loads were evaluated through in situ and laboratory tests and simulated with numerical modelling. Initially, the geotechnical characterization of all materials was carried out by mean of large-scale tests. Then, drill holes were done on the roof of the mine and were monitored to determine possible discontinuities in it. Three seismic stations and a triaxial accelerometer were employed to measure the vibrations from blasting tests, establish the dynamic behaviour of roof and pillars and develop the transmission laws. At last, computer simulations by FLAC3D software were done to check the effect of vibrations on the stability of the roofs. The study shows that in-situ tests have a greater reliability than laboratory samples because of eliminating the effect of heterogeneities, that the pillars work decreasing the amplitude of the vibration around them, and that the tensile strength of a beam and depending on its span is overcome with waves in phase and delayed. The obtained transmission law allows designing a blasting which guarantees safety and prevents the risk of future failures.

Keywords: dynamic modelling, long term instability risks, room and pillar, seismic collapse

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Authors: Chaebong Kim, Yongmin Cho, Minkyung Han, Mooyoung Kim, KooSang Kim

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Background: Air pollution from global warming has a considerable influence on respiratory disease and atopic dermatitis (AD). Present studies base on a hypothesis about correlation between air pollutant and AD, and the results are analyzed from various points of view. Objectives: This study aimed to integrate the relevant researches for air pollutant and AD, and to perform the systematic literature review and meta-analysis to provide the basis of air pollutant control. Methods: Research materials were collected from original articles published in English academic journals including medicine, nursing and health science from August 1 to 31, 2016. We collected the materials from Pubmed, Medline, Embase, Cochrane Central database with Prisma (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) based on the Cochrane Systematic Review Manual, and performed the evaluation and analysis for selected materials. We got the research results for risk of bias using Rev-Man ver. 5.2, and meta analyses using STATA. Results: The prevalence of infantile atopic dermatitis were 1.05 times higher than other groups who were exposed to air pollution, and exposure to NO2 (1.08, 95% CI: 1.02 – 1.14), O3 (1.09, 95% CI: 1.04 – 1.15), SO2 (1.07, 95% CI: 1.02 – 1.12) in subgroup air pollutant was considerably associated with infantile atopic dermatitis. The prevalence of infantile atopic dermatitis was 1.03 times higher than other groups who were exposed to PM2.5, but the results were not statistically similar. Conclusion: Health effect from environmental pollution risen people’s interest in environmental diseases. Air pollutant was associated with AD in this study, but selected literature was based on non-RCT (Randomized Controlled Trial) study. Therefore, there was a limit in study method including control, matching, and correction of confounding variables. For clear conclusion, it is necessary to develop the appropriate tool for object of study and clear standard to measure of air pollutant.

Keywords: air pollution, atopic dermatitis, children, meta-analysis

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Authors: Azadeh Razzagh Shoar, Hassan Sadeghi Naeini

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There is little doubt that concepts such as space and place have become more common considering that human beings have grown more apart and more than having contact with each other, they are in contact with objects, spaces, and places. Cafés, as a third place which is neither home nor workplace, have attracted these authors’ interests, who are industrial and interior designers. There has been much research on providing suitable cafés, customer behavior, and criteria for spatial sense. However, little research has been carried out on consumerism, desire for variety, and their relationship with changing places, and specifically cafes in term of interior design. In fact, customer’s sense of place has mostly been overlooked. In this case study, authors conducted to challenge the desire for variety and consumerism as well as investigating the addictive factors in cafés. From the designers’ point of view and by collecting data through observing and interviewing café managers, this study investigates and analyzes the customers in two cafes located in a commercial building in northern Tehran (a part of city with above average economic conditions). Since these two cafés are at the same level in terms of interior and spatial design, the question is raised as to why customers patronize the newly built café despite their loyalty to the older café. This study aims to investigate and find the criteria based on the sense of space (café) in a consumerist society, a world where consumption is a myth. Going to cafés in a larger scale than a product can show a selection and finally who you are, where you go, which brand of coffee you prefer, and what time of the day you would like to have your coffee. The results show that since people spend time in cafés more than any other third place, the interaction they have with their environment is more than anything else, and they are consumers of time and place more than coffee or any other product. Also, if there is a sense of consumerism and variety, it is mostly for the place rather than coffee and other products. To satisfy this sense, individuals go to a new place (the new café). It can be easily observed that this sense overshadows the sense of efficiency, design, facilities and all important factor for a café.

Keywords: place, cafe, consumerist society, consumerism, desire for variety

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Authors: Vera Sovkova, Andrea Mickova, Matej Buzgo, Karolina Vocetkova, Eva Filova, Evzen Amler

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PCL (poly-ε-caprolactone) nanofibrous scaffolds with adhered liposomes were prepared and tested as a possible drug delivery system for various synthetic growth factors. TGFβ, bFGF, and IGF-I have been shown to increase hMSC (human mesenchymal stem cells) proliferation and to induce hMSC differentiation. Functionalized PCL nanofibers were prepared with synthetic growth factors encapsulated in liposomes adhered to them in three different concentrations. Other samples contained PCL nanofibers with adhered, free synthetic growth factors. The synthetic growth factors free medium served as a control. The interaction of liposomes with the PCL nanofibers was visualized by SEM, and the release kinetics were determined by ELISA testing. The potential of liposomes, immobilized on the biodegradable scaffolds, as a delivery system for synthetic growth factors, and as a suitable system for MSCs adhesion, proliferation and differentiation in vitro was evaluated by MTS assay, dsDNA amount determination, confocal microscopy, flow cytometry and real-time PCR. The results showed that the growth factors adhered to the PCL nanofibers stimulated cell proliferation mainly up to day 11 and that subsequently their effect was lower. By contrast, the release of the lowest concentration of growth factors from liposomes resulted in gradual proliferation of MSCs throughout the experiment. Moreover, liposomes, as well as free growth factors, stimulated type II collagen production, which was confirmed by immunohistochemical staining using monoclonal antibody against type II collagen. The results of this study indicate that growth factors enriched liposomes adhered to surface of PCL nanofibers could be useful as a drug delivery instrument for application in short timescales, be combined with nanofiber scaffolds to promote local and persistent delivery while mimicking the local microenvironment. This work was supported by project LO1508 from the Ministry of Education, Youth and Sports of the Czech Republic

Keywords: drug delivery, growth factors, hMSC, liposomes, nanofibres

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Authors: Amar Ranjan, Julieana Durai, Pranay Tanwar

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

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

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Authors: Anusha Edirisinghe

Abstract:

Sexual Gender based violence is a most common social phenomenon in higher education institutions. It has become a hidden crime of the Universities. Masculinities norms and attitudes are more influential and serve as key drivers and risk for ragging and SGBV. This research will reveal that in Sri Lankan universities, SGBV takes from the violence and murder of women students, assault and battery coerced sex, sexual harassment including harassment via information technology. This study focus is to prevention of ragging and SGBV in University system. Main objective of this paper describes and critically analyses of plight of ragging and SGBV in higher education institutions and legal and national level policy implementation to prevent these crimes in society. This paper is with special reference to ragging case from University of Kelaniya 2016. University Grant commission introduced an Act for the prevention of Ragging and gender standing committee established in Sri Lanka in 2016. And each university has been involved in the prevention of SGBV and ragging in higher education institutions. Case study from first year female student, reported sexual harassment was reported to the police station in May in 2016. After this case, the university has been implementing emergency action plan, short term and long term action plan. Ragging and SGBV task force was established and online complaint center opened to all students and academic and non- academics. Under these circumstances student complained to SGBV and other harassment to the university. University security system was strong support with police and marshals, and vigilant committees including lecturers. After this case all universities start to several programmes to stop violence in university

Keywords: higher Education, ragging, sexual gender-based violence, Sri Lanka

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Authors: Boularas El-Alia, Arbi Raja, Bachir Bouiadjra Sara, Rezk-Kallah Haciba, Rezkkallah Baghdad

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Objectives : To determine the handling practices of cytotoxic drugs and to describe clinical manifestations expressed by hospital personnel of Sidi Bel Abbes during the year 2014. Methods: Sectional descriptive study conducted in 3 center university hospital units (Hematology, Oncology and Urology) and Gynecology of EHS Sidi Bel Abbes. A questionnaire was administered to hospital workers regulary exposed to cytotoxic drugs. A work-place visit was performed to have an overview about working conditions. The Cytotoxic Contact Index (CCI) was calculated for each nurse on a period of 15 working days. Treatment of the results was done using SPSS software. Results: The survey reveals that 22 men and 58 women are exposed to cytotoxic drugs for an average of 7 years. Many symptoms such as ocular irritation (38,75%), throat irritation (56,25%), headache (68,75%), dizziness (43,75%), nausea (37,5%), metallic taste (30%), were reported with high frequency. Are noted in the offspring, 3 congenital anomalies,2 diaphragmatic hernia and a cleft palate. The Cytotoxic Contact Index (CCI) was higher than 3 among Oncology nurses and higher than 1 for most of the nurses of Hematology and Gynecology service. The wearing of personal protective clothing was not respected by all workers: (22/23) wear gloves and (20/23) wear a mask,(5/23) wear a cap, (2/23) wear glasses. Only 3 nurses have benefited from continuous training on handling cytotoxic drugs. Conclusion: This study shows a high occupational exposure risk to cytotoxic drugs among persons handling these drugs and the necessity to apply rigorously all measures related to personal protection awareness and training of personnel to minimize these exposure.

Keywords: cytotoxic drugs, handling, clinical manifestations, hospital staff

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Authors: Susanne Fridsten, Kristina Hellman, Anders Sundin, Lennart Blomqvist

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Background: Patients diagnosed with locally advanced cervical carcinoma are treated with definitive concomitant chemo-radiotherapy. Treatment failure occurs in 30-50% of patients with very poor prognoses. The treatment is standardized with risk for both over-and undertreatment. Consequently, there is a great need for biomarkers able to predict therapy outcomes to allow for individualized treatment. Aim: To explore the role of T2- and diffusion-weighted magnetic resonance imaging (MRI) for early prediction of therapy outcome and the optimal time point for assessment. Methods: A pilot study including 15 patients with cervical carcinoma stage IIB-IIIB (FIGO 2009) undergoing definitive chemoradiotherapy. All patients underwent MRI four times, at baseline, 3 weeks, 5 weeks, and 12 weeks after treatment started. Tumour size, size change (∆size), visibility on diffusion-weighted imaging (DWI), apparent diffusion coefficient (ADC) and change of ADC (∆ADC) at the different time points were recorded. Results: 7/15 patients relapsed during the study period, referred to as "poor prognosis", PP, and the remaining eight patients are referred to "good prognosis", GP. The tumor size was larger at all time points for PP than for GP. The ∆size between any of the four-time points was the same for PP and GP patients. The sensitivity and specificity to predict prognostic group depending on a remaining tumor on DWI were highest at 5 weeks and 83% (5/6) and 63% (5/8), respectively. The combination of tumor size at baseline and remaining tumor on DWI at 5 weeks in ROC analysis reached an area under the curve (AUC) of 0.83. After 12 weeks, no remaining tumor was seen on DWI among patients with GP, as opposed to 2/7 PP patients. Adding ADC to the tumor size measurements did not improve the predictive value at any time point. Conclusion: A large tumor at baseline MRI combined with a remaining tumor on DWI at 5 weeks predicted a poor prognosis.

Keywords: chemoradiotherapy, diffusion-weighted imaging, magnetic resonance imaging, uterine cervical carcinoma

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