Search results for: cancer risk assessment

Authors: Ahmed Elhussein, Hossam El-Zomor, Adel Alieldin, Mahmoud A. Afifi, Abdullah Elhusseiny, Hala Taha, Amal Refaat, Soha Ahmed, Mohamed S. Zagloul

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Background: A majority of children with retinoblastoma (60%) have a disease in one eye only (unilateral disease). This is a retrospective study to evaluate two different treatment modalities in those patients for saving their lives and vision. Methods: Four hundred and four patients were diagnosed with unilateral intraocular retinoblastoma at Children’s Cancer, Hospital Egypt (CCHE) through the period of July/2007 until December/2017. Management strategies included primary enucleation versus ocular salvage treatment. Results: Patients presented with mean age 24.5 months with range (1.2-154.3 months). According to the international retinoblastoma classification, Group D (n=172, 42%) was the most common, followed by group E (n=142, 35%), group C (n=63, 16%), and group B (n=27, 7%). All patients were alive at the end of the study except four patients who died, with 5-years overall survival 98.3% [CI, (96.5-100%)]. Patients presented with advanced disease and poor visual prognosis (n=241, 59.6%) underwent primary enucleation with 6 cycles adjuvant chemotherapy if they had high-risk features in the enucleated eye; only four patients out of 241 ended-up either with extraocular metastasis (n=3) or death (n=1). While systemic chemotherapy and focal therapy were the primary treatment for those who presented with favorable disease status and good visual prognosis (n=163, 40.4%); seventy-seven patients of them (47%) ended up with a pre-defined event (enucleation, EBRT, off protocol chemotherapy or 2ry malignancy). Ocular survival for patients received primary chemotherapy + focal therapy was [50.9% (CI, 43.5-59.6%)] at 3 years and [46.9% (CI,39.3-56%)] at 5 years. Comparison between upfront enucleation and primary chemotherapy for occurrence of extraocular metastasis revealed that there was no statistical difference between them except in group D (p value). While for occurrence of death, no statistical difference in all classification groups. Conclusion: In retinoblastoma, primary chemotherapy is a reasonable option and has a good probability for ocular salvage without increasing the risk of metastasis in comparison to upfront enucleation except in group D.

Keywords: CCHE, chemotherapy, enucleation, retinoblastoma

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Authors: Noor Ismael, Somaya Malkawi, Sherin Al Awady, Taleb Ismael

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Background/Significance: Cancer is a serious health condition that affects individuals’ quality of life during and after the course of this condition. Children who have survived cancer and their caregivers may deal with residual physical, cognitive or social disabilities. There is little research on caregivers’ health and wellbeing after cancer. To the authors’ best knowledge; there is no specific research about how caregivers cope with everyday stressors after cancer. Therefore, this study aimed to explore the coping strategies that caregivers of children who have survived cancer utilize to overcome everyday stressors. Methods: This study utilized a descriptive survey design. The sample consisted of 103 caregivers, who visited the health and wellness clinic at a national cancer center (additional demographics are presented in the results). The sample included caregivers of children who were off cancer treatments for at least two years from the beginning of data collection. The institution’s internal review board approved this study. Caregivers who agreed to participate completed the survey. The survey collected caregiver reported demographic information and the Brief COPE which measures caregivers' frequency of engaging in certain coping strategies. The Brief COPE consisted of 14 coping sub-scales, which are self-distraction, active coping, denial, substance use, use of emotional support, use of instrumental support, behavioral disengagement, venting, positive reframing, planning, humor, acceptance, religion, and self-blame. Data analyses included calculating sub-scales’ scores for the fourteen coping strategies and analysis of frequencies of demographics and coping strategies. Results: The 103 caregivers who participated in this study were 62% mothers, 80% married, 45% finished high school, 50% do not work outside the house, and 60% have low family income. Result showed that religious coping (66%) and acceptance (60%) were the most utilized coping strategies, followed by positive reframing (45%), active coping (44%) and planning (43%). The least utilized coping strategies in our sample were humor (5%), behavioral disengagement (8%), and substance-use (10%). Conclusions: Caregivers of children who have survived cancer mostly utilize religious coping and acceptance in dealing with everyday stressors. Because these coping strategies do not directly solve stressors like active coping and planning coping strategies, it is important to support caregivers in choosing and implementing effective coping strategies. Knowing from our results that some caregivers may utilize substance use as a coping strategy, which has negative health effects on caregivers and their children, there must be direct interventions that target these caregivers and their families.

Keywords: caregivers, cancer, stress, coping

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Authors: Longtao He, Han Wu

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Summary: As the need for elder care increases in China due to a growing aging population and, in particular, rising cancer rates, it becomes increasingly important to also support family caregivers, who are often the main source of care. We used a qualitative meta-synthesis to systematically evaluate and integrate the caregiving experiences of family caregivers of elderly cancer patients as revealed by articles published in Chinese journals. Findings: Nine studies are included in the final analysis. The caregiver experiences they describe are synthesized into three primary themes: care needs, care burden, and care gains, with numerous secondary themes. Besides the findings that seem to align with other findings across cultures, we have highlighted three main discoveries from the synthesis that may be quite specific to the Chinese context: 1. more sub-themes related to specific caregiving skills caregivers of cancer patients; 2. a call for health professionals to improve their communication skills with family caregivers; 3. the important role of filial piety. Applications: Our findings can be used to help health social workers and relevant policymakers in China support family caregivers by identifying the education and training required for caregivers, ways to make the most of potential care gains, and ways to ease care burdens.

Keywords: cancer, Chinese family caregivers, caregiving skills, care burden, care gains, health social work

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Authors: Jacinta Musyoka, Wesley Too

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Cervical cancer is the second leading cause of cancer-related deaths in Kenya and the second most common cancer among women, yet preventable following prevention strategies put in place, which includes vaccination with Human Papilloma Virus Vaccine (HPPV) among the young adolescent girls. Kenya has the highest burden of cervical cancer and the leading cause of death among women of reproductive age and is a known frequent type of cancer amongst women. This is expected to double by 2025 if the necessary steps are not taken, which include vaccinating girls between the ages of 9 and 14 and screening women. Parental decision is critical in ensuring that their daughters receive this vaccine. Hence this study sought to establish parental willingness and factors associate with the acceptability to vaccine adolescent daughters against the human papilloma virus for cervical cancer prevention in Machakos County, Eastern Region of Kenya. Method: Cross-sectional study design utilizing a mixed methods approach was used to collect data from Nguluni Health Centre in Machakos County; Matungulu sub-county, Kenya. This study targeted all parents of adolescent girls seeking health care services in the Matungulu sub-county area who were aged 18 years and above. A total of 220 parents with adolescent girls aged 10-14 years were enrolled into the study after informed consent were sought. All ethical considerations were observed. Quantitative data were analyzed using Multivariate regression analysis, and thematic analysis was used for qualitative data related to perceptions of parents on HPVV. Results, conclusions, and recommendations- ongoing. We expect to report findings and articulate contributions based on the study findings in due course before October 2022

Keywords: adolescents, human papilloma virus, kenya, parents

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Authors: Oguzhan Cepni, Doruk Kucuksarac, M. Hasan Yilmaz

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Risk premium of emerging markets are moving altogether depending on the momentum and shifts in the global risk appetite. However, the magnitudes of these changes in the risk premium of emerging market economies might vary. In this paper, we focus on how global risk factor affects credit default swaps (CDS) premiums of emerging markets using principal component analysis (PCA) and rolling regressions. PCA results indicate that the first common component accounts for almost 76% of common variation in CDS premiums of emerging markets. Additionally, the explanatory power of the first factor seems to be high over sample period. However, the sensitivity to the global risk factor tends to change over time and across countries. In this regard, fixed effects panel regressions are employed to identify the macroeconomic factors driving the heterogeneity across emerging markets. There are two main macroeconomic variables that affect the sensitivity; government debt to GDP and international reserves to GDP. The countries with lower government debt and higher reserves tend to be less subject to the variations in the global risk appetite.

Keywords: emerging markets, principal component analysis, credit default swaps, sovereign risk

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Authors: Omar Nouri, Wafa Mnejja, Fatma Dhouib, Syrine Zouari, Wicem Siala, Ilhem Charfeddine, Afef Khanfir, Leila Farhat, Nejla Fourati, Jamel Daoud

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Purpose and Objective: Intensity modulated radiation (IMRT) technique, associated with induction chemotherapy (IC) and/or concomitant chemotherapy (CC), is actually the recommended treatment modality for nasopharyngeal carcinomas (NPC). The aim of this study was to evaluate the therapeutic results and the patterns of relapse with this treatment protocol. Material and methods: A retrospective monocentric study of 145 patients with NPC treated between June 2016 and July 2021. All patients received IMRT with integrated simultaneous boost (SIB) of 33 daily fractions at a dose of 69.96 Gy for high-risk volume, 60 Gy for intermediate risk volume and 54 Gy for low-risk volume. The high-risk volume dose was 66.5 Gy in children. Survival analysis was performed according to the Kaplan-Meier method, and the Log-rank test was used to compare factors that may influence survival. Results: Median age was 48 years (11-80) with a sex ratio of 2.9. One hundred-twenty tumors (82.7%) were classified as stages III-IV according to the 2017 UICC TNM classification. Ten patients (6.9%) were metastatic at diagnosis. One hundred-thirty-five patient (93.1%) received IC, 104 of which (77%) were TPF-based (taxanes, cisplatin and 5 fluoro-uracil). One hundred-thirty-eight patient (95.2%) received CC, mostly cisplatin in 134 cases (97%). After a median follow-up of 50 months [22-82], 46 patients (31.7%) had a relapse: 12 (8.2%) experienced local and/or regional relapse after a median of 18 months [6-43], 29 (20%) experienced distant relapse after a median of 9 months [2-24] and 5 patients (3.4%) had both. Thirty-five patients (24.1%) died, including 5 (3.4%) from a cause other than their cancer. Three-year overall survival (OS), cancer specific survival, disease free survival, metastasis free survival and loco-regional free survival were respectively 78.1%, 81.3%, 67.8%, 74.5% and 88.1%. Anatomo-clinic factors predicting OS were age > 50 years (88.7 vs. 70.5%; p=0.004), diabetes history (81.2 vs. 66.7%; p=0.027), UICC N classification (100 vs. 95 vs. 77.5 vs. 68.8% respectively for N0, N1, N2 and N3; p=0.008), the practice of a lymph node biopsy (84.2 vs. 57%; p=0.05), and UICC TNM stages III-IV (93.8 vs. 73.6% respectively for stage I-II vs. III-IV; p=0.044). Therapeutic factors predicting OS were a number of CC courses (less than 4 courses: 65.8 vs. 86%; p=0.03, less than 5 courses: 71.5 vs. 89%; p=0.041), a weight loss > 10% during treatment (84.1 vs. 60.9%; p=0.021) and a total cumulative cisplatin dose, including IC and CC, < 380 mg/m² (64.4 vs. 87.6%; p=0.003). Radiotherapy delay and total duration did not significantly affect OS. No grade 3-4 late side effects were noted in the evaluable 127 patients (87.6%). The most common toxicity was dry mouth which was grade 2 in 47 cases (37%) and grade 1 in 55 cases (43.3%).Conclusion: IMRT for nasopharyngeal carcinoma granted a high loco-regional control rate for patients during the last five years. However, distant relapses remain frequent and conditionate the prognosis. We identified many anatomo-clinic and therapeutic prognosis factors. Therefore, high-risk patients require a more aggressive therapeutic approach, such as radiotherapy dose escalation or adding adjuvant chemotherapy.

Keywords: therapeutic results, prognostic factors, intensity-modulated radiotherapy, nasopharyngeal carcinoma

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Authors: Roman Graf, Sergiu Gordea, Heather M. Ryan

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This paper presents an approach for easy creation and classification of institutional risk profiles supporting endangerment analysis of file formats. The main contribution of this work is the employment of data mining techniques to support set up of the most important risk factors. Subsequently, risk profiles employ risk factors classifier and associated configurations to support digital preservation experts with a semi-automatic estimation of endangerment group for file format risk profiles. Our goal is to make use of an expert knowledge base, accuired through a digital preservation survey in order to detect preservation risks for a particular institution. Another contribution is support for visualisation of risk factors for a requried dimension for analysis. Using the naive Bayes method, the decision support system recommends to an expert the matching risk profile group for the previously selected institutional risk profile. The proposed methods improve the visibility of risk factor values and the quality of a digital preservation process. The presented approach is designed to facilitate decision making for the preservation of digital content in libraries and archives using domain expert knowledge and values of file format risk profiles. To facilitate decision-making, the aggregated information about the risk factors is presented as a multidimensional vector. The goal is to visualise particular dimensions of this vector for analysis by an expert and to define its profile group. The sample risk profile calculation and the visualisation of some risk factor dimensions is presented in the evaluation section.

Keywords: linked open data, information integration, digital libraries, data mining

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Authors: Amichai Ben ari, Daniella Margalit

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Medical procedures, such as surgery, may have traumatic significance for some children. This study examines the relationship between maltreatment in children and the development Pediatric Medical Traumatic Stress (PMTS). To this end, differences in the level of distress of children after surgery were examined between two groups: children who were maltreated ("children at risk") and children from the control group ("children who are not at risk"). The study involved 230 parents of children who came to the hospital to undergo surgery. Parents filled out demographic questionnaires to measure socioeconomic variables and psychological questionnaires to measure the distress of the child and parent before surgery. After 6 months from the time of surgery, the parents again filled in the questionnaire measuring the child's distress. The results of the study showed that the level of distress experienced by children at risk after surgery was significantly higher relative to children who are not at risk. It was also found that the level of distress experienced by parents of children at risk in relation to their child’s surgery is significantly higher compared to parents of children who are not at risk. Finally, it was found that the variables: (1) pre-morbid psychological functioning of the child. (2) Parental and family functioning in daily life. (3) Exposure of the child to traumatic events. (4) Support factors for the family. Are variables that predict the development of PMTS in children after surgery, but only for children at risk and not for children who are not at risk. The significance of the findings in relation to the need to identify at-risk populations in the hospitals and the policies derived from them were discussed, and several directions were raised for further research.

Keywords: children at risk, pediatric medical traumatic stress (PMTS), PTSD, medical procedures

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Authors: Desta Gebretekle Shiferaw, Balakrishna Kalluraya

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Triazoles are basic five-membered ring heterocycles with an unsaturated, six-delocalized electron ring system. Since the dawn of click chemistry, triazoles have represented a functional heterocyclic core that has been the foundation of medicinal chemistry. The compounds with 1,2,3-triazole rings can be used in several fields, including medicine, organic synthesis, polymer chemistry, fluorescent imaging, horticulture, and industries, to name a few. Besides that, they found it to have health applications in the prevention and reduction of the risk of diseases, such as anti-cancer, antimicrobial, antiviral, and anti-inflammatory properties. Here, we present the synthesis of twelve 1,2,3-triazolyl chalcone derivatives (4a–l), which were produced in high yields by coupling substituted aldehydes and triazolyl acetophenone (3a–d) in ethanol. The title products were characterized by physicochemical, infrared, nuclear magnetic resonance, and mass spectral methods. The in vitro tests were used to evaluate the antioxidant and antimicrobial activity of each of the prepared molecules. The preliminary assessment and 2,2-diphenyl-1-picrylhydrazyl activity of the title compounds showed significantly higher antibacterial activity and moderate-to-good antifungal and antioxidant activities compared to their standards. This work presents the synthesis of triazolyl chalcone derivatives and their biological activity. Based on the findings, these compounds could be used as lead compounds in antimicrobial and antioxidant research in the future.

Keywords: antibacterial activity, antifungal activity, antioxidant activity, chalcone, 1, 2, 3-triazole

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Authors: Hromada Martin

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Risk analysis is considered as a fundamental aspect relevant for ensuring the level of critical infrastructure protection, where the critical infrastructure is seen as system, asset or its part which is important for maintaining the vital societal functions. Article actually discusses and analyzes the potential application of selected tools of information support for the implementation and within the framework of risk analysis and critical infrastructure protection. Use of the information in relation to their risk analysis can be viewed as a form of simplifying the analytical process. It is clear that these instruments (information support) for these purposes are countless, so they were selected representatives who have already been applied in the selected area of critical infrastructure, or they can be used. All presented fact were the basis for critical infrastructure resilience evaluation methodology development.

Keywords: critical infrastructure, protection, resilience, risk analysis

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Authors: A. Sainvil, J. Mallela, L. M. Pereira

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Adolescents and young adults (AYA) diagnosed with cancer are tasked with managing their health through treatment, a time when reliance on and independence from parents may change in unexpected ways. Resilience allows patients to cope and manage their own health through treatment, promoting motivation and a healthier lifestyle. The film acts as a source of reflection through the cancer journey, which may have an impact on how patients cope. The current research investigated relationships between resilient linguistic qualities of the video narratives and attitudes toward personal health management. N=24 patients diagnosed between ages 11-18 were recruited. First, participants provided demographic information, then made a video testimonial about their cancer experience. After filming, participants then completed a questionnaire on the perceived benefits for themselves and others for making the video. Videos were transcribed and analyzed for thematic content via codebook and for linguistic qualities, indicating resilience with the use of the Linguistic Inquiry and Word Count Analysis Program (LIWC). Linear regressions were then calculated to explore relationships between resilient qualities, thematic content, and participants’ perceptions of their medical team and willingness to care for themselves. Participants who spoke with greater narrator connectedness were more likely to change their view of their medical team (β=.628 p=.034). When a participant believed that providers were likely to view their video, they were marginally more likely to want to take better care of themselves (β=.367, p=.078). Participants who spoke in depth about their health reported higher intention to take better care of themselves (β=.785, p=.033). AYAs with cancer who showcased certain resilient qualities within their narrative were more likely to consider taking better care of themselves. Additionally, the more patients reflected on their health, the more they wanted to take better care of themselves. These relationships were stronger when a patient believed that a provider would watch their video. Study findings highlight the utility of film in uncovering aspects of resilience and coping that may lead to healthier behaviors in AYAs with cancer.

Keywords: adolescents, cancer, resilience, health management

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Authors: Kayum Fokoue Carole

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This paper aims at verifying the effectiveness of reaching target populations while paying attention to their cultural background when communicating new knowledge, ideas or technology in a multicultural world. Our case study is an experiment on the communication of knowledge on breast cancer in three sub-Saharan countries (Ghana, Tchad, and Cameroon health). The methodology consisted of submitting a semi-structured questionnaire to local populations in some localities in these target countries in order to determine the cultural barriers hindering the effective communication of knowledge on breast cancer. Once this done, sensitization documents on breast cancer were translated into Ewe (Ghana), Mbaye (Tchad), Ghomala’, Ewondo, and Fufulde (Cameroon). In each locality, a sensitization programme was organised for two groups. For one group, the cultural barriers discovered were taken into consideration while communicating during the programme whereas in the other group, they were not. Another questionnaire was disseminated after three months to verify the level of appropriation of those who attended the campaign based on Chumbow’s appropriation theory. This paper, therefore, discusses some spiritual beliefs, representations and practices in the target African communities hindering effective communication of issues on breast cancer in the target localities. Findings reveal that only 38% of respondents in the group of those for whom cultural barriers were not taken into account during the programme had a high level of appropriation while for the other group, 86% had a high level of appropriation. This is evidence that the communication of issues on breast cancer can be more effective by reaching different populations in a language they best master while paying attention to their culture. Therefore, international communication of new knowledge should be culturally contextualised. Suggestions at the end of the paper are directed towards the achievement of these goals. The present work promotes international partnership in addressing and resolving global health preoccupations since research findings from one community/country can be mutualized in partnership with other communities and countries.

Keywords: cultural barriers, communication, health, breast cancer

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Authors: Nicole C. Valdez, Vincent L. Borromeo, Conrad C. Chong, Ahmad F. Mazahery

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Breast cancer is the most prevalent cancer worldwide, where the majority of cases are estrogen-receptor positive and involve 2 receptor proteins. The binding of estrogen to estrogen receptor alpha (ERα) promotes breast cancer growth, while it's binding to estrogen-receptor beta (ERβ) inhibits tumor growth. While natural products have been a promising source of chemotherapeutic agents, the challenge remains in finding a bioactive compound that specifically targets cancer cells, minimizing side effects on normal cells. Flavonoids are natural products that act as phytoestrogens and induce the same response as estrogen. They are able to compete with estrogen for binding to ERα; however, it has a higher binding affinity for ERβ. Their abundance in nature and low toxicity make them a potential candidate for breast cancer treatment. This study aimed to determine which particular flavonoids can specifically recognize ERβ and potentially be used for breast cancer treatment through molecular docking. A total of 206 flavonoids comprised of 97 isoflavones and 109 flavanones were collected from ZINC15, while the 3D structures of ERβ and ERα were obtained from Protein Data Bank. These flavonoid subclasses were chosen as they bind more strongly to ERs due to their chemical structure. The structures of the flavonoid ligands were converted using Open Babel, while the estrogen receptor protein structures were prepared using Autodock MGL Tools. The optimal binding site was found using BIOVIA Discovery Studio Visualizer before docking all flavonoids on both ERβ and ERα through Autodock Vina. Genistein is a flavonoid that exhibits anticancer effects by binding to ERβ, so its binding affinity was used as a baseline. Eriodictyol and 4”,6”-Di-O-Galloylprunin both exceeded genistein’s binding affinity for ERβ and was lower than its binding affinity for ERα. Of the two, eriodictyol was pursued due to its antitumor properties on a lung cancer cell line and on glioma cells. It is able to arrest the cell cycle at the G2/M phase by inhibiting the mTOR/PI3k/Akt cascade and is able to induce apoptosis via the PI3K/Akt/NF-kB pathway. Protein pathway and gene analysis were also conducted using ChEMBL and PANTHER and it was shown that eriodictyol might induce anticancer effects through the ROS1, CA7, KMO, and KDM1A genes which are involved in cell proliferation in breast cancer, non-small cell lung cancer, and other diseases. The high binding affinity of eriodictyol to ERβ, as well as its potential affected genes and antitumor effects, therefore, make it a candidate for the development of new breast cancer treatment. Verification through in vitro experiments such as checking the upregulation and downregulation of genes through qPCR and checking cell cycle arrest using a flow cytometry assay is recommended.

Keywords: breast cancer, estrogen receptor, flavonoid, molecular docking

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Authors: Mohammad Ali Hasanzadeh, Thierry Van Elslander, Eddy Van De Voorde

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About 90 percent of world merchandise trade by volume being carried by sea. Maritime transport remains as back bone behind the international trade and globalization meanwhile all seaborne goods need using at least two ports as origin and destination. Amid seaborne traded cargos, container traffic is a prosperous market with about 16% in terms of volume. Albeit containerized cargos are less in terms of tonnage but, containers carry the highest value cargos amongst all. That is why efficient handling of containers in ports is very important. Accidents are the foremost causes that lead to port inefficiency and a surge in total transport cost. Having different port safety management systems (PSMS) in place, statistics on port accidents show that numerous accidents occur in ports. Some of them claim peoples’ life; others damage goods, vessels, port equipment and/or the environment. Several accident investigation illustrate that the most common accidents take place throughout transport operation, it sometimes accounts for 68.6% of all events, therefore providing a safer workplace depends on reducing collision risk. In order to quantify risks at the port area different variables can be used as exposure measurement. One of the main motives for defining and using exposure in studies related to infrastructure is to account for the differences in intensity of use, so as to make comparisons meaningful. In various researches related to handling containers in ports and intermodal terminals, different risk exposures and also the likelihood of each event have been selected. Vehicle collision within the port area (10-7 per kilometer of vehicle distance travelled) and dropping containers from cranes, forklift trucks, or rail mounted gantries (1 x 10-5 per lift) are some examples. According to the objective of the current research, three categories of accidents selected for collision risk assessment; fall of container during ship to shore operation, dropping container during transfer operation and collision between vehicles and objects within terminal area. Later on various consequences, exposure and probability identified for each accident. Hence, reducing collision risks profoundly rely on picking the right risk exposures and probability of selected accidents, to prevent collision accidents in container terminals and in the framework of risk calculations, such risk exposures and probabilities can be useful in assessing the effectiveness of safety programs in ports.

Keywords: container terminal, collision, seaborne trade, risk exposure, risk probability

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Authors: Gabriela-Andreea Despescu, Mădălina-Elena Mavrodin, Gheorghe Lăzăroiu, Florin Adrian Grădinaru

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The purpose of this paper is to contribute to the enhancement of a hydroelectric plant protection by coordinating protection measures and existing security and introducing new measures under a risk management process. Also, the plan identifies key critical elements of a hydroelectric plant, from its level vulnerabilities and threats it is subjected to in order to achieve the necessary protection measures to reduce the level of risk.

Keywords: critical infrastructure, risk analysis, critical infrastructure protection, vulnerability, risk management, turbine, impact analysis

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Authors: Harriet Nalubega, Eddie Mwebesa

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In Uganda, over 90% of people use herbal remedies. Herbal medicine use has been associated with delayed clinical appointments, presentation with advanced cancers, financial constraints, and misdiagnosis. This study aimed to evaluate the prevalence of herbal medicine use and practices amongst cancer patients receiving Palliative Care at Mobile Hospice Mbarara (MHM) and the associated challenges. This was a mixed-methods prospective study conducted in 2022 at MHM, where patients were interviewed, and a questionnaire was completed. 87% of the patients had used herbal medicine. Of these, 83% were female, and 59% had not received formal education. 27% of patients had used herbal remedies for a year or more. 51% of patients who were consuming herbs stopped using them after starting palliative care treatment. Motivations for herbal medicine use were in the hope for a cure in 59%, for pain relief in 30%, and peer influence in 10%. There is a high prevalence of herbal medicine use in Palliative Care. Female gender and lack of formal education were disproportionately associated with herbal remedy use. Most patients consume herbal remedies in search of a cure or to relieve severe pain. Education of cancer patients about herbal remedy use may improve treatment outcomes in Palliative Care.

Keywords: prevalence, herbal medicine, cancer patients, palliative care

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Authors: Markus Stralla

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This study employs a GMM framework to examine the impact of potential regulatory intervention regarding the occupations of supervisory board members in cooperative banking. To achieve insights, the study proceeds in two different ways. First, it investigates the changes in board structure prior and following to the German Act to Strengthen Financial Market and Insurance Supervision (FinVAG). Second, the study estimates the influence of Ph.D.Share, professional concentration and supervisory power on bank-risk changes in consideration of the implementation of FinVAG. Therefore, the study is based on a sample of 246 German cooperative banks from 2006-2011 while applying four different measures of bank risk, namely credit-, equity-, liquidity-risk, and Z-Score, with the former three also being addressed in FinVAG. Results indicate that the implementation of FinVAG results in (most likely unintentional) structural changes, especially at the expense of farmers, and affects all risk measures and relations between risk measures and supervisory board characteristics in a risk-reducing and therefore intended way. To disentangle the complex relationship between board characteristics and risk measures, the study utilizes two-step system GMM estimator to account for unobserved heterogeneity and simultaneity in order to reduce endogeneity problems. The findings may be especially relevant for stakeholders, regulators, supervisors and managers.

Keywords: bank governance, bank risk-taking, board of directors, regulation

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Authors: Ali Reza Ghanbarnezhad Ghazvini, Seyyed Hamid Reza Mosayyebi

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In recent years, an earthquake has occurred approximately every five years in certain regions of Iran. To mitigate the impact of these seismic events, it is crucial to identify and thoroughly assess the vulnerability of buildings and infrastructure, ensuring their safety through principled reinforcement. By adopting new methods of risk assessment, we can effectively reduce the potential risks associated with future earthquakes. In our research, we have observed that the coefficient of behavior in the fourth chapter is 1.65 for the initial structure and 1.72 for the Superframe structure. This indicates that the Superframe structure can enhance the strength of the main structural members by approximately 10% through the utilization of super beams. Furthermore, based on the comparative analysis between the two structures conducted in this study, we have successfully designed a stronger structure with minimal changes in the coefficient of behavior. Additionally, this design has allowed for greater energy dissipation during seismic events, further enhancing the structure's resilience to earthquakes. By comprehensively examining and reinforcing the vulnerability of buildings and infrastructure, along with implementing advanced risk assessment techniques, we can significantly reduce casualties and damages caused by earthquakes in Iran. The findings of this study offer valuable insights for civil engineering professionals in the field of structural engineering, aiding them in designing safer and more resilient structures.

Keywords: modal pushover analysis, response modification factor, high-strength concrete, concrete shear walls, high-rise building

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Authors: Rolivhuwa Bishop Ramagoma1*, Lynn Cairncross1, , Saartjie Roux1

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According to the world health organisation, colon cancer is among the most common cancers diagnosed in both men and women. Specifically, it is the second leading cause of cancer related deaths accounting for over 860 000 deaths worldwide in 2018. Currently, chemotherapy has become an essential component of most cancer treatments. Despite progress in cancer drug development over the previous years, traditional chemotherapeutic drugs still have low selectivity for targeting tumour tissues and are frequently constrained by dose-limiting toxicity. The creation of nanoscale delivery vehicles capable of directly directing treatment into cancer cells has recently caught the interest of researchers. Herein, the development of peptide-functionalized polyethylene glycol gold nanoparticles (Peptide-PEG-AuNPs) as a cellular probe and delivery agent is described, with the higher aim to develop a specific diagnostic prototype and assess their specificity not only against cell lines but primary human cells as well. Gold nanoparticles (AuNPs) were synthesized and stabilized through chemical conjugation. The synthesized AuNPs were characterized, stability in physiological solutions was assessed, their cytotoxicity against colon carcinoma and non-carcinoma skin fibroblasts was also studied. Furthermore, genetic effect through real-time polymerase chain reaction (RT-PCR), localization and uptake, peptide specificity were also determined. In this study, different peptide-AuNPs were found to have preferential toxicity at higher concentrations, as revealed by cell viability assays, however, all AuNPs presented immaculate stability for over 3 months following the method of synthesis. The final obtained peptide-PEG-AuNP conjugates showed good biocompatibility in the presence of high ionic solutions and biological media and good cellular uptake. Formulation of colon cancer specific targeting peptide was successful, additionally, the genes/pathways affected by the treatments were determined through RT-PCR. Primary cells study is still on going with promising results thus far.

Keywords: nanotechnology, cancer, diagnosis, therapeutics, gold nanoparticles.

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Authors: Muhammad Umar Hassan

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Renal cell carcinoma is a subset of kidney cancer that arises in the lining of DCT and is present in parenchymal tissue. Diagnosis is based on lab reports, including urinalysis, renal function tests (RFTs), and electrolyte balance, along with imaging techniques. Organ failure and other complications have been commonly observed in these cases. Over the years, the presentation of patients has varied, so carcinoma was classified on the basis of site, shape, and consistency for detailed analysis. Lifestyle patterns and occupational history were inquired about and recorded. Methods: Data from 100 patients presenting to the oncology and nephrology department of Mayo Hospital in the year 2015-2020 were included in this retrospective study on a random basis. The study was specifically focused on three risk factors. Smoking, occupational exposures, and Hakim medicine are taken by the patient for any cause. After procurement of data, follow-up contacts of these patients were established, resulting in a detailed analysis of lifestyle. Conclusion: The inference drawn is a direct causal link between smoking, industrial workplace exposure, and Hakim medicine with the development of Renal Cell Carcinoma. It was shown in the majority of the patients and hence confirmed our hypothesis.

Keywords: renal cell carcinoma, kidney cancer, clear cell carcinoma

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Authors: Ali E. Abbas

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This paper highlights some of the normative issues that might result by setting independent thresholds in risk analyses and particularly with safety regions. A second objective is to explain how such regions can be specified appropriately in a meaningful way. We start with a review of the importance of setting deterministic trade-offs among target requirements. We then show how to determine safety regions for risk analysis appropriately using utility functions.

Keywords: decision analysis, thresholds, risk, reliability

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Authors: Zahra Sokar, Sara Oufquir, Brahim Eddafali, Abderrahman Chait

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Fenugreek is one of the oldest plants used in traditional herbal medicine. Several studies have demonstrated the anticancer effects of seeds by inhibiting the proliferation, angiogenesis, invasion and metastasis of various cancers. While there is plenty of research demonstrating the antineoplastic effects of dormant seeds, little is known about the potential of sprouts in fighting cancer. Therefore, we propose to study the chemoprotective effect of germinating fenugreek seeds on keratoacanthoma skin cancer induced by cutaneous exposure to DMA/Croton oil in mice. The results obtained show that oral administration of 250 and 500 mg/kg aqueous sprout seed extract reduces the incidence, rate, volume, and tumor weight in a very significant manner. Histological examination revealed that mice treated with 250 mg/kg showed strong inhibition of squamous cell carcinoma formation with thickening of the epithelial layer and mild acanthosis and hyperkeratosis. A dose of 500 mg/kg prevented invasion and the occurrence of hyperkeratosis. Fenugreek sprouts appear to be a promising natural product for preventing keratoacanthoma skin cancer. Nevertheless, further studies in the same field need to be developed to evaluate the antineoplastic potential of germinated seeds.

Keywords: anticancer, fenugreek, keratoacanthoma, sprouts

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Authors: Nur Amalina Dayana Abd Aziz

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Assessment is an integral part of teaching and learning in any syllabus in the world. Recently, a new assessment system, School-Based Assessment (SBA) was introduced and implemented in the Malaysian education system to promote a more holistic, integrated and balanced assessment system. This effort is part of the reformation made in the Government Transformation Plan (GTP) to produce a world-class human capital as we are reaching and achieving the Vision 2020 in the near future. However, this new change has raised awareness and concerns from teachers, students, parents and non-profit organizations on how the new assessment is to be implemented and how it is affecting the students and teachers particularly. Therefore, this paper aims to investigate the issues that teachers face in implementing SBA in primary schools, the measures taken to address the issues and to propose ways of managing school-based assessment. Five national primary schools focusing in the urban areas in the Selangor state are chosen for this study to carry out. Data for the study will be gathered from interviews with teachers from each school, surveys and classrooms observation will be conducted in each school, and relevant documents are collected from the selected schools. The findings of this study will present the current issues that teachers from various types of national primary schools are facing and what actions they took to overcome the problems in carrying out SBA. Suggestions on how to better manage school-based assessment for teachers are also provided in this paper.

Keywords: community of practice, curriculum, managing change, school-based assessment

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Authors: Sardar Khana, Zar Ali Khana

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Rapid industrial development and urbanization contribute a lot to wastewater discharge. The wastewater enters into natural aquatic ecosystems from industrial activities and considers as one of the main sources of water pollution. Discharge of effluents loaded with heavy metals into the surrounding environment has become a key issue regarding human health risk, environment, and food chain contamination. Nickel causes fatigue, cancer, headache, heart problems, skin diseases (Nickel Itch), and respiratory disorders. Nickel compounds such as Nickel Sulfide and Nickel oxides in industrial environment, if inhaled, have an association with an increased risk of lung cancer. Therefore the removal of Nickel from effluents before discharge is necessary. Removal of Nickel by low-cost biosorbents is an efficient method. This study was aimed to investigate the efficiency of activated carbon and Pinusroxburgiisaw dust for the removal of Nickel from industrial effluents using commercial Activated Carbon, and raw P.roxburgii saw dust. Batch and column adsorption experiments were conducted for the removal of Nickel. The study conducted indicates that removal of Nickel greatly dependent on pH, contact time, Nickel concentration, and adsorbent dose. Maximum removal occurred at pH 9, contact time of 600 min, and adsorbent dose of 1 g/100 mL. The highest removal was 99.62% and 92.39% (pH based), 99.76% and 99.9% (dose based), 99.80% and 100% (agitation time), 92% and 72.40% (Ni Conc. based) for P.roxburgii saw dust and activated Carbon, respectively. Similarly, the Ni removal in column adsorption was 99.77% and 99.99% (bed height based), 99.80% and 99.99% (Concentration based), 99.98%, and 99.81% (flow rate based) during column studies for Nickel using P.Roxburgiisaw dust and activated carbon, respectively. Results were compared with Freundlich isotherm model, which showed “r2” values of 0.9424 (Activated carbon) and 0.979 (P.RoxburgiiSaw Dust). While Langmuir isotherm model values were 0.9285 (Activated carbon) and 0.9999 (P.RoxburgiiSaw Dust), the experimental results were fitted to both the models. But the results were in close agreement with Langmuir isotherm model.

Keywords: nickel removal, batch, and column, activated carbon, saw dust, plant uptake

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Authors: Arunima Datta, Prathama Guha Chaudhuri, Ashis Mukhopadhyay

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Background: Acceptance and commitment therapy (ACT) is one of the newer forms (third wave) therapy. This therapy helps a cancer patient to increase acceptance level about their disease as well as their present situation. Breast cancer patients are known to suffer from depression and mild cognitive impairment; both affect their quality of life. Objectives:The present study had assessed effect of structured ACT intervention on cognitive function and acceptance level among breast cancer patients who were undergoing chemotherapy. Method: Data was collected from 123 breast cancer patients those who were undergoing chemotherapy were willing to undergo psychological treatment, with no history of past psychiatric illness. Their baseline of cognitive function and acceptance levels were assessed using validated tools. The effect of sociodemographic factors and clinical factors on cognitive function was determined at baseline.The participants were randomly divided into two groups: experimental (ACT, 4 sessions over 2 months) and control group. Cognitive function and acceptance level were measured during post intervention on 2months follow-up. Appropriate statistical analyses were performed to determine the effect on cognitive function and acceptance level in two groups. Result: At baseline, the factors that significantly influenced slower speed of task performance were ER PR HER2 status; number of chemo cycle, treatment type (Adjuvant and neo-adjuvant) was related with that. Sociodemographic characteristics did not show any significant difference between slow and fast performance. Per and post intervention analysis showed that ACT intervention resulted in significant difference both in terms of speed of cognitive performance and acceptance level. Conclusion: ACT is an effective therapeutic option for treating mild cognitive impairment and improve acceptance level among breast cancer patients undergoing chemotherapy.

Keywords: acceptance and commitment therapy, breast cancer, quality of life, cognitive function

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Authors: Ahad Salimi, Hassan Masoumi

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Prostate cancer is one of the most common recognized cancers in men, and, is one of the most important mortality factors of cancer in this group. Determining of prostate’s boundary in TRUS (Transrectal Ultra Sound) images is very necessary for prostate cancer treatments. The weakness edges and speckle noise make the ultrasound images inherently to segment. In this paper a new automatic algorithm for prostate segmentation in TRUS images proposed that include three main stages. At first morphological smoothing and sticks filtering are used for noise removing. In second step, for finding a point in prostate region, SOFM algorithm is enlisted and in the last step, the boundary of prostate extracting accompanying active contour is employed. For validation of proposed method, a number of experiments are conducted. The results obtained by our algorithm show the promise of the proposed algorithm.

Keywords: SOFM, preprocessing, GVF contour, segmentation

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Authors: Yasmine Aridi, Lara Nasreddine, Maya Khalil, Arafat Tfayli, Anas Mugharbel, Farah Naja

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Breast cancer is the most commonly diagnosed cancer site among women worldwide and the second most common cause of cancer mortality. Breast cancer rates differ vastly between geographical areas, countries, and within the same country. In Lebanon, the proportion of breast cancer to all other sites of tumor is 38.2%; these rates are still lower than those observed worldwide, but remain the highest among Arab countries. Studies and evidence based reviews show a strong association between breast cancer development and prognosis and dietary habits, specifically the Mediterranean diet (MD). As such, the aim of this study is to examine dietary patterns and adherence to the MD among a sample of 182 breast cancer female patients in Beirut, Lebanon. Subjects were recruited from two major hospitals; a private medical center and a public hospital. All subjects were administered two questionnaires: socio- demographics and Mediterranean diet adherence. Five Mediterranean scores were calculated: MS, MSDPS, PMDI, PREDIMED and DDS. The mean age of the participants was 53.78 years. The overall adherence to the Mediterranean diet (MD) was low since the sample means of 3 out of the 5 calculated scores were less than the scores’ medians. Given that 4 out of the 5 Mediterranean scores significantly varied between the recruitment sites, women in the private medical center were found to adhere more to the MD. Our results also show that the majority of the sample population’s intakes are exceeding the recommendations for total and saturated fat, while meeting the requirements for fiber, EPA, DHA and Linolenic Acid. Participants in the private medical center were consuming significantly more calories, carbohydrates, fiber, sugar, Lycopene, Calcium, Iron and Folate and less fat. After conducting multivariate linear regression analyses, the following significant results were observed: positive associations between MD (CPMDI, PREDIMED) and monthly income & current state of health, while negative associations between MD (MSDPS, PREDIMED) and age & employment status. Our findings indicated a low overall adherence to the MD and identified factors associated with it; which suggests a need to address dietary habits among BC patients in Lebanon, specifically encouraging them to adhere to their traditional Mediterranean diet.

Keywords: Adherence, Breast cancer, Dietary patterns, Mediterranean diet, Nutrition

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Authors: Suliman Khan, Rabeea Siddique, Mengzhou Xue

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Background: Patients with neurological disorders often display altered circadian rhythms. The disrupted circadian rhythms through chronic jetlag or shiftwork are thought to increase the risk and severity of human disease, including cancer, psychiatric, and related brain diseases. In this study, we investigated the impact of shiftwork or chronic jetlag (CJL) like conditions on mice’s brains. Transcriptome profiling based on RNA sequencing revealed that genes associated with serious neurological disorders were differentially expressed in the nucleus accumbens (NAc) and prefrontal cortex (PFC). According to the qPCR analysis, several key regulatory genes associated with neurological disorders were significantly altered in the NAc, PFC, hypothalamus, hippocampus, and striatum. Serotonin levels and the expression levels of serotonin transporters and receptors were significantly altered in mice treated with CJL. Overall, these results indicate that CJL may increase the risk of neurological disorders by disrupting the key regulatory genes, biological functions, serotonin, and corticosterone. These molecular linkages can further be studied to investigate the mechanism underlying CJL or shiftwork-mediated neurological disorders in order to develop treatment strategies.

Keywords: chronic jetlag, molecular profiles, brain disorders, circadian rhythms

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Authors: Minseock Seo

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Dental education consists of both theoretical and practical learning for students. When dental students encounter practical courses as a new educational experience, they must also learn to evaluate themselves. The aim of this study was to investigate the self-assessment scores of third-year dental students and compare with the scores graded by the faculty in preclinical endodontic practice in a dental school in Korea. Faculty- and student-assigned scores were calculated from preclinical endodontic practice performed on phantom patients. The students were formally instructed on grading procedures for endodontic treatment. After each step, each item was assessed by the student. The students’ self-assessment score was then compared to the score by the faculty. The students were divided into 4 groups by analyzing the scores of self-assessment and faculty-assessment and statistically analyzed by summing the theoretical and practical examination scores. In the theoretical exam score, the group who over-estimated their performance (H group) was lower than the group with lower evaluation (L group). When comparing the first and last score determined by the faculty, H groups didn’t show any improvement, while the other group did. In H group, the less improvement of the self-assessment, the higher the theoretical exam score. In L group, the higher improvement of the self-assessment, the better the theoretical exam score. The results point to the need to develop students’ self-insight with more exercises and practical training.

Keywords: dental students, endodontic, preclinical practice, self-assessment

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Authors: Bu Kyung Park

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Background: The survival rate of pediatric cancer patients has been increased. Thus, the needs of long-term management and follow-up education after discharge continue to grow. Purpose: The purpose of this study was to explore the experiences of pediatric cancer patients and their families from first diagnosis to returning their social life. The ultimate goal of this study was to assess which information and intervention did pediatric cancer patients and their families required and needed, so that this could provide fundamental information for developing educational content of web-based intervention program for pediatric cancer patients. Research Approach: This study was based on a descriptive qualitative research design using semi-structured focus group interview. Participants: Twelve pediatric cancer patients and 12 family members participated in a total six focus group interview sessions. Methods: All interviews were audiotaped after obtaining participants’ approval. The recordings were transcribed. Qualitative Content analysis using the inductive coding approach was performed on the transcriptions by three coders. Findings: Eighteen categories emerged from the six main themes: 1) Information needs, 2) Support system, 3) Barriers to treatment, 4) Facilitators to treatment, 5) Return to social life, 6) Healthcare system issues. Each theme had both pediatric cancer patients’ codes and their family members’ codes. Patients and family members had high information needs through the whole process of treatment, not only the first diagnosis but also after completion of treatment. Hospitals provided basic information on chemo therapy, medication, and various examinations. However, they were more likely to rely on information from other patients and families by word of mouth. Participants’ information needs were different according to their treatment stage (e.g., first admitted patients versus cancer survivors returning to their social life). Even newly diagnosed patients worried about social adjustment after completion of all treatment, such as return to school and diet and physical activity at home. Most family members had unpleasant experiences while they were admitted in hospitals and concerned about healthcare system issues, such as medical error and patient safety. Conclusions: In conclusion, pediatric cancer patients and their family members wanted information source which can provide tailored information based on their needs. Different information needs with patients and their family members based on their diagnosis, progress, stage of treatment were identified. Findings from this study will be used to develop a patient-centered online health intervention program for pediatric cancer patients. Pediatric cancer patients and their family members had variety fields of education needs and soak the information from various sources. Web-based health intervention program for them is required to satisfy their inquiries to provide reliable information.

Keywords: focus group interview, family caregivers, pediatric cancer patients, qualitative content analysis

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