Search results for: surgical history

Authors: Shabnam Dadparvar, Laijin Shen, Farzad Ravanbod

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Regarding the issues that are currently happening in the world, more than any other time the differences between West and Islam is under discussion. The cultural relations between Islam and the West took a drastically new turn when Europe arose as the dominant and unchallenged force of the modern era. The author, by using descriptive- analytical method, tries to analyse one of the most controversial questions facing analysts of relations between the Islamic world and the West: What are the roots of the conflict? This paper addresses the history of the intellectual tradition of the West and the attitude of Muslim world regarding the rise of western modernity. Also, the differences between two groups on philosophical foundations such as religion, power, science and humanism will be explained. The author believes that the real difference between the West and Islam is epistemological.

Keywords: civilization, culture, Islam, West

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Authors: Diego Espinoza-Piedra, David Duran

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All architectural and land use processes are framed in a cultural, social and geographical context. The present study analyzes the Andean culture before the Spanish conquest in southern Ecuador, in the province of Azuay. This area has been habited for more than 10.000 years. The Canari and the Inca cultures occupied Azuay close to the arrival of the Spanish conquers. The Inca culture was settled in the Andes Mountains. The Canari culture was established in the south of Ecuador, on the actual provinces of Azuay and Canar. In contrast with history and archeology, to the best of our knowledge, their architecture has not yet been studied in this area because of the lack of architectural structures. Consequently, the present research reviewed the land use and culture for architectonic interpretations. The two main architectural objects in these cultures were dwellings and public buildings. In the first case, housing was conceived as temporary. It had to stand as long as its inhabitants lived. Therefore, houses were built when a couple got married. The whole community started the construction through the so-called ‘minga’ or collective work. The construction materials were tree branches, reeds, agave, ground, and straw. So that when their owners aged and then died, this house was easily disarmed and overthrown. Their materials become part of the land for agriculture. Finally, this cycle was repeated indefinitely. In the second case, the buildings, which we can call public, have presented erroneous interpretations. They have been defined as temples. But according to our conclusions, they were places for temporary accommodation, storage of objects and products, and in some special cases, even astronomical observatories. These public buildings were settled along the important road system called ‘Capac-Nam’, currently declared by UNESCO as World Cultural Heritage. The buildings had different scales at regular distances. Also, they were established in special or strategic places, which constituted a system of observatories. These observatories allowed to determine the cycles or calendars (solar or lunar) necessary for the agricultural production, as well as other natural phenomena. Most of the current minimal existence of physical structures in quantity and state of conservation is at the level of foundations or pieces of walls. Therefore, this study was realized after the identification of the history and culture of the inhabitants of this Andean region.

Keywords: Andean, pre-Colombian architecture, Southern Ecuador, sustainable

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Authors: Aminul Islam

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The issue of aging is now an emerging aspect of all over the world. Both the rural and urban societies of our country are not immune from this problem. This study mainly explored the influence of wealth on the enjoyment of role and status of the elderly in rural Bangladesh. It is based on empirical findings from the four villages of Gopalnagar union of Dhunat upazila of Bogra district. The study depicted that wealth has much influence regarding the enjoyment of role and status. Mixed approach has been given priority in this study. Survey, observation, case study and life history methods and focus group discussion technique have also been used in this study. Data have been collected from both primary and secondary sources. Simple random sampling procedure has also been followed in this study.

Keywords: wealth, role status, elderly

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Authors: Pietro Mortini, Marco Losa

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Objective: Resection of large lesions growing into the third ventricle remains a demanding surgery, sometimes at risk of severe post-operative complications. Transcallosal and transcortical routes were considered as approaches of choice to access the third ventricle, however neurological consequences like memory loss have been reported. We report clinical results of the previously described combined interhemispheric sub-commissural translaminaterminalis approach (CISTA) for the resection of large lesions located in the third ventricle. Methods: Authors conducted a retrospective analysis on 10 patients, who were operated through the CISTA, for the resection of lesions growing into the third ventricle. Results: Total resection was achieved in all cases. Cognitive worsening occurred only in one case. No perioperative deaths were recorded and, at last follow-up, all patients were alive. One year after surgery 80% of patients had an excellent outcome with a KPS 100 and Glasgow Outcome score (GOS) Conclusion: The CISTA represents a safe and effective alternative to transcallosal and transcortical routes to resect lesions growing into the third ventricle. It allows for a multiangle trajectory to access the third ventricle with a wide working area free from critical neurovascular structures, without any section of the corpus callosum, the anterior commissure and the fornix.

Keywords: craniopharingioma, surgery, sub-commissural translaminaterminalis approach (CISTA),

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Authors: Josine Beek, S. Agten, R. Del Pozo, B. Balis

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The objective of the present study was to compare the safety of intramuscular administration of Zuprevo® (tildipirosin, 40 mg/mL) with Draxxin® (tulathromycin, 100 mg/mL) in the treatment of swine respiratory disease at weaning age. The trial was carried out in two farrow-to-finish farms with 300 sows (farm A) and 500 sows (farm B) in a batch-production system. Farm A had no history of respiratory problems, whereas farm B had a history of respiratory outbreaks with increased mortality ( > 2%) in the nursery. Both farms were positive to Pasteurella multocida, Bordetella bronchiseptica, Actinobacillus pleuropneumoniae and Haemophilus parasuis. From each farm, one batch of piglets was included (farm A: 644 piglets; farm B: 963 piglets). One day before weaning (day 0; 18-21 days of age), piglets were identified by an individual ear tag and randomly assigned to a treatment group. At day 0, Group 1 was treated with a single intramuscular injection with Zuprevo® (tildipirosin, 40 mg/mL; 1 mL/10 kg) and group 2 with Draxxin® (tulathromycin, 100 mg/mL; 1 mL/40 kg). For practical reasons, dosage of the product was adjusted according to three weight categories: < 4 kg, 4-6 kg and > 6 kg. Within each farm, piglets of both groups were comingled at weaning and subsequently managed and located in the same facilities and with identical environmental conditions. Our study involved the period from day 0 until 10 weeks of age. Safety of treatment was evaluated by 1) visual examination for signs of discomfort directly after treatment and after 15 min, 1 h and 24 h and 2) mortality rate within 24 h after treatment. Efficacy of treatment was evaluated based on mortality rate from day 0 until 10 weeks of age. Each piglet that died during the study period was necropsied by the herd veterinarian to determine the probable cause of death. Data were analyzed using binary logistic regression and differences were considered significant if p < 0.05. The pig was the experimental unit. In total, 848 piglets were treated with tildipirosin and 759 piglets with tulathromycin. In farm A, one piglet with retarded growth ( < 1 kg at 18 days of age) showed an adverse reaction after injection of tildipirosin: lateral recumbence and dullness for ± 30 sec. The piglet recovered after 1-2 min. This adverse reaction was probably due to overdosing (12 mg/kg). No adverse effect of treatment was observed in any other piglet. There was no mortality within 24 h after treatment. No significant difference was found in mortality rate between both groups from day 0 until 10 weeks of age. In farm A, overall mortality rate was 0.3% (2/644). In farm B, mortality rate was 0.2% (1/502) in group 1 (tildipirosin) and 0.9% (4/461) in group 2 (tulathromycin)(p=0.60). The necropsy of piglets that died during the study period revealed no macroscopic lesions of the respiratory tract. In conclusion, Zuprevo® (tildipirosin, 40 mg/mL) was shown to be a safe and efficacious alternative to Draxxin® (tulathromycin, 100 mg/mL) for the early treatment of swine respiratory disease at weaning age.

Keywords: antibiotic treatment, safety, swine respiratory disease, tildipirosin

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

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

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

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Authors: Alexander Gretchenko, Liudmila Goncharenko, Sergey Sybachin

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This article summarizes the history of the discovery of N.D. Kondratiev of large cycles of economic conditions, as well as the creation and justification of the theory of innovation-cyclical economic development of Kondratiev-Schumpeter. An analysis of it in modern conditions is providing. The main conclusion in this article is that in general terms today it can be argued that the Kondratiev-Schumpeter theory is sufficiently substantiated. Further, the possibility of making a forecast of the development of the economic situation in the direction of applying this theory in practice, which demonstrate its effectiveness, is considered.

Keywords: Kondratiev's big cycles of economic conjuncture, Schumpeter's theory of innovative economic development, long-term cyclical forecasting, dating of Kondratiev cycles

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Authors: Joonha Park

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This essay examines the Soviet Artist Pavel Korin’s artistic pursuit towards his life-long project, “Requiem/Passing of the Rus,” framing the funeral of Tikhon, the last great defender of the Russian orthodox Church during the Great purge, as the final moment of “Rus,” which is the identity of the Russian people that built up in the 1000 year of history behind Russian Orthodoxy. Korin’s project remains in the form of a series of 29 man-sized portraits and a monumental blank canvas. Born in a family dedicated to iconography, Korin witnessed the historic drama during Stalin’s terror; therefore, he tried to convey the nation’s mourning for the disappearance of “Rus” and disapproval of the Soviet notion of atheism. Yet, due to Korin’s success as a state artist, many believed that the political pressure led Korin to give up his belief and controversy arose over the fact that Korin left the canvas blank. The empty 40-square-meter canvas, which remains untouched in his studio since 1930, supports this theory to an extent. However, resources such as Korin’s notes, primary accounts from his fellow Soviet Artists, and testimonies from his wife suggested that this assumption is incorrect. Moreover, Korin’s uninterrupted relationship with the church and the religious attributes in his commissioned works were brought up as evidence of Korin’s continued belief. The empty canvas not only represents Korin’s discontentment towards the repression and the hardships that the Orthodox Church experienced, but also depicts the identity that coexisted with the Church in order to bequeath this idea to future generations. The faultless canvas surrounded by the striking 29 portraits is a symbol of the highest spirit, similar to that of the iconography paintings placed in every Russian house that unites the Russian people till this day, therefore one can deduce that the legacy of “Requiem” is still relevant to the Russian people even under freedom of religious expression. Consequently, “Requiem” was on display at the Tretyakov Gallery for the first time in public in 2013 even though Korin started creating this piece in 1925, extolling Korin not only as an artist but also as a historian; by recording the turmoil of the Great Oppression, Korin exhibited the social responsibility universal to artists across time and space. In this essay, the legacy Korin left behind, both to his contemporaries and his posterity is reevaluated through the lens of his works, unfinished as they were.

Keywords: Pavel Korin, Art History, Art, Russia, Soviet Union, Requiem, Russian orthodox church, Treytyakov gallery, contemporary art, socialist realism, Maxim Gorky

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Authors: Hebert Sihle Ntuli

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From the beginning, women had a great contribution or share in shaping history by different means during different epochs. Africa in general and South Africa in particular, are replete with many examples of female dynasties, regents and rulers who took up positions of leadership through periods of nation-building and wars of resistance. Zulu culture is fraught with a plethora of women who contributed in shaping Zulu monarchy to what it became in the late 18th and 19th centuries. The aim of this paper is to discuss the contribution of women in shaping and sustaining Zulu monarchy during the period in question. This work adopted qualitative research method.

Keywords: Zulu monarchy, women, princess Mkabayi, Queen Nandi, Queen Monase

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Authors: Aathira H.

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Digital games can act as catalysts for educational transformation in the current scenario. Children and adolescence acquire this digital knowledge quickly and hence digital games can act as one of the most effective media for technology-mediated learning. Mobile gaming industries have seen the rise of a new trending genre of games, i.e., “Merge games” which is currently thriving in the market. This paper analysis on how gamifying historic and cultural narratives with merge mechanics can be an effective way to educate school children. Through the study of how merge mechanics in games have currently emerged as a trend., this paper argues how it can be integrated with a strong narrative which can convey history in an engaging way for education.

Keywords: game-based learning, merge mechanics, historical narratives, gaming innovations

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Authors: Shahla Afshar Paiman, Sedigheh Madani, Zahra Hosseininezhad

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Introduction: The most common causes of appendix luminal obstruction are fecaliths and lymphoid follicle hyperplasia. Appendicitis is a very rare Gastrointestinal complication of varicella zosterand it is mostly observed in immune-compromised patient. Case presentation: Here we reported a case of varicella zoster-related perforated appendicitis with synchronous encephalopathy as a first presentation of chickenpox in a 10-year-old boy. He had no history of immunodeficiency or predisposing factors and his diagnosis is confirmed by both serological lab tests and abdominal fluid (peritoneal secretion) PCR. Conclusion: Varicella zoster could cause appendicitis as first presentation, along with other critical complications look likes encephalopathy.

Keywords: Varicella zoster, appendicitis, encephalitis, children

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Authors: Deepak Jugran

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Purpose: The purpose of this study is to identify how past Pandemics shaped social evolution and cities. Methodology: A historical and comparative analysis of major historical pandemics in human history their origin, transmission route, biological response and the aftereffects. A Comprehensive pre & post pandemic scenario and focuses selectively on major issues and pandemics that have deepest & lasting impact on society with available secondary data. Results: Past pandemics shaped the behavior of human societies and their cities and made them more resilient biologically, intellectually & socially endorsing the theory of “Survival of the fittest” by Sir Charles Darwin. Pandemics & Infectious diseases are here to stay and as a human society, we need to strengthen our collective response & preparedness besides evolving mechanisms for strict controls on inter-continental movements of people, & especially animals who become carriers for these viruses. Conclusion: Pandemics always resulted in great mortality, but they also improved the overall individual human immunology & collective social response; at the same time, they also improved the public health system of cities, health delivery systems, water, sewage distribution system, institutionalized various welfare reforms and overall collective social response by the societies. It made human beings more resilient biologically, intellectually, and socially hence endorsing the theory of “AGIL” by Prof Talcott Parsons. Pandemics & infectious diseases are here to stay and as humans, we need to strengthen our city response & preparedness besides evolving mechanisms for strict controls on inter-continental movements of people, especially animals who always acted as carriers for these novel viruses. Pandemics over the years acted like natural storms, mitigated the prevailing social imbalances and laid the foundation for scientific discoveries. We understand that post-Covid-19, institutionalized city, state and national mechanisms will get strengthened and the recommendations issued by the various expert groups which were ignored earlier will now be implemented for reliable anticipation, better preparedness & help to minimize the impact of Pandemics. Our analysis does not intend to present chronological findings of pandemics but rather focuses selectively on major pandemics in history, their causes and how they wiped out an entire city’s population and influenced the societies, their behavior and facilitated social evolution.

Keywords: pandemics, Covid-19, social evolution, cities

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Authors: Ashutosh Biswas, Poonam Coushic, Kalpana Baruah, Paras Singla, A. C. Dhariwal, Pawana Murthy

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Burden of Dengue in Northern India Ashutosh Biswas, Poonam Coushic, Kalpana Baruah, Paras Singla, AC Dhariwal, Pawana Murthy. All India Institute of Medical Sciences, NVBDCP,WHO New Delhi, India Aim: This study was conducted to estimate the burden of dengue in capital region of India. Methodology:Seropositivity of Dengue for IgM Ab, NS1 Ag and IgG Ab were performed among the blood donors’ samples from blood bank, those who were coming to donate blood for the requirement of blood for the admitted patients in hospital. Blood samplles were collected through out the year to estimate seroprevalance of dengue with or without outbreak season. All the subjects were asymptomatic at the time of blood donation. Results: A total of 1558 donors were screened for the study. On the basis of inclusion/ exclusion criteria, we enrolled 1531subjects for the study.Twenty seven donors were excluded from the study, out of which 6 were detected HIV +ve, 11 were positive for HBsAg and 10 were found positive for HCV.Mean age was 30.51 ± 7.75 years.Of 1531subjects, 18 (1.18%) had a past history of typhoid fever, 28 (1.83%) had chikungunya fever, 9 (0.59%) had malaria and 43 subjects (2.81%) had a past history of symptomatic dengue infection.About 2.22% (34) of subjects were found to have sero-positive for NS1 Ag with a peak point prevalence of 7.14% in the month of October and sero-positive of IgM Ab was observed about 5.49% (84)with a peak point prevalence of 14.29% in the month of October. Sero-prevalnce of IgGwas detected in about 64.21% (983) of subjects. Conclusion: Acute asymptomatic dengue (NS1 Ag+ve) was observed in 7.14%, as the subjects were having no symptoms at the time of sampling. This group of subjects poses a potential public health threat for transmitting dengue infection through blood transfusion (TTI) in the community as evident by presence of active viral infection due to NS1Ag +VE. Therefore a policy may be implemented in the blood bank for testing NS1 Ag to look for active dengue infection for preventing dengue transmission through blood transfusion (TTI). Acute or Subacute dengue infection ( IgM Ab+ve) was observed from 5.49% to 14.29% which is a peak point prevalence in the month of October. About 64.21% of the population were immunized by natural dengue infection ( IgG Ab+ve) in theNorthern province of India. This might be helpful for implementing the dengue vaccine in a region. Blood samples in blood banks should be tested for dengue before transfusion to any other person to prevent transfusion transmitted dengue infection as we estimated upto 7.14% positivity of NS1 Ag in our study which indicates presence of dengue virus in blood donors’ samples.

Keywords: Dengue Burden, Seroprevalance, Asymptomatic dengue, Dengue transmission through blood transfusion

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Authors: Axel Thallemer, Aleksandar Kostadinov, Abel Fam, Alex Teo

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For centuries, the forming processes in nature served as a source of inspiration for both architects and designers. It seems as most human artifacts are based on ideas which stem from the observation of the biological world and its principles of growth. As a fact, in the cultural history of Homo faber, materials have been mostly used in their solid state: From hand axe to computer mouse, the principle of employing matter has not changed ever since the first creation. In the scope of history only recently and by the help of additive-generative fabrication processes through Computer Aided Design (CAD), designers were enabled to deconstruct solid artifacts into an outer skin and an internal lattice structure. The intention behind this approach is to create a new topology which reduces resources and integrates functions into an additively manufactured component. However, looking at the currently employed lattice structures, it is very clear that those lattice structure geometries have not been thoroughly designed, but rather taken out of basic-geometry libraries which are usually provided by the CAD. In the here presented study, a group of 20 industrial design students created new and unique lattice structures using natural paragons as their models. The selected natural models comprise both the animate and inanimate world, with examples ranging from the spiraling of narwhal tusks, off-shooting of mangrove roots, minimal surfaces of soap bubbles, up to the rhythmical arrangement of molecular geometry, like in the case of SiOC (Carbon-Rich Silicon Oxicarbide). This ideation process leads to a design of a geometric cell, which served as a basic module for the lattice structure, whereby the cell was created in visual analogy to its respective natural model. The spatial lattices were fabricated additively in mostly [X]3 by [Y]3 by [Z]3 units’ volumes using selective powder bed melting in polyamide with (z-axis) 50 mm and 100 µm resolution and subdued to mechanical testing of their elastic zone in a biomedical laboratory. The results demonstrate that additively manufactured lattice structures can acquire different properties when they are designed in analogy to natural models. Several of the lattices displayed the ability to store and return kinetic energy, while others revealed a structural failure which can be exploited for purposes where a controlled collapse of a structure is required. This discovery allows for various new applications of functional lattice structures within industrially created objects.

Keywords: bio-inspired, biomimetic, lattice structures, additive manufacturing

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Authors: P. Mounnarath, U. Schmitz, Ch. Zhang

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Fragility analysis is an effective tool for the seismic vulnerability assessment of civil structures in the last several years. The design of the expansion joints according to various bridge design codes is almost inconsistent, and only a few studies have focused on this problem so far. In this study, the influence of the expansion joint clearances between the girder ends and the abutment backwalls on the seismic fragility assessment of continuous integral bridge frames is investigated. The gaps (ranging from 60 mm, 150 mm, 250 mm and 350 mm) are designed by following two different bridge design code specifications, namely, Caltrans and Eurocode 8-2. Five bridge models are analyzed and compared. The first bridge model serves as a reference. This model uses three-dimensional reinforced concrete fiber beam-column elements with simplified supports at both ends of the girder. The other four models also employ reinforced concrete fiber beam-column elements but include the abutment backfill stiffness and four different gap values. The nonlinear time history analysis is performed. The artificial ground motion sets, which have the peak ground accelerations (PGAs) ranging from 0.1 g to 1.0 g with an increment of 0.05 g, are taken as input. The soil-structure interaction and the P-Δ effects are also included in the analysis. The component fragility curves in terms of the curvature ductility demand to the capacity ratio of the piers and the displacement demand to the capacity ratio of the abutment sliding bearings are established and compared. The system fragility curves are then obtained by combining the component fragility curves. Our results show that in the component fragility analysis, the reference bridge model exhibits a severe vulnerability compared to that of other sophisticated bridge models for all damage states. In the system fragility analysis, the reference curves illustrate a smaller damage probability in the earlier PGA ranges for the first three damage states, they then show a higher fragility compared to other curves in the larger PGA levels. In the fourth damage state, the reference curve has the smallest vulnerability. In both the component and the system fragility analysis, the same trend is found that the bridge models with smaller clearances exhibit a smaller fragility compared to that with larger openings. However, the bridge model with a maximum clearance still induces a minimum pounding force effect.

Keywords: expansion joint clearance, fiber beam-column element, fragility assessment, time history analysis

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Authors: N. C. van der Merwe, J. Oosthuizen, M. F. Makhetha, J. Adams, B. K. Dajee, S-R. Schneider

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Women representing high-risk breast cancer families, who tested negative for pathogenic mutations in BRCA1 and BRCA2, are four times more likely to develop breast cancer compared to women in the general population. Sequencing of genes involved in genomic stability and DNA repair led to the identification of novel contributors to familial breast cancer risk. These include BLM and PALB2. Bloom's syndrome is a rare homozygous autosomal recessive chromosomal instability disorder with a high incidence of various types of neoplasia and is associated with breast cancer when in a heterozygous state. PALB2, on the other hand, binds to BRCA2 and together, they partake actively in DNA damage repair. Archived DNA samples of 66 BRCA1/2 negative high-risk breast cancer patients were retrospectively selected based on the presence of an extensive family history of the disease ( > 3 affecteds per family). All coding regions and splice-site boundaries of both genes were screened using High-Resolution Melting Analysis. Samples exhibiting variation were bi-directionally automated Sanger sequenced. The clinical significance of each variant was assessed using various in silico and splice site prediction algorithms. Comprehensive screening identified a total of 11 BLM and 26 PALB2 variants. The variants detected ranged from global to rare and included three novel mutations. Three BLM and two PALB2 likely pathogenic mutations were identified that could account for the disease in these extensive breast cancer families in the absence of BRCA mutations (BLM c.11T > A, p.V4D; BLM c.2603C > T, p.P868L; BLM c.3961G > A, p.V1321I; PALB2 c.421C > T, p.Gln141Ter; PALB2 c.508A > T, p.Arg170Ter). Conclusion: The study confirmed the contribution of pathogenic mutations in BLM and PALB2 to the familial breast cancer burden in South Africa. It explained the presence of the disease in 7.5% of the BRCA1/2 negative families with an extensive family history of breast cancer. Segregation analysis will be performed to confirm the clinical impact of these mutations for each of these families. These results justify the inclusion of both these genes in a comprehensive breast and ovarian next generation sequencing cancer panel and should be screened simultaneously with BRCA1 and BRCA2 as it might explain a significant percentage of familial breast and ovarian cancer in South Africa.

Keywords: Bloom Syndrome, familial breast cancer, PALB2, South Africa

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Authors: Liping Qiu, Xiaofeng Zhang

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In its long history, precious tomb murals suffered from various diseases due to natural and man-made destruction. The key to how to protect tomb murals is how to strengthen and protect the tomb murals. In order to maximize the life of the tomb murals, the artistic, historic, and scientific values of the tomb murals can be continued. In this paper, four kinds of traditional reinforcement materials (silicone acrylic lotion, pure acrylic lotion, polyvinyl acetate lotion, and B72) are selected to reinforce the ground support layer of tomb murals, and the reinforcement effect of each reinforcement material on the ground support layer of murals is compared and analyzed, and the best protection material is obtained.

Keywords: mural, destruction cycle, reinforcement material, disease

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

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Introduction: Spondylothoracic dysostosis, also known as Jarcho-Levin syndrome, is defined by a shortened neck and thorax, a protruding abdomen, inguinal and umbilical hernias, atypical spinal structure and rib fusion, leading to restricted chest movement or difficulty in breathing, along with urinary tract abnormalities and, potentially severe scoliosis. Aim: This is the case of a patient diagnosed with Jarcho-Levin syndrome, aiming to detail the range of abnormalities observed in this syndrome, the observed complications, and the therapeutic approaches employed. Results: A three-month-old male infant, born of a consanguineous marriage, delivered at full term by cesarean section, was admitted to the pediatric department for severe acute bronchiolitis. In his prenatal history, morphological ultrasound revealed macrosomia, a shortened spine, irregular vertebrae with thickened skin, normal fetal cardiac ultrasound, and the absence of the right kidney. His perinatal history included respiratory distress, requiring ventilatory support for five days. Upon physical examination, he had stunted growth, scoliosis, a short neck and trunk, longer upper limbs compared to lower limbs, varus equinus in the right foot, a neural tube defect, a low hairline, and low-set ears. Spondylothoracic dysostosis was suspected, leading to further investigations, including a normal transfontaneous ultrasound, a spinal cord ultrasound revealing a lipomyelocele-type closed dysraphism with a low-attached cord, an abdominal ultrasound indicating a single left kidney, and a cardiac ultrasound identifying Kommerell syndrome. Due to a lack of resources, genetic testing could not be performed, and the diagnosis was based on clinical criteria. Conclusion: Jarcho-Levin syndrome can result in a mortality rate of about 50%, primarily due to respiratory complications associated with thoracic insufficiency syndrome. Other complications, like heart and neural tube defects, can also lead to premature mortality. Therefore, early diagnosis and comprehensive treatment involving various specialists are essential.

Keywords: Jarcho-Levin syndrome, congenital disorder, scoliosis, spondylothoracic dysostosis, neural tube defect

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Authors: Hsiao-Wen Tsai

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Motor vehicle accident is the first cause of head injury in the world; severe head injury cases may cause conscious disturbance and death. This is a report about a case of a young adult patient suffering from motor vehicle accident leading to severe head injury who passed through three time surgical procedures, and his mother (who is the informal caregiver). This case was followed from 28th January to 15th February 2011 by using Gordon’s 11 functional health patterns. Patient’s cognitive-perceptual and self-perception-self-concept patterns were altered. Anxiety was also noted on his informal caregiver due to patients’ condition. During the intensive care period, maintaining patient’s vital signs and cerebral perfusion pressure were essential to avoid secondary neuronal injury. Multi-sensory stimulation, caring accompanying, supporting, listening and encouraging patient’s family involved in patient care were very important to reduce informal caregiver anxiety. Finally, the patient consciousness improved from GCS 4 to GCS 11 before discharging from ICU. Patient’s primary informal caregiver, his mother, also showed anxiety improvement. This is was successful case with traumatic brain injury recovered from coma.

Keywords: anxiety, multi-sensory stimulation, reduce intracranial adaptive capacity, traumatic brain injury

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Authors: Sandra Adarve, Jhon Osorio

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Uncertainty has been studied in patients with different types of cancer, except in patients with hematologic cancer and undergoing transplantation. The purpose of this study was to identify factors associated with uncertainty in adults patients with malignant hemato-oncology diseases who are scheduled to undergo hematopoietic stem cell transplantation based on Merle Mishel´s Uncertainty theory. This was a cross-sectional study with an analytical purpose. The study sample included 50 patients with leukemia, myeloma, and lymphoma selected by non-probability sampling by convenience and intention. Sociodemographic and clinical variables were measured. Mishel´s Scale of Uncertainty in Illness was used for the measurement of uncertainty. A bivariate and multivariate analyses were performed to explore the relationships and associations between the different variables and uncertainty level. For this analysis, the distribution of the uncertainty scale values was evaluated through the Shapiro-Wilk normality test to identify statistical tests to be used. A multivariate analysis was conducted through a logistic regression using step-by-step technique. Patients were 18-74 years old, with a mean age of 44.8. Over time, the disease course had a median of 9.5 months, an opportunity was found in the performance of the transplantation of < 20 days for 50% of the patients. Regarding the uncertainty scale, a mean score of 95.46 was identified. When the dimensions of the scale were analyzed, the mean score of the framework of stimuli was 25.6, of cognitive ability was 47.4 and structure providers was 22.8. Age was identified to correlate with the total uncertainty score (p=0.012). Additionally, a statistically significant difference was evidenced between different religious creeds and uncertainty score (p=0.023), education level (p=0.012), family history of cancer (p=0.001), the presence of comorbidities (p=0.023) and previous radiotherapy treatment (p=0.022). After performing logistic regression, previous radiotherapy treatment (OR=0.04 IC95% (0.004-0.48)) and family history of cancer (OR=30.7 IC95% (2.7-349)) were found to be factors associated with the high level of uncertainty. Uncertainty is present in high levels in patients who are going to be subjected to bone marrow transplantation, and it is the responsibility of the nurse to assess the levels of uncertainty and the presence of factors that may contribute to their presence. Once it has been valued, the uncertainty must be intervened from the identified associated factors, especially all those that have to do with the cognitive capacity. This implies the implementation and design of intervention strategies to improve the knowledge related to the disease and the therapeutic procedures to which the patients will be subjected. All interventions should favor the adaptation of these patients to their current experience and contribute to seeing uncertainty as an opportunity for growth and transcendence.

Keywords: hematopoietic stem cell transplantation, hematologic diseases, nursing, uncertainty

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Authors: Bashaiar Alsanaa

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The advent of new forms of media has always led to a change in the way existing media deliver content. No medium has been replaced by another yet over the course of history. Whether this fact changes with the introduction of new age technology and social media remains to be seen. Snapchat may be the first application, to seriously challenge TV. It is perhaps the new face of television. The individualistic nature of Snapchat, whereby users control who, when, and in what order to watch, assesses user freedom from traditional broadcasters’ control. This study aims to fill the void in research conducted around such topic. The research explores how Snapchat maybe slowly but replacing TV. The study surveys users in Kuwait in order to present an overview of the topic. It also draws a framework through which implications and suggestions for future research may be discussed to better serve the advancement of media research.

Keywords: Kuwait, media, Snapchat, television

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Authors: A. S. Grewal, Sh. Dharambir, R. S. Sangwan, Vikas Dhanda

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Every Scene of Crime is of different kind in nature. Sometimes we see such type of circumstances that we become confused to judge whether the case is of homicide or suicide. In such circumstances a doyen is asked for the option. On the basis of his esoteric knowledge he finds such clues which force the sleuth to change the under sections of Indian penal Code. Here we have examined a case by visiting Scene of Crime and found that a person was found lying dead in a room. There was only one passage which was found opened, the pistol along with the fired cartridge case, misfired cartridge were lying on the spot. Observation method, mathematical calculations, chemical examination and other aspects were considered.

Keywords: country-made pistol, misfired cartridge, fired cartridge case, blackening, nitrite

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Authors: Shantanu Vyas, Neerja Meena

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Facial infiltrating lipomatosis is a rare lipomatous lesion, first described by Slavin in 1983. It is a benign pseudotumor pathology. It corresponds to a non-encapsulated collection of mature adipocytes infiltrating the local tissue and hyperplasia of underlying bone leading to a craniofacial deformity. Very few cases have been reported in the literature. We report the case of a 19-year-old female patient, who was consulted for a swelling of the right hemiface progressively evolving since birth. Physical examination revealed facial asymmetry. On palpation, the mass was soft, painless, not compressible, not pulsatile, not fluctuating. In view of the asymptomatic nature and slow progression of the lesion, a lipomatous tumour, namely lipoma, was suggested. CT scan image shows a hyperplastic subcutaneous fat on the right hemiface. On the right jugal and temporal areas, there is a subcutaneous formation of fatty density, poorly limited, with no detectable peripheral capsule. It merges with the adjacent fat. In the bone window, there was a hyperplasia of underlying bone. Facial lipomatosis infiltration of the face is a benign pseudotumor pathology. As a result, it can be confused with other disorders, in particular, hemifacial hyperplasia. Combination of physical and radiological findings can establish the diagnosis. Surgical treatment is done for cosmetic purposes.

Keywords: cosmetic correction and facial assemetry, aesthetic results, facial infiltration, surgery

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Authors: Meszár Tárik

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The aim of the study is to introduce the minority groups living in Iraq and to shed light on their current situation. The Middle East is a rather heterogeneous region in ethnic terms. It includes many ethnic, national, religious, linguistic, or ethnoreligious groups. The relationship between the majority and minority is the main cause of various conflicts in the region. It seems that most of the post-Ottoman states have not yet developed a unified national identity capable of integrating their multi-ethnic societies. The issue of minorities living in the Middle East is highly politicized and controversial, as the various Arab states consider the treatment of minorities as their internal affair, do not recognize discrimination or even deny the existence of any kind of minorities on their territory. This attitude of the Middle Eastern states may also be due to the fact that the minority issue can be abused and can serve as a reference point for the intervention policies of Western countries at any time. Methodologically, the challenges of these groups are perceived through the manifestos of prominent individuals and organizations belonging to minorities. The basic aim is to present the minorities’ own history in dealing with the issue. It also introduces the different ethnic and religious minorities in Iraq and analyzes their situation during the operation of the terrorist organization „Islamic State” and in the aftermath. It is clear that the situation of these communities deteriorated significantly with the advance of ISIS, but it is also clear that even after the expulsion of the militant group, we cannot necessarily report an improvement in this area, especially in terms of the ability of minorities to assert their interests and physical security. The emergence of armed militias involved in the expulsion of ISIS sometimes has extremely negative effects on them. Until the interests of non-Muslims are adequately represented at the local level and in the legislature, most experts and advocates believe that little will change in their situation. When conflicts flare, many Iraqi citizens usually leave Iraq, but because of the poor public security situation (threats from terrorist organizations, interventions by other countries), emigration causes serious problems not only outside the country’s borders but also within the country. Another ominous implication for minorities is that their communities are very slow if ever, to return to their homes after fleeing their own settlements. An important finding of the study is that this phenomenon is changing the face of traditional Iraqi settlements and threatens to plunge groups that have lived there for thousands of years into the abyss of history. Therefore, we not only present the current situation of minorities living in Iraq but also discuss their future possibilities.

Keywords: Middle East, Iraq, Islamic State, minorities

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Authors: Lynn Ruggieri

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The worldwide pandemic has only increased sustainability awareness. The public is demanding that businesses be held accountable for their impact on the environment. While financial data enjoys uniformity in reporting requirements, there are no uniform reporting requirements for non-financial data. Europe is leading the way with some standards being implemented for reporting non-financial sustainability data; however, there is no uniformity globally. And without uniformity, there is not a clear understanding of what information to include and how to disclose it. Sustainability reporting will provide important information to stakeholders and will enable businesses to understand their impact on the environment. Therefore, there is a crucial need for this data. This paper looks at the history of sustainability reporting in the countries of the European Union and throughout the world and makes a case for worldwide reporting requirements for sustainability.

Keywords: financial reporting, non-financial data, sustainability, global financial reporting

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Authors: Mahmoud Tarek, Alaa Obeida, Mai Magdy, Khalid Hussein, Aly Shalaby

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Background: More doctors are complaining of burnout than before, Burnout is a state of physical and mental exhaustion caused by the doctor’s lifestyle, unfortunately, Medical errors are also more likely in those suffering from burnout and these may result in malpractice suits. Methodology: It is a retrospective audit of burnout response on all neonatologists over a 9 months period. We gathered data using burnout questionnaire, it was obtained from 23 physicians, the physicians divided into 5 categories according to the final score of the 28 questions in the questionnaire. Category 1 with score from 28-38 with almost no work stress, category 2 with score (38-50) who express a low amount of job related stress, category 3 with score (51-70) with moderate amount of stress, category 4 with score (71-90) those express a high amount of job stress and begun to burnout, category 5 with score (91 and above) who are under a dangerous amount of stress and advanced stage of burnout. Results: 33 neonatologists have received the questionnaire, 23 responses were sent back with a response rate of 69.6%. The results showed that 61% of physicians fall in category 4, 31% of the physician in category 5, while 8% of physicians equally distributed between category 2 and 3 (4% each of them). On the other hand, there is no physician present in category 1. Conclusion: Burnout is prevalent in SNICUs, So interventions to minimize burnout prevalence may be of greater importance as this may be reflected indirectly on medical conditions of the patients and physicians, efforts should be done to decrease this high rate of burnout.

Keywords: Cairo, work overload, exhaustion, surgery, neonatal ICU

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Authors: Charles Ruffner, Michael Manton, Gintautas Kibirkstis, Gediminas Brazaitas, Vitas Marozas, Ekaterine Makrickiene, Rutile Pukiene, Per Angelstam

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In dynamic boreal forests, fire is an important natural disturbance, which drives regeneration and mortality of living and dead trees, and thus successional trajectories. However, current forest management practices focusing on wood production only have effectively eliminated fire as a stand-level disturbance. While this is generally well studied across much of Europe, in Lithuania, little is known about the historic fire regime and the role fire plays as a management tool towards the sustainable management of future landscapes. Focusing on Scots pine forests, we explore; i) the relevance of fire disturbance regimes on forestlands of Lithuania; ii) fire occurrence in the Dzukija landscape for dry upland and peatland forest sites, and iii) correlate tree-ring data with climate variables to ascertain climatic influences on growth and fire occurrence. We sampled and cross-dated 132 Scots pine samples with fire scars from 4 dry pine forest stands and 4 peatland forest stands, respectively. The fire history of each sample was analyzed using standard dendrochronological methods and presented in FHAES format. Analyses of soil moisture and nutrient conditions revealed a strong probability of finding forests that have a high fire frequency in Scots pine forests (59%), which cover 34.5% of Lithuania’s current forestland. The fire history analysis revealed 455 fire scars and 213 fire events during the period 1742-2019. Within the Dzukija landscape, the mean fire interval was 4.3 years for the dry Scots pine forest and 8.7 years for the peatland Scots pine forest. However, our comparison of fire frequency before and after 1950 shows a marked decrease in mean fire interval. Our data suggest that hemi-boreal forest landscapes of Lithuania provide strong evidence that fire, both human and lightning-ignited fires, has been and should be a natural phenomenon and that the examination of biological archives can be used to guide sustainable forest management into the future. Currently, fire use is prohibited by law as a tool for forest management in Lithuania. We recommend introducing trials that use low-intensity prescribed burning of Scots pine stands as a regeneration tool towards mimicking natural forest disturbance regimes.

Keywords: biodiversity conservation, cultural burning, dendrochronology, forest dynamics, forest management, succession

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Authors: Martin Van, Mohammed Javed, Sarah Hemington-Gorse

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Aim: Our aim was to determine the effect of size and tumor depth of basal cell carcinomas (BCCs) on surgical margin clearance. Methods: A retrospective study was conducted at the Welsh Centre for Burns and Plastic Surgery (WCBPS), Morriston Hospital between 1 Jan 2016 – 31 July 2016. Only patients with confirmed BCC on histopathological analysis were included. Patient data including anatomical region treated, lesion size, histopathological clearance margins and histological sub-types were recorded. An independent T-test was performed determine statistical significance. Results: A total of 228 BCCs were excised in 160 patients. Eleven lesions (4.8%) were incompletely excised. The nose area had the highest rate of incomplete excision. The mean diameter of incompletely excised lesions was 11.4mm vs 11.5mm in completely excised lesions (p=0.959) and the mean histological depth of incompletely excised lesions was 4.1mm vs. 2.5mm for completely excised BCCs (p < 0.05). Conclusions: BCC tumor depth of > 4.1 mm was associated with high rate of incomplete margin clearance. Hence, in prospective patients, a BCC tumor depth (>4 mm) on tissue biopsy should alert the surgeon of potentially higher risk of incomplete excision of lesion.

Keywords: basal cell carcinoma, excision margins, plastic surgery, treatment

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Authors: Wangxu Xia

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BACKGROUND BI-RADS 4 lesions raise the possibility of malignancy that warrant further clinical and radiologic work-up. This study aimed to evaluate the predictive performance of diffusion-weighted imaging(DWI) and microcalcifications on mammography for predicting malignancy of BI-RADS 4 lesions. In addition, the predictive performance of DWI combined with microcalcifications was alsocompared with the Kaiser score. METHODS During January 2021 and June 2023, 144 patients with 178 BI-RADS 4 lesions underwent conventional MRI, DWI, and mammography were included. The lesions were dichotomized intobenign or malignant according to the pathological results from core needle biopsy or surgical mastectomy. DWI was performed with a b value of 0 and 800s/mm2 and analyzed using theapparent diffusion coefficient, and a Kaiser score > 4 was considered to suggest malignancy. Thediagnostic performances for various diagnostic tests were evaluated with the receiver-operatingcharacteristic (ROC) curve. RESULTS The area under the curve (AUC) for DWI was significantly higher than that of the of mammography (0.86 vs 0.71, P<0.001), but was comparable with that of the Kaiser score (0.86 vs 0.84, P=0.58). However, the AUC for DWI combined with mammography was significantly highthan that of the Kaiser score (0.93 vs 0.84, P=0.007). The sensitivity for discriminating malignant from benign BI-RADS 4 lesions was highest at 89% for Kaiser score, but the highest specificity of 83% can be achieved with DWI combined with mammography. CONCLUSION DWI combined with microcalcifications on mammography could discriminate malignant BI-RADS4 lesions from benign ones with a high AUC and specificity. However, Kaiser score had a better sensitivity for discrimination.

Keywords: MRI, DWI, mammography, breast disease

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Authors: Merilin Ivanova Ivanova, Kalin Dimitrov Atanasov, Stefan Petrov Enchev

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Backgroud: Neuromyelitis optica spectrum disorder, also known as Devic’s disease, is a relapsing demyelinating autoimmune inflammatory disorder of the central nervous system associated with anti-aquaporin 4 (AQP4) antibodies that can manifest with devastating secondary neurological deficits. Most commonly affected are the optic nerves and the spinal cord-clinically this is often presented with optic neuritis (loss of vision), transverse myelitis(weakness or paralysis of extremities),lack of bladder and bowel control, numbness. APS is a core clinical entity of NMOSD and adds to the clinical representation the following symptoms: intractable nausea, vomiting and hiccup, it usually occurs isolated at onset, and can lead to a significant delay in the diagnosis. The condition may have features similar to multiple sclerosis (MS) but the episodes are worse in NMO and it is treated differently. It could be relapsing or monophasic. Possible complications are visual field defects and motor impairment, with potential blindness and irreversible motor deficits. In severe cases, myogenic respiratory failure ensues. The incidence of reported cases is approximately 0.3–4.4 per 100,000. Paediatric cases of NMOSD are rare but have been reported occasionally, comprising less than 5% of the reported cases. Objective: The case serves to show the difficulty when it comes to the diagnostic processes regarding a rare autoimmune disease with non- specific symptoms, taking large interval of rimes to reveal as complete clinical manifestation of the aforementioned syndrome, as well as the necessity of multidisciplinary approach in the setting of а general paediatric department in аn emergency hospital. Methods: itpatient's history, clinical presentation, and information from the used diagnostic tools(MRI with contrast of the central nervous system) lead us to the conclusion .This was later on confirmed by the positive results from the anti-aquaporin 4 (AQP4) antibody serology test. Conclusion: APS is a common symptom of NMOSD and is considered a challenge in a differential-diagnostic plan. Gaining an increased awareness of this disease/syndrome, obtaining a detailed patient history, and performing thorough physical examinations are essential if we are to reduce and avoid misdiagnosis.

Keywords: neuromyelitis, devic's disease, hiccup, autoimmune, MRI

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