Search results for: women with breast cancer
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 5112

Search results for: women with breast cancer

3972 Cancer Survivor’s Adherence to Healthy Lifestyle Behaviours; Meeting the World Cancer Research Fund/American Institute of Cancer Research Recommendations, a Systematic Review and Meta-Analysis

Authors: Daniel Nigusse Tollosa, Erica James, Alexis Hurre, Meredith Tavener

Abstract:

Introduction: Lifestyle behaviours such as healthy diet, regular physical activity and maintaining a healthy weight are essential for cancer survivors to improve the quality of life and longevity. However, there is no study that synthesis cancer survivor’s adherence to healthy lifestyle recommendations. The purpose of this review was to collate existing data on the prevalence of adherence to healthy behaviours and produce the pooled estimate among adult cancer survivors. Method: Multiple databases (Embase, Medline, Scopus, Web of Science and Google Scholar) were searched for relevant articles published since 2007, reporting cancer survivors adherence to more than two lifestyle behaviours based on the WCRF/AICR recommendations. The pooled prevalence of adherence to single and multiple behaviours (operationalized as adherence to more than 75% (3/4) of health behaviours included in a particular study) was calculated using a random effects model. Subgroup analysis adherence to multiple behaviours was undertaken corresponding to the mean survival years and year of publication. Results: A total of 3322 articles were generated through our search strategies. Of these, 51 studies matched our inclusion criteria, which presenting data from 2,620,586 adult cancer survivors. The highest prevalence of adherence was observed for smoking (pooled estimate: 87%, 95% CI: 85%, 88%) and alcohol intake (pooled estimate 83%, 95% CI: 81%, 86%), and the lowest was for fiber intake (pooled estimate: 31%, 95% CI: 21%, 40%). Thirteen studies were reported the proportion of cancer survivors (all used a simple summative index method) to multiple healthy behaviours, whereby the prevalence of adherence was ranged from 7% to 40% (pooled estimate 23%, 95% CI: 17% to 30%). Subgroup analysis suggest that short-term survivors ( < 5 years survival time) had relatively a better adherence to multiple behaviours (pooled estimate: 31%, 95% CI: 27%, 35%) than long-term ( > 5 years survival time) cancer survivors (pooled estimate: 25%, 95% CI: 14%, 36%). Pooling of estimates according to the year of publication (since 2007) also suggests an increasing trend of adherence to multiple behaviours over time. Conclusion: Overall, the adherence to multiple lifestyle behaviors was poor (not satisfactory), and relatively, it is a major concern for long-term than the short-term cancer survivor. Cancer survivors need to obey with healthy lifestyle recommendations related to physical activity, fruit and vegetable, fiber, red/processed meat and sodium intake.

Keywords: adherence, lifestyle behaviours, cancer survivors, WCRF/AICR

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3971 The Strategic Roles of Women in Small Family Businesses: Evidence from Two Emerging Economies in West Africa

Authors: Bamidele Wale-Oshinowo, Doris Akyere Boateng, Lebura Sorbarikor

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Women play significant roles when it comes to the survival of family businesses; however, their efforts are less acknowledged across the developing world. In the case where these businesses are started by husbands, women in many instances work as hard as the men to build up the business. In spite of this, the benefits women receive are not equal to their inputs. For instance, the profits accruing from ownership of these businesses are mainly enjoyed by husbands, as they are deemed to be the legal owners of family businesses in most developing economies. Though the number of women involvement in the ownership, management, and direction of family businesses keeps increasing over the years, their efforts sometimes are ‘invisible’ and not rewarded. Using a phenomenological approach, this study purposively selected 20 businesswomen each from Ghana and Nigeria for in-depth interviews on the different roles they play in ensuring the success of their family businesses (FBs). This study also explored the challenges and opportunities that these women have within their family businesses. Among the major findings of this study is the important strategic direction that women give in terms of providing both tangible and intangible resources such as transfer of transit knowledge to the next generation. Women were also found to play a significant role in the implementation of entrepreneurial orientation within small family businesses in Ghana and Nigeria. However, the study revealed that women experience various challenges as stakeholders in family businesses, among which are: work-life balance issues, succession issues, and culture-related presuppositions about gender roles both within the business and in their families. In the light of the study’s findings, critical recommendations made include encouraging founders and/or owners of family businesses to create a conducive and viable platform for women to grow into key leadership positions within Family businesses; doing this would impact strongly on the growth rate of these form of businesses within the African Region.

Keywords: emerging economies, control, management, resources, strategy, women

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3970 Women Entrepreneurship in Poland and Its Impact on the Country’s Economic Development

Authors: Sabina Klimek

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In general, entrepreneurs are viewed as agents of change whose goal is to ensure that resources are efficiently utilized. They are very important in the global economy; they create wealth and provide jobs. At the same time, many policymakers say that women entrepreneurs are a ‘special group’ worthy of their own research and policies. The status of Polish women has been changing as well, even though, to a large extent, it is still defined by the double role that women are expected to fill according to the dominant stereotypical model of family life. However, in the past decade, Polish women’s economic activities have experienced rapid growth and today are at a high level. In the article, the author presents the results of a survey conducted among women entrepreneurs in Poland concerning the functioning of their enterprises, motivation in setting up a company, and barriers that hinder them in business. The questionnaire (300 questionnaires were provided) and case studies carried out by the author have proven that female entrepreneurs in Poland are characterized by commonalities. Mostly they run small or micro-enterprises, operate in larger cities, are well-educated, and run service companies. Their main motivation to run their own business is mostly indicated by their need for independence. However, one of their biggest barriers and hesitations is the apprehension of non-payment. Entrepreneurs want to develop their companies, go to foreign markets and implement new solutions. They are not afraid of the future; they are only trying to create it. Detailed hypothesis, which reads as follows. The author additionally conducted a macroeconomic analysis calculating what part of GDP in Poland is produced by female entrepreneurs. The results of the study presented in this article prove that female entrepreneurship in Poland has a stable impact on the economy of the country, and women entrepreneurs produce over 13% of the national GDP. After years of growth in the number of female entrepreneurs in Poland, there has been a period of stabilization. However, there has also been a reduction in the number of self-employed people as well as the number of women in total employment. In the article, the author analyses the reasons for decreasing number of self-employed women and the total employment of women in Poland and provides suggestions for steps and incentives that should be made in order to encourage female entrepreneurship to grow in the country.

Keywords: women entrepreneurship, women in business, women entrepreneurship in Poland, Poland, GDP of Poland

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3969 Mutation Profiling of Paediatric Solid Tumours in a Cohort of South African Patients

Authors: L. Lamola, E. Manolas, A. Krause

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Background: The incidence of childhood cancer incidence is increasing gradually in low-middle income countries, such as South Africa. Globally, there is an extensive range of familial- and hereditary-cancer syndromes, where underlying germline variants increase the likelihood of developing cancer in childhood. Next-Generation Sequencing (NGS) technologies have been key in determining the occurrence and genetic contribution of germline variants to paediatric cancer development. We aimed to design and evaluate a candidate gene panel specific to inherited cancer-predisposing genes to provide a comprehensive insight into the contribution of germline variants to childhood cancer. Methods: 32 paediatric patients (aged 0-18 years) diagnosed with a malignant tumour were recruited, and biological samples were obtained. After quality control, DNA was sequenced using an ion Ampliseq 50 candidate gene panel design and Ion Torrent S5 technologies. Sequencing variants were called using Ion Torrent Suite software and were subsequently annotated using Ion Reporter and Ensembl's VEP. High priority variants were manually analysed using tools such as MutationTaster, SIFT-INDEL and VarSome. Putative identified candidates were validated via Sanger Sequencing. Results: The patients studied had a variety of cancers, the most common being nephroblastoma (13), followed by osteosarcoma (4) and astrocytoma (3). We identified 10 pathogenic / likely pathogenic variants in 10 patients, most of which were novel. Conclusions: According to the literature, we expected ~10% of our patient population to harbour pathogenic or likely pathogenic germline variants, however, we reported about 3 times (~30%) more than we expected. Majority of the identified variants are novel; this may be because this is the first study of its kind in an understudied South African population.

Keywords: Africa, genetics, germline-variants, paediatric-cancer

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3968 History of Russian Women: The Historical Overview of the Images and Roles of Women in Old and Modern Russia

Authors: Elena Chernyak

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The status of Russian women has changed dramatically over the course of Russian history and under different leadership and economic, political, and social conditions. The perception of women, their submissive roles, and low social status cause gender conflict that affects society: demographical issues, increased numbers of divorces, alcoholism, drug abuse, and crime. Despite the fact that around the world women are becoming more independent, protected by law, and play more important roles in society, Russian women are still dependent on men financially, socially, and psychologically. This paper critically explores the experience of Russian women over the course of over a thousand year of Russian history and how the position and image of women changed in Russian Empire, Soviet and post-Soviet Russia and what role women play in contemporary Russia. This paper is a result of deep examination of historical and religious literature, mass media, internet sources, and documents. This analysis shows that throughout history, the role and image of women in society have repeatedly varied depending on ideological and social conditions. In particular, the history of Russian women may be divided into five main periods. The first was the period of paganism, when almost all areas of life were open for women and when women were almost equal in social roles with men. During the second period, starting with the beginning of the Mongol invasion in the 13th century, the position of women was diminishing due to social transformation to the patriarchal society in which women started playing subordinate role in family and society. The third period – the period from the fourteenth through the sixteenth centuries - is a period of the total seclusion of Russian women from each part of social life. The fourth, Soviet period started after the Revolution of 1917. During that time, the position of women was drastically changed due to the transformation of traditional gender roles under the Bolshevik government. Woman's role was seen as worker-mothers who had a double duty: a worker and a mother. The final period began after the collapse of the Soviet Union. The restructuring (Perestroika) and post-Restructuring periods have had contradictory consequences and tremendous impact on Russian society. The image of women as partners and equal to men, which was promoted during the Soviet regime, has been replaced with the traditional functionalist views on family and the role of women, in which men and women have different but supposedly complementary roles. Modern Russia, despite publicly stating its commitment to equal rights, during last two decades has been reverting to an older social model with its emphasis on traditional gender roles, patriarchal ideas of dominant masculinity, and adverse attitudes to women, which are further supported and reinforced by the reviving Russian Orthodox Church. As demonstrated in this review, Russian women have never possessed the same rights as men and have always been subordinate to men. During all period of Russian history, patriarchal ideology maintained and reinforced in Russian society has always subjected women to manipulation, oppression, and victimization and portrayed women as not a ‘full human being’.

Keywords: women, Russia, patriarchy, religion, Russian Orthodox Church

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3967 Automatic Differentiation of Ultrasonic Images of Cystic and Solid Breast Lesions

Authors: Dmitry V. Pasynkov, Ivan A. Egoshin, Alexey A. Kolchev, Ivan V. Kliouchkin

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In most cases, typical cysts are easily recognized at ultrasonography. The specificity of this method for typical cysts reaches 98%, and it is usually considered as gold standard for typical cyst diagnosis. However, it is necessary to have all the following features to conclude the typical cyst: clear margin, the absence of internal echoes and dorsal acoustic enhancement. At the same time, not every breast cyst is typical. It is especially characteristic for protein-contained cysts that may have significant internal echoes. On the other hand, some solid lesions (predominantly malignant) may have cystic appearance and may be falsely accepted as cysts. Therefore we tried to develop the automatic method of cystic and solid breast lesions differentiation. Materials and methods. The input data were the ultrasonography digital images with the 256-gradations of gray color (Medison SA8000SE, Siemens X150, Esaote MyLab C). Identification of the lesion on these images was performed in two steps. On the first one, the region of interest (or contour of lesion) was searched and selected. Selection of such region is carried out using the sigmoid filter where the threshold is calculated according to the empirical distribution function of the image brightness and, if necessary, it was corrected according to the average brightness of the image points which have the highest gradient of brightness. At the second step, the identification of the selected region to one of lesion groups by its statistical characteristics of brightness distribution was made. The following characteristics were used: entropy, coefficients of the linear and polynomial regression, quantiles of different orders, an average gradient of brightness, etc. For determination of decisive criterion of belonging to one of lesion groups (cystic or solid) the training set of these characteristics of brightness distribution separately for benign and malignant lesions were received. To test our approach we used a set of 217 ultrasonic images of 107 cystic (including 53 atypical, difficult for bare eye differentiation) and 110 solid lesions. All lesions were cytologically and/or histologically confirmed. Visual identification was performed by trained specialist in breast ultrasonography. Results. Our system correctly distinguished all (107, 100%) typical cysts, 107 of 110 (97.3%) solid lesions and 50 of 53 (94.3%) atypical cysts. On the contrary, with the bare eye it was possible to identify correctly all (107, 100%) typical cysts, 96 of 110 (87.3%) solid lesions and 32 of 53 (60.4%) atypical cysts. Conclusion. Automatic approach significantly surpasses the visual assessment performed by trained specialist. The difference is especially large for atypical cysts and hypoechoic solid lesions with the clear margin. This data may have a clinical significance.

Keywords: breast cyst, breast solid lesion, differentiation, ultrasonography

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3966 New 5’-O- and 6-Substituted Purine Nucleoside Analogs: Synthesis and Cytotoxic Activity on Selected Human Cancer Cell Lines

Authors: Meral Tuncbilek, Duygu Sac, Irem Durmaz, Rengul Cetin Atalay

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Nucleoside analogs are a pharmacologically diverse family that includes cytotoxic compounds, antiviral agents, and immunosuppressive molecules. Purine nucleoside derivatives such as fludarabine, cladribine, and pentostatin are significant drugs used in chemotherapy for the treatment of solid tumors and hematological malignancies. In this study, we synthesized novel purine ribonucleoside analogs containing a 4-(4-substituted phenylsulfonyl) piperazine in the substituent at N6- and O-substituted sulfonyl group at 5’-position as putative cytotoxic agents. The newly obtained compounds were then characterized for their cytotoxicity in human cancer cell lines. The 5’, 6-disubstituted 9-(β-D-ribofuranosyl)purine derivatives (44-67) were readily obtained from commercially available inosine in seven steps in very cost effective synthesis approach. The newly synthesized compounds were first evaluated for their anti-tumor activities against human liver (Huh7), colon (HCT116) and breast (MCF7) carcinoma cell lines. The IC50 values were in micromolar concentrations with 5’, 6-disubstituted purine nucleoside derivatives. Time-dependent IC50 values for each molecule were also calculated in comparison with known cytotoxic agents Camptothecin (CPT), 5-Fluorouracil (5-FU), Cladribine, Pentostatine and Fludarabine. N6-(4-trifluoromethyl phenyl) / N6-(4-bromophenyl) and 5’-O-(4-methoxybenzene sulfonyl) / 5’-O-(benzenesulfonyl) derivatives 54, 64 displayed the best cytotoxic activity with IC50 values of 8.8, 7 µM against MCF7 cell line. The N6-(4-methylphenyl) analog 50 was also very active (IC50= 10.7 μM) against HCT116 cell line. Furthermore, compound 64 had a better cytotoxic activity than the known cell growth inhibitors 5-FU and Fludarabine on Huh7 (1.5 vs 30.7, 29.9 μM for 5-FU and Fludarabine).

Keywords: cytotoxic activity, Huh7, HCT116, MCF7, nucleoside, synthesis

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3965 An Evidence Map of Cost-Utility Studies in Non-Small Cell Lung Cancer

Authors: Cassandra Springate, Alexandra Furber, Jack E. Hines

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Objectives: To create an evidence map of the cost-utility studies available with non-small cell lung cancer patients, and identify the geographical settings and interventions used. Methods: Using the Disease, Study Type, and Model Type filters in heoro.com we identified all cost-utility studies published between 1960 and 2017 with patients with non-small cell lung cancer. These papers were then indexed according to pre-specified categories. Results: Heoro.com identified 89 independent publications, published between 1995 and 2017. Of the 89 papers, 74 were published since 2010, 28 were from the USA, and 35 were from Europe, 16 of which were from the UK. Other publications were from China and Japan (13), Canada (9), Australia and New Zealand (4), and other countries (8). Fifty-nine studies included a chemotherapy intervention, of which 23 included erlotinib or gefitinib, 21 included pemetrexed or docetaxel, others included nivolumab (3), pembrolizumab (2), crizotinib (2), denosumab (2), necitumumab (1), and bevacizumab (1). Also, 19 studies modeled screening, staging, or surveillance strategies. Conclusions: The cost-utility studies found for NSCLC most commonly looked at the effectiveness of different chemotherapy treatments, with some also evaluating the addition of screening strategies. Most were also conducted with patient data from the USA and Europe.

Keywords: cancer, cost-utility, economic model, non-small cell lung cancer

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3964 Women Academics' Insecure Identity at Work: A Millennials Phenomenon

Authors: Emmanouil Papavasileiou, Nikos Bozionelos, Liza Howe-Walsh, Sarah Turnbull

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Purpose: The research focuses on women academics’ insecure identity at work and examines its link with generational identity. The aim is to enrich understanding of identities at work as a crucial attribute of managing academics in the context of the proliferation of managerialist controls of audit, accountability, monitoring, and performativity. Methodology: Positivist quantitative methodology was utilized. Data were collected from the Scientific Women's Academic Network (SWAN) Charter. Responses from 155 women academics based in the British Higher Education system were analysed. Findings: Analysis showed high prevalence of strong imposter feelings among participants, suggesting high insecurity at work among women academics in the United Kingdom. Generational identity was related to imposter feelings. In particular, Millennials scored significantly higher than the other generational groups. Research implications: The study shows that imposter feelings are variously manifested among the prevalent generations of women academics, while generational identity is a significant antecedent of such feelings. Research limitations: Caution should be exercised in generalizing the findings to national cultural contexts beyond the United Kingdom. Practical and social implications: Contrary to popular depictions of Millennials as self-centered, narcissistic, materialistic and demanding, women academics who are members of this generational group appear significantly more insecure than the preceding generations. Value: The study provides insightful understandings into women academics’ identity at work as a function of generational identity, and provides a fruitful avenue for further research within and beyond this gender group and profession.

Keywords: academics, generational diversity, imposter feelings, United Kingdom, women, work identity

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3963 Trafficking of Women in International Migration: Issues and Major Challenges in Present Scenario

Authors: Neha Singh, Anshuman Rana

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Gender-Based Violence (GBV) is a violation of human rights and a form of discrimination which reinforces inequalities between men and women. It is defined as violence that is directed against a person on the basis of gender. There has been increased attention to human trafficking that has exposed to illegal migration. Trafficking is complex, but it generally takes place due to “push and pull factors”. India is both a source as well as a transit country for trafficking. Women are bought and sold with impunity and trafficked to other countries. They are forced to work as sex worker, forced labour and other practices of slavery. Trafficked victims often suffer from serious abuse and physical exhaustion. The effects of violence on women vary widely. GBV typically has physical, psychological and social effects. They face unwanted pregnancies, miscarriages, high rate of infertility and sexually transmitted disease. The social exclusion of women is so great that it constitutes a new form of apartheid. Women are considered as lesser value and deprived of their fundamental rights. Violation of human rights and fundamental freedom such as- trafficking of women, girls for sex trade, forced prostitution and sex tourism have become the focus of internationally organized crimes. My paper will analyse the impact of violence on society as well. Law alone cannot change the scenario and problem of gender-biasness. The whole issue of gender violence needs social awakening and change in attitude of masses, so that due respect and equal status is given to women.

Keywords: gender-based violence, trafficking, migration, violence impact, social exclusion, law enforcement

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3962 The Constitution of Kenya, 2010, and the Feminist Legal Theory

Authors: Tecla Rita Karendi, Andy Cons Matata

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Although before and at the advent of colonial administration, several women such as Mekatilili wa Menza and Muthoni Nyanjiru took up leadership positions in resisting the colonial administration. Kenya is generally considered a patriarchal society. Many women who tried to take up positions of leadership in postcolonial Kenya, such as the Nobel Prize winner Wangari Maathai, were branded as prostitutes or generally immoral women. However, the Constitution of Kenya, 2010, has since made a huge impact not only in the area of affirmative action but also in various aspects of the feminist legal theory such as the constitutional requirement that no more than two-thirds of the members of the elective or appointive bodies should be of the same gender. This favours women who are often sidelined in elective posts such as parliament or county assemblies and state-appointed posts in the parastatals and commissions. The constitution also recognizes the right to abortion, which was outrightly outlawed in the independence constitution. Certain practices adverse to women’s health, such as wife inheritance, female genital mutilation, and property rights, are either outlawed or framed to recognized women’s rights. The education of the girl-child is also now considered a priority, unlike in the past. Despite these developments, a lot remains to be done.

Keywords: feminist legal theory, constitution of Kenya, 2010, affirmative action, leadership

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3961 A Spatial Autocorrelation Analysis of Women’s Mental Health and Walkability Index in Mashhad City, Iran, and Recommendations to Improve It

Authors: Mohammad Rahim Rahnama, Lia Shaddel

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Today, along with the development of urbanism, its negative consequences on the health of citizens are emerging. Mental disorders are common in the big cities, while mental health enables individuals to become active citizens. Meanwhile, women have a larger share of mental problems. Depression and anxiety disorders have a higher prevalence rate among women and these disorders affect the health of future generations, too. Therefore, improving women’s mental health through the potentials offered by urban spaces are of paramount importance. The present study aims to first, evaluate the spatial autocorrelation of women’s mental health and walkable spaces and then present solutions, based on the findings, to improve the walkability index. To determine the spatial distribution of women’s mental health in Mashhad, Moran's I was used and 1000 questionnaire were handed out in various sub-districts of Mashhad. Moran's I was calculated to be 0.18 which indicates a cluster distribution pattern. The walkability index was calculated using the four variables pertaining to the length of walkable routes, mixed land use, retail floor area ratio, and household density. To determine spatial autocorrelation of mental health and the walkability index, bivariate Moran’s I was calculated. Moran's I was determined to be 0.37 which shows a direct spatial relationship between variables; 4 clusters in 9 sub-districts of Mashhad were created. In High-Low cluster, there was a negative spatial relationship and hence, to identify factors affecting walkability in urban spaces semi-structures interviews were conducted with 21 women in this cluster. The findings revealed that security is the major factor influencing women’s walking behavior in this cluster. In accordance with the findings, some suggestions are offered to improve the presence of women in this sub-district.

Keywords: Mashhad, spatial autocorrelation, women’s mental health, walkability index

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3960 Redefining State Security Using Gender: Case Study of the United States of America Post-Cold War

Authors: E. K. Linsenmayer

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Traditional international relations theorists define state security, the principal national interest, as a state’s military force. However, many political theorists argue the current definition of security is not comprehensive and therefore, problematic. This paper argues that women’s physical security is not only linked but also necessary to achieve state security. In today’s unipolar political international system, the United States continues to accredit national security to its military. However, in one of the most militarized countries, women remain insecure. Through a case study method of the United States, this paper illuminates a necessary political prescription: the empowerment of women through an inside-out, feminist theoretical approach that makes state security attainable. The research through empirical testing, drawing from several databases, shows the positive effects of women’s physical security on state security. Women’s physical security is defined in terms of equal legal practices, health, education, and female representation in the government. State security is measured by the relative peace of a state, its involvement in conflict and a state’s relations with neighboring states. This paper shows that empowering women, 50% of the world’s population, is necessary for ending the current vicious circle of militarization, war, and insecurity. Without undoing gender power dynamics at the individual and societal level, security at all levels remains unattainable.

Keywords: gender inequality, politics, state security, women's security

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3959 Influence of Pretreatment Magnetic Resonance Imaging on Local Therapy Decisions in Intermediate-Risk Prostate Cancer Patients

Authors: Christian Skowronski, Andrew Shanholtzer, Brent Yelton, Muayad Almahariq, Daniel J. Krauss

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Prostate cancer has the third highest incidence rate and is the second leading cause of cancer death for men in the United States. Of the diagnostic tools available for intermediate-risk prostate cancer, magnetic resonance imaging (MRI) provides superior soft tissue delineation serving as a valuable tool for both diagnosis and treatment planning. Currently, there is minimal data regarding the practical utility of MRI for evaluation of intermediate-risk prostate cancer. As such, the National Comprehensive Cancer Network’s guidelines indicate MRI as optional in intermediate-risk prostate cancer evaluation. This project aims to elucidate whether MRI affects radiation treatment decisions for intermediate-risk prostate cancer. This was a retrospective study evaluating 210 patients with intermediate-risk prostate cancer, treated with definitive radiotherapy at our institution between 2019-2020. NCCN risk stratification criteria were used to define intermediate-risk prostate cancer. Patients were divided into two groups: those with pretreatment prostate MRI, and those without pretreatment prostate MRI. We compared the use of external beam radiotherapy, brachytherapy alone, brachytherapy boost, and androgen depravation therapy between the two groups. Inverse probability of treatment weighting was used to match the two groups for age, comorbidity index, American Urologic Association symptoms index, pretreatment PSA, grade group, and percent core involvement on prostate biopsy. Wilcoxon Rank Sum and Chi-squared tests were used to compare continuous and categorical variables. Of the patients who met the study’s eligibility criteria, 133 had a prostate MRI and 77 did not. Following propensity matching, there were no differences between baseline characteristics between the two groups. There were no statistically significant differences in treatments pursued between the two groups: 42% vs 47% were treated with brachytherapy alone, 40% vs 42% were treated with external beam radiotherapy alone, 18% vs 12% were treated with external beam radiotherapy with a brachytherapy boost, and 24% vs 17% received androgen deprivation therapy in the non-MRI and MRI groups, respectively. This analysis suggests that pretreatment MRI does not significantly impact radiation therapy or androgen deprivation therapy decisions in patients with intermediate-risk prostate cancer. Obtaining a pretreatment prostate MRI should be used judiciously and pursued only to answer a specific question, for which the answer is likely to impact treatment decision. Further follow up is needed to correlate MRI findings with their impacts on specific oncologic outcomes.

Keywords: magnetic resonance imaging, prostate cancer, definitive radiotherapy, gleason score 7

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3958 To Assess Variables Related to Self-Efficacy for Increasing Physical Activity in Advanced-Stage Cancer Patients

Authors: S. Nikpour, S. Vahidi, H. Haghani

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Introduction: Exercise has mental and physical health benefits for patients with advanced stage cancer who actively receive chemotherapy, yet little is known about patients’ levels of interest in becoming more active or their confidence in increasing their activity level. Methods and materials: A convenience sample of 200 patients with advanced-stage cancer who were receiving chemotherapy completed self-report measures assessing physical activity level, mood, and quality-of-life variables. Qualitative data on patient-perceived benefits of, and barriers to, physical activity also were collected, coded by independent raters, and organized by predominant themes. Results: Current physical activity level, physical activity outcome expectations, and positive mood were significantly associated with self-efficacy. Fatigue was the most frequently listed barrier to physical activity; improved physical strength and health were the most commonly listed benefits. Participants identified benefits related to both general health and cancer-symptom management that were related to exercise. 59.5% of participants reported that they were seriously planning to increase or maintain their physical activity level, and over 40% reported having interest in receiving an intervention to become more active. Conclusion: These results suggested that many advanced-stage cancer patients who receive chemotherapy are interested in maintaining or increasing their physical activity level and in receiving professional support for exercise. In addition, these individuals identified general health and cancer-specific benefits of, and barriers to, physical activity. Future research will investigate how these findings may be incorporated into physical activity interventions for advanced-stage oncology patients receiving medical treatment.

Keywords: physical activity, cancer, self-efficacy

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3957 An Assessment of Government Entrepreneurship Programs for Women in Sabah Malaysia

Authors: Imelda Albert Gisip, Tarsiah T. Z. Taman

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In Asia, particularly in Malaysia women entrepreneurs contribute substantially to economic growth. This paper presents a review of women entrepreneurs’ program, focusing on Creating Millionaires among Young Women Entrepreneurs (CREAM@YWE) program in Sabah Malaysia which aims to accelerate the entrepreneurship among young women in Sabah Malaysia. Entrepreneurs is seen as essential for growth, job creation and social progress and the virtues of small business for Sabah Maju Jaya (SMJ), the Sabah state government Sabah State development plan for the year 2021-2025. SMJ guides the direction of the government's policies and programs, further guiding the implementation in a planned and strategic manner, to achieve targets and goals that coincide with the development needs of the state. One of the government’s agenda is to put its efforts more strongly to ensure that women entrepreneurs are well supported and enhanced. Thus, The CreaM@YWE Program was developed in 2018 with the main objective is to produce competitive young women entrepreneurs in Sabah and achieve "millionaire" status. CreaM@YWE Program is an innovation process which specifically developed to accelerate entrepreneurship sector particularly for women entrepreneurs in Sabah by incorporating strategic partnerships and collaborations with government agencies and industry players. Being the first of its kind in Sabah, the novelty of this project is providing a supportive ecosystem including six months intensive courses, guided through "hands-holding”, collaborations with strategic partners and easy access to government's assistance. Since its inception, the program has significantly impact society’s wellbeing particularly in empowering young women entrepreneurs in Sabah for the past six years and has produced many successful women entrepreneurs with “millionaire” status. Generally, improving women’s enterprise sector in Malaysia needs an overall enabling environment that allows development opportunities for women entrepreneurs including access to resources and support services. Since achieving the goal of women entrepreneurship policy requires effective partnerships and inclusiveness, Cream @YWE Program has managed to practice these in assisting small entrepreneurs among young women in Sabah in accessing public goods and business opportunities. This proves that achieving women’s economic empowerment requires sound policies, a holistic approach and long-term commitment. Thus, this paper presents how Cream@YWE Program has been supporting Sabah young women entrepreneurs by reforming the business environment to help create opportunities for women, while addressing the few existing gender-specific hurdles.

Keywords: entrepreneurship programs, women, Sabah, Malaysia

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3956 Role of Television in Constructing Gender for Young Women

Authors: Bhavna Negi

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Several studies highlight the significance of media in constructing realities around us. According to Forbes magazine the demand of televisions has increased several times in the developing nations. A recent survey reveals that 112 million Indian households have a television, with 61 percent accessing cable. The space and visibility of television has enormously grown over the last decade in Indian homes. This small box has indeed taken a large place in their daily routines. The multi channel viewing and TRPs puzzle the Indian audience. This medium creates and constructs social images and roles which form internal representation about societal functioing. According to National Council of Applied Economic Research about twenty seven percent Indian literate youth watches TV for recreation. The present study finds about the role of television and its impact on young college going women with reference to family based serials shown on television. It is interesting to see how young women perceive the popular family soaps and define norms, roles and spaces for a woman and a man. The paper further examines the subtle messages given to young women through television serials. It draws insights into the relationship between the contemporary Indian women and the images conceptualized and communicated on television.

Keywords: media, women, gender, social roles

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3955 pH and Thermo-Sensitive Nanogels for Anti-Cancer Therapy

Authors: V. Naga Sravan Kumar Varma, H. G. Shivakumar

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The aim of the study was to develop dual sensitive poly (N-isopropylacrylamide-co-acrylic acid) (PNA) nanogels(NGs) and studying its applications for Anti-Cancer therapy. NGs were fabricated by free radical polymerization using different amount of N-isopropylacrylamide and acrylic acid. A study for polymer composition over the effect on LCST in different pH was evaluated by measuring the absorbance at 500nm using UV spectrophotometer. Further selected NG’s were evaluated for change in hydrodynamic diameters in response to pH and temperature. NGs which could sharply respond to low pH value of cancer cells at body temperature were loaded with Fluorouracil (5-FU) using equilibrium swelling method and studied for drug release behaviour in different pH. A significant influence of NGs polymer composition over pH dependent LCST was observed. NGs which were spherical with an average particle size of 268nm at room temperature, shrinked forming an irregular shape when heated above to their respective LCST. 5FU loaded NGs did not intervene any difference in pH depended LCST behaviour of NGs. The in vitro drug release of NGs exhibited a pH and thermo-dependent control release. The cytoxicity study of blank carrier to MCF7 cell line showed no cytotoxicity. The results indicated that PNA NGs could be used as a potential drug carrier for anti-cancer therapy.

Keywords: pH and thermo-sensitive, nanogels, P(NIPAM-co-AAc), anti-cancer, 5-FU

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3954 Effect of Exercise Training on Body Composition and Metabolic Profile in Older Adults during Cancer Treatment

Authors: Adeline Fontvieille, Hugo Parent-Roberge, Marie-France Langlois, Tamas Fulop, Michel Pavic, Eleonor Riesco

Abstract:

Introduction: Total lean body mass is reduced during cancer treatment. This loss is called cancer cachexia and is accompanied by a progressive loss of fat mass. In older adults, these body composition changes can have a larger impact on metabolic health, physical autonomy, and cancer survival. Although currently untreatable, exercise training could reduce these effects. Hence, the objective of this pilot study is to investigate if 12 weeks of exercise training during cancer treatment can mitigate the loss of muscle mass and fat mass in older adults. Methods: A total of 40 older adults (65-80 years) with an ongoing treatment for a curable cancer are currently recruited and randomised in two groups: 1) Combined training (EX, n=20) and 2) Control group (CON, n=20). All variables are measured before and after 12 weeks of intervention: Anthropometry (weight, height, body mass index), body composition (total fat mass, visceral adipose tissue, total and appendicular muscle mass; DXA), metabolic profile (HDL-C and LDL-C, triglycerides, glucose and insulin levels). Results: Preliminary analyses revealed no impact of exercise training on appendicular muscle mass (p=0,31) and fat mass (p=0,31). Furthermore, total body weight, waist circumference, HDL-cholesterol, LDL-cholesterol, glucose and insulin levels remained unchanged (all p ≥ 0.79) after 12 weeks of training. However, statistical analyses revealed that triglyceride levels slightly increased (p=0.03), irrespective of the group. Conclusion: Preliminary analyses did not reveal any impact of aerobic and resistance exercise training on body composition in oncogeriatric patients. Furthermore, exercise training seems not efficient to prevent the cancer treatment-related triglyceride levels increase.

Keywords: muscle mass, fat mass, metabolic profile, combined training, aging, cancer

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3953 Oncogenic Role of MicroRNA-346 in Human Non-Small Cell Lung Cancer by Regulation of XPC/ERK/Snail/E-Cadherin Pathway

Authors: Cheng-Cao Sun, Shu-Jun Li, De-Jia Li

Abstract:

Determinants of growth and metastasis in cancer remain of great interest to define. MicroRNAs (miRNAs) have frequently emerged as tumor metastatic regulator by acting on multiple signaling pathways. Here, we report the definition of miR-346 as an oncogenic microRNA that facilitates non-small cell lung cancer (NSCLC) cell growth and metastasis. XPC, an important DNA damage recognition factor in nucleotide excision repair was defined as a target for down-regulation by miR-346, functioning through direct interaction with the 3'-UTR of XPC mRNA. Blocking miR-346 by an antagomiR was sufficient to inhibit NSCLC cell growth and metastasis, an effect that could be phenol-copied by RNAi-mediated silencing of XPC. In vivo studies established that miR-346 overexpression was sufficient to promote tumor growth by A549 cells in xenografts mice, relative to control cells. Overall, our results defined miR-346 as an oncogenic miRNA in NSCLC, the levels of which contributed to tumor growth and invasive aggressiveness.

Keywords: microRNA-346, miR-346, XPC, non-small cell lung cancer, oncogenesis

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3952 The Pitfalls of Empowerment Initiatives in India: Overcoming Male Resistance to Women Empowerment Through Community Outreach, TVET, and Improved Sanitation

Authors: Christopher Coley, Srividya Sheshadri, Rao R. Bhavani

Abstract:

Empowering marginalized populations, especially women, with greater economic, social, and other leadership roles has been shown to have a profound effect on entire communities. There are discernible links between sustainable development, poverty reduction, and skill training for empowerment; however, one of the major challenges with implementing empowerment programs is to establish an understanding within the community that investing in women’s education carries the potential of high return for everyone. Effective strategies that can both empower women, and overcome the complex social issues normally faced, need to be developed and shared across stakeholders. Amrita University’s AMMACHI Labs, a research lab engaged in women empowerment through Technical Vocational Education and Training (TVET), has launched a new initiative, WE: Sanitation, a project aiming to train women to build their own toilets and promote healthy sanitation practices in rural villages across India. While in some cases, the community has come together and toilets are being built, there has been resistance by the community, especially men, in many places. This paper will explore the experiences of field workers and the initial results of the WE: Sanitation project, including observations on the trends of community dynamics, raise important questions for the direction of development work in general, and especially for sanitation projects in rural India.

Keywords: community-based development, gender dynamics, Indian sanitation, women empowerment, TVET

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3951 Seroprevalence and Determinants of Toxoplasmosis in Pregnant Women Attending Antenatal Clinic at the University Teaching Hospital, Lusaka, Zambia: A Cross-Sectional Study

Authors: Christiana Frimpong, Mpundu Makasa, Lungowe Sitali, Charles Michelo

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Background: Toxoplasmosis is a neglected zoonotic disease which is prevalent among pregnant women especially in Africa. This study aimed to determine the seroprevalence and determinants of the disease among pregnant women attending the antenatal clinic at the University Teaching Hospital (UTH). Method: A cross-sectional study was employed where 411 pregnant women attending the antenatal clinic at UTH were interviewed using closed-ended questionnaires. Their blood was also tested for Toxoplasma gondii IgG and IgM antibodies using the OnSite Toxo IgG/IgM Combo Rapid Test cassettes by CTK Biotech, Inc, USA. Result: The overall seroprevalence of the infection (IgG) was 5.87%. There was no seropositive IgM result. Contact with cats showed 7.81 times the risk of contracting the infection in the pregnant women and being a farmer/being involved in construction work showed 15.5 times likelihood of contracting the infection. Socio-economic status of the pregnant women also presented an inverse relationship (showed association) with the infection graphically. However, though there were indications of the association between contact with cats, employment type as well as the socioeconomic status of the pregnant women with the infection, there was not enough evidence to suggest these factors as significant determining factors of Toxoplasma gondii infection in our study population. Conclusion: There is a low prevalence of Toxoplasma gondii infection among pregnant women in Lusaka, Zambia. Screening for the infection among pregnant women can be done once or twice during pregnancy to help protect both mother and child from the disease. Health promotion among women of child bearing age on the subject is of immense importance in order to help curb the situation. Further studies especially that of case-control and cohort studies should be carried out in the country in order to better ascertain the extent of the condition nationwide.

Keywords: determinants, pregnant women, seroprevalence, toxoplasmosis, University Teaching Hospital (UTH), Zambia

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3950 Exclusive Breastfeeding Abandonment among Adolescent Mothers: A Cohort Study

Authors: Maria I. Nuñez-Hernández, Maria L. Riesco

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Background: Exclusive breastfeeding (EBF) up to 6 months old infant have been considered one of the most important factors in the overall development of children. Nevertheless, as resources are scarce, it is essential to identify the most vulnerable groups that have major risk of EBF abandonment, in order to deliver the best strategies. Children of adolescent mothers are within these groups. Aims: To determine the EBF abandonment rate among adolescent mothers and to analyze the associated factors. Methods: Prospective cohort study of adolescent mothers in the southern area of Santiago, Chile, conducted in primary care services of public health system. The cohort was established from 2014 to 2015, with a sample of 105 adolescent mothers and their children at 2 months of life. The inclusion criteria were: adolescent mother from 14 to 19 years old; not twin babies; mother and baby leaving the hospital together after birthchild; correct attachment of the baby to the breast; no difficulty understanding the Spanish language or communicating. Follow-up was performed at 4 and 6 months old infant. Data were collected by interviews, considering EBF as breastfeeding only, without adding other milk, tea, juice, water or other product that not breast milk, except drugs. Data were analyzed by descriptive and inferential statistics, by Kaplan-Meier estimator and Log-Rank test, admitting the probability of occurrence of type I error of 5% (p-value = 0.05). Results: The cumulative EBF abandonment rate at 2, 4 and 6 months was 33.3%, 52.2% and 63.8%, respectively. Factors associated with EBF abandonment were maternal perception of the quality of milk as poor (p < 0.001), maternal perception that the child was not satisfied after breastfeeding (p < 0.001), use of pacifier (p < 0.001), maternal consumption of illicit drugs after delivery (p < 0.001), mother return to school (p = 0.040) and presence of nipple trauma (p = 0.045). Conclusion: EBF abandonment rate was higher in the first 4 months of life and is superior to the population of women who breastfeed. Among the EBF abandonment factors, one of them is related to the adolescent condition, and two are related to the maternal subjective perception.

Keywords: adolescent, breastfeeding, midwifery, nursing

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3949 Inflammatory Changes in Postmenopausal Women including Th17 and Treg

Authors: Ae Ra Han, Seoung Eun Huh, Ji Yeon Kim, Joanne Kwak-Kim, Sung Ki Lee

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Objective: Prevalence of osteoporosis, cardiovascular disorders, and Alzheimer's disease rapidly increase after menopause. Immune activation and inflammation are suggested as an important pathogenesis of these serious diseases. Several pro-inflammatory cytokines are increased in women with surgical or natural menopause. However, the little is known about IL-17 producing T cells and Foxp3+ regulatory T (Treg) cells in post-menopause. Methods: A total of 34 postmenopausal women, who had no active cardiovascular, endocrine and infectious disorders were recruited as study group and healthy premenopausal women participated as controls. Peripheral blood mononuclear cells were isolated. Immuno-morphologic (CD3, CD4, CD8, CD19, CD56/CD16), intracellular cytokine (TNF-alpha, IFN-gamma, IL-10, IL-17), and Treg cell (Foxp3) studies were carried out using flow cytometry. The proportion of peripheral lymphocytes, including IL-17 producing and Foxp3+ Treg cells immune cell in each group were statistically analyzed. Results: The proportion of NK cells was significantly increased in menopausal women as compared to that of controls (P=.005). The ratios of TNF-alpha/IL-10 producing CD3+CD4+ T cells were increased in postmenopausal women. CD3+IL-17+ T cell level was higher in postmenopausal women and CD4+ Foxp3+ Treg cells was lower than that of controls. The ratios of CD3+IL-17+ T cell to CD3+Foxp3+ and to CD4+Foxp3+ Treg cells were significantly increased in postmenopausal women (P=.001). Conclusions: We found enhanced innate immunity and Th1- and Th17-mediated adaptive immunity in postmenopausal women. This may explain increasing prevalence of chronic inflammatory diseases after menopause. Further studies are needed to elucidate what factors contribute to this inflammatory shift in the postmenopause.

Keywords: inflammation, immune cell, menopause, Th17, regulatory T cell

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3948 Variability in Contraception Choices and Abortion Rates among Female Garment Factory Workers in Urban and Rural Cambodia

Authors: Olalekan Olaluwoye, Joanne Williams, Elizabeth Hoban

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Background: Modern contraceptives are effective in preventing unwanted pregnancies and therefore the potential to reduce abortion rates. There is a need for information about how rates of contraceptive use and abortion vary across Cambodia and the relationship between the prevalence of modern contraception use and abortion rates. This study compares the use of contraception and abortion among female garment factory workers in rural and urban areas of Cambodia. Method: Cross-sectional surveys were conducted with 1701 women working in eleven garment factories in rural and urban areas of Cambodia. Sexual and reproductive health data were collected using Audio-Assisted Survey Interviews and analysed using STATA 14 software. Findings: Over 70% of the respondents were less than 30 years of age across both rural and urban settings and over 50% have only primary education, thus the study population was largely young women with limited education. A significantly higher proportion of the rural women earned over $200 in the previous month compared with their urban counterparts. The majority of the urban women (51.5%) were married, while single women (46.9%) made up the largest group working in the rural factories. A significantly larger proportion of women in the rural areas (83.9%) were sexually active compared to the urban women (50.9%). More women from the rural areas (41.4%) had been pregnant at some time compared with the urban population (37.7%). The use of any contraceptive method among sexually active women was significantly higher in the rural areas (80.1%) compared to the urban areas (65.7%) with p-value=0.000. However, among those women who used contraception, the prevalence of modern contraception use was slightly higher in the urban population (68.8% urban, 63.4% rural, p-value=0.1). For women who had a history of pregnancy the abortion prevalence was higher among rural women (43.8%) compared to their urban counterparts (37.7%). Regression analysis showed that after adjustment for the demographic variables (age, relationship status, income, education) only age and relationship status had a significant influence on the use of modern contraception.Single females who were sexually active and older women, who had potentially completed their families, were more likely to choose modern contraception. Conclusion: Although overall the use of contraception was higher among rural women, the use of modern contraception was higher among urban women.This finding may partly explain the higher rates of abortion among women in the rural areas as traditional contraception methods have higher failure rates and are more likely to result in an unplanned pregnancy.Despite the regional variation, the high rates of abortion across the country suggest there is a need for improve education on family planning among female garment factory workers in Cambodia.

Keywords: abortion, Cambodia, contraception, garment factory

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3947 A U-shaped Relationship between Body Mass Index and Dysmenorrhea: A Longitudinal Study

Authors: H. Ju, M. Jones, G. D. Mishra

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Introduction: Limited longitudinal studies have examined the relationship between BMI and dysmenorrhea, resulting in mixed results. This study aims to investigate the long-term association between BMI and dysmenorrhea. Methods: 9,688 women from Australian Longitudinal Study on Women’s Health (ALSWH), a prospective population-based cohort study, were followed for 13 years. Data were collected through self-reported questionnaires repeatedly on all variables, including dysmenorrhea, weight and height. The longitudinal association between dysmenorrhea and BMI or BMI transition (change of BMI categories between two successive surveys) was investigated by generalized estimating equations. Results: When the women were aged 22 to 27 years, approximately 11% were obese, 7% underweight, and 25% reported dysmenorrhea. Over the study period, the prevalence of obesity doubled whereas that of underweight declined substantially. The prevalence of dysmenorrhea remained relatively stable. Compared to women with a normal weight, significantly higher odds of reporting dysmenorrhea were detected for both women who were underweight (odds ratio (OR) 1.25, 95% confidence interval (CI) 1.09, 1.43) and obese (OR 1.20, 95% CI 1.10, 1.31). Being overweight was not associated with increased risk of dysmenorrhea. Compared to women who remained at normal weight or overweight over time, significant risk was detected for women who: remained underweight or obese (OR 1.35, 95% CI 1.23, 1.49), were underweight but became normal or overweight (OR 1.29, 95% CI 1.11, 1.50), became underweight (OR 1.24, 95% CI 1.01, 1.52). However, the higher risk among obese women disappeared when they lost weight and became normal weight or overweight (OR 1.07, 95% CI 0.87, 1.30). Conclusions: A U-shaped association was revealed between dysmenorrhea and BMI, revealing higher risk of dysmenorrhea for both underweight and obese women. Further, the risk disappeared when obese women lost weight and acquired a healthier BMI. However obesity certainly poses a greater burden of disease from the public health perspective, thus requires greater effort to tackle the increasing problem at the population level. It is important to maintain a healthy weight over time for women to enjoy a better reproductive health.

Keywords: body mass index, dysmenorrhea, obesity, painful period, underweight

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3946 New Trends in Pakistani Cinema: Muslim Women, Cinematic Struggle and the Global World

Authors: Sana Zia

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One of the most important questions for research on Muslim women's representation is the relationship between Islam and women’s situation in Islamic countries. In this context, certain questions can be raised like is it possible to analyze women’s situation in Islamic countries like Pakistan? Or what is the relationship between Islam and patriarchy? So this paper will examine all these questions by analysing Muslim women's representation in Pakistani Cinema. It is also significant to note that despite political and religious constraints in Muslim countries, in particular, Pakistan, women have not only been part of the film industry for long, but they also have chosen films as their feminist tool to question and expose the effects of patriarchy, religious fundamentalism, and gender-specific socio-cultural oppression. The religious-cultural ethos that could include gender-specific restrictions and limitations on their creative expression as Muslim women in an Islamic society. A new wave of Pakistani cinema is pivoting around strong Muslim female characters and opened up a new thought about Islamic women.Their contributions and success through this medium emphasized the need to investigate the significance and effectiveness of contemporary cinema as a tool of resistance and cross-cultural communication in a Muslim society. So this research can also provide a better understanding about Islam that needs to be modernized and reclaimed from the clutches of fundamentalism and extremism. This paper thus investigates the interrelation of women's representation and Pakistani cinema by analysing two films ‘Bol: To speak up’ and ‘Dukhter: Daughter’. The feminist analysis of these films not only helps to understand the new trends and dimensions in representation of Muslim women in Pakistani cinema, but this also helps to raise awareness globally regarding the depiction of Muslim women. So to foreground the above mentioned discussion, the films under study helps to evaluate their significance, the role they play towards activism, resistance, and global awareness in terms of what could be termed as a Muslim woman. The paper thus provides a valuable insight that how and why Islam is being used as a mechanism to merge social, political and economic factors to define the rights and conditions of Pakistani Muslim women and highlight the cinematic struggle of the film maker’s which by using films as an awareness tool are going to highlight the problems and issues of Muslim women in the global world.

Keywords: Muslim women, Pakistani cinema, patriarchy, religious fundamentalism

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3945 An Improved Circulating Tumor Cells Analysis Method for Identifying Tumorous Blood Cells

Authors: Salvador Garcia Bernal, Chi Zheng, Keqi Zhang, Lei Mao

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Circulating Tumor Cells (CTC) is used to detect tumoral cell metastases using blood samples of patients with cancer (lung, breast, etc.). Using an immunofluorescent method a three channel image (Red, Green, and Blue) are obtained. These set of images usually overpass the 11 x 30 M pixels in size. An aided tool is designed for imaging cell analysis to segmented and identify the tumorous cell based on the three markers signals. Our Method, it is cell-based (area and cell shape) considering each channel information and extracting and making decisions if it is a valid CTC. The system also gives information about number and size of tumor cells found in the sample. We present results in real-life samples achieving acceptable performance in identifying CTCs in short time.

Keywords: Circulating Tumor Cells (CTC), cell analysis, immunofluorescent, medical image analysis

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3944 Risk Factor of Anal Incontinence among Women in Makassar

Authors: Azizah Nurdin, Trika Irianta, Mardiah Tahir, Maisuri T. Chalid

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Background: Studies of anal incontinence in the general population are rare however its financial healthcare cost is significant. Women attended Hasanuddin University Teaching Hospital and its networking in Makassar, Indonesia was surveyed between February to April 2015 about their obstetrical and gynecological history. Aims: To establish obstetrical risk factor of anal incontinence among women in Makassar. Methods: In a cross sectional face to face interview study, 135 women aged 30 years or more were selected randomly. Participants were asked to complete an anal incontinence questionnaire. Results: From a total sample of 135 respondents, 42,2 % reported has flatulence incontinence. Parity, history of anal sphincter laceration, history of having large baby, history of assisted vaginal delivery were shown have no significant association with anal incontinence, while history of episiotomy was shown have a significant association with anal incontinence (p value < 0.05). The risk of flatulence incontinence was higher among women with history of episiotomy (OR : 2,85, 95 % CI = 1,58- 5,13) Conclusions: This study has confirmed that fecal incontinence is a fairly common symptom. Flatulence incontinence is the most frequent even. An obstetrical factor like episiotomy is one of risk factor that could be avoided in order to prevent anal incontinence.

Keywords: anal incontinence, flatulence incontinence, obstetrical risk factor, women

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3943 Intraoperative Inter Pectoral and Sub Serratus Nerve Blocks Reduce Post Operative Opiate Requirements in Breast Augmentation Surgery

Authors: Conor Mccartney, Mark Lee

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Background: An essential component in ambulatory breast augmentation surgery is good analgesia. The demographic undergoing this operation is usually fit, low risk with few comorbidities. These patients do not require long-term hospitalization and do not want to spend excessive time in the hospital for financial reasons. Opiate analgesia can have significant side effects such as nausea, vomiting and sedation. Reducing volumes of postoperative opiates allows faster ambulation and discharge from day surgery. We have developed two targeted nerve blocks that can be applied by the operating surgeon in a matter of seconds under direct vision, not requiring imaging. Anecdotally we found that these targeted nerve blocks reduced opiate requirements and allowed accelerated discharge and faster return to normal activities. This was then tested in a prospective randomized, double-blind trial. Methods: 20 patients were randomized into saline (n = 10) or Ropivicaine adrenaline solution (n = 10). The operating surgeon and anesthetist were blinded to the solution. All patients were closely followed up and morphine equivalents were accurately recorded. Follow-up pain scores were recorded using the Overall Benefit of Analgesia pain questionnaire. Findings: The Ropivicaine nerve blocks significantly reduced opiate requirements postoperatively (p<0.05). Pain scores were significantly decreased in the study group (p<0.05). There were no side effects attributable to the nerve blocks. Conclusions: Intraoperative targeted nerve blocks significantly reduce postoperative opiate requirements in breast augmentation surgery. This results in faster recovery and higher patient satisfaction.

Keywords: breast augmentation, nerve block, postoperative recovery, opiate analgesia, inter pectoral block, sub serratus block

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