Search results for: clinical interpretation

Authors: Marina Galakhova

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Nowadays, language variants, as well as minority languages and cultures, are of increased interest, and the desire to protect them is rising. The Maori language is defined as a vulnerable language by UNESCO. Its usage is confined to intra-family communication. It is not being utilized by the younger generation or being taught at an early age; therefore, it is being replaced by more frequently used languages. Maori loanwords are a unique part of New Zealand English. That is why it is worth our attention. The aim of this study is to investigate Maori cultural loanwords in the New Zealand media. Methods of analysis of lexical units, etymological interpretation, and linguocultural commenting were used. The results of the research show that Maori borrowings are used in the media, not only with regard to Maori people but also to the whole nation. The Maori language is often used in media texts, most often without a translation in English. Not only are words borrowed, but also cultural concepts. The language usage is limited to the following spheres: everyday life, education, religion, and media. The conclusion can also be drawn that Maori words are used to emphasize a new bicultural national identity; the revival of the Maori language and culture contributed to a large number of borrowings into New Zealand English. It has been established that the Maori language is substratum because Maori provides an intrusive language, which is English with language material. It is stated that the number of borrowings denoting Maori culture is very significant. This group is even greater than the group relating to flora and fauna. Language policy in New Zealand is designed to protect and promote the Maori language and culture. Tables of Maori loanwords are also presented.

Keywords: loanwords, Maori, minority languages, New Zealand

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Authors: Najrullah Khan, Athar Ali Khan

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The Topp-Leone distribution was introduced by Topp- Leone in 1955. In this paper, an attempt has been made to fit Topp-Leone Generalized exponential (TPGE) distribution. A real survival data set is used for illustrations. Implementation is done using R and JAGS and appropriate illustrations are made. R and JAGS codes have been provided to implement censoring mechanism using both optimization and simulation tools. The main aim of this paper is to describe and illustrate the Bayesian modelling approach to the analysis of survival data. Emphasis is placed on the modeling of data and the interpretation of the results. Crucial to this is an understanding of the nature of the incomplete or 'censored' data encountered. Analytic approximation and simulation tools are covered here, but most of the emphasis is on Markov chain based Monte Carlo method including independent Metropolis algorithm, which is currently the most popular technique. For analytic approximation, among various optimization algorithms and trust region method is found to be the best. In this paper, TPGE model is also used to analyze the lifetime data in Bayesian paradigm. Results are evaluated from the above mentioned real survival data set. The analytic approximation and simulation methods are implemented using some software packages. It is clear from our findings that simulation tools provide better results as compared to those obtained by asymptotic approximation.

Keywords: Bayesian Inference, JAGS, Laplace Approximation, LaplacesDemon, posterior, R Software, simulation

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Authors: Ezzati Givi M., Hoveizi E., Nezhad Marani N.

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Platinum-based anticancer therapeutics are the most widely used drugs in clinical chemotherapy but have major limitations and various side effects in clinical applications. Gonadotoxicity and sterility is one of the most common complications for cancer survivors, which seem to be drug-specific and dose-related. Therefore, many efforts have been dedicated to discovering a new structure of platinum-based anticancer agents with improved therapeutic index, fewer side effects. In this regard, new Pt(II)-phosphane complexes containing heterocyclic thionate ligands (PCTL) have been synthesized, which show more potent antitumor activities in comparison to cisplatin. Cisplatin, the best leading metal-based antitumor drug in the field, induces testicular toxicity on Leydig and Sertoli cells leading to serious side effects such as azoospermia and infertility. Therefore in the present study, we aimed to investigate the cytotoxicity effect of PCTL on mice TM4 Sertoli cells with particular emphasis on the role of autophagy in comparison to cisplatin. In this study, an MTT assay was performed to evaluate the IC50 of PCTL and to analyze the TM3 Leydig cell's viability. Cells morphology was evaluated via invert microscope and Changing in morphology for nuclei swelling or autophagic vacuoles formation were assessed by DAPI and MDC staining. Testosterone production in the culture medium was measured using an ELISA kit. Finally, the expression of Autophagy-related genes, Atg5, Beclin1 and p62, were analyzed by qPCR. Based on the obtained results by MTT, the IC50 value of PCTL was 50 μM in TM3 cells and cytotoxic effects was in a dose- and time-dependent manner. Cells morphological changes investigated by inverted microscopy, DAPI, and MDC staining which showed the cytotoxic concentrations of PCTL was significantly higher than cisplatin in the treated TM3 Leydig cells. The results of PCR showed a lack of expression of the p62, Atg5 and Beclin1 gene in TM3 cells treated with PCTL in comparison to cisplatin and control groups. It should be noted that the effects of 25 μM PCTL concentration on TM3 cells have been associated with increased testosterone production and secretion, which requires further study to explain the possible causes and involved molecular mechanisms. The results of the study showed that the PCTL had less-lethal effects on TM3 cells in comparison to cisplatin and probably did not induce autophagy in TM3 cells.

Keywords: platinum-based anticancer agents, cisplatin, Leydig TM3 cells, autophagy

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Authors: Jutharat Attawet, Alex Y. Wang, Cindy M. Farquhar, Elizabeth A. Sullivan

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Background: Adverse maternal and perinatal outcomes of multiple pregnancies resulting from multiple embryo transfers (ET) has become significant concerns. This is particularly relevant for gestational carriers since they usually do not have infertility issues. Single embryo transfer (SET) therefore has been encouraged to assist reproductive technology (ART) practice in order to reduce multiple pregnancies. Objectives: This systematic review aims to investigate the pregnancy and birth outcomes of SET and multiple ET in surrogacy arrangements. Search methods: This study is a systematic review. Electronic databases were searched from CINAHL, Medline, Embase, Scopus and ProQuest for studies from 1980 to 2017. Cross-references and national ART reports were also manual searchings. Articles without restriction of English language and study types were accessed. Carrier cycles involving in SET and multiple ET were identified in database searching. The main outcome measures including clinical pregnancy, live delivery and multiple deliveries per gestational carrier cycle were compared between SET and multiple ET. Mantel-Haenzel risk ratios (RRs) with 95% confidence intervals (CIs), using the numbers of outcome events in SET and multiple ET of each study were calculated suing RevMan5.3. Outcomes: The search returned 97 articles of which 5 met the inclusion criteria. Approximately 50% of carrier cycles were transferred a single embryo and 50% were transferred more than one embryo. The clinical pregnancy rate (CPR) was 39% for SET and 53% for multiple ET, which was not significantly different with RR = 0.83 (95% CI: 0.67-1.03). The live delivery rate was 33% for SET and 57% for multiple ET which was not significantly different with RR = 0.78 (95% CI: 0.61-1.00). The multiple delivery rate per carrier was greater risks in the multiple ET carrier cycles (RR =0.4, 95% CI: 0.01-0.26). There were 104 sets of twins (including one set of twins selectively reduced from triplets to twins) and 1 set of triples in the multiple ET carrier cycle. In the SET carrier cycles, there were 2 sets of twins. Significance of the study: SET should be advocated among surrogate carriers to prevent multiple pregnancies and subsequent adverse outcomes for both carrier and baby. Surrogacy practice should be reviewed and surrogate carriers should be fully informed of the risk of adverse maternal and birth outcome of multiple pregnancies due to multiple embryo transfers.

Keywords: assisted reproduction, birth outcomes, carrier, gestational surrogacy, multiple embryo transfer, multiple pregnancy, pregnancy outcomes, single embryo transfer, surrogate mother, systematic review

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Authors: Piotr Wadolowski, Grzegorz Krzesinski, Piotr Gutowski

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The aim of the presented work is to recognize the impact of mini-plate application approach on the stress and displacement within the stabilization devices and surrounding bones. The mini-plate osteosynthesis technique is widely used by craniofacial surgeons as an improved replacement of wire connection approach. Many different types of metal plates and screws are used to the physical connection of fractured bones. Below investigation is based on a clinical observation of patient hospitalized with mini-plate stabilization system. Analysis was conducted on a solid mandible geometry, which was modeled basis on the computed tomography scan of the hospitalized patient. In order to achieve most realistic connected system behavior, the cortical and cancellous bone layers were assumed. The temporomandibular joint was simplified to the elastic element to allow physiological movement of loaded bone. The muscles of mastication system were reduced to three pairs, modeled as shell structures. Finite element grid was created by the ANSYS software, where hexahedral and tetrahedral variants of SOLID185 element were used. A set of nonlinear contact conditions were applied on connecting devices and bone common surfaces. Properties of particular contact pair depend on screw - mini-plate connection type and possible gaps between fractured bone around osteosynthesis region. Some of the investigated cases contain prestress introduced to the mini-plate during the application, what responds the initial bending of the connecting device to fit the retromolar fossa region. Assumed bone fracture occurs within the mandible angle zone. Due to the significant deformation of the connecting plate in some of the assembly cases the elastic-plastic model of titanium alloy was assumed. The bone tissues were covered by the orthotropic material. As a loading were used the gauge force of magnitude of 100N applied in three different locations. Conducted analysis shows significant impact of mini-plate application methodology on the stress distribution within the miniplate. Prestress effect introduces additional loading, which leads to locally exceed the titanium alloy yield limit. Stress in surrounding bone increases rapidly around the screws application region, exceeding assumed bone yield limit, what indicate the local bone destruction. Approach with the doubled mini-plate shows increased stress within the connector due to the too rigid connection, where the main path of loading leads through the mini-plates instead of plates and connected bones. Clinical observations confirm more frequent plate destruction of stiffer connections. Some of them could be an effect of decreased low cyclic fatigue capability caused by the overloading. The executed analysis prove that the mini-plate system provides sufficient support to mandible fracture treatment, however, many applicable solutions shifts the entire system to the allowable material limits. The results show that connector application with the initial loading needs to be carefully established due to the small material capability tolerances. Comparison to the clinical observations allows optimizing entire connection to prevent future incidents.

Keywords: mandible fracture, mini-plate connection, numerical analysis, osteosynthesis

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Authors: Luen Chow Chan

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With the advocacy of green transportation and green traveling, cycling has become increasingly popular nowadays. Physiology and bike design are key factors for the influence of cycling efficiency. Therefore, this study aimed to investigate the significance of bike-frame geometric factors on cycling efficiency and muscle activation for different body sizes of non-professional Asian male cyclists. Participants who represented various body sizes, as measured by leg and back lengths, carried out cycling tests using a tailor-assembled road bike with different ergonomic design configurations including seat-height adjustments (i.e., 96%, 100%, and 104% of trochanteric height) and bike frame sizes (i.e., small and medium frames) for an assessable distance of 1 km. A specific power meter and self-developed adaptable surface electromyography (sEMG) were used to measure average pedaling power and cadence generated and muscle activation, respectively. The results showed that changing the seat height was far more significant than the body and bike frame sizes. The sEMG data evidently provided a better understanding of muscle activation as a function of different seat heights. Therefore, the interpretation of this study is that the major bike ergonomic design factor dominating the cycling efficiency of Asian participants with different body sizes was the seat height.

Keywords: bike frame sizes, cadence rate, pedaling power, seat height

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Authors: Anna Rudzińska, Katarzyna Szklener, Pola Juchaniuk, Anna Rodzajweska, Katarzyna Machulska-Ciuraj, Monika Rychlik- Grabowska, Michał łOziński, Agnieszka Kolak-Bruks, SłAwomir Mańdziuk

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Introduction: Immune checkpoint inhibition (ICI) belongs to the modern forms of anti-cancer treatment. Due to the constant development and continuous research in the field of ICI, many aspects of the treatment are yet to be discovered. One of the less researched aspects of ICI treatment is the influence of the adverse effects on the treatment success rate. It is suspected that adverse events in the course of the ICI treatment indicate a better response rate and correlate with longer progression-free- survival. Methodology: The research was conducted with the usage of the documentation of the Department of Clinical Oncology and Chemotherapy. Data of the patients with a lung cancer diagnosis who were treated between 2019-2022 and received ICI treatment were analyzed. Results: Out of over 133 patients whose data was analyzed, the vast majority were diagnosed with non-small cell lung cancer. The majority of the patients did not experience adverse effects. Most adverse effects reported were classified as grade 1 or grade 2 according to CTCAE classification. Most adverse effects involved skin, thyroid and liver toxicity. Statistical significance was found for the adverse effect incidence and overall survival (OS) and progression-free survival (PFS) (p=0,0263) and for the time of toxicity onset and OS and PFS (p<0,001). The number of toxicity sites was statistically significant for prolonged PFS (p=0.0315). The highest OS was noted in the group presenting grade 1 and grade 2 adverse effects. Conclusions: Obtained results confirm the existence of the prolonged OS and PFS in the adverse-effects-charged patients, mostly in the group presenting mild to intermediate (Grade 1 and Grade 2) adverse effects and late toxicity onset. Simultaneously our results suggest a correlation between treatment response rate and the toxicity grade of the adverse effects and the time of the toxicity onset. Similar results were obtained in several similar research conducted - with the proven tendency of better survival in mild and moderate toxicity; meanwhile, other studies in the area suggested an advantage in patients with any toxicity regardless of the grade. The contradictory results strongly suggest the need for further research on this topic, with a focus on additional factors influencing the course of the treatment.

Keywords: adverse effects, immunotherapy, lung cancer, PD-1/PD-L1 inhibitors

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Authors: Ling-Lang Huang

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Background: The holistic health care should ideally cover physical, mental, spiritual, and social aspects of a patient. With very constrained time in current clinical practice system, medical decisions often tip the balance in favor of evidence-based medicine (EBM) in comparison to patient's personal values. Even in the era of competence-based medical education (CBME), when scrutinizing the items of entrustable professional activities (EPAs), we found that EPAs of establishing doctor-patient relationship remained incomplete or even missing. This phenomenon prompted us to raise this project aiming at advocating value-based medicine (VBM), which emphasizes the importance of patient’s values in medical decisions. A true and effective doctor-patient communication and relationship should be a well-balanced harmony of EBM and VBM. By constructing VBM into current EPAs, we can further promote genuine shared decision making (SDM) and fix the missing link in holistic health care. Methods: In this project, we are going to find out EPA elements crucial for establishing an ideal doctor-patient relationship through three distinct pairs of doctor-patient relationships: patients with pulmonary arterial hypertension (relatively young but with grave disease), patients undergoing surgery (facing critical medical decisions), and patients with terminal diseases (facing forthcoming death). We’ll search for important EPA elements through the following steps: 1. Narrative approach to delineate patients’ values among 2. distinct groups. 3.Hermeneutics-based interview: semi-structured interview will be conducted for both patients and physicians, followed by qualitative analysis of collected information by compiling, disassembling, reassembling, interpreting, and concluding. 4. Preliminarily construct those VBM elements into EPAs for doctor-patient relationships in 3 groups. Expected Outcomes: The results of this project are going to give us invaluable information regarding the impact of patients’ values, while facing different medical situations, on the final medical decision. The competence of well-blending and -balanced both values from patients and evidence from clinical sciences is the missing link in holistic health care and should be established in future EPAs to enhance an effective SDM.

Keywords: value-based medicine, shared decision making, entrustable professional activities, holistic health care

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Authors: Ashok E. Kalange

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Diagnosis according to Ayurveda is to find the root cause of a disease. Out of the eight different kinds of examinations, Nadi-Pariksha (pulse examination) is important. Nadi-Pariksha is done at the root of the thumb by examining the radial artery using three fingers. Ancient Ayurveda identifies the health status by observing the wrist pulses in terms of 'Vata', 'Pitta' and 'Kapha', collectively called as tridosha, as the basic elements of human body and in their combinations. Diagnosis by traditional pulse analysis – NadiPariksha - requires a long experience in pulse examination and a high level of skill. The interpretation tends to be subjective, depending on the expertise of the practitioner. Present work is part of the efforts carried out in making Nadi-Parikshan objective. Nadi Parikshan Yantra (three point pulse examination system) is developed in our laboratory by using three pressure sensors (one each for the Vata, Pitta and Kapha points on radial artery). The radial pulse data was collected of a large number of subjects. The radial pulse data collected is analyzed on the basis of relative amplitudes of the three point pulses as well as in frequency and time domains. The same subjects were examined by Ayurvedic physician (Nadi Vaidya) and the dominant Dosha - Vata, Pitta or Kapha - was identified. The results are discussed in details in the paper.

Keywords: Nadi Parikshan Yantra, Tridosha, Nadi Pariksha, human pulse data analysis

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Authors: F. Jiménez, R. Jódar, M. Martín, G. Sánchez, G. Sciavicco

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Abstract—Attribute or feature selection is one of the basic strategies to improve the performances of data classification tasks, and, at the same time, to reduce the complexity of classifiers, and it is a particularly fundamental one when the number of attributes is relatively high. Its application to unsupervised classification is restricted to a limited number of experiments in the literature. Evolutionary computation has already proven itself to be a very effective choice to consistently reduce the number of attributes towards a better classification rate and a simpler semantic interpretation of the inferred classifiers. We present a feature selection wrapper model composed by a multi-objective evolutionary algorithm, the clustering method Expectation-Maximization (EM), and the classifier C4.5 for the unsupervised classification of data extracted from a psychological test named BASC-II (Behavior Assessment System for Children - II ed.) with two objectives: Maximizing the likelihood of the clustering model and maximizing the accuracy of the obtained classifier. We present a methodology to integrate feature selection for unsupervised classification, model evaluation, decision making (to choose the most satisfactory model according to a a posteriori process in a multi-objective context), and testing. We compare the performance of the classifier obtained by the multi-objective evolutionary algorithms ENORA and NSGA-II, and the best solution is then validated by the psychologists that collected the data.

Keywords: evolutionary computation, feature selection, classification, clustering

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Authors: Chen-Chang Lee, Po-Chou Chen, Jo-Chi Jao, Chun-Chung Lui, Leung-Chit Tsang, Lain-Chyr Hwang

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Fetal Magnetic Resonance Imaging (MRI) is a challenge task because the fetal movements could cause motion artifact in MR images. The remedy to overcome this problem is to use fast scanning pulse sequences. The Single-Shot Fast Spin-Echo (SSFSE) T2-weighted imaging technique is routinely performed and often used as a gold standard in clinical examinations. Fast spoiled gradient-echo (FSPGR) T1-Weighted Imaging (T1WI) is often used to identify fat, calcification and hemorrhage. Fast Imaging Employing Steady-State Acquisition (FIESTA) is commonly used to identify fetal structures as well as the heart and vessels. The contrast of FIESTA image is related to T1/T2 and is different from that of SSFSE. The advantages and disadvantages of these two scanning sequences for fetal imaging have not been clearly demonstrated yet. This study aimed to compare these three rapid MRI techniques (SSFSE, FIESTA, and FSPGR) for fetal MRI examinations. The image qualities and influencing factors among these three techniques were explored. A 1.5T GE Discovery 450 clinical MR scanner with an eight-channel high-resolution abdominal coil was used in this study. Twenty-five pregnant women were recruited to enroll fetal MRI examination with SSFSE, FIESTA and FSPGR scanning. Multi-oriented and multi-slice images were acquired. Afterwards, MR images were interpreted and scored by two senior radiologists. The results showed that both SSFSE and T2W-FIESTA can provide good image quality among these three rapid imaging techniques. Vessel signals on FIESTA images are higher than those on SSFSE images. The Specific Absorption Rate (SAR) of FIESTA is lower than that of the others two techniques, but it is prone to cause banding artifacts. FSPGR-T1WI renders lower Signal-to-Noise Ratio (SNR) because it severely suffers from the impact of maternal and fetal movements. The scan times for these three scanning sequences were 25 sec (T2W-SSFSE), 20 sec (FIESTA) and 18 sec (FSPGR). In conclusion, all these three rapid MR scanning sequences can produce high contrast and high spatial resolution images. The scan time can be shortened by incorporating parallel imaging techniques so that the motion artifacts caused by fetal movements can be reduced. Having good understanding of the characteristics of these three rapid MRI techniques is helpful for technologists to obtain reproducible fetal anatomy images with high quality for prenatal diagnosis.

Keywords: fetal MRI, FIESTA, FSPGR, motion artifact, SSFSE

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Authors: Bulcha Belay Etana, Benny Malengier, Debelo Oljira, Janarthanan Krishnamoorthy, Lieva Vanlangenhove

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Electromyography (EMG) is a technique used to measure the electrical activity of muscles. EMG can be used to assess muscle function in a variety of settings, including clinical, research, and sports medicine. The aim of this study was to develop a wearable textile sensor for EMG monitoring. The sensor was designed to be soft, stretchable, and washable, making it suitable for long-term use. The sensor was fabricated using a conductive thread material that was embroidered onto a fabric substrate. The sensor was then connected to a microcontroller unit (MCU) and a Wi-Fi-enabled module. The MCU was programmed to acquire the EMG signal and transmit it wirelessly to the Wi-Fi-enabled module. The Wi-Fi-enabled module then sent the signal to a server, where it could be accessed by a computer or smartphone. The sensor was able to successfully acquire and transmit EMG signals from a variety of muscles. The signal quality was comparable to that of commercial EMG sensors. The development of this sensor has the potential to improve the way EMG is used in a variety of settings. The sensor is soft, stretchable, and washable, making it suitable for long-term use. This makes it ideal for use in clinical settings, where patients may need to wear the sensor for extended periods of time. The sensor is also small and lightweight, making it ideal for use in sports medicine and research settings. The data for this study was collected from a group of healthy volunteers. The volunteers were asked to perform a series of muscle contractions while the EMG signal was recorded. The data was then analyzed to assess the performance of the sensor. The EMG signals were analyzed using a variety of methods, including time-domain analysis and frequency-domain analysis. The time-domain analysis was used to extract features such as the root mean square (RMS) and average rectified value (ARV). The frequency-domain analysis was used to extract features such as the power spectrum. The question addressed by this study was whether a wearable textile sensor could be developed that is soft, stretchable, and washable and that can successfully acquire and transmit EMG signals. The results of this study demonstrate that a wearable textile sensor can be developed that meets the requirements of being soft, stretchable, washable, and capable of acquiring and transmitting EMG signals. This sensor has the potential to improve the way EMG is used in a variety of settings.

Keywords: EMG, electrode position, smart wearable, textile sensor, IoT, IoT-integrated textile sensor

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Authors: Belgherbi Aicha, Hadjidj Ismahen, Bessaid Abdelhafid

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The phase of segmentation is an important step in the processing and interpretation of medical images. In this paper, we focus on the segmentation of liver and spleen from the abdomen computed tomography (CT) images. The importance of our study comes from the fact that the segmentation of ROI from CT images is usually a difficult task. This difficulty is the gray’s level of which is similar to the other organ also the ROI are connected to the ribs, heart, kidneys, etc. Our proposed method is based on the anatomical information and mathematical morphology tools used in the image processing field. At first, we try to remove the surrounding and connected organs and tissues by applying morphological filters. This first step makes the extraction of interest regions easier. The second step consists of improving the quality of the image gradient. In this step, we propose a method for improving the image gradient to reduce these deficiencies by applying the spatial filters followed by the morphological filters. Thereafter we proceed to the segmentation of the liver, spleen. To validate the segmentation technique proposed, we have tested it on several images. Our segmentation approach is evaluated by comparing our results with the manual segmentation performed by an expert. The experimental results are described in the last part of this work.The system has been evaluated by computing the sensitivity and specificity between the semi-automatically segmented (liver and spleen) contour and the manually contour traced by radiological experts.

Keywords: CT images, liver and spleen segmentation, anisotropic diffusion filter, morphological filters, watershed algorithm

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Authors: Petr Sifta, Vaclav Bittner, Martin Kysela, Matej Kolar

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The purpose of the research described in this work is to answer how to measure the rheologic (viscoelastic) properties tendo–deformational characteristics of soft tissue. The method would also resemble muscle palpation examination as it is known in clinical practice. For this purpose, an instrument with the working name “myotonometer” has been used. At present, there is lack of objective methods for assessing the muscle tone by viscous and elastic properties of soft tissue. That is why we decided to focus on creating or finding quantitative and qualitative methodology capable of specifying muscle tone.

Keywords: rheologic properties, tendo–deformational characteristics, viscosity, elasticity, hypertonus

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Authors: O. Onigbogi, M. Onigbogi Jr., O. Ojo

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Background: The advances in mobile telephone technology has led to a rise in its use globally which has improved service delivery, empowered businesses and changed the way people access information. The practice of many health professionals has also been affected by the information and communications technology (ICT) revolution because they have better access to information. This study was conducted to assess the willingness to participate in mobile technology interventions to improve pregnancy outcomes in Lagos, Nigeria. Materials and Methods: A total of 238 respondents completed self-administered questionnaires. SPSS version 18 data editor was used to analyze data. Univariate odds ratios and 95% confidence intervals (95 % CI) were used to evaluate the correlates of Willingness to Use (WTU) mobile phones to receive health messages during pregnancy. Results: A total of 107 women (45% of the respondents) reported that they will be willing to receive health-related information on their phones during pregnancy. Greater willingness was associated with higher education (OR = 1.25, 95% CI: 1.13–1.53), involvement with community volunteer organizations (OR = 1.25, 95% CI: 1.05–1.52), monetary incentives (OR = 1.37, 95% CI: 1.14–1.45) and nulliparity (OR = 1.39, 95% CI: 1.02–1.42). Decreased willingness was associated with concerns about wrong interpretation of information (OR = 0.42, 95% CI: 0.21–0.54), poor mobile telephone service by providers (OR = 0.61, 95% CI: 0.52–0.78), increase in number of messages (OR = 0.78, 95% CI: 0.53–0.76). Conclusion: The level of WTU recorded indicates that much work still needs to be done before this novel approach could be used adopted in delivering health-related information. Incentives for would-be subjects should also be a part of the planning to encourage greater participation.

Keywords: mobile, outcomes, pregnancy, technology, telephone

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Authors: Monika Dmitrzak-Weglarz, Aleksandra Rajewska-Rager, Maria Skibinska, Natalia Lepczynska, Piotr Sibilski, Joanna Pawlak, Pawel Kapelski, Joanna Hauser

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Epidermal growth factor (EGF) is a well-known neurotrophic factor that involves in neuronal growth and synaptic plasticity. The proteomic research provided in order to identify novel candidate biological markers for mood disorders focused on elevated EGF serum level in patients during depression episode. However, the EGF association with mood disorder spectrum among adolescents and young adults has not been studied extensively. In this study, we aim to investigate the serum levels of EGF in adolescents and young adults during hypo/manic, depressive episodes and in remission compared to healthy control group. In our study, we involved 80 patients aged 12-24 years in 2-year follow-up study with a primary diagnosis of mood disorder spectrum, and 35 healthy volunteers matched by age and gender. Diagnoses were established according to DSM-IV-TR criteria using structured clinical interviews: K-SADS for child and adolescents, and SCID for young adults. Clinical and biological evaluations were made at baseline and euthymic mood (at 3th or 6th month of treatment and after 1 and 2 years). The Young Mania Rating Scale and Hamilton Rating Scale for Depression were used for assessment. The study protocols were approved by the relevant ethics committee. Serum protein concentration was determined by Enzyme-Linked Immunosorbent Assays (ELISA) method. Human EGF (cat. no DY 236) DuoSet ELISA kit was used (R&D Systems). Serum EGF levels were analysed with following variables: age, age under 18 and above 18 years old, sex, family history of affective disorders, drug-free vs. medicated. Shapiro-Wilk test was used to test the normality of the data. The homogeneity of variance was calculated with Levene’s test. EGF levels showed non-normal distribution and the homogeneity of variance was violated. Non-parametric tests: Mann-Whitney U test, Kruskall-Wallis ANOVA, Friedman’s ANOVA, Wilcoxon signed rank test, Spearman correlation coefficient was applied in the analyses The statistical significance level was set at p<0.05. Elevated EGF level at baseline (p=0.001) and at month 24 (p=0.02) was detected in study subjects compared with controls. Increased EGF level in women at month 12 (p=0.02) compared to men in study group have been observed. Using Wilcoxon signed rank test differences in EGF levels were detected: decrease from baseline to month 3 (p=0.014) and increase comparing: month 3 vs. 24 (p=0.013); month 6 vs. 12 (p=0.021) and vs. 24 (p=0.008). EGF level at baseline was negatively correlated with depression and mania occurrence at 24 months. EGF level at 24 months was positively correlated with depression and mania occurrence at 12 months. No other correlations of EGF levels with clinical and demographical variables have been detected. The findings of the present study indicate that EGF serum level is significantly elevated in the study group of patients compared to the controls. We also observed fluctuations in EGF levels during two years of disease observation. EGF seems to be useful as an early marker for prediction of diagnosis, course of illness and treatment response in young patients during first episode od mood disorders, which requires further investigation. Grant was founded by National Science Center in Poland no 2011/03/D/NZ5/06146.

Keywords: biological marker, epidermal growth factor, mood disorders, prediction

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Authors: Denys Sebov, Viktoriia Korotaieva, Kateryna Markina

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The clinical advantage of the multipill combination drugs administration (polypill-strategy) over single-component drugs (monopill-strategy) has been established in patients with comorbid arterial hypertension, heart failure, chronic coronary syndrome, diabetes. It was found that polypill-strategy provides better treatment adherence in 33.4% of the patients. It was proven a significant decrease in systolic and diastolic blood pressure, as well as a decrease in dispersion index due to the stability of the blood pressure profile in patients with the polypill-strategy treatment.

Keywords: polypill, artetial hypertension, cardiovascular disease, compliance

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Authors: Afef Badri

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Metaphorical creativity does not constitute a static property of discourse. It is an interactive dynamic process created online. There has been a lack of research concerning online produced metaphorical creativity. This paper intends to account for metaphorical creativity in online talk-in-interaction as a dynamic process that emerges as discourse unfolds. It brings together insights from the emergentist approach to the study of metaphor in verbal interactions and insights from conceptual blending approach as a model for analysing online metaphorical constructions to propose a model for studying metaphorical creativity in interactive talk. The model is based on three focal points. First, metaphorical creativity is a dynamic emergent and open-to-change process that evolves in real time as interlocutors constantly blend and re-blend previous metaphorical contributions. Second, it is not a product of isolated individual minds but a joint achievement that is co-constructed and co-elaborated by interlocutors. The third and most important point is that the emergent process of metaphorical creativity is tightly shaped by contextual variables surrounding talk-in-interaction. It is grounded in the framework of interpretation of interlocutors. It is constrained by preceding contributions in a way that creates textual cohesion of the verbal exchange and it is also a goal-oriented process predefined by the communicative intention of each participant in a way that reveals the ideological coherence/incoherence of the entire conversation.

Keywords: communicative intention, conceptual blending, the emergentist approach, metaphorical creativity

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Authors: Kelly La Venture

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Destination promotion has become increasingly important to economic development in the United States. Key stakeholders of the First City on the Mississippi recognizes the importance of the visitor economy and decided to invest in destination promotion of the city as ‘True North’. The purpose of the study was to analyze the economic impact and stakeholder perceptions of destination promotion of the First City on the Mississippi as ‘True North’ using the case study method. Using a semi-structured guide consisting of 8 questions and additional probing questions, investigators engaged in 30-90 minute interviews with 20 key stakeholders. Data captured was then subjected to thematic analysis and interpretation. Through a review of literature and interview analysis, data indicate(1) there is increasing value in the visitor economy of the First City on the Mississippi,(2) the visitor economy warrants investments in destination promotion,(3) economic development can be more effective through coordination of destination promotion of as ‘True North’ and,(4) destination promotion fuels development across the entire economic spectrum. As a result, the First City on the Mississippi should prioritize marketing efforts of as ‘True North’ and coordinate these efforts with economic development initiatives. The destination promotion of the First City on the Mississippi as ‘True North’ may raise the communities profile and open doors to increased tourism, business relocation, business expansion, and entrepreneurs ready to start up a new organization.

Keywords: case study method, destination promotion, economic development, leisure and business travel

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Authors: Achim Kampker, Heiner Hans Heimes, Mathias Ordung, Jan-Philip Ganser

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In the past years, the automotive industry has changed significantly. Innovative mobility concepts have become more important, and electric vehicles see a chance of replacing vehicles with combustion engines in the long term. However, the coming years will be characterized by coexistence. In this context, there are two possible production scenarios: One the one hand, electric vehicles could be manufactured in bespoke assembly lines. Concerning the uncertainty regarding sales figures development, this alternative boasts a high investment risk. Therefore, an integrated assembly building upon existing structures also seems a feasible solution. This empirical study aims at validating hypotheses concerning theoretical and practical challenges of the integrated production in the final assembly. In order to take a test of approaches of the research by analyzing censored feedback of professionals, these hypotheses are validated in the framework of an expert study. For this purpose, hypotheses have been generated on the basis of a requirements analysis and a concept specification. Thereupon, a list of question has been implemented and deduced from the hypotheses to execute an online- and written-survey and interviews with professionals. The interpretation and evaluation of the findings includes an inter-component comparison for the electric drivetrain. Furthermore, key drivers for a sufficient integrated product and process design are presented.

Keywords: automotive industry, final assembly, integrated manufacturing, product and process development

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Authors: R. D. Esposito, V. M. Barberá, P. García Morales, P. Dorado Rodríguez, J. Sanz, M. Fuentes, D. Planes Meseguer, M. Saceda, L. Fernández Fornos, M. P. Ventero

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Results obtained by our group on glioblastoma multiforme (GBM) primary cultures , show a dramatic potentiation of radiation effects when 2 units/ml of D-amino acid oxidase (DAO) enzyme are added, free or immobilized in magnetic nanoparticles, to irradiated samples just after the irradiation. Cell cultures were exposed to radiation doses of 7Gy and 15Gy of 6 MV photons from a clinical linear accelerator. At both doses, we observed a clear enhancing effect of radiation-induced damages due to the addition of DAO.

Keywords: D-amino Acid Oxidase (DAO) enzyme, magnetic particles, nanotechnology, radiation therapy enhancement

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Authors: Slamet Subiyantoro, Mulyanto

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Revealing the structure and symbolism meaning of the walisanga’s mosque arts in Java is very important to explain the philosophy of religious foundation which is a manifestation of the norms/ value system and behavior of the Javanese Islam society that support the culture. This research's aims are also to find the structure pattern of walisanga’s mosque and its symbolic meaning in the context of Javanese Islam society. In order to obtain the research objectives, the research were done in several walisanga’s mosques in Java using anthropological approach which is focused on its interpretation and semiotic analysis. The data were collected through interviews with key informants who well informed about the shape and symbolism of walisanga’s mosques in Java. The observation technique is done through visiting walisanga’s mosques to see directly about its structure/ architecture. In completing the information of comprehensive result of the research, it is also used documents and archives as well as any other source which is analyzed to deepen the discussion in answering the problems research. The flow of analysis is done using an interactive model through stages of data collection, data reduction, data presentation and verification. The analysis is done continuously in a cycle system to draw valid conclusions. The research result indicates that the structure/architecture of walisanga’s mosque in Java is structured/built up vertically as well as horizontally. Its structure/architecture is correlated to each other which is having a sacred meaning that is a process represents the mystical belief such as sangkan paraning dumadi and manuggaling kawula gusti.

Keywords: Walisanga’s mosques, Java, structure and architecture, meaning

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Authors: Mariola Głowacka

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The aim of the study was to determine the level of adaptation to the current health situation and its impact on the adherence state of people in the pre- and senior age. The work covers the results of the first of the fourteen parts of the study conducted in a group of 2,000 people aged 55 plus. This part of the project was carried out with the use of two standardized tools: the HLC adaptation scale (the health locus of control scale and The Adherence in Chronic DiseasesScale (ACDS). The obtained results showed the range of influence of particular areas of self-acceptance of the health state (health and disease) on their adherence, taking into account specific clinical conditions.

Keywords: adaptation to the current health situation, adherence, senior, badania

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Authors: Margareth S. Zanchetta, Kateryna Metersky, Valerie Tan, Charissa Cordon, Stephanie Lucchese, Yana Siganevich, Prasha Sivasundaram, Truong Binh Nguyen, Imran Qureshi

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Due to a new area of practice, Canadian nurses possess knowledge gaps regarding the use of cannabis-based therapies by clients/patients. Education related to medical cannabis (MC) and recreational cannabis (RC) is required to promote nurses’ competency and confidence in supporting clients/patients using MC/RC toward the improvement of health outcomes. A team composed of nursing researchers and undergraduate/graduate students implemented a national survey to explore this theme with the population of undergraduate, graduate (MN and NP), and Post-Diploma (RN Bridging) nursing students enrolled in Canadian Universities Nursing Programs. Upon Research Ethics Board approval, survey recruitment was supported by major nursing stakeholders. The research questions were : (a) Which are the most preferred sources of information on MC/RC for nursing students? (b) Which are the factors and preferred learning modalities that could increase interest in learning about MC/RC, and (c) What are the future career plans among nursing students, and how would they consider the prospective use of cannabis in their practice? The survey was available from Sept. 2022 to Feb. 2023, hosted by a remote platform. An original questionnaire (English-French) was composed of 18 multiple choice questions and 2 open-ended questions. Sociodemographic information and closed-ended responses were compiled as descriptive statistics, while narrative accounts will be analysed through thematic analysis. Respondents (n=153) were from 7 Canadian provinces, national (99%) and international students (1%); the majority of respondents (61%) were in the age range of 21-30 years old. Results indicated that respondents perceive a gap in the undergraduate curriculum on the topics of MC/RC (91%) and that their learning needs include regulations (90%), data on effectiveness (88%), dosing best practices (86%), contraindications (83%), and clinical and medical indications (76%). Respondents reported motivation to learn more about MC/RC through online lectures/videos (65%), e-learning modules or online interactive training (61%), workshops (51%), webinars (36%), and social media (35%). Their primary career-related motivations regarding MC/RC knowledge include enhancing nursing practice (76%), learning about this growing scope of practice (61%), keeping up-to-date responding to scientific curiosity (59%), learning about evidence-based practice (59%), and utilizing alternative forms of medical treatment (37%). Respondents indicated that the integration of topics on cannabis in any course in the undergraduate and/or graduate curriculum would increase their desire to learn about MC/RC as equally as exposure within a clinical setting (75%). The emerging trend in the set of narrative responses (n=130) suggests that respondents believe educational MC/RC content should be integrated into core nursing courses. Respondents also urged educators to be well-informed about evidence-based practice related to MC/RC and to reflect upon stigma and biases surrounding its use. Future knowledge dissemination and translation activities include scholarly products and presentations to stimulate discussion amongst nursing faculty and students, as well as nurses in clinical settings. The goal is to mobilise talents and build collaboration for the development of a socially responsive curriculum on MC/RC competency to address the education-related expectations of all these social actors.

Keywords: Canada, medical cannabis, nursing education, nursing graduate student, nursing undergraduate student, online survey, recreational cannabis

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Authors: Aryati Yashadhana, Ted Fields Jnr., Wendy Fernando, Kelvin Brown, Godfrey Blitner, Francis Hayes, Ruby Stanley, Brian Donnelly, Bridgette Jerrard, Anthea Burnett, Anthony B. Zwi

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Indigenous Australians experience some of the worst health outcomes globally, with life expectancy being significantly poorer than those of non-Indigenous Australians. This is largely attributed to preventable diseases such as diabetes (prevalence 39% in Indigenous Australian adults > 55 years), which is attributed to a raised risk of diabetic visual impairment and cataract among Indigenous adults. Our study aims to explore the interface between structural and sociocultural determinants and human agency, in order to understand how they impact (1) accessibility of eye health and chronic disease services and (2) the potential for Indigenous patients to achieve positive clinical eye health outcomes. We used Participatory Action Research methods, and aimed to privilege the voices of Indigenous people through community collaboration. Semi-structured interviews (n=82) and patient focus groups (n=8) were conducted by Indigenous Community-Based Researchers (CBRs) with diabetic Indigenous adults (> 40 years) in four remote communities in Australia. Interviews (n=25) and focus groups (n=4) with primary health care clinicians in each community were also conducted. Data were audio recorded, transcribed verbatim, and analysed thematically using grounded theory, comparative analysis and Nvivo 10. Preliminary analysis occurred in tandem with data collection to determine theoretical saturation. The principal investigator (AY) led analysis sessions with CBRs, fostering cultural and contextual appropriateness to interpreting responses, knowledge exchange and capacity building. Identified themes were conceptualised into three spheres of influence: structural (health services, government), sociocultural (Indigenous cultural values, distrust of the health system, ongoing effects of colonialism and dispossession) and individual (health beliefs/perceptions, patient phenomenology). Permeating these spheres of influence were three core determinants: economic disadvantage, health literacy/education, and cultural marginalisation. These core determinants affected accessibility of services, and the potential for patients to achieve positive clinical outcomes at every level of care (primary, secondary, tertiary). Our findings highlight the clinical realities of institutionalised and structural inequities, illustrated through the lived experiences of Indigenous patients and primary care clinicians in the four sampled communities. The complex determinants surrounding inequity in health for Indigenous Australians, are entrenched through a longstanding experience of cultural discrimination and ostracism. Secure and long term funding of Aboriginal Community Controlled Health Services will be valuable, but are insufficient to address issues of inequity. Rather, working collaboratively with communities to build trust, and identify needs and solutions at the grassroots level, while leveraging community voices to drive change at the systemic/policy level are recommended.

Keywords: indigenous, Australia, culture, public health, eye health, diabetes, social determinants of health, sociology, anthropology, health equity, aboriginal and Torres strait islander, primary care

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Authors: Anne Nicole Fuentes

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A 29 year old Gravida 1 Para 0 who presented at the hospital with a 5-week history of amenorrhea, abdominal pain and vaginal bleeding. Transvaginal ultrasound revealed 3 pathologic findings : Tuboovarian complex on the right adnexa, a complex mass indicative of an unruptured ectopic pregnancy and right ovarian new growth probably endometrioma. Pelvic laparotomy was done and histopathologic finding revealed tubal pregnancy, right and mature cystic teratoma of the right ovary. This case report demonstrates the importance of considering the coexistence of different gynecologic pathologies in the same patient and clinical importance of an accurate diagnostic evaluation.

Keywords: mature cystic teratoma, ectopic pregnancy, Tuboovarian abscess, bHCG

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Authors: Andrey V. Malyshev, Anna B. Petrova, Anatoly P. Surzhikov

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The article presents the results of the influence of diamagnetic additives on the defects level of ferrite ceramics. For this purpose, we use a previously developed method based on the mathematical analysis of experimental temperature dependences of the initial permeability. A phenomenological expression for the description of such dependence was suggested and an interpretation of its main parameters was given. It was shown, that the main criterion of the integral defects level of ferrite ceramics is the relation of two parameters correlating with elastic stress value in a material. Model samples containing a controlled number of intergranular phase inclusions served to prove the validity of the proposed method, as well as to assess its sensitivity in comparison with the traditional XRD (X-ray diffraction) analysis. The broadening data of diffraction reflexes of model samples have served for such comparison. The defects level data obtained by the proposed method are in good agreement with the X-ray data. The method showed high sensitivity. Therefore, the legitimacy of the selection relationship β/α parameters of phenomenological expression as a characteristic of the elastic state of the ferrite ceramics confirmed. In addition, the obtained data can be used in the detection of non-magnetic phases and testing the optimal sintering production technology of soft magnetic ferrites.

Keywords: cure point, initial permeability, integral defects level, homogeneity

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Authors: Boris Nemzer, Tania Reyes-Izquierdo, Zbigniew Pietrzkowski

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Glucosinolate is a family of glucosides that can be found in a family of brassica vegetables. Upon the damage of the plant, glucosinolate breakdown by an internal enzyme myrosinase (thioglucosidase; EC 3.2.3.1) into isothiocyanates, such as sulforaphane. Sulforaphane is formed by glucoraphanin cleaving the sugar off by myrosinase and rearranged. Sulforaphane nitrile is formed in the same reaction as sulforaphane with the active of epithiospecifier protein (ESP). Most common food processing procedure would break the plant and mix the glucoraphanin and myrosinase together, and the formed sulforaphane would be further degraded. The purpose of this study is to understand the glucoraphanin/sulforaphane and the myrosinase activity of broccoli seeds germinated at a different time and technological processing conditions that keep the activity of the enzyme to form sulforaphane. Broccoli seeds were germinated in the house. Myrosinase activities were tested as the glucose content using glucose assay kit and measured UV-Vis spectrophotometer. Glucosinolates were measured by HPLC/DAD. Sulforaphane was measured using HPLC-DAD and GC/MS. The 6 hr germinated sprouts have a myrosinase activity 32.2 mg glucose/g, which is comparable with 12 and 24 hour germinated seeds and higher than dry seeds. The glucoraphanin content in 6 hour germinated sprouts is 13935 µg/g which is comparable to 24 hour germinated seeds and lower than the dry seeds. GC/MS results show that the amount of sulforaphane is higher than the amount of sulforaphane nitrile in seeds, 6 hour and 24 hour germinated seeds. The ratio of sulforaphane and sulforaphane nitrile is high in 6 hour germinated seeds, which indicates the inactivated ESP in the reaction. After evaluating the results, the short time germinated seeds can be used as the source of glucoraphanin and myrosinase supply to form potential higher sulforaphane content. Broccoli contains glucosinolates, glucoraphanin (4-methylsulfinylbutyl glucosinolate), which is an important metabolite with health-promoting effects. In the pilot clinical study, we observed the effects of a glucosinolates/glucoraphanin-rich extract from short time germinated broccoli seeds on blood adenosine triphosphate (ATP), reactive oxygen species (ROS) and lactate levels. A single dose of 50 mg of broccoli sprouts extract increased blood levels of ATP up to 61% (p=0.0092) during the first 2 hours after the ingestion. Interestingly, this effect was not associated with an increase in blood ROS or lactate. When compared to the placebo group, levels of lactate were reduced by 10% (p=0.006). These results indicate that broccoli germinated seed extract may positively affect the generation of ATP in humans. Due to the preliminary nature of this work and promising results, larger clinical trials are justified.

Keywords: broccoli glucosinolates, glucoraphanin, germinated seeds, myrosinase, adenosine triphosphate

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Authors: Omaima E. S. Mohammed, Amira A. A. Abdallah, Amal A. M. El Borady

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Background: Core stability training has recently attracted attention for improving muscle performance. Purpose: This study investigated the effect of beginners' core stability exercises on trunk active repositioning error at 30° and 60° trunk flexion. Methods: Forty healthy males participated in the study. They were divided into two equal groups; experimental “group I” and control “group II”. Their mean age, weight and height were 19.35±1.11 vs 20.45±1.64 years, 70.15±6.44 vs 72.45±6.91 kg and 174.7±7.02 vs 176.3±7.24 cm for group I vs group II. Data were collected using the Biodex Isokinetic system at an angular velocity of 60º/s. The participants were tested twice; before and after a 6-week period during which group I performed a core stability training program. Results: The Mixed 3-way ANOVA revealed significant increases (p<0.05) in the absolute error (AE) at 30˚ compared with 60˚ flexion in the pre-test condition of group I and II and the post-test condition of group II. Moreover, there were significant decreases (p<0.05) in the AE in the post-test condition compared with the pre-test in group I at both 30˚ and 60˚ flexion with no significant differences for group II. Finally, there were significant decreases (p<0.05) in the AE in group I compared with group II in the post-test condition at 30˚ and 60˚ flexion with no significant differences for the pre-test condition Interpretation/Conclusion: The improvement in trunk proprioception indicated by the decrease in the active repositioning error in the experimental group recommends including core stability training in the exercise programs that aim to improve trunk proprioception.

Keywords: core stability, isokinetic, trunk proprioception, biomechanics

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Authors: Xiaoli Tian

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The recent growing interest in and use of complementary and alternative medicine is a global phenomenon. In many regions, traditional Chinese medicine (TCM), an important type of complementary and alternative medicine, has been formally integrated into the healthcare system. Consequently, today’s doctors face increasing requests and questions from patients regarding TCM. However, studies of TCM focus either on patients’ approaches to TCM and Western medicine (WM) or on the politics involved in the institutionalization of TCM. To our knowledge, sociological studies on doctors’ attitudes toward TCM are rare. This paper compares the receptivity of WM-trained Chinese doctors to TCM in Hong Kong and mainland China, in order to evaluate the interplay between professional training and dominant medical paradigms, on the one hand, and institutional legitimacy and government and client pressures to accept TCM, on the other. Based on survey and in-depth interviews with Western-medicine doctors in Hong Kong and mainland China, this research finds that: there is major difference between Western-medicine doctors’ attitude toward traditional Chinese medicine (TCM) in Hong Kong and mainland China. Doctors in Hong Kong are still suspicious toward TCM, no matter if they have exposure to TCM or not. Even some doctors who have much knowledge about TCM, such as got a diploma or certificate in TCM or tried TCM themselves, are still suspicious. This is because they hold up to the ideal of 'evidence-based medicine' and emphasize the kind of evidence based on randomized controlled trial (RCT). To Western medicine doctors in Hong Kong, this is the most reliable type of evidence for any medical practice, but it is lacking in TCM. This is the major reason why they do not trust TCM and would not refer patients to TCM in clinical practices. In contrast, western medicine doctors in mainland China also know about randomized controlled trial (RCT) and believe that’s the most reliable evidence, but they tend to think experience-based evidence is also reliable. On this basis, they think TCM also has clinical effectiveness. Research findings reveal that legitimacy based on institutional arrangements is a relevant factor, but how doctors understand their professional boundaries also play an important role. Doctors in Hong Kong are more serious about a strict professional boundary between Western medicine and TCM because they benefited from it, such as a very prestigious status and high income. Doctors in mainland China tend to be flexible about professional boundaries because they never benefited from a well-defined strict professional boundary. This is related to a long history of the lack of professionalism in China but is also aggravated by the increasing state support of TCM.

Keywords: evidence-based decision-making, institutional legitimacy, professional behavior, traditional Chinese medicine

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