Search results for: cancer stories
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2602

Search results for: cancer stories

922 Human Health Risks Assessment of Particulate Air Pollution in Romania

Authors: Katalin Bodor, Zsolt Bodor, Robert Szep

Abstract:

The particulate matter (PM) smaller than 2.5 μm are less studied due to the limited availability of PM₂.₅, and less information is available on the health effects attributable to PM₁₀ in Central-Eastern Europe. The objective of the current study was to assess the human health risk and characterize the spatial and temporal variation of PM₂.₅ and PM₁₀ in eight Romanian regions between the 2009-2018 and. The PM concentrations showed high variability over time and spatial distribution. The highest concentration was detected in the Bucharest region in the winter period, and the lowest was detected in West. The relative risk caused by the PM₁₀ for all-cause mortality varied between 1.017 (B) and 1.025 (W), with an average 1.020. The results demonstrate a positive relative risk of cardiopulmonary and lung cancer disease due to exposure to PM₂.₅ on the national average 1.26 ( ± 0.023) and 1.42 ( ± 0.037), respectively.

Keywords: PM₂.₅, PM₁₀, relative risk, health effect

Procedia PDF Downloads 161
921 Tumor Detection Using Convolutional Neural Networks (CNN) Based Neural Network

Authors: Vinai K. Singh

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In Neural Network-based Learning techniques, there are several models of Convolutional Networks. Whenever the methods are deployed with large datasets, only then can their applicability and appropriateness be determined. Clinical and pathological pictures of lobular carcinoma are thought to exhibit a large number of random formations and textures. Working with such pictures is a difficult problem in machine learning. Focusing on wet laboratories and following the outcomes, numerous studies have been published with fresh commentaries in the investigation. In this research, we provide a framework that can operate effectively on raw photos of various resolutions while easing the issues caused by the existence of patterns and texturing. The suggested approach produces very good findings that may be used to make decisions in the diagnosis of cancer.

Keywords: lobular carcinoma, convolutional neural networks (CNN), deep learning, histopathological imagery scans

Procedia PDF Downloads 136
920 Procedure to Use Quantitative Bone-Specific SPECT/CT in North Karelia Central Hospital

Authors: L. Korpinen, P. Taskinen, P. Rautio

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This study aimed to describe procedures that we developed to use in the quantitative, bone-specific SPECT/CT at our hospital. Our procedures included the following questions for choosing imaging protocols, which were based on a clinical doctor's referral: (1) Is she/he a cancer patient or not? (2) Are there any indications of inflammatory rheumatoid arthritis? We performed about 1,106 skeletal scintigraphies over two years. About 394 patients were studied with quantitative bone-specific single-photon emission computed tomography/computerized tomography (SPECT/CT) (i.e., about 36% of all bone scintigraphies). Approximately 64% of the patients were studied using the conventional Anterior-Posterior/Posterior-Anterior imaging. Our procedure has improved efficiency and decreased cycle times.

Keywords: skeletal scintigraphy, SPECT/CT, imaging, procedure

Procedia PDF Downloads 152
919 Low SPOP Expression and High MDM2 expression Are Associated with Tumor Progression and Predict Poor Prognosis in Hepatocellular Carcinoma

Authors: Chang Liang, Weizhi Gong, Yan Zhang

Abstract:

Purpose: Hepatocellular carcinoma (HCC) is a malignant tumor with a high mortality rate and poor prognosis worldwide. Murine double minute 2 (MDM2) regulates the tumor suppressor p53, increasing cancer risk and accelerating tumor progression. Speckle-type POX virus and zinc finger protein (SPOP), a key of subunit of Cullin-Ring E3 ligase, inhibits tumor genesis and progression by the ubiquitination of its downstream substrates. This study aimed to clarify whether SPOP and MDM2 are mutually regulated in HCC and the correlation between SPOP and MDM2 and the prognosis of HCC patients. Methods: First, the expression of SPOP and MDM2 in HCC tissues were detected by TCGA database. Then, 53 paired samples of HCC tumor and adjacent tissues were collected to evaluate the expression of SPOP and MDM2 using immunohistochemistry. Chi-square test or Fisher’s exact test were used to analyze the relationship between clinicopathological features and the expression levels of SPOP and MDM2. In addition, Kaplan‒Meier curve analysis and log-rank test were used to investigate the effects of SPOP and MDM2 on the survival of HCC patients. Last, the Multivariate Cox proportional risk regression model analyzed whether the different expression levels of SPOP and MDM2 were independent risk factors for the prognosis of HCC patients. Results: Bioinformatics analysis revealed the low expression of SPOP and high expression of MDM2 were related to worse prognosis of HCC patients. The relationship between the expression of SPOP and MDM2 and tumor stem-like features showed an opposite trend. The immunohistochemistry showed the expression of SPOP protein was significantly downregulated while MDM2 protein significantly upregulated in HCC tissue compared to that in para-cancerous tissue. Tumors with low SPOP expression were related to worse T stage and Barcelona Clinic Liver Cancer (BCLC) stage, but tumors with high MDM2 expression were related to worse T stage, M stage, and BCLC stage. Kaplan–Meier curves showed HCC patients with high SPOP expression and low MDM2 expression had better survival than those with low SPOP expression and high MDM2 expression (P < 0.05). A multivariate Cox proportional risk regression model confirmed that a high MDM2 expression level was an independent risk factor for poor prognosis in HCC patients (P <0.05). Conclusion: The expression of SPOP protein was significantly downregulated, while the expression of MDM2 significantly upregulated in HCC. The low expression of SPOP and high expression. of MDM2 were associated with malignant progression and poor prognosis of HCC patients, indicating a potential therapeutic target for HCC patients.

Keywords: hepatocellular carcinoma, murine double minute 2, speckle-type POX virus and zinc finger protein, ubiquitination

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918 Physicians’ Knowledge and Perception of Gene Profiling in Malaysia: A Pilot Study

Authors: Farahnaz Amini, Woo Yun Kin, Lazwani Kolandaiveloo

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Availability of different genetic tests after completion of Human Genome Project increases the physicians’ responsibility to keep themselves update on the potential implementation of these genetic tests in their daily practice. However, due to numbers of barriers, still many of physicians are not either aware of these tests or are not willing to offer or refer their patients for genetic tests. This study was conducted an anonymous, cross-sectional, mailed-based survey to develop a primary data of Malaysian physicians’ level of knowledge and perception of gene profiling. Questionnaire had 29 questions. Total scores on selected questions were used to assess the level of knowledge. The highest possible score was 11. Descriptive statistics, one way ANOVA and chi-squared test was used for statistical analysis. Sixty three completed questionnaires was returned by 27 general practitioners (GPs) and 36 medical specialists. Responders’ age range from 24 to 55 years old (mean 30.2 ± 6.4). About 40% of the participants rated themselves as having poor level of knowledge in genetics in general whilst 60% believed that they have fair level of knowledge. However, almost half (46%) of the respondents felt that they were not knowledgeable about available genetic tests. A majority (94%) of the responders were not aware of any lab or company which is offering gene profiling services in Malaysia. Only 4% of participants were aware of using gene profiling for detection of dosage of some drugs. Respondents perceived greater utility of gene profiling for breast cancer (38%) compared to the colorectal familial cancer (3%). The score of knowledge ranged from 2 to 8 (mean 4.38 ± 1.67). Non-significant differences between score of knowledge of GPs and specialists were observed, with score of 4.19 and 4.58 respectively. There was no significant association between any demographic factors and level of knowledge. However, those who graduated between years 2001 to 2005 had higher level of knowledge. Overall, 83% of participants showed relatively high level of perception on value of gene profiling to detect patient’s risk of disease. However, low perception was observed for both statements of using gene profiling for general population in order to alter their lifestyle (25%) as well as having the full sequence of a patient genome for the purpose of determining a patient’s best match for treatment (18%). The lack of clinical guidelines, limited provider knowledge and awareness, lack of time and resources to educate patients, lack of evidence-based clinical information and cost of tests were the most barriers of ordering gene profiling mentioned by physicians. In conclusion Malaysian physicians who participate in this study had mediocre level of knowledge and awareness in gene profiling. The low exposure to the genetic questions and problems might be a key predictor of lack of awareness and knowledge on available genetic tests. Educational and training workshop might be useful in helping Malaysian physicians incorporate genetic profiling into practice for eligible patients.

Keywords: gene profiling, knowledge, Malaysia, physician

Procedia PDF Downloads 326
917 Community Education Leadership and Organizational Culture: Perceptions of Empowerment

Authors: Aisha M. Khairat

Abstract:

Community education in the Arab Republic of Egypt is a model that provides education to remote, underprivileged villages and hamlets where children have no access to public education. The community education model is based on the philosophy of transforming individuals to reach their full potential and on instilling the seeds of empowerment and citizenship to induce societal transformation. This research aims at investigating the degree to which the leadership style and organizational culture of the Egyptian community schools demonstrates an empowering approach. Nile Valley NGO, an Egyptian Non-Governmental Organization (NGO) leading hundreds of Egyptian community schools was studied to investigate the perceptions of empowerment amongst its leadership. This in turn will have serious implications on the level of empowerment the communities managed by Nile Valley NGO are experiencing, and will serve as an indicator to the degree to which community schools are achieving their goals in transforming individuals and empowering communities and reforming Egyptian education – and not just a tool to reach literacy. This mixed-methods research utilized surveys and semi-structured interviews to capture the perceptions of empowerment in the views of a sample of 380 community schools facilitators (teachers) spanning 8 Egyptian governorates and Nile Valley NGO’s community education project team and leadership. The findings demonstrate interesting leadership approaches with traits from transformational and servant leadership theoretical models. The organizational culture at Nile Valley NGO reflects the universal dichotomy between market-oriented and humanitarian orientations. The perceptions of empowerment were positive, and several success stories were uncovered in spite of the many challenges faced on the national level and despite the scarcity or resources.

Keywords: community education, community schools in Egypt, empowerment, organizational culture, leadership

Procedia PDF Downloads 179
916 Prediction of Bariatric Surgery Publications by Using Different Machine Learning Algorithms

Authors: Senol Dogan, Gunay Karli

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Identification of relevant publications based on a Medline query is time-consuming and error-prone. An all based process has the potential to solve this problem without any manual work. To the best of our knowledge, our study is the first to investigate the ability of machine learning to identify relevant articles accurately. 5 different machine learning algorithms were tested using 23 predictors based on several metadata fields attached to publications. We find that the Boosted model is the best-performing algorithm and its overall accuracy is 96%. In addition, specificity and sensitivity of the algorithm is 97 and 93%, respectively. As a result of the work, we understood that we can apply the same procedure to understand cancer gene expression big data.

Keywords: prediction of publications, machine learning, algorithms, bariatric surgery, comparison of algorithms, boosted, tree, logistic regression, ANN model

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915 Innate Immunity of Insects in Brief

Authors: Ehsan Soleymaninejadian

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As the field of immunology is growing day by day, and its chaotic system amazes more people, greed of research in this area is growing; however dealing with human or mammalian cells such as mice make the research expensive. Although there are some differences between higher animals with insects, importance of innate immunity during evolution made it untouched. So, for understanding the innate immunity insects can be good models. They are cheap; reproduction is fast and in the case genetics, less complicated. In this review, we tried to briefly tackle with important factors in insects’ innate immunity such as melanization, encapsulation, JAK-STAT, IMD, and Toll pathways. At the end, we explained how hormones and nerve system also can impact on immune system and make it more beautiful. In concluding remarks, the possibility of taking help from insect immune system to fight against diseases such as cancer has been considered.

Keywords: insects, innate immunity, melanization, intracellular pathways, hormones

Procedia PDF Downloads 226
914 Monoallelic and Biallelic Deletions of 13q14 in a Group of 36 CLL Patients Investigated by CGH Haematological Cancer and SNP Array (8x60K)

Authors: B. Grygalewicz, R. Woroniecka, J. Rygier, K. Borkowska, A. Labak, B. Nowakowska, B. Pienkowska-Grela

Abstract:

Introduction: Chronic lymphocytic leukemia (CLL) is the most common form of adult leukemia in the Western world. Hemizygous and or homozygous loss at 13q14 occur in more than half of cases and constitute the most frequent chromosomal abnormality in CLL. It is believed that deletions 13q14 play a role in CLL pathogenesis. Two microRNA genes miR-15a and miR- 16-1 are targets of 13q14 deletions and plays a tumor suppressor role by targeting antiapoptotic BCL2 gene. Deletion size, as a single change detected in FISH analysis, has haprognostic significance. Patients with small deletions, without RB1 gene involvement, have the best prognosis and the longest overall survival time (OS 133 months). In patients with bigger deletion region, containing RB1 gene, prognosis drops to intermediate, like in patients with normal karyotype and without changes in FISH with overall survival 111 months. Aim: Precise delineation of 13q14 deletions regions in two groups of CLL patients, with mono- and biallelic deletions and qualifications of their prognostic significance. Methods: Detection of 13q14 deletions was performed by FISH analysis with CLL probe panel (D13S319, LAMP1, TP53, ATM, CEP-12). Accurate deletion size detection was performed by CGH Haematological Cancer and SNP array (8x60K). Results: Our investigated group of CLL patients with the 13q14 deletion, detected by FISH analysis, comprised two groups: 18 patients with monoallelic deletions and 18 patients with biallelic deletions. In FISH analysis, in the monoallelic group the range of cells with deletion, was 43% to 97%, while in biallelic group deletion was detected in 11% to 94% of cells. Microarray analysis revealed precise deletion regions. In the monoallelic group, the range of size was 348,12 Kb to 34,82 Mb, with median deletion size 7,93 Mb. In biallelic group discrepancy of total deletions, size was 135,27 Kb to 33,33 Mb, with median deletion size 2,52 Mb. The median size of smaller deletion regions on one copy chromosome 13 was 1,08 Mb while the average region of bigger deletion on the second chromosome 13 was 4,04 Mb. In the monoallelic group, in 8/18 deletion region covered RB1 gene. In the biallelic group, in 4/18 cases, revealed deletion on one copy of biallelic deletion and in 2/18 showed deletion of RB1 gene on both deleted 13q14 regions. All minimal deleted regions included miR-15a and miR-16-1 genes. Genetic results will be correlated with clinical data. Conclusions: Application of CGH microarrays technique in CLL allows accurately delineate the size of 13q14 deletion regions, what have a prognostic value. All deleted regions included miR15a and miR-16-1, what confirms the essential role of these genes in CLL pathogenesis. In our investigated groups of CLL patients with mono- and biallelic 13q14 deletions, patients with biallelic deletion presented smaller deletion sizes (2,52 Mb vs 7,93 Mb), what is connected with better prognosis.

Keywords: CLL, deletion 13q14, CGH microarrays, SNP array

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913 Comparison of the Toxicity of Silver and Gold Nanoparticles in Murine Fibroblasts

Authors: Šárka Hradilová, Aleš Panáček, Radek Zbořil

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Nanotechnologies are considered the most promising fields with high added value, brings new possibilities in various sectors from industry to medicine. With the growing of interest in nanomaterials and their applications, increasing nanoparticle production leads to increased exposure of people and environment with ‘human made’ nanoparticles. Nanoparticles (NPs) are clusters of atoms in the size range of 1–100 nm. Metal nanoparticles represent one of the most important and frequently used types of NPs due to their unique physical, chemical and biological properties, which significantly differ from those of bulk material. Biological properties including toxicity of metal nanoparticles are generally determined by their size, size distribution, shape, surface area, surface charge, surface chemistry, stability in the environment and ability to release metal ions. Therefore, the biological behavior of NPs and their possible adverse effect cannot be derived from the bulk form of material because nanoparticles show unique properties and interactions with biological systems just due to their nanodimensions. Silver and gold NPs are intensively studied and used. Both can be used for instance in surface enhanced Raman spectroscopy, a considerable number of applications of silver NPs is associated with antibacterial effects, while gold NPs are associated with cancer treatment and bio imaging. Antibacterial effects of silver ions are known for centuries. Silver ions and silver-based compounds are highly toxic to microorganisms. Toxic properties of silver NPs are intensively studied, but the mechanism of cytoxicity is not fully understood. While silver NPs are considered toxic, gold NPs are referred to as toxic but also innocuous for eukaryotic cells. Therefore, gold NPs are used in various biological applications without a risk of cell damaging, even when we want to suppress the growth of cancer cells. Thus, gold NPs are toxic or harmless. Because most studies comparing particles of various sizes prepared in various ways, and testing is performed on different cell lines, it is very difficult to generalize. The novelty and significance of our research is focused to the complex biological effects of silver and gold NPs prepared by the same method, have the same parameters and the same stabilizer. That is why we can compare the biological effects of pure nanometals themselves based on their chemical nature without the influence of other variable. Aim of our study therefore is to compare the cytotoxic effect of two types of noble metal NPs focusing on the mechanisms that contribute to cytotoxicity. The study was conducted on murine fibroblasts by selected common used tests. Each of these tests monitors the selected area related to toxicity and together provides a comprehensive view on the issue of interactions of nanoparticles and living cells.

Keywords: cytotoxicity, gold nanoparticles, mechanism of cytotoxicity, silver nanoparticles

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912 A Sequence of Traumatic Pain: Feminist Issues within Laila Al-Othman’s Ṣamt al-Farāshāt (Silence of the Butterflies)

Authors: Khaled Igbaria

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Laila Al-Othman is a well-known feminist writer in Kuwait and the entire Arab world. She was born in 1943 in Kuwait to a large and wealthy family. The author has written several short stories, as well as novels, such as The Woman and the Cat (1985) and Wasumayya Comes out of the Sea (1986), which was chosen as one of the best 100 Arab novels of the 21st century. Another prominent novel of hers is Ṣamt al-Farāshāt [Silence of the Butterflies] (2007), which was highly controversial in her native Kuwait upon publication. For this study, her engagement in feminism was achieved by exploring the different ways in which her novel, Ṣamt al-Farāshāt [Silence of the Butterflies], addresses several feminist issues, mainly forced marriage, rape and sexual abuse, gender-based physical, sexual violence, and enforced silence. This paper focuses on demonstrating social obstacles and continuous trauma caused by a sequence of pain experienced by Arab females in their patriarchal society. This study argues that the novel reveals a sustained effort to raise the banner of feminism and a strong desire to liberate Arab women from patriarchal domination. Al-Othman successfully and uniquely represents women as gender-based traumatic victims of sexual and physical violence, forced silence, and general oppression in the patriarchal Arab society, as those needing help, support, protection, and liberation. They are not represented as independent or free. Methodologically, the study employs a qualitative literary analysis method in addition to trauma theory psychoanalysis, concentrating on feminist issues highlighted in the novel.

Keywords: Al-Othman, Arab women pain, trauma within narration., Silence of the Butterflies

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911 Biological Applications of CNT Inherited Polyaniline Nano-Composites

Authors: Yashfeen Khan, Anees Ahmad

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In the last few decades, nano-composites have been the topic of interest. Presently, the modern era enlightens the synthesis of hybrid nano-composites over their individual counterparts because of higher application potentials and synergism. Recently, CNT hybrids have demonstrated their pronounced capability as effective sorbents for the removal of heavy metal ions (the root trouble) and organic contaminants due to their high specific surface area, enhanced reactivity, and sequestration characteristics. The present abstract discusses removal efficiencies of organic, inorganic pollutants through CNT/PANI/ composites. It also represents the widespread applications of CNT like monitoring biological systems, biosensors, as heat resources for treating cancer, fire retardant applications of polymer/CNT composites etc. And considering the same, this article aims to brief the scenario of CNT-PANI nano-composites.

Keywords: biosensors, CNT, hybrids, polyaniline, synergism

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910 Gender, Language and Body: Literary Representations in Popular Culture Narratives

Authors: Eirini Arvanitaki

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Romance has incrementally grown in popularity over the last century. The first Mills & Boon romance novel was published in 1909 and since then romance has not only survived but it has become a long standing genre. There are several reasons behind its durability and success. First, its ability to please and appeal to a mass audience. Romance novels are products of commercial success situated in large scale production, especially if one takes into account the high volume of romance novels published, translated and distributed all around the world every month. Second, what has also contributed to keeping the romance genre alive is the content of the books and their effect on the reader. These are stories of two heterosexual individuals who meet, fall in love, face obstacles and successfully overcome them. Through the love plots, the books address anxieties, concerns and everyday troubles that the average reader can identify with. Additionally, the romance novel is a means of escapism from everyday life and responsibilities as well as a short-lived opportunity to enjoy personal time/space and focus on one’s self. Third, the genre’s ability to adapt to the periods and societies in which it is published has also assisted in prolonging its longevity. This paper discusses the ways in which popular romance authors write and engage with the body. Despite the claim that popular romance narratives adjust their contents in accordance with different time periods and social phenomena, the paper highlights the dissimilarities between writing the female and male body and suggests that women romance writers are yet to break free from phallogocentric law. The examination of the projections of the body and the language used to describe it indicates that these narratives are flexible enough to adjust to twenty-first century but only within the limits of their own conventionality.

Keywords: body, gender, language, literary representations, popular romance narratives, taboo

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909 Evaluation of Role of Surgery in Management of Pediatric Germ Cell Tumors According to Risk Adapted Therapy Protocols

Authors: Ahmed Abdallatif

Abstract:

Background: Patients with malignant germ cell tumors have age distribution in two peaks, with the first one during infancy and the second after the onset of puberty. Gonadal germ cell tumors are the most common malignant ovarian tumor in females aged below twenty years. Sacrococcygeal and retroperitoneal abdominal tumors usually presents in a large size before the onset of symptoms. Methods: Patients with pediatric germ cell tumors presenting to Children’s Cancer Hospital Egypt and National Cancer Institute Egypt from January 2008 to June 2011 Patients underwent stratification according to risk into low, intermediate and high risk groups according to children oncology group classification. Objectives: Assessment of the clinicopathologic features of all cases of pediatric germ cell tumors and classification of malignant cases according to their stage, and the primary site to low, intermediate and high risk patients. Evaluation of surgical management in each group of patients focusing on surgical approach, the extent of surgical resection according to each site, ability to achieve complete surgical resection and perioperative complications. Finally, determination of the three years overall and disease-free survival in different groups and the relation to different prognostic factors including the extent of surgical resection. Results: Out of 131 cases surgically explored only 26 cases had re exploration with 8 cases explored for residual disease 9 cases for remote recurrence or metastatic disease and the other 9 cases for other complications. Patients with low risk kept under follow up after surgery, out of those of low risk group (48 patients) only 8 patients (16.5%) shifted to intermediate risk. There were 20 patients (14.6%) diagnosed as intermediate risk received 3 cycles of compressed (Cisplatin, Etoposide and Bleomycin) and all high risk group patients 69patients (50.4%) received chemotherapy. Stage of disease was strongly and significantly related to overall survival with a poorer survival in late stages (stage IV) as compared to earlier stages. Conclusion: Overall survival rate at 3 three years was (76.7% ± 5.4, 3) years EFS was (77.8 % ±4.0), however 3 years DFS was much better (89.8 ± 3.4) in whole study group with ovarian tumors had significantly higher Overall survival (90% ± 5.1). Event Free Survival analysis showed that Male gender was 3 times likely to have bad events than females. Patients who underwent incomplete resection were 4 times more than patients with complete resection to have bad events. Disease free survival analysis showed that Patients who underwent incomplete surgery were 18.8 times liable for recurrence compared to those who underwent complete surgery, and patients who were exposed to re-excision were 21 times more prone to recurrence compared to other patients.

Keywords: extragonadal, germ cell tumors, gonadal, pediatric

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908 Film Review of 'Heroic Saviours and Survivors': The Representation of Sex Trafficking in Popular Films in India

Authors: Nisha James, Shubha Ranganathan

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One of the most poignant forms of organized crime against women, which has rarely made it to the world of Indian cinema, is that of sex trafficking, i.e. the forcible involvement of women in the sex trade through fraud or coercion (Hughes, 2005). In the space of Indian cinema, much of the spotlight has been on the sensational drug trafficking and gang mafia of Bombay. During our research on sex trafficking, the rehabilitated women interviewed often expressed strong criticism about mass media’s naive portrayal of prostitutes as money-minting, happy and sexually driven women. They argued that this unrealistic portrayal ignored the fact that this was not a reality for the majority of trafficked women. Given the gravity of sex trafficking as a human rights issue, it is, therefore, refreshing to see three recent films on sex trafficking in Indian Languages – Naa Bangaaru Talli (2014, Telugu), Mardaani (2014, Hindi) and Lakshmi (2014, Hindi). This paper reviews these three films to explore the portrayal of the everyday reality of trafficking for women. Film analysis was used to understand the representation of psychological issues in the media. The strength of these movies starts with their inspirations which are of true stories and that they are all aimed at bringing awareness about the issue of sex trafficking, which is a rising social evil in Indian society though none of the three films move to portray the next phase of rehabilitation and reintegration of victims, which is a very complex and important process in the life of a survivor. According to findings, survivors of sex trafficking find the rehabilitation and reintegration into society to be a slow and tough part of their life as they continuously face stigma and social exclusion and have to strive to live against all odds of non-acceptance starting from their family.

Keywords: film review, Indian films, sex trafficking, survivors

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907 Variations in Breast Aesthetic Reconstruction Rates between Asian and Caucasian Patients Post Mastectomy in a UK Tertiary Breast Referral Centre: A Five-Year Institutional Review

Authors: Wisam Ismail, Chole Wright, Elizabeth Baker, Cathy Tait, Mohamed Salhab, Richard Linforth

Abstract:

Background: Post-mastectomy breast reconstruction is an important treatment option for women with breast cancer with psychosocial, emotional and quality of life benefits. Despite this, Asian patients are one-fifth as likely as Caucasian patients to undergo reconstruction after mastectomy. Aim: This study aimed to assess the difference in breast reconstruction rates between Asian and Caucasian patients treated at Bradford Teaching Hospitals between May 2011 – December 2015.The long-term goal is to equip healthcare professionals to improve breast cancer treatment outcome by increasing breast reconstruction rates in this sub-population. Methods: All patients undergoing mastectomy were identified using a prospectively collected departmental database. Further data was obtained via retrospective electronic case note review. Bradford city population is about 530.000 by the end of 2015, with 67.44% of the city's population was White ethnic groups and 26.83% Asian Ethnic Groups (UK population consensus). The majority of Asian population speaks Urdu, hence an Urdu speaking breast care nurse was appointed to facilitate communications and deliver a better understanding of the reconstruction options and pathways. Statistical analysis was undertaken using the SAS program. Patients were stratified by age, self-reported ethnicity, axillary surgery and reconstruction. Relative odds were calculated using univariate and multivariate logistic regression analyses with adjustment for known confounders. An Urdu speaking breast care nurse was employed throughout this period to facilitate communication and patient decision making. Results: 506 patients underwent Mastectomy over 5 years. 72 (14%) Asian v. 434 (85%) Caucasian. Overall median age is 64 years (SD1.1). Asian median age is 62 (SD0.9), versus Caucasian 65 (SD1.2). Total axillary clearance rate was 30% (42% Asian v.30% Caucasian). Overall reconstruction rate was 126 patients (28.9%).Only 6 of 72 Asian patients (<1%) underwent breast reconstruction versus 121of 434 Caucasian (28%) (p < 0.04), Odds ratio 0.68, (95% confidence interval 0.57-0.79). Conclusions: There is a significant difference in post-mastectomy reconstruction rates between Asian and Caucasian patients. This difference is likely to be multi-factorial. Higher rates of axillary clearance in Asian patients might suggest later disease presentation and/or higher rates of subsequent adjuvant therapy, both of which, can impact on the suitability of breast reconstruction. Strategies aimed at reducing racial disparities in breast reconstruction should include symptom awareness to enable earlier presentation and facilitated communication to ensure informed decision-making.

Keywords: aesthetic, Asian, breast, reconstruction

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906 Nanomechanical Characterization of Healthy and Tumor Lung Tissues at Cell and Extracellular Matrix Level

Authors: Valeria Panzetta, Ida Musella, Sabato Fusco, Paolo Antonio Netti

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The study of the biophysics of living cells drew attention to the pivotal role of the cytoskeleton in many cell functions, such as mechanics, adhesion, proliferation, migration, differentiation and neoplastic transformation. In particular, during the complex process of malignant transformation and invasion cell cytoskeleton devolves from a rigid and organized structure to a more compliant state, which confers to the cancer cells a great ability to migrate and adapt to the extracellular environment. In order to better understand the malignant transformation process from a mechanical point of view, it is necessary to evaluate the direct crosstalk between the cells and their surrounding extracellular matrix (ECM) in a context which is close to in vivo conditions. In this study, human biopsy tissues of lung adenocarcinoma were analyzed in order to define their mechanical phenotype at cell and ECM level, by using particle tracking microrheology (PTM) technique. Polystyrene beads (500 nm) were introduced into the sample slice. The motion of beads was obtained by tracking their displacements across cell cytoskeleton and ECM structures and mean squared displacements (MSDs) were calculated from bead trajectories. It has been already demonstrated that the amplitude of MSD is inversely related to the mechanical properties of intracellular and extracellular microenvironment. For this reason, MSDs of particles introduced in cytoplasm and ECM of healthy and tumor tissues were compared. PTM analyses showed that cancerous transformation compromises mechanical integrity of cells and extracellular matrix. In particular, the MSD amplitudes in cells of adenocarcinoma were greater as compared to cells of normal tissues. The increased motion is probably associated to a less structured cytoskeleton and consequently to an increase of deformability of cells. Further, cancer transformation is also accompanied by extracellular matrix stiffening, as confirmed by the decrease of MSDs of matrix in tumor tissue, a process that promotes tumor proliferation and invasiveness, by activating typical oncogenic signaling pathways. In addition, a clear correlation between MSDs of cells and tumor grade was found. MSDs increase when tumor grade passes from 2 to 3, indicating that cells undergo to a trans-differentiation process during tumor progression. ECM stiffening is not dependent on tumor grade, but the tumor stage resulted to be strictly correlated with both cells and ECM mechanical properties. In fact, a greater stage is assigned to tumor spread to regional lymph nodes and characterized by an up-regulation of different ECM proteins, such as collagen I fibers. These results indicate that PTM can be used to get nanomechanical characterization at different scale levels in an interpretative and diagnostic context.

Keywords: cytoskeleton, extracellular matrix, mechanical properties, particle tracking microrheology, tumor

Procedia PDF Downloads 280
905 Novel EGFR Ectodomain Mutations and Resistance to Anti-EGFR and Radiation Therapy in H&N Cancer

Authors: Markus Bredel, Sindhu Nair, Hoa Q. Trummell, Rajani Rajbhandari, Christopher D. Willey, Lewis Z. Shi, Zhuo Zhang, William J. Placzek, James A. Bonner

Abstract:

Purpose: EGFR-targeted monoclonal antibodies (mAbs) provide clinical benefit in some patients with H&N squamous cell carcinoma (HNSCC), but others progress with minimal response. Missense mutations in the EGFR ectodomain (ECD) can be acquired under mAb therapy by mimicking the effect of large deletions on receptor untethering and activation. Little is known about the contribution of EGFR ECD mutations to EGFR activation and anti-EGFR response in HNSCC. Methods: We selected patient-derived HNSCC cells (UM-SCC-1) for resistance to mAb Cetuximab (CTX) by repeated, stepwise exposure to mimic what may occur clinically and identified two concurrent EGFR ECD mutations (UM-SCC-1R). We examined the competence of the mutants to bind EGF ligand or CTX. We assessed the potential impact of the mutations through visual analysis of space-filling models of the native sidechains in the original structures vs. their respective side-chain mutations. We performed CRISPR in combination with site-directed mutagenesis to test for the effect of the mutants on ligand-independent EGFR activation and sorting. We determined the effects on receptor internalization, endocytosis, downstream signaling, and radiation sensitivity. Results: UM-SCC-1R cells carried two non-synonymous missense mutations (G33S and N56K) mapping to domain I in or near the EGF binding pocket of the EGFR ECD. Structural modeling predicted that these mutants restrict the adoption of a tethered, inactive EGFR conformation while not permitting association of EGFR with the EGF ligand or CTX. Binding studies confirmed that the mutant, untethered receptor displayed a reduced affinity for both EGF and CTX but demonstrated sustained activation and presence at the cell surface with diminished internalization and sorting for endosomal degradation. Single and double-mutant models demonstrated that the G33S mutant is dominant over the N56K mutant in its effect on EGFR activation and EGF binding. CTX-resistant UM-SCC-1R cells demonstrated cross-resistance to mAb Panitumuab but, paradoxically, remained sensitive to the reversible receptor tyrosine kinase inhibitor Erlotinib. Conclusions: HNSCC cells can select for EGFR ECD mutations under EGFR mAb exposure that converge to trap the receptor in an open, constitutively activated state. These mutants impede the receptor’s competence to bind mAbs and EGF ligand and alter its endosomal trafficking, possibly explaining certain cases of clinical mAb and radiation resistance.

Keywords: head and neck cancer, EGFR mutation, resistance, cetuximab

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904 The Design Method of Artificial Intelligence Learning Picture: A Case Study of DCAI's New Teaching

Authors: Weichen Chang

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To create a guided teaching method for AI generative drawing design, this paper develops a set of teaching models for AI generative drawing (DCAI), which combines learning modes such as problem-solving, thematic inquiry, phenomenon-based, task-oriented, and DFC . Through the information security AI picture book learning guided programs and content, the application of participatory action research (PAR) and interview methods to explore the dual knowledge of Context and ChatGPT (DCAI) for AI to guide the development of students' AI learning skills. In the interviews, the students highlighted five main learning outcomes (self-study, critical thinking, knowledge generation, cognitive development, and presentation of work) as well as the challenges of implementing the model. Through the use of DCAI, students will enhance their consensus awareness of generative mapping analysis and group cooperation, and they will have knowledge that can enhance AI capabilities in DCAI inquiry and future life. From this paper, it is found that the conclusions are (1) The good use of DCAI can assist students in exploring the value of their knowledge through the power of stories and finding the meaning of knowledge communication; (2) Analyze the transformation power of the integrity and coherence of the story through the context so as to achieve the tension of ‘starting and ending’; (3) Use ChatGPT to extract inspiration, arrange story compositions, and make prompts that can communicate with people and convey emotions. Therefore, new knowledge construction methods will be one of the effective methods for AI learning in the face of artificial intelligence, providing new thinking and new expressions for interdisciplinary design and design education practice.

Keywords: artificial intelligence, task-oriented, contextualization, design education

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903 Spoken Rhetoric in Arabic Heritage

Authors: Ihab Al-Mokrani

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The Arabic heritage has two types of spoken rhetoric: the first type which al-Jaahiz calls “the rhetoric of the sign,” which means body language, and the rhetoric of silence which is of no less importance than the rhetoric of the sign, the speaker’s appearance and movements, etc. The second type is the spoken performance of utterances which bears written rhetoric arts like metaphor, simile, metonymy, etc. Rationale of the study: First: in spite of the factual existence of rhetorical phenomena in the Arabic heritage, there has been no contemporary study handling the spoken rhetoric in the Arabic heritage. Second: Arabic Civilization is originally a spoken one. Comparing the Arabic culture and civilization, from one side, to the Greek, roman or Pharaonic cultures and civilizations, from the other side, shows that the latter cultures and civilizations started and flourished written while the former started among illiterate people who had no interest in writing until recently. That sort of difference on the part of the Arabic culture and civilization created a rhetoric different from rhetoric in the other cultures and civilizations. Third: the spoken nature of the Arabic civilization influenced the Arabic rhetoric in the sense that specific rhetorical arts have been introduced matching that spoken nature. One of these arts is the art of concision which compensates for the absence of writing’s means of preserving the text. In addition, this interprets why many of the definitions of the Arabic rhetoric were defining rhetoric as the art of concision. Also, this interprets the fact that the literary genres known in the Arabic culture were limited by the available narrow space like poetry, anecdotes, and stories, while the literary genres in the Greek culture were of wide space as epics and drama. This is not of any contrast to the fact that some Arabic poetry would exceed 100 lines of poetry as Arabic poetry was based on the line organic unity, which means that every line could stand alone with a full meaning that is not dependent on the rest of the poem; and that last aspect has never happened in any culture other than the Arabic culture.

Keywords: Arabic rhetoric, spoken rhetoric, Arabic heritage, culture

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902 The Divine Elephant: Asian Elephants in Religions and Religious Practices

Authors: Ashna Sinha, Surendra Varma

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The Asian elephant is predominantly found in South Asian and Southeast Asian countries. They are intrinsically associated with the religions, religious and cultural practices and festivals of these regions. Amazingly, these magnificent animals are also mentioned in the texts and are found sculpted on the walls of places of religious significance even in the Middle Eastern countries, and evidently, they have been mentioned in all the major religions. The elephants are intrigued and associated with the cultural and religious practices of Asians for thousands of years. While some of the practices and festivals in certain geographical regions are going on for years; some regions and religions have gone through a cultural shift and cultural adaptation, and have incorporated the participation of these divine beings. The symbolism of elephants is used for preaching and giving philosophical lessons through stories and painted art, across different religions through varying literary and visual artworks. The animals carved on the ancient and present day temples can easily be found in South and South East Asian countries, signifying the importance of the animal in a given religion which the temples are associated with. Though not sculpted but captive elephants are easily found on the premises of the places of worship to give a blessing to the people or to give a tour to show their own connotation with the religion. They are also used for carrying out processions in varying religious and cultural activities, and are considered to be of immense value as they add an extra glamour and publicize the wealth and weightiness of that distinct religion or culture. Our critical review of elephant’s association with religions and their practices show, although they give a higher degree of value and respects to this animal, the practices do not match with their biological design, but profoundly compromise their welfare and conservation. It is time to follow the values the animal enjoy and use the same for their conservation and welfare.

Keywords: conservation, elephant, religion, welfare

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901 A Photographic Look on the Socio-Educational Inclusion of Young Refugees and Asylum-Seekers

Authors: Mara Gabrielli, Jordi Pamies Rovira

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From a theoretical and interdisciplinary approach to visual ethnography and visual anthropology, this small scale, in-depth study explores the potential of photography as a participatory ethnographic method for a deep-understanding of the socio-educational integration of young refugees and asylum-seekers in the host society as regards their daily experiences, their needs, desires, expectations, and future goals. Qualitative data is collected by the author by observing 12 young participants in the age group 12-24 years per week for 12 months. The data consists of field notes, participatory observation, in-depth interviews with professionals, and the use of visual participatory ethnographic methods. Therefore, the young participants build their stories through the implementation of two participatory photographic methods - the 'photo-diary' and the 'photo-elicitation' - that permit them to analyse and narrate their social and educational experiences from their perspectives, thus collaborating in the construction of knowledge during the different stages of the research. Preliminary findings show the high resilience and social adaptability of young refugees and asylum-seekers to achieve their goals and overcome structural and socio-cultural barriers. However, the uncertainty of their administrative situation during the asylum submission and the lack of specific resources might impact negatively on their educational pathways and the transition to the labour market. Finally, this study also highlights the benefits of participatory photographic methods in ethnographic research, which impacts positively the well-being of these young people, helps them to develop critical thinking, and it also allows them to access information more respectfully when narrating painful experiences.

Keywords: photo-diary, photo-elicitation, resilience, strategies, visual methodologies, young refugees and asylum seekers

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900 Basal Cell Carcinoma: Epidemiological Analysis of a 5-Year Period in a Brazilian City with a High Level of Solar Radiation

Authors: Maria E. V. Amarante, Carolina L. Cerdeira, Julia V. Cortes, Fiorita G. L. Mundim

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Basal cell carcinoma (BCC) is the most prevalent type of skin cancer in humans. It arises from the basal cells of the epidermis and cutaneous appendages. The role of sunlight exposure as a risk factor for BCC is very well defined due to its power to influence genetic mutations, in addition to having a suppressor effect on the skin immune system. Despite showing low metastasis and mortality rates, the tumor is locally infiltrative, aggressive, and destructive. Considering the high prevalence rate of this carcinoma and the importance of early detection, a retrospective study was carried out in order to correlate the clinical data available on BBC, characterize it epidemiologically, and thus enable effective prevention measures for the population. Data on the period from January 2015 to December 2019 were collected from the medical records of patients registered at one pathology service located in the southeast region of Brazil, known as SVO, which delivers skin biopsy results. The study was aimed at correlating the variables, sex, age, and subtypes found. Data analysis was performed using the chi-square test at a nominal significance level of 5% in order to verify the independence between the variables of interest. Fisher's exact test was applied in cases where the absolute frequency in the cells of the contingency table was less than or equal to five. The statistical analysis was performed using the R® software. Ninety-three basal cell carcinoma were analyzed, and its frequency in the 31-to 45-year-old age group was 5.8 times higher in men than in women, whereas, from 46 to 59 years, the frequency was found 2.4 times higher in women than in men. Between the ages of 46 to 59 years, it should be noted that the sclerodermiform subtype appears more than the solid one, with a difference of 7.26 percentage points. Reversely, the solid form appears more frequently in individuals aged 60 years or more, with a difference of 8.57 percentage points. Among women, the frequency of the solid subtype was 9.93 percentage points higher than the sclerodermiform frequency. In males, the same percentage difference is observed, but sclerodermiform is the most prevalent subtype. It is concluded in this study that, in general, there is a predominance of basal cell carcinoma in females and in individuals aged 60 years and over, which demonstrates the tendency of this tumor. However, when rarely found in younger individuals, the male gender prevailed. The most prevalent subtype was the solid one. It is worth mentioning that the sclerodermiform subtype, which is more aggressive, was seen more frequently in males and in the 46-to 59-year-old range.

Keywords: basal cell carcinoma, epidemiology, sclerodermiform basal cell carcinoma, skin cancer, solar radiation, solid basal cell carcinoma

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899 Chemical and Bioactive Constituents Isolated from the Formosa Zamia furfureace L.

Authors: Chien-Liang Chao, Yun-Sheng Lin

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Secondary metabolites are applied in the human life of the Chinese herbal medicine. Many drugs are originally extracted from natural products with combination of pharmaceutical and chemical studies. Crude extract of the leaves from Zamia furfureace L. has been shown to exhibit anticancer activities. The first chemical investigation of this plant was carried out by our group. In this study, four known compounds were isolated from Zamia furfureace L. with three lignins (Sesamin (1), Wodeshiol (2) and Paulownin (3)), and one dipeptide (Aurantiamide acetate (4)). The structures of these compounds were analyzed through the 1D-NMR(1H-NMR,13C-NMR)、2D-NMR(COSY、HMQC、HMBC、NOESY) spectroscopic analysis, and by comparison of variety of physical data (IR, mass spectrometry, ultraviolet, optical rotation). Among them, Aurantiamide acetate (4) exhibited weak cytotoxic activity against human gastric cancer cells.

Keywords: Zamia furfureace L., AGS, sesamin, Aurantiamide acetate, secondary metabolites

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898 Design and Development of Novel Anion Selective Chemosensors Derived from Vitamin B6 Cofactors

Authors: Darshna Sharma, Suban K. Sahoo

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The detection of intracellular fluoride in human cancer cell HeLa was achieved by chemosensors derived from vitamin B6 cofactors using fluorescence imaging technique. These sensors were first synthesized by condensation of pyridoxal/pyridoxal phosphate with 2-amino(thio)phenol. The anion recognition ability was explored by experimental (UV-VIS, fluorescence and 1H NMR) and theoretical DFT [(B3LYP/6-31G(d,p)] methods in DMSO and mixed DMSO-H2O system. All the developed sensors showed both naked-eye detectable color change and remarkable fluorescence enhancement in the presence of F- and AcO-. The anion recognition was occurred through the formation of hydrogen bonded complexes between these anions and sensor, followed by the partial deprotonation of sensor. The detection limit of these sensors were down to micro(nano) molar level of F- and AcO-.

Keywords: chemosensors, fluoride, acetate, turn-on, live cells imaging, DFT

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897 Understanding John H. Johnson and Ebony Magazine Financial Responsiveness to Rise of Black Power in the U.S, 1966

Authors: Sid Ahmed Ziane

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This paper argues for Johnson's financial responsiveness to the rise of Black Power and its advocate, 'Stokely Carmichael' in 1966. John H. Johnson was a Black businessman and the owner of Ebony magazine, one of the widely read Black magazines in the U.S. His magazine, however, was designed only to promoting Black fashion, aesthetic, marketing, and consumerism. In mid-1966, the mainstream of the Civil Rights movement was heading into two distinct camps when some of its advocates, led by Stokely Carmichael, began to question the slow pace of the Civil Rights and sought to pursue a more radical approach to bring about upheaval to the Black community. Their new approach, however, propelled the national media into paying close attention to their activities, their new methods, and their radical orientations. In fact, the major White-oriented media discredited Carmichael and distorted his public image via sensational stories and race-mongering reports. However, the Black owned outlets such as The Liberator advocated his agendas, whereas other magazines such as The Crisis rejected them. Based on such oral sources and Ebony’s online issues, this paper adds and argues that Johnson had also responded to the rise of Black Power and Carmichael. This reaction had, in fact, aimed at scooping and selling Carmichael and his new orientation as well as advertising him in his magazine to attract the readers who showed a strong tendency to hear and read about the heyday and even the ferment of Black Power. This paper is part of an ongoing project which aims at framing our understanding of how the Black print media and the modern Black liberation struggle were correlated and could shape each other by appraising their agendas, milestones, and their pivotal figures.

Keywords: Black power, Ebony magazine, John Johson, Stokely Carmichael

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896 The Differentiation of Performances among Immigrant Entrepreneurs: A Biographical Approach

Authors: Daniela Gnarini

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This paper aims to contribute to the field of immigrants' entrepreneurial performance. The debate on immigrant entrepreneurship has been dominated by cultural explanations, which argue that immigrants’ entrepreneurial results are linked to groups’ characteristics. However, this approach does not consider important dimensions that influence entrepreneurial performances. Furthermore, cultural theories do not take into account the huge differences in performances also within the same ethnic group. For these reason, this study adopts a biographical approach, both at theoretical and at methodological level, which can allow to understand the main aspects that make the difference in immigrants' entrepreneurial performances, by exploring the narratives of immigrant entrepreneurs, who operate in the restaurant sector in two different Italian metropolitan areas: Milan and Rome. Through the qualitative method of biographical interviews, this study analyses four main dimensions and their combinations: a) individuals' entrepreneurial and migratory path: this aspect is particularly relevant to understand the biographical resources of immigrant entrepreneurs and their change and evolution during time; b) entrepreneurs' social capital, with a particular focus on their networks, through the adoption of a transnational perspective, that takes into account both the local level and the transnational connections. This study highlights that, though entrepreneurs’ connections are significant, especially as far as those with family members are concerned, often their entrepreneurial path assumes an individualised trajectory. c) Entrepreneurs' human capital, including both formal education and skills acquired through informal channels. The latter are particularly relevant since in the interviews and data collected the role of informal transmission emerges. d) Embeddedness within the social, political and economic context, to understand the main constraints and opportunities both at local and national level. The comparison between two different metropolitan areas within the same country helps to understand this dimension.

Keywords: biographies, immigrant entrepreneurs, life stories, performance

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895 Understanding the Impact of Ephemerality and Mobility on Social Media News: A Content Analysis of News on Snapchat

Authors: Chelsea Peterson-Salahuddin

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Over the past decade, news outlets have increasingly used social media as a means to create and distribute news content to audiences. Ephemerality, the transitory nature of media, and mobility, media viewing on mobile technologies, are two increasingly salient attributes of social media content; yet little is known about how these features influence news selection practices of news outlets when distributing news via social media. To account for this gap, this study examines the influences of ephemerality and mobility on social media news content on the social media application Snapchat, in order to understand how these qualities of digital media influence and shape news content. Findings from this study suggest that understandings of ephemerality and mobility play a key role in influencing social media news. This paper suggests that as these factors become increasingly salient in our dominant news viewing environments, being able to understand how they manifest themselves in online news reporting practices is critical for both scholars and practitioners of news as they aim to understand what 'newsworthiness' means in the current, digital age. Findings from this study also enhance our current understandings of how the technological affordances of online and digital media platforms play a key role in shaping the kinds being produced and what information is being prioritized and highlighted in our contemporary news media environment. This is especially important in our current era where new mediums and technologies for news dissemination are continuously arising, and reorienting our understandings of what is considered ‘news'. As a key site of mass communication, discourse, and stories highlighted in the news do critical work in defining culture and ideology. Thus, better understanding the contours of news in our contemporary moment is critical in understanding cultural norms and meaning-making.

Keywords: content analysis, ephemerality, mobile communication, social media news

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894 Metagenomics, Urinary Microbiome, and Chronic Prostatitis

Authors: Elmira Davasaz Tabrizi, Mushteba Sevil, Ercan Arican

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Directly or indirectly, the human microbiome, or the population of bacteria and other microorganisms living in the human body, has been linked with human health. Various research has examined the connection with both illness status and the composition of the human microbiome, even though current studies indicate that the gut microbiome influences the mucosa and immune system. A significant amount of effort is being put into understanding the human microbiome's natural history in terms of health outcomes while also expanding our comprehension of the molecular connections between the microbiome and the host. To maintain health and avoid disease, these efforts ultimately seek to find efficient methods for recovering human microbial communities. This review article describes how the human microbiome leads to chronic diseases and discusses evidence for an important significant disorder that is related to the microbiome and linked to prostate cancer: chronic prostatitis (CP).

Keywords: urobiome, chronic prostatitis, metagenomic, urinary microbiome

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893 Maternal Review: Challenges Experienced by Midwives in Malawi

Authors: Mercy D. Chirwa, Juliet Nyasulu, Lebisti Modiba, Makombo Ganga-Limando

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Maternal death review is an initiative that provides a deeper understanding of the causes and circumstances sorounding of maternal deaths in Malawi and globally. Midwives are frontline members of the healthcare team and have stories about what pregnant women go through as such they are better placed to contribute to these reviews. Despite midwives’ participation as members of the facility-based maternal death review team, maternal deaths continues to occur. A lot has been documented around processes involved in maternal review, however, not much has been written around challenges experienced by midwives in maternal death review. This study explored the challenges faced by midwives in the implementation of maternal death reviews in the context of the healthcare system in Malawi. Methodology: This was a qualitative exploratory study design. Focus group discussions and individual face-to-face interviews were used to collect data in the study. A total of 40 midwives, who met the inclusion criteria, participated in the study. Data was analysed manually using a thematic content procedure. Findings: The four major challenges identified were: knowledge and skill gaps; lack of leadership and accountability; lack of institutional political will and inconsistency in conducting FBMDR, impeding midwives’ effective contribution to the implementation of maternal death review. The practical solutions and recommendations that emerged were: need-based knowledge and skills updates, supportive leadership, effective and efficient interdisciplinary work ethics, and sustained availability of material and human resources. Conclusion: Midwives have the highest potential to contribute to the reduction of maternal deaths. Practice development strategies are required to improve their practice in all the areas they are challenged with.

Keywords: facility-based maternal death review, maternal deaths, midwife, midwife challenges

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