Search results for: muscle status

Authors: Sumit Kanwar, Manisha Chand, Gregory Gilot

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Background: Septic arthritis of the shoulder has infrequently been discussed. Focus on infection of the untouched shoulder has not heretofore been described. We present four patients with glenohumeral septic arthritis. Methods: Case 1: A 59 year old male with left shoulder pain in the anterior, posterior and superior aspects. Case 2: A 60 year old male with fever, chills, and generalized muscle aches. Case 3: A 70 year old male with right shoulder pain about the anterior and posterior aspects. Case 4: A 55 year old male with global right shoulder pain, swelling, and limited ROM. Results: In case 1, the left shoulder was affected. Physical examination, swelling was notable, there was global tenderness with a painful range of motion (ROM). The lab values indicated an erythrocyte sedimentation rate (ESR) of 96, and a C-reactive protein (CRP) of 304.30. Imaging studies were performed and MRI indicated a high suspicion for an abscess with osteomyelitis of the humeral head. Our second case’s left arm was affected. He had swelling, global tenderness and painful ROM. His ESR was 38, CRP was 14.9. X-ray showed severe arthritis. Case 3 differed with the right arm being affected. Again, global tenderness and painful ROM was observed. His ESR was 94, and CRP was 10.6. X-ray displayed an eroded glenoid space. Our fourth case’s right shoulder was affected. He had global tenderness and painful, limited ROM. ESR was 108 and CRP was 2.4. X-ray was non-significant. Discussion: Monoarticular septic arthritis of the virgin glenohumeral joint is seldom diagnosed in clinical practice. Common denominators include elevated ESR, painful, limited ROM, and involvement of the dominant arm. The male population is more frequently affected with an average age of 57. Septic arthritis is managed with incision and drainage or needle aspiration of synovial fluid supplemented with 3-6 weeks of intravenous antibiotics. Due to better irrigation and joint visualization, arthroscopy is preferred. Open surgical drainage may be indicated if the above methods fail. Conclusion: If a middle-aged male presents with vague anterior or posterior shoulder pain, elevated inflammatory markers and a low grade fever, an x-ray should be performed. If this displays degenerative joint disease, the complete further workup with advanced imaging, such as an MRI, CT scan, or an ultrasound. If these imaging modalities display anterior space joint effusion with soft tissue involvement, we can suspect septic arthritis of the untouched glenohumeral joint and surgery is indicated.

Keywords: glenohumeral joint, identification, infection, septic arthritis, shoulder

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Authors: Kateryna Pilyarchuk

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A dress has, since times immemorial, been used to communicate the wearer’s identity. When a new trend is born, fashionistas buy it not only with the purpose to beautify themselves, but also to acquire the collective identity. Fashion has become a means of narrating one’s stance and status. Thus, when one spends money on a brand, one pays for some unmaterial components associated with it. This paper will present some ways in which fashion magazines promote consumerism by drawing on women’s craving for collective identity and need to fill in their identity gap by means of a purchase. By applying the method of critical discursive psychology, it will present layers of ideology and positions that become visible in framing of the message in U.S. Harper’s Bazaar. In this context, fashion decisions that are presented to its readers will be critically evaluated from the gender perspective. It will be demonstrated that what is presented as a postfeminist choice in the neoliberal society is still, to a considerable extent, oppressive and driven by the male gaze. As the findings show, the contemporary female identities in fashion are still built on the principles of traditional femininity. Magazines and fashion discourse train women that they should fear being left out of fashion and, by extension, out of the category of the sexually appealing (from the male perspective).

Keywords: collective identity, critical discursive psychology, fashion discourse, identity gap

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Authors: Yong Seong Kim, Seongbin Hong, So Hun Kim, Moonsuk Nam

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Background: Patients who undergo thyroidectomy due to thyroid cancer often complain weight gain, although they are on suppressive thyroid hormone treatment. The aim of this study is to know whether thyroid cancer patients gain the weight after thyroidectomy and weight change is dependent on estrogen state or use of rhTSH. Material and Method: We performed a retrospective chart review of subjects receiving medical care at an academic medical center. Two hundred two patients who underwent total thyroidectomy were included. As a control group, patients with thyroid nodule and euthyroidism were matched for age, gender, menopausal status. The weight changes occurring over first one year and thyroid function were assessed. Results: Mean age was 51±12 years and patients was composed with 38% of premenopausal, 15 % perimenopausal women, 37% of postmenopausal women and 20% of men. Patients with thyroid cancer gained 2.2 kg during the first year. It’ was not significantly different with control. However, weigh change in perimenopausal and post menopausal women gained more weight than control (P <0.05). Age, baseline body weight and weight gain were not correlated. Discussion: Patient who had undergone thyroidectomy gained more weight than their control, especially in peri- and postmenopausal women. Patients in this age should be monitored for their weight carefully.

Keywords: weight gain, thyroidectomy, thyroid cancer, weight chance

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Authors: Bok Yae Chung, Eun Hee Oh

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Breast cancer patients require more nutritional interventions than others. However, a few studies have attempted to assess the overall nutritional status, to reduce body weight and BMI by improving diet, and to improve the prognosis of cancer for breast cancer patients. The purpose of this study was to evaluate the effect of diet intervention in the breast cancer patients through meta-analysis. For the study purpose, 16 studies were selected by using PubMed, ScienceDirect, ProQuest and CINAHL. Meta-analysis was performed using a random-effects model, and the effect size on outcome variables in breast cancer was calculated. The effect size for outcome variables of diet intervention was a large effect size. For heterogeneity, moderator analysis was performed using intervention type and intervention duration. All moderators did not significant difference. Diet intervention has significant positive effects on outcome variables in breast cancer. As a result, it is suggested that the timing of the intervention should be no more than six months, but a strategy for sustaining long-term intervention effects should be added if nutritional intervention is to be administered for breast cancer patients in the future.

Keywords: breast cancer, diet, mete-analysis, intervention

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Authors: Therese Scali

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Over the years, the European Union has continued to extend its action on lesbian, gay men, bisexual and transgender (LGBT) rights to a range of areas including access to justice, asylum, freedom of expression and assembly, parenting, and mutual recognition of civil status within the EU. The European Parliament has been a driving force behind such action adopting a range of resolutions calling for continued progress in this field. In particular, Belgium has been one of the first countries to legalize same-sex parenting and to create a general framework for action against negative attitudes towards gay and lesbian parents. The present paper aims at highlighting public healthcare workers’ attitudes towards different types of same-sex headed families in Belgium, and the content of their interventions in schools. Results revealed that attitudes can go from supportive to unsupportive, and participants do not show the same degree of support towards the different types of same-sex parenting. This contribution highlights work’s implication for public policy by understanding the resources and challenges that health-care professionals face in their work.

Keywords: attitudes, gay and lesbian parents, health-care workers, homophobia, prevention

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Authors: Mostafa Kazemi, Zahra N. Farkhani

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This paper proposes an integrated Data Envelopment Analysis (DEA) and Variance Inflation Factor (VIF) model for measuring the technical efficiency of decision making units. The model is validated using a set of 69% sales representatives’ dairy products. The analysis is done in two stages, in the first stage, VIF technique is used to distinguish independent effective factors of resellers, and in the second stage we used DEA for measuring efficiency for both constant and variable return to scales status. Further DEA is used to examine the utilization of environmental factors on efficiency. Results of this paper indicated an average managerial efficiency of 83% in the whole sales representatives’ dairy products. In addition, technical and scale efficiency were counted 96% and 80% respectively. 38% of sales representative have the technical efficiency of 100% and 72% of the sales representative in terms of managerial efficiency are quite efficient.High levels of relative efficiency indicate a good condition for sales representative efficiency.

Keywords: data envelopment analysis (DEA), relative efficiency, sales representatives’ dairy products, variance inflation factor (VIF)

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Authors: Alieh Arasteh

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The main purpose of this study was to investigate the effect of parents and educators on the self-control of children in pre-primary schools in District 5 of Tehran. The method of this survey was a survey and post-correlation type. The statistical population of this study included all teachers and parents of children in preschool centers in the region. The 5th city of Tehran in 1397 was the number of kindergartens in 117 centers and the number of parents was 1872, the sample size of the parents was 320 and the sample size of the trainers was 76. The method of sampling in this study was randomized and clustered. The data gathering tool was Rosenbaum and Ronen (1992) self-control skills, a five-factor questionnaire NEO personality Costa and McCrae (1985) and a questionnaire on demographic characteristics, reliability using Cronbach's alpha, the data analysis was performed using the software spss24. The results of the research showed that the personality characteristics of parents, parents' socioeconomic status and personality traits of educators affect the self-control dimensions of pre-primary school children (P <0.05).

Keywords: self-control, pre-primary school, the effect of parents, couches

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Authors: Humberto Miranda, Haroldo G. Santana, Gabriel A. Paz, Vicente P. Lima, Jeffrey M. Willardson

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Foam rolling is a practice that has increased in popularity before and after strength training. The purpose of this study was to compare the acute effects of different foam rolling periods for the lower body muscles on subsequent performance (total repetitions and training volume), myoelectric activity and rating of perceived exertion in trained men. Fourteen trained men (26.2 ± 3.2 years, 178 ± 0.04 cm height, 82.2 ± 10 kg weight and body mass index 25.9 ± 3.3kg/m2) volunteered for this study. Four repetition maximum (4-RM) loads were determined for hexagonal bar deadlift and 45º angled leg press during test and retest sessions over two nonconsecutive days. Five experimental protocols were applied in a randomized design, which included: a traditional protocol (control)—a resistance training session without prior foam rolling; or resistance training sessions performed following one (P1), two (P2), three (P3), or four (P4) sets of 30 sec. foam rolling for the lower extremity musculature. Subjects were asked to roll over the medial and lateral aspects of each muscle group with as much pressure as possible. All foam rolling was completed at a cadence of 50 bpm. These procedures were performed on both sides unilaterally as described below. Quadriceps: between the apex of the patella and the ASIS; Hamstring: between the gluteal fold and popliteal fossa; Triceps surae: between popliteal fossa and calcaneus tendon. The resistance training consisted of five sets with 4-RM loads and two-minute rest intervals between sets, and a four-minute rest interval between the hexagonal bar deadlift and the 45º angled leg press. The number of repetitions completed, the myoelectric activity of vastus lateralis (VL), vastus medialis oblique (VMO), semitendinosus (SM) and medial gastrocnemius (GM) were recorded, as well as the rating of perceived exertion for each protocol. There were no differences between the protocols in the total repetitions for the hexagonal bar deadlift (Control - 16.2 ± 5.9; P1 - 16.9 ± 5.5; P2 - 19.2 ± 5.7; P3 - 19.4 ± 5.2; P4 - 17.2 ± 8.2) (p > 0.05) and 45º angled leg press (Control - 23.3 ± 9.7; P1 - 25.9 ± 9.5; P2 - 29.1 ± 13.8; P3 - 28.0 ± 11.7; P4 - 30.2 ± 11.2) exercises. Similar results between protocols were also noted for myoelectric activity (p > 0.05) and rating of perceived exertion (p > 0.05). Therefore, the results of the present study indicated no deleterious effects on performance, myoelectric activity and rating of perceived exertion responses during lower body resistance training.

Keywords: self myofascial release, foam rolling, electromyography, resistance training

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Authors: Ali Hamza, Bertug Akintug

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Having an appropriate plan of sanitation systems is one of the critical issues for global urban slums. Poor sanitation systems in urban slums outcomes an enhanced vulnerability of severe diseases, low hygiene and environmental risks within our environment. Mentioning human excreta being one of the most highly risked pollutants among all the other major contributors of sanitation pollutants is increasing public health risks and amounts of pollution loads within the slum environment. Higher population growth, urge of urbanization and illegal status of urban slums makes it impossible to increase the level of performance of sanitation systems in urban slums. According to Sustainable Sanitation Alliance, design parameters for sanitation systems were set up to ensure sustainable environment. This paper reviews the characteristics of human excreta at present, treatment technologies, and procedures of processes that can be adopted feasibly in the urban slums. Keeping these factors as our significant concern of study, assessment of sustainable sanitation systems is done using sanitation chain concept in accordance to the pre-determined sustainability indicators and criteria which reflect the potential and feasible application of waterless sanitation systems bringing sustainable sanitation systems in urban slums.

Keywords: human excreta, sanitation chain, sustainable sanitation systems, urban slums

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Authors: Amelia Tero-Vescan, Camil-Eugen Vari, Laura Ciulea, Cristina Filip, Silvia Imre

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A HPLC –UV method for the identification of ephedrine (EPH), sibutramine (SB), yohimbine (Y) and caffeine (CF) was developed. Separation was performed on a Kromasil 100-RP8, 150 mm x 4.6 mm, 5 mm column equipped with a precolumn Kromasil RP 8. Mobile phase was a gradient of 80-35 % sodium dihydrogen phosphate pH=5 with NH4OH and acetonitrile over 15 minutes time of analysis. Based on the responses of 113 athletes about dietary supplements (DS) consumed for "fat burning" and weight loss which have a legal status in Romania, 28 supplements have been selected and investigated for their content in CF, Y, legal substances, and SB, EPH (prohibited substances in DS). The method allows quantitative determination of the four substances in a short analysis time and with minimum cost. The presence of SB and EPH in the analyzed DS was not detected while the content in CF and Y considering the dosage recommended by the manufacturer does not affect the health of the consumers. DS labeling (plant extracts with CF and Y content) allows manufacturers to avoid declaring correct and exact amounts per pharmaceutical form (pure CF or equivalent and Y, respectively).

Keywords: dietary supplements, sibutramine, ephedrine, yohimbine, caffeine, HPLC

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Authors: Mo Zhou, Samantha Ashby, Lyn Ebert

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In China, the changes that men experience in the perinatal period are not well researched. Men are also at risk of maladaptation to parenthood. The aim of this research is to review current studies regarding changes that Chinese men experience during transitioning to parenthood. 5 databases were employed to search relevant papers. The search found 128 articles. Based on the inclusion and exclusion criteria, 35 articles were included in this integrative review. Results showed the changes that Chinese fathers experienced during the transition to parenthood can be divided into two aspects: family relationships and mental problems. During transition to parenthood, fathers usually experienced an increase in their disappointment with marital conflict resolution and decreased sexual intimacy with their partner. Mental health declined, with fathers often feeling depressed and/or anxious during this time. Some men were diagnosed with clinical depression. The predictors of these changes included three domains: personal background (age and income), family background (gender of infant, relationship status and unplanned child) and cultural background (‘doing the month’, Confucianism, policy, social support).

Keywords: China, men, fatherhood, life change, postpartum

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Authors: Atef Mohamed Kamel Ahmed

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House crows (Corvus splendens) have become well-established in Ismailia Governorate, Egypt, where they pose several and serious impacts on native biodiversity, ecosystems and humans health. However, there is a lack of literature on the status and effects of invasive birds in Egypt. Over the past 10 years in Ismailia, House crow have increased at a rate approaching (60000 birds)15% per annum; if this were allowed to continue, the population now 10909 birds and will exceed more by 2013, probably accompanied by an increase in geographical distribution in all Suez canal regions and an exacerbation of the problems caused. Population control is recommended, involving improvements in urban hygiene and the capture of adult crows using stupefying baits. Suitable baits and stupefacient doses were identified and these should be used annually, just before the breeding season. Control should be accompanied by studies of relevant aspects of the biology of house crows in Ismailia Governorate.

Keywords: environmental impact t, non-native invasive species, House crow birds, risk management, Ismailia-Egypt

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Authors: Anna Tokajuk, Agnieszka Zakrzeska, Ewa Chabielska, Halina Car

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Whey is a by-product generated mainly in the production of cheese and casein. Powder forms of whey are used widely in the food industry as well as a high-protein food for infants, for convalescents, by athletes and especially by bodybuilders to increase muscle mass during exercise. Whey protein concentrate-80 (WPC-80) is a source of bioactive peptides with beneficial effects on the cardiovascular system. It is known that whey proteins health beneficial properties include antidiabetic, blood pressure lowering, improving cardiovascular system function, antibacterial, antiviral and other effects. To study its influence on the development of thrombosis, venous thrombosis model was performed according to the protocol featured by Reyers with modification by Chabielska and Gromotowicz. Male Wistar-Crl: WI (Han) rats from researched groups were supplemented with two doses of WPC-80 (0.3 or 0.5 g/kg) for 7, 14 or 21 days and after these periods, one-hour venous thrombosis model was performed. Control group received 0.9 % NaCl solution and was sham operated. The statistical significance of results was computed by Mann – Whitney’s test. We observed that thrombus weight was decreased in animals obtaining WPC-8080 and that was statistically significant in 14 and 21-day supplemented groups. Blood count parameters did not differ significantly in rats with and without thrombosis induction whether they were fed with WPC-80 or not. Moreover, the number of platelets (PLT) was within the normal range in each group. The examined coagulation parameters in rats of the control groups were within normal limits. After WPC-80 supplementation there was the tendency to prolonged activated partial thromboplastin time (aPTT), but in comparison, the results did not turn out significant. In animals that received WPC-80 0.3 g·kg-1 for 21 days with and without induced thrombosis, prothrombin time (PT) and an international normalized ratio (INR) was somewhat decreased, remaining within the normal range, but the nature and significance of this observation are beyond the framework of the current study. Additionally, fibrinogen and thrombin time (TT) did not differ significantly between groups. Therefore the exact effect of WPC-80 on coagulation system is still elusive and requires further thorough research including mechanisms of action. Determining the potential clinical application of WPC-80 requires the selection of the optimal dose and duration of supplementation.

Keywords: antithrombotic, rats, venous thrombosis, WPC-80

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Authors: Theodosios Paralikas, Evangelia Kotrotsiou, Mairy Gouva, Manolis Mentis, Stiliani Stavrotheodorou, Stiliani Kotrotsiou, Maria Malliarou

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There is a big discussion in the international literature on empathy, job satisfaction and job occupational among various of disciplines, including social workers. Νevertheless these parameters have not been specifically studied in the Greek territory. This paper aims to study empathy of social workers, to produce results related to whether empathy is influenced by demographic factors such as gender, age, marital status, level of education and study their perceived stress levels and also the satisfaction they derive from their work. For the first time, an attempt is made to link the empathy of these professionals to their job satisfaction and their anxiety. The sample of this survey consists of 165 social workers working on providers of public and private social services. The results showed that social workers have high levels of empathy contrary to the perceived stress levels which were low to moderate. Regarding the field of the job satisfaction, the survey showed that social workers are very satisfied with their workpiece and workplace. The survey shows no significant relationship between empathy and demographic factors, but there is a significant relationship between empathy and the workpiece/job satisfaction and the feeling of success.

Keywords: empathy, stress, job satisfaction, social workers

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Authors: Terryann Clark, Kabir Dasgupta, Sonia Lewycka, Gail Pacheco, Alexander Plum

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This paper focused on two main research aims using data from the Growing Up in New Zealand (GUINZ) birth cohort: 1. To examine ethnic differences in life-course trajectories in the use and experience of healthcare services in early childhood years (namely immunisation, dental checks and use of General Practitioners (GPs)) 2. To quantify the contribution of relevant explanatory factors to ethnic differences. Current policy in New Zealand indicates there should be, in terms of associated direct costs, equitable access by ethnicity for healthcare services. However, empirical evidence points to persistent ethnic gaps in several domains. For example, the data highlighted that Māori have the lowest immunisation rates, across a number of time points in early childhood – despite having a higher antenatal intention to immunise relative to NZ European. Further to that, NZ European are much more likely to have their first-choice lead maternity caregiver (LMC) and use child dental services compared to all ethnicities. Method: This research explored the underlying mechanisms behind ethnic differences in the use and experience of child healthcare services. First, a multivariate regression analysis was used to adjust raw ethnic gaps in child health care utilisation by relevant covariates. This included a range of factors, encompassing mobility, socio-economic status, mother and child characteristics, household characteristics and other social aspects. Second, a decomposition analysis was used to assess the proportion of each ethnic gap that can be explained, as well as the main drivers behind the explained component. The analysis for both econometric approaches was repeated for each data time point available, which included antenatal, 9 months, 2 years and 4 years post-birth. Results: The following findings emerged: There is consistent evidence that Asian and Pacific peoples have a higher likelihood of child immunisation relative to NZ Europeans and Māori. This was evident at all time points except one. Pacific peoples had a lower rate relative to NZ European for receiving all first-year immunisations on time. For a number of potential individual and household predictors of healthcare service utilisation, the association is time-variant across early childhood. For example, socio-economic status appears highly relevant for timely immunisations in a child’s first year, but is then insignificant for the 15 month immunisations and those at age 4. Social factors play a key role. This included discouragement or encouragement regarding child immunisation. When broken down by source, discouragement by family has the largest marginal effect, followed by health professionals; whereas for encouragement, medical professionals have the largest positive influence. Perceived ethnically motivated discrimination by a health professional was significant with respect to both reducing the likelihood of achieving first choice LMC, and also satisfaction levels with child’s GP. Some ethnic gaps were largely unexplained, despite the wealth of factors employed as independent variables in our analysis. This included understanding why Pacific mothers are much less likely to achieve their first choice LMC compared to NZ Europeans; and also the ethnic gaps for both Māori and Pacific peoples relative to NZ Europeans concerning dental service use.

Keywords: child health, cohort analysis, ethnic disparities, primary healthcare

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Authors: Allyson Augusta Shrikhande, Alexa Rains, Tayyaba Ahmed, Marjorie Mamsaang, Rakhi Vyas, Janaki Natarajan, Erika Moody, Christian Reutter, Kimberlee Leishear, Yogita Tailor, Sandra Sandhu-Restaino, Lora Liu, Neha James, Rosemarie Filart

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Characterized by consistent difficulty getting and keeping an erection firm enough for intercourse, Erectile Dysfunction may affect up to 15% of adult men. Although awareness and access to treatment have improved in recent years, many patients do not actively seek diagnosis or treatment due to the stigma surrounding this condition. Patients who do seek treatment are often dissatisfied by the efficacy of the medication. The condition inhibits patients’ quality of life by worsening mental health and relationships. The purpose of this study was to test the effectiveness of an outpatient neuromuscular treatment protocol in treating the symptoms of Chronic Pelvic Pain and Erectile Dysfunction, improving pain and function. 56 patients ages 20-79 presented to an outpatient clinic for treatment of pelvic pain and Erectile Dysfunction symptoms. These symptoms had persisted for an average of 4 years. All patients underwent external ultrasound-guided hydro-dissection technique targeted at pelvic peripheral nerves in combination with pelvic floor musculature trigger-point injections. To measure the effects of this treatment, a five question Erectile Dysfunction questionnaire was completed by each patient at their first visit to a clinic and three months after treatment began. Answers were summed for a total score of 5-25, with a higher score indicating optimal function. The average score before treatment was 14.125 (SD 5.411) (a=0.05; CI 12.708-15.542), which increased by 18% to an average of 16.625 (SD 6.423) (a=0.05; CI 14.943-18.307) after treatment (P=0.0004). Secondary outcome variables included a Visual Analogue Scale (VAS) to measure pelvic pain intensity and the Functional Pelvic Pain Scale (FPPS) to measure function across multiple areas. VAS scores reduced by 51% after three months. Before treatment, the mean VAS score was 5.87, and the posttreatment mean VAS score was 2.89. Pelvic pain functionality improved by 34% after three months. Pretreatment FPPS scores averaged at 7.48, decreasing to 4.91 after treatment. These results indicate that this unique treatment was very effective at relieving pain and increasing function for patients with Erectile Dysfunction.

Keywords: chronic pelvic pain, erectile dysfunction, nonsurgical, outpatient, trigger point injections

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Authors: Abdullah Nurus Salam Khan, Farhana Karim, Mohiuddin Ahsanul Kabir Chowdhury, S. Masum Billah, Nabila Zaka, Alexander Manu, Shams El Arifeen

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Globally, pre-eclampsia (PE) and ante-partum haemorrhage (APH) are two major causes of maternal mortality. Prompt identification and management of these conditions depend on competency of the birth attendants. Since these conditions are infrequent to be observed, clinical vignette based assessment could identify the extent of health worker’s competence in managing emergency obstetric care (EmOC). During June-August 2016, competence of 39 medical officers (MO) and 95 nurses working in obstetric ward of 15 government health facilities (3 district hospital, 12 sub-district hospital) was measured using clinical vignettes on PE and APH. The vignettes resulted in three outcome measures: total vignette scores, scores for diagnosis component, and scores for management component. T-test was conducted to compare mean vignette scores and linear regression was conducted to measure the strength and association of vignette scores with different cadres of health workers, facility’s readiness for EmOC and average annual utilization of normal deliveries after adjusting for type of health facility, health workers’ work experience, training status on managing maternal complication. For each of the seven component of EmOC items (administration of injectable antibiotics, oxytocic and anticonvulsant; manual removal of retained placenta, retained products of conception; blood transfusion and caesarean delivery), if any was practised in the facility within last 6 months, a point was added and cumulative EmOC readiness score (range: 0-7) was generated for each facility. The yearly utilization of delivery cases were identified by taking the average of all normal deliveries conducted during three years (2013-2015) preceding the survey. About 31% of MO and all nurses were female. Mean ( ± sd) age of the nurses were higher than the MO (40.0 ± 6.9 vs. 32.2 ± 6.1 years) and also longer mean( ± sd) working experience (8.9 ± 7.9 vs. 1.9 ± 3.9 years). About 80% health workers received any training on managing maternal complication, however, only 7% received any refresher’s training within last 12 months. The overall vignette score was 8.8 (range: 0-19), which was significantly higher among MO than nurses (10.7 vs. 8.1, p < 0.001) and the score was not associated with health facility types, training status and years of experience of the providers. Vignette score for management component (range: 0-9) increased with higher annual average number of deliveries in their respective working facility (adjusted β-coefficient 0.16, CI 0.03-0.28, p=0.01) and increased with each unit increase in EmOC readiness score (adjusted β-coefficient 0.44, CI 0.04-0.8, p=0.03). The diagnosis component of vignette score was not associated with any of the factors except it was higher among the MO than the nurses (adjusted β-coefficient 1.2, CI 0.13-2.18, p=0.03). Lack of competence in diagnosing and managing obstetric complication by the nurses than the MO is of concern especially when majority of normal deliveries are conducted by the nurses. Better EmOC preparedness of the facility and higher utilization of normal deliveries resulted in higher vignette score for the management component; implying the impact of experiential learning through higher case management. Focus should be given on improving the facility readiness for EmOC and providing the health workers periodic refresher’s training to make them more competent in managing obstetric cases.

Keywords: Bangladesh, emergency obstetric care, clinical vignette, competence of health workers

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Authors: M. Skibinska, A. Rajewska-Rager, M. Dmitrzak-Weglarz, N. Lepczynska, P. Sibilski, P. Kapelski, J. Pawlak, J. Twarowska-Hauser

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Introduction: Neurotrophic factors have been implicated in neuropsychiatric disorders. Brain-Derived Neurotrophic Factor (BDNF) influences neuron differentiation in development as well as synaptic plasticity and neuron survival in adulthood. BDNF is widely studied in mood disorders and has been proposed as a biomarker for depression. BDNF is synthesized as precursor protein – proBDNF. Both forms are biologically active and exert opposite effects on neurons. Aim: The aim of the study was to examine the serum levels of BDNF and proBDNF in unipolar and bipolar young patients below 24 years old during hypo/manic, depressive episodes and in remission compared to healthy control group. Methods: In a prospective 2 years follow-up study, we investigated alterations in levels of BDNF and proBDNF in 79 patients (23 males, mean age 19.08, SD 3.3 and 56 females, mean age 18.39, SD 3.28) diagnosed with mood disorders: unipolar and bipolar disorder compared with 35 healthy control subjects (7 males, mean age 20.43, SD 4.23 and 28 females, mean age 21.25, SD 2.11). Clinical characteristics including mood, comorbidity, family history, and treatment, were evaluated during control visits and clinical symptoms were rated using the Hamilton Depression Rating Scale and Young Mania Rating Scale. Serum BDNF and proBDNF concentrations were determined by Enzyme-Linked Immunosorbent Assays (ELISA) method. Serum BDNF and proBDNF levels were analysed with covariates: sex, age, age > 18 and < 18 years old, family history of affective disorders, drug-free vs. medicated status. Normality of the data was tested using Shapiro-Wilk test. Levene’s test was used to calculate homogeneity of variance. Non-parametric Tests: Mann-Whitney U test, Kruskal-Wallis ANOVA, Friedman’s ANOVA, Wilcoxon signed rank test, Spearman correlation coefficient were applied in analyses The statistical significance level was set at p < 0.05. Results: BDNF and proBDNF serum levels did not differ between patients at baseline and controls as well as comparing patients in acute episode of depression/hypo/mania at baseline and euthymia (at month 3 or 6). Comparing BDNF and proBDNF levels between patients in euthymia and control group no differences have been found. Increased BDNF level in women compared to men at baseline (p=0.01) have been observed. BDNF level at baseline was negatively correlated with depression and mania occurence at 24 month (p=0.04). BDNF level at 12 month was negatively correlated with depression and mania occurence at 12 month (p=0.01). Correlation of BDNF level with sex have been detected (p=0.01). proBDNF levels at month 3, 6 and 12 negatively correlated with disease status (p=0.02, p=0.008, p=0.009, respectively). No other correlations of BDNF and proBDNF levels with clinical and demographical variables have been detected. Discussion: Our results did not show any differences in BDNF and proBDNF levels between depression, mania, euthymia, and controls. Imbalance in BDNF/proBDNF signalling may be involved in pathogenesis of mood disorders. Further studies on larger groups are recommended. Grant was founded by National Science Center in Poland no 2011/03/D/NZ5/06146.

Keywords: bipolar disorder, Brain-Derived Neurotrophic Factor (BDNF), proBDNF, unipolar depression

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Authors: Hwayeon Song

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The long-term purpose of research and development (R&D) programs is to strengthen national competitiveness by developing new knowledge and technologies. Thus, it is important to determine a proper budget for government programs to maintain the vigor of R&D when the total funding is tight due to the national deficit. In this regard, a ripple effect analysis for the budgetary changes in R&D programs is necessary as well as an investigation of the current status. This study proposes a new approach using Artificial Neural Networks (ANN) for both tasks. It particularly focuses on R&D programs related to Construction and Transportation (C&T) technology in Korea. First, key factors in C&T technology are explored to draw impact indicators in three areas: economy, society, and science and technology (S&T). Simultaneously, ANN is employed to evaluate the relationship between data variables. From this process, four major components in R&D including research personnel, expenses, management, and equipment are assessed. Then the ripple effect analysis is performed to see the changes in the hypothetical future by modifying current data. Any research findings can offer an alternative strategy about R&D programs as well as a new analysis tool.

Keywords: Artificial Neural Networks, construction and transportation technology, Government Research and Development, Ripple Effect

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Authors: I. O. Oyatayo, K. T. Oyatayo, B. Mamman

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This study was aimed at the assessment of heavy metal pollution of the water in river Benue along Ibi, Taraba State, Nigeria. Water samples were collected at ten sampling points over a distance of 100 meters each. The following water quality parameters were determined: TDS, copper, zinc, chromium, iron, mercury, nickel, and manganese, and the results were compared with the Nigerian Standard for Drinking Water Quality (NSDWQ) and WHO maximum permitted limits. The water quality analysis was conducted using the atomic absorption spectrophotometer (Model: 01-0960-00) at 510 nm. The mean value concentrations of copper, zinc, chromium, nickel, mercury, and mercury are within the permissible limits, while that of iron is above the limit. The summary of ANOVA single-factor statistics with a specified rejection level at α 0.05 is insignificant. The study concludes that the quality of water from river Benue along Ibi is deteriorating and unfit for human consumption. It was recommended that residents of the study area should be enlightened on the effects of indiscriminate dumping of waste and the proper handling and application of fertilizer and herbicides, as some of these end up in the river via surface runoff.

Keywords: heavy, metal, pollution, river, Ibi

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Authors: Rajnish Gupta, R. S. Gupta

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Present research was aimed to investigate antidiabetic and antioxidant status of Lupeol in streptozotocin induced diabetes. Rats were divided into following groups mainly: control, diabetic, normal group as well as diabetic treated with Lupeol at 25 and 35 mg/kg b.wt./day for 21 days, diabetic group treated with glibenclamide. Tissue (pancreas, kidney and liver) as well as serum biochemical parameters were analysed for any abnormal behavior. Lupeol administration reduced diabetes onset with significant improvement in serum insulin level also strengthened by increase in β-Cell counts. A significant decrease was observed in serum glucose level. Furthermore, Lupeol treatment increased the antioxidant enzymes, glycolytic enzymes and also protein levels with a decrease in the level of thiobarbituric acid-reactive oxygen species and gluconeogenic enzymes. Present study proves that Lupeol administration significantly reinstated serum and tissue biochemical parameters and thus strengthening its antidiabetic potential.

Keywords: oxidative stress, pterostilbene, thiobarbituric acid, reactive oxygen species

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Authors: Zeinab Jafari A., Ali Sharifnezhad B., Mohammad Razi C., Mohammad Haghpanahi D., Arash Maghsoudi

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Background and Objective: Sports-related rupture of the anterior cruciate ligament (ACL) and following injuries have been associated with various disorders, such as long-lasting changes in muscle activation patterns in athletes, which might last after ACL reconstruction (ACLR). The rupture of the ACL might result in abnormal patterns of movement execution, extending the treatment period and delaying athletes’ return to sports (RTS). As ACL injury is especially prevalent among athletes, the lengthy treatment process and athletes’ absence from sports are of great concern to athletes and coaches. Thus, estimating safe time of RTS is of crucial importance. Therefore, using a deep neural network (DNN) to classify the health levels of ACL in injured athletes, this study aimed to estimate the safe time for athletes to return to competitions. Methods: Ten athletes with ACLR and fourteen healthy controls participated in this study. Three health levels of ACL were defined: healthy, six-month post-ACLR surgery and nine-month post-ACLR surgery. Athletes with ACLR were tested six and nine months after the ACLR surgery. During the course of this study, surface electromyography (sEMG) signals were recorded from five knee muscles, namely Rectus Femoris (RF), Vastus Lateralis (VL), Vastus Medialis (VM), Biceps Femoris (BF), Semitendinosus (ST), during single-leg drop landing (SLDL) and forward hopping (SLFH) tasks. The Pseudo-Wigner-Ville distribution (PWVD) was used to produce three-dimensional (3-D) images of the energy distribution patterns of sEMG signals. Then, these 3-D images were converted to two-dimensional (2-D) images implementing the heat mapping technique, which were then fed to a deep convolutional neural network (DCNN). Results: In this study, we estimated the safe time of RTS by designing a DCNN classifier with an accuracy of 90 %, which could classify ACL into three health levels. Discussion: The findings of this study demonstrate the potential of the DCNN classification technique using sEMG signals in estimating RTS time, which will assist in evaluating the recovery process of ACLR in athletes.

Keywords: anterior cruciate ligament reconstruction, return to sports, surface electromyography, deep convolutional neural network

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Authors: K. C. Wong

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This paper demonstrates a number of examples in the hope to shed some light on the possibility of designing future operating systems in a more adaptation-based manner. A modern operating system, we conceive, should possess the capability of 'learning' in such a way that it can dynamically adjust its services and behavior according to the current status of the environment in which it operates. In other words, a modern operating system should play a more proactive role during the session of providing system services to users. As such, a modern operating system is expected to create a computing environment, in which its users are provided with system services more matching their dynamically changing needs. The examples demonstrated in this paper show that user's resource access patterns 'learned' and determined during a session can be utilized to improve system performance and hence to provide users with a better and more effective computing environment. The paper also discusses how to use the frequency, the continuity, and the duration of resource accesses in a session to quantitatively measure and determine user's resource access patterns for the examples shown in the paper.

Keywords: adaptation-based systems, operating systems, resource access patterns, system performance

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Authors: Mark Gavriel, Ariel J. Jaffa, Dan Grisaru, David Elad

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The human endometrium-myometrium interface (EMI) is the uterine inner barrier without a separatig layer. It is composed of endometrial epithelial cells (EEC) and endometrial stromal cells (ESC) in the endometrium and myometrial smooth muscle cells (MSMC) in the myometrium. The EMI undergoes structural remodeling during the menstruation cycle which are essential for human reproduction. Recently, we co-cultured a layer-by-layer in vitro model of EEC, ESC and MSMC on a synthetic membrane for mechanobiology experiments. We also treated the model with progesterone and β-estradiol in order to mimic the in vivo receptive uterus In the present study we analyzed the cytokines profile in a single layer of EEC the hormonal treated in vitro model of the EMI. The methodologies of this research include simple tissue-engineering . First, we cultured commercial EEC (RL95-2, ATCC® CRL-1671™) in 24-wellplate. Then, we applied an hormonal stimuli protocol with 17-β-estradiol and progesterone in time dependent concentration according to the human physiology that mimics the menstrual cycle. We collected cell supernatant samples of control, pre-ovulation, ovulation and post-ovulaton periods for analysis of the secreted proteins and cytokines. The cytokine profiling was performed using the Proteome Profiler Human XL Cytokine Array Kit (R&D Systems, Inc., USA) that can detect105 human soluble cytokines. The relative quantification of all the cytokines will be analyzed using xMAP – LUMINEX. We conducted a fishing expedition with the 4 membranes Proteome Profiler. We processed the images, quantified the spots intensity and normalized these values by the negative control and reference spots at the membrane. Analyses of the relative quantities that reflected change higher than 5% of the control points of the kit revealed the The results clearly showed that there are significant changes in the cytokine level for inflammation and angiogenesis pathways. Analysis of tissue-engineered models of the uterine wall will enable deeper investigation of molecular and biomechanical aspects of early reproductive stages (e.g. the window of implantation) or developments of pathologies.

Keywords: tissue-engineering, hormonal stimuli, reproduction, multi-layer uterine model, progesterone, β-estradiol, receptive uterine model, fertility

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Authors: Dave Kenneth Tayao Cayado, Carlo P. Magno

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The most common source of bias detected are those of gender and socioeconomic status. The present study investigated the Differential Item Functioning (DIF) or item bias between public and private school students in a vocabulary test. Studies on DIF were expanded by using the type of school as a source of bias. There were 200 participants in this study. 100 came from a public secondary school and 100 came from a private secondary school. The vocabulary skills of students were measured using a standardized vocabulary test for grade 7 students. Using DIF, specifically the Rasch-Welch approach, it was found that out of 24 items, 12 were biased for a specific group. The vocabulary skills on the use of slang, idiomatic expression, personification, collocations, and partitive relations were biased for private schools while the use of slang and homonymous words were biased for public school students. The analysis debunked the trend that private school students are outperforming public school students in terms of academic achievement. It was revealed that there are some competencies that private school students are having difficulty and vice versa.

Keywords: differential item functioning, item bias, public school students, private school students, vocabulary

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Authors: T. Prommi, P. Thamsenanupap

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The influence of physicochemical water quality parameters on the abundance and diversity of caddisfly larvae was studied in seven sampling stations in Mae Tao and Mae Ku watersheds, Mae Sot District, Tak Province, northern Thailand. The streams: MK2 and MK8 as reference site, and impacted streams (MT1-MT5) were sampled bi-monthly during July 2011 to May 2012. A total of 4,584 individual of caddisfly larvae belonging to 10 family and 17 genera were found. The larvae of family Hydropsychidae were the most abundance, followed by Philopotamidae, Odontoceridae, and Leptoceridae, respectively. The genus Cheumatopsyche, Hydropsyche, and Chimarra were the most abundance genera in this study. Results of CCA ordination showed the total dissolved solids, sulfate, water temperature, dissolved oxygen and pH were the most important physicochemical factors to affect distribution of caddisflies communities. Changes in the caddisfly fauna may indicate changes in physicochemical factors owing to agricultural pollution, urbanization, or other human activities. Results revealed that the order Trichoptera, identified to species or genus, can be potentially used to assess environmental water quality status in freshwater ecosystems.

Keywords: Caddisfly larvae, environmental variables, diversity, streams

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Authors: Asiye Ciftci, Zeki Kaya

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Populus nigra is one of the most economically and ecologically important forest trees in Turkey, well known for its rapid growth, good ability to vegetative propagation and the extreme uses of its wood. Due to overexploitation, loss of natural distribution area and extreme hybridization and introgression, Populus nigra is one of the most threatened tree species in Turkey and Europe. Using 20 nuclear microsatellite loci, the genetic structure of European black poplar populations along the two largest rivers of Turkey was analyzed. All tested loci were highly polymorphic, displaying 5 to 15 alleles per locus. Observed heterozygosity (overall Ho = 0.79) has been higher than the expected (overall He = 0.58) in each population. Low level of genetic differentiation among populations (FST= 0,03) and excess of heterozygotes for each river were found. Human-mediated dispersal, phenotypic selection, high level of gene flow and extensive circulations of clonal materials may cause those situations. The genetic data obtained from this study could provide the basis for efficient in situ and ex-situ conservation and restoration of species natural populations in its natural habitat as well as having sustainable breeding and poplar plantations in the future.

Keywords: populus, clonal, loci, ex situ

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Authors: Diksha Kadam

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The study of images of women in literature and women writers has been a significant area of concern for the last four decades because it is as ‘the study of signification and meaning production’ play a vital role in shaping the perceptions and consciousness of various segment of society in relation to the lives, roles, problems and experiences of different categories of women as women and as autonomous citizen of society. In the history of worlds English literature the status of women and representation of her in the writings is an issue of discussion always. The essence of her existence in the literature is felt; the ecstasy of her feelings is always seen. The literature is full of facts and figures. She is one of them. Her contribution to the literature is undoubtedly a beginning of a new era. Multiple challenges and multiple identities as represented in majority of the literary texts and in real provide much hope and assurance to the new generation of mothers and daughters in the direction of transformation of the individual and collective consciousness of society paving way for the emergence of an actually empowered new woman. This paper will focus on some of the prominent Indian and American women writers in English literature and the various dimensions of her image through some of the prominent works. This attempt of mine will be merely a salute to those women who have struggled to prove their identity as one of the members of society.

Keywords: role of women’s writing, new era, contribution to the literature, consciousness, existence

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Authors: M. Hosseinnezhad, K. Gharanjig

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Natural dyes, extracted from black carrot and bramble, were utilized as photosensitizers to prepare dye-sensitized solar cells (DSSCs). Spectrophotometric studies of the natural dyes in solution and on a titanium dioxide substrate were carried out in order to assess changes in the status of the dyes. The results show that the bathochromic shift is seen on the photo-electrode substrate. The chemical binding of the natural dyes at the surface photo-electrode were increased by the chelating effect of the Ti(IV) ions. The cyclic voltammetry results showed that all extracts are suitable to be performed in DSSCs. Finally, photochemical performance and stability of DSSCs based on natural dyes were studied. The DSSCs sensitized by black carrot extract have been reported to achieve up to Jsc=1.17 mAcm^-2, Voc= 0.55 V, FF= 0.52, η=0.34%, whereas Bramble extract can obtain up to Jsc=2.24 mAcm^-2, Voc= 0.54 V, FF= 0.57, η=0.71%. The power conversion efficiency was obtained from the mixed dyes in DSSCs. The power conversion efficiency of dye-sensitized solar cells using mixed Black carrot and Bramble dye is the average of the their efficiency in single DSSCs.

Keywords: anthocyanin, dye-sensitized solar cells, green energy, optical materials

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Authors: Kiran Datta, Daniella Holland-Hart, Anthony Byrne

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Introduction: Oesophago-gastric (OG) cancers are the fifth commonest in the UK, accounting for over 12,000 deaths each year. Most patients will present at later stages of the disease, with only 21% of patients with stage 4 disease surviving longer than a year. As a result, many patients are unsuitable for curative surgery and instead receive palliative treatment to improve prognosis and symptom burden. However, palliative chemotherapy can result in significant toxicity: almost half of the patients are unable to complete their chemotherapy regimen, with this proportion rising significantly in older and frailer patients. In addition, clinical trials often exclude older and frailer patients due to strict inclusion criteria, meaning there is limited evidence to guide which patients are most likely to benefit from palliative chemotherapy. Inappropriate chemotherapy administration is at odds with the goals of palliative treatment and care, which are to improve quality of life, and this also represents a significant resource expenditure. This literature review aimed to examine and appraise evidence regarding treatment resilience in order to guide clinicians in identifying the most suitable candidates for palliative chemotherapy. Factors influencing treatment resilience were assessed, as measured by completion rates, dose reductions, and toxicities. Methods: This literature review was conducted using rapid review methodology, utilising modified systematic methods. A literature search was performed across the MEDLINE, EMBASE, and Cochrane Library databases, with results limited to papers within the last 15 years and available in English. Key inclusion criteria included: 1) participants with either oesophageal, gastro-oesophageal junction, or gastric cancers; 2) patients treated with palliative chemotherapy; 3) available data evaluating the association between baseline participant characteristics and treatment resilience. Results: Of the 2326 papers returned, 11 reports of 10 studies were included in this review after excluding duplicates and irrelevant papers. Treatment resilience factors that were assessed included: age, performance status, frailty, inflammatory markers, and sarcopenia. Age was generally a poor predictor for how well patients would tolerate chemotherapy, while poor performance status was a better indicator of the need for dose reduction and treatment non-completion. Frailty was assessed across one cohort using multiple screening tools and was an effective marker of the risk of toxicity and the requirement for dose reduction. Inflammatory markers included lymphopenia and the Glasgow Prognostic Score, which assessed inflammation and hypoalbuminaemia. Although quick to obtain and interpret, these findings appeared less reliable due to the inclusion of patients treated with palliative radiotherapy. Sarcopenia and body composition were often associated with chemotherapy toxicity but not the rate of regimen completion. Conclusion: This review demonstrates that there are numerous measures that can estimate the ability of patients with oesophago-gastric cancer to tolerate palliative chemotherapy, and these should be incorporated into clinical assessments to promote personalised decision-making around treatment. Age should not be a barrier to receiving chemotherapy and older and frailer patients should be included in future clinical trials to better represent typical patients with oesophago-gastric cancers. Decisions regarding palliative treatment should be guided by these factors identified as well as patient preference.

Keywords: frailty, oesophago-gastric cancer, palliative chemotherapy, treatment resilience

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