Search results for: mindfulness-based cognitive therapy

Authors: Reem Osama Yousif Ali, Osama Yousif Ali Al Gibali

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Introduction: Balanced nutrition is undeniably essential for maintaining health, body functions, and integrity of cell metabolism; however, some sick patients cannot tolerate oral or enteral feeding to meet their nutritional needs, so partial or total parenteral nutrition (PN) may be the most suitable alternative route in such situations. Dietitians are fundamental personnel among the medical team to ensure the proper provision of PN service, which was introduced in Sudan in the 1980s. Objective: The study aimed to recognize the dietitians' awareness of parenteral nutrition and their role in providing this service in Sudan – Khartoum State. Methodology: Formulated questionnaire forms composed of twelve questions were distributed to the dietitians working in four tertiary level hospitals. Results: The majority (75%) of the responded dietitians had reasonable knowledge about the importance of PN, its advantages, and its indications. Sixty percent of them were mindful of the PN side effects. Most of the dietitians were aware of the different assessment measurements and PN calculations and were exposed in their clinical practice to patients who were in need of PN, but only a few of them (about 30%) had the actual chance to participate in the formulation and application of PN therapy. The unavailability of the multidisciplinary team, lack of the required equipment and financial support, and associated complications were basic obstacles to the provision of long-term PN service in Khartoum state hospitals. Conclusion: Although dietitians in Khartoum state hospitals have good information about PN definition, indications, accesses, and assessment measures, they do not have enough knowledge and clinical exposure that make them confident to provide the PN service. Establishing a few models of parenteral nutrition units in tertiary hospitals will be of great help, as well as providing the dietitian's training in the area of parenteral nutrition. Further study can explore more requirements to run this service.

Keywords: nutrition support, dietitian, Sudan, parenteral nutrition, nutrition support team

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Authors: Randy S. Magdaluyo, Lea M. Cabar, Jefferson Q. Correa

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One recurring issue in ESL writing is the confusing differences in the writing conventions of the first language and the target language. Culture may play an intriguing role in specifying writing features and structures that ESL writers have to follow. Although writing is typically organized in a three-part structure with introduction, body, and conclusion, it is important to analyze the complex nature of ESL writing. This study investigated the organizational features and structures of argumentative essays written in English by thirty college ESL students from three linguistic backgrounds (Cebuano, Chavacao, and Tausug) in a Philippine university. The nature of word order and sentence construction in the students’ essays and the specific components of the introduction, body, and conclusion were quantitatively and qualitatively analyzed based on ESL writing models. Focus group discussions were also conducted to help clarify the possible influence of students’ first language on the ways their essays were conceptualized and organized. Results indicate that while there was no significant difference in the overall introduction, body, and conclusion in all essays, the sentence length was interestingly different for each linguistic group of ESL students, and the word order was notably inconsistent with the S-V-O pattern of the target language. The first language was also revealed to have a facilitative role in the cognitive translation process of these ESL students. As such, implications for a multicultural writing pedagogy was discussed and recommended considering both the students’ native resources in their first language and the ESL writing models in their target language.

Keywords: community funds of knowledge, contrastive rhetoric, ESL writing, multicultural writing pedagogy

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Authors: Stephen Osei Akyiaw, Divine Kwabena Atta Kyere-Owusu

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Malaria has been a worldwide menace of a health condition to human beings for several decades with majority of people on the African continent with most causalities where Ghana is no exception. Therefore, this study employed the use of animation to enhance awareness creation on the spread and prevention of Malaria in Effutu Communities in the Central Region of Ghana. Working with the interpretivist paradigm, this study adopted Art-Based Research, where the AIDA Model and Cognitive Theory of Multimedia Learning (CTML) served as the theories underpinning the study. Purposive and convenience sampling techniques were employed in selecting sample for the study. The data collection instruments included document review and interviews. Besides, the study developed an animation using the local language of the people as the voice over to foster proper understanding by the rural community folks. Also, indigenous characters were used for the animation for the purpose of familiarization with the local folks. The animation was publicized at Health Town Halls within the communities. The outcomes of the study demonstrated that the use of animation was effective in enhancing the awareness creation for preventing and controlling malaria disease in rural communities in Effutu Communities in the Central Region of Ghana. Health officers and community folks expressed interest and desire to practice the preventive measures outlined in the animation to help reduce the spread of Malaria in their communities. The study, therefore, recommended that animation could be used to curtail the spread and enhanced the prevention of Malaria.

Keywords: malaria, animation, prevention, communities

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Authors: Chrysanthi Nega, Fotini-Sonia Apergi

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Child sexual abuse (CSA) in Greece is a highly prevalent phenomenon and yet remains largely underreported. CSA can negatively impact cognitive, emotional and psychosocial development, as well as personality formation and capacity for initiation and maintenance of healthy interpersonal relationships. It is particularly important for school-based prevention programs to be implemented early in elementary school, as they are reportedly effective in lowering abuse incidences and providing knowledge for coping in threatening environments. The purpose of the current study was to test the effectiveness of a school-based CSA prevention program (Safe-Touches) on Greek elementary school students (grades 1-3, N=272) and explore the effect of age and time of testing (academic term). There was a significant effect of age in the knowledge of Inappropriate Touch, when comparing pre and post-intervention assessments, with third graders showing greatest gains in knowledge, followed by second and first graders. Time of testing during the academic year also had a significant effect, as first graders tested later in the school year, scored higher on knowledge of Inappropriate Touch. The findings of the current study provide insight into the optimal timing to implement CSA prevention programs. Exposure to such programs and incorporation in the school curricula could largely benefit children of the Greek community in terms of safety and awareness.

Keywords: child sexual abuse, Safe-Touches, school-based prevention, schooling

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Authors: Avirup Chowdhury, Angus K. McFadyen, Linsey Batchelor

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Blood cultures (BCs) are an important aspect of management of the septic patient, identifying the underlying pathogen and its antibiotic sensitivities. However, while the current literature outlines indications for initial BCs to be taken, there is little guidance for repeat sampling in the following 5-day period and little information on how antibiotic use can affect the usefulness of this investigation. A retrospective cohort study was conducted using inpatients who had undergone 2 or more BCs within 5 days between April 2016 and April 2017 at a 400-bed hospital in the west of Scotland and received antibiotic therapy between the first and second BCs. The data for BC sampling was collected from the electronic microbiology database, and cross-referenced with data from the hospital electronic prescribing system. Overall, 283 BCs were included in the study, taken from 92 patients (mean 3.08 cultures per patient, range 2-10). All 92 patients had initial BCs, of which 83 were positive (90%). 65 had a further sample within 24 hours of commencement of antibiotics, with 35 positive (54%). 23 had samples within 24-48 hours, with 4 (17%) positive; 12 patients had sampling at 48-72 hours, 12 at 72-96 hours, and 10 at 96-120 hours, with none positive. McNemar’s Exact Test was used to calculate statistical significance for patients who received blood cultures in multiple time blocks (Initial, < 24h, 24-120h, > 120h). For initial vs. < 24h-post BCs (53 patients tested), the proportion of positives fell from 46/53 to 29/53 (one-tailed P=0.002, OR 3.43, 95% CI 1.48-7.96). For initial vs 24-120h (n=42), the proportions were 38/42 and 4/42 respectively (P < 0.001, OR 35.0, 95% CI 4.79-255.48). For initial vs > 120h (n=36), these were 33/36 and 2/36 (P < 0.001,OR ∞). These were also calculated for a positive in initial or < 24h vs. 24-120h (n=42), with proportions of 41/42 and 4/42 (P < 0.001, OR 38.0, 95% CI 5.22-276.78); and for initial or < 24h vs > 120h (n=36), with proportions of 35/36 and 2/36 respectively (P < 0.001, OR ∞). This data appears to show that taking an initial BC followed by a BC within 24 hours of antibiotic commencement would maximise blood culture yield while minimising the risk of false negative results. This could potentially remove the need for as many as 46% of BC samples without adversely affecting patient care. BC yield decreases sharply after 48 hours of antibiotic use, and may not provide any clinically useful information after this time. Further multi-centre studies would validate these findings, and provide a foundation for future health policy generation.

Keywords: antibiotics, blood culture, efficacy, inpatient

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Authors: Bindu Shrestha, Sudarshan R. Tiwari, Sushil B. Bajracharya

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Urban household cooking fuel choice is highly influenced by human behavior and energy culture parameters such as cognitive norms, material culture and practices. Although these parameters have a leading role in Kathmandu for cleaner households, they are not incorporated in the city’s energy policy. This paper aims to identify trade-offs to transform resident behavior in cooking pattern towards cleaner technology from the questionnaire survey, observation, mapping, interview, and quantitative analysis. The analysis recommends implementing a Collaborative Cultural Model (CCM) for changing impact on the neighborhood from the policy level. The results showed that each household produces 439.56 kg of carbon emission each year and 20 percent used unclean technology due to low-income level. Residents who used liquefied petroleum gas (LPG) as their cooking fuel suffered from an energy crisis every year that has created fuel hoarding, which ultimately creates more energy demand and carbon exposure. In conclusion, the carbon emission can be reduced by improving the residents’ energy consumption culture. It recommended the city to use holistic action of changing habits as soft power of collaboration in two-way participation approach within residents, private sectors, and government to change their energy culture and behavior in policy level.

Keywords: energy consumption pattern, collaborative cultural model, energy culture, fuel stacking

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Authors: Nighat Bakhtiar, Ali Raza Khan, Shahid Khan Khattak, Aamir Ali Syed

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Introduction: Chemoradiation followed by resection has been the standard therapy for resectable (cT1-4aN0-3M0) esophageal carcinoma. The optimal surgical approach remains a matter of debate. Therefore, the purpose of this study was to share our experiences of minimal invasive esophagectomies concerning morbidity, mortality and oncological quality. This study aims to enlighten the world about the surgical outcomes after minimally invasive esophagectomy at Shaukat Khanum Hospital Lahore. Objective: The purpose of this study is to review an institutional experience of Surgical outcomes of Minimal Invasive esophagectomies for esophageal cancer. Methodology: This retrospective study was performed after ethical approval at Shaukat Khanum Memorial Cancer Hospital and Research Centre (SKMCH&RC) Pakistan. Patients who underwent Minimal Invasive esophagectomies for esophageal cancer from March 2018 to March 2023 were selected. Data was collected through the human information system (HIS) electronic database of SKMCH&RC. Data was described using mean and median with minimum and maximum values for quantitative variables. For categorical variables, a number of observations and percentages were reported. Results: A total of 621 patients were included in the study, with the mean age of the patient was 39 years, ranging between 18-58 years. Mean Body Mass Index of patients was 21.2.1±4.1. Neo-adjuvant chemoradiotherapy was given to all patients. The mean operative time was 210.36 ± 64.51 minutes, and the mean blood loss was 121 milliliters. There was one mortality in 90 days, while the mean postoperative hospital stay was 6.58 days with a 4.64 standard deviation. The anastomotic leak rate was 4.2%. Chyle leak was observed in 12 patients. Conclusion: The minimal invasive technique is a safe approach for esophageal cancers, with minimal complications and fast recovery.

Keywords: minimal invasive, esophagectomy, laparscopic, cancer

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Authors: Lubna Khondker

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Background: Melasma is a common pigmentary dermatosis, manifested by hyperpigmented macules or patches on the face, commonly occurring in females due to an acquired disorder in the melanogenesis process. Although several treatments are currently used, it remains a great challenge due to recurrence and refractory nature. It was recently reported that tranexamic acid (TA-plasmin inhibitor) is an effective treatment for melasma. Objective: This study aims to compare the efficacy and side effects of intralesional injection of Tranexamic acid with oral Tranexamic acid in the treatment of melasma. Methods: A clinical trial was done in the Department of Dermatology and Venereology, Bangabandhu Sheikh Mujib Medical University, for a period of 4 years. A total of 100 patients with melasma who did not respond to topical therapy were included in the study as group A and group B. Group A Patients were administered intralesional injection (10 mg/ml) of Tranexamic acid( TA) weekly for 6 weeks, and group B patients were treated with oral tranexamic acid 250 mg 12 hourly for 12 weeks after taking informed consent. The severity and extent of pigmentation were assessed by the modified melasma area severity index (MASI). The response to treatment was assessed by MASI at 4 weeks, 8 weeks, and 12 weeks after stopping treatment. Results: The study showed the MASI scores at the baseline, 4 weeks, 8 weeks, and 12 weeks in group A were 18.23±1.22, 6.14±3.26, 3.21±2.14 and 2.11±2.01 respectively, and in group B, 17.87±1.12, 11.21±6.25, 6.57±4.26 and 6.41±4.17 respectively. The mean MASI significantly reduced in group A compared to group B in the 4th, 8th, and 12th weeks. The present study showed that among group A patients, 56% rated excellent (>75% reduction) in outcome, 32% good (50-75% reduction), 8% moderate (25-50% reduction) and only 4% (<25% reduction) was unsatisfactory and among group B patients, 14% rated excellent in outcome, 28% good, 36% moderate and 22% was unsatisfactory. Overall improvement in our study in group A was 96% and in group B 78%. Side effects were negligible, and all the patients tolerated the treatment well. Conclusion: Based on our results, intralesional Tranexamic acid (10 mg/ml) is more effective and safer than oral Tranexamic acid in the treatment of melasma.

Keywords: intralesional tranexamic acid, melasma, oral tranexamic acid, MASI score

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Authors: Konesh Navsaria, Itumeleng Ramodumo

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The study explored university students’ perceptions of cannabis use on academic life at a higher education institution (HEI) in Nelson Mandela Bay, South Africa. Cannabis is described as the most commonly-used drug by youth, especially those who are in tertiary institutions. The use of cannabis has both negative and positive effects; this is evident in different areas of human functioning. Cannabis usage has been debated upon in courts regarding its legalization and decriminalization, and on the 18th of September 2018, the South African High Court decriminalized cannabis for personal use. Cannabis use has increased in academic settings, and this has raised concerns about how it affects the mental health of students. A qualitative approach was used for the study with an explorative, descriptive design. Purposive sampling was used to select 15 participants for the study. Data were collected using focused-group interviews, following ethical clearance from the HEI. The collected data were analyzed and interpreted using thematic analysis, and cognitive behavioural theory was used as the theoretical framework. The research findings indicated both positive and negative influences of cannabis use on mental health. Most participants who expressed positive effects have used cannabis before, whereas most participants with negative perspectives of cannabis use on mental health are non-cannabis users. The findings revealed that participants perceived that the quantity of cannabis smoked determined whether there was a positive or negative effect on mental health; that is, large doses of cannabis were perceived as having negative effects. The research findings also revealed that the legalization of cannabis is very likely to increase its use and also highlighted precautionary measures users take to avoid the substance’s negative effects on mental health.

Keywords: cannabis use, mental health, university students, legalization

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Authors: Sajed Yaghoubnezhad, Sedygheh Rezai

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Background and Aim: Since currently in Iran, students with learning disabilities are identified after entering school, and with the approach to the gap between IQ and academic achievement, the purpose of this study is to design and calculate the content validity of the pre-school screening checklist (5-7) exposed to learning difficulties. Methods: This research is a fundamental study, and in terms of data collection method, it is quantitative research with a descriptive approach. In order to design this checklist, after reviewing the research background and theoretical foundations, cognitive abilities (visual processing, auditory processing, phonological awareness, executive functions, spatial visual working memory and fine motor skills) are considered the basic variables of school learning. The basic items and worksheets of the screening checklist of pre-school students 5 to 7 years old with learning difficulties were compiled based on the mentioned abilities and were provided to the specialists in order to calculate the content validity ratio index. Results: Based on the results of the table, the validity of the CVR index of the background information checklist is equal to 0.9, and the CVR index of the performance checklist of preschool children (5 to7 years) is equal to 0.78. In general, the CVR index of this checklist is reported to be 0.84. The results of this study provide good evidence for the validity of the pre-school sieve screening checklist (5-7) exposed to learning difficulties.

Keywords: checklist, screening, preschoolers, learning difficulties

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Authors: Hulya Ilyasoglu Buyukkestelli, Sedef Nehir El

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Lutein is a member of xanthophyll group of carotenoids found in fruits and vegetables. Lutein accumulates in the macula region of the retina and known as macular pigment which absorbs damaging light in the blue wavelengths. The presence of lutein in retina has been related to decreased risk of two common eye diseases, age-related macular degeneration, and cataract. Being a strong antioxidant, it may also have effects on prevention some types of cancer, cardiovascular disease, cognitive dysfunction. Humans are not capable of synthesizing lutein de novo; therefore it must be provided naturally by the diet, fortified foods, and beverages or nutritional supplement. However, poor bioavailability and physicochemical stability limit its usage in the food industry. Poor solubility in digestive fluids and sensitivity to heat, light, and oxygen are both affect the stability and bioavailability of lutein. In this context, new technologies, delivery systems and formulations have been applied to improve stability and solubility of lutein. Nanotechnology, including nanoemulsion, nanocrystal, nanoencapsulation technology and microencapsulation by complex coacervation, spray drying are promising ways of increasing solubilization of lutein and stability of it in different conditions. Bioavailability of lutein is also dependent on formulations used, starch formulations and milk proteins, especially sodium caseinate are found effective in improving the bioavailability of lutein. Designing foods with highly bioavailable and stabile lutein needs knowledge about current technologies, formulations, and further needs. This review provides an overview of the new technologies and formulations used to improve bioavailability of lutein and also gives a future outlook to food researches.

Keywords: bioavailability, formulation, lutein, nanotechnology

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Authors: Gholamreza Hashemitabr, Reza Valadan, Alireza Rafiei, Mohammad Reza Bassami

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Breast cancer is the most common malignancy among women worldwide. Cancer cells use a complex multilayer network of epidermal growth factor receptors (EGFRs) signaling pathways to support their survival and growth. The overlapping networks of EGFRs signaling pathways account for the failure of most ErbB-targeted therapies. The aim of this study was to enrich a pool of recombinant antibody fragments against common epitopes of ErbB1 and ErbB2 in order to simultaneous blockade of ErbBs signaling pathways. ErbB1 and ErbB2 were expressed stably in VERO cells. Selection of recombinant antibodies was performed on live cells expressing either of ErbB1 and ErbB2 receptors using subtractive phage display approach. The results of PCR and DNA fingerprinting in the last round of panning showed that most clones contained insert (80% and 85% for ErbB1 and ErbB2 respectively) with an identical restriction pattern. The selected clones showed positive reaction to both ErbB1 and ErbB2 receptors in phage-ELISA test. Furthermore, the resulting soluble antibody fragments recognized common epitopes of both immunoprecipitated ErbB1 and ErbB2 in western blot. Additionally, the antibodies directed against the dimerization domain of ErbB1 demonstrated a significant absorbance in EGF-stimulated VERO/ErbB1 cells than non-stimulated cells (1.91 and 1.09 respectively). Moreover, the results of dimerization inhibition test showed that these antibodies blocked ErbB1 and ErbB2 dimerization on the surface of ErbB1 and ErbB2 expressing VERO cells. Regarding the importance of pan-ErbB approach to cancer therapy, the antibodies developed here might provide novel therapeutics for simultaneous blockade of ErbBs signaling pathways.

Keywords: breast cancer, single-chain antibody, ErbB1, ErbB2, epitope

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Authors: Panadda Rojpibulstit, Suthathip Kittisenachai, Songchan Puthong, Sirikul Manochantr, Pornpen Gamnarai, Sasichai Kangsadalampai, Sittiruk Roytrakul

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Hepatocellular carcinoma (HCC) is the most primary hepatic cancer worldwide. Nowadays a targeted therapy via monoclonal antibodies (mAbs) specific to tumor-associated antigen is continually developed in HCC treatment. In this regard, after establishing and consequently exploring Hep88 mAb’s tumoricidal effect on hepatocellular carcinoma cell line (HepG2 cell line), the Hep88 mAb’s specific Ag from both membrane and cytoplasmic fractions of HepG2 cell line was identified by 2-D gel electrophoresis and western blot analysis. After in-gel digestion and subsequent analysis by liquid chromatography-mass spectrometry (LC-MS), mortalin (HSPA9) and alpha-enolase were identified. The recombinant proteins specific to Hep88 mAb were cloned and expressed in E.coli BL21 (DE3). Moreover, alteration of HepG2 and Chang liver cell line after being induced by Hep88 mAb for 1-3 days was investigated using a transmission electron microscope. The result demonstrated that Hep88 mAb can bind to the recombinant mortalin (HSPA9) andalpha-enolase. In addition, gradual appearance of mitochondria vacuolization and endoplasmic reticulum dilatation were observed. Taken together, paraptosis-like programmed cell death (PCD) of HepG2 is induced by binding of mortalin (HSPA9) and alpha-enolase to Hep88 mAb. Mortalin depletion by formation of Hep88 mAb-mortalin (HSPA9) complex might initiate transcription-independent of p53-mediated apoptosis. Additionally, Hep88 mAb-alpha-enolase complex might initiate HepG2 cells energy exhaustion by glycolysis pathway obstruction. These results imply that Hep88 mAb might be a promising tool for development of an effective treatment of HCC in the next decade.

Keywords: Hepatocellular carcinoma, Monoclonal antibody, Paraptosis-like program cell death, Transmission electron microscopy, mortalin (HSPA9), alpha-enolase

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Authors: Y. Melis, E. Apicella, E. Dozio, L. Mendolicchio

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Introduction: Feeding and Eating Disorders (FED) represent the psychiatric pathology with the highest mortality rate and one of the major disorders with the highest psychiatric and clinical comorbidity. The vagus nerve represents one of the main components of the sympathetic and parasympathetic nervous system and is involved in important neurophysiological functions. In FED, there is a spectrum of symptoms which with TaVNS (Transcutaneous Auricular Vagus Nerve Stimulation) therapy, is possible to have a therapeutic efficacy. Materials and Methods: Sample subjects are composed of 15 female subjects aged > 18 ± 51. Admitted to a psychiatry community having been diagnosed according to DSM-5: anorexia nervosa (AN) (N= 9), bulimia nervosa (BN) (N= 5), binge eating disorder (BED) (N= 1). The protocol included 9 weeks of Ta-VNS stimulation at a frequency of 1.5-3.5 mA for 4 hours per day. The variables detected are the following: Heart Rate Variability (HRV), Hamilton Depression Rating Scale (HAMD-HDRS-17), Body Mass Index (BMI), Beck Anxiety Index (BAI). Results: Data analysis showed statistically significant differences between recording times (p > 0.05) in HAM-D (t0 = 18.28 ± 5.31; t4 = 9.14 ± 7.15), in BAI (t0 = 24.7 ± 10.99; t4 = 13.8 ± 7.0). The reported values show how during (T0-T4) the treatment there is a decay of the degree in the depressive state, in the state of anxiety, and an improvement in the value of BMI. In particular, the BMI in the AN-BN sub-sample had a minimum gain of 5% and a maximum of 11%. The analysis of HRV did not show a clear change among subjects, thus confirming the discordance of the activity of the sympathetic and parasympathetic nervous system in FED. Conclusions: Although the sample does not possess a relevant value to determine long-term efficacy of Ta-VNS or on a larger population, this study reports how the application of neuro-stimulation in FED may become a further approach therapeutic. Indeed, substantial improvements are highlighted in the results and confirmed hypotheses proposed by the study.

Keywords: feeding and eating disorders, neurostimulation, anxiety disorders, depression

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Authors: Itsuo Yokoyama, Rikako Kikuti, Miti Sekikawa, Tosinori Asai, Sarai Tsuyoshi

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Introduction: Vascular access for hemodialysis therapy is often difficult, even for experienced medical personnel. Ultrasound guided needle placement have been performed occasionally but is not always helpful in certain cases with complicated vascular anatomy. Obtaining precise anatomical knowledge of the vascular structure is important to prevent access-related complications. With augmented reality (AR) device such as AR glasses, the virtual vascular structure is shown superimposed on the actual patient vessels, thus enabling the operator to maneuver catheter placement easily with free both hands. We herein report our method of AR guided vascular access method in dialysis treatment Methods: Three dimensional (3D) object of the arm with arteriovenous fistula is computer graphically created with 3D software from the data obtained by computer tomography, ultrasound echogram, and image scanner. The 3D vascular object thus created is viewed on the screen of the AR digital display device (such as AR glass or iPad). The picture of the vascular anatomical structure becomes visible, which is superimposed over the real patient’s arm, thereby the needle insertion be performed under the guidance of AR visualization with ease. By this method, technical difficulty in catheter placement for dialysis can be lessened and performed safely. Considerations: Virtual reality technology has been applied in various fields and medical use is not an exception. Yet AR devices have not been widely used among medical professions. Visualization of the virtual vascular object can be achieved by creation of accurate three dimensional object with the help of computer graphical technique. Although our experience is limited, this method is applicable with relative easiness and our accumulating evidence has suggested that our method of vascular access with the use of AR can be promising.

Keywords: abdominal-aorta, calcification, extraskeletal, dialysis, computer graphics, 3DCG, CT, calcium, phosphorus

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Authors: Caren Hilger, Silke Burkert, Friederike Kendel

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Men with localized prostate cancer (PCa) have to choose among different treatment options, such as active surveillance (AS) and radical prostatectomy (RP). All available treatment options may be accompanied by specific psychological or physiological side effects. Depending on the nature and extent of these side effects, patients are more or less likely to be satisfied or to struggle with their treatment decision in the long term. Therefore, the aim of this study was to assess and explain decisional regret in men with localized PCa. The role of erectile functioning as one of the main physiological side effects of invasive PCa treatment, depressive symptoms as a common psychological side effect, and the association of erectile functioning and depressive symptoms with decisional regret were investigated. Men with localized PCa initially managed with AS or RP (N=292) were matched according to length of therapy (mean 47.9±15.4 months). Subjects completed mailed questionnaires assessing decisional regret, changes in erectile functioning, depressive symptoms, and sociodemographic variables. Clinical data were obtained from case report forms. Differences among the two treatment groups (AS and RP) were calculated using t-tests and χ²-tests, relationships of decisional regret with erectile functioning and depressive symptoms were computed using multiple regression. Men were on average 70±7.2 years old. The two treatment groups differed markedly regarding decisional regret (p<.001, d=.50), changes in erectile functioning (p<.001, d=1.2), and depressive symptoms (p=.01, d=.30), with men after RP reporting higher values, respectively. Regression analyses showed that after adjustment for age, tumor risk category, and changes in erectile functioning, depressive symptoms were still significantly associated with decisional regret (B=0.52, p<.001). Additionally, when predicting decisional regret, the interaction of changes in erectile functioning and depressive symptoms reached significance for men after RP (B=0.52, p<.001), but not for men under AS (B=-0.16, p=.14). With increased changes in erectile functioning, the association of depressive symptoms with decisional regret became stronger in men after RP. Decisional regret is a phenomenon more prominent in men after RP than in men under AS. Erectile functioning and depressive symptoms interact in their prediction of decisional regret. Screening and treating depressive symptoms might constitute a starting point for interventions aiming to reduce decisional regret in this target group.

Keywords: active surveillance, decisional regret, depressive symptoms, erectile functioning, prostate cancer, radical prostatectomy

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Authors: Calvin Chiu, Samar Saade Needham

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The factors associated with the development of major depressive disorder (MDD) have been an ongoing area of concern within the field of psychopathology. Among parents, the rise in stress factors for individuals receiving less social support contributes to an increase in MDD cases. Understanding the causal aspects of MDD through the interworking of stress development within social support disparities provides critical insights into preventive measures for depressive symptoms. The present study seeks to assess the impact of social support on stress formation within MDD. Such that single parents lacking social support prompt an increase in stress formation, which proliferates the progression of MDD. Participants in this study were 450 ethnic minority mothers and fathers experiencing health inequities during pregnancy and early childhood. Perceived stress, social support, and depression are assessed by multi-item questionnaires that produce score ranges for general findings. Results indicated that lower social support scores resulted in higher depression scores, and higher perceived stress scores produced higher depression scores. Furthermore, single parents reported higher depression scores. These findings overlap with studies on paternal depression and suggest that MDD is a product of stress accumulation due to declining social support systems. Future studies may specify effective social support systems for decreasing stress accumulation in MDD formation in preventive strategies.

Keywords: major depressive disorder, stress formation, cognitive-behavioral outcomes, deficit-based behaviors

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Authors: Genesis Julyus T. Agcaoili, Esperanza C. Cabrera

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Thirty (30) isolates of lactic acid bacteria (LAB) from traditionally-prepared fermented products specifically fermented soy-bean paste, fermented mustard and fermented rice-fish mixture were studied for their in vitro antimicrobial and cytotoxic activities. Seventeen (17) isolates were identified as Lactobacillus plantarum, while 13 isolates were identified as Enterococcus spp using 16s rDNA sequences. Disc diffusion method was used to determine the antibacterial activity of LAB against Staphylococcus aureus (ATCC 25923) and Escherichia coli (ATCC 25922), while the modified agar overlay method was used to determine the antifungal activity of LAB isolates on the yeast Candida albicans, and the dermatophytes Microsporum gypseum, Trichophyton rubrum and Epidermophyton floccosum. The filter-sterilized LAB supernatants were evaluated for their cytotoxicity to mammalian colon cancer cell lines (HT-29 and HCT116) and normal human dermal fibrolasts (HDFn) using resazurin assay (PrestoBlueTM). Colchicine was the positive control. No antimicrobial activity was observed against the bacterial test organisms and the yeast Candida albicans. On the other hand, all of the tested LAB strains were fungicidal for all the test dermatophytes. Cytotoxicity index profiles of the supernatants of the 15 randomly picked LABs and negative control (brain heart infussion broth) suggest nontoxicity to the cells when compared to colchicine, whereas all LAB supernatants were found to be cytotoxic to HT-29 and HCT116 colon cancer cell lines. Results provide strong support for the role of the lactic acid bacteria studied in antimicrobial treatment and anticancer therapy.

Keywords: antimicrobial, fermented products, fungicidal activity, lactic acid bacteria, probiotics

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Authors: Moustafa Elwan, Sohier Shehata, Fatma Sedek, Manar Hussine

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One of the most risky factors that lead to a foot injury during physical activities are both high and low arched feet. Normally the medial longitudinal arch of the foot develops in the first 10 years of life, so flexible flat foot has an inversely relationship with age in the first decade, all over the world, the prevalence of flat foot is increasing. In approximately 15% of foot deformities cases, the deformity does not disappear and remains throughout adulthood, 90% of the clinical cases are complaining from foot problems are due to flatfoot. Flatfoot creates subtalar over pronation, which creates tibial and femoral medial rotation, and that is accompanied with increases of pelvic tilting anteriorly, which may influence the lumbar vertebrae alignment by increasing muscle tension and rotation. Objective: To study the impact of the flexible flatfoot on lumbosacral angle (angle of Ferguson). Methods: This experiment included 40 volunteers (14 females &26 males) gathered from the Faculty of Physical Therapy, Modern University of Technology and Information, Cairo, Egypt, for each participant, four angles were measured in the foot( talar first metatarsal angle, lateral talocalcaneal angle, , Calcaneal first metatarsal angle, calcaneal inclination angle) and one angle in the lumbar region (lumbosacral angle). Measurement of these angles was conducted by using Surgimap Spine software (version 2.2.9.6). Results: The results demonstrated that there was no significant correlation betweenFerguson angle and lateral talocalcaneal (r=0.164, p=0.313). Also, there was no significant correlation between Ferguson angle and talo first metatarsal “Meary’s angle" (r=0.007, p=0.968). Moreover, there was no significant correlation between Ferguson angle and calcaneal-first metatarsal angle (r=0.083, p=0.612). Also, there was no significant correlation between Ferguson angle and calcaneal inclination angle (r= 0.032, p= 0.846). Conclusion: It can be concluded that there is no significant correlation between the flexible flat foot and lumbosacral angle So, more study should be conducted in large sample and different ages and conditions of foot problems.

Keywords: calcaneal first metatarsal, calcaneal inclination, flatfoot, ferguson’s angle, lateral talocalcaneal angle, lumbosacral angle, and talar first metatarsal angle

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Authors: Wen-Chyan Tsai, Syed S. H. Rizvi

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Organic solvent residues are always associated with liposomes produced by the traditional techniques like the thin film hydration and reverse phase evaporation methods, which limit the applications of these vesicles in the pharmaceutical, food and cosmetic industries. Our objective was to develop a novel and benign process of liposomal microencapsulation by using supercritical carbon dioxide (SC-CO2) as the sole phospholipid-dissolving medium and a green substitute for organic solvents. This process consists of supercritical fluid extraction followed by rapid expansion via a nozzle and automatic cargo suction. Lecithin and cholesterol mixed in 10:1 mass ratio were dissolved in SC-CO2 at 20 ± 0.5 MPa and 60 oC. After at least two hours of equilibrium, the lecithin/cholesterol-laden SC-CO2 was passed through a 1000-micron nozzle and immediately mixed with the cargo solution to form liposomes. Liposomal micro-encapsulation was conducted at three pressures (8.27, 12.41, 16.55 MPa), three temperatures (75, 83 and 90 oC) and two flow rates (0.25 ml/sec and 0.5 ml/sec). Liposome size, zeta potential and encapsulation efficiency were characterized as functions of the operating parameters. The average liposomal size varied from 400-500 nm to 1000-1200 nm when the pressure was increased from 8.27 to 16.55 MPa. At 12.41 MPa, 90 oC and 0.25 ml per second of 0.2 M glucose cargo loading rate, the highest encapsulation efficiency of 31.65 % was achieved. Under a confocal laser scanning microscope, large unilamellar vesicles and multivesicular vesicles were observed to make up a majority of the liposomal emulsion. This new approach is a rapid and continuous process for bulk production of liposomes using a green solvent. Based on the results to date, it is feasible to apply this technique to encapsulate hydrophilic compounds inside the aqueous core as well as lipophilic compounds in the phospholipid bilayers of the liposomes for controlled release, solubility improvement and targeted therapy of bioactive compounds.

Keywords: liposome, micro encapsulation, supercritical carbon dioxide, non-toxic process

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Authors: William Cheng, Yuni Astria, Rini Sekartini

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Background: Prevalence of anemia among school-aged children is relatively high (25.4%). This condition can affect children’s life, including cognitive function. One of the most common factors that is associated with anemia in children is nutritional status. This simple indicator will be very helpful in identifying more population at risk. The aim of this study is to correlate the clinical implication of nutritional status to the prevalence of anemia in children, with intention to determine a more effective nutritional status indicator in detecting anemia. Method: Anthropometric and haemoglobin status were gathered from children between 5 to 7-years-old in one of the urban areas in Jakarta in 2012. We identified children with haemoglobin level under 11.5 as anemia and correlated them to their WHO z-score from each of these indicators: Body Weight for Age (normal weight and underweight), Height for Age (not stunted and stunted), and Body Mass Index for Age (not wasted and wasted). Results: A total of 195 children were included in this research and 57 of them (29,2%) were diagnosed as anemia. The majority of the children had good nutritional status, however, 30 (15,4%) of them were found to be underweight, 33 (16,9%) were stunted, and 1 children (0,5%) was wasted. There were no overweight result found in this population. From the three nutritional status indicators, none proved to be statistically significant in relation to the incidence of anemia (p>0.05). Out of 33 children who were diagnosed as stunted, 36.36 % were found to have anemia, in comparison to 27,7% of children who were not stunted. Meanwhile, among 30 children who were diagnosed as underweight, 33,3 % of them were anemic whereas only 28,4% of the normal weight group were anemic. Conclusion: In this study, there is no significant correlation between anemia with any nutritional status indicator. However, more than a third of the stunted children are proven to have low haemoglobin status. The finding of stunting in children should be given more attention to further investigate for anemia.

Keywords: school-aged children, nutritional status, anemia, pediatrics

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Authors: Xin Li, Yan-Rong Guo, Jin-Fang Lin, Yi Feng, Håkan Billig, Ruijin Shao

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Background: Young women with polycystic ovary syndrome (PCOS) have a high risk of developing endometrial carcinoma. There is a need for the development of new medical therapies that can reduce the need for surgical intervention so as to preserve the fertility of these patients. The aim of the study was to describe and discuss cases of PCOS and insulin resistance (IR) women with early endometrial carcinoma while being co-treated with Diane-35 and metformin. Methods: Five PCOS-IR women who were scheduled for diagnosis and therapy for early endometrial carcinoma were recruited. The hospital records and endometrial pathology reports were reviewed. All patients were co-treated with Diane-35 and metformin for 6 months to reverse the endometrial carcinoma and preserve their fertility. Before, during, and after treatment, endometrial biopsies and blood samples were obtained and oral glucose tolerance tests were performed. Endometrial pathology was evaluated. Body weight (BW), body mass index (BMI), follicle-stimulating hormone (FSH), luteinizing hormone (LH), total testosterone (TT), sex hormone-binding globulin (SHBG), free androgen index (FAI), insulin area under curve (IAUC), and homeostasis model assessment of insulin resistance (HOMA-IR) were determined. Results: Clinical stage 1a, low grade endometrial carcinoma was confirmed before treatment. After 6 months of co-treatment, all patients showed normal epithelia. No evidence of atypical hyperplasia or endometrial carcinoma was found. Co-treatment resulted in significant decreases in BW, BMI, TT, FAI, IAUC, and HOMA-IR in parallel with a significant increase in SHBG. There were no differences in the FSH and LH levels after co-treatment. Conclusions: Combined treatment with Diane-35 and metformin has the potential to revert the endometrial carcinoma into normal endometrial cells in PCOS-IR women. The cellular and molecular mechanisms behind this effect merit further investigation.

Keywords: PCOS, progesterone resistance, insulin resistance, steroid hormone receptors, endometrial carcinoma

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Authors: Marah El-Beeli, Abdullah Balkhair, Zakaryia Al Muharmi, Samir Al Adawi, Mansoor Al-Jabri, Abdullah Al Rawahi, Hazaa Al Yahyae, Eman Al Balushi, Yahya M. Al-Farsi

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The health care service and the anticancer chemotherapeutics has changed the natural history of cancer into manageable chronic disease and improve the cancer patient’s lifestyle and increase the survival time. Despite that, still, infection is the major dilemma opposing the cancer patient either because of the clinical presentation of the cancer type and impaired immune system or as a consequence of anticancer therapy. This study has been conducted to1) track changes in the epidemiology of hospital-acquired bloodstream infections among patients with malignancies in the last five years. 2) To explore the causative pathogens and 3) the outcome of HA-BSIs in patients with a different types of malignancies. An ampi-directional study (retrospective and prospective follow up) of patients with malignancies admitted at Sultan Qaboos University hospital (570-bed tertiary hospital) during the study period (from January 2015 to December 2019). The cumulative frequency and prevalence rates of HA-BSIs by patients and isolates were calculated. In addition, the cumulative frequency of participants with single versus mixed infections and types of causative micro-organisms of HA-BSIs were obtained. A total of 1246 event of HA-BSIs has occurred during the study period. Nearly the third (30.25%) of the HA-BSI events was identified among 288 patients with malignancies. About 20% of cases were mixed infections (more than one isolate). Staphylococcus spp were the predominant isolated pathogen (24.7%), followed by Klebsiella spp (15.8%), Escherichia spp (13%), and Pseudomonas spp (9.3%). About half (51%) of cases died in the same year, and (64%) of the deaths occur within two weeks after the infection. According to the observations, no changes in the trends of epidemiology, causative pathogens, morbidity, and mortality rates in the last five years.

Keywords: epidemiology, haematological malignancies, hospital acquired bloodstream infections, solid malignancies

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Authors: J. Van der Walt, N. A. Plastow, M. Unger

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Gross and fine motor skill difficulties among children affect their ability to learn and progress in school. Research indicates that children in low socio-economic areas are at a higher risk of motor skill difficulties, while therapy resources are limited. The Hopscotch motor skill programme is a well-researched accessible in-school intervention developed by occupational and physiotherapists through complex intervention development. The development stage of the complex intervention development model firstly included a prevalence study in a low-resourced area in the West Coast of South Africa, indicating a high prevalence with significant motor skill difficulties among pre-school children at 14.5% with fine motor skill difficulties at 24.6%. A scoping review identifies motor skill interventions for pre-school children and a proposed a framework of fundamental concepts to consider when developing a motor skill intervention. a Delphi-study considered the framework and encouraged collaboration between therapists and educators to make the programme accessible, resource and cost effective, specifically geared towards a rural, low resourced area. The results from the Delphi study, together with the proposed framework from the scoping review was used to develop the Hopscotch programme, adopting a task-shifting approach. The eight-week small-group programme is facilitated by teachers with the support of therapists. The programme aims to improve the motor skills of pre-school aged children with motor skill difficulties to promote academic readiness through obstacle courses, ball skill games and fine motor games and crafts. A randomised controlled trial is planned as a next stage to determine the preliminary effect of the programme on the motor and early academic skills of pre-school children.

Keywords: accesible learning, motor skill intervention, school readiness, task shifting

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Authors: Fatemeh Ghaemi, Padideh Feyzi, Zohreh Dortaj

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Cancer is one of the common diseases that may cause death due to malignancy. The physical problems of cancer patients can have an impact on the psychological and social aspects of their lives. Depression is one of these problems that threaten the lives of these patients and can also reduce their quality of life. Helping patients with cancer to find meaning in life can increase their level of health and improve their quality of life. This study thus examines the effectiveness of group logotherapy on the depression and quality of life of women with cancer. Depression was measured using the Beck Depression Inventory (BDI) and quality of life was measured using Quality of Life Questionnaire (WHOQL) with acceptable and reliable indicators in the pre-test and post-test stages. The experimental group received group therapy in eight, sixty-minute sessions and the control group did not receive any intervention. After collecting the questionnaires, the mean and standard deviations were used to describe the data and the statistical method of multivariate analysis of covariance was used at the significant level (P≤0.05). The results were analyzed using SPSS(22). The results showed that there was a significant difference between post-test depression scores in the experimental group and the control group. Also, there was a significant difference between the post-test scores of quality of life and its components (psychological, physical, social and environmental health) in the experimental group and control group. The findings of this study showed the effectiveness of group logotherapy in decreasing depression and improving the quality of life of cancer patients. By focusing the minds of the people on the present and changing the attitude of the human being towards themselves, life and environment can help the depressed people, and by influencing the individual's view of himself, accepting responsibility, accepting life with purpose, paying attention to life uniformly, it allows a person to maintain his quality of life even with cancer. Therefore, it is recommended that this approach be used as a group intervention in hospitals and care units for cancer patients and even in people with certain diseases.

Keywords: cancer, depression, group psychiatry, quality of life

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Authors: Talal Asif, Maya Kosinska, Lucas Georger, Krish Sardesai, Muhammad Shah Miran

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This article presents a case review and literature review focused on the challenges of managing subaortic membranes (SAM) in young adult patients with mild aortic regurgitation (AR) or aortic stenosis (AS). The study aims to discuss the diagnosis of SAM, imaging studies used for assessment, management strategies in young patients, the risk of valvular damage, and the controversy surrounding prophylactic resection in mild AR. The management of SAM in adults poses challenges due to limited treatment options and potential complications, necessitating further investigation into the progression of AS and AR in asymptomatic SAM patients. The case presentation describes a 40-year-old male with muscular dystrophy who presented with symptoms and was diagnosed with SAM. Various imaging techniques, including CT chest, transthoracic echocardiogram (TTE), and transesophageal echocardiogram (TEE), were used to confirm the presence and severity of SAM. Based on the patient's clinical profile and the absence of surgical indications, medical therapy was initiated, and regular outpatient follow-up was recommended to monitor disease progression. The discussion highlights the challenges in diagnosing SAM, the importance of imaging studies, and the potential complications associated with SAM in young patients. The article also explores the management options for SAM, emphasizing surgical resection as the definitive treatment while acknowledging the limited success rates of alternative approaches. Close monitoring and prompt intervention for complications are crucial in the management of SAM. The concluding statement emphasizes the need for further research to explore alternative treatments for SAM in young patients.

Keywords: subaortic membrane, management, case report, literature review, aortic regurgitation, aortic stenosis, left ventricular outflow obstruction, guidelines, heart failure

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Authors: My Ha, Suwei Lin, Huiying Zou

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This study aimed at investigating the association between teacher support and academic resilience in a developing country. Using the data from PISA 2018 Student Questionnaire and Cognitive Tests, the study provided evidence of the significant impact teacher support had on reading literacy among 15-year-old students from low socio-economic status (SES) homes in Vietnam. From a total of 5773 Vietnamese participants from all backgrounds, a sample of 1765 disadvantaged students was drawn for analysis. As a result, 32 percent of the low SES sample was identified as resilient. Through their response to the PISA items regarding the frequency of support they received from teachers, the result of Latent Class Analysis (LCA) divides children into three subgroups: High Support (74.6%), Fair Support (21.6%), and Low Support (3.8%). The high support group reported the highest proportion of resilient students. Meanwhile, the low support group scored the lowest mean on reading test and had the lowest rate of resilience. Also, as the level of support increases, reading achievement becomes less dependent on socioeconomic status, reflected by the decrease in both the slope and magnitude of their correlation. Logistic regression revealed that 1 unit increase in standardized teacher support would lead to an increase of 29.1 percent in the odds of a student becoming resilient. The study emphasizes the role of supportive teachers in promoting resilience, as well as lowering educational inequity in general.

Keywords: academic resilience, disadvantaged students, teacher support, inequity, PISA

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Authors: Yvette Reisinger

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Relatively little is known about the Arab travel market, especially the outbound travel market from Arab countries in the Middle East. The Kuwaiti travel market is the smallest yet fastest growing in the Gulf Cooperation Council (GCC) region. The Kuwaiti travel market represents a great potential for the international tourism industry. Kuwaiti nationals have a very high spending power due to the Kuwaiti dinar being the highest-valued currency unit in the world. Although Europe, North America, and Asia/Pacific try to attract the Arab tourist market the number of Kuwaiti travellers attracted to these destinations is very low. The success in attracting the Kuwaiti travel market to Western countries must be guided by an analysis of the factors that affect its travel decisions. The objective of the study is to identify major factors that influence Kuwaiti nationals’ intentions to travel to Western countries. A model is developed and empirically tested on a sample of 343 Kuwaiti nationals. A series of regression analyses are run to determine the effects of different factors on Kuwaiti’s travel decisions. A Herman’s single factor test and Durbin-Watson test are used to assess the validity of the regression model. Analysis is controlled for socio-demographics. The results show that the Muslim friendly amenities and destination cognitive image exert significant effects on Kuwaiti nationals’ intentions to travel to Western countries. The study provides a better understanding of the factors that attract Kuwaiti tourists to Western countries. By knowing what encourages Kuwaitis to travel to Western countries marketers can plan and promote these countries accordingly. The study provides a foundation of future empirical research into the Kuwaiti/Arab travel market.

Keywords: Kuwaiti travel market, travel decisions, Western countries

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Authors: Anantdeep Kaur, Sharanjeet Singh

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Early childhood education and assessment of children is a very essential tool that helps them in their growth and development. Techniques should be developed, and tools should be created in this field as it is a very important learning phase of life. Some information and sources are included for student assessment to provide a record of growth in all developmental areas cognitive, physical, Language, social-emotional, and approaches to learning. As an early childhood educator, it is very important to identify children who need special support and counseling to improve them because they are not mentally mature to discuss with the teacher their problems and needs. It is the duty and responsibility of the educator to assess children from their body language, behavior, and their routine actions about their skills that can be improved and which can take them forward in their future life. And also, children should be assessed with their weaker points because this is the right time to correct them, and they be improved with certain methods and tools by working on them constantly. Observing children regularly with all their facets of development, including intellectual, linguistic, social-emotional, and physical development. Every day, a physical education class should be regulated to check their physical growth activities, which can help to assess their physical activeness and motor abilities. When they are outside on the playgrounds, it is very important to instill environmental understanding among them so that they should know that they are very part of this nature, and it will help them to be one with the universe rather than feeling themselves individually. This technique assists them in living their childhood full of energy all the time. All types of assessments have unique purposes. It is important first to determine what should be measured, then find the program that best assesses those.

Keywords: special needs, motor ability, environmental understanding, physical development

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Authors: Catarina Isabel Ramos Pereira, Jorge Machado, Begona Alonso Criado, Maria João Santos

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Introduction: Gait disorders are one of the symptoms that have severe implications on the quality of life in Parkinson's disease (PD). Currently, there is no therapy to reverse or treat this condition. None of the drugs used in conventional medical treatment is entirely efficient, and all have a high incidence of side effects. Acupuncture treatment is believed to improve motor ability, but there is still little scientific evidence in individuals with PD. Aim: The aim of the study is to investigate the acute effect of acupuncture on gait parameters in Parkinson's disease. Methods: This is a randomized and controlled crossover study. The same individual patient was part of both the experimental (real acupuncture) and control group (false acupuncture/sham), and the sequence was randomized. Gait parameters were measured at two different moments, before and after treatment, using four force platforms as well as the collection of 3D markers positions taken by 11 cameras. Images were quantitatively analyzed using Qualisys Track Manager software that let us extract data related to the quality of gait and balance. Seven patients with the diagnosis of Parkinson's disease were included in the study. Results: Statistically significant differences were found in gait speed (p = 0.016), gait cadence (p = 0.006), support base width (p = 0.0001), medio-lateral oscillation (p = 0.017), left-right step length (p = 0.0002), and stride length: right-right (p = 0.0000) and left-left (p = 0.0018), time of left support phase (p = 0.029), right support phase (p = 0.025) and double support phase (p = 0.015), between the initial and final moments for the experimental group. Differences in right-left stride length were found for both groups. Conclusion: Our results show that acupuncture could enhance gait in Parkinson's disease patients. Deep research involving a larger number of volunteers should be accomplished to validate these encouraging findings.

Keywords: acupuncture, traditional Chinese medicine, Parkinson's disease, gait

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