Search results for: Arab women pain

Authors: Pramoda Karunarathna, Hemamalie Gunatilaka

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This study is based on experiences of Sri Lankan lesbian and gay workers’ career in the corporate sector, which include both manufacturing and service sectors. The study has started with the intention of shedding light on a grey area to observe the negative effects on lesbian and gay workers and their experiences while they are employed in the Sri Lankan corporate sector. In order to understand the experiences of lesbian and gay workers while they are at work within the corporate sector, the study seeks to address four questions. First research question is about the challenges faced by lesbian and gay workers while they are at work, and the second research question looks at their career patterns. Third research question seeks to address the behavior at work, and the fourth research question looks at the influence of class, religion, and cultural aspects on the career of lesbian and gay workers. Methodologically, the research was based on semi-structured interviews with nine participants (five gay men and four lesbian women) having work experience in the corporate sector and residing in Colombo, the capital city of Sri Lanka. The research found that the participants have gone through the process of developing sexual identity; gay men possess more feminine characteristics, while lesbian women possess more masculine characteristics. Further, their identity gets revealed in different ways, such as through the curriculum vitae, at the interviews, through the attire and behavior, and with the use of social media. The study also found that lesbian and gay workers experience discrimination due to violation of hierarchical power difference by other employees and marginalization, verbal and nonverbal abuse by other men at work are common experiences. Another finding is that lesbian and gay workers adopt strategies for survival at work, and they prefer the NGO sector to the corporate sector. In contrast, even within the corporate sector, advertising is preferred by lesbian and gay workers. Some of the Sri Lankan corporate sector organizations, especially multinational organizations, have initiated diversity training, and it might lead to making these organisations lesbian and gay-friendly workplaces in the future. It is also found that nearly 44 percent of the participants do not have a religion, and it is due to the rejection of deviant behaviours by most of the religions. In conclusion, lesbian and gay workers experience discrimination at work in the Sri Lankan corporate sector with an exception to the companies relating to advertising and non-governmental organisations is the sector that these workers prefer the most.

Keywords: lesbian workers, gay workers, Sri Lankan corporate sector, discrimination

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Authors: Sheila M. Wicks, Gail Mahady, Udesh Patel, Joanna Michel, Armando Caceres

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Introduction: The genus piperaceae contains approximately 1000 species of herbs scrubs small trees and hanging vines distributed in both hemispheres. During our ethno medical work in Guatemala of the 27 plant families documented for us e by the Qeqchi Maya for reproductive disorders the most prominent were the Piperaceae (15%) and Menispermiaceae. Our Previous work showed that extracts from form Piper and Cissampelos species bound to both and progesterone and the estrogen receptors. In this work active extracts from Piper aeruginosibaccum Trelease, P auritum, P tuerckheimii and Cissampels tropaeolifolia were tested in functionalized cell based assays including a SEAP reporter gene and by qPCR of ER-responsive gene expression in MCF-7cells. In the reporter gene assay P aeruginosibaccum was estrogenic and enhanced E2 EFFECTS IN MCF-7 CELLS. P. tuerckheimi was not estrogenic alone but significantly enhanced the effects of E2 on SEAP reporter gene expression. Both altered mRNA expression of E2 responsive genes in MCF-7. Methods: this is collaborative project between University of Illinois at Chicago and University of San Carlos Guatemala City. 144 spices of plants were collected in Guatemala of which 57 used to treat a variety of women's reproductive health. The Genus Piperaraceae contains approximately 1000 species of herbs scrubs and small trees. Active extracts of the plants were tested in functionalized in cell-based bioassays including SEAP reporter genes. Results demonstrated altered mRNA expression of E2 responsive genes in MC-7 cells plants were collected in Guatemala of which 57 used. Conclusion of the 5 plants tested all were shown to contain components of binding to estrogenic receptor to a greater or lesser degree. These effects support the use of QEqchi Maya women in Guatemala for reproductive.

Keywords: reporter genes, MC7, guatemala piperaceae, reproductive health

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Authors: Ozge Yilmaz Kusbeci, Ipek Inci

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Aim: Musculoskeletal problems are very common in Parkinson’s disease (PD). They affect quality of life and cause disabilities. However they are under-evaluated, and under-treated. The aim of this study is to evaluate the prevalence and clinical features of musculoskeletal problems in patients with Parkinson disease (PD) compared to controls. Methods: 50 PD patients and 50 age and sex matched controls were interviewed by physicians about their musculoskeletal problems. Results: The prevalence of musculoskeletal problems was significantly higher in the PD group than in the control group (p < 0.05). Commonly involved body sites were the shoulder, low back, and knee. The shoulder and low back was more frequently involved in the PD group than in the control group. However, the knee was similarly involved in both groups. Among the past diagnoses associated with musculoskeletal problems, frozen shoulder, low back pain and osteoporosis more common in the PD group than in the control group (p < 0.05). Furthermore, musculoskeletal problems in the PD group tended to receive less treatment than that of the control group. Conclusion: Musculoskeletal problems were more common in the PD group than in the controls. Therefore assessment and treatment of musculoskeletal problems could improve quality of life in PD patients.

Keywords: parkinson disease, musculoskeletal problems, quality of life, PD disease

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Authors: Prabhu Thangaraju, Manoj Deepak, A. Sivakumar

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Removal of inter vertebral disc along with spinal fusion has many disadvantages such as causing stress fractures. If it is possible regenerate the spine it would be possible avoid the complications of the surgery and achieve better results. Our study involves the use of mesenchymal stem cells in regenerating the discs. Our study involved 10 patients who presented with degenerative disc disease between 2008-2011 in our hospital. After adequate pre-operative check prepared mesenchymal stem cells were injected into the disc spaces. These patients were subjected to conservative therapy for a minimum of six weeks before they were accepted into the study. They were followed up regularly for a minimum of 2years with serial radiographs and MRI. 8 out of the 10 patients had completed reduction in the pain. The T2 weighted MRI images in 9 out of the 10 patients showed a bright signal compared the previous Images which indicated that there was improvement in the hydration levels. From the case study of 10 patients who were subjected to mesenchymal cell therapy in our hospital, we can conclude that the use of mesenchymal cells in treatment of intervertebral disc degeneration in a safe and effective option.

Keywords: mesenchymal stem cells, intervertebral disc, the spine, disc degeneration

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Authors: Sengly Sroy, Elodie Arnaud, Adrien Servent, Sokneang In, Sylvie Avallone

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In Cambodia, fish plays an important role for local community in term of food habits, preference and contribution to several nutritional intakes. Consumed on a daily basis, fishes and their derivatives products are good sources of proteins, essential fatty acids and fat-soluble vitamins. They mainly obtain from the Tonle Sap Lake but, during the last decade, the fish population decreased drastically due to climate change and human activities as well. Contamination by agricultural residues and heavy metals were identified. However, fishes are currently used in several nutrition programs for children and pregnant women to improve their nutritional status. The aim of our work was to characterize the nutritional profile and contamination of 10 fish species consumed near the Tonle Sap Lake with a special attention to fatty acid and fat-soluble vitamin profiles. Fish samples were analyzed for their nutritional profiles (AOAC methods for macronutrients and micronutrients), their lipid content (Folch modified method), their Fatty acid (FAME method), their vitamin A (HPLC) and their heavy metals (ICP-MS). The total lipid contents ranged from 1.43 to 10.00% according to fish species. Lipid profile was mainly dominated by saturated fat (from 47.95 to 57.32%) but some fish species were particularly rich in ω-3 and ω-6 especially eicosapentaenoic acid EPA (3.05%) and docosahexaenoic acid DHA (2.82%). The more the fishes were fats, the more they contained vitamin A, DHA and EPA. Vitamin A is particularly abundant in small fishes (250.10 μg RE/100 g) compare to big ones (13.77 μg RE/100 g) because they are consumed as a whole with their organs (liver) and head. However, the contents of heavy metal in some species are higher than the maximum permitted level (MPL) from codex alimentarius, especially Mn. The results obtained provided important information on the most interesting fish in term of human nutrition and the potential risk of contaminants. The fatty acids are important for child development and pregnant women. These data are useful for supply chain stakeholders and the people in charge of nutrition program.

Keywords: fat-soluble vitamin, fatty acid, freshwater fish, lipid content, Tonle Sap Lake

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Authors: Sokol Isaraj, Lorela Bendo

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Botulinum toxin is the most commonly used treatment to reduce the appearance of dynamic facial wrinkles. It can smooth out wrinkles and restore a more youthful appearance. Although allergic reactions after botox injection are rare, care should be taken by the physician to diagnose the condition and provide suitable treatment in time. The authors report a case of allergic reaction with angioedema to abobotulinumtoxin A. A 50-year-old woman complaining of dynamic wrinkles was injected in a private clinic with Dysport. After two weeks, she returned to the clinic for the touch-up session. Thirty minutes after the completion of the injections in the crow’s feet area, she described the feeling of mild pain and warmth in the injected area, followed by angioedema. The symptoms couldn’t be controlled by IM corticosteroid, and the patient was referred to a hospital center. After adequate systemic treatment for four days, there was a resolution of the symptoms. Despite the reported safety of abobotulinumtoxin A, this case warns practitioners of unpredictably adverse reactions, which require rapid recognition and intravenous support.

Keywords: botulinum toxin, side effects, angioedema, injections

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Authors: Deepak Mohan, Sushma Sharma

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Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) are a group of widely used drugs for the treatment of rheumatoid diseases and to relieve pain and inflammation due to their analgesic anti-pyretic and anti-inflammatory properties. The therapeutic and many of the toxic effects of NSAIDs result from reversible inhibition of enzymes in the cyclooxygenase (COX) group. In the present investigation the effect of the drug on the concentration of lipids, and on the activity of the enzymes i.e. acid and alkaline phosphatase, GOT, GPT and lipid peroxidase were studied. There was a significant enhancement in the activities of both acid and alkaline phosphatase after 21 days of treatment. Proportionate increase in the MDA contents was observed after different days of diclofenac treatment. Cellular damage in the liver resulted in decrease in the activity of both GOT (Glutamate oxaloacetate transaminase) and GPT (Glutamate pyruvate transaminase) in both low and high dose groups. Significant decrease in the liver contents was also observed in both dose groups.

Keywords: anti-inflammatory, cyclooxygenase, glutamate oxaloacetate transaminase, malondialdehyde

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Authors: Sadia Munir

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The aim of this study is to investigate changes in placental development and vascular dysfunction which subsequently affect feto-maternal health in pregnancies complicated by gestational diabetes mellitus (GDM). Fetal and postnatal adverse health outcomes of GDM are shown to be associated with disturbances in placental structure and function. Children of women with GDM are more likely to be obese and diabetic in childhood and adulthood. GDM also increases the risk of adverse pregnancy outcomes, including preeclampsia, birth injuries, macrosomia and neonatal hypoglycemia, respiratory distress syndrome, neonatal cardiac dysfunction and stillbirth. Incidences of type 2 diabetes in the MENA region are growing at an alarming rate which is estimated to become more than double by 2030. Five of the top 10 countries for diabetes prevalence in 2010 were in the Gulf region. GDM also increases the risk of development of type 2 diabetes. Interestingly, more than half of the women with GDM develop diabetes later in their life. The human placenta is a temporary organ located at the interface between mother and fetal blood circulation. Placenta has a central role as both a producer as well as a target of several molecules that are involved in placental development and function. We have investigated performed a Pubmed search with key words placenta, GDM, placental villi, vascularization, cytokines, growth factors, inflammation, hypoxia, oxidative stress and pathophysiology. We have investigated differences in the development and vascularization of placenta, their underlying causes and impact on feto-maternal health through literature review. We have also identified gaps in the literature and research questions that need to be answered to completely understand the central role of placenta in the GDM. This study is important in understanding the pathophysiology of placenta due to changes in the vascularization of villi, surface area and diameter of villous capillaries in pregnancies complicated by GDM. It is necessary to understand these mechanisms in order to develop treatments to reverse their effects on placental malfunctioning, which in turn, will result in improved mother and child health.

Keywords: gestational diabetes mellitus, placenta, vasculature, villi

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Authors: Damian Gordon, Paul Doyle, Anna Becevel, Júlia Vilafranca Molero, Cinta Gascon, Arianna Vitiello, Tina Baloh

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It has long been recognized that the creation of any teaching content can be enhanced if the development process follows a pre-defined approach, which is often referred to as an instructional design methodology. These methodologies typically define a number of stages, or phases, that an educator should undertake to help ensure the quality of the final teaching content that is developed. In this paper, we present an instructional design methodology that is focused specifically on the introduction of blended resources into a heretofore bricks-and-mortar course. To achieve this, research was undertaken concerning a range of models of instructional design, as well as literature covering some of the key challenges and “pain points” of blending. Following this, our model, the BL-5D model, is presented, which incorporates some key questions at each stage of this five-stage methodology to guide the development process. Finally, a discussion of some of the key themes and issues that have been uncovered in this work is presented, as well as a template for a blended learning case study that emerged from this approach.

Keywords: blended learning, challenges of blended learning, design methodologies, instructional design

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Authors: Gomes C. C. Izabel, Lanzotti B. Rafaela, Orlandi S. Fabiana

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Chronic Kidney Disease is considered a serious public health problem. The exploitation of resilience has been guided by studies conducted in various contexts, especially in hemodialysis, since the impact of diagnosis and restrictions produced during the treatment process because, despite advances in treatment, remains the stigma of the disease and the feeling of pain, hopelessness, low self-esteem and disability. The objective was to evaluate the level of resilience of patients in chronic renal dialysis. This is a descriptive, correlational, cross and quantitative research. The sample consisted of 100 patients from a Renal Replacement Therapy Unit in the countryside of São Paulo. For data collection were used the characterization instrument of Participants and the Resilience Scale. There was a predominance of males (70.0%) were Caucasian (45.0%) and had completed elementary education (34.0%). The average score obtained through the Resilience Scale was 131.3 (± 20.06) points. The resiliency level submitted may be considered satisfactory. It is expected that this study will assist in the preparation of programs and actions in order to avoid possible situations of crises faced by chronic renal patients.

Keywords: hemodialysis units, renal dialysis, renal insufficiency chronic, resilience psychological

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Authors: Leyla Sattarzadeh, Maghsoud Peeri, Mohammadali Azarbaijani, Hasan Matin Homaee

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Inflammation by various mechanisms may cause atherosclerosis. Systemic circulating inflammatory markers such as C-reactive protein (CRP), pro-inflammatory cytokines such as Interleukin-6 (IL-6) and adhesion molecules like Intracellular Adhesion Molecule-1 (ICAM-1) are the predictors of cardiovascular diseases. Regarding the conflicting results about the effect of resistance exercise training on these inflammatory markers, the present study aimed to examine the effect of eight week different patterns of resistance exercise training on CRP, IL-6 and ICAM-1 levels in healthy untrained women. 40 volunteered and healthy untrained female university students (aged: 21+ 3 yr., Body Mass Index: 21.5+ 3.5 kg/m2) were selected purposefully and divided into three groups. At the end of training protocol and after subjects drop during the protocol in upper body exercise training (n=11), lower body (n=12) completed the eight week of training period although the control group (n=7) did anything. Blood samples gathered pre and post experimental period and CRP, IL-6 and ICAM-1 levels were evaluated using special laboratory kits, then the difference of pre and post values of each indices analyzed using one way Analysis of Variance (α < 0.05). The results of one way ANOVA for difference of pre and post values of CRP and ICAM-1 showed no significant changes due to the exercise training. But there were significant differences between groups about IL-6. Tukey post- hoc test indicated that there is significant difference between the differences of pre and post values of IL-6 between lower body exercise training group and control group, and eight weeks of lower body exercise training lead to significant changes in IL-6 values. There were no changes in anthropometric indices. The findings show that the different patterns of upper and lower body exercise training by involving the different amount of muscles altered the IL-6 values in lower body exercise training group probably because of engaging the bigger amount of muscles, but showed any significant changes about CRP and ICAM-1 probably due to intensity and duration of exercise or the lower levels of these markers at baseline of healthy people.

Keywords: C-reactive protein, interleukin-6, intracellular adhesion molecule-1, resistance training

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Authors: Iris W. A. Boot, Anke Wesselius, Maurice P. Zeegers

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Diet may play an essential role in the aetiology of bladder cancer (BC). Vitamin D is involved in various biological functions which have the potential to prevent BC development. Besides, vitamin D also influences the uptake of calcium and phosphorus , thereby possibly indirectly influencing the risk of BC. The aim of the present study was to investigate the relation between vitamin D intake and BC risk. Individual dietary data were pooled from three cohort studies. Food item intake was converted to daily intakes of vitamin D, calcium and phosphorus. Pooled multivariate hazard ratios (HRs), with corresponding 95% confidence intervals (CIs) were obtained using Cox-regression models. Analyses were adjusted for gender, age and smoking status (Model 1), and additionally for the food groups fruit, vegetables and meat (Model 2). Dose–response relationships (Model 1) were examined using a nonparametric test for trend. In total, 2,871 cases and 522,364 non-cases were included in the analyses. The present study showed an overall increased BC risk for high dietary vitamin D intake (HR: 1.14, 95% CI: 1.03-1.26). A similar increase BC risk with high vitamin D intake was observed among women and for the non-muscle invasive BC subtype, (HR: 1.41, 95% CI: 1.15-1.72, HR: 1.13, 95% CI: 1.01-1.27, respectively). High calcium intake decreased the BC risk among women (HR: 0.81, 95% CI: 0.67-0.97). A combined inverse effect on BC risk was observed for low vitamin D intake and high calcium intake (HR: 0.67, 95% CI: 0.48-0.93), while a positive effect was observed for high vitamin D intake in combination with low, moderate and high phosphorus (HR: 1.31, 95% CI: 1.09-1.59, HR: 1.17, 95% CI: 1.01-1.36, HR: 1.16, 95% CI: 1.03-1.31, respectively). Combining all nutrients showed a decreased BC risk for low vitamin D intake, high calcium and moderate phosphor intake (HR: 0.37, 95% CI: 0.18-0.75), and an increased BC risk for moderate intake of all the nutrients (HR: 1.18, 95% CI: 1.02-1.38), for high vitamin D and low calcium and phosphor intake (HR: 1.28, 95% CI: 1.01-1.62), and for moderate vitamin D and calcium and high phosphorus intake (HR: 1.27, 95% CI: 1.01-1.59). No significant dose-response analyses were observed. The findings of this study show an increased BC risk for high dietary vitamin D intake and a decreased risk for high calcium intake. Besides, the study highlights the importance of examining the effect of a nutrient in combination with complementary nutrients for risk assessment. Future research should focus on nutrients in a wider context and in nutritional patterns.

Keywords: bladder cancer, nutritional oncology, pooled cohort analysis, vitamin D

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Authors: Jameson Mirimu, Edward Mawejje, Ibra Twinomujuni

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Introduction: Adolescent girls and young women (AGYW) are a vulnerable category whose risk of acquiring HIV is 20 times compared to the general population accounting for 25% of the new infections. Despite proven scientific evidence of preventing HIV acquisition, Oral Pre-Exposure Prophylaxis (PreP) is less used as one of the biomedical interventions among the AGYW. By 2020, only 31000-32000 of the targeted 90,000 persons in Uganda enrolled on Oral PreP LPHS-EC project employed a combination of Expanded Peer Outreach Approach (EPOA) and Effective client follow-up to increase PreP initiation (PrEP_NEW) and continuation for more than three months (PrEP_CT). Method: Quantitatively, data from National Key population Combination tracker retrospectively analyzed by M&E, focused group discussion with AGYWs and Health care workers to identify barriers. Barriers found; hesitancy of AGYW, misconceptions about Oral PrEP, inadequate knowledge and skills in handling adolescent and Data quality issues. To address the mentioned barriers, youth friendly corners initiated in study sites, identified PrEP Champions among the AGYW, oral PrEP dialogues, group Antenatal counselling, CQI Projects initiated, weekly perfomance meetings to track performance. Results: Routine program data review PrEP_NEW and PrEP_CT increased from 5% (4/80) and 4% (2/54), respectively, in July 2022 to 90% (72/80) and 79% (43/54) respectively for PrEP_NEW and PrEP_CT at the end of March 2023. Lessons Learnt: Demystifying misconception about oral Prep through provision of adequate information by involving health care workers through skills enhancement, CQI projects are critical intervention. Conclusion: With improved safe spaces, skills enhancement of health workers, stakeholders’ engagement through Oral Prep dialogues is critical in improving PreP uptake and continuity among the AGYWS.

Keywords: prep, uptake, continuation, AGYW

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Authors: Z. Nurzaireena, K. Azalea, T. Azirawaty, S. Jameela, G. Muralitharan

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The aim of this study is the review of the management practices of sickle cell disease patients during pregnancy, as well as the maternal and neonatal outcome at Ampang Hospital, Selangor. The study consisted of a review of pregnant patients with sickle cell disease under follow up at the Hematology Clinic, Ampang Hospital over the last seven years to assess their management and maternal-fetal outcome. The results of the review show that Ampang Hospital is considered the public hematology centre for sickle cell disease and had successfully managed three pregnancies throughout the last seven years. Patients’ presentations, managements and maternal-fetal outcome were compared and reviewed for academic improvements. All three patients were seen very early in their pregnancy and had been given a regime of folic acid, antibiotics and thrombo-prophylactic drugs. Close monitoring of maternal and fetal well being was done by the hematologists and obstetricians. Among the patients, there were multiple admissions during the pregnancy for either a painful sickle cell bone crisis, haemolysis following an infection and anemia requiring phenotype- matched blood and exchange transfusions. Broad spectrum antibiotics coverage during and infection, hydration, pain management and venous-thrombolism prophylaxis were mandatory. The pregnancies managed to reach near term in the third trimester but all required emergency caesarean section for obstetric indications. All pregnancies resulted in live births with good fetal outcome. During post partum all were nursed closely in the high dependency units for further complications and were discharged well. Post partum follow up and contraception counseling was comprehensively given for future pregnancies. Sickle cell disease is uncommonly seen in the East, especially in the South East Asian region, yet more cases are seen in the current decade due to improved medical expertise and advance medical laboratory technologies. Pregnancy itself is a risk factor for sickle cell patients as increased thrombosis event and risk of infections can lead to multiple crisis, haemolysis, anemia and vaso-occlusive complications including eclampsia, cerebrovasular accidents and acute bone pain. Patients mostly require multiple blood product transfusions thus phenotype-matched blood is required to reduce the risk of alloimmunozation. Emphasizing the risks and complications in preconception counseling and establishing an ultimate pregnancy plan would probably reduce the risk of morbidity and mortality to the mother and unborn child. Early management for risk of infection, thromboembolic events and adequate hydration is mandatory. A holistic approach involving multidisciplinary team care between the hematologist, obstetricians, anesthetist, neonatologist and close nursing care for both mother and baby would ensure the best outcome. In conclusion, sickle cell disease by itself is a high risk medical condition and pregnancy would further amplify the risk. Thus, close monitoring with combine multidisciplinary care, counseling and educating the patients are crucial in achieving the safe outcome.

Keywords: anaemia, haemoglobinopathies, pregnancy, sickle cell disease

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Authors: Moustafa Ali

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The aim of this paper is to discuss and question some of the widely accepted concepts within the conceptual framework of gender from terminological, scientific, and Muslim cultural perspectives, and to introduce a new definition and a model of gender in the Arab and Muslim societies. This paper, therefore, uses a generic methodology and document analysis and comes in three sections and a conclusion. The first section discusses some of the terminological issues in the conceptual framework of gender. The second section highlights scientific issues, introduces a definition and a model of gender, whereas the third section offers Muslim cultural perspectives on some issues related to gender in the Muslim world. The paper, then, concludes with findings and recommendations reached so far.

Keywords: gender definition, gender equalities, sex-gender separability, fairness-based model of gender

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Authors: Joelle Fong

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Older persons are at greatest risk of becoming frail. As survival to the age of 80 and beyond continues to increase, the health and frailty of older Americans has garnered much recent attention among policy makers and healthcare administrators. This paper examines patterns in old-age frailty within a multistate actuarial model that characterizes the stochastic process of biological ageing. Using aggregate population-level U.S. mortality data, we implement a stochastic aging model to examine cohort trends and gender differences in frailty distributions for older Americans born 1865 – 1894. The stochastic ageing model, which draws from the fields of actuarial science and gerontology, is well-established in the literature. The implications for public health insurance programs are also discussed. Our results suggest that, on average, women tend to be frailer than men at older ages and reveal useful insights about the magnitude of the male-female differential at critical age points. Specifically, we note that the frailty statuses of males and females are actually quite comparable from ages 65 to 80. Beyond age 80, however, the frailty levels start to diverge considerably implying that women are moving quicker into worse states of health than men. Tracking average frailty by gender over 30 successive birth cohorts, we also find that frailty levels for both genders follow a distinct peak-and-trough pattern. For instance, frailty among 85-year old American survivors increased in years 1954-1963, decreased in years 1964-1971, and again started to increase in years 1972-1979. A number of factors may have accounted for these cohort differences including differences in cohort life histories, differences in disease prevalence, differences in lifestyle and behavior, differential access to medical advances, as well as changes in environmental risk factors over time. We conclude with a discussion on the implications of our findings on spending for long-term care programs within the broader health insurance system.

Keywords: actuarial modeling, cohort analysis, frail elderly, health

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Authors: Zeinab Farhat, Nicolas Errien, Romuald Wernert, Véronique Verriele, Frédéric Amiard, Philippe Daniel

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Ovarian cancer, also known as the silent killer, is the fifth most common cancer among women worldwide, and its death rate is higher than that of other gynecological cancers. The low survival rate of women with high-grade serous ovarian carcinoma highlights the critical need for the development of new methods for early detection and diagnosis of the disease. The aim of this study was to evaluate if Raman spectroscopy combined with chemometric methods such as Principal Component Analysis (PCA) could differentiate between cancerous and normal tissues from different types of samples, such as paraffin embedding, chemical deparaffinized, formalin-fixed and fresh samples of the same normal and malignant ovarian tissue. The method was applied specifically to two critical spectral regions: the signature region (860-1000 〖cm〗^(-1)) and the high-frequency region (2800-3100 〖cm〗^(-1) ). The mean spectra of paraffin-embedded in normal and malignant tissues showed almost similar intensity. On the other hand, the mean spectra of normal and cancer tissues from chemical deparaffinized, formalin-fixed, and fresh samples show significant intensity differences. These spectral differences reflect variations in the molecular composition of the tissues, particularly lipids and proteins. PCA, which was applied to distinguish between cancer and normal tissues, was performed on whole spectra and on selected regions—the PCA score plot of paraffin-embedded shows considerable overlap between the two groups. However, the PCA score of chemicals deparaffinized, formalin-fixed, and fresh samples showed a good discrimination of tissue types. Our findings were validated by analyses of a set of samples whose status (normal and cancerous) was not previously known. The results of this study suggest that Raman Spectroscopy associated with PCA methods has the capacity to provide clinically significant differentiation between normal and cancerous ovarian tissues.

Keywords: Raman spectroscopy, ovarian cancer, signal processing, Principal Component Analysis, classification

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Authors: Aliza Lee, Mark Wilt, John Bonk, Scott Floyd, Bradley Hoffman, Karen Uchmanowicz

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Bipartite medial cuneiforms are relatively rare but may play a significant role in biomechanical and gait abnormalities. It is believed that a bipartite medial cuneiform may alter the available range of motion due to its larger morphological variant, thus limiting the metatarsal plantarflexion needed to achieve adequate hallux dorsiflexion for normal gait. Radiographic and clinical assessments were performed on 2 patients who reported foot pain along the first ray. Both patients had visible bipartite medial cuneiforms on MRI. Using gait plate and Metascan™ analysis, both were noted to have four measurements far beyond the expected range. Medial and lateral heel peak pressure, hallux peak pressure, and 1st metatarsal peak pressure were all noted to be increased. These measurements are believed to be increased due to the hindrance placed on the available ROM of the 1st ray by the increased size of the medial cuneiform. A larger patient population would be needed to fully understand this developmental anomaly.

Keywords: bipartite medial cuneiforms, cuneiform, developmental anomaly, gait abnormality

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Authors: Amy Claridge, Tishra Beeson

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Background: Maternal depression is a serious health concern impacting between 10-16% of birthing persons. It is associated with difficulty in emotional interaction and the formation of attachment bonds between parent and infant. Longitudinally, maternal depression can have severe, lasting impacts on both parent and child, increasing the risk for mental, social, and physical health issues. Rates of prenatal depression have been higher among individuals who were pregnant during the first year of the COVID-19 pandemic. Pregnant persons are considered a high-risk group for poor clinical outcomes from COVID-19 infection and may also have faced or continue to face additional stressors such as financial burdens, loss of income or employment, and the benefits accompanying employment, especially among those in the United States (U.S.). It is less clear whether individuals who gave birth during the pandemic continue to experience high levels of depressive symptoms or whether symptoms have been reduced as a pandemic response has shifted. The current study examined longitudinal reports of depressive symptoms among individuals in the U.S. who gave birth between March 2020 and September 2021. Methods: This mixed-method study involved surveys and interviews with birthing persons (18-45 years old) in their third trimester of pregnancy and at 8 weeks postpartum. Participants also completed a follow-up survey at 12-18 months postpartum. Participants were recruited using convenience methods via an online survey. Survey participants included 242 U.S. women who self-reported depressive symptoms (10-item Edinburgh Postnatal Depression Scale) at each data collection wave. A subset of 23 women participated in semi-structured prenatal and 8-week postpartum qualitative interviews. Follow-up interviews are currently underway and will be integrated into the presentation. Preliminary Results: Prenatal depressive symptoms were significantly positively correlated to 8-week and 12-18-month postpartum depressive symptoms. Participants who reported clinical levels of depression prenatally were 3.29 times (SE = .32, p < .001) more likely to report clinical levels of depression at 18 months postpartum. Those who reported clinical depression at 8-weeks postpartum were 6.52 times (SE = .41, p < .001) more likely to report clinical levels of depression at 18 months postpartum. Participants who gave birth earlier in the pandemic reported significantly higher prenatal (t(103) = 2.84, p < .01) and 8-week postpartum depressive symptoms (t(126) = 3.31, p < .001). Data from qualitative interviews contextualize the findings. Participants reported negative emotions during pregnancy, including sadness, grief, and anxiety. They attributed this in part to their experiences of pregnancy during the pandemic and uncertainty related to the birth experience and postpartum period. Postpartum interviews revealed some stressors specific to childbirth during the COVID-19 pandemic; however, most women reflected on positive experiences of birth and postpartum. Conclusions: Taken together, findings reveal a pattern of persistent depressive symptoms among U.S. parents who gave birth during the pandemic. Depressive symptoms are of significant concern for the health of parents and children, and the findings of this study suggest a need for continued mental health intervention for parents who gave birth during the pandemic. Policy and practice implications will be discussed.

Keywords: maternal mental health, perinatal depression, postpartum depression, covid-19 pandemic

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Authors: Omyma Alosaimi, Asma Alsumait

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The website developer and designer should follow usability guidelines to provide a user-friendly interface. Using tools to measure usability, the evaluator can evaluate automatically hundreds of links within few minutes. It has the advantage of detecting some violations that only machines can detect. For that using usability evaluating tool is important to find as many violations as possible. There are many websites usability testing tools, but none is developed to measure the usability of e-government website nor Arabic e-government websites. To measure the usability of the Arabic e-government websites, a tool is developed and tested in this paper. A comparison of using a tool specifically developed for e-government websites and general usability testing tool is presented.

Keywords: e-government, human computer interaction, usability evaluation, usability guidelines

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Authors: Fernando Valerio-Holguin

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Over the recent three decades, the tourism industry in the Dominican Republic has had an enormous impact on the country’s culture. The arrival of tourists from Germany, France, Italy, Russia and the United States has rewritten Dominican cultural identity and created a cultural palimpsest in the areas of language, gastronomy, habits, fashion, values, and gender relations. As a consequence of tourism, a prostitution network has flourished across the country. In the film Sand Dollars (2015) directed by Laura Amelia Guzmán and Israel Cárdenas, Noelí (Janet Mojica), a young mulatto woman, altogether with her boyfriend (Ricardo Ariel Toribio), strips tourists of dollars and euro through prostitution. One of her frequent clients is Anne, a mature French woman (Geraldine Chaplin). While Noeli’s goal is to get all the euros she can, Anne falls in love with her and tries to bring her to France. Both the content of the film and its cinematographic languages are analyzed in light of theory of coloniality. This concept shows how European and American tourism, through the power of money, perpetuates colonial discourse, i. e., how race and ethnocentrism permeate cultural activities in their former colonies. Moreover, in the content analysis of the film the concepts of exchange value and fetishism are crucial to understanding how the colonial body becomes sexual commodity. They facilitate grasping the film’s inequity in terms of power in the relationship between the two women: the white old European woman and the young, poor, third-world mulatta. Even though the film attempts to break away from compulsory heterosexuality, the power relation between the two women persists due to the presence of the axis of race, ethnicity, age and gender. Both the novel Les dollars des sables written by Jean-Noel Pancrazi, and the film Sand Dollars offer an interesting insight into sex tourism and coloniality and shed additional light on the power relations between the former colonizers and its colonies.

Keywords: coloniality, ethnocentrism, exchange value, Europe, fetishism, money, power, prostitution, sex tourism, United States of America

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Authors: Amanda Julia Binay, Patricia Elise Suarez

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Female representation in media is an important subject in the discussion of gender equality, especially in impactful and influential media like film. As the Filipino film industry continues to grow and evolve, the need for analysis on Filipino female representation on screen is imperative. Additionally, there has been limited research made on female representation in the Philippine film scene. Thus, the paper aims to analyze the presence and evolution of female representation in Philippine cinema and compare the findings with that of American films to see how Filipino filmmakers hold their own against the standards of international movements that call for more and better female representation, especially in Hollywood. The participants selected were Filipino and American films released within the years 1975 to 2020 in five (5) year intervals. Twenty (20) critically acclaimed and highest-grossing Filipino films and twenty (20) critically acclaimed and highest-grossing Hollywood films were then subject to the Bechdel and Peirce tests to obtain statistical measures of their female representation. The findings of the study reveal that the presence of female representation in Philippine film history has been consistent and has continued to grow and evolve throughout the years, with strong female leads with vibrant characteristics and diverse stories. However, analysis of female representation regarding American films has shown an extreme lack thereof with more misogynistic, sexist, and limiting ideals. Thus, the study concludes that the state of female representation in Philippine cinema and film industry holds its own when compared to American cinema and film industry and even outperforms it in many aspects of female representation, such as consistent inclusion and depiction of multi-dimensional female leads and female relationships. Hence, the study implies that women’s consistent presence in Philippine cinema mirrors Filipino women’s prominent role in Philippine society and that American cinema must continue to make efforts to change their portrayals of female characters, leads, and relationships to make them more grounded in reality.

Keywords: female representation, gender studies, feminism, philippine cinema, American cinema, bechdel test, peirce test, comparative analysis

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Authors: Ammal M. Metwally, Walaa A. Basha, Ghada A. Abdel-Latif, Amira S. El Rifay

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Introduction: Improving breastfeeding practices does not always link to interventions relying on improving nutrition awareness and education alone but needs cultural and behavioral insights. Aim: Our study provided educational intervention through the use of the social marketing (SM) approach, which was respectable to societal norms allowing more conscious choices by mothers to achieve the maximum potential of physical growth of their infants. This study evaluated the effectiveness of the used approach for improving breastfeeding practices and the physical growth of infants aged up to 2 years. Methodology: A quasi-experimental intervention design with a posttest-only control design was done over three years duration to motivate mothers’ voluntary behavioral change toward breastfeeding promotion using SM principles: product, price, place, and promotion. The interventions targeted 464 pregnant women in their last trimester, mothers of children up to 2 years, and 1454 women in their childbearing period. Results: Most mothers showed increased awareness about the benefits of breastfeeding and became interested in breastfeeding their children outside the house using the breastfeeding cover (Gawn). Breastfeeding initiation, exclusive breastfeeding under six months, frequency of breastfeeding per day, and percentage of children who continued breastfeeding till two years were significantly increased (from 30%, 23 %, 56%, and 32% to 62 %, 47.3 %, 69 %, and 43.5 %). With the attention of the nutritional educational sessions three or more times, the majority of indicators had the most significant improvement. The females who recorded underweight results over males during the first two years of life significantly improved after the intervention (from 53.8 % to 15.4%, respectively). At the same time, females that were found to be obese before the intervention (7.7 %) became no longer obese. Conclusions: Nutritional interventions that are based on the use SM approach showed improvement for the majority of the key performance indicators. Although they doubled their value before the intervention, the majority were still modest (below 50 %). With sustained use of the SM approach, infants will achieve their maximum potential for physical growth by providing economically disadvantaged mothers with breastfeeding support.

Keywords: social marketing approach, early breastfeeding initiation, exclusive breastfeeding, responsiveness to cues of hunger and satiety, physical growth of infants

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Authors: David Maina Muthegethi

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For decades, archaeological work of Swahili Civilization has mainly concentrated on exploration of economic and political dynamics of City states. This paper moves further and explore how gender roles were formed, maintained, negotiated and re-negotiated through time and space in Gede City. Unlike other Swahili city states, Gede was located around two miles away from the shores of Indian Ocean. Nonetheless, the city was characterized by security walls, stone houses, mosques and tombs typical of Swahili City states such as Kilwa. The study employed several methods of data collection namely: archival research, survey, re-examination of collected materials and excavation of Gede archaeological site. Since, the study aimed to examine gender roles across different social class, a total of three houses were excavated based on their social hierarchy. Thus, the houses were roughly categorized as belonging to elites, middle class and lower class. The house were located in the inner wall, second inner wall and the outer wall of Gede City respectively. Key findings shows that gender roles differed considerably along classes in Gede archaeological site. For instance, the women of the elite and middle class were active participants in Gede international trade through production and consumption of imported goods. This participation corresponded with commercialization of Gede households especially in elite’ areas where they hosted international traders. On the other hand, the middle class houses, women concentrated on running of light industries aimed at supplying goods for the urban community. Thus, they were able to afford exotic goods as their elites counterparts. Lastly, the gender roles of lower class entailed subsistence gender roles with little participation in Gede formal commerce. Interestingly, gender roles in Gede were dynamic in nature and response to cultural diffusion, spread of Islam, intensification of trade, diversification of subsistence patterns and urbanization. Therefore, this findings, demonstrate centrality of gender in reconstruction of social lives of Swahili Civilization.

Keywords: gender roles, Islam, Swahili civilization, urbanization

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Authors: Chirag Kothawade, Gourie Jagtap, PreetKaur Relusinghani, Vedang Chavan, Smitha S. Bhosale

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Psychological research has proven that music relieves stress, elevates mood, and is responsible for the release of “feel-good” chemicals like oxytocin, serotonin, and dopamine. It comes as no surprise that music has been a popular tool in rehabilitation centers and therapy for various disorders, thus with the interminably rising numbers of people facing mental health-related issues across the globe, addressing mental health concerns is more crucial than ever. Despite the existing music recommendation systems, there is a dearth of holistically curated algorithms that take care of the needs of users. Given that, an undeniable majority of people turn to music on a regular basis and that music has been proven to increase cognition, memory, and sleep quality while reducing anxiety, pain, and blood pressure, it is the need of the hour to fashion a product that extracts all the benefits of music in the most extensive and deployable method possible. Our project aims to ameliorate our users’ mental state by building a comprehensive mood-based music recommendation system called “Viby”.

Keywords: language, communication, speech recognition, interaction

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Authors: Ratchaneewan Salao, Steven W. Edwards, Kiatichai Faksri, Kanin Salao

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Background: A two-dose regimen of COVID-19 vaccination (inactivated whole virion SARS-CoV-2 and adenoviral vector) has been widely used. Side effects are very low, but several adverse effects have been reported. Methods: A 40-year-old female patient, with a previous history of thyroid goitre, developed severe neck pain, headache, nausea and fatigue 7-days after receiving second vaccination with Vaxzevria® (Oxford-AstraZeneca). Clinical and laboratory findings, including thyroid function tests and ultrasound of thyroid glands, were performed. Results: Her left thyroid gland was multinodular enlarged, and severely tender on palpation. She had difficulty in swallowing and had tachycardia but no signs of hyperthyroidism. Laboratory results supported a diagnosis of subacute thyroiditis. She was prescribed NSAID (Ibuprofen 400 mg) and dexamethasone for 3-days and her symptoms resolved. Conclusions: Although this is an extremely rare event, physicians may encounter more cases of this condition due to the extensive vaccination program using this combination of vaccines.

Keywords: SARS-CoV-2, adenoviral vector vaccines, vaccination, subacute thyroiditis

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Authors: Julia V. F. Cortes, Maria E. V. Amarante, Carolina L. Cerdeira, Roberta B. V. Silva

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Nonmelanoma skin cancer is more commonly diagnosed than all other malignancies combined. In that group, cutaneous squamous cell carcinoma stands out for having the highest probability of metastasis and recurrence after treatment, in addition to being the second most prevalent form of skin cancer. Its main risk factors include exposure to carcinogens, such as ultraviolet radiation related to sunlight exposure, smoking, alcohol consumption, and human papillomavirus (HPV) infection. Considering the increased risk of skin cancer in the Brazilian population, caused by the high incidence of solar radiation, and the importance of identifying risk phenotypes for the accomplishment of public health actions, an epidemiological study was conducted in a city with a tropical climate located in southeastern Brazil, aiming to identify the target population and assist in primary and secondary prevention. This study describes the profile of patients with cutaneous squamous cell cancer, correlating the variables, sex, age, and differentiation. The study used as primary data source the results of anatomopathological exams delivered from January 2015 to December 2019 for patients registered at one pathology service, which analyzes the results of biopsies, Thus, 66 patients with cutaneous squamous cell carcinoma were analyzed. The most affected age group was 60 years or older (78.79%), emphasizing that moderately differentiated (79.49%) and well-differentiated forms (66.67%) are prevalent in this age group, resulting in a difference of 12.82 percentage points between them. In addition, the predominant sex was male (58%), and it was found that half of the women and 65.79% of men had a moderately differentiated type, whereas the well-differentiated type was slightly more frequent in women. It is worth noting that the moderately differentiated subtype has a 59.20% prevalence among all cases. Thus, it was concluded that the most affected age group was 60 years or older and that men were more affected. As for the subtype, the moderately differentiated one, which is recognized for presenting the second-highest risk for metastasis, was prevalent in this study, affecting 6.6% more men and predominating in the elderly.

Keywords: cutaneous squamous cell carcinoma, epidemiology, skin cancer, spinal cell cancer

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Authors: Iman Ali Ahmed Al-Rashed

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This paper directs attention to the limitations of the teacher-centered strategy in teaching. The aim of this study is to draw more educational attention to learner-centered strategy in order to shift the emphasis from the traditional concept of teaching to a new concept in teaching. To begin bridging the traditional concept of teaching and the new concept, the study will explore the new concept of teaching to support teaching in Arab World generally and in Iraq specifically. A qualitative case study orientation was used to collect data in the form of classroom observations, interviews and field notes. The teaching practices used by three university instructors are investigated and according to the findings, some explanations and recommendations are made.

Keywords: case study, learner-centered strategy, qualitative study, teacher-centered strategy, traditional teaching

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Authors: Elham Rezaee, Sayyed Abbas Tabatabai

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Dual inhibition of COX-2 and sEH enzymes represents one of the distinct pharmaceutical approaches for the treatment of inflammation, pain, cancers, and other diseases. The discovery of these inhibitors for treatment is a great deal of attention because of some advantages such as increased efficacy, a promising safety profile, ease of formulation, and better target engagement. In this research, based on the structure-activity relationship of COX-2 and sEH inhibitors, some amide derivatives with oxadiazole and dihydropyrimidinone rings against sEH and COX-2 enzymes were developed. The designed compounds showed high affinity to the active site of both enzymes in docking studies and were synthesized in good yield and characterized by IR, Mass, 1HNMR, and 13CNMR. All of the novel compounds exhibited considerable in-vitro sEH and COX-2 inhibitory activities in comparison with 12-(3-Adamantan-1-yl-ureido)- dodecanoic acid and celecoxib (a potent urea-based sEH inhibitor and selective nonsteroidal anti-inflammatory drug, respectively). Ethyl 6-methyl-4-(4-(4-(methylsulfonyl)benzamido)phenyl)-2-oxo-1,2,3,4-tetrahydropyrimidine-5-carboxylate was found to be the most selective COX-2 inhibitor (COX-2/COX-1 ratio: 683) with IC50 value of 2.1 nM targeting sEH enzyme.

Keywords: COX-2, dual inhibitors, sEH, synthesis

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Authors: Elnaz Saeedi, Jamileh Abolaghasemi, Mohsen Nasiri Tousi, Saeedeh Khosravi

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Goals and Objectives: A typical analysis of survival data involves the modeling of time-to-event data, such as the time till death. A frailty model is a random effect model for time-to-event data, where the random effect has a multiplicative influence on the baseline hazard function. This article aims to investigate the use of gamma frailty model with concomitant variable in order to individualize the prognostic factors that influence the liver cirrhosis patients’ survival times. Methods: During the one-year study period (May 2008-May 2009), data have been used from the recorded information of patients with liver cirrhosis who were scheduled for liver transplantation and were followed up for at least seven years in Imam Khomeini Hospital in Iran. In order to determine the effective factors for cirrhotic patients’ survival in the presence of latent variables, the gamma frailty distribution has been applied. In this article, it was considering the parametric model, such as Exponential and Weibull distributions for survival time. Data analysis is performed using R software, and the error level of 0.05 was considered for all tests. Results: 305 patients with liver cirrhosis including 180 (59%) men and 125 (41%) women were studied. The age average of patients was 39.8 years. At the end of the study, 82 (26%) patients died, among them 48 (58%) were men and 34 (42%) women. The main cause of liver cirrhosis was found hepatitis 'B' with 23%, followed by cryptogenic with 22.6% were identified as the second factor. Generally, 7-year’s survival was 28.44 months, for dead patients and for censoring was 19.33 and 31.79 months, respectively. Using multi-parametric survival models of progressive and regressive, Exponential and Weibull models with regard to the gamma frailty distribution were fitted to the cirrhosis data. In both models, factors including, age, bilirubin serum, albumin serum, and encephalopathy had a significant effect on survival time of cirrhotic patients. Conclusion: To investigate the effective factors for the time of patients’ death with liver cirrhosis in the presence of latent variables, gamma frailty model with parametric distributions seems desirable.

Keywords: frailty model, latent variables, liver cirrhosis, parametric distribution

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