Search results for: Naomi Sakamoto

Authors: Naomi Sakamoto, Eisuke Fukuma, Mika Nashimoto, Yoshitomo Koshida

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Background: Selective localization of the metastatic lymph node with clip and removal of clipped nodes with sentinel lymph node (SLN), known as targeted axillary dissection (TAD), reduced false-negative rates (FNR) of SLN biopsy (SLNB) after neoadjuvant chemotherapy (NAC). For the patients who achieved nodal pathologic complete response (pCR), accurate staging of axilla by TAD lead to omit axillary lymph node dissection (ALND), decreasing postoperative arm morbidity without a negative effect on overall survival. This study aimed to investigate the ultrasound (US) identification rate and success removal rate of two kinds of ultrasound-visible clips placed in metastatic lymph nodes during TAD procedure. Methods: This prospective study was conducted using patients with clinically T1-3, N1, 2, M0 breast cancer undergoing NAC followed by surgery. A US-visible clip was placed in the suspicious lymph node under US guidance before neoadjuvant chemotherapy. Before surgery, US examination was performed to evaluate the detection rate of clipped node. During the surgery, the clipped node was removed using several localization techniques, including hook-wire localization, dye-injection, or fluorescence technique, followed by a dual-technique SLNB and resection of palpable nodes if present. For the fluorescence technique, after injection of 0.1-0.2 mL of indocyanine green dye (ICG) into the clipped node, ICG fluorescent imaging was performed using the Photodynamic Eye infrared camera (Hamamatsu Photonics k. k., Shizuoka, Japan). For the dye injection method, 0.1-0.2 mL of pyoktanin blue dye was injected into the clipped node. Results: A total of 29 patients were enrolled. Hydromark™ breast biopsy site markers (Hydromark, T3 shape; Devicor Medical Japan, Tokyo, Japan) was used in 15patients, whereas a UltraCor™ Twirl™ breast marker (Twirl; C.R. Bard, Inc, NJ, USA) was placed in 14 patients. US identified the clipped node marked with the UltraCore Twirl in 100% (14/14) and with the Hydromark in 93.3% (14/15, p = ns). Success removal of clipped node marked with the UltraCore Twirl was achieved in 100% (14/14), whereas the node marked with the Hydromark was removed in 80% (12/15) (p = ns). Conclusions: The ultrasound identification rate differed between the two types of ultrasound-visible clips, which also affected the success removal rate of clipped nodes. Labelling the positive node with a US-highly-visible clip allowed successful TAD.

Keywords: breast cancer, neoadjuvant chemotherapy, targeted axillary dissection, breast tissue marker, clip

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Authors: Reem Saad Alqahtani

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Drawing on minority literature, this research highlights the role of three contemporary Arab American writers, considering the significance of the historical and cultural contexts of the brutal attacks of 9/11. The focus of the research is to draw attention to the poetry of Samuel Hazo, Nathalie Handal, and Naomi Shihab Nye as representatives of the identity crisis, whose experiences left them feeling marginalized and alienated in both societies, and reflected as one of the ethnic American minority groups, as demonstrated in their poetry, with a special focus on hybridity, resistance, identity, and empowerment. The study explores the writers’ post-9/11 experience, affected by the United States’ long history of marginalization and discrimination against people of colour, placing Arab American literature with that of other ethnic American groups who share the same experience and contribute to composing literature characterized by the aesthetics of cultural hybridity, cultural complexity, and the politics of minorities to promote solidarity and coalition building. Indeed, the three selected Arab American writers have found a link between their narration and the identity of the exiled by establishing an identity that is a kind of synthesis of diverse identities of Western reality and Eastern nostalgia. The approaches applied in this study will include historical/biographical, postcolonial, and discourse analysis. The first will be used to emphasize the influence of the biographical aspects related to the community, identity, and resistance of the three poets on their poetry. The second is used to investigate the effects of postcolonialism on the poets and their responses to it, while the third understand the sociocultural, political, and historical dimensions of the texts, establishing these poets as representative of the Arab American experience. This study is significant because it will help shed light on the importance of the Arabic hybrid identity in creating resistance to minority communities within American society.

Keywords: Arab American, identity, hybridity, post-9/11

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Authors: Kazuko Sakamoto, Keiichiro Kawarabayashi, Yoji Kitani

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Japanese sweets are one of the important elements of the Chur Japan strategy. In this research, we investigated what kind of sweets are liked to the Chinese tourist. What is generally eaten is influenced by culture, a sense of values, and business practice. Therefore, what was adapted there is sold. However, when traveling, what its country does not have is called for. Then, how far should we take in Chinese people's taste in a design?　This time, the design attribute (a color and a form) which leads to sweets "being delicious" was clarified by rough aggregate theory.As a result, the difference in the taste of Chinese people and Japanese people became clear.

Keywords: design attribute, international comparison, taste by appearance, design attribute

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Authors: Kotaro Miura, Makoto Sakamoto, Yuji Tanabe

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We focus on internal stress and displacement of an elastic axisymmetric contact problem for indentation of a layer-substrate body. An elastic layer is assumed to be perfectly bonded to an elastic semi-infinite substrate. The elastic layer is smoothly indented with a flat-ended cylindrical indenter. The analytical and exact solutions were obtained by solving an infinite system of simultaneous equations using the method to express a normal contact stress at the upper surface of the elastic layer as an appropriate series. This paper presented the numerical results of internal stress and displacement distributions for hard-coating system with constant values of Poisson’s ratio and the thickness of elastic layer.

Keywords: indentation, contact problem, stress distribution, coating materials, layer-substrate body

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Authors: Kazuko Sakamoto

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It is difficult to explain the factor of design preference only in culture or a geographical environment. It is necessary to turn one's eyes also to the factor in an individual. The purpose of this research is to clarify design potential which is inherent in consumers. Design potential is the consciousness and interpretation to an individual design. That is, it catches quantitatively the preparatory state which faces design. For example, a mobile phone differs in designs, such as a color and a form, by the country or the area. It is considered because a regional consumer taste exists. The root is design potential. This consists of design participation, design knowledge, and design sensitivity. Having focused this time is by design sensitivity, and international comparison of the Netherlands, Bangladesh, China, and Japan was performed. As a result, very interesting finding has been derived. For example, although Bangladesh caught the similarity of goods by the color, other three nations were caught in the form. Moreover, although the Netherlands, Bangladesh, and China liked symmetry, only Japan liked asymmetry. This shows that history and a cultural background have had big influence to the design.

Keywords: design-potential, cultural difference, form characteristic, product development

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Authors: Ovett Nwosimiri

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Historically the concept of race has played a significant part in the existence of African philosophy. Race, as part of the historical events, has been used as a reason for colonization. In recent years, there has been a numerous work on the concept of race. Some philosophers have devoted their time to the discourse of race and to understand the ascription of the race. These philosophers have dedicated their time and energy to the concept of race. Philosophers, like Joshua Glasgow, W. E. B. Du Bois, Lucius Outlaw, Kwame Anthony Appiah, Naomi Zack, Emmanuel C. Eze and many others took up the task to explain the concept of race, and also to explain in their view whether the concept of race should be conserved or eliminated. According to the eliminativists, the concept of race should be eliminated. According to the conservationists, the concept of race should be conserved. The aim of this paper is to look at the possibility of transcending the concept of race. In order to do this, the paper will briefly explain Joshua Glasgow’ idea theory of ‘racial reconstructionism’, and it will propose a theory of ‘racial transcendentalism’ as a way of transcending the concept of race. The paper will argue that we should see the concept of race as a concept that has a future beyond the mere meaning and ideas that call for its elimination or conservation.

Keywords: conservationists, eliminativists, race, transcending

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Authors: H. Sakamoto, Y. Nakagawara, S. Oguri

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Drought stress is a critical environmental factor that adversely affects crop productivity and quality. Because of their immobile nature, plants have evolved mechanisms to sense and respond to drought stress. We identified a novel locus of Arabidopsis, designated DRA1 (drought responsive ankyrin 1), whose disruption leads to increased drought stress tolerance. DRA1 encodes a transmembrane protein with an ankyrin repeat motif that has been implicated in diverse cellular processes such as signal transduction. RT-PCR analysis revealed that there were at least two splicing variants of DRA1 transcripts in wild type plants. In response to drought stress, the levels of DRA1 transcripts retaining second and third introns were increased, whereas these introns were removed under unstressed conditions. These results suggest that DRA1 protein may negatively regulate plant drought tolerance and that the expression of DRA1 is regulated in response to drought stress by alternative splicing.

Keywords: alternative splicing, ankyrin repeat, Arabidopsis, drought tolerance

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Authors: Naomi Seidu, Edward Poluyi, Chibuikem Ikwuegbuenyi, Eghosa Morgan

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The current poor prognosis of glioblastoma has called for the need for an improvement in treatment methods in order to improve its survival rate. Despite the different interventions currently available for this tumor, the average survival is still only a few months. (12-15). The aim is to create a more favorable prognosis and have a reduction in the resistance to treatment currently being experienced, even with surgical interventions and chemotherapy. From the available literature, there is a relationship between the presence of HOX genes (Homeobox genes) and glioblastoma, which could be attributable to the increasing treatment resistance. Hence silencing these genes can be a key to improving survival rates of glioblastoma. A series of studies have highlighted the role that HOX genes play in glioblastoma prognosis. Promotion of human glioblastoma initiation, aggressiveness, and resistance to Temozolomide has been associated with HOXA9. The role of HOX gene expression in cancer stem cells should be studied as it could provide a means of designing CSC-targeted therapies, as CSCs play a part in the initiation and progression of solid tumors.

Keywords: GBM- glioblastoma, HOXA gene- homeobox genes cluster, signaling pathways, temozolomide

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Authors: H. Sakamoto, S. Kurosawa, M. Suzuki, S. Oguri

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In Arabidopsis, several genes encoding proteins with ankyrin repeats and trans-membrane domains (AtANKTM) have been identified as mediators of biotic and abiotic stress responses. It has been known that the expression of an AtANKTM gene, At2g24600, is induced in response to abiotic stress and that there are four splicing variants derived from this locus. In this study, by RT-PCR and sequencing analysis, an unknown splicing variant of the At2g24600 transcript was identified. Based on differences in the predicted amino acid sequences, the five splicing variants are divided into three groups. The three predicted proteins are highly homologous, yet have different numbers of ankyrin repeats and trans-membrane domains. It is generally considered that ankyrin repeats mediate protein-protein interaction and that the number of trans-membrane domains affects membrane topology of proteins. The protein variants derived from the At2g24600 locus may have different molecular functions each other.

Keywords: alternative splicing, ankyrin repeats, trans-membrane domains, arabidopsis

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Authors: Christina Cheong, Naomi Keena

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In the face of growing urbanization the construction of new buildings is inevitable and with current construction methods leading to environmental degradation much questioning is needed around reducing the environmental impact of buildings. This paper explores the global environmental issue of concrete production in parallel with the problem of plastic waste, and questions if new solutions into plastic waste additions in concrete is a viable sustainable solution with positive systematic implications to living systems, both human and non-human. We investigate how certification programs can be used to access the sustainability of the new concrete composition. With this classification we look to the health impacts as well as reusability of such concrete in a second or third life cycle. We conclude that such an approach has benefits to the environment and that taking a circular approach to its development, in terms of the overall life cycle of the new concrete product, can help understand the nuances in terms of the material’s environmental and human health impacts.

Keywords: Concrete, Plastic waste additions to concrete, sustainability ratings, sustainable materials

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Authors: Kazuko Sakamoto

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Anthropomorphic agents have been successful in areas where there are many human interactions, such as education and medical care. The persuasive effect is also expected in e-shopping sites on the web. This indicates that customer service is not necessarily human but can play that role. However, the 'humanity' in anthropomorphism sometimes has a risk of working negatively. In general, as the appearance of anthropomorphic agents approaches humans, it is thought that their affinity with humans increases. However, when the degree of similarity reaches a certain level, it gives the user a weird feeling. This is the 'eerie valley' phenomenon. This is a concept used in the world of robotics, but it seems to be applicable to anthropomorphic agents such as characters. Then what kind of design can you accept as an anthropomorphic agent that gives you a feeling of friendliness or good feeling without causing discomfort or fear to people? This study focused on this point and examined what design and characteristics would be effective for marketing communication. As a result of the investigation, it was found that there is no need for gaze and blinking, the size of the eyes is normal or large, and the impression evaluation is higher when the structure is as simple as possible. Conversely, agents with high eye-gaze and white-eye ratios had low evaluations, and the negative impact on eye-gaze was particularly large.

Keywords: anthropomorphicgents, design evaluation, marketing communication, customer service

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Authors: Naomi Sato, Tomonori Sato, Kenji Masui, Rob Stanborough

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To date, there are few studies on the subjective experiences of patients with chronic low-back pain (CLBP). The purpose of this study was to gain a better understanding of CLBP patients’ perceptions and attitudes regarding pain. Individual, semi-constructed interviews were conducted with 7 Japanese and 10 Americans who had been diagnosed with CLBP. The interviews were transcribed verbatim and analyzed based on a content analysis approach. The study proposal was approved by the Institutional Review Board of the first author’s affiliate university. All participants provided written consent. Participants’ ages ranged from 48 to 82. Five main categories were emerged, namely, 'There are no reasons for long-term chronic pain,' 'Just will not worsen,' 'Have something to help me cope,' 'Pain restricts my life,' and 'Have something to relieve me.' Participants lived with CLBP, which could sometimes be avoided as a result of the coping strategies that they employed, and due to which they sometimes felt helpless, despite their efforts. As a result, they had mixed feelings, which included resignation, resoluteness, and optimism. However, their perceptions and attitudes toward pain seemed to differ based on their backgrounds, including biological, social, religious, and cultural status. There is a need for the development of a scale in future studies, to enable quantitative measurement of individuals’ perceptions of and attitudes toward pain. There is also a need for an investigation of factors influencing perceptions and attitudes toward pain.

Keywords: attitude, chronic low-back pain, perception, qualitative study

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Authors: Mitsuyoshi Tomiya, Kentaro Kawamura, Shoichi Sakamoto

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In chaotic billiard systems, scar-like localization has been found on time-evolving wave packet. We may call it the “dynamical scar” to separate it to the original scar in stationary states. It also comes out along the vicinity of classical unstable periodic orbits, when the wave packets are launched along the orbits, against the hypothesis that the waves become homogenous all around the billiard. Then time-evolving wave packets are investigated numerically in phase space. The Wigner function is adopted to detect the wave packets in phase space. The 2-dimensional Poincaré sections of the 4-dimensional phase space are introduced to clarify the dynamical behavior of the wave packets. The Poincaré sections of the coordinate (x or y) and the momentum (Px or Py) can visualize the dynamical behavior of the wave packets, including the behavior in the momentum degree also. For example, in “dynamical scar” states, a bit larger momentum component comes first, and then the a bit smaller and smaller components follow next. The sections made in the momentum space (Px or Py) elucidates specific trajectories that have larger contribution to the “dynamical scar” states. It is the fixed point observation of the momentum degrees at a specific fixed point(x0, y0) in the phase space. The accumulation are also calculated to search the “dynamical scar” in the Poincare sections. It is found the scars as bright spots in momentum degrees of the phase space.

Keywords: chaotic billiard, Poincaré section, scar, wave packet

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Authors: Doki Naomi Onyeje, Doki Gowon Ama

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The past 4 years have been traumatic for Nigerians, having to deal with a number of complex economic issues with dire consequences for the economy. Households have had to respond variously to some of these problems in peculiar ways, depending, of course, on the nature and character of a particular shock. The type, magnitude, intensity and duration of a particular shock might be the determinant of different household responses. While households’ responses to the Global Financial Crisis and Covid 19 Pandemic have been documented by researchers, other economic shocks have continued to emerge in Nigeria. The dramatic turn of events since coming on board of the new government on May 29th 2023, has introduced a new economic twist that households will have to adjust to. This study, therefore, sets out to examine household responses by disaggregating them by their livelihood sources. A survey of 420 households across North Central Nigeria will be done to generate information on the respective responses. A Multinomial logit regression analysis will be employed to test the hypothesis that livelihood source(s) influences household responses to economic shocks. Consequently, responses from public and private households will be examined. The expected results should be that household responses might have some similarities, but it is expected that some peculiar responses across groups will emerge and these differences will guide for group-specific interventions. The Theatre for Development (TfD) approach will be used to disseminate and propagate results from this study to and among stakeholders for effective policy frameworks.

Keywords: drama, dynamics, economic shocks, household responses, Nigeria

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Authors: H. Sakamoto, J. Tochimoto, S. Kurosawa, M. Suzuki, S. Oguri

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Salt stress adversely affects plant growth at various stages of development including seed germination, seedling establishment, vegetative growth and finally reproduction. Because of their immobile nature, plants have evolved mechanisms to sense and respond to salt stress. Seed dormancy is an adaptive trait that enables seed germination to coincide with favorable environmental conditions. We identified a novel locus of Arabidopsis, designated SHG1 (salt hypersensitive germination 1), whose disruption leads to reduced germination rate under moderate salt stress conditions. SHG1 encodes a transmembrane protein with an ankyrin repeat motif that has been implicated in diverse cellular processes such as signal transduction. The SGH1-disrupted Arabidopsis mutant died at the cotyledon stage when sown on salt-containing medium, although wild type plants could form true leaves under the same conditions. On the other hand, this mutant showed similar phenotypes to wild type plants when sown on medium without salt and transferred to salt-containing medium at the vegetative stage. These results suggested that SHG1 played indispensable role in the seed germination and seedling establishment under moderate salt stress conditions. SHG1 may be involved in the release of seed dormancy.

Keywords: germination, ankyrin repeat, arabidopsis, salt tolerance

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Authors: Naomi Mutea, Jossete Jones

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The project aimed at exploring the views and perceptions of nurse leaders and educators regarding use of International Classification for Nursing Practice (ICNP) in an informal approach which involved face to face discussions, after which a decision would be made on whether to proceed and propose introduction of ICNP project in Kenya as a pilot project which would mean all nurses would use a standard approach to reporting and documenting nursing care. In addition the project was to determine the best approaches/methods that can be used to introduce ICNP in the Kenyan nursing education and practice environment using the findings of the pilot project. Further four cardex reports were reviewed to establish if nurses on the bedside used a standardized language in documenting and reporting care processes. The cardex reports showed that nurses do not use ICNP or any other standardized language. The results of the discussions revealed that this would be a challenge due to several challenges experienced in conducting nursing research in resource-limited environments. The following questions were asked during the informal discussions with the educators/leaders: •What is currently being taught in terms of standardized nursing language? •Are you familiar with ICNP? •Do you view it advantageous to have a standardized language? •What is the greatest need at the moment in terms of curriculum development for BSN regarding use of standardized nursing language? •If you had a wish to change something in your curriculum, what would that be?

Keywords: nursing, standardized language, ICNP, resource-limited care environments

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Authors: Naomi Weiner-Levy

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The Mofet Institute of Research, established a School of Professional Development, the only one of its kind in Israel and throughout the world. It offers specialized programs for teacher educators, providing them with the professional knowledge and skills. The studies aim at updating teachers about rapidly changing knowledge and skills. Teacher educators are conceptualized as shifting from first order practitioners (school teachers) to second order practitioners. Those who train teachers are referred to as third order practitioners. The instructors in the School of Professional Development are third-order practitioners – teacher educators specializing in teaching their colleagues. Collegial guidance by teachers’ college staff members is no simple task: Tutors must be expert in their field of specialization, as well as in instruction. Moreover, although colleagues, they have to position themselves within the group as authoritative figures in terms of instruction and knowledge. To date, the role and professional identity of these third-order practitioners, has not been studied. To understand the nature and development of professional identity, a qualitative study was conducted in which 12 tutors of various subjects were interviewed. These were analyzed by categorical content analysis. The findings, assessed professional identity through a post-modern prism, while examining the interplay among events that tutors experienced, the knowledge they acquired and the structuring of their professional identity. The Tutors’ identity transformed through negotiating with ‘self’ and ‘other’ in the class, and constructed by their mutual experiences as tutors and learners. Understanding the function and identity of tutors facilitates comprehension of this unique training process for teacher educators.

Keywords: professional development, professional identity, teacher education, tutoring

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Authors: T. Sakamoto, S. Kainuma

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Firstly, in order to examine the influence of the remaining amount of the rust on the coating film durability, the accelerated deterioration tests were carried out. In order to prepare test specimens, uncoated steel plates were corroded by the Salt Spray Test (SST) prior to the accelerated deterioration tests, and then the prepared test specimens were coated by epoxy resin and phthalic acid resin each of which has different gas-barrier performance. As the result, it was confirmed that the under-film corrosion occurred in the area and the adjacency to great quantities of salt exists in the rust, and did not occurred in the specimen which was applied the epoxy resin paint after the surface preparation by the power tool. Secondly, in order to clarify the influence of the corrosive factors on the coating film durability, outdoor exposure tests were conducted for one year on actual steel bridge located at a coastal area. The tests specimens consist of coated corroded plates and the uncoated steel plates, and they were installed on the different structural members of the bridge for one year. From the test results, the uncoated steel plates which were installed on the underside of the member are easily corrosive and had highly correlation with the amount of salt in the rust. On the other hand, the most corrosive under-film steel was the vertical surface of the web plate. Thus, it was confirmed that under-film corrosion rate was not match with corrosion rate of the uncoated steel. Consequently, it is estimated that the main factors of under-film corrosion are gas-barrier property of coating film and corrosive factors such as water vapor and temperature. The salt which significantly corrodes the uncoated steel plate is not directly related to the under-film corrosion.

Keywords: accelerated deterioration test, coating durability, environmental factor, under-film corrosion

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Authors: Nayak Amar, Turner Naomi, Gobina Edward

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The Scottish Higher Education Institutes must report their scope 1 & 2 emissions, whereas reporting scope 3 is optional. Scope 3 is indirect emissions which embodies a significant component of total carbon footprint and therefore it is important to record, measure and report it accurately. Robert Gordon University (RGU) reported only business travel, grid transmission and distribution, water supply and transport, and recycling scope 3 emissions. This study estimates the RGUs total scope 3 emissions by comparing it with a similar HEI in scale. The scope 3 emission reporting of sixteen Scottish HEI was studied. Glasgow Caledonian University was identified as the nearest neighbour by comparing its students' full time equivalent, staff full time equivalent, research-teaching split, budget, and foundation year. Apart from the peer, data was also collected from the Higher Education Statistics Agency database. RGU reported emissions from business travel, grid transmission and distribution, water supply, and transport and recycling. This study estimated RGUs scope 3 emissions from procurement, student-staff commute, and international student trip. The result showed that RGU covered only 11% of the scope 3 emissions. The major contributor to scope 3 emissions were procurement (48%), student commute (21%), international student trip (16%), and staff commute (4%). The estimated scope 3 emission was more than 14 times the reported emissions. This study has shown the relative importance of each scope 3 emissions source, which gives a guideline for the HEIs, on where to focus their attention to capture maximum scope 3 emissions. Moreover, it has demonstrated that it is possible to estimate the scope 3 emissions with limited data.

Keywords: HEI, university, emission calculations, scope 3 emissions, emissions reporting

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Authors: Tianqi Yin

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Following the establishment of the state of Israel, how to harmonize the relationship between Palestinians and Jews in Israel has always been an intractable problem. As the number of Palestinian Arabs in Israel has increased to over two million, the issue has become more severe. Due to a variety of factors, Israeli Palestinians and Israeli Jews often find it hard to interact with each other, let alone form a relationship. Multiple authors and directors have produced cultural works to touch on the issue, exposing the reasons for the irreconcilable relation between the two ethnic groups. This paper analyzes the representation scenes of the Palestinian-Jewish relationship in three prominent cultural works, each from a distinct perspective, to examine the intrinsic challenges from the Israeli side that curb the two ethnicities from interacting successfully. The first scene is from the Jewish perspective in Amos Oz’s memoir A Tale of Love and Darkness, in which young Oz, a Jewish boy, attempts to interact with Aisha, a young Israeli-Arab girl, but eventually failed because of an accident. The second scene is from a short Israeli film Bus Station which, from an outsider perspective, depicted a brief encounter between an Arab woman and a Jewish woman in Jerusalem. The third scene is the initially successful yet eventually failed relationship between Eyad, a Palestinian boy, and Naomi, a Jewish girl, in an elite Israeli high school from the 2014 film A Borrowed Identity, which is depicted through Eyad’s Arab perspective. Through the analysis of these three narratives, this paper argues that the burden of national responsibility, family influences, and Israeli government’s discriminatory policies are the three main factors on the Jewish side, in ascender order of importance, that make Arab-Jewish interaction hard in Israel.

Keywords: arab-Jewish interaction, ethnographic conflicts, israel, Jewish narrative, narrative styles

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Authors: Naomi W. Maina

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Fertility preference is a subject of great significance in developing countries. Studies reveal that the preferences of fertility are actually significant in determining the society’s fertility levels because the fertility behavior of the future has a high likelihood of falling under the effect of currently observed fertility inclinations. The objective of this study was to establish the factors associated with fertility preference amongst couples in Kenya by fitting a multinomial logistic regression model against 5,265 couple data obtained from Kenya demographic health survey 2014. Results revealed that the type of place of residence, the region of residence, age and spousal age gap significantly influence desire for additional children among couples in Kenya. There was the notable high likelihood of couples living in rural settlements having similar fertility preference compared to those living in urban settlements. Moreover, geographical disparities such as in northern Kenya revealed significant differences in a couples desire to have additional children compared to Nairobi. The odds of a couple’s desire for additional children were further observed to vary dependent on either the wife or husbands age and to a large extent the spousal age gap. Evidenced from the study, was the fact that as spousal age gap increases, the desire for more children amongst couples decreases. Insights derived from this study would be attractive to demographers, health practitioners, policymakers, and non-governmental organizations implementing fertility related interventions in Kenya among other stakeholders. Moreover, with the adoption of devolution, there is a clear need for adoption of population policies that are County specific as opposed to a national population policy as is the current practice in Kenya. Additionally, researchers or students who have little understanding in the application of multinomial logistic regression, both theoretical understanding and practical analysis in SPSS as well as application on real datasets, will find this article useful.

Keywords: couples' desire, fertility, fertility preference, multinomial regression analysis

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Authors: Naomi Huang Wenya, Xin Xiaohui, Vijaya Rao, Wong Ting Hway, Chow Kah Hoe Pierce, Tan Hiang Khoon

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Background: The majority of the cancelled elective surgeries caused by the COVID-19 pandemic globally were estimated to occur in low- and middle-income countries (LMICs), where surgical services had long been in short supply even before the pandemic. Therefore, minimising disruption to existing surgical care in LMICs is of crucial importance during a pandemic. This study aimed to explore contributory factors to the continuity of surgical care in LMICs, in the face of a pandemic. Methods: Semi-structured interviews were conducted over zoom, with surgical leaders of 25 tertiary hospitals from 11 LMICs in South and Southeast Asia, from September to October 2020. Key themes were subsequently identified from the interview transcripts, using Braun and Clarke's method of thematic analysis. Results: The COVID-19 pandemic affected all surgical services of participating institutions but to varying degrees. Overall, elective surgeries suffered the gravest disruption, followed by outpatient surgical care, and finally, emergency surgeries. Keeping healthcare workers safe and striving for continuity of essential surgical care emerged as notable response strategies observed across all participating institutions. Conclusion: This study suggested that four factors are important for the resilience of surgical care against COVID-19: adequate COVID-19 testing capacity and effective institutional infection control measures, designated COVID-19 treatment facilities, a whole-system approach to balancing pandemic response and meeting essential surgical needs, and active community engagement. These findings can inform healthcare institutions in other countries, especially LMICs, in their effort to tread a fine line between preserving healthcare capacity for pandemic response and protecting surgical services against pandemic disruption.

Keywords: COVID-19, pandemic, LMICs, continuity of surgical service

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Authors: Shouta Sora, Shizuki Kuriu, Radhika Mishra, Ariunbuyan Sukhbaatar, Maya Sakamoto, Shiro Mori, Tetsuya Kodama

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Lymph node (LN) metastasis accounts for 20 - 30 % of all deaths in patients with head and neck cancer. Therefore, the control of metastatic lymph nodes (MLNs) is necessary to improve the life prognosis of patients with cancer. In a classical metastatic theory, tumor cells are thought to metastasize hematogenously through a bead-like network of lymph nodes. Recently, a lymph node-mediated hematogenous metastasis theory has been proposed, in which sentinel LNs are regarded as a source of distant metastasis. Therefore, the treatment of MLNs at the early stage is essential to prevent distant metastasis. Radiation therapy is one of the primary therapeutic modalities in cancer treatment. In addition, total body irradiation (TBI) has been reported to act as activation of natural killer cells and increase of infiltration of CD4+ T-cells to tumor tissues. However, the treatment effect of TBI for MLNs remains unclear. This study evaluated the possibilities of low-dose total body irradiation (L-TBI) and middle-dose total body irradiation (M-TBI) for the treatment of MLNs. Mouse breast cancer FM3A-Luc cells were injected into subiliac lymph node (SiLN) of MXH10/Mo/LPR mice to induce the metastasis to the proper axillary lymph node (PALN) and lung. Mice were irradiated for the whole body on 4 days after tumor injection. The L-TBI and M-TBI were defined as irradiations to the whole body at 0.2 Gy and 1.0 Gy, respectively. Tumor growth was evaluated by in vivo bioluminescence imaging system. In the non-irradiated group, tumor activities on SiLN and PALN significantly increased over time, and the metastasis to the lung from LNs was confirmed 28 days after tumor injection. The L-TBI led to a tumor growth delay in PALN but did not control tumor growth in SiLN and metastasis to the lung. In contrast, it was found that the M-TBI significantly delayed the tumor growth of both SiLN and PALN and controlled the distant metastasis to the lung compared with non-irradiated and L-TBI groups. These results suggest that the M-TBI is an effective treatment method for MLNs in the early stage and distant metastasis from lymph nodes via blood vessels connected with LNs.

Keywords: metastatic lymph node, lung metastasis, radiation therapy, total body irradiation, lymphatic system

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Authors: Naomi Nathan

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Introduction Digitalization of medical education can revolutionize how medical students learn and interact with the medical curriculum across contexts. With the increasing availability of the internet and mobile connectivity in LMICs, online medical education platforms and digital learning tools are becoming more widely available, providing new opportunities for learners to access high-quality medical education and training. However, the adoption and integration of digital technologies in medical education in LMICs is a complex process influenced by various factors, including learners' perceptions and attitudes toward digital learning. In Ethiopia, the adoption of digital platforms for medical education has been slow, with traditional face-to-face teaching methods still being the norm. However, as access to technology improves and more universities adopt digital platforms, it is crucial to understand how medical students perceive this shift. Methodology This study investigated medical students' perception of the digitalization of medical education in relation to their access to the Lecturio Digital Medical Education Platform through a capacity-building project. 740 medical students from over 20 medical universities participated in the study. The students were surveyed using a questionnaire that included their attitudes toward the digitalization of medical education, their frequency of use of the digital platform, and their perceived benefits and challenges. Results The study results showed that most medical students had a positive attitude toward digitalizing medical education. The most commonly cited benefit was the convenience and flexibility of accessing course material/curriculum online. Many students also reported that they found the platform more interactive and engaging, leading to a more meaningful learning experience. The study also identified several challenges medical students faced when using the platform. The most commonly reported challenge was the need for more reliable internet access, which made it difficult for students to access content consistently. Overall, the results of this study suggest that medical students in Ethiopia have a positive perception of the digitalization of medical education. Over 97% of students continuously expressed a need for access to the Lecturio platform throughout their studies. Conclusion Significant challenges still need to be addressed to fully realize the Lecturio digital platform's benefits. Universities, relevant ministries, and various stakeholders must work together to address these challenges to ensure that medical students fully participate in and benefit from digitalized medical education - sustainably and effectively.

Keywords: digital medical education, EdTech, LMICs, e-learning

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Authors: Johanna Perdomo, Riki Lamont, Edmund Pickering, Naomi C. Paxton, Maria A. Woodruff

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Background: Tissue Engineering (TE) has combined advanced materials, such as biomaterials, to create affordable scaffolds and dynamic systems to generate stimulation of seeded cells on these scaffolds, improving and maintaining the cellular growth process in a cell culture. However, Few TE skin products have been clinically translated, and more research is required to produce highly biomimetic skin substitutes that mimic the native elasticity of skin in a controlled manner. Therefore, this work will be focused on the fabrication of a novel mechanical system to enhance the TE treatment approaches for the reparation of damaged tissue skin. Aims: To archive this, a soft robotic device will be created to emulate different deformation of skin stress. The design of this soft robot will allow the attachment of scaffolds, which will then be mechanically actuated. This will provide a novel and highly adaptable platform for dynamic cell culture. Methods: Novel, low-cost soft robot is fabricated via 3D printed moulds and silicone. A low cost, electro-mechanical device was constructed to actuate the soft robot through the controlled combination of positive and negative air pressure to control the different state of movements. Mechanical tests were conducted to assess the performance and calibration of each electronic component. Similarly, pressure-displacement test was performed on scaffolds, which were attached to the soft robot, applying various mechanical loading regimes. Lastly, digital image correlation test was performed to obtain strain distributions over the soft robot’s surface. Results: The control system can control and stabilise positive pressure changes for long hours. Similarly, pressure-displacement test demonstrated that scaffolds with 5µm of diameter and wavy geometry can displace at 100%, applying a maximum pressure of 1.5 PSI. Lastly, during the inflation state, the displacement of silicone was measured using DIC method, and this showed a parameter of 4.78 mm and strain of 0.0652. Discussion And Conclusion: The developed soft robot system provides a novel and low-cost platform for the dynamic actuation of tissue scaffolds with a target towards dynamic cell culture.

Keywords: soft robot, tissue engineering, mechanical stimulation, dynamic cell culture, bioreactor

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Authors: Mmamapudi Kubjane, Natacha Berkowitz, Rene Goliath, Naomi S. Levitt, Robert J. Wilkinson, Tolu Oni

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Background: South Africa remains a high tuberculosis (TB) burden country globally and the burden of diabetes – a TB risk factor is growing rapidly. As an infectious disease, TB also induces transient hyperglycaemia. Therefore, screening for diabetes in newly diagnosed tuberculosis patients may result in misclassification of transient hyperglycaemia as diabetes. Objective: The objective of this study was to determine and compare the prevalence of hyperglycaemia (diabetes and impaired glucose regulation (IGR)) in TB patients and to assess the cross-sectional association between TB and hyperglycaemia at enrolment and after three months of follow-up. Methods: Consecutive adult TB and non-TB participants presenting at a TB clinic in Cape Town were enrolled in this cross-sectional study and follow-up between July 2013 and August 2015. Diabetes was defined as self-reported diabetes, fasting plasma glucose (FPG) ≥ 7.0 mmol·L⁻¹ or glycated haemoglobin (HbA1c) ≥ 6.5%. IGR was defined as FPG 5.5– < 7.0 mmol·L⁻¹ or HbA1c 5.7– < 6.5%. TB patients initiated treatment. After three months, all participants were followed up and screened for diabetes again. The association between TB and hyperglycaemia was assessed using logistic regression adjusting for potential confounders including sex, age, income, hypertension, waist circumference, previous prisoner, marital status, work status, HIV status. Results: Diabetes screening was performed in 852 participants (414 TB and 438 non-TB) at enrolment and in 639 (304 TB and 335 non-TB) at three-month follow-up. The prevalence of HIV-1 infection was 69.6% (95% confidence interval (CI), 64.9–73.8 %) among TB patients, and 58.2% (95% CI, 53.5–62.8 %) among the non-TB participants. Glycaemic levels were much higher in TB patients than in the non-TB participants but decreased over time. Among TB patients, the prevalence of IGR was 65.2% (95% CI 60.1 - 69.9) at enrollment and 21.5% (95% CI 17.2-26.5) at follow-up; and was 50% (45.1 - 54.94) and 32% (95% CI 27.9 - 38.0) respectively, among non-TB participants. The prevalence of diabetes in TB patients was 12.5% (95% CI 9.69 – 16.12%) at enrolment and 9.2% (95% CI, 6.43–13.03%) at follow-up; and was 10.04% (95% CI, 7.55–13.24%) and 8.06% (95% CI, 5.58–11.51) respectively, among non-TB participants. The association between TB and IGT was significant at enrolment (adjusted odds ratio (OR) 2.26 (95% CI, 1.55-3.31) but disappeared at follow-up 0.84 (0.53 - 1.36). However, the TB-diabetes association remained positive and significant both at enrolment (2.41 (95% CI, 1.3-4.34)) and follow-up (OR 3.31 (95% CI, 1.5 - 7.25)). Conclusion: Transient hyperglycaemia exists during tuberculosis. This has implications on diabetes screening in TB patients and suggests a need for diabetes confirmation tests during or after TB treatment. Nonetheless, the association between TB and diabetes noted at enrolment persists at 3 months highlighting the importance of diabetes control and prevention for TB control. Further research is required to investigate the impact of hyperglycaemia (transient or otherwise) on TB outcomes to ascertain the clinical significance of hyperglycemia at enrolment.

Keywords: diabetes, impaired glucose regulation, transient hyperglycaemia, tuberculosis

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Authors: Denise Ben-Porath, Tracy Masterson

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In the past, individuals who struggled with and sought treatment for mental health difficulties were stigmatized. However, the current generation holds more open attitudes around mental health issues. Indeed, public figures such as Demi Lovato, Naomi Osaka, and Simone Biles have taken to social media to break the silence around mental health, discussing their own struggles and the benefits of treatment. Thus, there is considerable reason to believe that this generation would hold fewer stigmatizing attitudes toward mental health difficulties and treatment compared to previous ones. In this study, we explored possible changes in stigma on mental health diagnosis and treatment seeking behavior between two generations: Gen Z, the current generation, and Gen X, those born between 1965-1980. It was hypothesized that Gen Z would hold less stigmatizing views on mental illness than Gen X. To examine possible changes in stigma attitudes between these two generations, we conducted a cross-generational cohort design by using the same methodology employed 20 years ago from the Ben-Porath (2002) study. Thus, participants were randomly assigned to read one of the following four case vignettes employed in the Ben-Porath (2002) study: (a) “Tom” who has received psychotherapy due to depression (b) “Tom” who has been depressed but received no psychological help, (c) “Tom” who has received medical treatment due to a back pain, or (d) “Tom” who had a back pain but did not receive medical attention. After reading the vignette, participants rated “Tom” on various personality dimensions using the IFQ Questionnaire and answered questions about their frequency of social media use and willingness to seek mental health treatment on a scale from 1-10. Identical to the results 20 years prior, a significant main effect was found for diagnosis with “Tom” being viewed in more negative terms when he was described as having depression vs. a medical condition (back pain) [F (1, 376) = 126.53, p < .001]. However, in the study conducted 20 years earlier, a significant interaction was found between diagnosis and help-seeking behavior [F (1, 376) = 8.28, p < .005]. Specifically, “Tom” was viewed in the most negative terms when described as depressed and seeking treatment. Alternatively, the current study failed to find a significant interaction between depression and help seeking behavior. These findings suggest that while individuals who hold a mental health diagnosis may still be stigmatized as they were 20 years prior, seeking treatment for mental health issues may be less so. Findings are discussed in the context of social media use and its impact on destigmatization.

Keywords: stigma, mental illness, help-seeking, social media

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Authors: Louise Bunce, Jill Childs, Adam J. Lonsdale, Naomi King

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A major concern for the Social Work profession concerns the frequency of burn-out and high turnover of staff. The characteristic of resilience has been identified as playing a crucial role in social workers’ ability to have a satisfying and successful career. Thus a critical role for social work education is to develop resilience in social work students. We currently need to know more about how to train resilient social workers who will also increase the academic standing of the profession. The specific aim of this research was to quantify characteristics that may contribute towards resilience and academic success among student social workers in order to mitigate against the problems of burn-out and low academic standing. These three characteristics were competence (effectiveness at mastering the environment), autonomy (sense of control and free will), and relatedness (interacting and connecting with others), as specified in Self-Determination Theory (SDT). When these three needs are satisfied, we experience higher degrees of motivation to succeed and wellbeing. Thus when these three needs are met in social work students, they have the potential to raise academic standards and promote wellbeing characteristics that contribute to the development of resilience. The current study tested the hypothesis that higher levels of autonomy, competence, and relatedness, as defined by SDT, will predict levels of academic success and resilience in social work students. Two hundred and ten social work students studying at a number of universities completed well-established questionnaires to assess autonomy, competence, and relatedness, level of academic performance and resilience (The Brief Resilience Scale). In this scale, students rated their agreement with items e.g., ‘I bounce back quickly after hard times’ and ‘I usually come through difficult times with little struggle’. After controlling for various factors, including age, gender, ethnicity, and course (undergraduate or postgraduate) preliminary analysis revealed that the components of SDT provided useful predictive value for academic success and resilience. In particular, autonomy and competence provided a useful predictor of academic success while relatedness was a particularly useful predictor of resilience. This study demonstrated that SDT provides a valuable framework for helping to understand what predicts academic success and resilience among social work students. This is relevant because the psychological needs for autonomy, competence and relatedness can be affected by external social and cultural pressures, thus they can be improved by the right type of supportive teaching practices and educational environments. These findings contribute to the growing evidence-base to help build an academic and resilient social worker student body and workforce.

Keywords: education, resilience, self-determination theory, student social workers

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Authors: E. Nakamachi, K. Matsumoto, K. Yamamoto, Y. Morita, H. Sakamoto

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In recently, electromagnetic and mechanical stimulations have been recognized as the effective extracellular environment stimulation technique to enhance the defected peripheral nerve tissue regeneration. In this study, we developed a new hybrid bioreactor by adopting 50 Hz uniform alternative current (AC) magnetic stimulation and 4% strain mechanical stimulation. The guide tube for nerve regeneration is mesh structured tube made of biodegradable polymer, such as polylatic acid (PLA). However, when neural damage is large, there is a possibility that peripheral nerve undergoes necrosis. So it is quite important to accelerate the nerve tissue regeneration by achieving enhancement of nerve axonal extension rate. Therefore, we try to design and fabricate the system that can simultaneously load the uniform AC magnetic field stimulation and the stretch stimulation to cells for enhancement of nerve axonal extension. Next, we evaluated systems performance and the effectiveness of each stimulation for rat adrenal pheochromocytoma cells (PC12). First, we designed and fabricated the uniform AC magnetic field system and the stretch stimulation system. For the AC magnetic stimulation system, we focused on the use of pole piece structure to carry out in-situ microscopic observation. We designed an optimum pole piece structure using the magnetic field finite element analyses and the response surface methodology. We fabricated the uniform AC magnetic field stimulation system as a bio-reactor by adopting analytically determined design specifications. We measured magnetic flux density that is generated by the uniform AC magnetic field stimulation system. We confirmed that measurement values show good agreement with analytical results, where the uniform magnetic field was observed. Second, we fabricated the cyclic stretch stimulation device under the conditions of particular strains, where the chamber was made of polyoxymethylene (POM). We measured strains in the PC12 cell culture region to confirm the uniform strain. We found slightly different values from the target strain. Finally, we concluded that these differences were allowable in this mechanical stimulation system. We evaluated the effectiveness of each stimulation to enhance the nerve axonal extension using PC12. We confirmed that the average axonal extension length of PC12 under the uniform AC magnetic stimulation was increased by 16 % at 96 h in our bio-reactor. We could not confirm that the axonal extension enhancement under the stretch stimulation condition, where we found the exfoliating of cells. Further, the hybrid stimulation enhanced the axonal extension. Because the magnetic stimulation inhibits the exfoliating of cells. Finally, we concluded that the enhancement of PC12 axonal extension is due to the magnetic stimulation rather than the mechanical stimulation. Finally, we confirmed that the effectiveness of the uniform AC magnetic field stimulation for the nerve axonal extension using PC12 cells.

Keywords: nerve cell PC12, axonal extension, nerve regeneration, electromagnetic-mechanical stimulation, bioreactor

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Authors: Nipa Debnath, Harinarayan Das, Takahiko Kawaguchi, Naonori Sakamoto, Kazuo Shinozaki, Hisao Suzuki, Naoki Wakiya

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Nowadays spinel ferrite magnetic thin films have drawn considerable attention due to their interesting magnetic and electrical properties with enhanced chemical and thermal stability. Spinel ferrite magnetic films can be implemented in magnetic data storage, sensors, and spin filters or microwave devices. It is well established that the structural, magnetic and transport properties of the magnetic thin films are dependent on microstructure. Spinodal decomposition (SD) is a phase separation process, whereby a material system is spontaneously separated into two phases with distinct compositions. The periodic microstructure is the characteristic feature of SD. Thus, SD can be exploited to control the microstructure at the nanoscale level. In bulk spinel ferrites having general formula, MₓFe₃₋ₓ O₄ (M= Co, Mn, Ni, Zn), phase separation via SD has been reported only for cobalt ferrite (CFO); however, long time post-annealing is required to occur the spinodal decomposition. We have found that SD occurs in CoF thin film without using any post-deposition annealing process if we apply magnetic field during thin film growth. Dynamic Aurora pulsed laser deposition (PLD) is a specially designed PLD system through which in-situ magnetic field (up to 2000 G) can be applied during thin film growth. The in-situ magnetic field suppresses the recombination of ions in the plume. In addition, the peak’s intensity of the ions in the spectra of the plume also increases when magnetic field is applied to the plume. As a result, ions with high kinetic energy strike into the substrate. Thus, ion-impingement occurred under magnetic field during thin film growth. The driving force of SD is the ion-impingement towards the substrates that is induced by in-situ magnetic field. In this study, we report about the occurrence of phase separation through SD and evolution of microstructure after phase separation in spinel ferrite thin films. The surface morphology of the phase separated films show checkerboard like domain structure. The cross-sectional microstructure of the phase separated films reveal columnar type phase separation. Herein, the decomposition wave propagates in lateral direction which has been confirmed from the lateral composition modulations in spinodally decomposed films. Large magnetic anisotropy has been found in spinodally decomposed nickel ferrite (NFO) thin films. This approach approves that magnetic field is also an important thermodynamic parameter to induce phase separation by the enhancement of up-hill diffusion in thin films. This thin film deposition technique could be a more efficient alternative for the fabrication of self-organized phase separated thin films and employed in controlling of the microstructure at nanoscale level.

Keywords: Dynamic Aurora PLD, magnetic anisotropy, spinodal decomposition, spinel ferrite thin film

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