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Intracytoplasmic sperm injection (ICSI) is performed in cases of infertility by injecting a motile and morphologically normal sperm cell under a routine ×400 magnification at which is hard to distinguish morphologically healthy sperm. Recently, the use of high-powered differential interference contrast optics gave the opportunity to select a sperm under ultra-high magnification of ×10,160. The aim of the present study was to evaluate the efficacy of the intracytoplasmic morphologically selected sperm injection (IMSI) technique in different infertility populations undergoing ICSI. Main outcome measures of routine ICSI were compared with IMSI in three different groups of patients (1, non-selected; 2, male infertility; and 3, repeated implantation failure group). Results were analysed to evaluate the effects of the IMSI procedure and to find the most suitable group of patients who may benefit from the procedure. IMSI caused a significant increase in the fertilization and top quality embryo rates in the male infertility group and a significant increase in fertilization and pregnancy rates in the repeated implantation failure group, whereas no effect was observed in the non-selected group with patients of various indications. A positive effect of IMSI on the outcome of male factor infertility and repeated implantation failure patients was observed. Data observed confirmed that the application of IMSI was beneficial for a selected group of patients with male factor infertility and repeated implantation failure.
Medicine is one of the most important areas of higher education. It is important that undergraduate students are well educated and have theoretical knowledge, but also have good clinical skills after graduating from medical training.
To understand whether the training objectives of the emergency medical internship was completed or not and to find the relationship between young doctors’ self-confidence and what they can do via using Rosenberg self-esteem scale (RSES). In addition, an objective was to consider which learning methods are more useful based on the feedback.
This survey study was performed in 2018 at Bulent Ecevit University, Faculty of Medicine, Zonguldak, Turkey with the students who completed an emergency department rotation in the 2017-2018 education term. The questionnaire was composed by the researchers. It consisted of three parts which were included demographic information and education methods in emergency medicine of internships, questions about knowledge goals and learning goals for basic medicine applications, and RSES to assess young doctors’ self-confidence.
96 young doctors with the mean age of 25.22 ± 1.216 years(minimum 23 and maximum 30 years) were in the study5. 3 (55.2%) of which were female. All young doctors were evaluated with RSES4. (4.2%) of which were low self-confidence and 32 (33.3%) of which were high self-confidence. The best useful learning methods were clinical application of interaction with patients (n=828. 5%) and invasive procedures performed on patients (n=727. 5%).
The more you practice, the more you learn. Practice-based education is an important factor in a young doctor’s life. Besides, the higher self-confidence you have, the more you can. Young doctors with high self-esteem see themselves as qualified to perform applications even in complicated situations. However, more studies are needed to find out whether they could really perform or not.
Values are important in understanding the managerial behaviour. Values are the unique criteria that enable people to become conscious of social relations and duties. We contribute to this understanding through determining the values which affect an organisation’s business approach by providing evidence from a comparative study of various airports through a questionnaire method. The study was carried out with 163 participants and factor analysis was used to reduce the complexity of a data set so that it becomes easier to use the data in applied settings. Ranking analysis was used to get the values hierarchy of managers. This hierarchy-addicted culture helps to understand corporate sustainability and loyalty. Managing values increases quality and retains sustainability. Further suggestions are made regarding values that should be taken into consideration for achieving corporate strategies, whether operating regionally or globally. This study contributes towards improving awareness on the effects of values in business management in both theory and practice, along with their limitations. The analysis shows that there is a conformity between organisational and individual values.
OBJECTIVES/SPECIFIC AIMS: (1) To evaluate the association of patient and clinical factors with adherence to adjuvant hormone therapy (HT). (2) To examine the association of HT-related symptoms and the extent of remediation with early discontinuation of hormone therapy. METHODS/STUDY POPULATION: Retrospective cohort study of risk factors for interruption and early discontinuation of adjuvant hormone therapy in hormone receptor-positive nonmetastatic breast cancer patients diagnosed between 2009 and 2015. This study will include incident hormone receptor-positive breast cancer patients who initiated their HT and were followed at Tufts MC until Dec 31, 2016. Primary data source is electronic medical records (EMRs) RESULTS/ANTICIPATED RESULTS: The primary outcome of this study is early discontinuation to HT, defined as the first treatment gap of greater than or equal to 180 days following the initiation of HT. Treatment interruption, defined as any patient- or provider-initiated treatment gap of ≥ 2 weeks, will be examined as the secondary endpoint. Any HT-related symptoms occurred during a follow-up interval will be captured and categorized into five major types (i.e., vasomotor, neuropsychological, gastrointestinal, gynecological, and musculoskeletal symptoms). Onset and duration of a HT-related symptom will be recorded. Severity of the symptoms will also be rated by clinical oncologists. Remediations in response to HT- related symptoms will be collected and categorized into to two groups (pharmacological or non-pharmacological) and whether they were patient- or provider-initiated. Response to a remediation is defined as complete relief, partial relied, no relief, or with worsening symptoms. Response to a treatment change (i.e., HT switch or hold) was collected separately but using the same criteria. Analyses will be performed on the association between patient and clinical factors with rates of nonadherence (unplanned treatment interruption and/or early discontinuation) of hormone therapy, respectively. We also will explore whether patients with elevated symptoms and/or incomplete remediation will have earlier discontinuation of hormone therapy. DISCUSSION/SIGNIFICANCE OF IMPACT: Through formal chart review, we will establish a dataset that contains highly detailed information about treatment-emergent symptoms and remediations, which will enable us to quantitatively assess the impact of these treatment factors on adherence to hormone therapy for breast cancer. The in-depth analysis of risk factors associated with nonadherence to hormone therapy will inform development of interventions to improve cancer outcomes.
Legionella pneumophila genotyping is important for epidemiological investigation of nosocomial and community-acquired outbreaks of legionellosis. The prevalence of legionellosis in pneumonia patients in the West Bank was monitored for the first time, and the sequence types (STs) from respiratory samples were compared with STs of environmental samples from different wards of the hospital. Sputum (n = 121) and bronchoalveolar lavage (BAL) (n = 74) specimens were cultured for L. pneumophila; genomic DNA was tested by 16S rRNA polymerase chain reaction (PCR) amplification. Nested PCR sequence-based typing (NPSBT) was implemented on DNA of the respiratory and environmental PCR-positive samples. Only one respiratory specimen was positive for L. pneumophila by culture. BAL gave a higher percentage of L. pneumophila-positive samples, 35% (26/74) than sputum, 15% (18/121) by PCR. NPSBT revealed the following STs: ST 1 (29%, 7/24), ST 461 (21%, 5/24), ST 1037 (4%, 1/24) from respiratory samples, STs from environmental samples: ST 1 (28.5%, 4/14), ST 187 (21.4%, 3/14) and ST 2070, ST 461, ST 1482 (7.1%, 1/14) each. This study emphasises the advantage of PCR over culture for the detection of L. pneumophila in countries where antibiotics are indiscriminately used prior to hospital admission. ST 1 was the predominant ST in both respiratory and environmental samples.
The accuracy of two calculation algorithms of the Varian Eclipse treatment planning system (TPS), the electron Monte Carlo algorithm (eMC) and general Gaussian pencil beam algorithm (GGPB) for calculating peripheral dose distribution of electron beams was investigated.
Peripheral dose measurements were carried out for 6, 9, 12, 15, 18 and 22 MeV electron beams using parallel plate ionisation chamber and EBT3 film in the slab phantom. Measurements were performed for 6×6, 10×10 and 25×25 cm2 cone sizes at dmax of each energy up to 20 cm beyond the field edges. The measured and TPS calculated data were compared.
The TPS underestimated the out-of-field doses. The difference between measured and calculated doses increase with the cone size. For ionisation chamber measurement, the largest deviation between calculated and measured doses is <4·29% using the eMC, but can increase up to 8·72% of the distribution using GGPB. For film measurement, the minimum gamma analysis passing rates between measured and calculated dose distributions for all field sizes and energies used in this study were 91·2 and 74·7% for eMC and GGPB, respectively.
The use of GGPB for planning large field treatments with 6 MeV could lead to inaccuracies of clinical significance.
To investigate the predictive ability of the previously established global cerebrovascular disease (CeVD) burden scale on long-term clinical outcomes in a longitudinal study of Asian elderly participants across the spectrum of cognitive impairment.
A case-control study was conducted over a 2-year period involving participants with no cognitive impairment, cognitive impairment-no dementia (CIND), and Alzheimer's disease (AD). Annually, cognitive function was assessed with a comprehensive neuropsychological battery and the clinical dementia rating (CDR) scale was used to stage disease severity.
Of 314 participants, 102 had none/very mild CeVD, 31 mild CeVD, 94 moderate CeVD, and 87 severe CeVD at baseline. There was a 1.14 and 1.42 units decline per year on global cognitive z-scores in moderate and severe CeVD groups, respectively, compared to none/very mild CeVD. Moderate-severe CeVD predicted significant functional deterioration at year 2 (HR = 2.0, 95% CI = 1.2–3.4), and conversion to AD (HR = 6.3, 95% CI = 1.7–22.5), independent of medial temporal atrophy.
The global CeVD burden scale predicts poor long-term clinical outcome independent of neurodegenerative markers. Furthermore, CeVD severity affects the rate of cognitive and functional deterioration. Hence, cerebrovascular burden, which is potentially preventable, is a strong prognostic indicator, both at preclinical and clinical stages of AD, independent of neurodegenerative processes.
When nanoparticles and nanofibers combined at the nanoscale, they could create new features in the material and therefore new areas of use. In this study, polyvinylpyrrolidone (PVP) nanofibers containing carbon nanoparticles produced by dense medium plasma technology have been fabricated via electrospinning technique for the first time, a new class of nanocomposite mat material has been prepared and evaluated for medical devices. A dense medium plasma technique is used for nanoparticles synthesis, which is novel, cost-efficient, and fast technology when is compared with other common nanoparticles synthesis techniques. Carbon based nanoparticles are synthesized from an arc sustained in benzene (purity, 99.5%) between iron electrodes by the lab-made dense medium plasma system. The study first mentions the production of nanoparticles by a pressure of 8 bar argon gas for glow discharge in a period of 9 seconds using a 0.5 cm electrode distance in a liquid environment (volume of benzene: 30 ml). Then, separated carbon nanoparticles are integrated with the PVP nanofibers produced by the electrospinning method. Processing parameters of PVP nanofibers containing carbon nanoparticle (nanocomposites) are optimized with various conditions such as polymer concentration: 7.8-8.0 %w/v, ratio of nanoparticle to polymer solution: 1-3.9 mg /ml, distance of electrode: 10-25 cm, processing time: 5-30 min. All samples are characterized by contact angle measurements, scanning electron microscopy and transmission electron microscopy. At the same time, electrical conductivity of nanocomposite mats are tested for foreseeing usage in biomedical application. Results showed that carbon nanoparticles have diameters in 25 ± 5.4 nm. New nanocomposite material production is proven by transmission electron microscopy. It is a super hydrophilic mat material (static contact angle is lower than 10°). According to the optimization of processing parameters, the diameters of nanocomposite fibers reach down to 150 ±75 nm., Nanocomposite mat resistance is found to be dramatically higher than that for the bare PVP nanofiber mat resistance. According to these results, usage in biomedical application of new material was discussed. It has a great potential to use as biocompatible, light, insulator new material.
To examine the risk factors of prelacteal feeding (PLF) among mothers in sub-Saharan Africa (SSA).
We pooled data from Demographic and Health Surveys in twenty-two SSA countries. The key outcome variable was PLF. A multilevel logistic regression model was used to explore factors associated with PLF.
Demographic and Health Surveys in twenty-two SSA countries.
Mother–baby pairs (n 95348).
Prevalence of PLF in SSA was 32·2 %. Plain water (22·1 %), milk other than breast milk (5·0 %) and sugar or glucose water (4·1 %) were the predominant prelacteal feeds. In the multivariable analysis, mothers who had caesarean section delivery had 2·25 times the odds of giving prelacteal feeds compared with mothers who had spontaneous vaginal delivery (adjusted OR=2·25; 95 % CI 2·06, 2·46). Other factors that were significantly associated with increased likelihood of PLF were mother’s lower educational status, first birth rank, fourth or above birth rank with preceding birth interval less than or equal to 24 months, lower number of antenatal care visits, home delivery, multiple birth, male infant, as well as having an average or small sized baby at birth. Mothers aged 20–34 years were less likely to give prelacteal feeds compared with mothers aged ≤19 years. Belonging to the second, middle or fourth wealth quintile was associated with lower likelihood of PLF compared with the highest quintile.
To achieve optimal breast-feeding, there is a need to discourage breast-feeding practices such as PLF. Breast-feeding promotion programmes should target the at-risk sub-population groups discovered in our study.
Lymantia dispar (L.) (Lepidoptera: Lymantriidae), commonly known as the gypsy moth, is a serious forest pest, and beneficial insects are particularly important for reducing its population numbers. Ooencyrtus kuvanae (Howard) (Hymenoptera: Encyrtidae) is an arrhenotokous, solitary egg parasitoid of L. dispar. In this study, we evaluated a new substitute host, Philosamia ricini (Danovan) (Lepidoptera: Saturniidae) for O. kuvanae. We investigated some of the biological effects of O. kuvanae on P. ricini eggs. In this context, the importance of the age of the female parasitoid (1, 3 or 5 days old), host age (1–2 and 3–4 days old) and host number (40, 60 and 80 host eggs) were examined under laboratory conditions (25 ± 1 °C, 65 ± 5% relative humidity and a 16 : 8 h photoperiod [light : dark]). The highest rate of offspring production (89.90%) occurred with 40 (1–2-day-old) host eggs and 5-day-old females. The mean developmental period ranged from 16.5 ± 0.08 days to 18.7 ± 0.08 days. The mean lifespan of the parasitoid was 51.10 ± 1.1 (n = 60) days with bio-honey and 3.92 ± 0.14 (n = 60) days without food. The mean fecundity was 68.88 ± 3.22 offspring/female. Peak adult emergence occurred between 2 and 9 days. The mean oviposition and mean post-oviposition periods of the female parasitoid were 22.76 ± 1.37 days and 13.64 ± 1.40 days, respectively. O. kuvanae was reared for more than ten generations on the eggs of P. ricini. Based on our findings, P. ricini can be used to rear O. kuvanae for the biological control of L. dispar.
The goal of this study was to characterize the Hamra goat population and to determine if Hamra goats of Beni Arouss and Rommani regions belong to the same population. Eleven morphometric traits of 157 Hamra animals (94 from Beni Arouss and 63 from Rommani) were used for this study. Overall, heart girth, body length, height at withers (HaW), height at rump (HS), chest depth (ChD), pelvis width (PW), chest width (CW), cannon circumference, head length (HeL), head width (HeW) and horn length (HL) of Hamra goats averaged 81.3, 61.5, 64.8, 65.3, 40.9, 19.3, 20.2, 9.67, 28.0, 26.3 and 23.4 cm, respectively. The effect of region was significant only on HaW, PW, HeL, HeW and HL, indicating certain homogeneity among goats of the two regions. Moreover, the inter region variance component ranged from 0 percent (absence of variability) for HS, CW, ChD and ChD to 18.5 percent for HeL, suggesting that the variability of body measurements between Beni Arouss and Rommani regions is very low. The factor analysis revealed four factors, which accounted for 73.5 percent of the total variance. The most discriminant variables between the two populations were HeL, HeW, PW and CW. The Mahalanobis distance between the two populations was 1.197, suggesting that there was genetic exchange between the two populations. The discriminant analysis showed that 80.9 percent of Rommani and 50.0 percent of Beni Arouss individuals were classified into their respective population. Results obtained will help in developing improvement and preservation strategies for the Hamra goat population.
Chest pain in adolescents is rarely associated with cardiac disease. Adolescents with medically unexplained chest pain usually have high levels of anxiety and depression. Psychological stress may trigger non-cardiac chest pain. This study evaluated risk factors that particularly characterise adolescence, such as major stressful events, in a clinical population. The present study was conducted on 100 adolescents with non-cardiac chest pain and 76 control subjects. Stressful life events were assessed by interviewing patients using a 36-item checklist, along with the Children’s Depression Inventory and Spielberger’s State-Trait Anxiety Inventory for children, in both groups. Certain stressful life events, suicidal thoughts, depression, and anxiety were more commonly observed in adolescents with non-cardiac chest pain compared with the control group. Moreover, binary logistic regression analysis showed that trouble with bullies, school-related problems, and depression may trigger non-cardiac chest pain in adolescents. Non-cardiac chest pain on the surface may point to the underlying psychosocial health problems such as depression, suicidal ideas, or important life events such as academic difficulties or trouble with bullies. The need for a psychosocial evaluation that includes assessment of negative life events and a better management have been discussed in light of the results.
Humanitarian organisations supporting Syrian refugees in Jordan have conducted needs assessments to direct resources appropriately.
To present a model of psychosocial concerns reported by Syrian refugees and a peer review of research practices.
Academic and grey literature databases, the United Nations Syria Regional Response website, key humanitarian organisation websites and Google were searched for needs assessments with Syrian refugees in Jordan between February 2011 and June 2015. Information directly reporting the views of Syrian refugees regarding psychosocial needs was extracted and a qualitative synthesis was conducted.
Respondents reported that psychological distress was exacerbated by both environmental (financial, housing, employment) and psychosocial outcomes (loss of role and social support, inactivity), which are themselves stressors. Need for improvement in research methodology, participatory engagement and ethical reporting was evident.
Participatory engagement strategies might help to address identified psychosocial outcomes. More rigorous qualitative methods are required to ensure accuracy of findings.
Working gas pressure during sputter deposition can significantly affect the conformality of a thin film when it is grown on a nanostructured surface. In this study, we fabricated core-shell nanostructured photodetectors, where n-type In2S3 nanorod arrays (core) were coated with p-type CuInS2 (CIS) films (shell) at relatively low and high Ar gas pressures. In2S3 nanorods were prepared by glancing angle deposition (GLAD) technique using a thermal evaporator unit. CIS films were deposited by RF sputtering at Ar pressures of 2.7x10-2 mbar (high pressure sputtering, HIPS) and 7.3x10-3 mbar (low pressure sputtering, LPS). The morphological characterization was carried out by means of SEM. The photocurrent measurement was conducted under 1.5 AM Sun under no bias. Nanostructured photodetectors of HIPS-CIS/GLAD-In2S3 (i.e. HIPS-GLAD) were shown to demonstrate enhanced photoresponse with a photocurrent value of 98 μA, which is about ∼230% higher than that of LPS-GLAD devices. The enhancement originates from the improved core-shell structure achieved by more conformal coating of the CIS shell. In addition, the results were compared to their counterpart thin-film devices incorporating an In2S3 film coated either with HIPS or LPS CIS layer. Nanorod devices with high and low pressure CIS films showed photocurrent values ∼20 times and ∼ 19 times higher compared to those of high and low pressure film devices, respectively. This finding can be explained by the higher light absorption property of nanorods, and the reduced inter-electrode distance as a result of core-shell structure, which allows the effective capture of the photo-generated carriers. Therefore, the results of this work can pave way to the development of high photoresponse core-shell semiconductor devices fabricated by physical vapor deposition techniques.
The wild species of tomato Solanum pennellii (Lpa) is more tolerant to salt-induced oxidative stress than the cultivated species Solanum lycopersicum (Lem), due to the increase of several antioxidative metabolites and enzymes in this species under stress. The increase of reduced glutathione (GSH), one of these metabolites, in NaCl-treated Lpa, is due at least partly to the elevation of γ-glutamylcysteine synthetase (γ-ECS). Introgression line IL 8–3, which was found to include the Lpa orthologue of the γ-ECS gene (Lpa γ-ECS) in Lem's genetic background, was used to assign this gene to chromosome 8 and to assess its relative contribution to the effective antioxidative response of Lpa to stress. The growth of IL 8–3 and Lem plants responded similarly to NaCl and cadmium (Cd) stresses. In both genotypes, GSH and H2O2 levels responded also similarly to NaCl stress. NaCl and Cd stresses affected similarly the transcription of the γ-ECS gene in leaves of both IL 8–3 and Lpa plants. The effect of buthionine sulfoximine (BSO), a competitive inhibitor of the γ-ECS enzyme, on γ-ECS transcription was also similar in these two genotypes. Taken together, these results suggest that γ-ECS orthologues differ mainly in the regulation of their transcription and not at the post-transcriptional or translational levels. The mutation(s) led to these differences in the response of the two orthologues to the salinity and heavy metal stresses are expected to occur in a cis-regulatory element(s) located relatively close to γ-ECS.
To investigate the presence of neuropsychiatric symptoms (NPS) and sub-syndromes in elderly community-dwelling Asians with varying severity of cognitive impairment.
Chinese and Malay participants (n = 613) from the Epidemiology of Dementia in Singapore (EDIS) Study aged ≥ 60 years underwent clinical examination, neuropsychological testing, and NPS assessment using the Neuropsychiatric Inventory (NPI). Diagnosis of no cognitive impairment (NCI), cognitive impairment-no dementia (CIND), including CIND-mild and CIND-moderate, and dementia were made using established criteria.
A significant increase in the numbers of NPS was observed accompanying with increasing severity of cognitive impairment (p < 0.001). Compared to those with NCI/CIND-mild, participants with CIND-moderate [Odds ratio (OR): 4.2, 95% confidence interval (CI): 1.8–10.0] or dementia [OR: 9.2, 95% CI: 2.3–36.0] were more likely to have two or more neuropsychiatric sub-syndromes. Participants with CIND-moderate were more likely to have hyperactivity [OR: 2.0, 95% CI: 1.0–3.8] and apathy [OR: 2.9, 95% CI: 1.0–8.4] sub-syndromes, whereas patients with dementia were more likely to have psychosis [OR: 6.9, 95% CI: 2.4–20.1], affective (OR: 8.7, 95% CI: 1.8–42.9), and hyperactivity (OR: 5.4, 95% CI: 1.8–16.1). Furthermore, executive dysfunction and visual memory impairment were associated with the presence of three neuropsychiatric sub-syndromes; whist language and visuomotor speed impairment were related to the presence of two sub-syndromes. By contrast, impairment in attention, verbal memory, and visuoconstruction were not associated with any of the sub-syndromes.
The presence of NPS and sub-syndromes increase with increasing severities of cognitive impairment, and different neuropsychiatric syndromes are associated with specific impairment on cognitive domains in community-dwelling Asian elderly.