BRAIN DRAIN AND ITS REPERCUSSIONS ON THE NEEDS OF THE PALESTINIAN LABOR MARKET: A STUDY OF THE CAUSES AND CONSEQUENCES OF MIGRATION AMONG EDUCATED YOUTH

Background:Young women undergoing percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS) experience greater short-term adverse events than young men. There is a scarcity of data on the short-term adverse outcomes between young Bangladeshi males and females with ACS undergoing PCI.Objectives: This study was conducted to compare the short-term outcomes of PCI between young males and females presenting with ACS.Methods: This prospective observational study was done in the Department of Cardiology, National Institute of Cardiovascular Diseases (NICVD) fromApril 2016 to March 2017. 190 young patients with ACS and undergoing PCI were enrolled. They were equally divided into two groups, group I (young females <55 years) and group II (young males <45 years).Results: The mean age of young females and males was 43.8±6.9 years and 40.1±4.3 years respectively. Young women had significantly higher risk factors of hypertension (62.1% vs 33.7%, p<0.0010) and diabetes (57.9% vs 31.6%, p<0.001) in comparison to young men. Overall, young women experienced significantly greater incidence of short-term adverse events in comparison to young men (14.7% vs. 6.3%, p=0.04) and had significantly higher rates of severe bleeding (6.3% vs 1.1%, p=0.04), vascular access site complications (8.4% vs 2.1%, p=0.04) and recurrent ischaemia at 30 days (7.4% vs. 2.1%, p=0.04). Major adverse cardiac events (MACE) were higher among young females, in comparison to young males (4.1% vs 2.1%, p=0.4). Young females experienced significantly higher rates of short-term net adverse clinical events (NACE) than young males (10.5% vs 3.2%, p=0.04). Female gender (odds ratio [OR] 11.7), diabetes (OR 2.5), hypertension (OR 1.78), decreased ejection fraction (OR 1.41) and smaller stent diameter (OR 1.15) were identified as independent predictors of adverse short-term outcomes among young ACS patients undergoing PCI.Conclusion: Young women experienced significantly more adverse short-term outcomes after PCI. They had significantly greater NACE, largely driven by increased rates of major bleeding. Female gender was an independent predictor of adverse short-term outcomes among young ACS patients undergoing PCI.Bangladesh Heart Journal 2018; 33(1) : 1-9

Background: Acute coronary syndrome (ACS) among young people is increasingly prevalent. However, there is a scarcity of data on the gender differences of in-hospital adverse outcomes among ACS patients after percutaneous coronary intervention (PCI) among young Bangladeshis. This study was conducted to compare the in-hospital outcomes of PCI between young males and females presenting with ACS.Methods: This prospective observational study was done in the Department of Cardiology, National Institute of Cardiovascular Diseases (NICVD) fromApril 2016 to March 2017. 190 young patients with ACS and undergoing PCI were enrolled. They were equally divided into two groups, group I (young females <55 years) and group II (young males <45 years).Results: The mean age of young females and males was 43.8±6.9 years and 40.1±4.3 years respectively. Young women had significantly higher risk factors of hypertension (62.1% vs 33.7%, p<0.0010) and diabetes (57.9% vs 31.6%, p<0.001) in comparison to young men. Young women had angiographically less severe coronary artery disease (CAD), with significantly higher numbers of ACC/AHA lesion type B2 (40% vs 25.3%, p=0.03) and C (20% vs 9.47%, p=0.03), and greater frequency of multivessel disease. Overall, young women experienced greater incidence of in-hospital adverse events in comparison to young men (13.7% vs. 6.3%, p=0.09) and had significantly higher rates of severe bleeding (6.3% vs 1.1%, p=0.04) and vascular access site complications (8.4% vs 2.1%, p=0.04). Major adverse cardiac events were higher among young females, in comparison to young males (2.1% vs 0%, p=0.47). Young females experienced significantly higher rates of short-term net adverse clinical events (NACE) than young males (10.5% vs 3.2%, p=0.04). Female gender (odds ratio [OR] 11.7), diabetes (OR 2.5), hypertension (OR 1.78), decreased ejection fraction (OR 1.41) and smaller stent diameter (OR 1.15) were identified as independent predictors of adverse in-hospital outcomes among young ACS patients undergoing PCI.Conclusion: Young women with ACS presented with significantly more risk factors and experienced more adverse in-hospital outcomes after PCI, despite angiographically less severe CAD. They had significantly greater NACE, largely driven by increased rates of major bleeding. Female gender was an independent predictor of adverse in-hospital outcomes among young ACS patients undergoing PCI.University Heart Journal Vol. 12, No. 2, July 2016; 61-67

Different human-like cardiomyopathies associated to β-adrenergic stimulation are experimentally modeled in animals through variations in dose, route, and duration of administration of different cardiotoxic drugs. However, associated changes in the vasculature and their relation to systemic inflammation, and the influence of cardiovascular diseases risk factors (gender and age) upon them are seldom analyzed. Here we studied the effect of age and gender on the vasoreactivity of aortas from mice subjected to in vivo repeated β-adrenergic stimulation with different doses of isoproterenol (ISO) in association with circulating inflammatory cytokines. Young (2 months) and old (18 months) male and female mice received 0 (control), 5, 40, 80 or 160 μg/g/d of ISO (7 days, s.c.). IL-1α, IL-4 and vascular cell adhesion molecule-1 (VCAM-1) were quantified in plasma. In vitro, norepinephrine-induced vasoconstriction and acetylcholine-induced relaxation were measured in aortas. No differences in contraction, relaxation, IL-1α, and IL-4 were found between control young males and females. Age decreased contraction in males and relaxation was lower in females and abolished in males. VCAM-1 was higher in young males than in females and increased in old mice. Vasoconstriction in ISO-treated mice results as a bell-shaped curve on contraction in young and old males, with lower values in the latter. In females, ISO-160 increased contraction in young females but decreased it in old females. Vasorelaxation was reduced in ISO-treated young males and females. ISO-80 and 160 reduced vasorelaxation in old females, and intermediate doses relaxed aortas from old males. VCAM-1 was higher in young and old males with ISO-80 and 160; while VCAM-1 was higher only with ISO-160 in old females. Our results demonstrate that repeated β-adrenergic stimulation modifies vascular reactivity depending on gender, age, and dose. Females were less sensitive to alterations in vasoreactivity, and young females required a higher amount of the adrenergic stimuli than old females to show vascular alterations. Changes were independent of IL-1α and IL-4. VCAM-1 only changed in old females stimulated with ISO 160. Our results highlight the relevance of considering and comparing in the same study females and aged organisms to improve the accuracy of applications to clinical studies.

Effects of nine social life indicators on age-adjusted and age-specific annual suicide mortality of male and female Japanese population in the years 1953-96 were investigated by multiple regression analysis on time series data. Unemployment rate was significantly related to the age-adjusted mortality in both males and females. Also, female labour force participation was positively related to the male mortality; persons and 65 and above was inversely related to the male mortality. Results on the age-specific mortality indicated that: during the 44 yr, (1) unemployment significantly related with the mortality of young, middle-aged and elderly males and young females; (2) female labour force participation significantly related with the mortality of young and elderly males and young females; aged population significantly related with the mortality of middle-aged and elderly males; (4) young population significantly related with the mortality of young and middle-aged males and females; (5) divorce significantly related with the mortality of middle-aged and elderly males and young males and females; (6) persons employed in primary industries significantly related with the mortality in middle-aged males and young males and females; and (7) population density significantly related with the mortality of middle-aged males and young females.

Objective. To study state dynamics of the cardiovascular system of athletes in acyclic sports against the background of submaximal physical activity to identify individuals at high risk of cardiovascular complications, including sudden cardiac deathMaterials and methods. The survey was conducted among athletes of acyclic sports. Number of people examined: 50, average age 20.0±3.5 years old. Of these, 30 (60%) were men, average age 19.9±3.4 years old; women – 20 (40%), average age 21.0±3.8 years old. Qualification of athletes: CMS, MS, MSIC.Results. At rest, instability of the depolarization phase is indicated by two ECG markers: a fragmented frQRS complex and a spatial QRS-T angle of more than 105º. Fragmented frQRS was detected in 73% of young males and 33% of young females. The average values of the QRS-T angle were within the physiological norm: 63±23º in young males and 40±14º in young females. Electrical ventricular systole, expressed by the Q-T interval, was 373±26 ms in young males and 385±35 ms in young females. The average value of the second indicator of repolarization instability Q-T interval dispersion was 50.7±12.8 ms in young males and 39.3±14.6 ms in young females. The average TWA amplitude in young males was 21.0 (18; 24) μV, and 20.5 (14; 25) μV in young females. Analysis of ECG markers of dysfunction of autonomic nervous regulation showed that the slowdown in heart rate DC was 19.0 (14.8; 31.5) ms in young males, 19.5 (11.8; 21.5) ms in young females. The acceleration of heart rate AC in young males was 19.8 (13.8; 26.0) ms, and 19.5 (11.5; 21.5) ms in young females.After the load, no statistically significant changes in the frequency of detection of fragmented frQRS were observed in young males (p = 0.7472), while in young females a statistically significant increase in the frequency of detection of frQRS was detected (p = 0.0226). The average value of the QRS-T angle increased significantly – from 63±23ºto 85±25º in young males (p = 0.0117), while it did not change significantly in young females – from 40±24º to 55±26º (p = 0.2606). Q-T dispersion in afterload compared to rest increased from 50.7±12.8 ms and reached 72.8±25.0 ms (p = 0.000) in young males and from 39.3±14.6 ms to 68.2 ±10.7 ms in young females (p = 0.0029). Deceleration (DC) and acceleration (AC) of heart rate decreased significantly in young males. For young males – by 77.7 and 82.3%, respectively (p < 0.0001), and for young females – by 84.9 and 80.0%, respectively (p < 0.0001).Conclusion. At rest, we identified only 10 markers of electrical instability of the myocardium, and 38 markers after exercise, that is, almost 4 times more. This suggests that even in highly qualified athletes, load causes a trend towards electrical instability of the myocardium, mainly in the repolarization phase and in relation to autonomic nervous regulation.

Our recent report indicated that although prostacyclin does not mediate sweating in young and older males, it does modulate cutaneous vasodilation in both groups to a similar extent (Fujii et al. J Physiol 594 (21), 6419–6429, 2016). The same study also suggested that nitric oxide synthase (NOS) and calcium‐activated potassium (KCa) channels contribute to the prostacyclin‐induced cutaneous vasodilation in young males but, these contributions are diminished in older males. In our current study, we sought to evaluate whether the same responses are observed in young and older females. In young (25±4 years) and older (60±6 years) females (10 per group), cutaneous vascular conductance (CVC) and sweat rate were evaluated at four intradermal forearm skin sites: 1) Control, 2) 10 mM L‐NNA, a non‐specific NOS inhibitor, 3) 50 mM tetraethylammonium (TEA), a non‐specific KCa channel blocker, and 4) 10 mM L‐NNA + 50 mM TEA. All fours sites were co‐administered with prostacyclin in an incremental manner (0.04, 0.4, 4, 40, 400 μM each for 25 min). Our results demonstrated that both NOS and/or KCa channels contribute to prostacyclin‐induced cutaneous vasodilation for young and older females. This is based on our observations that the increased CVC due to prostacyclin administration was attenuated by TEA (0.4 μM) and a combination of L‐NNA and TEA (at all concentrations tested) in young females. Additionally, in older females the increased CVC due to prostacyclin administration was also reduced by separate administration of either L‐NNA or TEA (0.04–4 μM), and a combination of both agents (0.04–40 μM) (all P≤0.05). Surprisingly, increases in CVC in response to 0.04–4 μM prostacyclin were greater in older relative to young females (all P≤0.05), and these age‐related differences were diminished when both L‐NNA and TEA were simultaneously administered (all P>0.05). No effect on sweat rate was observed in either group (all concentrations, P>0.05). We conclude that while prostacyclin does not mediate sweating, it modulates cutaneous vasodilation to a greater extent in older relative to young females. Wherein, this modulation is likely due to NOS‐ and KCa channel‐dependent mechanisms.Support or Funding InformationThis study was supported by the Natural Sciences and Engineering Research Council of Canada (Discovery grant, RGPIN‐06313‐2014; Discovery Grants Program ‐ Accelerator Supplement, RGPAS‐462252‐2014). Funds held by Dr. Glen P. Kenny.

From Café Culture to Tweets

1. Vasoconstrictor responses to inspiratory gasp were determined in fingertip skin by laser Doppler flowmetry in relation to age and gender of healthy adults. Variations of the responses were examined together with variations in body mass index and vital capacity. 2. In the absence of any significant difference in the baseline blood flow, the index of vasoconstrictor response (per cent change) induced by inspiratory gasp was higher in young males than in young females (71.4% versus 59.4%; P < 0.05), and in the same direction as the change in vital capacity determined in the same laboratory setting. Similar parallel differences in the indexes of vasoconstrictor response and vital capacity existed between young and middle-aged males, suggesting that the differences observed were not due to gender or age per se. 3. Strong positive correlations between the index of the vasoconstrictor response and vital capacity in the same subject were found when young males and females were pooled together and when young and middle-aged males were pooled together. Furthermore, after graded inspiratory gasp, graded vasoconstrictor response was observed in the same subject, indicating a close relationship between the depth of inspiration (magnitude of stimulus) and the index of the vasoconstrictor response (reactivity). 4. We concluded that the index of the vasoconstrictor response induced by inspiratory gasp depends significantly on the magnitude of the vital capacity. These results provide a new approach for quantifying dynamic changes in skin blood flow and raise caveats about comparing differences in neurovascular functions using single measurements of vasoconstrictor response induced by inspiratory gasp as an index.

Changes in body mass, fat mass, lean dry mass, and energy content of little brown bats, Myotis lucifugus (LeConte), captured at a cave in southern Vermont, were quantified during the pre-hibernation period in late summer and autumn. Adults of both sexes showed maximum rates of increase in body mass from mid-August to mid-September, during which time the average gain was 2.3 g for males and 2.1 g for females. These gains represent 32.9% and 29.6% of the pre-hibernation body masses for adult males and females, respectively. Young-of-the-year of both sexes weighed about 1 to 2 g less than adults during most of the pre-hibernation period. In mid-September, adult females weighed significantly less than a cohort of adult females captured at a maternity roost on the same date. Adult bats reached their maximum pre-hibernating body mass in mid-September, whereas young bats reached their maximum pre-hibernating body mass one month later. From mid-July to mid-September, we found no significant differences in mean body mass between young males and females, but in mid-October when they entered hibernation, young females weighed significantly more than young males and almost as much as adult females. Young males and females arrived at the swarming-hibernation site in late summer with an average lean body mass and fat index approximately 20% lower than adults. By early October, young females achieved minimum adult levels of lean dry mass, but by the time they entered hibernation the lean mass of young males was still about 10% lower than adults. During the pre-hibernation period, lean dry mass and fat mass of all bats were significantly correlated with body mass. Regression equations derived from these data were used to estimate total energy content of bats. The acquisition of maximum fat reserves by M. lucifugus in the pre-hibernation period may be as important for successful reproduction as it is for sustaining hibernation. The fattest adult males may gain a reproductive advantage if they acquire enough energy reserves to sustain autumn mating and hibernation, and engage in multiple matings during the winter. The fattest females should gain a reproductive advantage by maximizing fat reserves before entering hibernation, and retaining sufficient energy reserves at the end of hibernation to facilitate ovulation. Relatively low survival and reduced fecundity in females at northern latitudes may reflect the relatively low fat reserves deposited by young females in their first autumn.

Objective. Motor vehicle crashes are the leading cause of death for 15-to 20-year-olds. In 2004, nearly 8,000 15to 20-year-old drivers were killed in crashes. Epidemiologic studies repeatedly identify overrepresentation of young males in fatal crashes. Recent studies of young females and risk-taking behaviors (drug use, violent crime, risky sexual behavior) show unfavorable trends. The objective of this study is to study the extent of contribution of young female drivers to national fatal crashes over and to uncover unfavorable trends linked to risky driving behavior. Methods. Data from the National Highway Traffic Safety Administration's Fatal Analysis Reporting System (FARS) on drivers in crashes with one or more fatalities during 1995–2004 were studied. Five age groups were used: 16, 17, 18, 19–20, and 21–24 years. Linear regression was used to measure trends over time. The regression results represent differences in proportions and changes in proportion of crashes that fell into specified categories. The FARS multiple imputation data sets was used to estimate the proportion of drivers with positive blood alcohol, and variance estimates were corrected for the imputation procedure. Results. In all, 139,000 fatal crashes involving the noted age groups occurred over 10 years. Safety restraint use: Females had more safety restraint use (by 17.8%) but a smaller increase in use over time. Driver's license validity: The percentage of valid licensure decreased over the study for young males and females both in the general population and among drivers in fatal crashes. Single-vehicle crashes: A lower proportion of female drivers (8.9% fewer) were involved in single-vehicle fatal crashes. This proportion changed little over the study period. Alcohol use: Females had a 16.7% lower proportion than males of alcohol involvement in fatal crashes. This lower proportion was seen throughout the age groups. When accounting for change over the study period, female drivers had a similar to male increase in alcohol-involved fatal crashes. Presence of peer passengers: Female drivers were less likely to have age peers as passengers. Conclusions. While young male drivers surpass young females in number of fatal crashes, there are unfavorable trends linked to crash fatalities in young females. Our results suggest a smaller increase in safety restraint use, proportional decrease in license validity, and an increase in rate of alcohol-involved fatal crashes that approaches that seen in young males. These findings have considerable implications for future traffic safety social marketing campaigns, programs, and interventions.

To compare finger systolic blood pressures in males and females and in younger and older persons and provide normal values for all four fingers in younger and older males and females. Eighty healthy subjects participated in the study: 20 males and 20 females aged 20-30 years, and 20 males and 20 females aged 55-65 years. Finger systolic blood pressures (FSBPs) were measured using strain-gauge plethysmography following local cooling at 30 and 10 degrees C in accord with International Standard 14835-2. The FSBPs were measured simultaneously in the thumb and the four fingers of the dominant hand and the percentage changes in finger systolic blood pressures (%FSBPs) due to the cold provocation were calculated. The median finger systolic blood pressures increased with increasing age in both females and males, with the increase highly significant at 30 degrees C but not at 10 degrees C. The %FSBPs were not significantly affected by the age of males, but were significantly lower in older females than younger females. The FSBPs were lower in females than in males at 30 degrees C but there was no significant difference between genders at 10 degrees C. The %FSBPs were higher in younger females than younger males, but only significantly higher in the middle finger and there were no significant differences between the genders in the older age group. There were only minor differences between the four fingers in the FSBPs at 30 and 10 degrees C. The %FSBPs across the four fingers were similar in the younger subjects and in the older females, but varied with finger in the older males. Although there are some differences in the %FSBPs associated with age, gender, and finger, the differences may be sufficiently small to use a single value criterion when deciding on abnormalities in FSBP associated with cold provocation for persons aged 20-65 years.

This study explores the role of social media in shaping public opinion towards political, educational, and economic issues among the university students. The study aims to investigate the use of social media and how it builds various opinions among the respondents. Using a qualitative research approach and phenomenological research design, the researcher collected data through simple random sampling technique from twelve respondents by utilizing an interview guide. The thematic analysis method was employed to interpret the data. We extracted the themes from the collected data, such as use of social media and public opinion towards political issues, educational issues, and economic issues. Findings reveal that social media significantly contributes to opinion formation, offering a platform for debate, news consumption, and exposure to diverse viewpoints. Respondents reported using social media not only for entertainment but also for learning, networking, and activism. Keywords: Social Media, Public Opinion, Educational Issues, Political Issues, Economic Issues

Immediately after World War II, drastic agricultural land reform was implemented in Japan. This reform has been considered one of the most successful agrarian reform projects in the world. It is often said that the reform gave former tenant farmers new incentives, which contributed to the rapid growth of Japanese agriculture, but little empirical evidence has been presented to support that assertion. Most past studies discussed the impact of reform without distinguishing between political and economic issues. How was the agrarian structure changed by reform? What kind of economic and political issues were raised, solved, or remained intact? The author explores the political and economic motives for reform and the conditions that allowed such drastic reform to succeed. He also identifies economic issues that were inoculated by the reform, and chronologically traces reform's progress. His conclusion: Japanese land reform succeeded politically but, as an industrial policy, brought serious economic problems. Japan's reform experience offers precious lessons to developing countries now intent on implementing agrarian reform. Land reform in Japan demolished a class structure based on landholding. Landlords were no longer supreme and rural society was restructured, so the rural population became supportive of the ruling conservative party. But land reform had little effect on agricultural production. Land ownership was transferred from landlords to tillers of the soil, and small tenant farmers became small owner-cultivators, with no apparent change in farm size. The traditional agricultural production structure from prewar Japan remained. Agriculture grew after the war, but not because of land reform--possibly because of greater technical knowledge and the recovery of critical inputs, such as knowledge and the recovery of critical inputs, such as fertilizer, that were in short supply during the war. The income and standard of living of rural people may have improved, but it is not clear to what extent land reform contributed to capital formation in agriculture. More empirical work is needed.

The theological currents of liberation theology in Latin America and interfaith dialogues in Asia are widely perceived to have developed along separate tracks, with Asian Christians, comprising tiny islands in great seas of Asian religions, focusing dialogue across faith traditions, and the Latin Americans focusing on political and economic issues. Some commentators have claimed that early Latin American liberation theology (LALT) was primarily focused on economic and political issues, only turning in a subsequent paradigm shift to questions of cultures, spiritualities and cosmovisions.

ObjectivesIn a retrospective study, we aimed to explore the prevalence of risk factors and trends of obstructive coronary artery disease (CAD) in Indian females <45 years of age compared to males of the same age group who underwent percutaneous coronary intervention (PCI). Materials and MethodsThis was a retrospective, observational, multi-centre study of young Indian females and males (<45 years) who underwent PCI as per the guidelines at three high-volume centres in India. ResultsIn a group of 3656 patients under the age of 45 who had PCI, 3.1% of those with obstructive CAD were young women (n = 113), while 6.9% were young men (n = 254). Traditional risk factors such as hypertension (p = 0.73), diabetes (p = 0.61), and family history of premature CAD (p = 0.63) were equally common in both genders, whereas dyslipidaemia (p < 0.001), overweight (p < 0.006), smoking (p = 0.004) and, alcoholism (p < 0.001) were more common in young males. Acute coronary syndrome was the most common clinical presentation. Single-vessel disease was common, with the involvement of the left anterior descending artery as the most common angiographic feature. The prevalence of cardiogenic shock was 4.4% in females and 4.1% in males, while the in-hospital mortality rate was 1.77% in young females and 2% in young males. ConclusionsObstructive CAD in young men and women accounted for 10% of all CAD cases requiring PCI. Although men account for the majority of patients, CAD in women under the age of 45 is not uncommon. Traditional risk factors are becoming more prevalent in younger women.