Main Variables Research Articles

Impact of lymphovascular invasion on survival in surgically treated upper tract urothelial carcinoma: a nationwide analysis.

To assess the prognostic ability of lymphovascular invasion (LVI) in upper tract urothelial carcinoma (UTUC) as a predictor of overall survival (OS) using a large North American cohort. Our cohort included 5940 patients with clinical M0 UTUC who underwent a radical nephroureterectomy (RNU), between 2010 and 2016, within the National Cancer Database. The main variable of interest was LVI status, and its interaction with pathological nodal (pN) status. Kaplan-Meier curves were used to depict the OS also stratifying patients on LVI status. Cox regression analysis tested the impact of LVI status on OS after accounting for the available covariates. The median (interquartile range [IQR]) age at diagnosis was 71 (63-78) years and most patients had pathological T1 stage disease (48.6%). Nodal status was pN0, pN1 and pNx in 45.8%, 6.3% and 47.9%, respectively. Overall, 22.1% had LVI. The median (IQR) follow-up time was 32.6 (16.0-53.3) months. At the 5-year postoperative follow-up, the estimated OS rate was 28% in patients with LVI vs 66% in those without LVI (P < 0.001). When patients were stratified based on nodal status those rates were 32% vs 68% in pN0 patients (P < 0.001), 23% vs 30% in pN1 patients (P = 0.8), and 28% vs 65% in pNx patients (P < 0.001). On multivariable analysis, the presence of LVI was associated with less favourable OS (hazard ratio 1.79, 95% confidence interval 1.60-1.99; P < 0.001). Our study assessed the impact of LVI on OS in patients with UTUC in a large North American nationwide cohort. Our series, as the largest to date, indicate that LVI is associated with less favourable survival outcomes in patients with UTUC after RNU, and this variable could be used in counselling patients about their prognosis and might be a useful tool for future trials to risk-stratify patients.

What Is Health Literacy Among Orthognathic Surgery Patients?

BackgroundHealth literacy of orthognathic surgery patients has not been thoroughly evaluated. PurposeThe purpose of this study was to estimate health literacy and identify risk factors associated with inadequate health literacy in orthognathic surgery patients. Study Design, Setting, SampleA cross-sectional study was implemented utilizing patients ages 14-80 years who presented for orthognathic surgery evaluation between September 2021 and December 2022. Subjects were excluded from the study if they did not complete the orthognathic surgery evaluation, were not between the ages of 14-80 years old, or did not complete the Brief Health Literacy Screening Tool (BRIEF) questionnaire during intake. Subjects who have not undergone orthognathic surgery but completed the initial evaluation for orthognathic surgery were included in the study. Predictor variablesThe predictor variables were a set of risk factors for inadequate health literacy: age, sex, primary language, race, estimated household income, and diagnosis. Main Outcome VariableThe main outcome variable was health literacy assessed using the Brief Health Literacy Screening Tool (BRIEF). During intake, subjects completed the BRIEF questionnaire consisting of four questions scored on an ordinal scale of 1-5. Inadequate health literacy was defined as a BRIEF score ≤16. CovariatesNot applicable. AnalysesBivariate and multivariate analyses were performed. P < 0.05 was considered statistically significant. ResultsOf 150 patients presenting for orthognathic surgery, fifteen percent of patients had inadequate health literacy via the BRIEF test. The mean age of those with adequate health literacy was 27.9 years (SD, +12.5) compared to 18.5 years (SD, +5.7) for those with inadequate health literacy (p=<0.001). After adjusting for sex, language, race, estimated household income, and diagnosis via multivariate analysis, increasing age was associated with decreased odds of inadequate health literacy (adjusted odds ratio= 0.81 (CI, 0.72-0.92), p=<0.001). Conclusion and RelevanceIn the complex process of orthognathic surgery, it is essential to identify patients with inadequate health literacy that may require additional health literacy interventions. Ultimately, 15% of orthognathic surgery subjects had inadequate health literacy, and younger patients were the most susceptible as the odds of inadequate health literacy decreased with increasing age.

Impact of Non Scheduled Public Mini Bus Stops on Transit Trip Time: A Case Study Amman-Jordan

Public transport services face many challenges around the world. Due to the rise in demand for public transport, authorities desperately need to develop the systems, and it provides a service to be the same level for private cars in terms of service reliability measures. This research aims to study the influence of the non-scheduled random public mini bus stops on travel time for a specific mini bus route. These non-scheduled stops became a habitual behavior for Public mini buses, which affects the daily users of this transportation service in Jordan. In this study, a comprehensive plan was designed to collect data regarding the mini bus behavior along a selected bus route, using a transit on- board survey, GPS and questionnaires. The data collection involved locations of non-scheduled stops, number of stops, distance and speed. The data was then used to develop a trip time model. The developed model detects the delay time due to the non- scheduled mini bus stops. The analysis of the data indicated that passengers mainly depend on random mini bus stops because there aren’t scheduled stops, thus a large impact on traffic jam. Furthermore, it was found that the main variables that affect the trip travel time are the total delay time due to stopping randomly to board and alight passengers. The study concluded that eliminating the non-scheduled mini bus stops will reduce the trip time, thus get improve he service reliability.

Aspergillus awamori MK788209 cellulase: production, statistical optimization, pea peels saccharification and textile applications

BackgroundThe demand for low-cost cellulolytic enzyme synthesis is rising in the enzyme market. This work aims to produce cellulase by utilizing various agricultural wastes and investigating the use of enzyme in saccharification and textile industries.ResultsSolid state fermentation (SSF) was applied to produce industrial enzymes, particularly cellulase, through utilizing Molokhia (Corchorus olitorius) stems by Aspergillus awamori MK788209 isolate. Two stages of statistical factorial designs Plackett-Burman (PB) and Central Composite Design (CCD) were applied to enhance the A. awamori MK788209 cellulase production from Molokhia stems (MS). The fold increase of enzyme production by PB followed by CCD was 2.51 and 4.86, respectively. Additionally, the A. awamori MK788209 culture filtrate was highly effective in saccharifying various agricultural wastes, particularly pea peels (PP) (yielding 98.33 mg reducing sugar/ml), due to its richness in cellulase, laccase, xylanase, pectinase, and amylase. By optimizing the three main variables; pea peel weight, culture filtrate volume added, and saccharification time by CCD, the sugar recovery from PP was enhanced, leading to a 3.44-fold increase in reducing sugar recovery (338 mg reducing sugar /ml). Furthermore, the A. awamori MK788209 culture filtrate showed high efficacy in textile applications, enhancing the roughness, weight loss, white index, and printing capability of treated cotton fabrics.ConclusionsA. Awamori MK788209 produced cellulase which was effective in PP saccharification. The enzyme was also capable of enhancing cotton fabric properties.

The relationship between intimate partner violence and child malnutrition: a retrospective study in 29 sub-Saharan African countries.

Intimate partner violence (IPV) and child malnutrition are global public health issues. Assessing the association between IPV and child anthropometric failures (stunting, underweight, and wasting) in 29 Sub-Saharan African (SSA) countries can provide significant global health solutions. Some studies have found an association between IPV against women and child malnutrition, but the conclusions are inconsistent. The physical and psychological conditions, living environment, and rights of the mother may be involved. We collected and analyzed the Demographic and Health Surveys data (2010-2021) of 29 SSA countries. The main exposure variables were various types of IPV, classified as physical, sexual, and emotional violence. The outcome was the child's development index, which can be roughly divided into stunting, wasting, and underweight. An adjusted binary logistic regression model was used to test the relationship between IPV and children's nutritional status. A total of 186,138 children under 5 years of age were included in the analysis; 50,113 (27.1%) of the children were stunted, 11,329 (6.1%) were wasted, and 39,459 (21.3%) were underweight in all regions. The child's gender, age, duration of breastfeeding, complementary feeding, and vitamin A supplements intake in the past 6 months were associated with their nutritional status (p < 0.001). Sexual violence was the strongest factor associated with stunting, which remained statistically significant after controlling all variables (AOR = 1.11; 95% CI: 1.02, 1.21; p = 0.012). We also found a small negative association between wasting and IPV. For underweight, there were no associations with IPV after controlling for all variables (p > 0.05). IPV is positively associated with child stunting in SSA countries. Sexual violence showed a strong positive correlation with stunting. Wasting was unexpectedly negatively associated with IPV. There was no clear correlation between underweight and violence.

Hyponatremia after COVID-19 is frequent in the first year and increases re-admissions

Hyponatremia on admission has been related to worse outcomes in patients with COVID-19 infection. However, little is known about the frequency and the associated risk factors of hyponatremia after COVID-19 discharge. We performed an observational 24-month follow-up study of patients admitted during the first COVID-19 wave. Kaplan–Meier curves and Cox proportional hazard models were used to assess the main variables in predicting hyponatremia on follow-up (HYPO-FU). A total of 161 out of 683 (24.4%) developed HYPO-FU. The group with HYPO-FU comprised of more men [(62.3%) vs. (49.2%); p < 0.01], older [65.6 ± 18.2 vs. 60.3 ± 17.0; p < 0.01] and more frequently re-admitted [(16.2%) vs. (3.8%); p < 0.01). The rate of HYPO-FU was higher in the first year 23.6 per 100 individuals per year. After Cox regression analysis, the independent risk factors of HYPO-FU were diabetes [OR 2.12, IC 95% (1.48–3.04)], hypertension [OR 2.18, IC 95% (1.53–3.12)], heart failure [OR 3.34, IC 95% (1.72–6.48)] and invasive ventilation support requirement [OR: 2.38, IC 95% (1.63–3.50)]. To conclude, HYPO-FU was frequent in the first year after COVID-19 infection, and the risk was higher in older men with comorbidities, increasing rehospitalisation. Further studies aimed at evaluating the beneficial effects of correcting hyponatremia in these patients are warranted.

Risk Factors for Infection Recurrence After Surgical Resection of Advanced Stage Osteonecrosis of the Mandible

BackgroundAdvanced stage osteoradionecrosis (ORN) and medication-related osteonecrosis of the jaw (MRONJ) are challenging disease entities requiring multimodal therapy including surgical resection. However, risk factors associated with infection recurrence are poorly understood. PurposeThe purpose of this study was to identify risk factors associated with infection recurrence following resection of advanced stage ORN or MRONJ of the mandible. Study design, setting, sampleThis was a retrospective cohort study including patients who underwent segmental mandibulectomy for management of ORN or MRONJ between 2016 and 2021 at the authors’ institution. Subjects who did not have margin viability data were excluded. Predictor/exposure/independent variableThe primary predictor variable was viability of resection margins on histopathologic analysis (viable or non-viable). Secondarily, other risk factors categorized as demographic (age, sex, race), medical (comorbidities), and perioperative (reconstructive modality, antibiotic duration, microbiological growth) were evaluated. Main outcome variableThe primary outcome variable was time to infection recurrence defined as time from surgical resection to clinical diagnosis of a fistula tract, abscess, or persistent inflammatory symptoms necessitating surgical intervention. CovariatesNot applicable. AnalysesDescriptive and bivariate statistics were used to identify associations between risk factors and time to infection recurrence. A significance level of p ≤ 0.05 was considered significant. ResultsThe cohort consisted of 57 subjects with a mean age of 63.3 ± 10.0 years (71.9% Male, 75.4% White) treated for ORN (47.4%) or MRONJ (52.6%). A total of 19/57 (33%) subjects developed a recurrence of infection with one and two year survival of 75.8% and 66.2%, respectively. Non-viable resection margins were associated with earlier time to infection recurrence (p ≤ 0.001, Hazard Ratio (HR) = 11.9, 95% Confidence Interval (CI) = 3.84 – 36.7) as was younger age (p = 0.005, HR = 0.921, 95% CI = 0.869 – 0.976) and atypical pathogen growth on culture (p = 0.002, HR = 8.58, 95% CI = 2.24 – 32.8). Conclusions and RelevanceHistopathologic margin viability was associated with earlier time to infection recurrence following resection of advanced stage ORN or MRONJ of the mandible. Additional studies are needed to identify interventions that may improve outcomes in this demographic.

The Effect of Low Carbon on Urban Economy: Romer Model and Empirical Evidence

We investigate the relationship between carbon emissions and the economy, focusing on the environmental and economic conditions of cities in China. The research is conducted within the framework of low-carbon city pilot policies, aiming to determine whether city economies in China are growing, declining, or exhibiting a “U-shape” pattern under low-carbon circumstances. A sample of 29 cities, including municipalities and provincial capitals, was selected from the period between 2011 and 2016. Using regression analysis, we examine the negative correlation between GDP and carbon emissions and total industrial sulfur dioxide emissions. Additionally, we find a positive association between GDP and park green area. The robustness of our findings is confirmed through Budget Revenue tests. Furthermore, Difference-in-Differences (DID) testing reveals the positive impact of control variables on the two main variables under investigation.

Unleashing the Power of Plasma and Flow: A Novel Cold Plasma‐Oscillatory System for Enhanced Continuous Biodiesel Production from Sunflower Oil

While fossil fuel resources are limited, the increasing demand for energy in the industrial and transportation sectors has led to using renewable fuels. This study aims to improve biodiesel production from sunflower oil by combining cold plasma and oscillatory systems through a transesterification process. The four main operational variables are examined, such as molar ratio (MR) (1:6–1:12), catalyst concentration (CC) (0.5–1.25 wt%), plasma exposure time (PET) (25–75 s), and residence time (RT) (30–90 s). The smooth periodic constriction reactor's physical attributes, including the diameter of the tube (D), the diameter of the constricted region (d0), and the distance between baffles (l), as well as the properties of the cold plasma system, are determined. The data analysis presents that PET, RT, CC, and MR have the greatest effect on efficiency. This optimization indicates that by exposing the reaction mixture to plasma for 59.99 s, adding 1.09% by weight of the catalyst, and with a MR of 7.17 in 86.43 s, biodiesel with a conversion percentage of 94.75% is produced. The results show that the optimum point matches with EN 14214 standard.

Lateral Margin Graft for Minimizing Visible Lateral Margin on Radix Using Autologous Rib Cartilage in Asian Rhinoplasty

BackgroundVisible lateral margin after rhinoplasty is considered one of the potential complications. PurposeThe purpose is to assess the suitability of implementing a lateral margin graft (LMG) to mitigate the occurrence of a visible lateral margin (VLM) during augmentation rhinoplasty with autologous rib cartilage.Study Design, Setting, Sample: This is a retrospective cohort study between January 2016 and April 2022 in a private clinic. The inclusion criteria were patients who underwent augmentation rhinoplasty for aesthetic purposes using autologous rib cartilage. Patients who received allogenic tissue grafts or alloplastic materials, those with systemic diseases, and pregnant or breastfeeding females were excluded. Predictor variableThe primary predictor variable is the implementation or non-implementation of a LMG. Main outcome variablesThe primary outcome variable is the aesthetic satisfaction and the degree of minimization of the VLM when LMG is implemented and when it is not. Therefore, to understand the aesthetic satisfaction, the author used the Rhinoplasty Outcome Evaluations questionnaire (ROE), and to understand the degree of minimization of the VLM, the author measured the Lateral margin visibility score (LMVS) using a 5-Point Likert scale score. CovariatesThe evaluated covariates included sex, age at surgery, number of previous rhinoplasties, purpose of surgery and postoperative complications. AnalysesThe data were analyzed using the Independent Samples T-test, Paired T-test, Oneway ANOVA test. A significance level of P< 0.05 was employed for all statistical analyses. ResultsA total of 69 consecutive patients were included in the study, divided into Group 1(21 patients without LMG) and Group 2(48 patients with LMG). Postoperative ROE scores increased by 15.31±4.03 in Group 1 and 22.60±6.77 in Group 2 compared to preoperative ROE scores(P<0.001). In the patients’ LMVS, Group 1 had a score of 2.48±0.81, while Group 2 had a score of 3.06±0.76 points(P=0.009). In the surgeons’ LMVS, surgeon 1 indicated scores of 2.38±0.74 and 2.94±0.89 points, respectively(P=0.007). Furthermore, surgeon 2 indicated scores of 2.28±0.72 and 2.90±0.83 points, respectively(P=0.002). ConclusionWhen performing rhinoplasty using autologous rib cartilage, the use of a LMG can minimize the visible lateral margin, which increases patient satisfaction and the surgical completeness.

Machine learning, a powerful tool for the prediction of BiVO4 nanoparticles efficiency in photocatalytic degradation of organic dyes

Wastewater pollution caused by organic dyes is a growing concern due to its negative impact on human health and aquatic life. To tackle this issue, the use of advanced wastewater treatment with nano photocatalysts has emerged as a promising solution. However, experimental procedures for identifying the optimal conditions for dye degradation could be time-consuming and expensive. To overcome this, machine learning methods have been employed to predict the degradation of organic dyes in a more efficient manner by recognizing patterns in the process and addressing its feasibility. The objective of this study is to develop a machine learning model to predict the degradation of organic dyes and identify the main variables affecting the photocatalytic degradation capacity and removal of organic dyes from wastewater. Nine machine learning algorithms were tested including multiple linear regression, polynomial regression, decision trees, random forest, adaptive boosting, extreme gradient boosting, k-nearest neighbors, support vector machine, and artificial neural network. The study found that the XGBoosting algorithm outperformed the other models, making it ideal for predicting the photocatalytic degradation capacity of BiVO4. The results suggest that XGBoost is a suitable model for predicting the photocatalytic degradation of wastewater using BiVO4 with different dopants.

A New Hybrid Supervisory Control System for Cabinet-Type Firebox Furnaces

In this paper, an intelligent hybrid Industrial Control System (ICS) and a Supervisory Control System (SCS) are proposed to improve the efficiency, safety, availability, and control capabilities of industrial furnaces. The main components of ICS are process control systems and advanced control systems that consist of overheating protection and load control. New soft sensors are designed as a combination of Laguerre filters and an artificial neural network to estimate the surface temperature of the furnace’s tubes, which allows the protection system to adjust fuel flow rate via overriding commands. Model-based fault detection systems are developed to detect faults in the combustion system and fouling in the furnace tubes and prepare features for the supervisory system. The supervisory control system is responsible for interfering between different components, evaluating the situation, and decision making based on the unit status and process conditions. An intuitionistic fuzzy inference system is employed as the core of the supervisory controller to tolerate disturbance and faults by switching the control modes. Test studies using experimental data of the furnace indicate the capability of the proposed monitoring and control system to operate in various loading situations and recover the system from abnormal conditions. <italic xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">Note to Practitioners</i> —In petrochemical industries, several reports have been issued about the load reduction of fired-heater furnaces imposed by combustion system faults and emergency shutdowns to carry out un-planned repairs due to fouling and wax-formation in tubes. Different activities such as detecting abnormal conditions, identifying faults, and enforcing corrective action can be performed by operators through manual actions. This paper is focused on designing a new supervisory control system (SCS) to be able to recover the fired heater furnace from abnormal conditions and keep running the plant. The SCS evaluates the condition of the unit by acquiring information from main variables, sensors, actuators, operating status of components and utilities, and operator commands. By identifying the root cause of faults, SCS makes decision on recognizing hazard degree, raising alarms, and applying automatic corrective actions.

Motivational Interviewing as a Tool to Increase Motivation and Adherence to a Long COVID Telerehabilitation Intervention: Secondary Data Analysis from a Randomized Clinical Trial.

Although motivational interviewing was originally developed to address abuse disorders, scientific evidence confirms that it is an increasingly used and effective approach in a wide range of therapeutic interventions. To date, however, no studies have analyzed the use of this tool in patients with persistent symptoms following coronavirus disease 2019, a condition known as Long COVID. To analyze the effectiveness of motivational interviewing with regard to the adherence to telerehabilitation for Long COVID using a mobile application. As a secondary objective, factors related to greater motivation before and after the motivational interviewing techniques were analyzed. This longitudinal design substudy used a sample of 52 adult patients with Long COVID participating in the intervention group of a randomized clinical trial. This trial examined the effectiveness of a telerehabilitation program for this population using a mobile application. This program included three motivational interviews to achieve maximum treatment adherence. In this study, the main variables were motivation and adherence to application use. Sociodemographic and clinical data, personal constructs, and affective state were also collected. Subsequently, a descriptive, correlational, and regression statistical analysis was performed using the SPSS Statistics program. The median motivation prior to the first motivational interview was 8 (IQR 2), the median at the end of the last motivational interview was 8.5 (IQR 2.75), and the change in motivation levels after the three motivational interviews was 0.5 (IQR 1). Affective state and final motivation scores were predictors of greater adherence to telerehabilitation treatment. A high level of motivation after participating in motivational interviewing appears to be related to higher levels of adherence to telerehabilitation in patients with Long COVID. This suggests that motivational interviewing may be an effective tool in the treatment of this disease.

Characterization Approach for Compression Molded Discontinuous Fiber Thermoplastic Composites

Thermoplastic composites show potential in increasing the manufacturing production rate of composite aerospace structures. This is largely due to their ability to be consolidated quickly using automated processes. A variety of reinforced thermoplastic material forms are offered that can be processed multiple ways in order to meet structural performance requirements at the necessary production volumes without substantial compromise. Intrinsically, this requires generating a significant amount of statistically-based material property data for each unique material and process combination. Currently, the National Institute for Aviation Research (NIAR) and the Federal Aviation Administration (FAA) are developing a material qualification framework for compression molded discontinuous fiber thermoplastic composites in consensus with industry experts. To aid in the development of the qualification framework, a screening test matrix was formed to identify the key processing parameters and evaluate the appropriate test methods and specimen sizes. Three main variables were considered in the trial testing: reinforcement size, material flow behavior and panel thickness. The effect of these key processing parameters on the mechanical properties are discussed along with guidelines for testing and characterization.

Influence of main production variables to nutritional characteristics of winery effluent Kombucha

Determination of sugar, nitrogen and phosphorus consumption by kombucha culture is necessary in order to gain additional insight into the kombucha metabolic pathways, nutritional value of the produced beverages, and to set basis for optimising the conditions for large scale production. Kombucha beverage was made using effluent obtained from grape must clarification phase of white wine production. The fermentation medium was prepared by diluting the sterilized initial medium with approximately 16% of total reducing sugars to 3, 5, and 7% of total reducing sugars. The duration of the fermentation was nine days at 20, 25, and 30?C. Sugars, nitrogen and phosphorus content was measured using DNS, Kjeldahl and molybdenum blue method, respectively. The highest sugars content was in the initial medium (16.34%) and the lowest was after nine days of fermentation at 30 ?C with 3% initial sugars content (0.17%). Residual levels of sugars, nitrogen and phosphorus after three days were modelled using response surface methodology. The proposed mathematical models for sugars and nitrogen content showed an exceptional correlation with the experimentally obtained values. With this study the insight into kombucha?s consumption of basic nutrients, nutritional value of the obtained products and optimization of products composition was provided

Does use of GP and specialist services vary across areas and according to individual socioeconomic position? A multilevel analysis using linked data in Australia

ObjectiveTimely access to primary care and supporting specialist care relative to need is essential for health equity. However, use of services can vary according to an individual’s socioeconomic circumstances or...

Fertility Preservation in Patients With Cancer: Nurses' Views, Experiences, and Perceptions of Benefits and Barriers.

To evaluate nurses' views, experiences, and perceptions of the benefits and barriers to fertility preservation (FP) care for patients with cancer. The sample consisted of 236 nurses who provided care before gonadotoxic treatment for people with cancer in three university hospitals in Istanbul, Turkey, from January to June 2018. The data were collected using a participant information form and the Oncology FP Survey. The main research variables were nurses' views, experiences, and perceptions of benefits and barriers to FP care. Data were evaluated using means, SDs, frequencies, and the Mann-Whitney U test. Patients and their families were informed about FP most of the time. This information was given by physicians about half the time and by nurses less than one-fourth of the time. Mean scores on the Oncology FP Survey were moderate and indicated challenges among nurses in self-confidence, self-awareness of personal limitations, and perceived barriers when providing effective FP care. Nurses face challenges in providing counseling about FP options for patients with cancer and their families. Increasing self-confidence, reducing personal limitations, and decreasing perceived barriers to FP care through appropriate training may improve nurses' ability to provide FP counseling.

Comparison of Levobupivacaine over Lignocaine for Peribulbar Anesthesia in Cataract Surgery – A Randomized Control Study in a Tertiary Care Hospital

Abstract Introduction: Regional anesthesia is a better alternative whenever general anesthesia is undesirable or contraindicated. Peribulbar block is considered preferable over retrobulbar block in achieving anesthesia for intraocular and extraocular surgeries. It is widely used because it is easier to perform. Objectives: This study compares the efficacy of levobupivacaine over lignocaine for peribulbar anesthesia in cataract surgery. Methods: A prospective, randomized double-blinded study comparing levobupivacaine for peribulbar anesthesia in cataract surgery was done with 30 patients in each group. Included patients were randomly categorized into Group 1 and Group 2. Group 1 received lignocaine with adrenaline and Group 2 received 0.5% levobupivacaine with main outcome variables of the study intraoperative and postoperative pain, motor sensory onset, akinesia score, and analgesia duration. Results: In both the groups, there was no significant difference in terms of age and gender. There was statistical significance between the two groups in terms of motor blockade. There is a significant mean difference between Group 1 and Group 2 when compared with akinesia score with P &lt; 0.05. The pain was less in Group 2 than Group 1. There is no significant difference in both when compared with verbal pain score. Heart rate and blood pressure showed a difference. Conclusion: Topical anesthesia with levobupivacaine was more effective than lignocaine surgeries with better analgesia and lesser complication.

The Role of Curcumin in Gastric Carcinoma by Modulating the Immune System and its SAR

The second most prevalent cancer in the world and the fifth most common malignant tumour is gastric carcinoma. It is thought that several factors, including genetics, epigenetics, and environmental impacts, contribute to the development of gastric cancer. One of the main pathogenic variables associated with stomach cancer risk has been identified as inflammation. There are currently few methods to treat the gastric carcinoma. Therefore, an alternative plan is urgently needed. Explaining the importance of curcumin derived from Curcuma longa Linn. in stomach cancer is the goal of this review. According to recent research, Curcumin (CUR) has a great effect against stomach mucosal injury brought on by non-steroidal anti-inflammatory medicines, gastric mucosal injury in rats, stress haemorrhage, and Helicobacter pylori infection. In this review article, we have discussed the chemistry of CUR, the role of CUR in immunomodulation, and gastric cancer. We have also highlighted the various signalling pathway of gastric cancer where CUR work. By controlling miRNAs on gastric cancer and other relevant signal pathways, CUR exhibits notable anti-inflammatory and anti-cancer properties. In future there are more research work will be done on CUR.

A Multisite Study on the Effect of a Urinary Incontinence Self-Management Program on Community-Dwelling Older Women in Korea.

The purpose of this study was to evaluate the effects of a urinary incontinence (UI) self-management program on UI symptoms, knowledge, and self-efficacy in community-dwelling older women. A 1-group pretest-posttest design. Participants were recruited from 14 primary healthcare posts (PHCPs) in South Chungcheong Province, rural South Korea. A total of 163 women participated in a 5-session UI self-management program. The UI self-management program was sequentially conducted across 14 PHCPs between May and November 2016. In each PHCP, 6 to 22 women participated in the program. The program consisted of weekly 90-minute sessions that were conducted across 5 weeks. Each session included a lecture on UI, reflective discussion, pelvic floor muscle training, and the assignment of homework (exercises and a daily bladder diary). Main outcome variables were measured using the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF), Urinary Incontinence Knowledge Scale (UIKS), and Geriatric Self-Efficacy Index for Urinary Incontinence (GSE-UI), which were administered before and after the intervention. Descriptive statistics were computed, and Wilcoxon signed-rank tests analyzed the data. The intervention resulted in a significant decrease in the ICIQ-SF scores, which was indicative of improvement in UI severity (pretest: 6.64 [SD 6.15], posttest: 4.76 [SD 5.08], P = .001), significant increases in the UIKS (pretest: 15.69 [SD 6.36], posttest: 23.14 [SD 5.54], P = .001] and GSE-UI (pretest: 75.34 [SD 31.80], [posttest: 86.20 [SD 27.06], P = .001) scores. The UI self-management program improved UI symptoms, knowledge, and self-efficacy among community-dwelling older women.