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To determine the prevalence of underlying high-intermediate (high-IM) and high-risk endometrial cancer (EC) in patients with preoperative diagnosis of Endometrial intraepithelial neoplasia (EIN) and to assess the impact of the information retrieved from the sentinel lymph node (SLN) on adjuvant therapy.Retrospective cohort study of women undergoing hysterectomy, optional bilateral salpingo-oophorectomy (BSO) and lymph nodes assessment for EIN between December 2007 and August 2021.One hundred and sixty two (162) eligible patients were included, of whom 101 (62.3%) had a final diagnosis of EIN, while 61 (37.7%) were ultimately diagnosed with carcinoma. Out of 15 patients with high-IM to high-risk disease (9.25% of all EIN), 12 had grade 2-3 EC including 8 with50% myometrial invasion, 2 with serous subtype, 1 with cervical invasion and 2 with pelvic lymph nodes involvement. Of the 3 patients with grade 1 EC, one patient had disease involving the adnexa and 2 patients had tumor invading50% of the myometrium and with lymphovascular space invasion (LVSI). Ten patients received vaginal brachytherapy after surgery, 3 patients with extrauterine spread were treated with systemic chemotherapy followed by vaginal brachytherapy and pelvic external-beam radiotherapy and 2 patients with early-stage serous carcinoma received chemotherapy followed by vaginal brachytherapy.Information from SLN, even when negative, can be helpful in the management of patients with EC after preoperative EIN, as some patients are found to have high-IM to high-risk disease on final pathology. These patients would require either re-staging surgery or adjuvant external beam radiotherapy, both could be avoided by proper staging.

ObjectiveWe aimed to evaluate the surgical and oncological outcomes of elderly patients with intermediate to high-risk endometrial cancer undergoing staging with sentinel lymph node (SLN) sampling and pelvic lymphadenectomy.MethodsWe conducted a retrospective study of elderly (>65-year-old) patients diagnosed with endometrial cancer between December 2007 and August 2017. These patients had been treated at a single center in Montreal, Canada. We compared the surgical and oncological outcomes of three cohorts undergoing surgical staging in non-overlapping eras: 1) lymphadenectomy, 2) lymphadenectomy and SLN sampling, 3) SLN sampling alone. Using life tables, Kaplan-Meier survival curves and log-rank tests, we analyzed 2-year progression-free survival, overall survival, and disease-specific survival.ResultsOur study included 278 patients with a median age of 73 years (range; 65–91): 84 (30.2%) underwent lymphadenectomy, 120 (43.2%) underwent SLN sampling with lymphadenectomy, and 74 (26.6%) had SLN sampling alone. The SLN sampling alone group had shorter operative times with a median duration of 199 minutes (range, 75–393) compared with 231 (range, 125–403) and 229 (range, 151–440) minutes in the SLN sampling with lymphadenectomy and lymphadenectomy cohorts; respectively (pConclusionSentinel lymph node-based surgical staging is feasible and associated with better surgical outcomes and comparable oncological outcomes in elderly patients with intermediate and high-risk endometrial cancer.

Developing automated code compliance checking systems is becoming increasingly complex—to the extent of challenging the implementation of these systems. This paper addresses the need to develop an automated system that prioritises user accessibility. Accordingly, the study aims to develop a system through a semi-automated rule translation process and the utilisation of BIM models in native file format. A total of 256 fire safety clauses in Malaysian regulations were translated through logic-based approaches (classification technique, decomposition through semantic mark-up method, and interview method), which further assisted in identifying the necessary BIM properties. A visual programming language was then utilised to demonstrate the proof-of-concept prototype. The classification technique and semantic mark-up method were established and structured in this study by developing a framework and flowchart to provide specific guidelines for formalizing the clauses. The semi-automated translation process encouraged the participation of relevant regulatory experts and provided more user accessibility compared to existing studies. This study also offered more practicality for designers to employ the system by utilizing native BIM model data representation. High mean scores ranging from 4.09 to 4.96 were obtained for the validation process, which affirmed the feasibility of the BIM-based Automated System for Malaysian Code Compliance Checking (BIMSMACC) to assist designers.

Our objective was to evaluate the associations with interstitial cystitis during pregnancy using a United States inpatient database.We conducted a retrospective cohort study utilizing the Nationwide Inpatient Sample database from the Healthcare Cost and Utilization Project. ICD-9 code number 595.1 was used to extract cases of chronic interstitial cystitis and these pregnancies were compared to pregnancies without chronic interstitial cystitis, using the Chi-squared test to evaluate nominal variables. A multivariate logistic regression model was subsequently used to adjust for statistically significant confounders (p value0.05).There were 9,095,995 deliveries during the study period; 793 pregnant women were found to have chronic interstitial cystitis. When controlling for confounding effects in terms of pregnancy outcomes, the diagnosed group had a greater risk of developing pregnancy-induced hypertension (adjusted OR 1.57, 95% CI 1.21-2.05), preeclampsia (adjusted OR 2.06, 95% CI 1.47-2.87), preterm delivery (adjusted OR 1.63, 95% CI 1.23-2.17), preterm premature rupture of membranes (adjusted OR 2.18, 95% CI 1.25-3.79), chorioamnionitis (adjusted OR 2.05, 95% CI 1.24-3.37), delivery via cesarean section (adjusted OR 1.57, 95% CI 1.32-1.88), maternal infection (adjusted OR 2.19, 95% CI 1.40-3.43), and deep venous thromboembolism (adjusted OR 10.56, 95% CI 3.37-33.09).Interstitial cystitis diagnosis is associated with an increased risk of preeclampsia, preterm birth, and other adverse pregnancy outcomes in this database study. Prospective studies are required to confirm the findings of the correlation between interstitial cystitis and adverse pregnancy outcomes.

Vitamin E is an established antioxidant. However, the effect of vitamin E on healthspan, which deteriorates during ageing, has not been determined because most related studies have emphasized its effects on lifespan. Therefore, the purpose of this study was to determine the effect of palm tocotrienol-rich fraction (TRF) on the lifespan, locomotion and thermotolerance of Caenorhabditis elegans, which share many common gene sequences with humans. The nematodes were treated with different concentrations of TRF (0 - 200 μg/mL), and the number of surviving nematodes at each concentration (N=30, duplicate) was counted daily under a light microscope to determine the optimal dose of treatment. The nematodes were divided into 3 groups, namely; control, Tween-80 (vehicle) and TRF-treated. Locomotion and thermotolerance were determined on day 4 and 12 of treatment in adult nematodes. ImageJ was used for locomotion analysis, and thermotolerance was determined based on nematode survivals after exposure to 37 °C. TRF-treated C. elegans had significantly longer lifespans compared to controls (P = 0.003). The TRF group (50 μg/mL) had the longest mean lifespan (23.5 days), which was significantly longer compared to controls, (18.5 days; (P = 0.002). However, locomotion was similar between all groups. In the thermotolerance assay, the survival determined on day 4 and day 12 of TRF-treatment was higher compared to controls (P= 0.046). Interestingly, the Tween- 80-treated group showed similar results as the TRF-treated group compared to controls. The findings indicate that TRF prolongs the lifespan and increases the thermotolerance of C. elegans but does not improve the locomotion of the worms as they age.

Pediculosis is an integumentary disease caused by the ecto-parasite Pediculus humanus capitis, which infests human hair. It is a common public health problem that is most prominent worldwide in elementary school children. The current study aimed to investigate the prevalence, risk factors, and genetic diversity of P. humanus capitis among primary school children in the Erbil province. For this purpose, this study was conducted from October 2019 to December 2019 among 1100 randomly selected elementary school children aged 6-12. Data collection was performed via a regular questionnaire and physical hair examination. For the genetic diversity part, after collecting one louse randomly from each individual, DNA was extracted. The mitochondrial Cox1 gene was then amplified by universal primer and PCR. Gene sequencing was performed by ABI (BioNEER, South Korea). Data analysis was done by Chi-Square and T-test using the SPSS ver. 23. The overall infestation rate was 21.27%, and the rate was significantly higher among females (34.93%) compared to males (7.91%). Some variables had found the prevalence rate to be strongly affected. This included age; the rate was not significant (26.87%) in the age group 8-9 years compared to other age groups. According to hair length, the rate was significantly increased (36.52%) among children with tall hair. In terms of hair type, the incidence of curly-haired children was significantly higher (31.54%); in terms of hair color, there were not significant differences among blonde children (25.90%) and others. According to the results of Cox1 gene sequencing, of 234 infested children to lice, 86 (36.75%) of them were exposed to clade A, 38 (16.24%) were exposed to clade B, clade C has not been seen among any children (0%), 105 students (44.87%) were exposed to clade D, and 5 of them exposed to clade E (2.14%). Eventually, a significantly higher incidence (33.78%) was reported in rural primary school children. The infection rate of human head lice in Erbil province is still high, which is one of the health problems of children in public schools.

Introduction: Intrapartum cardiotocography (CTG) was used for several decades to detect a stressed fetus so that delivery can be expedited to prevent birth asphyxia. The main aim of the study was to calculate the risk of neonatal acidemia (pH ≤ 7.10) according to duration of the 2nd stage of labor and occurrence of the International Federation of Gynecology and Obstetrics (FIGO) 2015 CTG classification parameters. Materials and Methods: This was a retrospective case-control study on 552 pregnancies receiving continuous CTG monitoring in labor and immediate hemogasanalysis at birth. Cases with umbilical artery (UA) pH ≤ 7.10 and controls with UA pH ≥ 7.10 were matched for parity and gestational age at delivery, with ratio 1:5. Logistic regression analysis, adjusted for the expected risk in the general population, was used to calculate the baseline risk of UA pH ≤ 7.10 in the absence of any CTG pathological feature and those associated with pathological CTG patterns occurring in the 2nd stage according to FIGO 2015. Results: Seventy-three cases and 387 controls reached 2nd stage and were included in the analysis. For those reaching 2nd stage, the mean adjusted risk of acidemia associated with nonpathological CTG was 1.6%. Stratification of risk according to duration of the 2nd stage yielded risks of neonatal acidemia of 1.23, 2.08, 5.81, and 15.22% at 30, 60, 120, and 180 min, respectively. Bradycardia >10 min was associated with risk of neonatal acidemia of 9.9 and 15.8% for 2nd-stage durations of 30 and 60 min, respectively. Risks associated with 1 prolonged deceleration >5 min were 6.80, 11.08, 27.0, and 51.0% at 30, 60, 120, and 180 min, respectively. Repetitive late or prolonged decelerations >30 min were associated with risk of neonatal acidemia of 2.43, 4.14, 11.17, and 26.45% at 30, 60, 120, and 180 min, respectively. Conclusion: The risk of neonatal acidemia is directly proportional to duration of the 2nd stage, irrespective of the presence of CTG abnormalities, increasing 12-fold (1.2–15.3%) from 30 to 180 min. Occurrence of FIGO 2015 pathological CTG patterns showed a decreasing impact from bradycardia >10 min to decelerations >5 min, recurrent later or prolonged decelerations >30 min, and nonpathological CTG.

Background Students' mental health is a growing concern. COVID-19 pandemic resulted in academic and non-academic challenges which caused students' burnout, anxiety, and reduced empathy. Objectives The study objectives were to assess burnout amongst QU Health students, determine the relationship between burnout and anxiety, and burnout and empathy, and to determine the students coping strategies. Methods A convergent mixed-methods design was used: (1) a cross-sectional survey using validated instruments. Maslach Burnout Inventory-General Students Survey (MBI-GS(S)) to measure burnout, Generalized Anxiety Disorder 7-item Scale (GAD-7) to measure anxiety, and Interpersonal Reactivity Index (IRI) to measure empathy; (2) focus groups to get a deeper insight of the students' experiences and coping strategies. Descriptive and multivariate statistical analyses were used for the survey while the focus groups were analysed using deductive thematic analysis following the coping reserve model. Results 21.45% of students responded to the survey. Burnout was reported according to the subscales. MBI-Exhaustion (MBI-EX) subscale (mean= 4.07, SD= 1.56), MBI-Cynicism (MBI-CY) subscale (mean= 2.63, SD= 1.53), and MBI-Professional Efficacy (MBI-PE) subscale (mean= 3.97, SD= 1.22). MBI-EX and MBI-CY were associated with GAD-7 scores. MBI-EX and MBI-CY were associated with IRI-Empathic Concern (IRI-EC) and IRI-Personal Distress (IRI-PD) while MBI-PE was associated with IRI-Perspective Talking (IRI-PT) and IRI-EC. The students used many coping strategies to build resilience. Conclusion QU Health students experienced burnout during the spring 2020 semester. Many burnout causes and coping strategies were identified. It is suggested for QU to start mentorship programs and mental health initiatives to promote students' resilience.

Research question What is the association between congenital adrenal hyperplasia (CAH) and pregnancy, delivery and neonatal outcomes, using a population database cohort. Design Retrospective study using the Health Care Cost and Utilization Project-Nationwide Inpatient Sample database from 2004–2014. ICD-9 code 255.2 was used to extract the cases of CAH. Pregnancies complicated with CAH were compared with the other pregnancies. All confounding variables were adjusted using multivariate logistic regression, based on any significant differences between the two groups. Results A total of 9,096,788 deliveries occurred during the study period. Two hundred and ninety-nine pregnant women had CAH. Chorioamnionitis was higher in CAH compared with controls after controlling for risk factors (adjusted OR 2.67, 95% CI 1.17 to 6.06). The rates of caesarean section and maternal infection were also higher in CAH than controls (adjusted OR 2.10, 95% CI 1.44 to 3.07 and adjusted OR 2.63, 95% CI 1.22 to 5.63, respectively). Risk of gestational diabetes and pregnancy-induced hypertension rates were not significantly different in CAH (adjusted OR 1.53, 95% CI 0.91 to 2.58 and adjusted OR 0.87, 95% CI 0.49 to 1.56, respectively). At birth, 8% and 2.2% of the neonates were found to be small for gestational age in the CAH and the control groups, respectively (adjusted OR 3.37, 95% CI 1.86 to 6.11). Congenital anomalies were encountered in 2.7% and 0.4% in the CAH and control groups, respectively (adjusted OR 5.24, 95% CI 2.31 to 11.90). Conclusions Women with CAH were at risk of complications and fetal anomalies. Expected increases in rates of hypertension and gestational diabetes were not encountered. These patients will benefit from surveillance to decrease morbidity.

Building Information Modelling (BIM) is an emerging technological process which highly promotes a better collaborative working environment in the Architecture, Engineering and Construction (AEC) industry. It is essential that the Higher Education (HE) sector innovates its education system to integrate between different disciplines in the AEC industry to encourage the adoption of BIM. In conjunction with this, BIM Intensive Training was conducted for a selected number of final year undergraduate students at Universiti Teknologi Malaysia. They were assigned a real time construction project, utilizing BIM software applications for model authoring, model review, 4D modelling and project coordination. It was observed that the participants were able to overcome various challenges through information sharing and team collaboration. A BIM coordination workflow was produced during the training to assist them in organizing their work. Although their existing knowledge of BIM and their skills using the software applications were quite limited, they were capable in learning expeditiously as the assignment provided them with real-world problems. A year after the training, more than half of the participants agreed that the training had helped them to secure their employment and excel in their current involvements in BIM-based projects. However, due to the current scenario many firms are yet to embrace BIM, there are participants who could not utilize the training. Hence, the establishment of a dynamic and continuous collaboration between professionals and HE sector is the way forward in transforming the traditional structure of AEC industry into a more collaborative and technological approach.

Objective Although its use in endometrial cancer staging is relatively new, sentinel lymph node (SLN) sampling has been shown to be highly accurate and is associated with few complications. However, some studies report lower rates of detection with SLN sampling among patients with obesity. The aim of the current study is to evaluate the feasibility of SLN sampling in endometrial cancer for patients with obesity, and to determine whether omitting lymph node dissection (LND) in surgical staging using SLN sampling impacts oncologic outcomes. Methods we conducted a retrospective study of patients with obesity (BMI ≥35 kg/m2), diagnosed with endometrial carcinoma between 2007 and 2017, that compared surgical and oncologic outcomes of 2 cohorts: patients who underwent LND and patients who underwent SLN without lymphadenectomy. The primary outcome was operative time. Secondary outcomes included intraoperative bleeding; lymph node assessment information; intraoperative and postoperative adverse events; and oncologic outcomes including progression-free survival (PFS), overall survival (OS), and disease-specific survival (DSS). PFS was defined as the time from surgery to the recurrence or death from any cause. OS was defined as time from diagnosis to death or the last date the patient was known to be alive, and DSS was defined as the time from the surgery to death from the disease. Results Out of 223 patients with a median BMI of 40.6 kg/m2, 140 underwent LND and 83 underwent SLN alone. The median operative time for patients in the SLN group was shorter than that of patients in the LND group (190.5 [range 108–393] vs. 238 [131–440] min; P Conclusions In patients with obesity, omitting LND from surgical staging with SLN sampling was associated with shorter operative times and less bleeding and did not affect survival at 2 years.

The study was ambitious to report the progression of “Halal Tourism” in different countries including Muslim majority countries and non-Muslim majority countries around the world. It was carried out by review and reference to the previous study about Halal tourism from researchers from different countries. News from official tourism website, announcement on newspaper and magazine also contributed to the latest development of Halal tourism in various counties. In most Muslim majority countries, the effort was made by investing in development of Muslim friendly travel environment such as increasing the number of in Halal certified restaurant, the number of shariah compliance hotel, the number of prayer facilities, and enhancing the local Muslim culture. For non-Muslim countries, awareness of the concept of “Halal” was been educated to the non-Muslim and the governments are more concern about the needs of Muslim travelers compared to 10 years ago. However, the mutual benefits of both Muslim and non-Muslim travelers must be taken care despite the speedy progression of Halal tourism in order to ensure the sustainability of this industry. To dates, there is no report in details about this new trend of tourism that includes a wide range of different countries. This study was hoped to be able to trigger more study on this field in order to enhance the comprehensiveness of Halal tourism around the world.

The checking process of the building design with building regulations or codes is a time-consuming and error prone process. The automation of code compliance checking process has been explored since 1960s and becoming more vigorous with the emergence of Building Information Modeling (BIM). A neutral format, Industry Foundation Classes (IFC) which is developed under BIM platform had led to better collaboration and information exchange throughout BIM software and development of the checking system. Generally, the structure of an automated system consists of rule interpretation stage, building model preparation stage, rule execution stage and rule reporting stage. Rule interpretation stage is the most vital and complex stage. In interpreting the rules, various techniques have been investigated and applied to employ comprehensive and accurate checking process on the building designs which are mainly in IFC format. The most common techniques used are by utilizing existing software such as Solibri Model Checker, establishing a plug-in application, adopting object-based approach, logical approach and ontological approach. This paper provides a highlight and review on previous studies which successfully employed the appropriate techniques in interpreting the rules for checking purposes. This will subsequently assist future research on this area and create more astounding code compliance checking system.

A comunicação organizacional tem vindo a assumir um lugar de destaque nas organizações e a realização de diagnósticos segue a longa tradição de se obter feedback acerca do estado actual das organizações relativamente a esta. Os Departamentos de Recursos Humanos, enquanto departamentos transversais das organizações, têm cada vez mais preocupações no modo como comunicam com os colaboradores e é neste contexto que se tornou pertinente a realização de um diagnóstico à comunicação na vertente da gestão de recursos humanos de uma Instituição do Sector Bancário, com vista à identificação de oportunidades de melhoria existentes nesta área. Para efectuar o diagnóstico supra referido, foram realizadas entrevistas aos colaboradores pertencentes aos departamentos da organização. Este projecto culminou com propostas de acções prioritárias, no sentido de se suprirem os gaps identificados, e assim, ir de encontro às necessidades e expectativas dos colaboradores e contribuir para o aumento da Satisfação, da Identificação e do Commitment organizacionais. Organisational communication has come to the forefront within organisations, with diagnoses being made in the long-standing tradition of obtaining feedback on the current state of organisational development in this field. Human resources departments, as departments that provide support across the entire organisation, have increasingly raised concerns about how communication with members of staff is processed. In this context, it became pertinent to provide a diagnosis of HR communication in a Bank, with the aim of pinpointing opportunities for improvement in this area. For that purpose, members of staff across all departments of the Bank were interviewed. This project culminated in proposed priority actions, targeted towards filling the identified gaps and, consequently, meeting staff needs and expectations and helping increase organisational identification and commitment and job satisfaction.