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Abdi A Gele,1,2 Samera A Qureshi,1 Prabhjot Kour,1 Bernadette Kumar,1 Esperanza Diaz1,3 1Norwegian Center for Minority Health Research, 2Department of Health, Institute of Nursing and Health Promotion, Oslo and Akershus University College, Oslo; 3Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway Abstract: Norway has a low incidence and mortality rate of cervical cancer, which is mainly due to the high participation rate of women in cervical cancer screening. However, the attendance of cervical cancer screening was reported to be low among immigrant women. For this reason, we conducted a qualitative study to obtain better insight into perceived barriers and challenges to cervical cancer screening among Somali and Pakistani women in the Oslo region. A convenient sample of 35 (18 Pakistani, 17 Somali) women were recruited for the study in collaboration with Somali and Pakistani community partners. Focus group discussions were used to explore barriers and facilitators to cervical cancer screening, whereas the Ecological Model was used as the framework for the study. The study found three levels of barriers to cervical cancer screening. The individual level included a lack of understanding of the benefits of the screening. The sociocultural level included the stigma attached to the disease and the belief that women who are unmarried are sexually inactive. The system-related level included a lack of trust toward the health care system. Based on the study results, and using a common denominator approach for the immigrant groups included, the study recommends three communication strategies with the potential to improve women’s participation in cervical cancer screening: 1) in-person communication and information material at health centers; 2) verbal communication with women through seminars and workshops to educate them about their risk of cancer and the importance of screening and 3) the initiation of better recall through SMS and letters written in native languages. Finally, an intervention study that compares the aforementioned strategies and proves their effectiveness in increasing immigrant women’s participation in cervical cancer screening is recommended. Keywords: cervical cancer, immigrant women, Somali and Pakistani women, preventive health

ne. Many directors in the field of cinema have benefited from these meanings and psychological connotations of color in their works, as the psychological impact of color appears in the theatrical scene.Through research, some artworks are monitored and analyzed by the theory Color has great merit in the process of sight, in addition to the fact that the feeling of color increases the visual sensation, and then the perception and distinction between things very quickly.Color has a different meaning depending on the feelings that it provokes, it also plays a very important role in the world around a person, as it can influence his feelings, thinking, reactions, and the things he chooses.It is well known that the plastic arts are mainly based on the formation with a set of the available materials to the artist, so that he can produce an art work that expresses the aesthetic and utilitarian needs at the same time, and one of the most important of these materials is (colors); as It expresses the culture and history of peoples and reflexes the human impressions, colors indicates the Man’s taste and sophistication, and have their effect on people’s mood, as it convey a strong expression, evoke special feelings, and affect the soul with certain effects that differ from one person to another.. Colors also help in the process of artistic blending between realism, art and aesthetic effects of the visual image through achieving color harmony in the dramatic situation. There are different uses of colors in the artwork, including the use of color for its own aesthetic value, and there is the use of color in a symbolic use.There is no doubt that colors are an important factor in creating the appropriate atmosphere and influencing the theatrical scene with its aesthetic values, besides designing Decoration, lighting, clothing and makeup, to form an integrated artistic vision for the dramatic work. Color plays a vital role in the design of the theatrical scene. It also works to highlight the unity of the dramatic event, and the relationship of the characters with the contents of the composition of the sceclarifying of its meaning and importance.

The significance of different types of periodic solutions in nonlinear equations is vital across various practical applications. Our objective in this study was to uncover novel forms of periodic solutions for the modified regularized long wave equation. This particular model holds great importance in the realm of physics as it characterizes the propagation of weak nonlinearity and space-time dispersion waves, encompassing phenomena like nonlinear transverse waves in shallow water, ion-acoustic waves in plasma, and phonon waves in nonlinear crystals. By employing the methodology of modified rational sine-cosine and sinh–cosh functions, we successfully derived new kink-periodic and convex–concave-periodic solutions. To showcase the superiority of our proposed approach, we conducted a comparative analysis with the alternative Kudryashov-expansion technique. Furthermore, we visually depicted the diverse recovery solutions through 2D and 3D plots to enhance the understanding of our findings.

It is known that visual art is the art that is capable of making the spectator turns from state to another. Cinema is considered one of the most powerful and effective visual arts, and it has the ability to influence and persuade.In the beginning, in the field of visual effects cinema depended on traditional and simple methods that commensurate with the culture of the spectator at this time, then the technical progress was clearly and rapidly followed in the technological fields that helped to apply all kinds of optical illusions, which greatly contributed to change the shape and content of the movie."The art of Makeup” is considered one of the most important branches of optical illusions.Where it comes to mind that the art of makeup is only related to beautifying artists and hiding facial flaws to show them brilliantly, but the truth is that the art of makeup is the art of changing the appearance of the real face of the actor in a way that suits the character he performs, by using powders, colors….etc., to create certain facial features required to express the character or to be reincarnated.In addition to its application by many people to attend various artistic and masquerade events, and we often notice many people are using it in daily life, and they are often teenagers.Also cinematic makeup can deliver any kind of information to viewers without using words or wasting time, make-up in dramas differs from ordinary make-up, as it is subject to study as a self-stand art, because make-up has to be compatible with bright lighting, decorative angles and accessories.This type of art has become a pillar that specialized institutes are opened based on it, where young talents who found inspiration in cinematic works and other arts to paint them on faces and bodies using various colors and accessories could be contained, so that this type of art opens doors in front of their imagination to be creative and show their ideas no matter how strange and crazy it seems.

Migraine, a primary headache disorder, is a debilitating condition with reduced productivity, increased disability, and a very high economic burden. The present study aimed to individualize the treatment protocols for episodic and chronic migraine in order to reduce the duration, frequency, and severity of attacks, as well as the disability associated with migraine by comparing monotherapy and dual therapy.

Background: As part of the Integrated Child Development Services program, The Anganwadi system is mainly managed by the Anganwadi worker (AWW). The fundamental tasks performed by Anganwadi workers are crucial and must be completed as effectively as possible. Hence the good health of Anganwadi workers decides how efficiently they can do their allotted work. So, this study was conducted to assess the health profile of Anganwadi workers. Objective: To assess the health profile of Anganwadi workers attending a Health checkup camp at a Tertiary Hospital. Methodology: A cross sectional descriptive study was conducted at a free health camp in a Tertiary Hospital of Mumbai, India, by the staff and interns of the Department of Community medicine. All AWWs who attended the camp were included in the study. AWWs who attended the health checkup camp were assessed for morbidity. Data collected by semi structured questionnaire was entered into Microsoft Excel and analysed using SPSS version-17.0. Results: Most of AWWs were from the age group of between 41-50 years; more than half of them were matriculate and 34(69.38%) workers had an experience of more than 10 years. Around 49% of them were having abnormal BMI and 53% were anaemic. PAP smear findings were abnormal in 4% AWWs. Conclusion: AWWs are considered cornerstone in providing ICDS services, but in this study, we found that most of AWWs themselves were not at their good health. Regular health checkups of healthcare workers of each level should be done to efficiently deliver the healthcare services to people of our country.

Background: Childhood obesity is a grave public health concern in the 21st century. It is becoming a widespread problem in low and middle-income countries, particularly in urban areas. Childhood obesity is a precursor to metabolic syndrome, poor physical health, mental disorders, respiratory problems, and glucose intolerance, which can all continue into adulthood. Developing countries like India face a unique problem of a ‘double burden’, where undernutrition and obesity co-exist. Objectives: The study aimed to determine the prevalence of overweight/ obesity among school-going children and to identify the modifiable risk factors associated with it. Methodology: An epidemiological cross-sectional study was conducted in a private school located in the Western suburbs of Mumbai. The study included all students from the 1st to 10th standard of the secondary section, who were willing to participate. Before the study, necessary permissions were obtained from the school authorities and parental consent was taken. The study was conducted over 4 days in October 2023. Data was collected through interviews using a pre-structured questionnaire. The collected data will be analyzed using SPSS for descriptive and inferential statistics. Results: Among 521 participants, the Prevalence of Overweight is 14.77% and Obesity is 6.71% in our study. Statistical significance was found between BMI and Smartphone usage, BMI and Occupation of Mother. Conclusion: Dietary factors have always been associated with overweight & obesity however our study reveals that other factors also play a pivotal role in development of obesity which is an important risk factor for Non- Communicable Diseases further in adulthood.

Several numerical techniques for solving initial value problems arise in physical and natural sciences. In many cases, these problems require numerical treatment to achieve the required solution. However, in today’s modern era, numerical algorithms must be cost-effective with suitable convergence and stability features. At least the fifth-order convergent two-step optimized hybrid block method recently proposed in the literature is formulated in this research work with its variable stepsize approach for numerically solving first- and higher-order initial-value problems in ordinary differential equations. It has been constructed using a continuous approximation achieved through interpolation and collocation techniques at two intra-step points chosen by optimizing the local truncation errors of the main formulae. The theoretical analysis, including order stars for the relative stability, is considered. Both fixed and variable stepsize approaches are presented to observe the superiority of the latter approach. When tested on challenging differential systems, the method gives better accuracy, as revealed by the efficiency plots and the error distribution tables, including the machine time measured in seconds.

The prediction of oscillators is usually employed in various industrial and technological problems; such as car shock absorbers, bungee jumping, earthquake-proof buildings, musical instruments, metronome and the process of hearing. This manuscript investigates the effects of newly presented fractional operators on free and forced linear oscillators. The second order nonlinear classical governing differential equation of Duffing oscillator is reduced into second order linear classical governing differential equation of free and forced linear oscillators by invoking non-integer order differential operators namely Atangana-Baleanu and Caputo-Fabrizio. The fractionalized differential equation is solved by invoking Laplace transform method for finding the optimal solutions of displacement based on infinite series approach. The solutions of displacement are obtained via Atangana-Baleanu and Caputo-Fabrizio differential operators separately then expressed in terms of elementary and gamma functions. Finally the parametric analysis is depicted graphically on the basis of comparison of modern fractional operators subject to the emerging rheological parameters.

A novel mechanism for the elimination of false selvedge in rapier looms was successfully designed and developed, which functions to grip the protruding weft ends after each pick insertion during the weaving process, with subsequent cutting and suction of the protruding ends. The task is otherwise, presently performed by the formation of dummy or false selvedges in the fabric, requiring additional yarn other than that required for the actual fabric. A significant amount of yarn is wasted to form false selvedges, as they are removed and disposed as hard waste post weaving, which consequently increases the cost of fabric and narrows the profit margins. The developed mechanism was successfully installed and commissioned on an indigenous rapier loom leading to a reduction in the amount of hard waste otherwise generated, without affecting the normal functioning of the loom and the weaving process. The amount of reduction in hard waste was estimated and the quality of fabric manufactured before and after the installation was tested and analyzed.

Objectives: To determine outcome of stent implantation in patients with middle aortic syndrome.Design: Prospective study, case series.Setting: A tertiary paediatric cardiology centre in a children's hospital.Patients: Five patients, aged 4 to 17 years (mean 11.4 years), with upper limb hypertension due to middle aortic syndrome.Intervention: Stents were implanted in the mid/lower thoracic/upper abdominal aorta.Main Outcome Measure: Satisfactory deployment of stents and blood pressure control.Results: In all patients, angiocardiography showed long segment stenosis in the mid or lower thoracic/upper abdominal aorta. The pressure gradient was between 40 and 90 mm Hg (mean 63.2 mm Hg). Seven Palmaz stents were implanted. Immediately after implantation, the gradient decreased to between 0 and 35 mm Hg (mean 13.6 mm Hg). Angiography showed a satisfactory result with widely patent stents in all. In one patient, thrombosis of the stent occurred six days after implantation. This was successfully treated with infusion of alteplase, further balloon dilatation, and implantation of a second stent overlapping the first, both dilated to 10 mm diameter. One patient had elective redilatation of the stent six months after implantation, with further reduction of the gradient from 35 mm Hg to 10 mm Hg. At the latest follow up between three and 20 months (mean 12.2 months) after stent implantation, in four patients blood pressure was better controlled with antihypertensive drugs. One patient was normotensive without drugs. Computed tomography showed no aneurysm formation in the region of the stents.Conclusions: Stent implantation is a preferable alternative to surgery in the treatment of patients with middle aortic syndrome and merits further evaluation. [ABSTRACT FROM AUTHOR]

STUDY DESIGN.: Cross-sectional survey. OBJECTIVE.: The objective of this study was to investigate the authorship, content, and quality of information available to the public on the Internet pertaining to the cervical artificial disc replacement device. SUMMARY OF BACKGROUND DATA.: The Internet is widely used by patients as an educational tool for health care information. In addition, the Internet is used as a medium for direct-to-consumer marketing. Increasing interest in cervical artificial disc replacement has led to the emergence of numerous Web sites offering information about this procedure. It is thought that patients can be influenced by information found on the Internet. METHODS.: A cross section of Web sites accessible to the general public was surveyed. Three commonly used search engines were used to locate 150 (50/search engine) Web sites providing information about the cervical artificial disc replacement. Each Web site was evaluated with regard to authorship and content. RESULTS.: Fifty-three percent of the Web sites reviewed were authorized by a private physician group, 4% by an academic physician group, 13% by industry, 16% were news reports, and 14% were not otherwise categorized. Sixty-five percent of Web sites offered a mechanism for direct contact and 19% provided clear patient eligibility criteria. Benefits were expressed in 80% of Web sites, whereas associated risks were described in 35% or less. European experiences were noted in 17% of Web sites, whereas only 9% of Web sites detailed the current US experience. CONCLUSION.: The results of this study demonstrate that much of the content of the Internet-derived information pertaining to the cervical artificial disc replacement is for marketing purposes and may not represent unbiased information. Until we can confirm the content on a Web site to be accurate, patients should be cautioned when using the Internet as a source for health care information related to cervical disc replacement. [ABSTRACT FROM AUTHOR]

Breuste J., Schnellinger J., Qureshi S., Faggi A.: Urban ecosystem services on the local level: Urban green spaces as providers. Ekologia (Bratislava), Vol. 32, No. 3, p. 209-304, 2013. Ecosystem services are provided at different spatial and service/functional scales. The local level is the basic unit for ecosystem services, especially when it comes to the human dimension of urban landscapes. These services are provided by green elements (patches) or basic complex ecosystems (green areas) which differ from their neighbourhoods through their structures and functions. This study reviews the generally available knowledge on urban green functions and services at the site level and explains them by using own studies in five different cities in three different continents related to distinct ecosystem services. This allows the development of a methodology to evaluate and compare ecosystem services at the site level. The methodology is based at two levels, patch and green space, and includes the relationship with the surrounding green and built-up space. Different urban green space types are characterized by their internal structures of vegetation, size, shape and location in relation to at least a semi-quantitative scaling of their urban ecosystem services. The evaluated urban green spaces are public urban green spaces. The urban ecosystem services assessed include climate regulation, biodiversity, nature experience, recreation and health. The actual urban challenges, such as land use change, adaptation to climate change, demographic change and urban cultural diversity, demand a systematic and very concrete monitoring of urban ecosystem services at the site level.

Abstract Background Hepatitis C virus (HCV) infection is one of the leading causes of chronic liver disease (CLD). About 80% of those exposed to the virus develop a chronic infection. Hyperhomocysteinemia, which is an independent risk factor for atherosclerotic vascular disease and thromboembolism, may develop in HCV-infected patients although altered alanine amino transferase (ALT) enzyme levels are generally associated with damage to liver cells. The gold standard therapy for chronic hepatitis C patients is pegylated interferon combined with an anti-viral drug (ribavirin). The current study aimed to investigate the effect of antiviral therapy on plasma homocysteine (Hcy) levels in HCV patients in addition to other parameters. Methods 532 HCV-infected patients and 70 healthy controls were recruited for the study. All patients were subjected to laboratory investigations including HCV-RNA levels, complete blood cell counts, serum levels of homocysteine, ALT, alkaline phosphatase (ALP), lipid profile and liver ultrasonographic examination. The outcome of treatment with pegylated interferon α plus ribavirin treatment and sustained virologic response (SVR) was determined 6–9 months post-therapy. Results Hyperhomocysteinemia was found in 91.35% of HCV-infected patients. The difference in plasma Hcy concentrations reached statistical significance between the patient and control groups. ALT, cholesterol and triglycerides (TGs) levels were found higher than normal in the patients group. After receiving a combined therapy for 24 weeks, 43.66% patients showed an SVR (responders); 30.98% patients were non-responders while 25.35% patients initially responded to therapy but again retrieved positive status of HCV infection six months post-therapy (relapse-cirrhotic patients). The mean levels of plasma Hcy, ALT and ALP were significantly reduced in responders within 10 weeks of therapy when compared with non-responders and relapse-cirrhotic patients. Conclusion Elevated homocysteine levels in serum due to HCV infection can be reduced to normal range with the standard interferon α plus ribavirin treatment. This study highlights the significance of the measurement of serum homocysteine levels in the diagnosis and monitoring of HCV infection treatment in addition to other laboratory parameters.

Abstract Background Clinical practice guidelines (CPGs) have become increasingly popular, and the methodology to develop guidelines has evolved enormously. However, little attention has been given to the updating process, in contrast to the appraisal of the available literature. We conducted an international survey to identify current practices in CPG updating and explored the need to standardize and improve the methods. Methods We developed a questionnaire (28 items) based on a review of the existing literature about guideline updating and expert comments. We carried out the survey between March and July 2009, and it was sent by email to 106 institutions: 69 members of the Guidelines International Network who declared that they developed CPGs; 30 institutions included in the U.S. National Guideline Clearinghouse database that published more than 20 CPGs; and 7 institutions selected by an expert committee. Results Forty-four institutions answered the questionnaire (42% response rate). In the final analysis, 39 completed questionnaires were included. Thirty-six institutions (92%) reported that they update their guidelines. Thirty-one institutions (86%) have a formal procedure for updating their guidelines, and 19 (53%) have a formal procedure for deciding when a guideline becomes out of date. Institutions describe the process as moderately rigorous (36%) or acknowledge that it could certainly be more rigorous (36%). Twenty-two institutions (61%) alert guideline users on their website when a guideline is older than three to five years or when there is a risk of being outdated. Twenty-five institutions (64%) support the concept of "living guidelines," which are continuously monitored and updated. Eighteen institutions (46%) have plans to design a protocol to improve their guideline-updating process, and 21 (54%) are willing to share resources with other organizations. Conclusions Our study is the first to describe the process of updating CPGs among prominent guideline institutions across the world, providing a comprehensive picture of guideline updating. There is an urgent need to develop rigorous international standards for this process and to minimize duplication of effort internationally.

Abstract By virtue of its direct contact with the environment, the lung is constantly challenged by infectious and non-infectious stimuli that necessitate a robust yet highly controlled host response coordinated by the innate and adaptive arms of the immune system. Mammalian Toll-like receptors (TLRs) function as crucial sentinels of microbial and non-infectious antigens throughout the respiratory tract and mediate host innate immunity. Selective induction of inflammatory responses to harmful environmental exposures and tolerance to innocuous antigens are required to maintain tissue homeostasis and integrity. Conversely, dysregulated innate immune responses manifest as sustained and self-perpetuating tissue damage rather than controlled tissue repair. In this article we review aspects of Toll-like receptor function that are relevant to the development of acute lung injury and chronic obstructive lung diseases as well as resistance to frequently associated microbial infections.

Abstract Introduction Primary Ewing's sarcoma or primitive neuroectodermal tumor of the genital tract of women is uncommon. Rarer still is its occurrence in the vagina, with only five cases described so far. Out of these, only one case was confirmed using molecular analysis. Case presentation We present an extremely rare case of Ewing's sarcoma or primitive neuroectodermal tumor in a 17-year-old Indian girl. She presented with a vaginal mass that was initially diagnosed as a malignant round cell tumor. Immunohistochemistry showed diffuse positivity for vimentin, membranous positivity for MIC2, and positivity for BCL2 and FLI-1. On the other hand, she was negative for cytokeratin, epithelial membrane antigen, desmin, Myo D-1, myogenin and smooth muscle actin. A diagnosis of primitive neuroectodermal tumor was thus offered. Furthermore, a molecular analysis of our patient using reverse transcription-polymerase chain reaction technique showed positivity for t(11; 22) (q24; q12) (EWSR1-FLI1), thus confirming the diagnosis of a Ewing's sarcoma/primitive neuroectodermal tumor. Our patient was offered chemotherapy on Institutional protocol EFT 2001. Conclusion This is a rare case of primary vaginal Ewing's sarcoma or primitive neuroectodermal tumor, which was confirmed with molecular analysis, in the youngest patient known so far. This study reinforces the value of integrating morphological features with membranous MIC2 positivity, along with application of molecular techniques in objective identification of an Ewing's sarcoma or primitive neuroectodermal tumor at uncommon sites.

Abstract Background Psychiatric disorders affect about 450 million individuals worldwide. A number of treatment modalities such as psychotropic medications, psychotherapy and electroconvulsive therapy can be used to treat these disorders. Attitudes of general public play a pivotal role in effective utilization of mental health services. We explored the perceptions of general public of Karachi, Pakistan regarding psychotherapy. Methods A cross-sectional study was conducted in Karachi, Pakistan during July-August, 2008. A three-step sampling strategy and a structured questionnaire were employed to survey knowledge and perceptions of adult general public about psychotherapy. Descriptive statistics were used for baseline characteristics. Logistic regression models were used to investigate any significant associations between baseline characteristics of the participants and their perceptions. Results The study sample comprised of 985 individuals (536 males; 531 financially independent) with an average age of 36.7 years (SD 13.54 years) and 12.5 years (SD 3.09 years) of education were included. Majority (59.4%; n = 585) claimed to be aware of psychotherapy as a treatment option for psychiatric disorders but 47.5% of these (n = 278/585) failed to identify its correct definition. Concerns voiced by the participants about psychotherapy included stigma (48.7%) and breech in confidentiality (39.5%); 60.7% opined it cost effective and 86.5% favored its use as an adjuvant modality. A preference for psychotherapy as the treatment strategy for psychiatric disorders was demonstrated by 46.6% (n = 459/985). Younger, more educated, financially independent and female participants were more likely to prefer psychotherapy as were those who deemed it cost effective. Conclusion Positive attitudes regarding the acceptability, clinical utility and cost-effectiveness of psychotherapy were observed in a sample representative of general public of Karachi, Pakistan. These findings highlight its potential utility for devising pragmatic mental health strategies in the face of limited resources.

Abstract Background Of the nearly 100,000 street-based IDUs in Pakistan, 20% have HIV. We investigated the recent rise in HIV prevalence from 12 to 52% among IDUs in Sargodha despite > 70% coverage with syringe exchanges. Methods We interviewed approximately 150 IDUs and 30 outreach workers in focus group discussions. Results We found six rural and 28 urban injecting locations. Urban locations have about 20–30 people at any time and about 100 daily; rural locations have twice as many (national average: 4–15). About half of the IDUs started injecting within the past 2 years and are not proficient at injecting themselves. They use street injectors, who have 15–16 clients daily. Heroin is almost exclusively the drug used. Most inject 5–7 times daily. Nearly all injectors claim to use fresh syringes. However, they load, inject and share using a locally developed method called scale. Most Pakistani IDUs prefer to double pump drug the syringe, which allows mixing of blood with drug in the syringe. The injector injects 3 ml and keeps 2 ml (the scale) as injection fee. The injector usually pools all the leftover scale (now with some blood mixed with drug) either for his own use or to sell it. Most IDUs backload the scale they buy into their own fresh syringes. Discussion Use of an unprecedented method of injecting drugs that largely bypasses fresh syringes, larger size of sharing networks, higher injection frequency and near universal use of street injectors likely explain for the rapid rise in HIV prevalence among IDUs in Sargodha despite high level provision of fresh syringes. This had been missed by us and the national surveillance, which is quantitative. We have addressed this by hiring injectors as peer outreach workers and increasing syringe supply. Our findings highlight both the importance of qualitative research and operations research to enrich the quality of HIV prevention programs.

Abstract Background Urinary incontinence (UI) is a prevalent symptom in middle-aged women, but data on incidence is limited and rarely reported. In order to analyze incidence, remission, or development patterns of severity and types of UI, we have established a 15-year prospective cohort (1997–2012). Methods The Cohort is based on the national collection of health data gathered from county studies (CONOR). Hordaland Health Study (HUSK) is one of them from Hordaland County. Each of the county studies may have local sub-studies and our Cohort is one of them. The Cohort included women aged 40–45 in order to have a broad approach to women's health including UI and other lower urinary tract symptoms (LUTS). A onefifth random sampling from HUSK was used to create the Cohort in 1997–1999. For the necessary sample size a preliminary power calculation, based on a 70% response rate at inclusion and 5% annual attrition rates was used. The Cohort is planned to collect data through questionnaires every second year for the 15-year period from 1997–2012. Discussion The Cohort represents a relatively large random sample (N = 2,230) of about 15% of the total population of women born between 1953–57 in the county of Hordaland. Our data shows that the cohort population is very similar to the source population. The baseline demographic, social and medical characteristics of the Cohort are compared with the rest of women in HUSK (N = 7,746) and there were no significant differences between them except for the level of education (P = 0.001) and yearly income (P = 0.018), which were higher in the Cohort population. Urological characteristics of participants from the Cohort (N = 1,920) were also compared with the other participants (N = 3,400). There were no significant statistical differences except for somewhat more urinary continence (P = 0.04), more stress incontinence (P = 0.048) and smaller amount of leakage (P = 0.015) in the Cohort. In conclusion, the Cohort ispopulation-based, with little selection bias, and thus is a rather unique study forinvestigating UI and LUTS in comparison with many other projects with similar purposes.

Abstract Background Cryptococcus neoformans (C. neoformans) is a globally distributed fungal pathogen with the potential to cause serious disease, particularly among immune compromised hosts. Exposure to this organism is believed to occur by inhalation and may result in pneumonia and/or disseminated infection of the brain as well as other organs. Little is known about the role of airway epithelial cells in cryptococcal recognition or their ability to induce an inflammatory response. Methods Immortalized BEAS-2B bronchial epithelial cells and primary normal human bronchial epithelium (NHBE) were stimulated in vitro with encapsulated or acapsular C. neoformans cultivated at room temperature or 37°C. Activation of bronchial epithelial cells was characterized by analysis of inflammatory cytokine and chemokine expression, transcription factor activation, fungal-host cell association, and host cell damage. Results Viable C. neoformans is a strong activator of BEAS-2B cells, resulting in the production of the neutrophil chemokine Interleukin (IL)-8 in a time- and dose-dependent manner. IL-8 production was observed only in response to acapsular C. neoformans that was grown at 37°C. C. neoformans was also able to induce the expression of the chemokine CXCL1 and the transcription factor CAAT/enhancer-binding protein beta (CEBP/β) in BEAS-2B cells. NHBE was highly responsive to stimulation with C. neoformans; in addition to transcriptional up regulation of CXCL1, these primary cells exhibited the greatest IL-8 secretion and cell damage in response to stimulation with an acapsular strain of C. neoformans. Conclusion This study demonstrates that human bronchial epithelial cells mediate an acute inflammatory response to C. neoformans and are susceptible to damage by this fungal pathogen. The presence of capsular polysaccharide and in vitro fungal culture conditions modulate the host inflammatory response to C. neoformans. Human bronchial epithelial cells are likely to contribute to the initial stages of pulmonary host defense in vivo.

Abstract Background Pectoralis major myocutaneous (PMMC) flap continues to be the workhorse in head and neck reconstruction. Although free tissue transfer has revolutionized the reconstruction in cancers of the oral region, PMMC is still considered a readily accessible source of vascularized soft tissue available to the reconstructive surgeon and especially in most developing nations where due to the cost, time, expertise, or infrastructural constraints free flaps cannot be generally offered. Although commonly used in adults, it has been hardly described for reconstruction in children. Case presentation We present a 4-year-old child with recurrent fibromatosis of the oropharyngeal region where the PMMC was used for reconstruction of the surgical defect and to the best of our knowledge is the youngest patient undergoing reconstruction with PMMC for neoplastic lesion of the head and neck. Conclusion The PMMC flap is justifiably a popular flap that continues to command an important place in the head and neck surgeon's reconstructive armamentarium.

Herniated disks in the lumbar spine are the leading cause of patient visits to spinal surgeons in the United States. Although magnetic resonance imaging (MRI) is the diagnostic test of choice in patients with a herniated disk, plain radiographs can provide important information and should remain a standard part of the diagnostic workup in any patient indicated for revision spine surgery. This article describes a case of a 36-year-old man with a >6-month history of worsening lumbar radiculopathy who was diagnosed with lumbar disk herniations based on MRI alone and underwent 2 unsuccessful attempts at microdiskectomy at another institution. Further workup by the senior author (A.C.H.), which included initial plain radiographs followed by computed tomography, demonstrated a large disk herniation with a markedly calcified annulus as the continuing source of neurologic compression. The patient underwent revision lumbar decompression with attention being paid to the removal of the calcified annulus and disk material that resulted in complete resolution of his symptoms. Although MRI is the diagnostic test of choice in the evaluation of spinal pathology, plain radiographs can provide important additional information that can be vital to the successful outcome of patients undergoing revision spinal surgery. [ABSTRACT FROM AUTHOR]