Search results for: failed trabeculectomy

Authors: Sarah K. Amer, Walaa Alaa

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Epilepsy is an important cause of mortality and morbidity, according to WHO statistics. It is characterized by the presence of frequent seizures occurring more than 24 hours apart. Carbamazepine (CBZ) is considered first-line treatment for epilepsy. However, reports have shown that CBZ oral formulations failed to achieve optimum systemic delivery, minimize side effects, and enhance patient compliance. Besides, the literature has signified the lack of therapeutically efficient CBZ transdermal formulation and the urge for its existence owing to its ease and convenient method of application and highlighted capability to attain higher bioavailability and more extended-release profiles compared to conventional oral CBZ tablets. This work aims to prepare CBZ microspheres (MS) that are embedded in a transdermal gel containing Vitamin B to be co-delivered. MS were prepared by emulsion-solvent diffusion method using Eudragit S as core forming polymer and hydroxypropyl methylcellulose (HPMC) polymer. The MS appeared to be spherical and porous in nature, offering a large surface area and high entrapment efficiency of CBZ. The transdermal gel was prepared by solvent-evaporation technique using HPMC that, offered high entrapment efficiency and Eudragit S that provided an extended-release profile. Polyethylene glycol, Span 80 and Pyridoxine were also added. Data indicated that combinations of CBZ with pyridoxine can reduce epileptic seizures without affecting motor coordination. Extended-release profiles were evident for this system. The patches were furthermore tested for thickness, moisture content, folding endurance, spreadability and viscosity measurements. This novel pharmaceutical formulation would be of great influence on seizure control, offering better therapeutic effects.

Keywords: epilepsy, carbamazepine, pyridoxine, transdermal

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Authors: Adane Kassa Shikur

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Today’s supply chains (SC) have become vulnerable to unexpected and ever-intensifying disruptions from myriad sources. Consequently, the concept of supply chain resilience (SCRes) has become crucial to complement the conventional risk management paradigm, which has failed to cope with unexpected SC disruptions, resulting in severe consequences affecting SC performances and making business continuity questionable. Advancements in cutting-edge technologies like artificial intelligence (AI) and their potential to enhance SCRes by improving critical antecedents in the different phases have attracted the attention of scholars and practitioners. The research from academia and the practical interest of the industry have yielded significant publications at the nexus of AI and SCRes during the last two decades. However, the applications and examinations have been primarily conducted independently, and the extant literature is dispersed into research streams despite the complex nature of SCRes. To close this research gap, this study conducts a systematic literature review of 106 peer-reviewed articles by curating, synthesizing, and consolidating up-to-date literature and presents the state-of-the-art development from 2010 to 2022. Bayesian networks are the most topical ones among the 13 AI techniques evaluated. Concerning the critical antecedents, visibility is the first ranking to be realized by the techniques. The study revealed that AI techniques support only the first 3 phases of SCRes (readiness, response, and recovery), and readiness is the most popular one, while no evidence has been found for the growth phase. The study proposed an AI-SCRes framework to inform research and practice to approach SCRes holistically. It also provided implications for practice, policy, and theory as well as gaps for impactful future research.

Keywords: ANNs, risk, Bauesian networks, vulnerability, resilience

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Authors: Wahyu Riawanti

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Food safety is the one of a prominent issue for globalization era. The more concern is paid in international food and agriculture trade; the more consumers will consider raising the standard of food safety. For this reason, the role of the issue is not only in term of added value but since then also the main requirement in import export activity, including agriculture products. Unfortunately, Indonesia and other developing countries found it difficult to fulfill some of the technical issues and end it up with the lower export activity. In this case, the technical requirements of food safety become an obstacle rather than challenging. Furthermore for local farmers’ activity, food safety is more or less a threat. The study is aimed to reveal on how Indonesian government had dealt with the certification regulation to face problem on competitiveness of Indonesian products. Local government has conducted the regulation of food certification. The study used the case of Salak Pondoh fruit (Salacca zalacca) certification process on Sleman District- Yogyakarta. Triangulation method was used to analyze the effectiveness of the certification program. The quantitative data series taken from 7 farmer groups during the certification processes were used for the research main data. The supporting qualitative data was obtained from in-depth interview with the members of farmers group. The pre-research result has shown that the impact varied from different groups. Conclusively the certification regulation has partly failed to make a significant change in local farmers’ competitiveness. Even the profit was increased, the highly amount budget of the program did not significantly increase the economic incentives for local farmers.

Keywords: economic incentive, food security, government regulation, international trade, local commodity, Salacca zalacca

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Authors: Rameesha Javaid

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Balochistan, the largest landmass named after and dominated by the 55% Baloch population, which has had a difficult anti-center history like their brothers the Kurds of Middle East, reluctantly acceded to Pakistan in 1947. The region, which attained the status of a province after two decades of accession, has lagged behind in social development and economic growth as compared to the other three federating units. The province has seen the least financial autonomy and administrative decentralization both in autocratic and democratic dispensations under geostrategic and security considerations. Significant corrections have been recently made in the policy framework through changing the formula for intra-provincial National Finance Award, curtailing the number of subjects under federal control, and reactivating the Council of Common Interests. Yet policymaking remains overwhelmingly bureaucratic under a weak parliamentary oversight. The provincial coalition governments are unwieldy and directionless. The government machinery has much less than the optimal capability, character, integrity, will, and opportunity to perform. Decentralization further loses its semblance in the absence of local governments for long intervals and with the hold of hereditary tribal chiefs. Increased allocations failed to make an impact in the highest per capita cost environment due to long distances and scattered settlements. Decentralization, the basic ingredient of federalism has remained mortgaged to geo-strategic factors, internal security perceptions, autocratic and individualistic styles of governments, bureaucratic policymaking structures, bad governance, non-existent local governments, and feudalistic tribal lords. This suboptimal federalism speaks for the present underdevelopment in Balochistan and will earmark the milestones in the future.

Keywords: Balochistan, economic development, federalism, political economy

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Authors: Tim Dunne, Jiaxiang Ren, Lei Zhao, Peng Cheng, Yi Song, Yu Liu, Wenhan Yue, Xiongwen Yang

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Two decades of the Shale Revolution has transforming transformed the global energy market, in part by the adaption of multi-stage dissolvable frac plugs. Magnesium has been favored for the bulk of plugs, requiring development of materials to suit specific field requirements. Herein, the mechanical and dissolution results from equal channel angular pressing (ECAP) of two cast dissolvable magnesium alloy are described. ECAP was selected as a route to increase the mechanical properties of two formulations of dissolvable magnesium, as solutionizing failed. In this study, 1” square cross section samples cast Mg alloys formulations containing rare earth were processed at temperatures ranging from 200 to 350 °C, at a rate of 0.005”/s, with a backpressure from 0 to 70 MPa, in a brass, or brass + graphite sheet. Generally, the yield and ultimate tensile strength (UTS) doubled for all. For formulation DM-2, the yield increased from 100 MPa to 250 MPa; UTS from 175 MPa to 325 MPa, but the strain fell from 2 to 1%. Formulation DM-3 yield increased from 75 MPa to 200 MPa, UTS from 150 MPa to 275 MPa, with strain increasing from 1 to 3%. Meanwhile, ECAP has also been found to reduce the dissolution rate significantly. A microstructural analysis showed grain refinement of the alloy and the movement of secondary phases away from the grain boundary. It is believed that reconfiguration of the grain boundary phases increased the mechanical properties and decreased the dissolution rate. ECAP processing of dissolvable high rare earth content magnesium is possible despite the brittleness of the material. ECAP is a possible processing route to increase mechanical properties for dissolvable aluminum alloys that do not extrude.

Keywords: equal channel angular processing, dissolvable magnesium, frac plug, mechanical properties

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Authors: Jinan Fiaidhi, Sabah Mohammed, Petros Zezos

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Capsule endoscopy (CE) is an established noninvasive diagnostic modality in investigating small bowel disease. CE has a pivotal role in assessing patients with suspected bleeding or identifying evidence of active Crohn's disease in the small bowel. However, CE produces lengthy videos with at least eighty thousand frames, with a frequency rate of 2 frames per second. Gastroenterologists cannot dedicate 8 to 15 hours to reading the CE video frames to arrive at a diagnosis. This is why the issue of analyzing CE videos based on modern artificial intelligence techniques becomes a necessity. However, machine learning, including deep learning, has failed to report robust results because of the lack of large samples to train its neural nets. In this paper, we are describing a thick data approach that learns from a few anchor images. We are using sound datasets like KVASIR and CrohnIPI to filter candidate frames that include interesting anomalies in any CE video. We are identifying candidate frames based on feature extraction to provide representative measures of the anomaly, like the size of the anomaly and the color contrast compared to the image background, and later feed these features to a decision tree that can classify the candidate frames as having a condition like the Crohn's Disease. Our thick data approach reported accuracy of detecting Crohn's Disease based on the availability of ulcer areas at the candidate frames for KVASIR was 89.9% and for the CrohnIPI was 83.3%. We are continuing our research to fine-tune our approach by adding more thick data methods for enhancing diagnosis accuracy.

Keywords: thick data analytics, capsule endoscopy, Crohn’s disease, siamese neural network, decision tree

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Authors: B. J. Mahen, N. E. Lloyd-Gale, S. Johnson, W. P. Rakowicz, M. J. Harris, A. D. Miller

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Background: Migraine is a leading cause of disability in the world. Calcitonin gene-related peptide (CGRP) receptor antagonists offer an approach to migraine prophylaxis by inhibiting the inflammatory and vasodilatory effects of CGRP. In recent years, NICE licensed the use of three CGRP-receptor antagonists: Fremanezumab, Galcanezumab, and Erenumab. Here, we present the outcomes of CGRP-antagonist treatment in a cohort of patients who suffer from episodic or chronic migraine and have failed at least three oral prophylactic therapies. Methods: We offered CGRP antagonists to 86 patients who met the NICE criteria to start therapy. We recorded the number of headache days per month (HDPM) at 0 weeks, 3 months, and 12 months. Of those, 26 patients were switched to an alternative treatment due to poor response or side effects. Of the 112 total cases, 9 cases did not sufficiently maintain their headache diary, and 5 cases were not followed up at 3 months. We have therefore included 98 sets of data in our analysis. Results: Fremanezumab achieved a reduction in HDPM by 51.7% at 3 months (p<0.0001), with 63.7% of patients meeting NICE criteria to continue therapy. Patients trialed on Galcanezumab attained a reduction in HDPM by 47.0% (p=0.0019), with 51.6% of patients meeting NICE criteria to continue therapy. Erenumab, however, only achieved a reduction in HDPM by 17.0% (p=0.29), and this was not statistically significant. Furthermore, 34.4%, 9.7%, and 4.9% of patients taking Fremanezumab, Galcanezumab, and Erenumab, respectively, continued therapy beyond 12 months. Of those who attempted drug holidays following 12 months of treatment, migraine symptoms relapsed in 100% of cases. Conclusion: We observed a significant improvement in HDPM amongst episodic and chronic migraine patients following treatment with Fremanezumab or Galcanezumab.

Keywords: migraine, CGRP, fremanezumab, galcanezumab, erenumab

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Authors: Farrah Anne Robert, Robert McClelland, Seng Kiat Kok

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Higher education service quality is widely regarded as key factors in the long term success of a higher education institution in attracting and retaining students. This research attempted to establish the impact of service quality on recruiting and retaining students in private higher education institutions (PHEI’s). 501 local and international students responded to a 49 item educational service measure questionnaire from PHEIs in Kuala Lumpur and Selangor, two states in Malaysia which together account for 60% of private colleges in Malaysia. Results from this research revealed that, inter-alia, facilities, employability, management and administration services, academic staff competence, curriculum and student overall experiences were key driving factors in attracting and retaining students. Lack of “campus-like building” facilities and lecturer’s effectiveness in delivering lectures were keys concerns in the provision of service quality by PHEI’s in Malaysia. Over the last decade, the Government of Malaysia has set a target of recruiting 200,000 international students to study in Malaysia by PHEI’s and PHEI’s have failed to achieve this target. This research suggests that service quality issues identified above are impacting efforts to recruit and retain both local and international students by PHEIs. The researcher recommends that further and detailed research be carried on these factors and its impact on recruitment and retention. PHEI administrators can benefit from this research by conducting an evaluation of service measures delivered in their institutions and take corrective measures. Prospective students can benefit from this study by including in their choice factors the “service quality delivery” of PHEI’s when deciding to enroll in a particular PHEI.

Keywords: higher education, recruitment, retention, service quality

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Authors: Edwina Owusu Panin

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Families may face significant obstacles as a result of single parenting and disabilities. The amenities and support those single parents need to give their children with disabilities the care they need are frequently out of their reach. These can include financial hardship, limited access to health and education, and social isolation. In addition, cultural attitudes toward disability can worsen these challenges, making it difficult for families to get the support and resources they need. Despite these challenges, many single parents have shown resilience and strength to overcome these difficulties and defend the rights of their children; some, too, have failed in taking care of their disabled children in Ghana. The study traces the developmental process of how single parents cope with disabled children. There is a discouraging fact that single father’s face a much more dreadful task in taking care of their disabled children in Ghana, which is later highlighted in the article. Additional research and support are needed to address the unique needs of families facing these challenges. This case study explores the experiences of single parents raising children with disabilities in Ghana. Using a qualitative approach, the study examines the challenges facing lone parents in caring for children, including access to healthcare, education and social support. In addition, the study examines the impact of cultural disability attitudes on the experiences of single parents and their children and what causes it in Ghana. Findings indicate that single parents in Ghana face significant challenges in accessing resources and support for their children and that cultural attitudes toward disability may aggravate these challenges. However, the study recommends the tenacity and strengths of how to create awareness, protect the welfare and also by encouraging single parents to face these challenges and protect the rights of their children, swaying away influences of bad cultural attitudes.

Keywords: disability, single parenting, case study, assessing

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Authors: Mohammad Ansari, Ahmed Ismail, Satinder Mann

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Overcrowding in Emergency departments (ED) of United Kingdom has become a common problem. Urgent Care centres were developed nearly a decade ago to reduce pressure on EDs. Unfortunately, the development of Urgent Care centres has failed to produce the projected effects. It was thought that nearly 40% patients attending ED would go to Urgent Care centres and these would be staffed by Primary care Physicians. Data reveals that no more than 20% patients were seen by Primary Care Physicians even when the Urgent Care Centre was based in the ED. This study was carried out at the ED of George Eliot Hospital, Nuneaton, UK where the Urgent Care centre was based in the ED and employed Primary Care Physicians with special interest in trauma for nearly one year. This was then followed by a Primary Care Physician and Advanced Nurse Practitioner. We compared the number of patients seen during these periods and the cost-effectiveness of the service.We randomly selected a week of patients seen by Primary Care Physicians with special interest in Trauma and by Primary Care Physicians and the Advanced Nurse Practitioner. We compared the number and type of patients seen during these two periods. Nearly 38% patients were seen by Primary care Physician with special interest in Trauma, whilst only 14.3% patients were seen by the Primary care Physician and Advanced Nurse Practitioner. The Primary Care Physicians with special interest in trauma were paid less. Our study confirmed that unless Primary Care Physicians are able to treat minor trauma and interpret x-rays, the urgent care service is not going to be cost effective. Numerous previous studies have shown that 15 to 20% patients attending ED can be treated by Primary Care Physicians who do not require any investigations for their management. It is advantageous to have Urgent Care Centres within the ED because if the patient deteriorates they can be transferred to ED. We recommend that the Urgent care Centres should be a part of ED. Our study shows that Urgent care Centres in the ED can be helpful and cost effective if staffed by either senior Emergency Physicians or Primary Care Physicians with special interest and experience in the management of minor trauma.

Keywords: urgent care centres, primary care physician, advanced nurse practitioner, trauma

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Authors: Umporn Wutchana

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An open ended problem and unstructured interview had been used to explore students’ conceptual and procedural understanding of vector components. The open ended problem had been designed based on research instrument used in previous physics education research. Without physical context, we asked students to find out magnitude and draw graphical form of vector components. The open ended problem was given to 211 first year students of faculty of science during the third (summer) semester in 2014 academic year. The students spent approximately 15 minutes of their second time of the General Physics I course to complete the open ended problem after they had failed. Consequently, their responses were classified based on the similarity of errors performed in the responses. Then, an unstructured interview was conducted. 7 students were randomly selected and asked to reason and explain their answers. The study results showed that 53% of 211 students provided correct numerical magnitude of vector components while 10.9% of them confused and punctuated the magnitude of vectors in x- with y-components. Others 20.4% provided just symbols and the last 15.6% gave no answer. When asking to draw graphical form of vector components, only 10% of 211 students made corrections. A majority of them produced errors and revealed alternative conceptions. 46.5% drew longer and/or shorter magnitude of vector components. 43.1% drew vectors in different forms or wrote down other symbols. Results from the unstructured interview indicated that some students just memorized the method to get numerical magnitude of x- and y-components. About graphical form of component vectors, some students though that the length of component vectors should be shorter than those of the given one. So then, it could be combined to be equal length of the given vectors while others though that component vectors should has the same length as the given vectors. It was likely to be that many students did not develop a strong foundation of understanding in vector components but just learn by memorizing its solution or the way to compute its magnitude and attribute little meaning to such concept.

Keywords: graphical vectors, vectors, vector components, misconceptions, alternative conceptions

Procedia PDF Downloads 169

Authors: Mohamad Sukeri Khalid, Che Su Mustaffa, Mohd Najib Marzuki, Mohd Fo’ad Sakdan, Sapora Sipon, Mohd Taib Ariffin, Shazwani Shafiai

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This paper describes the issues relating to the role of the flash flood early warning system provided by the Malaysian Government to the communities in Malaysia, specifically during the flash flood disaster in the Cameron Highlands, Malaysia. Normally, flash flood disasters can occur as a result of heavy rainfall in an area, and that water may possibly cause flooding via streams or narrow channels. For this study, the flash flood disaster in the Cameron Highlands occurred on 23 October 2013, and as a result the Sungai Bertam overflowed after the release of water from the Sultan Abu Bakar Dam. This release of water from the dam caused flash flooding which led to damage to properties and also the death of residents and livestock in the area. Therefore, the effort of this study is to identify the perceptions of the flash flood victims on the role of the flash flood early warning system. For the purposes of this study, data collection was gathered from those flood victims who were willing to participate in this study through face-to-face interviews. This approach helped the researcher to glean in-depth information about their feeling and perceptions on the role of the flash flood early warning system offered by the government. The data were analysed descriptively and the findings show that the respondents of 22 flood victims believe strongly that the flash flood early warning system was confusing and dysfunctional, and communities had failed to response positively to it. Therefore, most of the communities were not well prepared for the releasing of water from the dam that caused property damage and 3 people were killed in Cameron Highland flash flood disaster.

Keywords: communities affected, disaster management, early warning system, flash flood disaster

Procedia PDF Downloads 679

Authors: Mohammad Ansari, Satinder Mann, Ahmed Ismail

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Primary care patients in Emergency Departments (ED) have been the topic of discussion since 1998 in the United Kingdom. Numerous studies have analysed attendances in EDs retrospectively and suggest that at least one third to fifty percent patients attending ED with problems which could be managed appropriately in General Practice or minor injuries units. The pattern of ED Usage seems to be International. In Australia and many departments in the United States include walk in facilities staffed by physicians on family practice residency programme. It clearly appears in the United Kingdom that EDs have to accept that such patients with primary care problems will attend the ED and facilities will have to be provided to see and treat such patients. Urgent care centres were introduced in the United Kingdom nearly a decade ago to reduce the pressure on EDs. Most of these were situated near pre-existing EDs. Unfortunately these centres failed to have the desired effect of reducing the number of patients visiting EDs, it has been noticed that when more patients were seen in Urgent Care centres there were increased attendances in ED as well. A new model of Urgent Care centre was started in the ED of George Eliot Hospital, Nuneaton, UK. We looked at the working of the centre by looking at the number of patients seen daily against the number of total attendances in the ED. We studied the number and type of patients seen by the Urgent Care Doctor. All the medical records of the patients were seen and the time patients spent in the Urgent Care centre was recorded. The total number of patients seen during this study were 1532. 219 (14.3% ) were seen within our Urgent Care centre. None of the patients waited over four hours to be seen. It has been recognised that primary care patients in the ED are a major part of attendances of the department and unless these patients are seen in Urgent Care centres, overcrowding and long waits cannot been avoided. It has been shown that employing primary care Physicians in Urgent Care centres reduces overall cost because they do not carry out as many investigations as Junior Doctors. In our study over 14% patients were seen by Urgent Care Physicians and none of the patients waited for more than four hours and we feel that care provided to the patients by Urgent Care centre was highly effective and satisfying for the patient.

Keywords: urgent care centres, primary care physicians, overcrowding, cost

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Authors: Wegene Demeke

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Background: The demand for healthcare services is growing in developing and developed countries. Information and communication technology is used to facilitate healthcare services. In the case of developing countries, implementing telemedicine is aimed at providing healthcare for people living in remote areas where health service is not accessible. The implementations of telemedicine in developing countries are unsuccessful. For example, the recent study indicates that 90% of telemedicine projects are abandoned or failed in developing countries. Several researchers reported the technological challenges as the main factor for the non-adoption of telemedicine. However, this research reports the health professionals’ perspectives arising from technical, social and organizational factors that are considered as key elements for the setting and running of telemedicine in Ethiopia. The importance and significance of telemedicine for healthcare is growing. For example, the use of telemedicine in the current pandemic situation becomes an essential strategic element in providing healthcare services in developed countries. Method: Qualitative and quantitative exploratory research methods used to collect data to find factors affecting the adoption of Information and communication technologies for telemedicine use. The survey was distributed using emails and Google forms. The email addresses were collected from personal contact and publicly available websites in Ethiopia. The thematic analysis used to build the barriers and facilitators factors for establishing telemedicine services. A survey questionnaire with open-and-close questions was used to collect data from 175 health professionals. Outcome: The result of this research will contribute to building the key barriers and facilitators factors of telemedicine from the health professional perspectives in developing countries. The thematic analysis provides barriers and facilitators factors arising from technical, organizational, and social sources.

Keywords: telemedicine, ICT, developing country, Ethiopia, health service

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Authors: ȘercăIanu Mihai, Aldea Mihaela, Iacoboaea Cristina, Luca Oana, Nenciu Ioana

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The emergence and neutralization of illegal waste dumps represent a global concern for waste management ecosystems with a particularly pronounced impact on disadvantaged communities. All over the world, and in this particular case in Romania, a relevant number of people resided in houses lacking any legal forms such as land ownership documents or building permits. These areas are referred to as “informal settlements”. An increasing number of regions and cities in Romania are struggling to manage their waste dumps, especially in the context of increasing poverty and lack of regulation related to informal settlements. An example of such informal settlement can be found at the terminus of Bistra Street in Câlnic, which falls under the jurisdiction of the Municipality of Reșița in Caras Severin County. The article presents a case study that focuses on employing remote sensing techniques and spatial data to monitor and map illegal waste practices, with subsequent integration into a geographic information system tailored for the Reșița community. In addition, the paper outlines the steps involved in devising strategies aimed at enhancing waste management practices in disadvantaged areas, aligning with the shift toward a circular economy. Results presented in the paper contain a spatial mapping and visualization methodology calibrated with in situ data collection applicable for identifying illegal landfills. The emergence and neutralization of illegal dumps pose a challenge in the field of waste management. These approaches, which prove effective where conventional solutions have failed, need to be replicated and adopted more wisely.

Keywords: waste dumps, waste management, monitoring, GIS, informal settlements

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Authors: Abdullah Alaklabi, Ibrahim A. Arif, Sameera O. Bafeel, Ahmad H. Alfarhan, Anis Ahamed, Jacob Thomas, Mohammad A. Bakir

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Diospyros mespiliformis (Hochst. ex A.DC.; Ebenaceae) is a large deciduous medicinal plant. This plant species is currently listed as endangered in Saudi Arabia. Molecular identification of this plant species based on short sequence regions (571 and 664 bp) of plastid rbcL (ribulose-1, 5-biphosphate carboxylase) gene was investigated in this study. The endangered plant specimens were collected from Al-Baha, Saudi Arabia (GPS coordinate: 19.8543987, 41.3059349). Phylogenetic tree inferred from the rbcL gene sequences showed that this species is very closely related with D. brandisiana. The close relationship was also observed among D. bejaudii, D. Philippinensis and D. releyi (≥99.7% sequence homology). The partial rbcL gene sequence region (571 bp) that was amplified by rbcL primer-pair rbcLaF-rbcLaR failed to discriminate D. mespiliformis from the closely related plant species, D. brandisiana. In contrast, primer-pair rbcL1F-rbcL724R yielded longer amplicon, discriminated the species from D. brandisiana and demonstrated nucleotide variations in 3 different sites (645G>T; 663A>C; 710C>G). Although D. mespiliformis (EU980712) and D. brandisiana (EU980656) are very closely related species (99.4%); however, studied specimen showed 100% sequence homology with D. mespiliformis and 99.6% with D. brandisiana. The present findings showed that rbcL short sequence region (664 bp) of plastid rbcL gene, amplified by primer-pair rbcL1F-rbcL724R, can be used for authenticating samples of D. mespiliforformis and may provide help in authentic identification and management process of this medicinally valuable endangered plant species.

Keywords: Diospyros mespiliformis, endangered plant, identification partial rbcL

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Authors: Eric Lai, Sarah Lorger, David Eisinger, Richard Waugh

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Introduction: Percutaneous embolization of varicoceles has shown similar outcomes to surgery. However, there are advantages of radiological intervention as patients are not exposed to general anaesthesia, experience a quicker recovery and face a lower risk of major complications. Radiological interventions are also preferable after a failed surgical approach. We evaluate clinical outcomes of percutaneous embolization at a tertiary hospital in Sydney, Australia. Methods: Retrospective case series without a control group from a single site (Royal Prince Alfred Hospital, Sydney, Australia). A data search was performed on the interventional radiology database with the word “varicocele” between February 2017 and March 2022. 62 patients were identified. Each patient file was reviewed and included in the study if they met the inclusion criteria. Results: A total of 56 patients were included. 6 patients were excluded as they did not receive intervention after the initial diagnostic venography. Technical success was 100%. Complications were seen in 3 patients (5.3%). The complications included post-procedural pain and fever, venous perforation with no clinical adverse outcome, and a mild allergic reaction to contrast. Recurrence occurred in 3 patients (5.6%), all of whom received a successful second procedure. DISCUSSION: This study demonstrates comparable rates of technical success, complication rate and recurrence to other studies in the literature. When compared to surgical outcomes, the results were also similar. The main limitation is multiple patients lack long-term follow-up beyond 1 year, resulting in potential underestimation of the recurrence rate. Conclusion: Percutaneous embolization of varicocele is a safe alternative to surgical intervention.

Keywords: varicocele, interventional radiology, urology, radiology

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Authors: Saeid Haghjoo, Ebrahim Reyhani, Fahimeh Kolahdouz

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The present study aimed to evaluate the understanding of the students in Tehran universities (Iran) about the numerical representation of the average rate of change based on the Structure of Observed Learning Outcomes (SOLO). In the present descriptive-survey research, the statistical population included undergraduate students (basic sciences and engineering) in the universities of Tehran. The samples were 604 students selected by random multi-stage clustering. The measurement tool was a task whose face and content validity was confirmed by math and mathematics education professors. Using Cronbach's Alpha criterion, the reliability coefficient of the task was obtained 0.95, which verified its reliability. The collected data were analyzed by descriptive statistics and inferential statistics (chi-squared and independent t-tests) under SPSS-24 software. According to the SOLO model in the prestructural, unistructural, and multistructural levels, basic science students had a higher percentage of understanding than that of engineering students, although the outcome was inverse at the relational level. However, there was no significant difference in the average understanding of both groups. The results indicated that students failed to have a proper understanding of the numerical representation of the average rate of change, in addition to missconceptions when using physics formulas in solving the problem. In addition, multiple solutions were derived along with their dominant methods during the qualitative analysis. The current research proposed to focus on the context problems with approximate calculations and numerical representation, using software and connection common relations between math and physics in the teaching process of teachers and professors.

Keywords: average rate of change, context problems, derivative, numerical representation, SOLO taxonomy

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Authors: Jakub Zembrzuski, Bartosz Sobczyk, Mikołaj MIśkiewicz

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Besides designing new constructions, engineers all over the world must face another problem – maintenance, repairs, and assessment of the technical condition of existing bridges. To solve more complex issues, it is necessary to be familiar with the theory of finite element method and to have access to the software that provides sufficient tools which to enable create of sometimes significantly advanced numerical models. The paper includes a brief assessment of the technical condition, a description of the in situ non-destructive testing carried out and the FEM models created for global and local analysis. In situ testing was performed using strain gauges and displacement sensors. Numerical models were created using various software and numerical modeling techniques. Particularly noteworthy is the method of modeling riveted joints of the crossbeam of the viaduct. It is a simplified method that consists of the use of only basic numerical tools such as beam and shell finite elements, constraints, and simplified boundary conditions (fixed support and symmetry). The results of the numerical analyses were presented and discussed. It is clearly explained why the structure did not fail, despite the fact that the weld of the deck plate completely failed. A further research problem that was solved was to determine the cause of the rapid increase in values on the stress diagram in the cross-section of the transverse section. The problems were solved using the solely mentioned, simplified method of modeling riveted joints, which demonstrates that it is possible to solve such problems without access to sophisticated software that enables to performance of the advanced nonlinear analysis. Moreover, the obtained results are of great importance in the field of assessing the operation of bridge structures with an orthotropic plate.

Keywords: bridge, diagnostics, FEM simulations, failure, NDT, in situ testing

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Authors: Meral Melek Unver

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This paper aims to explore ways to help English as a Foreign Language (EFL) learners notice and revise voice in English and raise their awareness of when and how to use active and passive voice to convey meaning in their written and spoken work. Because passive voice is commonly preferred in certain genres such as academic essays and news reports, despite the current trends promoting active voice, it is essential for learners to be fully aware of the meaning, use and form of passive voice to better communicate. The participants in the study are 22 EFL learners taking a one-year intensive English course at a university, who will receive English medium education (EMI) in their departmental studies in the following academic year. Data from students’ written and oral work was collected over a four-week period and the misuse or inaccurate use of passive voice was identified. The analysis of the data proved that they failed to make sensible decisions about when and how to use passive voice partly because the differences between their mother tongue and English and because they were not aware of the fact that active and passive voice would not alternate all the time. To overcome this, a Test-Teach-Test shape lesson, as opposed to a Present-Practice-Produce shape lesson, was designed and implemented to raise their awareness of the decisions they needed to make in choosing the voice and help them notice the meaning and use of passive voice through concept checking questions. The results first suggested that awareness raising activities on the meaning and use of voice in English would be beneficial in having accurate and meaningful outcomes from students. Also, helping students notice and renotice passive voice through carefully designed activities would help them internalize the use and form of it. As a result of the study, a number of activities are suggested to revise and notice passive voice as well as a short questionnaire to help EFL teachers to self-reflect on their teaching.

Keywords: voice in English, test-teach-test, passive voice, English language teaching

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Authors: Hasan Frookh Jamal

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This is a case of a 36-year-old Bahraini gentleman diagnosed to have Cushing's Syndrome with a large anterior mediastinal mass. He was sent abroad to the Speciality hospital in Jordan, where he underwent diagnostic video-assisted thoracoscopy, partial thymectomy and pericardial fat excision. Histopathology of the mass was reported to be an Atypical carcinoid tumor with a low Ki67 proliferation index of 5%, the mitotic activity of 4 MF/10HPF and pathological stage classification(pTNM): pT1aN1. MRI of the pituitary gland showed an ill-defined non-enhancing focus of about 3mm on the Rt side of the pituitary on coronal images, with a similar but smaller one on the left side, which could be due to enhancing pattern rather than a real lesion as reported. The patient underwent Ga68 Dotate PET/CT scan post-operatively, which showed multiple somatostatin receptor-positive lesions seen within the tail, body and head of the pancreas and positive somatostatin receptor lymph nodes located between the pancreatic head and IVC. There was no uptake detected at the anterior mediastinum nor at the site of thymic mass resection. There was no evidence of any positive somatostatin uptake at the soft tissue or lymph nodes. The patient underwent IPSS, which proved that the source is, in fact, an ectopic source of ACTH secretion. Unfortunately, the patient's serum cortisol remained elevated after surgery and failed to be suppressed by 1 mg ODST and by 2 days LLDST with a high ACTH value. The patient was started on Osilodrostat for treatment of hypercortisolism for the time being and his future treatment plan with Lutetium-177 Dotate therapy vs. bilateral adrenalectomy is to be considered in an MDT meeting.

Keywords: cushing syndrome, neuroendocrine tumur, carcinoid tumor, Thymoma

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Authors: Bernice Badal

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This article addresses a persistent challenge related to teacher agency in knowledge acquisition in professional development (PD) workshops in contexts of educational change, given that scholarship identifies a need for more teacher involvement and amplification of teacher's voices. Theoretical concepts are drawn from Bandura’s Social cognitive theory, incorporating the triadic causation model of agency to examine the reciprocal nature of the context, teacher characteristics, and systemic influences that shape how knowledge is transmitted and acquired in PD workshops. This qualitative study, using a mix of classroom observations and interviews, explored the political, contextual, and personal characteristics of teacher agency in PD through an analysis of data extracted from a PhD study. The narratives of six teachers from three township schools are examined to show how PD efforts in South Africa have failed to take account of the holistic development of teacher agency in knowledge dissemination and how this shapes teacher self-efficacy beliefs about being able to masterfully apply the tenets of the reform. Agency, teacher voice, and contextual considerations were used as markers of the quality of the training provided to understand how knowledge is acquired and meaning is made. The findings suggest that systemic influences of institutionally imposed PD offer partial understandings of the reform, which is offered in traditional formats that do not consider teacher empowerment in knowledge production and the development of teacher agency. Common in all the participants’ responses is the need for more information and training on the prescribed approach for teaching English as a second language; however, this paper holds the view that more information may not solve teachers’ dilemmas. Accordingly, it recommends a restructuring of the programme with facilitators being more cognisant of teacher agency for the development of transformative teachers. The findings of the study contribute to the field of teacher knowledge, teacher training, and professional development in the context of educational reforms.

Keywords: teacher professional development, teacher voice, teacher agency, educational reforms, teacher knowledge

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Authors: Osamah S. Alanazi, Mohammad G. Kotbi, Mohammed O. AlFadil

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While renewable energy technology is developing in Saudi Arabia, and the ambitious 2030 vision encourages the shift towards more efficient and clean energy usage. The research on the application of geothermal resources in residential use for the Saudi Arabian context will contribute towards a more sustainable environment. This paper is a part of an ongoing master's thesis, which its main goal is to investigate the possibility of achieving a zero-carbon house in Riyadh by applying a ground-coupled system into a current sustainable house that uses a grid-tied solar system. The current house was built and designed by King Saud University for the 2018 middle east solar decathlon competition. However, it failed to reach zero-carbon operation due to the high cooling demand. This study will redesign and validate the house using Revit and Carriers Hourly Analysis 'HAP' software with the use of ordinary least square 'OLS' regression. After that, a ground source ventilation system will be designed using the 'GCV Tool' to reduce cooling loads. After the application of the ground source system, the new electrical loads will be compared with the current house. Finally, a simple economic analysis that includes the cost of applying a ground source system will be reported. The findings of this study will indicate the possibility and feasibility of reaching a zero-carbon house in Riyadh, Saudi Arabia, using a ground-coupled ventilation system. While cooling in the residential sector is the dominant energy consumer in the Gulf region, this work will certainly help in moving towards using renewable sources to meet those demands. This paper will be limited to highlight the literature review, the methodology of the research, and the expected outcome.

Keywords: renewable energy, zero-carbon houses, sustainable buildings, geothermal energy, solar PV, GCV Tool

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Authors: Zainab A. Alaghbri, Labiba A., Esam A.

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Tuberculosis (TB) is the fourth leading cause of death in Yemen and is considered a major priority by the Ministry of Public Health. The war in Yemen has led to the emergence of one of the worst humanitarian crises in the world. These circumstances may lead to exacerbate the situation of tuberculosis. This study aims to describe the trend and incidence of TB in north and east governorates, Yemen 2019-2021 and provide recommendations for interventions. A descriptive analysis was conducted during July to September 2022. Data of TB cases were obtained from the national tuberculosis program as soft copy. The Data included the TB case collected and diagnosed during 2019-2021. The data contains the following variables: Sex, age, governorates, smear-positive cases, extra-pulmonary cases, and treatment outcomes. 16791 TB cases were notified for an overall case notification rate 65.5/100000 for all forms (smear positive and Extra-pulmonary), There was a slightly declined in 2020 and 2021 by 1%. Both the pulmonary smear positive and Extra pulmonary rates were slightly decreased from 8.8 to 7.7 and 13.5 to 12.8 / 100, 000 populations respectively. For Tuberculosis cases by type of patient, the incidence of extra-pulmonary was the highest (12,9, 11.3 and 12,2/100000) over the three years. However, the incidence of pulmonary failure was the lowest. The majority of cases were in the age group 25-34. The overall treatment success rate for smear-positive patients was 88%. Of the 627 patients with documented unsuccessful outcomes (e.g., failure, death, and default), 165 (23%) died, 52 (8.3%) failed treatment, and 410 (65%) defaulted. Overall, the magnitude of tuberculosis decreased over the periods reviewed. The proportion of Extra-pulmonary TB was the highest. The success rate achieved after treatment was below the levels established by the WHO End Tuberculosis Strategy (90%). Failure to complete treatment may be responsible for the low success rate. Monitoring and addressing the risk factors that were associated with treatment outcomes and duration may help improve the likelihood of achieving favorable outcomes among cases of smear-positive pulmonary TB.

Keywords: tuberculosis, trend, incidence, yemen

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Authors: Vishnu Varthan Vaithiyalingamjagannathan, M. N. Sathishkumar, K. S. Lakhsmi, D. Satheeshkumar, Srividyaammayappanrajam

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Background:Naringenin, aglycone flavonoid possess certain activities like anti-oxidant, anti-estrogenic, anti-diabetic, cardioprotective, anti-obesity,anti-inflammatory, hepatoprotective and also have anti-cancer characteristics like carcinogenic inactivation, cell cycle arrest, anti-proliferation, apoptosis, anti-angiogenesis and enhances anti-oxidant activity. Methodology:The inhibitory effect of Naringenin in lung tumor progression estimated with adenocarcinoma (A549) cell lines (in vitro) and C57BL/6 mice injected with 5 X 106A549 cell lines (in vivo) in a tri-dose manner (Naringenin 100mg/kg,150mg/kg, and 200mg/kg) compared with standard chemotherapy drug cisplatin (7mg/kg). Results:The results of the present study revealed a dose-dependent activity in Naringenin and combination with cisplatin at a higher dose which showed decreased tumor progression in mice. In vitro studies carried out for estimation of cell survival and Nitric Oxide (NO) level, shows dose dependent action of Naringenin with IC50 value of 42µg/ml. In vivo studies were carried out in C57BL/6 mice. Naringenin satisfied the condition of an anti-cancer molecule with its characteristics in fragmentation assay, Zymography assay, anti-oxidant, and myeloperoxidase studies, than cisplatin which failed in anti-oxidant and myeloperoxidase effect. Both in vitro and in vivo establishes dose dependent decrease in NO levels. But whereas, Naringenin showed adverse results in Matrix Metalloproteinase (MMP) enzymatic levels with increase in dose levels. Conclusion:From the present study, Naringenin could suppress the lung tumor progression when given individually and also in combinatorial with standard chemotherapy drug.

Keywords: naringenin, in vitro, cell line, anticancer

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Authors: Iwona Kasior

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Purpose: Pelvic organ prolapse is the descent of pelvic organs into the vaginal opening. Currently, few trials have been conducted to determine the influence of pelvic floor muscle training in decreasing stage or symptoms associated with pelvic organ prolapse. The purpose of this case study is to determine whether pelvic floor muscle training can decrease the stage of pelvic organ prolapse and related symptoms. Case Presentation: This is the case of a 55-year-old female; recently diagnosed with midline cystocele, stage three. She has undergone corrective surgery that failed. She has now resorted to managing the condition with a home exercise regimen of voluntary pelvic floor muscle contractions, topical vaginal crème prescribed by her gynecologist, and slight lifestyle modifications. Methods: The patient was treated by a physical therapist for evaluation, vaginal exam, and educated in the ‘knack’ maneuver, lifestyle modifications, and proper technique of performing pelvic floor muscle contractions. The subject continued with a home exercise program with a specific regimen of pelvic floor muscle contractions and topical vaginal crème. Outcome: As determined by her physical therapist and the subject, her pelvic floor muscle strength had increased following the pelvic floor muscle training regimen and the use of the ‘knack’ maneuver. The subject reported a small decrease in the size of bulging prolapse and related symptoms of dryness, odor, vaginal discomfort, and the sensation of descent. Conclusion: Pelvic floor muscle training helped to lessen the degree of the prolapse, but not significantly enough to decrease the diagnosed stage.

Keywords: Kegel exercises, pelvic floor, pelvic organ prolapse, physical therapy

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Authors: Ben Kwame Agyei-Mensah

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This study investigated the influence of firm-specific characteristics which include proportion of Non-Executive Directors, ownership concentration, firm size, profitability, debt equity ratio, liquidity and leverage on the extent and quality of financial ratios disclosed by firms listed on the Ghana Stock Exchange. The research was conducted through detailed analysis of the 2012 financial statements of the listed firms. Descriptive analysis was performed to provide the background statistics of the variables examined. This was followed by regression analysis which forms the main data analysis. The results of the extent of financial ratio disclosure level, mean of 62.78%, indicate that most of the firms listed on the Ghana Stock Exchange did not overwhelmingly disclose such ratios in their annual reports. The results of the low quality of financial ratio disclosure mean of 6.64% indicate that the disclosures failed woefully to meet the International Accounting Standards Board's qualitative characteristics of relevance, reliability, comparability and understandability. The results of the multiple regression analysis show that leverage (gearing ratio) and return on investment (dividend per share) are associated on a statistically significant level as far as the extent of financial ratio disclosure is concerned. Board ownership concentration and proportion of (independent) non-executive directors, on the other hand were found to be statistically associated with the quality of financial ratio disclosed. There is a significant negative relationship between ownership concentration and the quality of financial ratio disclosure. This means that under a higher level of ownership concentration less quality financial ratios are disclosed. The findings also show that there is a significant positive relationship between board composition (proportion of non-executive directors) and the quality of financial ratio disclosure.

Keywords: voluntary disclosure, firm-specific characteristics, financial reporting, financial ratio disclosure, Ghana stock exchange

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Authors: Khaled Albriki, Feiyu Wang

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The failed rifted epicratonic Sirt basin is located in the northern margin of the African Plate with an area of approximately 600,000 km2. The organofacies' classification, characterization, and its distribution vertically and horizontally are carried out in 7 main troughs with 32 typical selected wells. 7 geological and geochemical cross sections including Rock-Eval data and % TOC data are considered in order to analyze and to characterize the main organofacies with respect to their geochemical and geological controls and also to remove the ambiguity behind the complexity of the orgnofacies types and distributions in the basin troughs from where the oil and gas are generated and migrated. This study confirmes that there are four different classical types of organofacies distributed in Sirt basin F, D/E, C, and B. these four clasical types of organofacies controls the type and amount of the hydrocarbon discovered in Sirt basin. Oil bulk property data from more than 20 oil and gas fields indicate that D/E organoface are significant oil and gas contributors similar to B organoface. In the western Sirt basin in Zallah-Dur Al Abd, Hagfa, Kotla, and Dur Atallha troughs, F organoface is identified for Etel formation, Kalash formation and Hagfa formation having % TOC < 0.6, whereas the good quality D/E and B organofacies present in Rachmat formation and Sirte shale formation both have % TOC > 1.1. Results from the deepest trough (Ajdabiya), Etel (Gas pron in Whadyat trough), Kalash, and Hagfa constitute F organofacies, mainly. The Rachmat and Sirt shale both have D/E to B organofacies with % TOC > 1.2, thus indicating the best organofacies quality in Ajdabiya trough. In Maragh trough, results show that Etel F organofacies and D/E, C to B organofacies related to Middle Nubian, Rachmat, and Sirte shale have %TOC > 0.66. Towards the eastern Sirt basin, in troughs (Hameimat, Faregh, and Sarir), results show that the Middle Nubian, Etel, Rachmat, and Sirte shales are strongly dominated by D/E, C to B (% TOC > 0.75) organofacies.

Keywords: Etel, Mid-Nubian, organic facies, Rachmat, Sirt basin, Sirte shale

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Authors: Nkrumak Micheal Atta Ofori

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The Vocational System is a decentralized Studies System implemented in Ghana as vocation studies strategy for grassroot that focuses on providing individuals with the specific skills, knowledge, and training necessary for a particular trade, craft, profession, or occupation. This article asks how devolution of vocational studies to local level authorities produces responsive and accountable representation and sustainable vocational learning under the vocational Studies System. It focuses on two case studies: Asokore Mampong and Atwima kwanwoma Municipal. Then, the paper asks how senior high school are developing new material and social practices around the vocational studies System to rebuild their livelihoods and socio-economic wellbeing. Here, the article focusses on Kumasi District, drawing lessons for the two other cases. The article shows how the creation of representative groups under the Vocational Studies System provides the democratic space necessary for effective representation of community aspirations. However, due to elite capture, the interests of privilege few people are promoted. The state vocational training fails to devolve relevant and discretionary resources to local teachers and do not follow the prescribed policy processes of the Vocational Studies System. Hence, local teachers are unable to promote responsive and accountable representation. Rural communities continue to show great interest in the Vocational Studies System, but the interest is bias towards gaining access to vocational training schools for advancing studies. There is no active engagement of the locals in vocational training, and hence, the Vocational Studies System exists only to promote individual interest of communities. This article shows how ‘failed’ interventions can gain popular support for rhetoric and individual gains.

Keywords: vocational studies system, devolution of vocational studies, local-level authorities, senior high schools and vocational learning, community aspirations and representation

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Authors: Waqqas-ur-Rehman Butt, Martin Servin, Marion Pause

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In recent years, object detection has gained much attention and very encouraging research area in the field of computer vision. The robust object boundaries detection in an image is demanded in numerous applications of human computer interaction and automated surveillance systems. Many methods and approaches have been developed for automatic object detection in various fields, such as automotive, quality control management and environmental services. Inappropriately, to the best of our knowledge, object detection under illumination with shadow consideration has not been well solved yet. Furthermore, this problem is also one of the major hurdles to keeping an object detection method from the practical applications. This paper presents an approach to automatic object detection in images under non-standardized environmental conditions. A key challenge is how to detect the object, particularly under uneven illumination conditions. Image capturing conditions the algorithms need to consider a variety of possible environmental factors as the colour information, lightening and shadows varies from image to image. Existing methods mostly failed to produce the appropriate result due to variation in colour information, lightening effects, threshold specifications, histogram dependencies and colour ranges. To overcome these limitations we propose an object detection algorithm, with pre-processing methods, to reduce the interference caused by shadow and illumination effects without fixed parameters. We use the Y CrCb colour model without any specific colour ranges and predefined threshold values. The segmented object regions are further classified using morphological operations (Erosion and Dilation) and contours. Proposed approach applied on a large image data set acquired under various environmental conditions for wood stack detection. Experiments show the promising result of the proposed approach in comparison with existing methods.

Keywords: image processing, illumination equalization, shadow filtering, object detection

Procedia PDF Downloads 194