Search results for: sustained anterior positivity

Authors: Amita Jain, Shantanu Prakash, Suruchi Shukla

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Introduction: Acute encephalitis syndrome (AES) is a complex multi etiology syndrome posing a great public health problem in the northern part of India. Japanese encephalitis (JE) virus is an established etiology of AES in this region. Recently, Scrub typhus (ST) is being recognized as an emerging aetiology of AES in JE endemic belt. This study was conducted to establish the direct evidence of Central nervous system invasion by Orientia tsutsugamushi leading to AES. Methodology: A total of 849 cases with clinical diagnosis of AES were enrolled from six districts (Deoria and its adjoining area) of the traditional north Indian Japanese encephalitis (JE) belt. Serum and Cerebrospinal fluid samples were collected and tested for major agent causing acute encephalitis. AES cases either positive for anti-ST IgM antibodies or negative for all tested etiologies were investigated for ST-DNA by real-time PCR. Results: Of these 505 cases, 250 patients were laboratory confirmed for O. tsutsugamushi infection either by anti-ST IgM antibodies positivity (n=206) on serum sample or by ST-DNA detection by real-time PCR assay on CSF sample (n=2) or by both (n=42).Total 29 isolate could be sequenced for 56KDa gene. Conclusion: All the strains were found to cluster with Gilliam strains. The majority of the isolates showed a 97–99% sequence similarity with Thailand and Cambodian strains. Gilliam strain of O.tsusugamushi is an emerging as one of the major aetiologies leading to AES in northern part of India.

Keywords: acute encephalitis syndrome, O. tsutsugamushi, Gilliam strain, North India, cerebrospinal fluid

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Authors: Kim Ji-Hyun, Jeon Hye-Seon, Kwon Oh-Yun, Park Eun-Young, Hwang Ui-Jae, Gwak Gyeong-Tae, Yoon Hyeo-Bin

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Stress urinary incontinence (SUI), a common women health problem, is an involuntary leakage of urine while sneezing, coughing, or physical exertion caused by insufficient strength of the pelvic floor and sphincter muscles. SUI also leads to decrease in quality of life and limits sexual activities. SUI is related to the increased bladder neck angle, bladder neck movement, funneling index, urethral width, and decreased urethral length. Various pelvic floor muscle electrical stimulation (ES) interventions have been applied to improve the symptoms of the people with SUI. ES activates afferent fibers of pudendal nerve and smoothly induces contractions of the pelvic floor muscles such as striated periurethral muscles and striated pelvic floor muscles. ES via intravaginal electrodes are the most frequently used types of the pelvic floor muscle ES for the female SUI. However, inserted electrode is uncomfortable and it increases the risks of infection. The purpose of this preliminary study was to determine if the 8-week transcutaneous pelvic floor ES would be effective to improve the symptoms and satisfaction of the females with SUI. Easy-K, specially designed ES equipment for the people with SUI, was used in this study. The oval shape stimulator can be placed on a toilet seat, and the surface has invaded electrode fit to contact with the entire vulva area while users are sitting on the stimulator. Five women with SUI were included in this experiment. Prior to the participation, subjects were instructed about procedures and precautions in using the ES. They have used the stimulator once a day for 20 minutes for each session at home. Outcome data was collected 3 times at the baseline, 4 weeks and 8 weeks after the intervention. Intravaginal sonography was used to measure the bladder neck angle, bladder neck movement, funneling index, thickness of an anterior rhabdosphincter and a posterior rhabdosphincter, urethral length, and urethral width. Leavator ani muscle (LAM) contraction strength was assessed by manual palpation according to the oxford scoring system. In addition, incontinence quality of life (IQOL) and female sexual function index (FSFI) questionnaires were used to obtain addition subjective information. Friedman test, a nonparametric statistical test, was used to determine the effectiveness of the ES. The Wilcoxon test was used for the post-hoc analysis and the significance level was set at .05. The bladder neck angle, funneling index and urethral width were significantly decreased after 8-weeks of intervention (p<.05). LAM contraction score, urethral length and anterior and posterior rhabdosphicter thickness were statistically increased by the intervention (p<.05). However, no significant change was found in the bladder neck movement. Although total score of the IQOL did not improve, the score of the ‘avoidance’ subscale of IQOL had significant improved (p<.05). FSFI had statistical difference in FSFI total score and ‘desire’ subscale (p<.05). In conclusion, 8-week use of a transcutaneous ES on peri-vulva area improved dynamic mechanical structures of the pelvic floor musculature as well as IQOL and conjugal relationship.

Keywords: electrical stimulation, Pelvic floor muscle, sonography, stress urinary incontinence, women health

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Authors: Patricia Shirley Almeida Prado, Liz Brito, Selma Paixão Argollo, Gracie Moreira, Leticia Matos Sobrinho

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Diffuse idiopathic skeletal hyperostosis (DISH) is a degenerative bone disease also known as Forestier´s disease and ankylosing hyperostosis of the spine is characterized by a tendency toward ossification of half the anterior longitudinal spinal ligament without intervertebral disc disease. DISH is not considered to be osteoarthritis, although the two conditions commonly occur together. Diagnostic criteria include fusion of at least four vertebrae by bony bridges arising from the anterolateral aspect of the vertebral bodies. These vertebral bodies have a 'dripping candle wax' appearance, also can be seen periosteal new bone formation on the anterior surface of the vertebral bodies and there is no ankylosis at zygoapophyseal facet joint. Clinically, patients with DISH tend to be asymptomatic some patients mention moderate pain and stiffness in upper back. This disease is more common in man, uncommon in patients younger than 50 years and rare in patients under 40 years old. In modern populations, DISH is found in association with obesity, (type II) diabetes; abnormal vitamin A metabolism and also associated with higher levels of serum uric acid. There is also some association between the increase of risk of stroke or other cerebrovascular disease. The DISH condition can be confused with Heterotopic Ossification, what is the bone formation in the soft tissues as the result of trauma, wounding, surgery, burnings, prolonged immobility and some central nervous system disorder. All these conditions have been described extensively as myositis ossificans which can be confused with the fibrodysplasia (myositis) ossificans progressive. As in the DISH symptomatology it can be asymptomatic or extensive enough to impair joint function. A third confusion osteoarthritis disease that can bring confusion are the enthesopathies that occur in the entire skeleton being common on the ischial tuberosities, iliac crests, patellae, and calcaneus. Ankylosis of the sacroiliac joint by bony bridges may also be found. CASE 1: this case is skeletal remains presenting skull, some vertebrae and scapulae. This case remains unidentified and due to lack of bone remains. Sex, age and ancestry profile was compromised, however the DISH pathognomonic findings and diagnostic helps to estimate sex and age characteristics. Moreover to presenting DISH these skeletal remains also showed some bone alterations and non-metrics as fusion of the first vertebrae with occipital bone, maxillae and palatine torus and scapular foramen on the right scapulae. CASE 2: this skeleton remains shows an extensive bone heterotopic ossification on the great trochanter area of left femur, right fibula showed a healed fracture in its body however in its inteosseous crest there is an extensive bone growth, also in the Ilium at the region of inferior gluteal line can be observed some pronounced bone growth and the skull presented a pronounced mandibular, maxillary and palatine torus. Despite all these pronounced heterotopic ossification the whole skeleton presents moderate bone overgrowth that is not linked with aging, since the skeleton belongs to a young unidentified individual. The appropriate osteopathological diagnosis support the human identification process through medical reports and also assist with epidemiological data that can strengthen vulnerable anthropological estimates.

Keywords: bone disease, DISH, human identification, human remains

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Authors: Moustafa Ibrahim Moustafa

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The purpose of this study was to determine the immediate and long term effects of a multimodal program, with the addition of cervical sagittal curve restoration and forward head correction, on severity of dizziness, disability, frequency of dizziness, and severity of cervical pain. 72 patients with cervicogenic dizziness, definite hypolordotic cervical spine, and forward head posture were randomized to experimental or a control group. Both groups received the multimodal program, additionally, the study group received the Denneroll cervical traction. All outcome measures were measured at three intervals. The general linear model indicated a significant group × time effects in favor of experimental group on measures of anterior head translation (F=329.4 P < .0005), cervical lordosis (F=293.7 P < .0005), severity of dizziness (F=262.1 P < .0005), disability (F=248.9 P < .0005), frequency of dizziness (F=53.9 P < .0005), and severity of cervical pain (F=350.1 P < .0005). The addition of Dennroll cervical traction to a multimodal program can positively affect dizziness management outcomes.

Keywords: randomized controlled trial, traction, dizziness, cervical

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Authors: Purushottam P. Khatiwada, Bikash Paudel, Ram B. Rana, Parshuram Biswakarma, Roshan Pudasaini

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Nepal has been putting its efforts into securing food and nutrition security for its citizens adopting different models and approaches. Home Garden approach, that integrates vegetables, fruits, small livestock, poultry along with other components like fish, honeybee, mushroom, spices for the promotion of nutritional security of resource-poor and disadvantaged groups was implemented during March 2009 to July 2013 spreading over 16 districts of Nepal covering 115 farmers groups, directly working with 3500 households. Sustained long-term impact of development interventions targeted to the resource-poor and disadvantaged groups has been a recurrent issue for donors, policymakers and practitioners alike. Considering the issue, a post-project evaluation was carried out in a selected project group (Dangibari of Jhapa) after four years of project completion in 2017 in order to evaluate the impact and understand the factors associated with its success. Qualitative information was collected through focus group discussion with group members and associated local institutions. For quantitative information, a quick survey was carried out to the same group members only selecting few indicators. The results are compared with the data obtained from the baseline study conducted by the project in March 2009. The impact of project intervention was evident as compared to the benchmarks established during the baseline, even after four years of project completion. The area under home garden is increased to 729 m² from 386 m² and average food self-sufficiency months increased to 10.22 from 8.11. Seven to eleven fruit species are maintained in the home gardens. An average number of vegetable species grown increased to 15.85 from 9.86. It has resulted in an increase in vegetables self-sufficient month to 8.74 from 4.74 and a huge increase in cash income NPR 6142.8 (USD 59.6) from NPR 385.7 (USD 3.9) from the sale of surplus vegetables. Coaching and mentoring including nutrition sensitization by the project staff at the beginning, inputs and technical support during the project implementation phase and projects effort on the institutional building of disadvantaged farmers were the key drivers of home garden sustainability and expansion. Specifically, package of home garden management trainings provided by the project staff, availability of group funds for buying inputs even after the project, uniting home garden group members in a cooperative, resource leveraging by local institutions through group lobbying, farmers innovations for maintaining home garden diversity and continuous backstopping support by few active members as local resource persons to other members are some additional factors contributing to sustain and/or improve the home garden status by the resource-poor and disadvantaged group.

Keywords: food-based nutrition, home garden, resource-poor and disadvantaged group, sustained impact

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Authors: Yousuf M. Al Suleimani, Robin Hiley

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The endogenous phospholipid lysophosphatidylinositol (LPI) was recently identified as a novel ligand for the G protein-coupled receptor 55 (GPR55) and an inducer of intracellular Ca2+ [Ca2+]i release. This study attempts to characterize Ca2+ signals provoked by LPI in HEK293 cells engineered to stably express human GPR55 and to test cannabinoid ligand activity at GPR55. The study shows that treatment with LPI stimulates a sustained, oscillatory Ca2+ release. The response is characterized by an initial rapid rise, which is mediated by the Gαq-PLC-IP3 pathway, and this is followed by prolonged oscillations that require RhoA activation. Ca2+ oscillations are initiated by intracellular mechanisms and extracellular Ca2+ is only required to replenish Ca2+ lost from the cytoplasm. Analysis of cannabinoid ligand activity at GPR55 revealed no clear effect of the endocannabinoid anandamide, however, rimonabant and the CB1 receptor antagonist AM251 evoked GPR55-mediated [Ca2+]i. Thus, LPI is likely to be a key plasma membrane mediator of signaling events and changes in gene expression through GPR55 activation.

Keywords: lysophosphatidylinositol, calcium, GPR55, cannabinoid

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Authors: Alexander V. Spirov, David M. Holloway, Ekaterina M. Myasnikova

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Segmentation of the early Drosophila embryo results from the dynamic establishment of spatial gene expression patterns. Patterning occurs on an embryo geometry which is a 'deformed' prolate ellipsoid, with anteroposterior and dorsal-ventral major and minor axes, respectively. Patterning is largely independent along each axis, but some interaction can be seen in the 'bending' of the segmental expression stripes. This interaction is not well understood. In this report, we investigate how 3D geometrical features of the early embryo affect the segmental expression patterning. Specifically, we study the effect of geometry on formation of the Bicoid primary morphogenetic gradient. Our computational results demonstrate that embryos with a much longer ventral than dorsal surface ('bellied') can produce curved Bicoid concentration contours which could activate curved stripes in the downstream pair-rule segmentation genes. In addition, we show that having an extended source for Bicoid in the anterior of the embryo may be necessary for producing the observed exponential form of the Bicoid gradient along the anteroposterior axis.

Keywords: Drosophila embryo, bicoid morphogenetic gradient, exponential expression profile, expression surface form, segmentation genes, 3D modelling

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Authors: C. Labate, M. P. De Santo, G. Lombardo, R. Barberi, M. Lombardo, N. M. Ziebarth

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In the past decades, the importance of corneal biomechanics in the normal and pathological functions of the eye has gained its credibility. In fact, the mechanical properties of biological tissues are essential to their physiological function. We are convinced that an improved understanding of the nanomechanics of corneal tissue is important to understand the basic molecular interactions between collagen fibrils. Ultimately, this information will help in the development of new techniques to cure ocular diseases and in the development of biomimetic materials. Therefore, nanotechnology techniques are powerful tools and, in particular, Atomic Force Microscopy has demonstrated its ability to reliably characterize the biomechanics of biological tissues either at the micro- or nano-level. In the last years, we have investigated the mechanical anisotropy of the human corneal stroma at both the tissue and molecular levels. In particular, we have focused on corneal cross-linking, an established procedure aimed at slowing down or halting the progression of the disease known as keratoconus. We have obtained the first evidence that riboflavin/UV-A corneal cross-linking induces both an increase of the elastic response and a decrease of the viscous response of the most anterior stroma at the scale of stromal molecular interactions.

Keywords: atomic force spectroscopy, corneal stroma, cross-linking, viscoelasticity

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Authors: Rajendra Chetty

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This paper analyses the experiences of teachers of literacy in underprivileged schools in the Western Cape, South Africa. The purpose is to provide teachers in poorly resourced schools within economically deprived areas an opportunity to voice their experiences of teaching literacy. The paper is based on an empirical study using interviews and classroom observation. A descriptive account of the observation data was followed by an interpretive analysis. The content analysis of the interview data led to the development of themes and patterns for the discussion. The study reveals key factors for literacy underachievement that include lack of critical and emancipatory pedagogies, resources, parental support, lack of teacher knowledge, absence of cognitive activities, and the social complexity of poverty. The paper recommends that a new model of literacy that is underpinned by critical pedagogy challenge inequality and provides strategic and sustained teacher support in disadvantaged schools is crucial in a society emerging from oppression and racism.

Keywords: critical pedagogy, disadvantaged schools, literacy, poverty

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Authors: Rahal Nacer, Beghdad Houda, Tehami Mohamed, Souici Abdelaziz

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Although the shrinkage of the concrete causes undesirable parasitic effects to the structure, it can then harm the resistance and the good appearance of the structure. Long term behaviourmodelling of steel-concrete composite beams requires the use of the time variable and the taking into account of all the sustained stress history of the concrete slab constituting the cross section. The work introduced in this article is a theoretical study of the behaviour of composite beams with respect to the phenomenon of concrete shrinkage. While using the theory of the linear viscoelasticity of the concrete, and on the basis of the rate of creep method, in proposing an analytical model, made up by a system of two linear differential equations, emphasizing the effects caused by shrinkage on the resistance of a steel-concrete composite beams. Results obtained from the application of the suggested model to a steel-concrete composite beam are satisfactory.

Keywords: composite beams, shrinkage, time, rate of creep method, viscoelasticity theory

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Authors: Mitrajit Biswas

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This paper is trying to understand the issues related to maintaining a fan base over a period of time. The paper would be trying to look into how the fan base can be actually engaged. That is what are the attributes of keeping a fan base interested and not feeling fatigued or tired. It would also try to understand that what are the key elements required for a franchise to be active and keep the fans engaged. The paper would look to understand the primary elements of a franchise like Marvel to keep the fans engaged for such a long period of time. This will help to improve the scope of literature on consumer engagement and consumption behaviour in modern times of unpredictability. It will also help to understand how the consumers take in a longer period of engagement. This would help to understand that despite huge success and investment in fan engagement and what could be the possible reasons for disengagement? This would include in-depth interviews with a global sample of around 50 people, which would be connected through purposive, convenient, and snowball sampling. It will help to understand whether the customer lifetime value as a theory can be sustained based on customer relationship management. If yes, how can products from certain companies predict and keep up the strategy for the prediction of the consumer engagement process?

Keywords: consumption, fatigue, brand loyalty, sustainable consumption

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Authors: Pauline Calleja, Brooke Alexander

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In 2010 the College of Emergency Nursing Australasia (CENA) undertook sole administration of the Trauma Nursing Program (TNP) across Australia. The original TNP was developed from recommendations by the Review of Trauma and Emergency Services-Victoria. While participant and faculty feedback about the program was positive, issues were identified that were common for industry training programs in Australia. These issues included didactic approaches, with many lectures and little interaction/activity for participants. Participants were not necessarily encouraged to undertake deep learning due to the teaching and learning principles underpinning the course, and thus participants described having to learn by rote, and only gain a surface understanding of principles that were not always applied to their working context. In Australia, a trauma or emergency nurse may work in variable contexts that impact on practice, especially where resources influence scope and capacity of hospitals to provide trauma care. In 2011, a program review was undertaken resulting in major changes to the curriculum, teaching, learning and assessment approaches. The aim was to improve learning including a greater emphasis on pre-program preparation for participants, the learning environment and clinically applicable contextualized outcomes participants experienced. Previously if participants wished to undertake assessment, they were given a take home examination. The assessment had poor uptake and return, and provided no rigor since assessment was not invigilated. A new assessment structure was enacted with an invigilated examination during course hours. These changes were implemented in early 2012 with great improvement in both faculty and participant satisfaction. This presentation reports on a comparison of participant evaluations collected from courses post implementation in 2012 and in 2015 to evaluate if positive changes were sustained. Methods: Descriptive statistics were applied in analyzing evaluations. Since all questions had more than 20% of cells with a count of <5, Fisher’s Exact Test was used to identify significance (p = <0.05) between groups. Results: A total of fourteen group evaluations were included in this analysis, seven CENA TNP groups from 2012 and seven from 2015 (randomly chosen). A total of 173 participant evaluations were collated (n = 81 from 2012 and 92 from 2015). All course evaluations were anonymous, and nine of the original 14 questions were applicable for this evaluation. All questions were rated by participants on a five-point Likert scale. While all items showed improvement from 2012 to 2015, significant improvement was noted in two items. These were in regard to the content being delivered in a way that met participant learning needs and satisfaction with the length and pace of the program. Evaluation of written comments supports these results. Discussion: The aim of redeveloping the CENA TNP was to improve learning and satisfaction for participants. These results demonstrate that initial improvements in 2012 were able to be maintained and in two essential areas significantly improved. Changes that increased participant engagement, support and contextualization of course materials were essential for CENA TNP evolution.

Keywords: emergency nursing education, industry training programs, teaching and learning, trauma education

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Authors: Hocine Hammoum, Karima Bouzelha, Lounis Ziani, Lounis Hamitouche

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In this paper, we study a complex structure which is an apartment building surmounted by a reinforced concrete water tank. The tank located on the top floor of the building is a container with capacity of 1000 m³. The building is complex in its design, its calculation and by its behavior under earthquake effect. This structure located in Algiers and aged of 53 years has been subjected to several earthquakes, but the earthquake of May 21^st, 2003 with a magnitude of 6.7 on the Richter scale that struck Boumerdes region at 40 Kms East of Algiers was fatal for it. It was downgraded after an investigation study because the central core sustained serious damage. In this paper, to estimate the degree of its damages, the seismic performance of the structure will be evaluated taking into account the hydrodynamic effect, using a static equivalent nonlinear analysis called pushover.

Keywords: performance analysis, building, reinforced concrete tank, seismic analysis, nonlinear analysis, hydrodynamic, pushover

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Authors: Karen Cilliers, Benedict John Page

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The middle cerebral artery (MCA) is the most complex cerebral artery although few anomalies are found compared to the other cerebral arteries. The branches of the MCA cover a large part of each hemisphere, therefore it is exposed in various operations. Although the segments of the MCA are similarly described by most authors, there is some disagreement on the branching pattern of the MCA. The aim of this study was to review the available literature on the anatomy and variations of the MCA, and to compare this to a pilot study. For the pilot study, 20 hemispheres were perfused with coloured silicone and the MCA was dissected. According to the literature, the two most common branching configurations are the bifurcating and trifurcating patterns. In the pilot study, bifurcation was observed in 19 hemispheres, and in one hemisphere there was no branching (monofurcation). No trifurcation was observed. The most commonly duplicated branch was the anterior parietal artery in 30%, and most commonly absent was the common temporal artery in 65% and the temporal polar artery in 40%. Very few studies describe the origins of the branches of the MCA, therefore a detailed description is given. Middle cerebral artery variations that are occasionally reported in the literature include fenestration, and a duplicated or accessory MCA, although no variations were observed in the pilot study. Aneurysms can frequently be observed at the branching of cerebral vessels, therefore a thorough knowledge of the vascular anatomy is vital. Furthermore, knowledge of possible variations is important since variations can have serious clinical implications.

Keywords: anatomy, anomaly, description, middle cerebral artery, origin, variation

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Authors: Hussain Ali Bekhet, Nor Hamisham Harun

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The main objective of this paper is to give a comprehensive review of non-renewable energy and renewable energy utilization in Malaysia, including hydropower, solar photovoltaic, biomass and biogas technologies. Malaysia mainly depends on non-renewable energy (natural gas, coal and crude oil) for electricity generation. Therefore, this paper provides a comprehensive review of the energy sector and discusses diversification of electricity generation as a strategy for providing sustainable energy in Malaysia. Energy policies and strategies to protect the non-renewable energy utilization also are highlighted, focusing in the different sources of energy available for high and sustained economic growth. Emphasis is also placed on a discussion of the role of renewable energy as an alternative source for the increase of electricity supply security. It is now evident that to achieve sustainable development through renewable energy, energy policies and strategies have to be well designed and supported by the government, industries (firms), and individual or community participation. The hope is to create a positive impact on sustainable development through renewable sources for current and future generations.

Keywords: Malaysia, non-renewable energy, renewable energy, sustainable energy

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Authors: Ravinesh C. Deo

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This article reviews the role of nozzle-exit conditions on the flow field of a plane jet. The jet issuing from a sharp-edged orifice plate at a Reynolds number (Re=18000) with nozzle aspect ratio (AR=72) exhibits the greatest shear-layer instabilities, highest entrainment and jet-spreading rates compared to the radially contoured nozzle. The growth rate of the shear-layer is the highest for the orifice-jet although this property could be amplified for larger Re or AR. A local peak in turbulent energy is found at x=10h. The peak appears to be elevated for an orifice-jet with lower Re or AR. The far-field energy sustained by the orifice-jet exceeds the contoured case although a higher Re and AR may enhance this value. The spectra displays the largest eddies generated by the contoured nozzle. However, the frequency of coherent eddies is higher for the orifice-jet, with a larger magnitude achievable for lower Re and AR.

Keywords: plane jet, Reynolds number, nozzle-exit conditions, nozzle geometry, aspect ratio

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Authors: Maria Georgiou

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This study examined whether there was a statistically significant difference between pretest and posttest achievement scores for students who received multimedia-based instructions in science. The paired samples t-test was used to address the research question and to establish whether there was a significant difference between pretest and posttest scores that may have occurred based on the students’ learning experience with multimedia technology. Findings indicated that there was a significant difference in students’ achievement scores before and after a multimedia-based instruction. Students’ achievement scores were increased by approximately two points, after students received multimedia-based instruction. On a paired samples t-test, a high level of significance was found, p = 0.000. Opportunities to learn with multimedia are more likely to result in sustained improvements in student achievement and a deeper understanding of science content. Multimedia can make learning more active and student-centered and activate student motivation.

Keywords: constructivist learning, hyperstudio, multimedia, multimedia-based instruction

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Authors: Usama Mohamed Ahamed

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This research deals with the bond behavior of carbon FRP composite wraps adhered/bonded to the surface of the concrete. Four concrete mixes were designed to achieve a concrete compressive strength of 18, 22.5,25 and 30 MP after 28 days of curing. The focus of the study is on bond degradation when the hybrid structure is exposed to hot weather conditions. Specimens were exposed to 50 0C temperature duration 6 months and other specimens were sustained in laboratory temperature ( 20-24) 0C. Upon removing the specimens from their conditioning environment, tension tests were performed in the machine using a specially manufactured concrete cube holder. A lightweight mortar layer is used to protect the bonded carbon FRP layer on the concrete surface. The results show that the higher the concrete's compressive, the higher the bond strength. The high temperature decreases the bond strength between concrete and carbon fiber-reinforced polymer. The use of a protection layer is essential for concrete exposed to hot weather.

Keywords: concrete, bond, hot weather and carbon fiber, carbon fiber reinforced polymers

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Authors: Ibrahim Ahmed Jajere

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Resource use conflicts capable of undermining of pastoralists’ livelihoods are on the increase in the North East Arid Zone of Nigeria. In order to expose socio - economic effects of conflicts and benefits of peace, this study assessed cost implications of farmers/pastoralists conflicts over natural resources. Interviews were conducted with 94 farmers, 90 agro-pastoralists and 91 pastoralists’ household heads. The farmers and agro-pastoralists were systematically sampled while pastoralists were located using snowballing. Both farmers and pastoralists suffered losses in the form of injuries to, and even death of household members, and loss of shelter. Farmers sustained losses of facilities and farm produce while pastoralists suffered loss and seizure of livestock, arrest of household members and forced migrations. The material losses in monetary terms amounted to 14,242,200.00 nairas for farmers, a figure higher than the 10,915,500.00 nairas incurred by pastoralists.

Keywords: cost, conflicts, farmers, pastoralists

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Authors: Clare Victoria Martin

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With reports of increased mental health problems and a lack of proactive, consistent well-being initiatives, well-being is a topical issue in the workplace, as well as a wider public health concern. Additionally, workplace well-being is closely linked to performance, both from a business perspective and in psychological research. Businesses are therefore becoming increasingly motivated to promote well-being, yet there are still barriers, including a lack of evidence-based workplace interventions, issues with measuring effectiveness and problems creating lasting cultural change. This review aimed to collate workplace well-being research to propose a comprehensive new model for delivering evidence-based workplace well-being training with a real potential for lasting impact. Method: A narrative review was conducted to meta-synthesise relevant research. Thematic analysis was then adopted as a systematic method of identifying key themes from the review to lead to practical recommendations. Interventions focusing on strengths, psychological capital, mindfulness and positivity (SPMP) dominated the research in this area, suggesting benefits of incorporating all four into training. However, to avoid a ‘quick fix’ mentality, the concept of training ‘well-being ambassadors’ as a preventative counterpart to mental health ‘first aiders’ was proposed alongside a new ‘REST and RISE’ model: well-being interventions should be ‘relatable’, ‘enjoyable’, ‘sociable’ and ‘trackable’ (REST) in order to increase ‘resilience’, ‘innovation’, ‘strengths’ and ‘engagement’ (RISE). If the REST principles are applied to interventions focusing on SPMP, research suggests individuals will RISE. Future research should empirically test this new well-being ambassador programme and REST/RISE model in an applied setting.

Keywords: performance, positive psychology, thriving, workplace well-being

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Authors: Ritesh Verma, Manisha Rathi, Chand Singh Dhull, Sumit Sachdeva, Jitender Phogat

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A Rathke's cleft cyst is a benign growth found on the pituitary gland in the brain, specifically a fluid-filled cyst in the posterior portion of the anterior pituitary gland. It occurs when the Rathke's pouch does not develop properly and ranges in size from 2 to 40mm in diameter. A 38-year-old male presented to the outpatient department with loss of vision in the inferior quadrant of the left eye since 15 days. Visual acuity was 6/6 in the right eye and 6/9 in the left eye. Visual field analysis by HFA-24-2 revealed an inferior field defect extending to the supero-temporal quadrant in the left eye. MRI brain and orbit was advised to the patient and it revealed a well defined cystic pituitary adenoma indenting left optic nerve near optic chiasm consistent with the diagnosis of Rathke’s cleft cyst (RCC). The patient was referred to neurosurgery department for further management. Symptoms vary greatly between individuals having RCCs. RCCs can be non-functioning, functioning, or both. Besides headaches, neurocognitive deficits are almost always present but have a high rate of immediate reversal if the cyst is properly treated or drained.

Keywords: pituitary tumors, rathke’s cleft cyst, visual field defects, vision loss

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Authors: Nikhat Iqbal Tamboli

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INTRODUCTION: road traffic accidents (RTAs) are one of the leading and common causes of ocular injuries especially in developing countries like India which are preventable with certain measures and so it is of public health importance. AIM: To study incidence and clinical presentation of ocular morbidity in road traffic accidents. METHOD: Prospective cross-sectional study was conducted on 360 patients reported in department of ophthalmology. Detailed ocular examination and relevant investigations done. RESULTS: Incidence of ocular injuries is 23%. male:female ratio is 4.5:1.Cases having Sub conjunctival haemorrhage [74].eccymosis[217]. lid lcerations [164]orbital fracture[12] corneal tear [7]corneal abrasion[2] sclera tear[6] hyphaema[4] traumatic mydriasis [7]traumatic cataract [2]vitreous haemorrhage [1]traumatic optic neuropathy[1].Maximum cases in age group 20-40 years, with two wheeler vehicles 94.7% .Under influence of alcohol 13.3%. CONCLUSION: Younger age group with male preponderance is involved in ocular trauma due to road traffic accidents .maximum cases reported are with anterior segment injuries. Alcohol and two wheeler vehicles are common risk factors. Injuries involving cornea had bad prognosis and involving retina had worst prognosis.

Keywords: ocular morbidity, eye trauma, RTA, eye injury

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Authors: Krista Mae F. Ramos, Lance Micaiah C. Dauz, Gylza Nicole D. Bautista, Rua R. Galang, Jeric Xyrus G. Karganilla

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With the recent proclamation of the possible reinforcement of Compulsory Military Service in the Philippines, debates and societal talks rose and circulated as opinions and perceptions regarding the topic continue to clash. This study aims to determine the perception of the youth on its reimplementation and identify various advantages and disadvantages based on their perspective. The responses were gathered through a virtual call interview, underwent the process of thematization, and were categorized into different themes. Results reflect that the students perceive compulsory military service as a necessity for national defense but requires a long time that can hinder their education and needs a strong foundation to be implemented and sustained. The participants acknowledged that the practice would instill discipline, patriotism, and nationalism, develop an individual’s physical abilities, provide skills and knowledge and improve a person’s self-defense. However, there are also concerns regarding the prominent military shaping and abuse, their loss of freedom of choice, and the chances of health deterioration.

Keywords: compulsory, military, service, reinforcement, perception

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Authors: H. Merhni, A. Sbiti, I. Ratbi, A. Sefiani

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The proximal spinal muscular atrophy (SMA) is a group of neuromuscular disorders characterized by progressive muscle weakness due to the degeneration and loss of anterior motor neurons of the spinal cord. Depending on the age of onset of symptoms and their evolution, four types of SMA, varying in severity, result in a mutations of the SMN gene (survival of Motor neuron). We have analyzed the DNA of 295 patients referred to our genetic counseling; since January 1996 until October 2014; for suspected SMA. The homozygous deletion of exon 7 of the SMN gene was found in 133 patients; of which, 40.6% were born to consanguineous parents. In countries like Morocco, where the frequency of heterozygotes for SMA is high, genetic testing should be offered as first-line and, after careful clinical assessment, especially in newborns and infants with congenital hypotonia unexplained and prognosis compromise. The molecular diagnosis of SMA allows a quick and certainly diagnosis, provide adequate genetic counseling for families at risk and suggest, for couples who want prenatal diagnosis. The analysis of the SMN gene is a perfect example of genetic testing with an excellent cost/benefit ratio that can be of great interest in public health, especially in low-income countries. We emphasize in this work for the benefit of the generalization of molecular diagnosis of SMA by the technique of PCR-enzymatic digestion in other centers in Morocco.

Keywords: Exon7, PCR-digestion, SMA, SMN gene

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Authors: Jahnavi Priya Alluri, Sarang Barbarwar

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With over 6000 years of sustained civilization, India has been home to diverse social customs and various communities. The country’s culture and architecture have been profoundly impacted by the extensive variation in its geography and climatic conditions. In its history, many kingdoms have ruled in the South Indian state of Andhra Pradesh. The vernacular constructions of this region have progressed considerably in this period. The paper discusses the impact on vernacular architecture in Venkatagiri, Andhra Pradesh, post the arrival of the British. The town was a small settlement that finds its roots in the Vijaynagara Empire. The study tries to highlight the amalgamation of colonial influences on the local construction techniques and material usage. It discusses the new variation in the style of architecture through the case of Venkatagiri Palace and its precincts. The paper also discusses the traits of distinction in the influence through various social and economic groups of the old city of the same town.

Keywords: vernacular architecture, colonial architecture, Venkatagiri, south Indian vernacular

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Authors: Mona Vijayaran, Gurleen Oberoi, Sanjay Mishra

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Introduction: p190 BCR‐ABL1 in CML is often associated with monocytosis. In the case described here, monocytosis is associated with coexisting p210 BCR‐ABL and CMML clones. Mutation analysis using next‐generation sequence (NGS) in our case showed TET2 and SRSF2 mutations. Aims & Objectives: A 75-year male was evaluated for monocytosis and thrombocytopenia. CBC showed Hb-11.8g/dl, TLC-12,060/cmm, Monocytes-35%, Platelets-39,000/cmm. Materials & Methods: Bone marrow examination showed a hypercellular marrow with myeloid series showing sequential maturation up to neutrophils with 30% monocytes. Immunophenotyping by flow cytometry from bone marrow had 3% blasts. Making chronic myelomonocytic leukemia as the likely diagnosis. NGS for myeloid mutation panel had TET2 (48.9%) and SRSF2 (32.5%) mutations. This report further supported the diagnosis of CMML. To fulfil the WHO diagnostic criteria for CMML, a BCR ABL1 by RQ-PCR was sent. The report came positive for p210 (B3A2, B2A2) Major Transcript (M-BCR) % IS of 38.418. Result: The patient was counselled regarding the unique presentation of the presence of 2 clones- P210 CML and CMML. After discussion with an international faculty with vast experience in CMML. It was decided to start this elderly gentleman on Imatinib 200mg and not on azacytidine, as ASXL1 was not present; hence, his chances of progressing to AML would be less and on the other end, if CML is left untreated then chances of progression to blast phase would always be a possibility. After 3 months on Imatinib his platelet count improved to 80,000 to 90,000/cmm, but his monocytosis persists. His 3rd month BCR-ABL1 IS% is 0.004%. Conclusion: After searching the literature, there were no case reports of a coexisting CML p210 with CMML. This case might be the first case report. p190 BCR ABL1 is often associated with monocytosis. There are few case reports of p210 BCR ABL1 positivity in patients with monocytosis but none with coexisting CMML. This case highlights the need for extensively evaluating patients with monocytosis with next-generation sequencing for myeloid mutation panel and BCR-ABL1 by RT-PCR to correctly diagnose and treat them.

Keywords: CMML, NGS, p190 CML, Imatinib

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Authors: Mohammed Saleem Tariq

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The enthusiasm for gluten avoidance in a growing market is met by improvements in sensitive detection methods for analysing gluten content. Paradoxically, manufacturers employ no such systems in the production process but continue to market their product as gluten free, a significant risk posed to an undetermined coeliac population. The paper resonates with an immunological response that causes gastrointestinal scarring and villous atrophy with the conventional description of personal injury. The current developing regime in the UK however, it is discussed, has avoided creating specific rules to provide an adequate level of protection for this type of vulnerable ‘characteristic’. Due to the struggle involved with identifying an appropriate cause of action, this paper analyses whether a claim brought in misrepresentation, negligence and/or under the Consumer Protect Act 1987 could be sustained. A necessary comparison is then made with the approach adopted by the Americans with Disability Act 1990 which recognises this chronic disease as a disability. The ongoing failure to introduce a level of protection which matches that afforded to those who fall into any one of the ‘protected characteristics’ under the Equality Act 2010, is inconceivable given the outstanding level of legal vulnerability.

Keywords: coeliac, litigation, misrepresentation, negligence

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Authors: Sydelle Barreto

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Sexual liberation has been thought of as a movement, an idea, and an antithesis of material oppression. Within feminism it has consistently resisted definition - different feminist schools of thought had entirely different constructions of what liberated feminine sexuality could look like and how we might get there. This paper will critique the current definition of sexual liberation as being limited and carceral in its perspectives of sexual assault and extremely reductive in its imaginings of sexual liberation. The ultimate goal of this assessment is to potentially outline what true sexual liberation might look like in a way that is inclusive but not ignorant of the realities of the patriarchy. The first critique of sexual liberation included in the paper centers around the limits of consent, carceral feminism and sexual subjectivity. The argument will build off the traditionally sex-negative critiques of consent as being limited in scope by explaining how a lack of nuance is even more dangerous to victims of sexual violations. The discussion will also expand an interrogant of consent to an interrogation of wantedness and desire. If we understand that critiquing the conditions of consent is important, we must also critique the way patriarchy and compulsory sexuality have affected desire. Using the aforementioned concept of compulsory sexuality, the paper will argue that while sexual liberation has begun to include queer and transgender individuals, it is still overwhelmingly allonormative. Sex positivity and its opponents both fail to include asexuality. This ultimately leads to a conflation of sexual liberation with genuine material liberation. Just as we cannot divorce our constructions of sexual liberation from the realities of the patriarchy and rape culture, we should consider compulsory sexuality as its own system of social regulation. The conclusion will begin to construct an alternative vision of sexual liberation, leveraging concepts of sexual subjectivity, including a rejection of carceral feminism as a response to sexual violence, and finally, leading to the beginnings of a deconstruction of compulsory sexuality. The paper concludes with a vision of sexual liberation that does not confuse itself with material liberation or mere sexual oppression, but rather a key way stops on the road to constructing our most authentic sexual selves.

Keywords: feminism, sexual assault, sexual liberation, consent

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Authors: Jyotismita Talukdar

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In this paper, a study has been made on the possibility and accuracy of early prediction of several Heart Disease using Artificial Neural Network. (ANN). The study has been made in both noise free environment and noisy environment. The data collected for this analysis are from five Hospitals. Around 1500 heart patient’s data has been collected and studied. The data is analysed and the results have been compared with the Doctor’s diagnosis. It is found that, in noise free environment, the accuracy varies from 74% to 92%and in noisy environment (2dB), the results of accuracy varies from 62% to 82%. In the present study, four basic attributes considered are Blood Pressure (BP), Fasting Blood Sugar (FBS), Thalach (THAL) and Cholesterol (CHOL.). It has been found that highest accuracy(93%), has been achieved in case of PPI( Post-Permanent-Pacemaker Implementation ), around 79% in case of CAD(Coronary Artery disease), 87% in DCM (Dilated Cardiomyopathy), 89% in case of RHD&MS(Rheumatic heart disease with Mitral Stenosis), 75 % in case of RBBB +LAFB (Right Bundle Branch Block + Left Anterior Fascicular Block), 72% for CHB(Complete Heart Block) etc. The lowest accuracy has been obtained in case of ICMP (Ischemic Cardiomyopathy), about 38% and AF( Atrial Fibrillation), about 60 to 62%.

Keywords: coronary heart disease, chronic stable angina, sick sinus syndrome, cardiovascular disease, cholesterol, Thalach

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Authors: Sayeeda Laeque Bangi

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Objectives: Treating white spot lesions (WSL) to create a sound and esthetically pleasing enamel surface is a question yet to be fully answered. The objective of this randomized controlled trial was to measure and compare the degree of regression of WSL during orthodontic treatment achieved by using three commercially available materials. Methods: A single-blinded randomized prospective clinical trial, comprising 80 patients categorized into four groups (one control group and three experimental groups, with 20 subjects per group) using block randomization, was conducted. Group A (control group): Colgate strong toothpaste; and experiments groups were Group B: GC tooth mousse, Group C: Phos-Flur mouthwash and Group D: SHY-NM. Subjects were instructed to use the designated dentifrice/mouthwash and photographs were taken at baseline, third and sixth months, and white spot lesions were reassessed in the maxillomandibular anterior teeth. Results: All the three groups had shown an improvement in WSL. But Group B has shown the greatest difference in mean values of decalcification index (DI) scores. Conclusion: All three commercially available products showed a regression of WSL over a 6-month duration. GC tooth mousse proved to be the most effective means of treating WSL over other regimens.

Keywords: white spot lesions, dentifrices, orthodontic therapy, remineralization

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