Search results for: visual history

Authors: Mohamed Salah El-Din Mahmoud, Heba Radi Atta Allah

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Background: Our study assesses the safety profile and efficacy of toric Implantable Collamer Lens (T-ICL) and toric implantable phakic contact lens (IPCL) for the correction of high myopia with astigmatism. Methods: A prospective interventional randomized comparative study included 60 myopic eyes divided into 2 groups, group A including 30 eyes that were implanted with T-ICL, and group B including 30 eyes that were implanted with toric IPCL. The refractive results, visual acuity, corneal endothelial cell count, and intraocular pressure (IOP) were evaluated at baseline and at 1, 6, and 9 months post-surgery. Any complications either during or after surgery were assessed. Results: A significant reduction in both spherical and cylindrical refractive errors with good predictability was reported in both groups compared with preoperative values. Regarding the predictability, In T-ICL group (A), the median spherical and cylindrical errors were significantly improved from (-10 D & -4.5 D) pre-operatively to (-0.25 D & - 0.3 D) at the end of 9 months follow up period. Similarly, in the toric IPCL group (B), the median spherical and cylindrical errors were significantly improved from (-11 D & -4.5 D) pre-operatively to (-0.25 D & - 0.3 D) at the end of 9 months follow up period. A statistically significant improvement of UCDVA at 9 months postoperatively was found in both groups, as median preoperative Log Mar UCDVA was 1.1 and 1.3 in groups A and B respectively, which was significantly improved to 0.2 in both groups at the end of follow-up period. Regarding IOP, no significant difference was found between both groups, either pre-operatively or during the postoperative period. Regarding the endothelial count, no significant differences were found during the pre-operative and postoperative follow-up periods between the two groups. Fortunately, no intra or postoperative complications as cataract, keratitis or lens decentration had occurred. Conclusions: Toric IPCL is a suitable alternative to T-ICL for the management of high myopia with astigmatism, especially in developing countries, as it is cheaper and easier for implantation than T-ICL. However, data over longer follow-up periods are needed to confirm its safety and stability.

Keywords: T-ICL, Toric IPCL, IOP, corneal endothelium

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Authors: Maria Jose Granero Paris, Ana Isabel Jimenez Zarco, Agustin Pablo Alvarez Herranz

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In the industrial sector the collaboration along the supply chain is key especially in order to develop product, production methods or process innovations. The access to resources and knowledge not being available inside the company, the achievement of cost competitive solutions, the reduction of the time required to innovate are some of the benefits linked with the collaboration with suppliers. The big industrial manufacturers have a long tradition to collaborate with their suppliers to develop new products in the developed countries. Since they have increased their global supply chains and global sourcing activities, the objective of the research is to analyse if the same best practices, way of working, experiences, information technology tools, governance methodologies are applied when collaborating with suppliers in the developed world or in developing countries. Most of the current research focuses to analyse the Supply Chain Collaboration in the developed countries and in recent years the number of publications related to the Supply Chain Collaboration in developing countries has increased, but there is still a lack of research comparing both and analysing the similarities, differences and key success factors among the Supply Chain Collaboration practices in developed and developing countries. With this gap in mind, the research under preparation will focus on the following goals: -Identify the most important elements required for a successful supply chain collaboration in the developed and developing countries. -Set up the optimal governance framework to manage the supply chain collaboration in the developed and developing countries. -Define some recommendations about required improvements in the current supply chain collaboration business relationship practices in place. Following the case methodology we will analyze the way manufacturers and suppliers collaborate in the development of new products, production methods or process innovations and in the set up of new global supply chains in two industries with different level of technology intensity and collaboration history being the automotive and aerospace industries.

Keywords: global supply chain networks, Supply Chain Collaboration, supply chain governance, supply chain performance

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Authors: Mohaammad Ahmadpanah, Amineh Akhondi, Mohammad Haghighi, Ali Ghaleiha, Leila Jahangard, Elham Salari

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Background: Working memory includes the capability to keep and manipulate information in a short period of time. This capability is the basis of complicated judgments and has been attended to as the specific and constant character of individuals. Children with attention deficit and hyperactivity are among the people suffering from deficiency in the active memory, and this deficiency has been attributed to the problem of frontal lobe. This study utilizes a new approach with suitable tasks and methods for training active memory and assessment of the effects of the trainings. Participants: The children participating in this study were of 7-15 year age, who were diagnosed by the psychiatrist and psychologist as hyperactive and attention deficit based on DSM-IV criteria. The intervention group was consisted of 8 boys and 6 girls with the average age of 11 years and standard deviation of 2, and the control group was consisted of 2 girls and 5 boys with an average age of 11.4 and standard deviation of 3. Three children in the test group and two in the control group were under medicinal therapy. Results: Working memory training meaningfully improved the performance in not-trained areas as visual-spatial working memory as well as the performance in Raven progressive tests which are a perfect example of non-verbal, complicated reasoning tasks. In addition, motional activities – measured based on the number of head movements during computerized measuring program – was meaningfully reduced in the medication group. The results of the second test showed that training similar exercise to teenagers and adults results in the improvement of cognition functions, as in hyperactive people. Discussion: The results of this study showed that the performance of working memory is improved through training, and these trainings are extended and generalized in other areas of cognition functions not receiving any training. Trainings resulted in the improvement of performance in the tasks related to prefrontal. They had also a positive and meaningful impact on the moving activities of hyperactive children.

Keywords: attention deficit hyperactivity disorder, working memory, non-medical treatment, children

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Authors: Sally Ibrahim, Mohamed Hedia, Mohamed Taqi, Mohamed Derbala, Karima Mahmoud, Youssef Ahmed, Sayed Ismail, Mohamed El-Belely

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The identification and quantification of serum microRNA (miRNA) from mares with endometritis might serve as useful and implementable clinical biomarkers for the early diagnosis of endometiritis. Aims of the current study were (I) to study the expression pattern of eca-miR-155, eca-miR-223, eca-miR-17, eca-miR-200a, and eca-miR-205, and (II) to determine the levels of interleukin 6 (IL-6), prostaglandins (PGF₂α and PGE₂), in the serum of Arabian mares with healthy and abnormal uterine status (endometritis). This study was conducted on 80 Arabian mares (4-14 years old). Mares were divided into 48 sub-fertile mares suspected of endometritis and 32 fertile at stud farms. The criteria for mares to be enrolled in the endometritis group were that they had been bred three or more times unsuccessfully in the breeding season or had a history of more than one year of reproductive failure. In addition, two or more of the following criteria on a checklist were present: abnormal clinical findings, transrectal ultrasonographic uterine examination showed abnormal fluid in the uterus (echogenic or ≥2 cm in diameter), positive endometrial cytology; and bacterial and/or fungal growth. Serum samples were collected for measuring IL-6, PGF₂α, and PGE₂ concentrations, as well as serum miRNA isolation and quantitative real-time PCR. Serum concentrations of IL-6, PGE₂, and PGF₂α were higher (P ≤ 0.001) in mares with endometritis compared to the control healthy ones. The expression profile of eca-miR-155, eca-miR-223, eca-miR-17, eca-miR-200a, and eca-miR-205 increased (P≤0.001) in mares with endometritis compared to the control ones. To the best of our knowledge, this is the first study that revealed that serum miRNA and serum inflammatory mediators (IL-6, PGE₂, and PGF₂α) could be used as non-invasive gold standard biomarkers, and therefore might be served as an important additional diagnostic tool for endometritis in Arabian mares. Moreover, estimation of the serum concentrations of serum miRNA, IL-6, PGE₂, and PGF₂α is a promising recommended tool during the breeding soundness examination in mares.

Keywords: Arabian Mares, endometritis, inflammatory mediators, serum miRNA

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Authors: Muhammad Shahid Shah, Akram Maqbool, Samina Ashraf

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Since start of this century, world has adopted inclusion as a trend in special education. To meet the challenges of inclusion response, the Punjab government has developed a progressive policy to implement inclusive education. The objectives of this research were to analyze the administration and implementation process by consideration on the management, student’s admission process, screening and assessment, adaptations in curriculum and instruction along with an evaluation, government and nonprofit organizations support. The sample consisted of 50 schools both public and private with a total of 3000 students, 9 percent of which (270) were students with disabilities. Among all the students with disabilities, 63 percent (170) were male and 37 percent (100) were female. The concluded remarks regarding management revealed that a large number of inclusive schools was lacking in terms of developing a certain model for inclusion, including the managerial breakup of staff, the involvement of stakeholders, and conducted frequent meetings. Many of schools are not able to restructure their school organizations due to lack of financial resources, consultations, and backup. As for as student’s admission/identification/assessment was concerned, only 12 percent schools applied a selection process regarding student admission, half of which used different procedures for disable candidates. Approximately 5 percent of inclusive schools had modified their curriculum, including a variety of standards. In terms of instruction, 25 percent of inclusive schools reported that they modified their instructional process. Only a few schools, however, provided special equipment for students with visual impairment, physical impairment, speech and hearing problems, students with mild intellectual disabilities, and autism. In a student evaluation, more than 45 percent reported that test items, administration, time allocations, and students’ reports were modified. For the primary board examination conducted by the Education Department of Government of Punjab, this number decreased dramatically. Finally, government and nonprofit organizations support in the forms of funding, coaching, and facilities were mostly provided by provincial governments and by Ghazali Education Trust.

Keywords: inclusion, identification, assessment, funding, facilities, evaluation

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Authors: Hammache Nadir

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The scientific study of human learning and memory is now more than 125 years old. Psychologists have conducted thousands of experiments, correlational analyses, and field studies during this time, in addition to other research conducted by those from neighboring fields. A huge knowledge base has been carefully built up over the decades. Given this backdrop, we may ask ourselves: What great changes in education have resulted from this huge research base? How has the scientific study of learning and memory changed practices in education from those of, say, a century ago? Have we succeeded in building a translational educational science to rival medical science (in which biological knowledge is translated into medical practice) or types of engineering (in which, e.g., basic knowledge in chemistry is translated into products through chemical engineering)? The answer, I am afraid, is rather mixed. Psychologists and psychological research have influenced educational practice, but in fits and starts. After all, some of the great founders of American psychology—William James, Edward L. Thorndike, John Dewey, and others—are also revered as important figures in the history of education. And some psychological research and ideas have made their way into education—for instance, computer-based cognitive tutors for some specific topics have been developed in recent years—and in years past, such practices as teaching machines, programmed learning, and, in higher education, the Keller Plan were all important. These older practices have not been sustained. Was that because they failed or because of a lack of systematic research showing they were effective? At any rate, in 2012, we cannot point to a well-developed translational educational science in which research about learning and memory, thinking and reasoning, and related topics is moved from the lab into controlled field trials (like clinical trials in medicine) and the tested techniques, if they succeed, are introduced into broad educational practice. We are just not there yet, and one question that arises is how we could achieve a translational educational science.

Keywords: affective, education, cognition, pshychology

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Authors: Charles Iledun Oyewole

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The daunting challenge that the ‘man with the hoe’ is going to face in the coming decades will be complex and interwoven. With global population already above 7 billion people, it has been estimated that food (crop) production must more than double by 2050 to meet up with the world’s food requirements. Nigeria population is also expected to reach over 240 million people by 2050, at the current annual population growth of 2.61 per cent. The country’s farming population is estimated at over 65 per cent, but the country still depends on food importation to complement production. The small scale farmer, who depends on simple hand tools: hoes and cutlasses, remains the centre of agricultural production, accounting for 90 per cent of the total agricultural output and 80 per cent of the market flow. While the hoe may have been a tool for sustainable development at a time in human history, this role has been smothered by population growth, which has brought too many mouths to be fed (over 170 million), as well as many industries to fuel with raw materials. It may then be argued that the hoe is unfortunately not a tool for the coming challenges and that agricultural mechanization should be the focus. However, agriculture as an enterprise is a ‘complete wheel’ which does not work when broken, particularly, in respect to mechanization. Generally, mechanization will prompt increase production, where land is readily available; increase production, will require post-harvest handling mechanisms, crop processing and subsequent storage. An important aspect of this is readily available and favourable markets for such produce; fuel by good agricultural policies. A break in this wheel will lead to the process of mechanization crashing back to subsistence production, and probably reversal to the hoe. The focus of any agricultural policy should be to chart a course for sustainable mechanization that is environmentally friendly, that may ameliorate Nigeria’s food and raw material gaps. This is the focal point of this article.

Keywords: Crop production, Farmer, Hoes, Mechanization, Policy framework, Population, Growth, Rural areas

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Authors: Matthew Armitt

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The revolutionary school of architectural teaching – VKhUTEAMAS (1923-1926) was a new approach for a new society bringing architectural education to the masses and masses to the growing industrial production. The school's pedagogical contribution of the 1920s made it an important school of the modernist movement, engaging pedagogy as a mode of experimentation. The teachers and students saw design education not just as a process of knowledge transfer but as a vehicle for design innovation developing an approach without precedent. This process of teaching and learning served as a vehicle for venturing into the unknown through a discipline of architectural teaching called “Space” developed by the Soviet architect Nikolai Ladovskii (1881-1941). The creation of “Space” was paramount not only for its innovative pedagogy but also as an experimental laboratory for developing new architectural language. This paper discusses whether the historical teaching of “Space” can function in the construction of the modern teaching identity today to promote value, richness, quality, and diversity inherent in architectural design education. The history of “Space” teaching remains unknown within academic circles and separate from the current architectural teaching debate. Using VKhUTEMAS and the teaching of “Space” as a pedagogical lens and drawing upon research carried out in the Russian Federation, America, Canada, Germany, and the UK, this paper discusses how historically different models of teaching and learning can intersect through examining historical based educational research by exploring different design studio initiatives; pedagogical methodologies; teaching and learning theories and problem-based projects. There are strong arguments and desire for pedagogical change and this paper will promote new historical and educational research to widen the current academic debate by exposing new approaches to architectural teaching today.

Keywords: VKhUTEMAS, discipline space, modernist pedagogy, teaching identity

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Authors: Rui Zhang

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Translation has been elevated to one of the key notions in contemporary cultural discourse for a wide range of fields. It focuses not only on communication or transmission of meaning between different languages, but also on ways in which the very act of translation can be understood as a metaphor for cultural process. In recent years, the notion of translation is employed by some contemporary Chinese artists in a conceptual way, whose works contribute to constructing/deconstructing global/local cultural discourse and their own cultural identities. This study examines two artworks by contemporary Chinese artist Gu Wenda from a translational perspective, namely Forest of Stone Steles - Retranslation & Rewriting of Tang Poetry and United Nations - China Monument: Temple of Heaven, aiming to broaden the scope of Translation Studies to investigate visual culture and enrich methodological approach to contemporary Chinese art. Focusing on the relationship between translation, visuality and materiality in these two works, this study explores the nature of translation as part of the production of cultural discourse in the age of globalization as well as a way of establishing cultural identity. Gu Wenda, one of the most prestigious artists in contemporary China, is considered a pioneer in ‘85 Art Movement of China, and thereafter he went abroad for his artistic pursuits. His transnational experience enriches his cultural identity and the underlying discourse constructed/deconstructed in many of his works. In the two works already mentioned, the concept of translation is deployed by Gu Wenda on both linguistic level and metaphorical level for artistic expression. These two works produce discourses in which the artist’s perception of cultural identity in a transnational context is articulated by the tension between source text and target text. Based on the conceptual framework of cultural identity proposed by Stuart Hall, analyses of Gu Wenda’s cultural identity revealed through translation in these two works are centred on two axes, i.e., the axis of similarity and continuity with Chinese intellectual culture and the axis of difference and rupture with it, and the dialogic relationship between these two vectors. It argues that besides serving as a means of constructing visuality in the two works, translation metaphorizes Gu Wenda’s journey from overcoming his cultural identity anxiety to re-establishing a transcultural identity embedded in the underlying discourse.

Keywords: contemporary Chinese art, cultural identity, transculturality, translation

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Authors: Rukia Yosuf

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Diabetes is a national healthcare crisis related to both macrovascular and microvascular complications. We hypothesized that higher levels of physical activity are associated with lower total and visceral fat mass, lower systolic blood pressure, and increased insulin sensitivity. Participant inclusion criteria: 21-50 years old, BMI ≥ 30 kg/m2, hemoglobin A1C 5.7-6.4, fasting glucose 100-125 mg/dL, and HOMA IR ≥ 2.5. Exclusion criteria: history of diabetes, hypertension, HIV, renal disease, hearing loss, alcoholic intake over four drinks daily, use of organic nitrates or PDE5 inhibitors, and decreased cardiac function. Total physical activity was measured using accelerometers, body composition using DXA, and insulin resistance via fsIVGTT. Clinical and biochemical cardiometabolic risk factors, blood pressure and heart rate were obtained using a calibrated sphygmomanometer. Anthropometric measures, fasting glucose, insulin, lipid profile, C-reactive protein, and BMP were analyzed using standard procedures. Within our study, we found correlations between levels of physical activity in a heterogeneous group of prediabetic adults. Patients with more physical activity had a higher degree of insulin sensitivity, lower blood pressure, total visceral adipose tissue, and overall lower total mass. Total physical activity levels showed small, but significant correlations with systolic blood pressure, visceral fat, lean mass and insulin sensitivity. After normalizing for the race, age, and gender using multiple regression, these associations were no longer significant considering our small sample size. More research into prediabetes will decrease the population of diabetics overall. In the future, we could increase sample size and conduct cross sectional and longitudinal studies in various populations with prediabetes.

Keywords: diabetes, kidney disease, nephrology, prediabetes

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Authors: NeisaKuonuo Tungoe

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Tenyidie, also known as Angami, is spoken by the Angami tribe of Nagaland, North-East India, bordering Myanmar (Burma). It belongs to the Tibeto-Burman language group, falling under the Kuki-Chin-Naga sub-family. Tenyidie studies have seen random attempts at explaining the phonemic inventory of Tenyidie. Different scholars have variously emphasized the grammar or the history of Tenyidie. Many of these claims have been stimulating, but they were often based on a small amount of merely suggestive data or on auditory perception only. The principal objective of this paper is to analyse the affricate segments of Tenyidie as an acoustic study. There are seven categories to the inventory of Tenyidie; Plosives, Nasals, Affricates, Laterals, Rhotics, Fricatives, Semi vowels and Vowels. In all, there are sixty phonemes in the inventory. As mentioned above, the only prominent readings on Tenyidie or affricates in particular are only reflected through auditory perception. As noted above, this study aims to lay out the affricate segments based only on acoustic conclusions. There are seven affricates found in Tenyidie. They are: 1) Voiceless Labiodental Affricate - / pf /, 2) Voiceless Aspirated Labiodental Affricate- / pfh /, 3) Voiceless Alveolar Affricate - / ts /, 4) Voiceless Aspirated Alveolar Affricate - / tsh /, 5) Voiced Alveolar Affricate - / dz /, 6) Voiceless Post-Alveolar Affricate / tʃ / and 7) Voiced Post- Alveolar Affricate- / dʒ /. Since the study is based on acoustic features of affricates, five informants were asked to record their voice with Tenyidie phonemes and English phonemes. Throughout the study of the recorded data, PRAAT, a scientific software program that has made itself indispensible for the analyses of speech in phonetics, have been used as the main software. This data was then used as a comparative study between Tenyidie and English affricates. Comparisons have also been drawn between this study and the work of another author who has stated that there are only six affricates in Tenyidie. The study has been quite detailed regarding the specifics of the data. Detailed accounts of the duration and acoustic cues have been noted. The data will be presented in the form of spectrograms. Since there aren’t any other acoustic related data done on Tenyidie, this study will be the first in the long line of acoustic researches on Tenyidie.

Keywords: tenyidie, affricates, praat, phonemic inventory

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Authors: Kirsten A. Bartels

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'Never again' and 'Lest we forget' have long been messages associated with the events of the Shoah. Yet as we attempt to learn from the past, we must find new ways to engage with its memories. The preservation of the culture and the value of tradition are critical factors in Jane Yolen's works of Holocaust fiction, The Devil's Arithmetic and Mapping the Bones, emphasized through the importance of remembering. That word, in its multitude of forms (remember, remembering, memories), occurs no less than ten times in the first four pages and over one hundred times in the one hundred and sixty-four-page narrative The Devil’s Arithmetic. While Yolen takes a different approach to showcasing the importance of memory in Mapping the Bones, it is of equal import in this work and arguably to the future of Holocaust knowing. The idea of remembering, the desire to remember, and the ability to remember, are explored in three divergent ways in The Devil’s Arithmetic. First, in the importance to remember a past which is not her own – to understand history or acquired memories. Second, in the protagonist's actual or initial memories, those of her life in modern-day New York. Third, in a reverse mode of forgetting and trying to reacquire that which has been lost -- as Hannah is processed in the camp and she forgets everything, all worlds prior to the camp are lost to her. As numbers replace names, Yolen stresses the importance of self-identity or owned memories. In addition, the importance of relaying memory, the transitions of memory from perspective, and the ideas of reflective telling are explored in Mapping the Bones -- through the telling of the story through the lens of one of the twins as the events are unfolding; and then the through the reflective telling from the lens of the other twin. Parallel to the exploration of the intersemiosis of memory is the discussion of literary shadows (foreshadowing, backshadowing, and side-shadowing) and their impact on the reader's experience with Yolen's narrative. For in this type of exploration, one cannot look at the events described in Yolen's work and not also contemplate the figurative shadows cast.

Keywords: holocaust literature, memory, narrative, Yolen

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Authors: A. Ibovi Mouondayi, S. Zaher, R. Assadi, K. Erraoui, S. Sboul, J. Daoudim, S. Bousselham, K. Nassar, S. Janani

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INTRODUCTION: Neuropathic pain (NP) caused by damage to the somatosensory nervous system has a significant impact on quality of life and is associated with a high economic burden on the individual and society. The treatment of neuropathic pain consists of the use of a wide range of therapeutic agents, including gabapentin, which is used in the treatment of neuropathic pain. OBJECTIF: The objective of this study was to evaluate the efficacy and tolerance of gabapentin in the treatment of neuropathic pain. MATERIAL AND METHOD: This is a monocentric, cross-sectional, descriptive, retrospective study conducted in our department over a period of 19 months from October 2020 to April 2022. The missing parameters were collected during phone calls of the patients concerned. The diagnostic tool adopted was the DN4 questionnaire in the dialectal Arabic version. The impact of NP was assessed by the visual analog scale (VAS) on pain, sleep, and function. The impact of PN on mood was assessed by the "Hospital anxiety, and depression scale HAD" score in the validated Arabic version. The exclusion criteria were patients followed up for depression and other psychiatric pathologies. RESULTS: A total of 67 patients' data were collected. The average age was 64 years (+/- 15 years), with extremes ranging from 26 years to 94 years. 58 women and 9 men with an M/F sex ratio of 0.15. Cervical radiculopathy was found in 21% of this population, and lumbosacral radiculopathy in 61%. Gabapentin was introduced in doses ranging from 300 to 1800 mg per day with an average dose of 864 mg (+/- 346) per day for an average duration of 12.6 months. Before treatment, 93% of patients had a non-restorative sleep quality (VAS>3). 54% of patients had a pain VAS greater than 5. The function was normal in only 9% of patients. The mean anxiety score was 3.25 (standard deviation: 2.70), and the mean HAD depression score was 3.79 (standard deviation: 1.79). After treatment, all patients had improved the quality of their sleep (p<0.0001). A significant difference was noted in pain VAS, function, as well as anxiety and depression, and HAD score. Gabapentin was stopped for side effects (dizziness and drowsiness) and/or unsatisfactory response. CONCLUSION: Our data demonstrate a favorable effect of gabapentin on the management of neuropathic pain with a significant difference before and after treatment on the quality of life of patients associated with an acceptable tolerance profile.

Keywords: neuropathic pain, chronic pain, treatment, gabapentin

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Authors: Mahmoud Abualsoud

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The era of Thutmosis III represents a transitional period between the art of the Thutmoside art and the Amarna period, so we intend to declare that it serves as the cradle of Amarna art. The study will examine the Statues of king Thutmose III that was discovered in Luxor by an Egyptian mission. These Statues have been transferred to the Conservation Center of the Grand Egyptian Museum (GEM) to be conserved and made ready to be displayed at the new museum (the project of the century). We focus on three Statues chosen because they relate to different years of the king's reign. These Statues were all made of granite. The first one is a Kneeling statue representing the god Amun showing king Thutmose III offering to the goddess Hathor. The second is decorated with king Thutmose III with the red crown, between the goddess Hathor and the royal wife, Nefertari. The third shows the king offering NW vessels and bread to the god Seker. Each statue is divided into registers containing a description and decorated with scenes of the king presenting offerings to gods. The proposed study will focus on the development which happened sequentially according to differences that occur in each statue. We will use comparative research to determine the workshops of these statues, whether one or several, and what are the distinguishing features of each one. We will examine what innovations the artisans added to royal art. The description and the texts will be translated with linguistic comments. This research focuses on text analyses and technology. Paleographic information found on these objects includes the names and titles of the king. This research focuses on text analyses and technology. The study aims to create a manual that may help in dating the artwork of Thutmosis III. This research will be beneficial and useful for heritage and ancient civilizations, particularly when we talk about opening museums like the Grand Egyptian Museum, which will exhibit a collection of statues. Indeed, this kind of study will open a new destination in order to know how to identify these collections and how to exhibit them commensurate with the nature of ancient Egyptian history and heritage.

Keywords: archaeological study, Giza, new kingdom, statues, royal art

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Authors: Muge Unal, Cengiz Uslu, Mehmet Faruk Altunkasa

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Walkability relates to the ability of the places to connect people with varied destinations within a reasonable amount of time and effort, and to offer visual interest in journeys throughout the network. So, the good quality of the physical environment and arrangement of walkway and sidewalk appear to be more crucial in influencing the pedestrian route choice. Also, proximity, connectivity, and accessibility are significant factor for walkability in terms of an equal opportunity for using public spaces. As a result, there are two important points for walkability. Firstly, the place should have a well-planned street network for accessible and secondly facilitate the pedestrian need for comfort. In this respect, this study aims to examine the both physical and bioclimatic comfort levels of the current condition of pedestrian route with reference to design criteria of a street to access the urban green spaces. These aspects have been identified as the main indicators for walkable streets such as continuity, materials, slope, bioclimatic condition, walkway width, greenery, and surface. Additionally, the aim was to identify the factors that need to be considered in future guidelines and policies for planning and design in urban spaces especially streets. Adana city was chosen as a study area. Adana is a province of Turkey located in south-central Anatolia. This study workflow can be summarized in four stages: (1) environmental and physical data were collected by referred to literature and used in a weighted criteria method to determine the importance level of these data , (2) environmental characteristics of pedestrian routes gained from survey studies are evaluated to hierarchies these criteria of the collected information, (3) and then each pedestrian routes will have a score that provides comfortable access to the park, (4) finally, the comfortable routes to park will be mapped using GIS. It is hoped that this study will provide an insight into future development planning and design to create a friendly and more comfort street environment for the users.

Keywords: comfort level, geographical information system (GIS), walkability, weighted criteria method

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Authors: Ashneel Ajay Singh, Naoki Suzuki, Kazumi Sakuramoto, Swastika Roshni, Paras Nath, Alok Kalla

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Albacore tuna (Thunnus alalunga) is one of the commercially important species of tuna in the North Pacific region. Despite the long history of albacore fisheries in the Pacific, its ecological characteristics are not sufficiently understood. The effects of changing climate on numerous commercially and ecologically important fish species including albacore tuna have been documented over the past decades. The objective of this study was to explore and elucidate the relationship of environmental variables with the stock parameters of albacore tuna. The relationship of the North Pacific albacore tuna recruitment (R), spawning stock biomass (SSB) and recruits per spawning biomass (RPS) from 1970 to 2012 with the environmental factors of sea surface temperature (SST), Pacific decadal oscillation (PDO), El Niño southern oscillation (ENSO) and Pacific warm pool index (PWI) was construed. SST and PDO were used as independent variables with SSB to construct stock reproduction models for R and RPS as they showed most significant relationship with the dependent variables. ENSO and PWI were excluded due to collinearity effects with SST and PDO. Model selections were based on R2 values, Akaike Information Criterion (AIC) and significant parameter estimates at p<0.05. Models with single independent variables of SST, PDO, ENSO and PWI were also constructed to illuminate their individual effect on albacore R and RPS. From the results it can be said that SST and PDO resulted in the most significant models for reproducing North Pacific albacore tuna R and RPS time series. SST has the highest impact on albacore R and RPS when comparing models with single environmental variables. It is important for fishery managers and decision makers to incorporate the findings into their albacore tuna management plans for the North Pacific Oceanic region.

Keywords: Albacore tuna, El Niño southern oscillation, Pacific decadal oscillation, sea surface temperature

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Authors: Himanshu Kushwah, Nidhi Sandal, Meenakshi K. Chauhan, Gaurav Mittal

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Excessive bleeding is the primary factor of avoidable death in both civilian trauma centers as well as the military battlefield. Hundreds of Indian troops die every year due to blood loss caused by combat-related injuries. These deaths are avoidable and can be prevented to a large extent by making available a suitable hemostatic dressing in an emergency medical kit. In this study, natural gums were evaluated as potential hemostatic agents in combination with calcium gluconate. The study compares the hemostatic activity of Gum Tragacanth (GT), Guar Gum (GG), Xanthan Gum (XG) and Gum Acacia (GA) by carrying out different in-vitro and in-vivo studies. In-vitro studies were performed using the Lee-White method and Eustrek method, which includes the visual and microscopic analysis of blood clotting. MTT assay was also performed using human lymphocytes to check the cytotoxicity of the gums. The in-vivo studies were performed in Sprague Dawley rats using tail bleeding assay to evaluate the hemostatic efficacy of the gums and compared with a commercially available hemostatic sponge, Surgispon. Erythrocyte agglutination test was also performed to check the interaction between blood cells and the natural gums. Other parameters like blood loss, adherence strength of the developed hemostatic dressing material incorporating these gums, re-bleeding, and survival of the animals were also studied. The data obtained from the MTT assay showed that Guar gum, Gum Tragacanth, and Gum Acacia were not significantly cytotoxic, but substantial cytotoxicity was observed in Xanthan gum samples at high concentrations. Also, Xanthan gum took the least time with its minimum concentration to achieve hemostasis, (approximately 50 seconds at 3mg concentration). Gum Tragacanth also showed efficient hemostasis at a concentration of 35mg at the same time, but the other two gums tested were not able to clot the blood in significantly less time. A sponge dressing made of Tragacanth gum was found to be more efficient in achieving hemostasis and showed better practical applicability among all the gums studied and also when compared to the commercially available product, Surgispon, thus making it a potentially better alternative.

Keywords: cytotoxicity, hemostasis, natural gums, sponge

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Authors: Tithi Banerjee, Ananya Mukhopadhyay

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The comparison of ancient tidalites recorded in both siliciclastics and carbonates has not been well documented due to a lack of suitable outcropping examples. The Proterozoic Simla Basin, Lesser Himalaya serves a unique example in this regard. An attempt has been made in the present work to differentiate sedimentary facies and architectural elements of tidalites in both siliciclastics and carbonates recorded in the Simla Basin. Lithofacies and microfacies analysis led to identification of 11 lithofacies and 4 architectural elements from the siliciclastics, 6 lithofacies and 3 architectural elements from the carbonates. The most diagnostic features for comparison of the two tidalite systems are sedimentary structures, textures, and architectural elements. The physical features such as flaser-lnticular bedding, mud/silt couplets, tidal rhythmites, tidal bundles, cross stratified successions, tidal bars, tidal channels, microbial structures are common to both the environments. The architecture of these tidalites attests to sedimentation in shallow subtidal to intertidal flat facies, affected by intermittent reworking by open marine waves/storms. The seventeen facies attributes were categorized into two major facies belts (FA1 and FA2). FA1 delineated from the lower part of the Chhaosa Formation (middle part of the Simla Basin) represents a prograding muddy pro-delta deposit whereas FA2 delineated from the upper part of the Basantpur Formation (lower part of the Simla Basin) bears the signature of an inner-mid carbonate ramp deposit. Facies distribution indicates development of highstand systems tract (HST) during sea level still stand related to normal regression. The aggradational to progradational bedsets record the history of slow rise in sea level.

Keywords: proterozoic, Simla Basin, tidalites, inner-mid carbonate ramp, prodelta, TST, HST

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Authors: Narupon Kunbootsri, Patpiya Sirasaporn

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Low back pain is the most common of chief complaints in chronic pain. Low back pain directly affect to activities daily living and also has high socioeconomic costs. The prevalence of low back pain is high in both genders in all populations. The symptoms of low back pain including, pain at low back area, muscle spasm, tenderness points and stiff back. Trancutanous Electrical Nerve Stimulation (TENS) is one of modalities mainly use for control pain. There was indicated that TENS is wildly use in low back pain, but no scientific data about the flexibility of muscle after TENS in low back pain. Thus the aim of this study was to investigate immediate effect of TENS on flexibility and health status in patients with chronic nonspecific low back pain. Eight chronic nonspecific low back pain patients 1 male and 7 female employed in this study. Participants were diagnosed by a doctor based on history and physical examination. Each participant received treatment at physiotherapy unit. Participants completed Roland Morris Disability Questionnaire (RMDQ), numeric rating scale (NRS) and trunk flexibility before treatment. Each participant received low frequency TENS set at asymmetrical, 10 Hz, 20 minutes per point. Immediately after treatment, participants completed RNS, RMDQ and trunk flexibility again. All participants were treated by only one physiotherapist. There was a statistically significant increased in flexibility immediately after low frequency TENS [mean difference -6.37 with 95%CI were (-8.35)-(-4.39)]. There was a statistically significant decreased in numeric rating scale [mean difference 2.13 with 95%CI were 1.08-3.16]. Roland Morris Disability Questionnaire showed improvement of health status average 44.8% immediately after treatment. In conclusion, the results of the present study indicate that immediately effect after low frequency TENS can decrease pain and improve flexibility of back muscle in chronic nonspecific low back pain patients.

Keywords: low back pain, flexibility, TENS, chronic

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Authors: Omran Al Balushi, Haitham Al Rawahi

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Enterprise Asset Management (eAM) has been implemented across different Generation, Transmission and Distribution subsidiaries in Nama Group companies. As part of Nama group, Oman Electricity Transmission Company (OETC) was the first company to implement this system. It was very important for OETC to implement and maintain such a system to achieve its business objectives and for effective operations, which will also support the delivery of the asset management strategy. Enterprise Asset Management (eAM) addresses the comprehensive asset maintenance requirements of Oman Electricity Transmission Company (OETC). OETC needs to optimize capacity and increase utilization, while lowering unit production. E-AM will enable OETC to adopt this strategy. Implementation of e-AM has improved operation performance with preventive and scheduled maintenance as well as it increased safety. Implementation of e-AM will also enable OETC to create optimal asset management strategy which will increase revenue and decrease cost by effectively monitoring operational data such as maintenance history and operation conditions. CMMS (Computerised Maintenance Management System) is the main software and the back-bone of e-AM system. It is used to provide an improved working practice to properly establish information and data flow related to maintenance activities. Implementation of e-AM system was one of the factors that supported OETC to achieve ISO55001 Certificate on fourth quarter of 2016. Also, full implementation of e-AM system will result in strong integration between CMMS and Geographical Information Systems (GIS) application and it will improve OETC to build a reliable maintenance strategy for all asset classes in its Transmission network. In this paper we will share our experience and knowledge of implementing such a system and how it supported OETC’s management to make decisions. Also we would highlight the challenges and difficulties that we encountered during the implementation of e-AM. Also, we will list some features and advantages of e-AM in asset management, preventive maintenance and maintenance cost management.

Keywords: CMMS, Maintenance Management, Asset Management, Maintenance Strategy

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Authors: Angel Adams

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In Australia, the contemporary social construction of hatred against the Islamic community was facilitated through the mainstream media. Australian public figures who have depicted Muslims and Islam not only as potential terrorists but also as incompatible with the country’s values and identities have helped to increase the level of fear against the Islamic community, leading sympathetic far-right movements to shift discussions towards anti-Islamic and anti-Muslim rhetoric. Political opportunities combined with a socially constructed narrative of fear of the ‘other’, introduced during the White Australia Policy of 1901, has allowed extreme and radical far-right movements to justify hate against the contemporary Australian Islamic community. This study aims to answer the following question: How does Australia’s founding provide a fertile environment to the spread of hatred against the contemporary Islamic community? The paper demonstrates that a forged social construct of grievances concerning the Islamic community in Australia has led to a surge in supply of far-right activism to combat what has become a perceived ‘national threat’. In essence, Australia’s history of a fear of the ‘other’ brings challenges to a multicultural society, and can potentially lead to a more unstable socio-political environment where abuse and violence are normalized and more likely to develop. Furthermore, the paper aims to bring a more nuanced understanding of what is considered ‘new far-right’ discourses with shared anti-Islam and anti-Muslim agendas in Australia. The political opportunity structures theory was the mechanism used to determine how new forms of far-right groups have become more mainstream in Australia. Previous studies on far-right groups in Australia have relied on qualitative data, but further empirical research in this area is sorely needed. Above all, this paper clarifies how hatred against minorities can have a negative impact on wider communities and allow a global narrative of ‘us’ versus ‘them’ to erupt from the fringes of society in Australia.

Keywords: Australia, Islamophobia, far-right, nationalism, political opportunity structures, political violence, social construction

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Authors: Dada. O.Akinola, Uche. I. Ebele, Bamiro .A.Rafatu, Akinbami A. Akinsegun, Dada O. Adeyemi, Adeyemi. O. Ibukun, Okunowo O.Bolanle, Abdulateef O. Kareem, Ibrahim.N. Ismaila, Dosu Rihanat

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Background: Hyperglycaemia alters qualitatively and quantitatively all the full blood count parameters. The alterations among other factors are responsible for the macrovascular and microvascular complications associated with diabetes mellitus (DM). This study is aimed at correlating haematological parameters in DM subjects with their fasting blood glucose (FBG) and anthropometric parameters. Materials and Methods: This was a cross-sectional study of participants attending DM clinic of Lagos State University Teaching Hospital (LASUTH), Ikeja. The study recruited one hundred and two (102) DM subjects and one hundred (100) non-DM controls. Venous blood samples were collected for full blood count (FBC) assay while FBG was done, structured questionnaires were administered, and anthropometric measurements of all participants were done. Data were analyzed with Statistical Package for Social Science (SPSS) version 23. P was set at ≤0.05. Results: The mean age of DM patients was 64.32± 11.31 years. Using a haemoglobin concentration cut-off of 11g/dl, 39.2%, and 13% DM and control participants respectively had values lower than 11g/dl. A total of 22.5% and 3% of DM and controls respectively gave a history of previous blood transfusion.White blood cells count and platelet count means were (6.12±1.60 and 5.30±7.52,p=0.59) and (213.31±73.58 and 228.91±73.21,p = 0.26) *109/L in DM subjects and controls respectively. FBG and all the anthropometric data in DM subjects were significantly higher than in controls. Conclusions: The prevalence of anaemia in DM subjects was three times higher than in controls. The white blood cell count was higher but not statistically significant in DM compared with controls. But platelet count was higher but not statistically significant in controls compared with DM subjects.

Keywords: haematological profile, diabetes mellitus, anthropometric data, fasting blood glucose

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Authors: Bagher Bayat, Wouter Verhoef, Behnaz Arabi, Christiaan Van der Tol

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The aim of this study was to follow the canopy reflectance patterns in response to soil water deficit and to detect trends of changes in biophysical and biochemical parameters of grass (Poa pratensis species). We used visual interpretation, imaging spectroscopy and radiative transfer model inversion to monitor the gradual manifestation of water stress effects in a laboratory setting. Plots of 21 cm x 14.5 cm surface area with Poa pratensis plants that formed a closed canopy were subjected to water stress for 50 days. In a regular weekly schedule, canopy reflectance was measured. In addition, Leaf Area Index (LAI), Chlorophyll (a+b) content (Cab) and Leaf Water Content (Cw) were measured at regular time intervals. The 1-D bidirectional canopy reflectance model SAIL, coupled with the leaf optical properties model PROSPECT, was inverted using hyperspectral measurements by means of an iterative optimization method to retrieve vegetation biophysical and biochemical parameters. The relationships between retrieved LAI, Cab, Cw, and Cs (Senescent material) with soil moisture content were established in two separated groups; stress and non-stressed. To differentiate the water stress condition from the non-stressed condition, a threshold was defined that was based on the laboratory produced Soil Water Characteristic (SWC) curve. All parameters retrieved by model inversion using canopy spectral data showed good correlation with soil water content in the water stress condition. These parameters co-varied with soil moisture content under the stress condition (Chl: R2= 0.91, Cw: R2= 0.97, Cs: R2= 0.88 and LAI: R2=0.48) at the canopy level. To validate the results, the relationship between vegetation parameters that were measured in the laboratory and soil moisture content was established. The results were totally in agreement with the modeling outputs and confirmed the results produced by radiative transfer model inversion and spectroscopy. Since water stress changes all parts of the spectrum, we concluded that analysis of the reflectance spectrum in the VIS-NIR-MIR region is a promising tool for monitoring water stress impacts on vegetation.

Keywords: hyperspectral remote sensing, model inversion, vegetation responses, water stress

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Authors: Jefferson S. Galanza, Jewel An Mischelle R.Camcam, Alyssa Karryl C. Co, Stephanie P. De Guzman, Jet Jet K. Dongui-is, Rodolfo Dane C. Frias, Ovelle C. Jueco, Harvey L. Matbagan, Victoria Luzette T. Rillon, Christelle Romyna H. Saruca, Jeanette Roma M. Villasper

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Background: Amidst numerous studies conducted on learning styles of students from a variety of courses, levels and school, a recent study recommended a great need for research on learning styles of student nurses. Moreover, related literatures have not been found exploring both the learning and teaching style of student nurses. Aims: The study aimed to determine the learning and teaching styles of student nurses and if there is an association between them. It also intended to discover whether student nurses are unimodal or multimodal in their styles and identified which faculty teaching style affords maximum outcome for student’s learning styles. Methods: Quantitative Descriptive-Correlational design was used. Participants were randomly selected 312 student nurses at School of Nursing X, Baguio City, Philippines. The questionnaire utilized a modified version of an adopted tool from Fleming’s VARK learning style version 7.2 (Visual, Auditory, Reader/Writer, Kinaesthetic) and Grasha’s teaching styles (Formal Authority, Demonstrator, Facilitator, Delegator). SPSS 19 was used for statistical treatment of data, where Chi square was used for the correlation of unimodal learning and teaching styles. Results/Finding: Majority of student nurses’ learning style is Kinesthetic and their teaching style is Demonstrator, which was also found to be significantly associated. Moreover, 8 out of 10 students are Unimodal in their learning and teaching modalities. In general, their preferred faculty teaching style is similar to their teaching style, which supports the concept, that teachers teach the way they learn. Conclusion: Study concludes that student nurses’ learning styles and teaching styles are varied, which exemplifies the uniqueness of every learner.This diversity in styles provided more evidence that a variety of mode of teaching and learning should be used by faculty and students to increase learning outcome and academic achievement. Recommendation: Future studies could be carried out in various schools of nursing utilizing faculty as respondents. Conduct assessment of learning style at the onset of classes/clinical placements so that faculty will become aware of the diversity of learners leading them to deliver diverse teaching methods.

Keywords: learning, learning styles, teaching styles, student nurses

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Authors: Luc de Brabandere

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Searchers in various disciplines have long tried to understand how a human being thinks. Most of them seem to agree that the brain works in two very different modes. For us, the first phase of thought imagines, diverges, and unlocks the field of possibilities. The second phase, judges converge and choose. But if we were to stop there, that would give the impression that thought is essentially an individual effort that seldom depends on context. This is, however, not the case. Whether we be a champion in creativity, so primarily in induction, or a master in logic where we are confronted with reality, the ideas we layout are indeed destined to be presented to third parties. They should therefore be exposed, defended, communicated, negotiated, or even sold. Regardless of the quality of the concepts we craft (creative thinking) and the interferences we build (logical thinking) we will take one day, or another, be confronted by people whose beliefs, opinions and ideas differ from ours (critical thinking). Logic and critique: The shared characteristics of logical and critical thoughts include a three-level structure of reasoning invented by the Greeks. For the first time in history, Aristotle tried to model thought deployable in three stages: the concept, the statement, and the reasoning. The three levels can be assessed according to different criteria. A concept is more or less useful, a statement is true or false, and reasoning is right or wrong. This three-level structure allows us to differentiate logic and critique, where the intention and words used are not the same. Logic only deals with the structure of reasoning and exhausts the problem. It regards premises as acquired and excludes the debate. Logic is in all certainty and pursues the truth. Critique is most probably searching for the plausible. Logic and creativity: Many known models present the brain as a two-stroke engine (divergence vs convergence, fast vs. slow, left-brain vs right-brain, Yin vs Yang, etc.). But that’s not the only thing. “Why didn’t we think of that before?” How often have we heard that sentence? A creative idea is the outcome of logic, but you can only understand it afterward! Through the use of exercises, we will witness how logic and creativity work together. A third theme is hidden behind the two main themes of the conference: logical thought, which the author can shed some light on.

Keywords: creativity, logic, critique, digital

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Authors: Anastasia Papachristou, Anastasia Ntikoudi, Vasileios Saridakis

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The safety and health care needs of refugees have become an increasingly important issue all over the world especially during last few decades. Wars are the primary reason for refugees to leave their countries. Moreover, refugees are frequently exposed to a variety of stressors such as socioeconomic disadvantages, poverty, changes in family structure and functioning, losing social support, difficulty to access education, living in very crowded places, experiencing racism and isolation. This systematic review included research studies published between 2007-2017 from the search databases Medline, Scopus, Cinahl and PubMed, with keywords 'war survivors', 'war trauma', 'psychiatric disorders', 'refugees'. In order to meet the purpose of the systematic review, further research for complementary studies was conducted into the literature references of the research articles included in this study that would meet the criteria. Overall, 14 studies were reviewed and evaluated. The majority of them demonstrated that the most common psychiatric disorders observed among war refugees are post-traumatic stress disorder (PTSD), depression, anxiety and multiple somatic complaints. Moreover, significant relationship was shown between the number of traumatic events experienced by the refugees and sociodemographic features such as gender, age and previous family history of any psychological disorder. War violence is highly traumatic, causing multiple, long-term negative outcomes such as the aforementioned psychiatric disorders. The number of the studies reviewed in this systematic review is not representative of the problem and its significance. The need for care of the survivors and their families is vital. Further research is necessary in order to clarify the role of predictive factors in the development and maintenance of post-traumatic stress and the rest psychiatric disorders following war trauma. In conclusion, it is necessary to have large multicenter studies in the future in order to be able to draw reliable conclusions about the effects of war.

Keywords: psychiatric disorders, refugees, war survivors, war trauma

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Authors: Catherine Harrison

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Faced with arrest, imprisonment and the denazification process in 1945, Tübingen University’s Professor of Theology, Gerhard Kittel, refused to abandon the “Christian” antisemitism which he had first expounded in his Die Judenfrage [The Jewish Question] (1933 and 1934). At the heart of this paper is a critical engagement with Die Judenfrage, the first in English. Putting Die Judenfrage into dialogue with Kittel’s 1946, Meine Verteidigung [My Defence] (1945-6) exposes the remarkable consistency of Kittel’s idiosyncratic but closely argued Christian theology of antisemitism. Girdling his career as a foremost theologian, antisemite and enthusiastic supporter of Hitler and the NSDAP, the consistency between Die Judenfrage and Meine Verteidigung attests Kittel’s consistent and authentic, intellectual position. In both texts, he claims to be advancing Christian, as opposed to “vulgar” or racial, antisemitism. Yet, in the thirteen years which divide them, Kittel had mediated contact with Nazi illuminati Rudolph Hess, Alfred Rosenberg, Winnifred Wagner, Josef Goebbels and Baldur von Schirach, through his publications in various antisemitic journals. The paper argues: Die Judenfrage, as both a text and as a theme, is axiomatic to Kittel’s defence statement; and that Die Judenfrage constitutes the template of Kittel’s arcane, personal “Christian” antisemitism of which Meine Verteidigung is a faithful impression. Both are constructed on the same theologically chimeric and abstruse hypotheses regarding Volk, Spätjudentum [late Judaism] and Heilgeschichte [salvation history]. Problematising these and other definitional vagaries that make up Kittel’s “Christian” antisemitism highlight the remarkable theoretical consistency between Die Judenfrage and Meine Verteidigung. It is concluded that a deadly synergy of Nazi racial antisemitism and the New Testament antisemitism shaped Kittel’s judgement to the degree that, despite the slipstream of concentration camp footage which was shaking the foundations of post-war German academia, Meine Verteidigung is a simple restatement of the antisemitsm conveyed in Die Judenfrage.

Keywords: Gerhard Kittel, Third Reich theology, the Jewish Question, Nazi antisemitism

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Authors: Anne Heirman, Vincent van der Noort, Rob van Son, Marije Petersen, Lisette van der Molen, Gyorgy Halmos, Richard Dirven, Michiel van den Brekel

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Objective: Voice prosthesis leakage significantly impacts laryngectomies patients' quality of life, causing insecurity and frequent unplanned hospital visits and costs. In this study, the concept of prophylactic voice prosthesis replacement was explored to prevent leakages. Study Design: A retrospective cohort study. Setting: Tertiary hospital. Methods: Device lifetimes and voice prosthesis replacements of a retrospective cohort, including all patients with laryngectomies between 2000 and 2012 in the Netherlands Cancer Institute, were used to calculate the number of needed voice prostheses per patient per year when preventing 70% of the leakages by prophylactic replacement. Various strategies for the timing of prophylactic replacement were considered: Adaptive strategies based on the individual patient’s history of replacement and fixed strategies based on the results of patients with similar voice prosthesis or treatment characteristics. Results: Patients used a median of 3.4 voice prostheses per year (range 0.1-48.1). We found a high inter-and intrapatient variability in device lifetime. When applying prophylactic replacement, this would become a median of 9.4 voice prostheses per year, which means replacement every 38 days, implying more than six additional voice prostheses per patient per year. The individual adaptive model showed that preventing 70% of the leakages was impossible for most patients, and only a median of 25% can be prevented. Monte-Carlo simulations showed that prophylactic replacement is not feasible due to the high Coefficient of Variation (Standard Deviation/Mean) in device lifetime. Conclusion: Based on our simulations, prophylactic replacement of voice prostheses is not feasible due to high inter-and intrapatient variation in device lifetime.

Keywords: voice prosthesis, voice rehabilitation, total laryngectomy, prosthetic leakage, device lifetime

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Authors: Shahnaz Haque, Anand Shukla, Sunita Singh, Anil Kem

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Introduction: Diabetes Mellitus is a chronic metabolic disease affecting millions worldwide. Metformin is the most commonly prescribed first line oral hypoglycemic drug for type 2 diabetes mellitus, but due to progressive worsening of blood glucose control during the natural history of type 2 diabetes, combination therapy usually becomes necessary. Objective: This study was designed to assess the treatment satisfaction between Sitagliptin versus Pioglitazone added to Metformin in patients with type 2 diabetes mellitus (T2DM). Methods: We conducted a prospective, open label, randomized, parallel group study in SIMS, Hapur, U.P. Eligible patients fulfilling inclusion criteria were randomized into two groups having 25 patients in each group using tab Sitagliptin 100mg, tab Pioglitazone 30mg added to ongoing tab Metformin (500mg) therapy for 16 weeks. The follow-up visits were on weeks 4,12 and 16. Result: 16 weeks later, addition of Sitagliptin 100mg compared to that of Pioglitazone 30 mg to ongoing Metformin therapy provided similar glycosylated hemoglobin (HbA1c) lowering efficacy in patients with T2DM with inadequate glycemic control on metformin monotherapy. Change in HbA1c in group1 was -0.656±0.21%(p<0.0001) whereas in group2 was -0.748±0.35%(p<0.0001). Hence decrease in HbA1c from baseline was more in group2. Both treatments were well tolerated with negligible risk of hypoglycaemia. Weight loss was observed with Sitagliptin in contrast to weight gain seen in Pioglitazone. Conclusion: In this study, Sitagliptin 100 mg along with metformin therapy in comparison to pioglitazone 30 mg plus metformin therapy was both effective, well-tolerated and improved glycemic control in both the groups. Addition of pioglitazone had cause oedema and weight gain to the patients whereas sitagliptin caused weight loss in its patients.

Keywords: sitagliptin, pioglitazone, metformin, type 2 diabetes mellitus

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Authors: Marah El-Beeli, Abdullah Balkhair, Zakaryia Al Muharmi, Samir Al Adawi, Mansoor Al-Jabri, Abdullah Al Rawahi, Hazaa Al Yahyae, Eman Al Balushi, Yahya M. Al-Farsi

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The health care service and the anticancer chemotherapeutics has changed the natural history of cancer into manageable chronic disease and improve the cancer patient’s lifestyle and increase the survival time. Despite that, still, infection is the major dilemma opposing the cancer patient either because of the clinical presentation of the cancer type and impaired immune system or as a consequence of anticancer therapy. This study has been conducted to1) track changes in the epidemiology of hospital-acquired bloodstream infections among patients with malignancies in the last five years. 2) To explore the causative pathogens and 3) the outcome of HA-BSIs in patients with a different types of malignancies. An ampi-directional study (retrospective and prospective follow up) of patients with malignancies admitted at Sultan Qaboos University hospital (570-bed tertiary hospital) during the study period (from January 2015 to December 2019). The cumulative frequency and prevalence rates of HA-BSIs by patients and isolates were calculated. In addition, the cumulative frequency of participants with single versus mixed infections and types of causative micro-organisms of HA-BSIs were obtained. A total of 1246 event of HA-BSIs has occurred during the study period. Nearly the third (30.25%) of the HA-BSI events was identified among 288 patients with malignancies. About 20% of cases were mixed infections (more than one isolate). Staphylococcus spp were the predominant isolated pathogen (24.7%), followed by Klebsiella spp (15.8%), Escherichia spp (13%), and Pseudomonas spp (9.3%). About half (51%) of cases died in the same year, and (64%) of the deaths occur within two weeks after the infection. According to the observations, no changes in the trends of epidemiology, causative pathogens, morbidity, and mortality rates in the last five years.

Keywords: epidemiology, haematological malignancies, hospital acquired bloodstream infections, solid malignancies

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