Search results for: poor outcome of delayed breast cancer treatment

Authors: A. Sathish, N. N. Lingaraju, K. N. Geetha, C. A. Srinivasamurthy, S. Bhaskar

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Under dryland conditions, it is observed that the soil organic matter is low due to low organic carbon content due to poor management with less use of inputs. On the other hand, disposal of sugar industry waste, i.e., spentwash is a major concern with limited space for land based treatment and disposal which causes environmental pollution. Spentwash is also a resource that can be applied for productive uses since it contains nutrients that have the potential for use in agriculture. The disposal of spent wash may lead to environmental pollution. Hence as an alternative mechanism, it was applied once to dry lands, and the experiments were conducted from 2012-13 to 2016-17 in kharif season in Maddur Taluk, Mandya District, Karnataka State, India. The study conducted was in 93 different farmers field (maize-11, finger millet-80 & horsegram-14). Spentwash was applied at the rate of 100 m³ ha⁻¹ before sowing of the crops. The results showed that yield of dryland crops like finger millet, horse gram and maize was recorded 14.75 q ha⁻¹, 6 q ha⁻¹ and 31.00 q ha⁻¹, respectively and the yield increase to an extent of 10-25 per cent with one time application of spentwash to dry lands compared to farmers practice, i.e., chemical fertilizer application. The higher yield may be attributed to slow and steady release of nutrients by spentwash throughout the crop growth period. In addition, the growth promoting and other beneficial substances present in spentwash might have also helped in better plant growth and yield. The soil sample analysis after harvest of the crops indicate acidic to neutral pH, EC of 0.11 dSm⁻¹ and Na of 0.20 C mol (P⁺) kg⁻¹ in the normal range which are not harmful. Hence, it can be applied to drylands at least once in 3 years which enhances yield as well as reduces environmental pollution.

Keywords: dryland crops, pollution, sugar industry waste, spentwash

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Authors: Dhanashree Moghe, Roberta Bullingham, Rizwan Ahmed, Tarun Singhal

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Aim: The NHS Bowel Screening Programme recommends the use of endoscopic tattooing for suspected malignant lesions that later require surgical or endoscopic localisation, using local protocols as guidance. This is in accordance with guidance from the BSG (The British Society of Gastroenterologists). We used a well-recognised local protocol as a standard to audit current tattooing practice in a large district general hospital with no current local guidelines. Method: A retrospective quantitative analysis of 50 patients who underwent segmental colonic resection for cancer over a 6-month period in 2021. We reviewed historic electronic endoscopy reports recording relevant data on tattoo indication and placement. Secondly, we carried out an anonymous survey of 16 independent lower GI endoscopists on self-reported details of their practice. Results: In our study, 28 patients (56%) had a tattoo placed at the time of their colonoscopy. Of these, only 53% (n=15) had the tattoo distal to the lesion, with the measured distance of the tattoo from the lesion only being documented in 8 reports. Only seven patients (25%) had a circumferential (4 quadrant) placement of the tattoo. 13 patients had lesions either in the caecum or rectum, locations deemed unnecessary as per BSG guidelines. Of the survey responses collected, there were four different protocols being used to guide practice. Only 50% of respondents placed tattoos at the correct distance from the lesion, and 83% placed the correct number of tattoos. Conclusion: There is a lack of standardisation of practices in colonic tattooing demonstrated in our study with incomplete compliance to our standard. The inadequate documentation of tattoo location can contribute to confusion and inaccuracy in the intraoperative localisation of lesions. This has the potential to increase operation length and morbidity. There is a need to standardise both technique and documentation in colonoscopic tattooing practice.

Keywords: colorectal cancer, endoscopic tattooing, colonoscopy, NHS BSCP

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Authors: Ming-Yeh Lu, Shiao-Shing Chen, Saikat Sinha Ray, Hung-Te Hsu

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The submerged anaerobic osmotic membrane bioreactor (AnOMBR) integrated with periodic microfiltration (MF) extraction for simultaneous phosphorus and clean water recovery from wastewater was evaluated. A laboratory-scale AnOMBR used cellulose triacetate (CTA) membranes with effective membrane area of 130 cm² was fully submerged into a 5 L bioreactor at 30-35 ℃. Active layer was orientated to feed stream for minimizing membrane fouling and scaling. Additionally, a peristaltic pump was used to circulate magnesium sulphate (MgSO₄) solution applied as draw solution (DS). Microfiltration membrane periodically extracted about 1 L solution when the TDS reaches to 5 g/L to recover phosphorus and simultaneously control the salt accumulation in the bioreactor. During experiment progress, the average water flux was around 1.6 LMH. The AnOMBR process showed greater than 95% removal of soluble chemical oxygen demand (sCOD), nearly 100% of total phosphorous whereas only partial of ammonia was removed. On the other hand, the average methane production of 0.22 L/g sCOD was obtained. Subsequently, the overall performance demonstrates that a novel submerged AnOMBR system is potential for simultaneous wastewater treatment and resource recovery from wastewater. Therefore, the new concept of this system can be used to replace for the conventional AnMBR in the future.

Keywords: anaerobic treatment, forward osmosis, phosphorus recovery, membrane bioreactor

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Authors: Hakim Derradji, M’Hammedi Yousra, Sabrou Abdelmalek, Tabet Nacer

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Introduction: This is a retrospective study carried out at the Central Hospital of Army from 2017 to 2022. Its objective is to demonstrate the best surgical method for the management of obstructive hydrocephalus secondary to a posterior fossa tumor in children, in pre, per, and post-operative. Patients and Methods: During this period, 24 children (over 1 year old) were admitted for treatment of the posterior fossa tumor with obstructive secondary hydrocephalus and the majority of whom benefited from VCS followed by surgery and excision, the rest, received after evacuation from other hospital structures, were managed there beforehand with ventriculoperitoneal diversion or external drainage. We found that the way hydrocephalus is managed has implications for subsequent management, hence the need for this study to determine the effectiveness of different surgical procedures used in the treatment of hydrocephalus in these patients. The evaluation is made on the basis of revision rate, complications, survival, and radiological evaluation. Results: 6 patients (25%) received a ventriculoperitoneal shunt (VPD), 15 patients (62%) underwent a ventriculocysternostomy (VCS), and 3 patients (12.5%) received temporary ventricular drainage before or during tumor excision. The post-operative results were almost similar. Nevertheless, a high failure rate (25%) was observed. No deaths are recorded. In total, 75% of children who had a DVP were reoperated. The revision by VCS was performed, in addition to the 4 patients benefiting from a DVP, with one patient having received external drainage, and only one revision of a VCS was recorded. In the two patients who received external drainage, restoration of CSF outflow was observed following tumor resection. Conclusion: VCS is indicated in the first intention in the treatment of hydrocephalus secondary to a posterior fossa tumor, in view of the satisfactory results obtained and the high failure rate in DVP, especially with the presence of metastatic cells in the peritoneum, but can be considered as a second-line treatment.

Keywords: posterior fossa tumor, obstructive hydrocephalus, DVP, VCS

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Authors: Olaide O. Wahab, Lukman O. Olasunkanmi, Krishna K. Govender, Penny P. Govender

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The economic and environmental challenges associated with azo disperse dyes applications are due to poor aqueous solubility and low degradation tendency which stems from low chemical reactivity. Poor aqueous solubility property of this group of dyes necessitates the use of dispersing agents which increase operational costs and also release toxic chemical components into the environment, while their low degradation tendency is due to the high stability of the azo functional group (-N=N-) in their chemical structures. To address these problems, this study investigated theoretically the effects of some polar substituents on the aqueous solubility and reactivity properties of disperse yellow (DY) 119 dye with a view to theoretically develop new azo disperse dyes with improved solubility in water and higher degradation tendency in the environment using DMol³ computational code. All calculations were carried out using the Becke and Perdew version of Volsko-Wilk-Nusair (VWN-BP) level of density functional theory in conjunction with double numerical basis set containing polarization function (DNP). The aqueous solubility determination was achieved with conductor-like screening model for realistic solvation (COSMO-RS) in conjunction with known empirical solubility model, while the reactivity was predicted using frontier molecular orbital calculations. Most of the new derivatives studied showed evidence of higher aqueous solubility and degradation tendency compared to the parent dye. We conclude that these derivatives are promising alternative dyes for more economic and environmental benign dyeing practice and therefore recommend them for synthesis.

Keywords: aqueous solubility, azo disperse dye, degradation, disperse yellow 119, DMol³, reactivity

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Authors: Chandralekha Ashangari, Amer Suleman

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Background and Purpose: The Postural Orthostatic Tachycardia Syndrome (POTS) affects primarily young women. POTS is a form of dysautonomia that is estimated to impact between 1,000,000 and 3,000,000 Americans, and millions more around the world. POTS is a form of orthostatic intolerance that is associated with many Gastrointestinal disturbances. The aim of this study is to determine the Gastrointestinal disturbances in Postural Orthostatic Tachycardia Syndrome (POTS) patients.2. Methods: 249 patients referred to our clinic from January to November with POTS. Reviewed the medical records of 249 POTS patients and gastrointestinal symptoms. Results: however out of 249 patients, 226 patients are female (90.76%; average age 32.69), 23 patients are male (9.24%; average age 27.91) Data analysis: Out of 249 patients 189 patients (76%) had vomiting or nausea, 150 patients (60%) had irritable bowel syndrome, 128 patients (51%) had bloating, 125 patients (50%) had constipation , 80 patients (32%) had abdominal pain, 56 patients (22%) had delayed gastric emptying, 24 patients (10%) had lactose intolerance, 8 patients (3%) had Gastroesophageal reflux disease, 5 patients (2%) had Iron deficiency anemia, 6 patients (2%) had Peptic ulcer disease, 4 patients (2%) had Celiac Disease. Conclusion: Patients with POTS have a very high prevalence of gastrointestinal symptoms however the majority of abnormalities appear to be motility related. Motility testing should be performed be performed in POTS patients. The diagnostic yield of endoscopic procedures appears to be low.

Keywords: gastrointestinal disturbances, Postural Orthostatic Tachycardia Syndrome (POTS), celiac disease, POTS patients

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Authors: Muhammad Waleed Asfandyar, Akhtar Ahmed, Syed Adib-ul-Hasan Rizvi

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Objective: To evaluate the ability of serum concentration of prostate specific antigen between two cutting points considering it as a predictor of skeletal metastasis on bone scintigraphy in men with prostate cancer. Settings: This study was carried out in department of Nuclear Medicine at Sindh Institute of Urology and Transplantation (SIUT) Karachi, Pakistan. Materials and Method: From August 2013 to November 2013, forty two (42) consecutive patients with prostate cancer who underwent technetium-99m methylene diphosphonate (Tc-99mMDP) whole body bone scintigraphy were prospectively analyzed. The information was collected from the scintigraphic database at a Nuclear medicine department Sindh institute of urology and transplantation Karachi Pakistan. Patients who did not have a serum PSA concentration available within 1 month before or after the time of performing the Tc-99m MDP whole body bone scintigraphy were excluded from this study. A whole body bone scintigraphy scan (from the toes to top of the head) was performed using a whole-body Moving gamma camera technique (anterior and posterior) 2–4 hours after intravenous injection of 20 mCi of Tc-99m MDP. In addition, all patients necessarily have a pathological report available. Bony metastases were determined from the bone scan studies and no further correlation with histopathology or other imaging modalities were performed. To preserve patient confidentiality, direct patient identifiers were not collected. In all the patients, Prostate specific antigen values and skeletal scintigraphy were evaluated. Results: The mean age, mean PSA, and incidence of bone metastasis on bone scintigraphy were 68.35 years, 370.51 ng/mL and 19/42 (45.23%) respectively. According to PSA levels, patients were divided into 5 groups < 10ng/mL (10/42), 10-20 ng/mL (5/42), 20-50 ng/mL (2/42), 50-100 (3/42), 100- 500ng/mL (3/42) and more than 500ng/mL (0/42) presenting negative bone scan. The incidence of positive bone scan (%) for bone metastasis for each group were O1 patient (5.26%), 0%, 03 patients (15.78%), 01 patient (5.26%), 04 patients (21.05%), and 10 patients (52.63%) respectively. From the 42 patients 19 (45.23%) presented positive scintigraphic examination for the presence of bone metastasis. 1 patient presented bone metastasis on bone scintigraphy having PSA level less than 10ng/mL, and in only 1 patient (5.26%) with bone metastasis PSA concentration was less than 20 ng/mL. therefore, when the cutting point adopted for PSA serum concentration was 10ng/mL, a negative predictive value for bone metastasis was 95% with sensitivity rates 94.74% and the positive predictive value and specificities of the method were 56.53% and 43.48% respectively. When the cutting point of PSA serum concentration was 20ng/mL the observed results for Positive predictive value and specificity were (78.27% and 65.22% respectively) whereas negative predictive value and sensitivity stood (100% and 95%) respectively. Conclusion: Results of our study allow us to conclude that serum PSA concentration of higher than 20ng/mL was the most accurate cutting point than a serum concentration of PSA higher than 10ng/mL to predict metastasis in radionuclide bone scintigraphy. In this way, unnecessary cost can be avoided, since a considerable part of prostate adenocarcinomas present low serum PSA levels less than 20 ng/mL and for these cases radionuclide bone scintigraphy could be unnecessary.

Keywords: bone scan, cut off value, prostate specific antigen value, scintigraphy

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Authors: Rujuta Matapurkar, Shivganesh Bhargava

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This paper discusses work-family enrichment and its relationship with certain antecedents and outcomes while considering effect of mindfulness and organizational pride as moderators. The work-family enrichment has been the topic of interest for researchers as well as practitioners for decades now. It focusses on the positive side of work family interaction rather that the scarcity or balance principle. Research shows that work family enrichment is linked to multiple work place outcomes like job satisfaction, organization citizenship behavior and turnover intention. Enrichment is also linked to life outcomes like life satisfaction, wellbeing. Thus not only the individuals but the organizations too want to engage in the activities resulting in the positive spillover between work and non-work domains. One of the recent focus areas in organization behavior literature has been Mindfulness. Mindfulness is defined as a trait or state in which the mind focuses on the present. It is the conscious attention and awareness of the present thought. The research in the area of mindfulness at work suggests that the same is related to work family balance and job satisfaction. This paper discusses the possibility of mindfulness having effect on the relationship between antecedents of enrichment and enrichment. On the outcome side job embeddedness and job ambivalence are the newest additions to the retention literature. Job ambivalence talks about having strong positive as well as negative feelings about the job. Job ambivalence is the work outcome which is linked to turnover intention. This paper talks about the relationship between enrichment and job ambivalence. Another measure for work place outcomes which is discussed in recent research is job embeddedness. This term talks about the advantages of continuing with the job rather than quitting it. It is described as like a net or a web in which an individual can become stuck and is focused on why people stay rather than on how they leave. The research has have found that establishing or increasing job embeddedness is likely to increase retention, attendance, citizenship and job performance. This paper studies the relationship between enrichment and embeddedness. Lastly this paper studies whether organizational pride has an an effect on the relationship between enrichment and its outcomes. This paper concludes with the direction for future research.

Keywords: work-family enrichment, mindfulness, job ambivalence, job embeddedness, organizational pride

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Authors: Debalke Dale, Bezabh Geneta, Yohannes Amene, Yordanos Bergene, Mohammed Yimam

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Background: A drug therapy problem (DTP) is an event or circumstance that involves drug therapies that actually or potentially interfere with the desired outcome and requires professional judgment to resolve. Heart failure is an emerging worldwide threat whose prevalence and health loss burden constantly increase, especially in the young and in low-to-middle-income countries. There is a lack of population-based incidence and prevalence of heart failure (HF) studies in sub-Saharan African countries, including Ethiopia. Objective: The aim of this study was designed to assess drug therapy problems and associated factors among patients with HF in the medical ward of Arba Minch General Hospital(AGH), Ethiopia, from June 5 to August 20, 2022. Methods: A retrospective cross-sectional study was conducted among 180 patients with HF who were admitted to the medical ward of AGH. Data were collected from patients' cards by using questionnaires. The data were categorized and analyzed by using SPSS version 25.0 software, and data were presented in tables and words based on the nature of the data. Result: Out of the total, 85 (57.6%) were females, and 113 (75.3%) patients were aged over fifty years. Of the 150 study participants, 86 (57.3%) patients had at least one DTP identified, and a total of 116 DTPs were identified, which is 0.77 DTPs per patient. The most common types of DTP were unnecessary drug therapy (32%), followed by the need for additional drug therapy (36%), and dose too low (15%). Patients who used polypharmacy were 5.86 (AOR) times more likely to develop DTPs than those who did not (95% CI = 1.625–16.536, P = 0.005), and patients with more co-morbid conditions developed 3.68 (AOR) times more DTPs than those who had fewer co-morbidities (95% CI = 1.28–10.5, P = 0.015). Conclusion: The results of this study indicated that drug therapy problems were common among medical ward patients with heart failure. These problems are adversely affecting the treatment outcomes of patients, so it requires the special attention of healthcare professionals to optimize them.

Keywords: heart failure, drug therapy problems, Arba Minch general hospital, Ethiopia

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Authors: Yan Lu, Song Hong, Janakiraman Udaiyappan, Aarti Nagayach, Quoc-Viet A. Duong, Masao Morita, Shun Saito, Yuichi Kobayashi, Yuhai, Zhao, Hongying Peng, Nicholas B. Pham, Walter J Lukiw, Christopher A. Vuong, Nicolas G. Bazan

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Aims: Neurodegeneration and behavior dysfunction occurs in patients with Alzheimer's Disease (AD), and as the disease progresses many patients develop cognitive impairment. 5XFAD mouse model of AD is widely used to study AD pathogenesis and treatment. This study aimed to investigate the effect of maresin like 1 (MaR-L1) treatment in AD pathology using 5XFAD mice. Methods: We tested 12-month-old male 5XFAD mice and wild type control mice treated with MaR-L1 in a battery of behavioral tasks. We performed open field test, beam walking test, clasping test, inverted grid test, acetone test, marble burring test, elevated plus maze test, cross maze test and novel object recognition test. We also studied neuronal loss, amyloid β burden, and inflammation in the brains of 5XFAD mice using immunohistology and Western blotting. Results: MaR-L1 treatment to the 5XFAD mice showed improved cognitive function of 5XFAD mice. MaR-L1 showed decreased anxiety behavior in open field test and marble burring test, increased muscular strength in the beam walking test, clasping test and inverted grid test. Cognitive function was improved in MaR-L1 treated 5XFAD mice in the novel object recognition test. MaR-L1 prevented neuronal loss and aberrant inflammation. Conclusion: Our finding suggests that behavioral abnormalities were normalized by the administration of MaR-L1 and the neuroprotective role of MaR-L1 in the AD. It also indicates that MaR-L1 treatment is able to prevent and or ameliorate neuronal loss and aberrant inflammation. Further experiments to validate the results are warranted using other AD models in the future.

Keywords: Alzheimer's disease, motor and cognitive behavior, 5XFAD mice, Maresin Like 1, microglial cell, astrocyte, neurodegeneration, inflammation, resolution of inflammation

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Authors: Rezki Akkal, Mohamed Khodja, Slimane Azzi

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Acidification is a technique used in oil reservoirs to improve annual production, reduce the skin and increase the pressure of an oil well while eliminating the formation damage that occurs during the drilling process, completion and, amongst others, to create new channels allowing the easy circulation of oil around a producing well. This is achieved by injecting an acidizing fluid at a relatively low pressure to prevent fracturing formation. The treatment fluid used depends on the type and nature of the reservoir rock traversed as well as its petrophysical properties. In order to understand the interaction mechanisms between the treatment fluids used for the reservoir rock acidizing, several candidate wells for stimulation were selected in the large Hassi Messaoud deposit in southern Algeria. The stimulation of these wells is completed using different fluids composed mainly of HCl acid with other additives such as corrosion inhibitors, clay stabilizers and iron controllers. These treatment fluids are injected over two phases, namely with clean tube (7.5% HCl) and matrix aidizing with HCl (15%). The stimulation results obtained are variable according to the type of rock traversed and its mineralogical composition. These results show that there has been an increase in production flow and head pressure respectively from 1.99 m3 / h to 3.56 m3 / h and from 13 Kgf / cm2 to 20 kgf / cm2 in the sands formation having good petrophysical properties of (porosity = 16%) and low amount of clay (Vsh = 6%).

Keywords: acidizing, Hassi-Messaoud reservoir, tube clean, matrix stimulation

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Authors: Prakash Singh

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Many schools throughout the world are facing constant pressure to cope with the violence and drug abuse of learners who show little or no respect for acceptable and desirable social norms. These delinquent learners tend to harbour feelings of being beyond reproach because they strongly believe that it is well within their rights to engage in violent and destructive behaviour. Knives, guns, and other weapons appear to be more readily used by them on the school premises than before. It is known that learners smoke, drink alcohol, and use drugs during school hours, hence, their ability to concentrate, work, and learn, is affected. They become violent and display disruptive behaviour in their classrooms as well as on the school premises, and this atrocious behaviour makes it possible for drug dealers and gangsters to gain access onto the school premises. The primary purpose of this exploratory quantitative study was therefore to establish how tobephobia (TBP), caused by school violence and drug abuse, affects teaching and learning in schools. The findings of this study affirmed that poor discipline resulted in producing poor quality education. Most of the teachers in this study agreed that educating learners who consumed alcohol and other drugs on the school premises resulted in them suffering from TBP. These learners are frequently abusive and disrespectful, and resort to violence to seek attention. As a result, teachers feel extremely demotivated and suffer from high levels of anxiety and stress. The word TBP will surely be regarded as a blessing by many teachers throughout the world because finally, there is a word that will make people sit up and listen to their problems that cause real fear and anxiety in schools.

Keywords: aims and objectives of quality education, debilitating effects of tobephobia, fear of failure associated with education, learners' violent behaviour and drug abuse

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Authors: Md. Nurul Islam Siddique, A. W. Zularisam

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The effect of gradual increase in organic loading rate (OLR) and temperature on biomethanation from petrochemical wastewater treatment was investigated using CSTR. The digester performance was measured at hydraulic retention time (HRT) of 4 to 2d, and start up procedure of the reactor was monitored for 60 days via chemical oxygen demand (COD) removal, biogas and methane production. By enhancing the temperature from 30 to 55 ˚C Thermophilic condition was attained, and pH was adjusted at 7 ± 0.5 during the experiment. Supreme COD removal competence was 98±0.5% (r = 0.84) at an OLR of 7.5 g-COD/Ld and 4d HRT. Biogas and methane yield were logged to an extreme of 0.80 L/g-CODremoved d (r = 0.81), 0.60 L/g-CODremoved d (r = 0.83), and mean methane content of biogas was 65.49%. The full acclimatization was established at 55 ˚C with high COD removal efficiency and biogas production. An OLR of 7.5 g-COD/L d and HRT of 4 days were apposite for petrochemical wastewater treatment.

Keywords: anaerobic digestion, petrochemical wastewater, CSTR, methane

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Authors: Nashaat A. Deiab, Aida Radwan, Mohamed S. Yahiya, Mohamed Elnagdy, Rasha Moustafa

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This study is to evaluate the dosimetric performance of our institution's 3D treatment planning system for wedged and off-axis 6MV photon beams, guided by the recommended QA tests documented in the AAPM TG53; NCS report 15 test packages, IAEA TRS 430 and ESTRO booklet no.7. The study was performed for Elekta Precise linear accelerator designed for clinical range of 4, 6 and 15 MV photon beams with asymmetric jaws and fully integrated multileaf collimator that enables high conformance to target with sharp field edges. Ten tests were applied on solid water equivalent phantom along with 2D array dose detection system. The calculated doses using 3D treatment planning system PrecisePLAN were compared with measured doses to make sure that the dose calculations are accurate for simple situations such as square and elongated fields, different SSD, beam modifiers e.g. wedges, blocks, MLC-shaped fields and asymmetric collimator settings. The QA results showed dosimetric accuracy of the TPS within the specified tolerance limits. Except for large elongated wedged field, the central axis and outside central axis have errors of 0.2% and 0.5%, respectively, and off- planned and off-axis elongated fields the region outside the central axis of the beam errors are 0.2% and 1.1%, respectively. The dosimetric investigated results yielded differences within the accepted tolerance level as recommended. Differences between dose values predicted by the TPS and measured values at the same point are the result from limitations of the dose calculation, uncertainties in the measurement procedure, or fluctuations in the output of the accelerator.

Keywords: quality assurance, dose calculation, wedged fields, off-axis fields, 3D treatment planning system, photon beam

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Authors: Sunmaila Oyetunji Raimi, Olufemi Akinloye Bolaji, Abiodun Ezekiel Adesina

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The lingering poor performance of students in basic science spells doom for a vibrant scientific and technological development which pivoted the economic, social and physical upliftment of any nation. This calls for identifying appropriate strategies for imparting basic science knowledge and attitudes to the teaming youths in secondary schools. This study, therefore, determined the impact of computer mediated power point presentations on students’ achievement in basic science in Oyo State, Nigeria. A pre-test, posttest, control group quazi-experimental design adopted for the study. Two hundred and five junior secondary two students selected using stratified random sampling technique participated in the study. Three research questions and three hypotheses guided the study. Two evaluative instruments – Students’ Basic Science Attitudes Scale (SBSAS, r = 0.91); Students’ Knowledge of Basic Science Test (SKBST, r = 0.82) were used for data collection. Descriptive statistics of mean, standard deviation and inferential statistics of ANCOVA, scheffe post-hoc test were used to analyse the data. The results indicated significant main effect of treatment on students cognitive (F(1,200)= 171.680; p < 0.05) and attitudinal (F(1,200)= 34.466; p < 0.05) achievement in Basic science with the experimental group having higher mean gain than the control group. Gender has significant main effect (F(1,200)= 23.382; p < 0.05) on students cognitive outcomes but not significant for attitudinal achievement in Basic science. The study therefore recommended among others that computer mediated power point presentations should be incorporated into curriculum methodology of Basic science in secondary schools.

Keywords: basic science, computer mediated power point presentations, gender, students’ achievement

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Authors: Dona Pamoda W. Jayatunga, Veer Bala Gupta, Eugene Hone, Ralph N. Martins

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Being a neurodegenerative disorder, Alzheimer’s disease (AD) affects a majority of the elderly demented worldwide. The key risk factors for AD are age, metabolic syndrome, allele status of APOE gene, head injuries and lifestyle. The progressive nature of AD is characterized by symptoms of multiple cognitive deficits exacerbated over time, leading to death within a decade from clinical diagnosis. However, it is revealed that AD originates via a prodromal phase that spans from one to few decades before symptoms first manifest. The key pathological hallmarks of AD brains are deposition of amyloid beta (Aβ) plaques and neurofibrillary tangles (NFT). However, the yet unknown etiology of the disease fails to distinguish mitochondrial dysfunction between a cause or an outcome. The absence of early diagnosis tools and definite therapies for AD have permitted recruits of nutraceutical-based approaches aimed at reducing the risk of AD by modulating lifestyle or be used as preventive tools during AD prodromal state before widespread neurodegeneration begins. The objective of the present study was to investigate beneficial effects of luteolin, a plant-based flavone compound, against AD. The neuroprotective effects of luteolin on amyloid beta (Aβ) (1-42)-induced neurotoxicity was measured using cultured human neuroblastoma BE(2)-M17 cells. After exposure to 20μM Aβ (1-42) for 48 h, the neuroblastoma cells exhibited marked apoptotic death. Co-treatment of 20μM Aβ (1-42) with luteolin (0.5-5μM) significantly protected the cells against Aβ (1-42)-induced toxicity, as assessed by the MTS [3-(4,5-dimethylthiazol-2-yl)-5-(3-carboxymethoxyphenyl)-2(4sulfophenyl)-2H-tetrazolium, inner salt; MTS] reduction assay and the lactate dehydrogenase (LDH) cell death assay. The results suggest that luteolin prevents Aβ (1-42)-induced apoptotic neuronal death. However, further studies are underway to determine its protective mechanisms in AD including the activity against tau hyperphosphorylation and mitochondrial dysfunction.

Keywords: Aβ (1-42)-induced toxicity, Alzheimer’s disease, luteolin, neuroblastoma cells

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Authors: Pratibha Goyal, Nupur Mathur, Anuradha Singh

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Antibiotic resistance is the worldwide threat to human health in this century. Excessive use of antibiotic after their discovery in 1940 makes certain bacteria to become resistant against antibiotics. Most common antibiotic-resistant bacteria include Staphylococcus aureus, Salmonella typhi, E.coli, Klebsiella pneumonia, and Streptococcus pneumonia. Among all Staphylococcus resistant strain called Methicillin-resistant Staphylococcus aureus (MRSA) is responsible for several lives threatening infection in human commonly found in the hospital environment. Our study aimed to isolate bacteriophage against MRSA from the hospital sewage treatment plant and to analyze its efficiency In Vivo in Swiss albino mice model. Sewage sample for the isolation of bacteriophages was collected from SDMH hospital sewage treatment plant in Jaipur. Bacteriophages isolated by the use of enrichment technique and after characterization, isolated phages used to determine phage treatment efficiency in mice. Mice model used to check the safety and suitability of phage application in human need which in turn directly support the use of natural bacteriophage rather than synthetic chemical to kill pathogens. Results show the plaque formation in-vitro and recovery of MRSA infected mice during the experiment. Favorable lytic efficiency determination of MRSA and Salmonella presents a natural way to treat lethal infections caused by Multidrug-resistant bacteria by using their natural host-pathogen relationship.

Keywords: antibiotic resistance, bacteriophages, methicillin resistance Staphylococcus aureus, pathogens, phage therapy, Salmonella typhi

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Authors: Gokhan Zengin, Abdurrahman Aktumsek

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The key enzyme inhibitory theory is one of the most accepted strategies in the treatment of global health problems including Alzheimer’s Disease and Diabetes mellitus. For this reason, the enzyme inhibitory potentials of different solvent extracts from Linaria genistifolia subsp. genistifolia were investigated against cholinesterase, and tyrosinase. The in vitro enzyme inhibitory potentials were measured with a microplate reader. The acetone and methanol extracts exhibited the strongest enzyme inhibitory effects on cholinesterase. However, the water extract was only active on tyrosinase. The results suggested that Linaria genistifolia subsp. genistifolia could be considered as a source of natural enzyme inhibitors for the treatment of major health problems.

Keywords: enzyme inhibitors, cholinesterase, tyrosinase, linaria, Turkey

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Authors: Nurul Z. Sani, Amalina N. Ghazali, Azree Elmy, Lee C. Yuen, Zar C. Thent

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Piper betel (P. betel) leaves is widely used in Asian countries for treating diabetes mellitus and its complication. In our previous study, we observed the positive effect of P.betel extract on diabetic wounds following 3 and 7 days of treatment. The aim of the present study was to determine the effect of P.betel leaves extract in the diabetic rats was observed in terms of body weight and wound contraction rates following 5 days of the treatment. Total 64 male Sprague-Dawley rats were used and the experimental rats received a single dose of 60mg/kg of Streptozotocin (STZ) injection, intraperitoneally. Four full thickness (6mm) cutaneous wounds were created on dorsum of each rat. The rats were divideid into (n=8): Non-treated Control (NC), Non-treated Diabetic (ND), diabetic treated with commercial cream (SN) and diabetic treated with 50mg/kg of P.betel extract (PB). The rats were sacrificed on day 0 and 5 post wounding. Significant increased in wound closure rate, body weight was observed in PB group compared to ND. Histological deterioration was restored in the P. betel extract treated wounds. It is concluded that topical application with P.betel extract for 5 days of post wounding offers positive scientific value in diabetic rats.

Keywords: diabetes, piper betel, wound healing, body weight, morphology

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Authors: Boudjelal Amel

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Arisarum vulgare, a member of the Araceae family, is an herbaceous perennial widely distributed in the Mediterranean region. A. vulgare is recognized for its medicinal properties and holds significant traditional importance in Algeria for the treatment of various human ailments, including pain, infections, inflammation, digestive disorders, skin problems, eczema, cancer, wounds, burns and gynecological diseases. Despite its extensive traditional use, scientific exploration of A. vulgare remains limited. The study aims to investigate for the first time the therapeutic potential of A. vulgare ethanolic extract obtained by ultrasound-assisted extraction. The chemical composition of the extract was determined by LC-MS/MS analysis. For in vitro phytopharmacological evaluation, several assays, including DPPH, ABTS, FRAP and reducing power, were employed to evaluate the antioxidant activity. The antibacterial activity was assessed againt Escherichia coli, Salmonella typhimurium, Staphylococus aureus, Enterococcus feacium by disk diffusion and microdilution methods. The possible inhibitory activity of ethanolic extract was analyzed against the cholinesterases enzymes (AChE and BChE). The DNA protection activity of A. vulgare ethanolic extract was estimated using the agarose gel electrophoresis method. The capacities of the extract to protect plasmid DNA (pBR322) from the oxidizing effects of H2O2 and UV treatment were evaluated by their DNA-breaking forms. The in vivo wound healing potential of a traditional ointment containing 5% of A. vulgare ethanolic extract was also investigated. The LC-MS/MS profiling of the extract revealed the presence of various bioactive compounds, including naringenin, chlorogenic, vanillic, cafeic, coumaric acids, trans-cinnamic and trans ferrulic acids. The plant extract presented considerable antioxidant potential, being the most active for Reducing power (0,07326±0.001 mg/ml) and DPPH (0.14±0.004 mg/ml). The extract showed the highest inhibition zone diameter against Enterococcus feacium (36±0.1 mm). The ethanolic extract of A. vulgare suppressed the growth of Staphylococus aureus, Escherichia coli and Salmonella typhimurium according to the MIC values. The extract of the plant significantly inhibited both AChE and BChE enzymes. DNA protection activity of the A. vulgare extract was determined as 90.41% for form I and 51.92% for form II. The in vivo experiments showed that 5% ethanolic extract ointment accelerated the wound healing process. The topical application of the traditional formulation enhanced wound closure (95,36±0,6 %) and improved histological parameters in the treated group compared to the control groups. The promising biological properties of Arisarum vulgare revealed that the plant could be appraised as a potential origin of bioactive molecules having multifunctional medicinal uses.

Keywords: arisarum vulgare, LC-MS/MS, antioxidant activity, antimicrobial activity, cholinesterases enzymes inhibition, dna-damage activity, in vivo wound healing

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Authors: Anan Jarab, Riham Almrayat, Salam Alqudah, Maher Khdour, Tareq Mukattash, Sharell Pinto

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Background: The prevalence of diabetes in Jordan is among the highest in the world, making it a particularly alarming health problem there. It has been indicated that poor adherence to the prescribed therapy lead to poor glycemic control and enhance the development of diabetes complications and unnecessary hospitalization. Purpose: To explore factors associated with medication non-adherence in patients with type 2 diabetes in Jordan. Materials and Methods: Variables including socio-demographics, disease and therapy factors, diabetes knowledge, and health-related quality of life in addition to adherence assessment were collected for 171 patients with type 2 diabetes using custom-designed and validated questionnaires. Logistic regression was performed to develop a model with variables that best predicted medication non-adherence in patients with type 2 diabetes in Jordan. Results: The majority of the patients (72.5%) were non-adherent. Patients were found four times less likely to adhere to their medications with each unit increase in the number of prescribed medications (OR = 0.244, CI = 0.08-0.63) and nine times less likely to adhere to their medications with each unit increase in the frequency of administration of diabetic medication (OR = 0.111, CI = 0.04-2.01). Patients in the present study were also approximately three times less likely (OR = 0.362, CI = 0.24-0.87) to adhere to their medications if they reported having concerns about side effects and twice more likely to adhere to medications (OR = 0.493, CI = 0.08-1.16) if they had one or more micro-vascular complication. Conclusion: The current study revealed low adherence rate to the prescribed therapy among Jordanians with type 2 diabetes. Simplifying dosage regimen, selecting treatments with lower side effects along with an emphasis on diabetes complications should be taken into account when developing care plans for patients with type 2 diabetes.

Keywords: type 2 diabetes, adherence, glycemic control, clinical pharmacist, Jordan

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Authors: Amenawo I. Offiong, Hodo B. Riman

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Public debt profile of Nigeria has continuously been on the increase over the years. The drop in international crude oil prices has further worsened revenue position of the country, thus, necessitating further acquisition of public debt to bridge the gap in revenue deficit. Yet, when we look back at the increasing public sector spending, there are concerns that the government spending do not amount to increase in public goods provided for the country. Using data from 1980 to 2014 the study therefore seeks to investigate the factors responsible for the poor provision of public goods in the face of increasing public debt profile. Using the unrestricted VAR model Governance and Tax revenue were introduced into the model as structural variables. The result suggested that governance and tax revenue were structural determinants of the effectiveness of public goods provisioning in Nigeria. The study therefore identified weak governance as the major reason for the non-provision of public goods in Nigeria. While tax revenue exerted positive influence on the provisions of public goods, weak/poor governance was observed to crowd the benefits from increase tax revenue. The study therefore recommends reappraisal of the governance system in Nigeria. Elected officers in governance should be more transparent and accountable to the electorates they represent. Furthermore, the study advocates for an annual auditing of all government MDAs accounts by external auditors to ensure (a) accountability of public debts utilization, (b) transparent in implementation of program support funds, (c) integrity of agencies responsible for program management, and (d) measuring program effectiveness with amount of funds expended.

Keywords: impulse response function, public debt shocks, governance, public goods, tax revenue, vector auto-regression

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Authors: Sadia Munir

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Preeclampsia is the contributor to the worldwide maternal mortality of approximately 100,000 deaths a year. It complicates about 10% of all pregnancies and is the first cause of maternal admission to intensive care units. Predicting preeclampsia is a major challenge in obstetrics. More importantly, no major progress has been achieved in the treatment of preeclampsia. As placenta is the main cause of the disease, the only way to treat the disease is to extract placental and deliver the baby. In developed countries, the cost of an average case of preeclampsia is estimated at £9000. Interestingly, preeclampsia may have an impact on the health of mother or infant, beyond the pregnancy. We performed a systematic search of PubMed including the combination of terms such as preeclampsia, biomarkers, treatment, hypoxia, inflammation, oxidative stress, vascular endothelial growth factor A, activin A, inhibin A, placental growth factor, transforming growth factor β-1, Nodal, placenta, trophoblast cells, microRNAs. In this review, we have summarized current knowledge on the identification of potential biomarkers for the diagnosis of preeclampsia. Although these studies show promising data in early diagnosis of preeclampsia, the current value of these factors as biomarkers, for the precise prediction of preeclampsia, has its limitation. Therefore, future studies need to be done to support some of the very promising and interesting data to develop affordable and widely available tests for early detection and treatment of preeclampsia.

Keywords: activin, biomarkers, growth factors, miroRNA

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Authors: Akanimo Emene, Robert Edyvean

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In developing countries, a low cost method of wastewater treatment is highly recommended. Adsorption is an efficient and economically viable treatment process for wastewater. The utilisation of this process is based on the understanding of the relationship between the growth environment and the metal capacity of the biomaterial. Luffa cylindrica (LC), a plant material, was used as an adsorbent in adsorption design system of heavy metals. The chemically modified LC was used to adsorb heavy metals ions, lead and cadmium, from aqueous environmental solution at varying experimental conditions. Experimental factors, adsorption time, initial metal ion concentration, ionic strength and pH of solution were studied. The chemical nature and surface area of the tissues adsorbing heavy metals in LC biosorption systems were characterised by using electron microscopy and infra-red spectroscopy. It showed an increase in the surface area and improved adhesion capacity after chemical treatment. Metal speciation of the metal ions showed the binary interaction between the ions and the LC surface as the pH increases. Maximum adsorption was shown between pH 5 and pH 6. The ionic strength of the metal ion solution has an effect on the adsorption capacity based on the surface charge and the availability of the adsorption sites on the LC. The nature of the metal-surface complexes formed as a result of the experimental data were analysed with kinetic and isotherm models. The pseudo second order kinetic model and the two-site Langmuir isotherm model showed the best fit. Through the understanding of this process, there will be an opportunity to provide an alternative method for water purification. This will be provide an option, for when expensive water treatment technologies are not viable in developing countries.

Keywords: adsorption, luffa cylindrica, metal-surface complexes, pH

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Authors: P. Slepicka, N. Slepickova Kasalkova, I. Michaljanicova, O. Nedela, Z. Kolska, V. Svorcik

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Polymers exposed to laser or plasma treatment or modified with different wet methods which enable the introduction of nanoparticles or biologically active species, such as amino-acids, may find many applications both as biocompatible or anti-bacterial materials or on the contrary, can be applied for a decrease in the number of cells on the treated surface which opens application in single cell units. For the experiments, two types of materials were chosen, a representative of non-biodegradable polymers, polyethersulphone (PES) and polyhydroxybutyrate (PHB) as biodegradable material. Exposure of solid substrate to laser well below the ablation threshold can lead to formation of various surface structures. The ripples have a period roughly comparable to the wavelength of the incident laser radiation, and their dimensions depend on many factors, such as chemical composition of the polymer substrate, laser wavelength and the angle of incidence. On the contrary, biopolymers may significantly change their surface roughness and thus influence cell compatibility. The focus was on the surface treatment of PES and PHB by pulse excimer KrF laser with wavelength of 248 nm. The changes of physicochemical properties, surface morphology, surface chemistry and ablation of exposed polymers were studied both for PES and PHB. Several analytical methods involving atomic force microscopy, gravimetry, scanning electron microscopy and others were used for the analysis of the treated surface. It was found that the combination of certain input parameters leads not only to the formation of optimal narrow pattern, but to the combination of a ripple and a wrinkle-like structure, which could be an optimal candidate for cell attachment. The interaction of different types of cells and their interactions with the laser exposed surface were studied. It was found that laser treatment contributes as a major factor for wettability/contact angle change. The combination of optimal laser energy and pulse number was used for the construction of a surface with an anti-cellular response. Due to the simple laser treatment, we were able to prepare a biopolymer surface with higher roughness and thus significantly influence the area of growth of different types of cells (U-2 OS cells).

Keywords: cell response, excimer laser, polymer treatment, periodic pattern, surface morphology

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Authors: Melby Chacko, Jagannath Nayak

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The aging behaviour of 6061 Al-15 vol% SiC composite was investigated using Rockwell B hardness measurement. The composite was solutionized at 350°C and quenched in water. The composite was aged at room temperature (T4 treatment) and also at 140°C, 160°C, 180°C and 200°C (T6 treatment). The natural and artificial aging behaviour of composite was studied using aging curves determined at different temperatures. The aging period for peak aging for different temperatures was identified. The time required for attaining peak aging decreased with increase in the aging temperature. The peak hardness was found to increase with increase with aging temperature and the highest peak hardness was observed at 180ºC. Beyond 180ºC the peak hardness was found to be decreasing.

Keywords: 6061 Al-SiC composite, aging curve, Rockwell B hardness, T4, T6 treatments

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Authors: I. Bochev, A. Shterev, S. Kyurkchiev

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One of the factors associated with poor success rates in human in vitro fertilization (IVF) is the suboptimal culture conditions in which fertilization and early embryonic growth occur. Co-culture systems with helper cell lines appear to enhance the in vitro conditions and allow embryos to demonstrate improved in vitro development. The co-culture of human embryos with monolayers of autologous endometrial stromal cell (EnSCs) results in increased blastocyst development with a larger number of blastomeres, lower incidence of fragmentation and higher pregnancy rates in patients with recurrent implantation failure (RIF). The aim of the study was to examine the influence of autologous endometrial stromal cell (EnSC) co-culture on day 3 embryo quality by comparing the morphological status of the embryos from the same patients undergoing consecutive IVF/Intracytoplasmic sperm injection (ICSI) cycles without and with EnSC co-culture. This retrospective randomized study (2015-2017) includes 20 couples and a total of 46 IVF/ICSI cycles. Each patient couple included had at least two IVF/ICSI procedures – one with and one without autologous EnSC co-culture. Embryo quality was assessed at 68±1 hours in culture, according to Istanbul consensus criteria (2010). Day 3 embryos were classified into three groups: good – grade 1; fair – grade 2; poor – grade 3. Embryos from all cycles were divided into two groups (A – co-cultivated; B – not co-cultivated) and analyzed. Second, for each patient couple, embryos from matched IVF/ICSI cycles (with and without co-culture) were analyzed separately. When an analysis of co-cultivated day 3 embryos from all cycles was performed (n=137; group A), 43.1% of the embryos were graded as “good”, which was not significantly different from the respective embryo quality rate of 42.2% (p = NS) in group B (n=147) with non-co-cultivated embryos. The proportions of fair and poor quality embryos in group A and group B were similar as well – 11.7% vs 10.2% and 45.2% vs 47.6% (p=NS), respectively. Nevertheless, the separate embryo analysis by matched cycles for each couple revealed that in 65% of the cases the proportion of morphologically better embryos was increased in cycles with co-culture in comparison with those without co-culture. A decrease in this proportion after endometrial stromal cell co-cultivation was found in 30% of the cases, whereas no difference was observed in only one couple. The results demonstrated that there is no marked difference in the overall morphological quality between co-cultured and non-co-cultured embryos on day 3. However, in significantly greater percentage of couples the process of autologous EnSC co-culture could increase the proportion of morphologically improved day 3 embryos. By mimicking the in vivo relationship between embryo and maternal environment, co-culture in autologous EnSC system represents a perspective approach to improve the quality of embryos in cases with elevated risk for development of embryos with impaired morphology.

Keywords: autologous endometrial stromal cells, co-culture, day 3 embryo, morphological quality

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Authors: Mustafa M. Bob, Siti Izaidah Azmi, Mohd Hakim Ab Halim, Nur Syahida Abdul Jamal, Aznah Nor-Anuar, Zaini Ujang

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In this research, the formation and development of aerobic granular sludge (AGS) for domestic wastewater treatment application in hot climate conditions was studied using a sequencing batch reactor (SBR). The performance of the developed AGS in the removal of organic matter and nutrients from wastewater was also investigated. The operation of the reactor was based on the sequencing batch system with a complete cycle time of 3 hours that included feeding, aeration, settling, discharging and idling. The reactor was seeded with sludge collected from the municipal wastewater treatment plant in Madinah city, Saudi Arabia and operated at a temperature of 40ºC using synthetic wastewater as influent. Results showed that granular sludge was developed after an operation period of 30 days. The developed granular sludge had a good settling ability with the average size of the granules ranging from 1.03 to 2.42 mm. The removal efficiency of chemical oxygen demand (COD), ammonia nitrogen (NH3-N) and total phosphorus (TP) were 87.31%, 91.93% and 61.25% respectively. These results show that AGS can be developed at elevated temperatures and it is a promising technique to treat domestic wastewater in hot and low humidity climate conditions such as those encountered in Saudi Arabia.

Keywords: aerobic granular sludge, hot climate, sequencing batch reactor, domestic wastewater treatment

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Authors: Sandeep J. Kumar

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Urbanisation is considered as the primary driver of land use and land cover change that has direct link to population and economic growth. In India, as well as in other developing countries, cities are urbanizing at an alarming rate. This unprecedented and uncontrolled urbanisation can result in urban sprawl. Due to a number of factors, urban sprawl is recognised to be a result of poor planning, inadequate policies, and poor governance. Urban sprawl may be seen as posing a threat to the development of sustainable cities. Hence, it is very essential to manage this. Planning for predicted future growth is critical to avoid the negative effects of urban growth at the local and regional levels. Thiruvananthapuram being the capital city of Kerala is a city of economic success, challenges, and opportunities. Urbanization trends in the city have paved way for Urban Sprawl. This thesis aims to formulate a framework to combat the emerging urban sprawl in the city of Thiruvananthapuram. For that, the first step was to quantify trends of urban growth in Thiruvananthapuram city using Geographical Information System(GIS) and remote sensing techniques. The technique and results obtained in the study are extremely valuable in analysing the land use changes. Secondly, these change in the trends were analysed through some of the critical factors that helped the study to understand the underlying issues of the existing city structure that has resulted in urban sprawl. Anticipating development trends can modify the current order. This can be productively resolved using regional and municipal planning and management strategies. Hence efficient strategies to curb the sprawl in Thiruvananthapuram city have been formulated in this study that can be considered as recommendations for future planning.

Keywords: urbanisation, urban sprawl, geographical information system(GIS), thiruvananthapuram

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Authors: Muhammad Tahir Riaz, Khalid Mehmood, Ahmad Waseem Akhtar, Tariq Abbas, Sadaqat Ali, Muhammad Altaf

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Livestock sector contributes around 55.9 and 11.8% to agriculture and GDP respectively, according to economic survey of Pakistan 2013-2014. The goats population has been estimated about 66.6 million (M). Parasitic infestation is a major health problem in goats causing loss in body weight, poor body condition, low birth weights, and difficulty in kidding. Keeping in view the utilization of these animals in the country, a pilot epidemiological survey was conducted to find out the major parasitic problems of goats in and around Derawar fort area, Cholistan. Data regarding 662 fecal samples of goats was collected from 25 tobas of Cholistan during June 2012 to June 2013. All the fecal samples were examined through Direct Smear Method and Salt Flotation Technique for the presence of helminth eggs. External parasites were taken from the various components of the carcass of goat and were conserved in 70% alcohol in hygienic, properly enclosed glass jars that were tagged thoroughly. The collected date was analyzed statistically by Chi-square test to find out the prevalence in goats. Out of 662 goats, 261 (39.42%) were found positive for parasites. 233 (35.20%) goats were found positive for gastrointestinal parasites while 28 (4.23%) were positive for external parasites including ticks 20 (3.02%) and mange 8 (1.21%). The higher prevalence of parasites in the study area may be due to pasture grazing, poor management and lack of extension work. In this regards proper management and control measures should be adopted to minimize the Parasitic Problems.

Keywords: Cholistan, goats, parasite, surveillance

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