Search results for: Mark Ivan Roblas

Authors: T. Abdulkadir

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Most often, marking and assessment of multiple choice kinds of examinations have been opined by many as a cumbersome and herculean task to accomplished manually in Nigeria. Usually this may be in obvious nexus to the fact that mass numbers of candidates were known to take the same examination simultaneously. Eventually, marking such a mammoth number of booklets dared and dread even the fastest paid examiners who often undertake the job with the resulting consequences of stress and boredom. This paper explores the evolution, as well as the set aim to envision and transcend marking the Multiple Choice Objectives- type examination into a thing of creative recreation, or perhaps a more relaxing activity via the use of the mobile phone. A more “pragmatic” dimension method was employed to achieve this work, rather than the formal “in-depth research” based approach due to the “novelty” of the mobile-smartphone e-Marking Scheme discovery. Moreover, being an evolutionary scheme, no recent academic work shares a direct same topic concept with the ‘use of cell phone as an e-marking technique’ was found online; thus, the dearth of even miscellaneous citations in this work. Additional future advancements are what steered the anticipatory motive of this paper which laid the fundamental proposition. However, the paper introduces for the first time the concept of mobile-smart phone e-marking, the steps to achieve it, as well as the merits and demerits of the technique all spelt out in the subsequent pages.

Keywords: cell phone, e-marking scheme (eMS), mobile phone, mobile-smart phone, multiple choice objectives (MCO), smartphone

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Authors: Przemyslaw Nogly, Tobias Weinert, Daniel James, Sergio Carbajo, Dmitry Ozerov, Antonia Furrer, Dardan Gashi, Veniamin Borin, Petr Skopintsev, Kathrin Jaeger, Karol Nass, Petra Bath, Robert Bosman, Jason Koglin, Matthew Seaberg, Thomas Lane, Demet Kekilli, Steffen Brünle, Tomoyuki Tanaka, Wenting Wu, Christopher Milne, Thomas A. White, Anton Barty, Uwe Weierstall, Valerie Panneels, Eriko Nango, So Iwata, Mark Hunter, Igor Schapiro, Gebhard Schertler, Richard Neutze, Jörg Standfuss

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Ultrafast isomerization of retinal is the primary step in a range of photoresponsive biological functions including vision in humans and ion-transport across bacterial membranes. We studied the sub-picosecond structural dynamics of retinal isomerization in the light-driven proton pump bacteriorhodopsin using an X-ray laser. Twenty snapshots with near-atomic spatial and temporal resolution in the femtosecond regime show how the excited all-trans retinal samples conformational states within the protein binding pocket prior to passing through a highly-twisted geometry and emerging in the 13-cis conformation. The aspartic acid residues and functional water molecules in proximity of the retinal Schiff base respond collectively to formation and decay of the initial excited state and retinal isomerization. These observations reveal how the protein scaffold guides this remarkably efficient photochemical reaction.

Keywords: bacteriorhodopsin, free-electron laser, retinal isomerization mechanism, time-resolved crystallography

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Authors: Aastha Chaudhry

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This continuous structuring of the ego through the developmental ages, starting with the body, has been understood through various perspectives from the object-relations world. Klein, Ogden, Winnicott to name a few, have been masters at helping mark a trajectory for the self to come to fruition. However, what constitutes those states, those relational structures, the dynamics of transference and the concept of inner objects has been more or less left unexplored in the psychoanalytic developmental theory. In this paper, through the help of a case study, Ogden’s ideas of an autistic contagious position and Kleinian theory of object relations is proposed to visualize a lens that helps to understand the relationship of the autistic self and body and allows us to take a look at object relations through countertransference. With the help of case vignettes, an understanding of experience is seen as dominated in the autistic contagious position with the help of defensive structuring that is not only self-fulfilling and sensorial oriented, but is also a pre symbolic mode of relating to the other. The aim of this clinical, experiential study is to better understand the self-body and the self-other relationships, or the absence thereof, in the autistic world and states. The goal of the study was to find such a relationship between play, body, structuring of experience and an autistic self in these individuals through that. Aim being that psychotherapy is brought to fore in the world of autism. The method was case study with one on one intervention, that was psychodynamically informed and play therapy based. Some of the findings after a year of work with these individuals were that: in the absence of a shared vocabulary, communication in two contrasting individuals happens primarily through the assistance of the body. Somatic countertransference, for instance, is how one can be with someone in a therapeutic relationship – and with autistic adolescents it is a further complicated relationship. With a mind somewhere in infanthood, and body experiencing adulthood, it becomes a challenge for the therapist to meet the client where they are. With pre-verbal states, play becomes such a potential space where two individuals could meet – a safe ground for forces to be contained. Play, then, becomes a mode of communication with such a population.

Keywords: autism, psychoanalytic, play, self

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Authors: Mukhtari Hussaini Muhammad, Abba Adamu

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The paper will examine the approaches and solutions that will be offered by Senior Secondary School II Students (Demonstration Secondary School, Azare Bauchi State Northern Nigeria – Hausa/ Fulani predominant area) toward solving exercises related to the circle theorem. The angle that an arc of a circle subtends at the center is twice that which it subtends at any point on the remaining part of the circumference. The Students will be divided in to 2 groups by given them numbers 1, 2; 1, 2; 1, 2, then all 1s formed group I and all 2s formed group II. Group I will be considered as control group in which the traditional method will be applied during instructions. Thus, the researcher will revise the concept of circle, state the theorem, prove the theorem and then solve examples. Group II, experimental group in which the concept of circle will be revised to the students and then the students will be asked to draw different circles, mark arcs, draw angle at the center, angle at the circumference then measure the angles constructed. The students will be asked to explain what they can infer/deduce from the angles measured and lastly, examples will be solved. During the next contact day, both groups will be subjected to solving exercises in the classroom related to the theorem. The angle that an arc of a circle subtends at the center is twice that which it subtends at any point on the remaining part of circumference. The solution to the exercises will be marked, the scores compared/analysed using relevant statistical tool. It is expected that group II will perform better because of the method/ technique followed during instructions is more learner-centered. By exploiting the talents of the individual learners through listening to the views and asking them how they arrived at a solution will really improve learning and understanding.

Keywords: circle theorem, control group, experimental group, traditional method

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Authors: Mihai-Ionut Firescu, Mark A. P. Carson

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We present a case of inferior vena cava agenesis (IVCA) associated with bilateral deep venous thrombosis (DVT) in a patient with Beckwith-Wiedemann syndrome (BWS). In adult patients with BWS presenting with bilateral lower limb oedema, specific aetiological factors should be considered. These include cardiomyopathy and intraabdominal tumours. Congenital malformations of the IVC, through causing relative venous stasis, can lead to lower limb oedema either directly or indirectly by favouring lower limb venous thromboembolism; however, they are yet to be reported as an associated feature of BWS. Given its life-threatening potential, the prompt initiation of treatment for bilateral DVT is paramount. In BWS patients, however, this can prove more complicated. Due to overgrowth, the above-average birth weight can continue throughout childhood. In this case, the patient’s weight reached 170 kg, impacting on anticoagulation choice, as direct oral anticoagulants have a limited evidence base in patients with a body mass above 120 kg. Furthermore, the presence of IVCA leads to a long-term increased venous thrombosis risk. Therefore, patients with IVCA and bilateral DVT warrant specialist consideration and may benefit from multidisciplinary team management, with hematology and vascular surgery input. Conclusion: Here, we showcased a rare cause for bilateral lower limb oedema, respectively bilateral deep venous thrombosis complicating IVCA in a patient with Beckwith-Wiedemann syndrome. The importance of this case lies in its novelty, as the association between IVC agenesis and BWS has not yet been described. Furthermore, the treatment of DVT in such situations requires special consideration, taking into account the patient’s weight and the presence of a significant, predisposing vascular abnormality.

Keywords: Beckwith-Wiedemann syndrome, bilateral deep venous thrombosis, inferior vena cava agenesis, venous thromboembolism

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Authors: Kechnit Djamel, Ammarri Abdelhadi, Raphael Tshimang, Mark Trrig

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One of the most important aspects of monitoring rivers is navigation. The variation of discharge in the river generally produces a change in available draft for a vessel, particularly in the low flow season, which can impact the navigable water path, especially when the water depth is less than the normal one, which allows safe navigation for boats. The water depth is related to the bathymetry of the channel as well as the discharge. For a seasonal update of the navigation maps, a daily discharge value is required. Many novel approaches based on earth observation and remote sensing have been investigated for large rivers. However, it should be noted that most of these approaches are not currently able to directly estimate river discharge. This paper discusses the application of remote sensing tools using the analysis of the reflectance value of MODIS imagery and is combined with field measurements for the estimation of discharge. This approach is applied in the lower reach of the Congo River (Pool Malebo) for the period between 2019 and 2021. The correlation obtained between the observed discharge observed in the gauging station and the reflectance ratio time series is 0.81. In this context, a Discharge Reflectance Model (DRM) was developed to express discharge as a function of reflectance. This model introduces a non-contact method that allows discharge monitoring using earth observation. DRM was validated by field measurements using ADCP, in different sections on the Pool Malebo, over two different periods (dry and wet seasons), as well as by the observed discharge in the gauging station. The observed error between the estimated and measured discharge values ranges from 1 to 8% for the ADCP and from (1% to 11%) for the gauging station. The study of the uncertainties will give us the possibility to judge the robustness of the DRM.

Keywords: discharge monitoring, navigation, MODIS, empiric, ADCP, Congo River

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Authors: S. M. Rifat, André L. Marchildon, Mark F. Tachie

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Experiments were performed to investigate the effects of roughness on the reattachment and redevelopment regions over a 12 mm forward facing step (FFS) in an open channel flow. The experiments were performed over an upstream smooth wall and a smooth FFS, an upstream wall coated with sandpaper 36 grit and a smooth FFS and an upstream rough wall produced from sandpaper 36 grit and a FFS coated with sandpaper 36 grit. To investigate only the wall roughness effects, Reynolds number, Froude number, aspect ratio and blockage ratio were kept constant. Upstream profiles showed reduced streamwise mean velocities close to the rough wall compared to the smooth wall, but the turbulence level was increased by upstream wall roughness. The reattachment length for the smooth-smooth wall experiment was 1.78h; however, when it is replaced with rough-smooth wall the reattachment length decreased to 1.53h. It was observed that the upstream roughness increased the physical size of contours of maximum turbulence level; however, the downstream roughness decreased both the size and magnitude of contours in the vicinity of the leading edge of the step. Quadrant analysis was performed to investigate the dominant Reynolds shear stress contribution in the recirculation region. The Reynolds shear stress and turbulent kinetic energy profiles after the reattachment showed slower recovery compared to the streamwise mean velocity, however all the profiles fairly collapse on their corresponding upstream profiles at x/h = 60. It was concluded that to obtain a complete collapse several more streamwise distances would be required.

Keywords: forward facing step, open channel, separated and reattached turbulent flows, wall roughness

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Authors: Katrina Angeline Santos, Francis Mark Fernandez, Francheska Esmao

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Intervention is defined as a forcible interference by a state or states with power in the affairs of another state using force or the threat of force. On the other hand, a military intervention is an intervention, specifically used to define an intervention which uses force. With these, the authors realized a lack in the concept of intervention wherein it is an invited one.The authors wrote this paper to introduce a concept of intervention wherein the intervening state is offering assistance to the state in crisis which asked for one. The authors decided to make a contextual description of this phenomenon because of the lack of concepts regarding intervention between the idea of a single state performing a ‘heroic’ role of intervening in the crisis of another state. The problem that the authors would like to address is regarding the lack of availability in the concept of intervention wherein the state in crisis is seeking the assistance of another state. The authors utilized a contextual description approach to the study through the descriptive presentation of the series of events, by utilizing the news articles and news reports published, which happened in Ukraine and Crimea. This concept is further demonstrated through the utilization of a conceptual framework which shows the mutual relationship between the states. From the analysis of the behavior of Russia and its role in the Crimean Crisis 2014, the authors are able to coin the term, 'Caped Intervention' to describe an intervention of a state as a response to the invitation of assistance of a state in crisis in order for them to achieve their goals. This concept entails a mutual relationship between an intervening state and a sate in crisis. The concept of Caped Intervention describes the role of Russia as a Caped State or an intervening state observed through its action towards Crimea. This concept will help in the observation of the behavior of actors or states in events such as this. It will further help in analyzing the actors’ role in intervention by making it possible to classify the intervening acts into another concept.

Keywords: assistance, caped intervention, crisis, heroic

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Authors: Sugandhi, Parteek Kumar, Sanmeet Kaur

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Sign Language (SL) is used by deaf and other people who cannot speak but can hear or have a problem with spoken languages due to some disability. It is a visual gesture language that makes use of either one hand or both hands, arms, face, body to convey meanings and thoughts. SL automation system is an effective way which provides an interface to communicate with normal people using a computer. In this paper, an avatar based dictionary has been proposed for text to Indian Sign Language (ISL) generation system. This research work will also depict a literature review on SL corpus available for various SL s over the years. For ISL generation system, a written form of SL is required and there are certain techniques available for writing the SL. The system uses Hamburg sign language Notation System (HamNoSys) and Signing Gesture Mark-up Language (SiGML) for ISL generation. It is developed in PHP using Web Graphics Library (WebGL) technology for 3D avatar animation. A multilingual ISL dictionary is developed using HamNoSys for both English and Hindi Language. This dictionary will be used as a database to associate signs with words or phrases of a spoken language. It provides an interface for admin panel to manage the dictionary, i.e., modification, addition, or deletion of a word. Through this interface, HamNoSys can be developed and stored in a database and these notations can be converted into its corresponding SiGML file manually. The system takes natural language input sentence in English and Hindi language and generate 3D sign animation using an avatar. SL generation systems have potential applications in many domains such as healthcare sector, media, educational institutes, commercial sectors, transportation services etc. This research work will help the researchers to understand various techniques used for writing SL and generation of Sign Language systems.

Keywords: avatar, dictionary, HamNoSys, hearing impaired, Indian sign language (ISL), sign language

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Authors: Ante Turudic, Filip Varga, Zlatko Liber, Jernej Jakse, Zlatko Satovic, Ivan Radosavljevic, Martina Grdisa

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Microsatellites (SSRs) are highly informative repetitive sequences of 2-6 base pairs, which are the most used molecular markers in assessing the genetic diversity of plant species. Dalmatian pyrethrum (Tanacetum cinerariifolium /Trevir./ Sch. Bip) is an outcrossing diploid (2n = 18) endemic to the eastern Adriatic coast and source of the natural insecticide pyrethrin. Due to the high repetitiveness and large size of the genome (haploid genome size of 9,58 pg), previous attempts to develop microsatellite markers using the standard methods were unsuccessful. A next-generation sequencing (NGS) approach was applied on genomic DNA extracted from fresh leaves of Dalmatian pyrethrum. The sequencing was conducted using NovaSeq6000 Illumina sequencer, after which almost 400 million high-quality paired-end reads were obtained, with a read length of 150 base pairs. Short reads were assembled by combining two approaches; (1) de-novo assembly and (2) joining of overlapped pair-end reads. In total, 6.909.675 contigs were obtained, with the contig average length of 249 base pairs. Of the resulting contigs, 31.380 contained one or multiple microsatellite sequences, in total 35.556 microsatellite loci were identified. Out of detected microsatellites, dinucleotide repeats were the most frequent, accounting for more than half of all microsatellites identifies (21,212; 59.7%), followed by trinucleotide repeats (9,204; 25.9%). Tetra-, penta- and hexanucleotides had similar frequency of 1,822 (5.1%), 1,472 (4.1%), and 1,846 (5.2%), respectively. Contigs containing microsatellites were further filtered by SSR pattern type, transposon occurrences, assembly characteristics, GC content, and the number of occurrences against the draft genome of T. cinerariifolium published previously. After the selection process, 50 microsatellite loci were used for primer design. Designed primers were tested on samples from five distinct populations, and 25 of them showed a high degree of polymorphism. The selected loci were then genotyped on 20 samples belonging to one population resulting in 17 microsatellite markers. Availability of codominant SSR markers will significantly improve the knowledge on population genetic diversity and structure as well as complex genetics and biochemistry of this species. Acknowledgment: This work has been fully supported by the Croatian Science Foundation under the project ‘Genetic background of Dalmatian pyrethrum (Tanacetum cinerariifolium /Trevir/ Sch. Bip.) insecticidal potential’ - (PyrDiv) (IP-06-2016-9034).

Keywords: genome assembly, NGS, SSR, Tanacetum cinerariifolium

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Authors: Thelma Palaoag, Melanie Basa, Jezreel Mark Panilo

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Checking short-answer questions and essays, whether it may be paper or electronic in form, is a tiring and tedious task for teachers. Evaluating a student’s output require wide array of domains. Scoring the work is often a critical task. Several attempts in the past few years to create an automated writing assessment software but only have received negative results from teachers and students alike due to unreliability in scoring, does not provide feedback and others. The study aims to create an application that will be able to check short-answer questions which incorporate information extraction. Information extraction is a subfield of Natural Language Processing (NLP) where a chunk of text (technically known as unstructured text) is being broken down to gather necessary bits of data and/or keywords (structured text) to be further analyzed or rather be utilized by query tools. The proposed system shall be able to extract keywords or phrases from the individual’s answers to match it into a corpora of words (as defined by the instructor), which shall be the basis of evaluation of the individual’s answer. The proposed system shall also enable the teacher to provide feedback and re-evaluate the output of the student for some writing elements in which the computer cannot fully evaluate such as creativity and logic. Teachers can formulate, design, and check short answer questions efficiently by defining keywords or phrases as parameters by assigning weights for checking answers. With the proposed system, teacher’s time in checking and evaluating students output shall be lessened, thus, making the teacher more productive and easier.

Keywords: information extraction, short-answer question, natural language processing, application

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Authors: Riyas Peringattuthodiyil, Mark Taylor, Ian Wallace, Ailish Nugent, Mike Mitchell, Judith Thompson, Allison McKee, Philip C. Johnston

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Aim of Study: The purpose of the study was to screen for diabetes through HbA1c in patients with chronic pancreatitis (CP) within the Belfast Trust. Background: Patients with chronic pancreatitis are at risk of developing diabetes, earlier diagnosis with subsequent multi-disciplinary input has the potential to improve clinical outcomes. Methods: Clinical and laboratory data of patients with chronic pancreatitis were obtained through the Northern Ireland Electronic Healthcare Record (NIECR), specialist hepatobiliary, and gastrointestinal clinics. Patients were invited to have a blood test for HbA1c. Newly diagnosed patients with diabetes were then invited to attend a dedicated Belfast City Hospital (BCH) specialist chronic pancreatitis and diabetes clinic for follow up. Results: A total of 89 chronic pancreatitis patients were identified; Male54; Female:35, mean age 52 years, range 12-90 years. Aetiology of CP included alcohol 52/89 (58%), gallstones 18/89 (20%), idiopathic 10/89 11%, 2 were genetic, 1: post ECRP, 1: IgG autoimmune, 1: medication induced, 1: lipoprotein lipase deficiency 1: mumps, 1: IVDU and 1: pancreatic divisum. No patients had pancreatic carcinoma. Mean duration of CP was nine years, range 3-30 years. 15/89 (16%) of patients underwent previous pancreatic surgery/resections. Recent mean BMI was 25.1 range 14-40 kg/m². 62/89 (70%) patients had HbA1c performed. Mean HbA1c was 42 mmol/mol, range 27-97mmol/mol, 42/62 (68%) had normal HbA1c (< 42 mmol/mol) 13/62 (21%) had pre-diabetes (42-47mmol/mol) and 7/62 (11%) had diabetes (≥ 48 mmol/mol). Conclusions: Of those that participated in the screening program around one-third of patients with CP had glycaemic control in the pre and diabetic range. Potential opportunities for improving screening rates for diabetes in this cohort could include regular yearly testing at gastrointestinal and hepatobiliary clinics.

Keywords: pancreatogenic diabetes, screening, chronic pancreatitis, trust experience

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Authors: M. S. Sulaiman, N. Hassan, M. A. Aziz, M. S. A. Haron, J. H. A. Halim

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The classic profile of heritage clay roof tiles gives unique characteristics and timeless style to the almost historical building. It is not only designed to meet basic construction needs, offering great performance and durability but also highlights unnoticed stamp impressions, known as ‘insignia imprinted.’ It seems that the insignia imprinted is not significant to all stakeholders, especially in preserving heritage clay roof tiles in Malaysia. They are not even realized the existence and importance of that element, where it represents the cognitive and social character of that particular era. It creates a sense of belongings for the manufacturers regarding their most elementary features, such as a fortress, crown, fauna and etc. This research aims to identify and analyze the late stamp marks on heritage interlocking clay roof tiles in a government heritage building in Malaysia. The methodology used is literature reviews (desktop study), observation on sites, and interviews. Initial findings from the preliminary observation on-site in Peninsular Malaysia show some evidence that the stamp marks appear on the front and back sides of the tile that indicates the year, manufacturer, code numbers, and logos. Almost more than 30 samples of different types of stamp marks were found and collected. Some of which had been described Guichard & Carvin Cie Marsielle St Andre France, Pierre Sacoman St Henry Marsielle, Tuileries Aixoises Les Milles B.D.R France, The Calicut Tile Co Feroke, And B. Pinto & Co Mangalore dated 1865, 1919 and 1936. In view of this abundance of materials, it will lead to the establishment of a comprehensive database consisting of detailed specifications and material performance for future conservation works and maintenance purposes that will sustain for future references.

Keywords: clay roof tiles, insignia imprinted, interlocking, stamp mark

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Authors: Ruiyuan Wang, Jing Han, Bruno Di Biase, Mark Antoniou

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The purpose of this study is to explore the relationship between working memory (WM) capacity and Chinese-English consecutive interpreting (CI) performance in interpreting learners with different study abroad experience (SAE). Such relationship is not well understood. This study also examines whether Chinese interpreting learners with SAE in English-speaking countries, demonstrate a better performance in inflectional morphology and agreement, notoriously unstable in Chinese speakers of English L2, in their interpreting output than learners without SAE. Fifty Chinese university students, majoring in Chinese-English Interpreting, were recruited in Australia (n=25) and China (n=25). The two groups matched in age, language proficiency, and interpreting training period. Study abroad (SA) group has been studying in an English-speaking country (Australia) for over 12 months, and none of the students recruited in China (the no study abroad = NSA group) had ever studied or lived in an English-speaking country. Data on language proficiency and training background were collected via a questionnaire. Lexical retrieval performance and working memory (WM) capacity data were collected experimentally, and finally, interpreting data was elicited via a direct CI task. Main results of the study show that WM significantly correlated with participants' CI performance independently of learning context. Moreover, SA outperformed NSA learners in terms of subject-verb number agreement. Apart from that, WM capacity was also found to correlate significantly with their morphosyntactic accuracy. This paper sheds some light on the relationship between study abroad, WM capacity, and CI performance. Exploring the effect of study abroad on interpreting trainees and how various important factors correlate may help interpreting educators bring forward more targeted teaching paradigms for participants with different learning experiences.

Keywords: study abroad experience, consecutive interpreting, working memory, inflectional agreement

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Authors: Syed Muhammad Basit Ali, Usama Saleem, Irtiza Ali

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Internal combustion engines have been pioneers in the aviation industry, use of piston engines for aircraft propulsion, from propeller-driven bi-planes to turbo-prop, commercial, and cargo airliners. To provide an adequate amount of thrust piston engine rotates the propeller at a specific rpm, allowing enough mass airflow. Thrust is the only forward-acting force of an aircraft that helps heavier than air bodies to fly, depending on the mathematical model and variables included in that with the correct measurement. Test-benches have been a bench-mark in the aerospace industry to analyse the results before a flight, having paramount significance in reliability and safety engineering, depending on the mathematical model and variables included in that with the correct measurement. Calculation of thrust from a piston engine also depends on environmental changes, the diameter of the propeller, and the density of air. The project would be centered on piston engines used in the aviation industry for light aircraft and UAVs. A static thrust test bench involves various units, each performing a designed purpose to monitor and display. Static thrust tests are performed on the ground, and safety concerns hold paramount importance. The execution of this study involves research, design, manufacturing, and results based on reverse engineering initiating from virtual design, analytical analysis, and simulations. The final evaluation of results gathered from various methods such as co-relation between conventional mass-spring and digital loadcell. On average, we received 17.5kg of thrust (25+ engine run-ups – around 40 hours of engine run), only 10% deviation from analytically calculated thrust –providing 90% accuracy.

Keywords: aviation, aeronautics, static thrust, test bench, aircraft maintenance

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Authors: Maria Albuquerque, Miguel Matias, Ângelo Sá, Juliana Sousa, Maria Manuel Mouzinho

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Obesity is a frequent disease in Portugal. The surgical treatment is very effective and has an indication when there is a failure of the medical treatment. Although massive weight loss is associated with considerable health gains, these patients are characterized by a variable degree of dermolipodistrophy. In some cases, there is even the development of physical symptoms such as intertriginous, and some degree of psychological distress is present. In almost all cases, a desire for a better body contour, which inhibits some aspects of social life, is a fact. A prospective study was made to access the impact of body contouring surgery in the quality of life of patients who underwent a massive weight lost correction surgical procedure at Centro Hospitalar de Lisboa Central between January 2020 and December 2021. The patients were submitted to the Body Q subjective questionnaire adapted for the Portuguese language and accessed for the following categories: Anguish with Appearance, Contempt with Body Image, Satisfaction with the Abdomen, and Overall Satisfaction with the Body. The questionnaire was repeated at the 6 months mark. A total of 80 patients were sampled. The sex distribution was 79 female and 1 male. The median BMI index before surgery was inferior to 28%. The pre operatory questionnaire showed high scores for Anguish with Appearance and low scores for the body image self-evaluation. Overall, there was an improvement of at least 50% in all the evaluated scores. Additionally, a correlation was found between abdominoplasty and the contempt with body image and satisfaction with the abdomen (p-value <0.05). Massive weight loss is associated with important body deformities that have a significant impact on the patient’s personal and social life. Body contouring surgery is then vital for these patients as it implicates major aesthetic and functional benefits.

Keywords: abdominoplasty, cruroplasty, obesity, massive weight loss

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Authors: Mark Herman Sumagang Potoy

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State of the City Address (SOCA) is a speech, modelled after the State of the Nation Address, given not as mandated by law but usually a matter of practice or tradition delivered before the chief executive’s constituents. Through this, the general public is made to know the performance of the local government unit and its agenda for the coming year. Therefore, it is imperative for SOCAs to clearly convey its message and carry out the myriad function of enlightening its readers which could be achieved through the proper use of reference. Anaphora and cataphora are the two major types of reference; the former refer back to something that has already been mentioned while the latter points forward to something which is yet to be said. This paper seeks to identify the types of reference employed on the SOCAs from 2014 to 2016 of Hon. Rosalina Garcia Jalosjos, Mayor of Dapitan City and look into how the references contribute to the clarity of the message of the text. The qualitative method of research is used in this study through an in-depth analysis of the corpus. As soon as the copies of the SOCAs are secured from the Office of the City Mayor, they are then analyzed using documentary technique categorizing the types of reference as to anaphora and cataphora, counting each of these types and describing the implications of the dominant types used in the addresses. After a thorough analysis, it is found out that the two reference types namely, anaphora and cataphora are both employed on the three SOCAs, the former being used more frequently than the latter accounting to 80% and 20% of actual usage, respectively. Moreover, the use of anaphors and cataphora on the three addresses helps in conveying the message clearly because they primarily become aids to avoid the repetition of the same element in the text especially when there wasn’t a need to emphasize a point. Finally, it is recommended that writers of State of the City Addresses should have a vast knowledge on how reference should be used and the functions they take in the text since this is a vital tool to clearly transmit a message. Moreover, English teachers should explicitly teach the proper usage of anaphora and cataphora, as instruments to develop cohesion in written discourse, to enable students to write not only with sense but also with fluidity in tying utterances together.

Keywords: anaphora, cataphora, reference, State of the City Address

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Authors: Katerina Zaharieva, Vicente Rives, Martin Tsvetkov, Raquel Trujillano, Boris Kunev, Ivan Mitov, Maria Milanova, Zara Cherkezova-Zheleva

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The nanostructured cobalt ferrite-type materials Sample A - Co0.25Fe2.75O4, Sample B - Co0.5Fe2.5O4, and Sample C - CoFe2O4 were prepared by co-precipitation in our previous investigations. The co-precipitated Sample B and Sample C were mechanochemically activated in order to produce Sample D - Co0.5Fe2.5O4 and Sample E- CoFe2O4. The PXRD, Moessbauer and FTIR spectroscopies, specific surface area determination by the BET method, thermal analysis, element chemical analysis and temperature-programmed reduction were used to investigate the prepared nano-sized samples. The changes of the Malachite green dye concentration during reaction of the photocatalytic decolorization using nanostructured cobalt ferrite-type catalysts with different chemical composition are included. The photocatalytic results show that the increase in the degree of incorporation of cobalt ions in the magnetite host structure for co-precipitated cobalt ferrite-type samples results in an increase of the photocatalytic activity: Sample A (4 х10-3 min-1) < Sample B (5 х10-3 min-1) < Sample C (7 х10-3 min-1). Mechanochemically activated photocatalysts showed a higher activity than the co-precipitated ferrite materials: Sample D (16 х10-3 min-1) > Sample E (14 х10-3 min-1) > Sample C (7 х10-3 min-1) > Sample B (5 х10-3 min-1) > Sample A (4 х10-3 min-1). On decreasing the degree of substitution of iron ions by cobalt ones a higher sorption ability of the dye after the dark period for the co-precipitated cobalt ferrite materials was observed: Sample C (72 %) < Sample B (78 %) < Sample A (80 %). Mechanochemically treated ferrite catalysts and co-precipitated Sample B possess similar sorption capacities, Sample D (78 %) ~ Sample E (78 %) ~ Sample B (78 %). The prepared nano-sized cobalt ferrite-type materials demonstrate good photocatalytic and sorption properties. Mechanochemically activated Sample D - Co0.5Fe2.5O4 (16х10-3 min-1) and Sample E-CoFe2O4 (14х10-3 min-1) possess higher photocatalytic activity than that of the most common used UV-light catalyst Degussa P25 (12х10-3 min-1). The dependence of the photo-catalytic activity and sorption properties on the preparation method and different degree of substitution of iron ions by cobalt ions in synthesized cobalt ferrite samples is established. The mechanochemical activation leads to formation of nano-structured cobalt ferrite-type catalysts (Sample D and Sample E) with higher rate constants than those of the ferrite materials (Sample A, Sample B, and Sample C) prepared by the co-precipitation procedure. The increase in the degree of substitution of iron ions by cobalt ones leads to improved photocatalytic properties and lower sorption capacities of the co-precipitated ferrite samples. The good sorption properties between 72 and 80% of the prepared ferrite-type materials show that they could be used as potential cheap absorbents for purification of polluted waters.

Keywords: nanodimensional cobalt ferrites, photocatalyst, synthesis, mechanochemical activation

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Authors: Armenio Lopes, Carlos Ferreira

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In the specific context of the Iberian Union between 1580 and 1640, characteristics emerged in Portuguese architecture that stood out from the main architectural production of the period. Recognised and identified aspects that had begun making their appearance decades before (1521) became significantly more marked during the Hapsburg-Spanish occupation. Distinctive even from the imperialist language of Spain, this trend would endure even after the restoration of independence (1706), continuing through to the start of the age of absolutism. Or perhaps not. This trend, recognised as Plain Style (Kubler), associated with a certain scarcity of resources, involved a certain formal and decorative simplification, as well as a particular set of conventions that would subsequently mark the landscape. This expression could also be seen as a means of asserting a certain spirit of independence as the Iberian Union breathed its last. The image of a simple, bare-bones architecture with purer design lines is associated by various authors –most notably Kubler– with the narratives of modernism, to whose principles it is similar, in a context-specific to the period. There is a contrast with some of the exuberance of the baroque or its expression in the Manueline period, in a similar fashion to modernism's responses to nineteenth-century eclecticism. This assertion and practice of simple architecture, drafted from the interpretation of the treaties, and highlighting a certain classical inspiration, was to become a benchmark in the theory of architecture, spanning the Baroque and Mannerism, until achieving contemporary recognition within certain originality and modernity. At a time when the baroque and its scenography became generally very widespread, it is important also to recognise the role played by plain style architecture in the construction of a rather complex and contradictory waterfront landscape, featuring promises of exuberance and more discrete practices.

Keywords: Carlos Mardel, Lisbon's waterfront, plain style, urban image on the waterfront

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Authors: Luisito L. Lacatan, Gian Carlo J. Bergonia, Felipe C. Buado III, Gerald L. Gono, Ron Mark V. Ortil, Calvin A. Yap

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This paper features the development of a Mobile Self-sustaining Electricity Generator for water distillation process with MCU- based wireless controller & indicator designed to solve the problem of scarcity of clean water. It is a fact that pure water is precious nowadays and its value is more precious to those who do not have or enjoy it. There are many water filtration products in existence today. However, none of these products fully satisfies the needs of families needing clean drinking water. All of the following products require either large sums of money or extensive maintenance, and some products do not even come with a guarantee of potable water. The proposed project was designed to alleviate the problem of scarcity of potable water in the country and part of the purpose was also to identify the problem or loopholes of the project such as the distance and speed required to produce electricity using a wheel and alternator, the required time for the heating element to heat up, the capacity of the battery to maintain the heat of the heating element and the time required for the boiler to produce a clean and potable water. The project has three parts. The first part included the researchers’ effort to plan every part of the project from the conversion of mechanical energy to electrical energy, from purifying water to potable drinking water to the controller and indicator of the project using microcontroller unit (MCU). This included identifying the problem encountered and any possible solution to prevent and avoid errors. Gathering and reviewing related studies about the project helped the researcher reduce and prevent any problems before they could be encountered. It also included the price and quantity of materials used to control the budget.

Keywords: mobile, self – sustaining, electricity generator, water distillation, wireless battery indicator, wireless water level indicator

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Authors: Ivan Orozco

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Introduction: Forced contraception constitutes part of an effort to control the life and reproductive capacity of women through public health institutions. This phenomenon has affected many Mexican women historically and still persists nowadays. The notion of reproductive governmentality refers to the mechanisms through which different historical configurations of social actors (state institutions, churches, donor agents, NGOs, etc.) use legislative controls, economic incentives, moral mandates, direct coercion, and ethical incitements, to produce, monitor and control reproductive behaviors and practices. This research focuses on the use of these mechanisms by the Mexican State to control women's contraceptive practices in a public hospital. Method: An Institutional Ethnography was carried out, with the objective of knowing women's experiences from their own perspective, as they occur in their daily lives, but at the same time, discovering the structural elements that shape the discourses that promote women's contraception, even against their will. The fieldwork consisted in an observation of the dynamics between different participants within a public hospital and the conduction of interviews with the medical and nursing staff in charge of family planning services, as well as women attending the family planning office. Results: Public health institutions in Mexico are state tools to control and regulate reproduction. There are several strategies that are used for this purpose, for example, health personnel provide insufficient or misleading information to ensure that women agree to use contraceptives; health institutions provide economic incentives to the members of the health staff who reach certain goals in terms of contraceptive placement; young women are forced to go to the family planning service, regardless of the reason they went to the clinic; health campaigns are carried out, consisting of the application of contraceptives outside the health facilities, directly in the communities of people who visit the hospital less frequently. All these mechanisms seek for women to use contraceptives, from the women’s perspective; however, the reception of these discourses is ambiguous. While, for some women, the strategies become coercive mechanisms to use contraceptives against their will, for others, they represent an opportunity to take control over their reproductive lives. Conclusion: Since 1974, the Mexican government has implemented campaigns for the promotion of family planning methods as a means to control population growth. Although it is established in several legislations that the counselling must be carried out with a gender and human rights perspective, always respecting the autonomy of people, these research testify that health personnel uses different strategies to force some women to use contraceptive methods, thereby violating their reproductive rights.

Keywords: feminist research, forced contraception, institutional ethnography, reproductive. governmentality

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Authors: Karl Gerrard Tiu See

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Military bases are an indelible mark of prolonged US defense relationships in the Pacific. Bases like the Subic Naval Base in Olongapo City have irreversible consequences for their host communities, not all of which are positive. One consequence the Subic Naval Base had for Olongapo City was the rise of vibrant sex industry. While the Philippine Senate voted to remove US bases like Subic in 1991, the question remains as to why did prostitution not end after the bases pull-out? To answer this question, the study used an institutionalist lens coupled with focus group discussions from the sex industry. It found that prostitution persisted due to two main reasons. The first was that like Olongapo City; the sex industry successfully shifted its reliance from the military to foreign tourism. The second was that agreements such as the 1996 Visiting Forces Agreement (VFA) ensured that the sex industry continued to receive US military clientele. With the contextual factors as the backdrop, this study used the Theory of Institutional Change to study institutions pivotal in altering Olongapo City and its sex industry after Subic Naval Base. These include local government, civil society actors such as NGOs, and the city’s economic base. The study found that policy such as the VFA allowed the bases period status quo to revive (Symbionts). This led to renewed exploitation from the military presence coupled with foreign tourism (Opportunists). The local government, however, shifted focus away from base reliance which allowed a reinvigorated civil society to effect a gradual change (Subversives). Furthermore, uncertainties like rising HIV incidence, abandoned children born from US soldiers, and the Enhanced Defence Cooperation Agreement (EDCA) remain to change the sex industry’s future, for better or worse.

Keywords: Philippine-USA defence relations, overseas USA basing, 1991 Philippine-USA bases pull-out, Olongapo city, Subic naval base, institutional change

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Authors: Nataliya Apanovich, Mark Wright

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Uganda is among the poorest but fastest growing populations in the world. Its annual population growth of 3% puts additional stress through land fragmentation, agricultural intensification, and deforestation on already highly weathered tropical (Ferralsol) soils. All of these factors lead to decreased agricultural yields and consequently diminished food security. The central region of Uganda, Buganda Kingdom, is especially vulnerable in terms of food security as its high population density coupled with mismanagement of natural resources led to gradual loss of its soil and even changes in microclimate. These changes are negatively affecting livelihoods of smallholder farmers who comprise 80% of all population in Uganda. This research focuses on biochar for soil remediation in Masaka District, Uganda. If produced on a small scale from locally sourced materials, biochar can increase the quality of soil in a cost and time effective manner. To assess biochar potential, 151 smallholder farmers were interviewed on the types of crops grown, agricultural residues produced and their use, as well as on attitudes towards biochar use and its production on a small scale. The interviews were conducted in 7 sub-counties, 32 parishes, and 92 villages. The total farmland covered by the study was 606.2 kilometers. Additional information on the state of agricultural development and environmental degradation in the district was solicited from four local government officials via informal interviews. This project has been conducted in collaboration with the international agricultural research institution, Makerere University in Kampala, Uganda. The results of this research can have implications on the way farmers perceive the value of their agricultural residues and what they decide to do with them. The underlying objective is to help smallholders in degraded soils increase their agricultural yields through the use of biochar without diverting the already established uses of agricultural residues to a new soil management practice.

Keywords: agricultural residues, biochar, central Uganda, food security, soil erosion, soil remediation

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Authors: Mark Salisbury

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The arrival of artificially intelligent avatars and the automation they bring is worrying many of us, not only for our livelihood but for the jobs that may be lost to our kids. We worry about what our place will be as human beings in this new economy where much of it will be conducted online in the metaverse – in a network of 3D virtual worlds – working with intelligent machines. The Future of Leadership was written to address these fears and show what our place will be – the right place – in this new economy of AI avatars, automation, and 3D virtual worlds. But to be successful in this new economy, our job will be to bring wisdom to our workplace and the marketplace. And we will use AI avatars and 3D virtual worlds to do it. However, this book is about more than AI and the avatars that we will work with in the metaverse. It’s about building Organizational intelligence (OI) -- the capability of an organization to comprehend and create knowledge relevant to its purpose; in other words, it is the intellectual capacity of the entire organization. To increase organizational intelligence requires a new kind of knowledge worker, a wisdom worker, that requires a new kind of leadership. This book begins your story for how to become a leader of wisdom workers and be successful in the emerging wisdom economy. After this presentation, conference participants will be able to do the following: Recognize the characteristics of the new generation of wisdom workers and how they differ from their predecessors. Recognize that new leadership methods and techniques are needed to lead this new generation of wisdom workers. Apply personal and professional values – personal integrity, belief in something larger than yourself, and keeping the best interest of others in mind – to improve your work performance and lead others. Exhibit an attitude of confidence, courage, and reciprocity of sharing knowledge to increase your productivity and influence others. Leverage artificial intelligence to accelerate your ability to learn, augment your decision-making, and influence others.Utilize new technologies to communicate with human colleagues and intelligent machines to develop better solutions more quickly.

Keywords: metaverse, generative artificial intelligence, automation, leadership, organizational intelligence, wisdom worker

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Authors: Arman Kishan, Mark Haft, Steve Li, Duc Nguyen, Dawn Laporte

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Objective: Patients with Type 2 diabetes (T2DM) often face higher postoperative complication rates. Limited data exist on outcomes in T2DM patients undergoing carpal tunnel release (CTR). This study aims to compare complication rates between endoscopic CTR (ECTR) and open CTR (OCTR) in patients with T2DM. Methods: This was a retrospective cohort study using the TriNetX database of 56741 patients with T2DM undergoing ECTR (N= 14,949) or OCTR (N= 41,792). Demographic data, medical comorbidities, and complication rates were analyzed. We used multivariable analysis to identify differences in postoperative complication rates between the two treatment methods in patients with T2DM. Results: Patients with T2DM undergoing ECTR had a significantly lower incidence of 90-day wound infection (p < 0.001), 90-day wound dehiscence (p < 0.001), and nerve injury (p < 0.001) when compared to patients who underwent OCTR. After matching, there was a significantly higher number of T2DM patients undergoing ECTR who had peripheral vascular disease (p = 0.045) and hypertension (p = 0.020) when compared to the OCTR group. These patients also had a lower incidence of fluid and electrolyte disorders (p = 0.002) and chronic blood loss anemia (p = 0.025). Conclusion: ECTR presents a superior choice for T2DM patients undergoing CTR, yielding significantly lower rates of wound infection, wound dehiscence, and nerve injury within 90 days post-surgery—reducing the risk by 31%, 48%, and 59%, respectively. These findings support the adoption of ECTR as the preferred method in this patient population, potentially leading to improved postoperative outcomes.

Keywords: endoscopic treatment of carpal tunnel syndrome, open treatment of carpal tunnel syndrome, carpal tunnel syndrome, postoperative complications in patients with diabetes mellitus

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Authors: Aihong Zhao, Priya Sastry, Mark L Field, Mohamad Bashir, Arvind Singh, David Richens

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Objectives: Intramural haematoma (IMH) is one of the pathologies, along with acute aortic dissection, that present as Acute Aortic Syndrome (AAS). Evidence suggests that unlike aortic dissection, some intramural haematomas may regress with medical management. However, intramural haematomas have been traditionally managed like acute aortic dissections. Given that some of these pathologies may regress with conservative management, it would be useful to be able to identify which of these may not need high risk emergency intervention. A computational aortic model was used in this study to try and identify intramural haematomas with risk of progression to aortic dissection. Methods: We created a computational model of the aorta with luminal blood flow. Reports in the literature have identified 11 mm as the radial clot thickness that is associated with heightened risk of progression of intramural haematoma. Accordingly, haematomas of varying sizes were implanted in the modeled aortic wall to test this hypothesis. The model was exposed to physiological blood flows and the stresses and strains in each layer of the aortic wall were recorded. Results: Size and shape of clot were seen to affect the magnitude of aortic stresses. The greatest stresses and strains were recorded in the intima of the model. When the haematoma exceeded 10 mm in all dimensions, the stress on the intima reached breaking point. Conclusion: Intramural clot size appears to be a contributory factor affecting aortic wall stress. Our computer simulation corroborates clinical evidence in the literature proposing that IMH diameter greater than 11 mm may be predictive of progression. This preliminary report suggests finite element modelling of the aortic wall may be a useful process by which to examine putative variables important in predicting progression or regression of intramural haematoma.

Keywords: intramural haematoma, acute aortic syndrome, finite element analysis,

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Authors: Abdallah Al-ZoubI, Mamoun Dmour

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The spectrum of IoT devices is becoming widely diversified, entering almost all possible fields and finding applications in industry, health, finance, logistics, education, to name a few. The IoT active endpoint sensors and devices exceeded the 12 billion mark in 2021 and are expected to reach 27 billion in 2025, with over $34 billion in total market value. This sheer rise in numbers and use of IoT devices bring with it considerable concerns regarding data storage, analysis, manipulation and protection. IoT Blockchain-based systems have recently been proposed as a decentralized solution for large-scale data storage and protection. COVID-19 has actually accelerated the desire to utilize IoT devices as it impacted both demand and supply and significantly affected several regions due to logistic reasons such as supply chain interruptions, shortage of shipping containers and port congestion. An IoT-blockchain system is proposed to handle big data generated by a distributed network of sensors and controllers in an interactive manner. The system is designed using the Ethereum platform, which utilizes smart contracts, programmed in solidity to execute and manage data generated by IoT sensors and devices. such as Raspberry Pi 4, Rasbpian, and add-on hardware security modules. The proposed system will run a number of applications hosted by a local machine used to validate transactions. It then sends data to the rest of the network through InterPlanetary File System (IPFS) and Ethereum Swarm, forming a closed IoT ecosystem run by blockchain where a number of distributed IoT devices can communicate and interact, thus forming a closed, controlled environment. A prototype has been deployed with three IoT handling units distributed over a wide geographical space in order to examine its feasibility, performance and costs. Initial results indicated that big IoT data retrieval and storage is feasible and interactivity is possible, provided that certain conditions of cost, speed and thorough put are met.

Keywords: IoT devices, blockchain, Ethereum, big data

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Authors: Roman Khanferyan, Levon Gevorkyan, Ivan Radysh

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Skin barrier dysfunction induces multiple inflammatory skin diseases. Epidemiological studies clearly support the link between most dermatological pathologies, immune disorders and metabolic disorders. Among them most common are psoriasis (PS) and Atopic dermatitis (AD). Psoriasis is a chronic immune-mediated inflammatory skin disease that affects 1.5 to 3.0% of the world's population. Comorbid metabolic disorders play an important role in the progression of PS and AD, as well. It is well known that PS, AD and overweight/obesity are associated with common pathophysiological mechanisms of mild chronic inflammation. The goal of the study was to study the immune disturbances in patients with PS, AD and comorbid metabolic disorders. To study the prevalence of comorbidity of PS and AD (data from 1406 patient’s histories of diseases) were analyzed. The severity of the disease is assessed using the PASI index (Psoriasis Area and Severity Index). 59 patients with psoriasis of different localizations of lesions and severity, as well as with different body mass index (BMI), were examined. The determination of the concentration of pro-inflammatory cytokines (IL-6, IL-8, IFNγ, IL-17, L-18 and TNFa) and chemokines (RANTES, IP-10, MCP-1 and Eotaxin) in sera and supernatants of 48h-cultivated peripheral blood mononuclear cell (PBMC) of psoriasis patients and healthy volunteers (36 adults) have been carried out by multiplex assay (Luminex Corporation, USA). It has been demonstrated that 42% of PS patients had comorbidity with different types of atopies. The most common was bronchial asthma and allergic rhinitis. At the same time, the prevalence of AD in PS patients was determined in 8.7% of patients. It has been shown that serum levels of all studied cytokines (IL-6, IL-8, IFNγ, IL-17, L-18 and TNF) in most of the studied patients were higher in PS patients than in those with AD and healthy controls (p<0.05). An in vitro synthesis of the IL-6 and IFNγ by PBMC demonstrated similar results to those determined in blood sera. There was a high correlation between BMI, immune mediators and the concentrations of adipokines and chemokines (p<0.05). The concentrations of Leptin and Resistin in obese psoriatic patients were greater by 28.6% and 17%, respectively, compared to non-obese psoriatic patients. In obese patients with psoriasis the serum levels of adiponectin were decreased up to 1.3-fold. The mean serum RANTES, IP-10, MCP-1, EOTAXIN levels in obese psoriatic patients were decreased by up to 13.1%, 21.9%, 40.4% and 28.2%, respectively. Similar results have been demonstrated in AD patients with comorbid overweight and obesity. Thus, the study demonstrated the important role of cytokines and chemokines dysregulation in inflammatory skin diseases, especially in patients with comorbid obesity and overweight. Metabolic disorders promote the severity of PS and AD, highly increase immune dysregulation, and synthesis of adipokines, which correlates with the production of proinflammatory immune mediators in comorbid obesity and overweight.

Keywords: psoriasis, atopic dermatitis, pro-inflammatory cytokines, chemokines, comorbid obesity

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Authors: Hannah K. M. Tang, Muhammad Ateeq, Mark J. Lake, Badr Abdullah, Frederic A. Bezombes

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There is little research applying virtual reality (VR) to the treatment of musculoskeletal injury in athletes. This is despite their prevalence, and the implications for physical and psychological health. Nevertheless, developments of wireless VR headsets better facilitate dynamic movement in VR environments (VREs), and more research is expected in this emerging field. This systematic review identified publications that used VR interventions for the analysis or treatment of lower-limb musculoskeletal injury of athletes. It established a search protocol, and through narrative discussion, identified existing trends. Database searches encompassed four term sets: 1) VR systems; 2) musculoskeletal injuries; 3) sporting population; 4) movement outcome analysis. Overall, a total of 126 publications were identified through database searching, and twelve were included in the final analysis and discussion. Many of the studies were pilot and proof of concept work. Seven of the twelve publications were observational studies. However, this may provide preliminary data from which clinical trials will branch. If specified, the focus of the literature was very narrow, with very similar population demographics and injuries. The trends in the literature findings emphasised the role of VR and attentional focus, the strategic manipulation of movement outcomes, and the transfer of skill to the real-world. Causal inferences may have been undermined by flaws, as most studies were limited by the practicality of conducting a two-factor clinical-VR-based study. In conclusion, by assessing the exploratory studies, and combining this with the use of numerous developments, techniques, and tools, a novel application could be established to utilise VR with dynamic movement, for the effective treatment of specific musculoskeletal injuries of athletes.

Keywords: athletes, lower-limb musculoskeletal injury, rehabilitation, return-to-sport, virtual reality

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Authors: Conor Mccartney, Mark Lee

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Background: An essential component in ambulatory breast augmentation surgery is good analgesia. The demographic undergoing this operation is usually fit, low risk with few comorbidities. These patients do not require long-term hospitalization and do not want to spend excessive time in the hospital for financial reasons. Opiate analgesia can have significant side effects such as nausea, vomiting and sedation. Reducing volumes of postoperative opiates allows faster ambulation and discharge from day surgery. We have developed two targeted nerve blocks that can be applied by the operating surgeon in a matter of seconds under direct vision, not requiring imaging. Anecdotally we found that these targeted nerve blocks reduced opiate requirements and allowed accelerated discharge and faster return to normal activities. This was then tested in a prospective randomized, double-blind trial. Methods: 20 patients were randomized into saline (n = 10) or Ropivicaine adrenaline solution (n = 10). The operating surgeon and anesthetist were blinded to the solution. All patients were closely followed up and morphine equivalents were accurately recorded. Follow-up pain scores were recorded using the Overall Benefit of Analgesia pain questionnaire. Findings: The Ropivicaine nerve blocks significantly reduced opiate requirements postoperatively (p<0.05). Pain scores were significantly decreased in the study group (p<0.05). There were no side effects attributable to the nerve blocks. Conclusions: Intraoperative targeted nerve blocks significantly reduce postoperative opiate requirements in breast augmentation surgery. This results in faster recovery and higher patient satisfaction.

Keywords: breast augmentation, nerve block, postoperative recovery, opiate analgesia, inter pectoral block, sub serratus block

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