Search results for: early intervention

Authors: Mujahid Ali, Wasif Mohammed Ali, Meraj Ahmad

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Background: Perforation peritonitis is the most common surgical emergency encountered by surgeons all over the world as well as in India. The etiology of perforation peritonitis in India continues to be different from its western counterparts. The aim of this study is to evaluate the spectrum of cases of perforation peritonitis at our hospital. Methods: A prospective study conducted includes three hundred thirtysix patients of perforation peritonitis at J. N. Medical College from October 2015 to July 2017. The patients were admitted, resuscitated and underwent emergency laparotomy. Data were collected in terms of demographic profile, clinical presentations, site of perforations, causes and surgical outcomes. Results: In this study, the most common cause of perforation peritonitis was peptic ulcer disease (43%), followed by enteric perforation (12.8%), tubercular perforation (12.5%), traumatic perforation (11.9%), appendicular perforation (9.8%), amoebic caecal perforation (3%), malignant perforation (1.5%), etc. The sites of perforations were stomach in majority (38.3%), ileum (31%), appendix (8%), duodenum (5.%), caecum (4.4%) ,colon (3%), jejunum (8.5%) and gall bladder (2%). The overall mortality was 21% in our study. Age >50 years (p= <0.0001, OR= 3.9260, CI= 2.2 to 6.9), organ failure (p= <0.0001, OR= 29.2, CI= 14.8 to 57.6), shock (p=<0.0001, OR=20.20, CI= 10.56 to 38.6), diffuse peritonitis (p<0.0015, OR= 6.8810, CI= 2.09 to 22.57) and faecal exudates (p<0.0001) were found to be significant factors affecting mortality. The most common complication associated was superficial wound infection (40%), followed by burst abdomen seen in 21% cases, intra-abdominal sepsis in 18% cases, electrolyte imbalances in 15% cases, anastomotic leak in 6% cases. Conclusion: In this study, stomach is the most common site of perforation with peptic ulcer disease being the most common etiology. Older age, presence of shock, organ failure and faecal peritonitis were the risk factors affecting the mortality of the patients. Early recognition, adequate resuscitation and referral of patients can influence outcome and reduces mortality as well as morbidity.

Keywords: etiology, mortality, perforation, spectrum

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Authors: Dovilė Bačėninaitė, Karina Džermeikaitė, Justinas Kirvela, Ramūnas Antanaitis

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Bacteria are often present in the mouth of cattle. Some of them can cause abscesses. Starting with severe swelling of the mouth, muscle spasm, or locked jaw, it can lead to inability to open its mouth, move the neck, cause pain while eating. While the calf is unable to eat properly, it becomes more susceptible to infectious diseases, lower weight gain can be observed. Abscesses can be considered as a continuum of oral disease, whereby early stages of the lumpy jaw could proceed from gingivitis to periodontal disease. In the event of tissue damage, bacteria can enter the bloodstream, even cause sepsis. The most common lesions occur when animals eat sharp grass, coarse fodder, sharp, piercing foreign bodies (this is especially common for calves when they are trying to eat inedible objects). A crossbred Holstein calf presented with a history of proliferative outgrowth in the mandibular region. On clinical examination, needle aspiration, mandibular swelling revealed sticky, white curd-like fluid containing. Pus bacteriology revealed gram-negative cocci. They were sensitive to amoxicillin, cephalexin, enrofloxacin, ceftiofur. Blood morphology was in physiological ranges. The calf was treated surgically. The growth was excised, the puss drained and the wound was flushed with potassium permanganate solution (0,01%). A week after clinical surgery examination was performed. The swelling was decreased. Superficial bacterial infections are often associated with poor hygiene, which should be improved before treatment is commenced. Clipping away dirty hair and gently washing affected areas of skin daily with solutions such as povidone-iodine, potassium permanganate is effective. Appropriate antibiotic therapy, based on sensitivity testing, may be used where there is evidence of systemic illness.

Keywords: calf, abscess, lumpy jaw, pus, Streptococcus, Staphylococcus, Actinobacillus, infection

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Authors: Rohit Kothari, Muneer Mohamed, Vivekanandh K., Sunmeet Sandhu, Preema Sinha, Anuj Bhatnagar

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Introduction: Hyper-IgE syndrome is a rare primary immunodeficiency syndrome characterised by triad of severe atopic dermatitis, recurrent pulmonary infections, and recurrent staphylococcal skin infections. The diagnosis requires a high degree of suspicion, typical clinical features, and not mere rise in serum-IgE levels, which may be seen in multiple conditions. Genetic studies are not always possible in a resource poor setting. This study highlights various presentations of Hyper-IgE syndrome in skin of color children. Case-series: Our study had six children of Hyper-IgE syndrome aged twomonths to tenyears. All had onset in first ten months of life except one with a late-onset at two years. All had recurrent eczematoid rash, which responded poorly to conventional treatment, secondary infection, multiple episodes of hospitalisation for pulmonary infection, and raised serum IgE levels. One case had occasional vesicles, bullae, and crusted plaques over both the extremities. Genetic study was possible in only one of them who was found to have pathogenic homozygous deletions of exon-15 to 18 in DOCK8 gene following which he underwent bone marrow transplant (BMT), however, succumbed to lower respiratory tract infection two months after BMT and rest of them received multiple courses of antibiotics, oral/ topical steroids, and cyclosporine intermittently with variable response. Discussion: Our study highlights various characteristics, presentation, and management of this rare syndrome in children. Knowledge of these manifestations in skin of color will facilitate early identification and contribute to optimal care of the patients as representative data on the same is limited in literature.

Keywords: absolute eosinophil count, atopic dermatitis, eczematous rash, hyper-immunoglobulin E syndrome, pulmonary infection, serum IgE, skin of color

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Authors: Priscilla Akua Agyapong

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Background: In a country of nearly 34 million people, Ghana suffers from rapidly growing pediatric CHD cases and not enough pediatric specialists to attend to the burgeoning needs of these children. Most of the cases are either missed or diagnosed late, resulting in increased mortality. According to the National Cardiothoracic Centre, 1 in every 100,000 births in Ghana has CHD; however, there is limited data on the clinical presentation and its management, one of the many reasons I decided to do this case study coupled with the loss my 2 month old niece to multiple Ventricular Septal Defect 3 years ago due late diagnoses. Method: A retrospective cohort study was performed at the child health clinic of one of Ghana’s public tertiary Institutions using data from their electronic health record (EHR) from February 2021 to April 2022. All suspected or provisionally diagnosed cases were included in the analysis. Results: Records of over 3000 children were reviewed with an approximate male to female ratio of 1:1.53 cases diagnosed during the period of study, most of whom were less than 5 years of age. 25 cases had complete clinical records, with acyanotic septal defects being the most diagnosed. 62.5% of the cases were ventricular septal defects, followed by Patent Ductus Arteriosus (23%) and Atrial Septal Defects (4.5%). Tetralogy of Fallot was the most predominant and complex cyanotic CHD with 10%. Conclusion: The indeterminate coronary anatomy of infants makes it difficult to use only echocardiography and other conventional clinical methods in screening for CHDs. There are rising modernizations and new innovative ways that can be employed in Ghana for early detection, hence preventing the delay of a potential surgical repair. It is, therefore, imperative to create the needed awareness about these “SILENT CRISES” and help save the Ghanaian child’s life.

Keywords: congenital heart defect(CHD), ventricular septal defect(VSD), atrial septal defect(ASD), patent ductus arteriosus(PDA)

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Authors: Steven Walker

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This paper assesses recent data on the prevalence of poverty among children and young people diagnosed with mental health problems. The paper will demonstrate that the current hierarchy of risk factors for developing mental health problems needs adjusting to place poverty among the highest risk factors. Globally poverty is calculated to keep rising especially among less developed countries, and the post-Covid 19 economic recession in developed countries is set to rise. The experience of young people enduring Pandemic isolation is already being quantified and is expected to increase referrals for specialist intervention. Searches on several medical/psychological/social databases using keywords: poverty, children, mental illness were undertaken between 2018 and 2021. Worldwide, 700 million people still live in extreme poverty, half of whom are children. Children are physically and mentally disproportionately affected. Children who grow up impoverished lack the basic necessities they need to survive and thrive. 150 million children have been plunged into multidimensional poverty due to COVID-19. The poorest children are twice as likely to die in childhood than their wealthier peers. For those growing up in humanitarian crises such as Ukraine, the risks of deprivation and exclusion are magnified. In the world’s richest countries, one in seven children still live in poverty. Currently, one in four children in the European Union are at risk of falling into poverty. In Europe the impact of Brexit on the UK economy is predicted to reduce GDP by 5% in 2021 with a corresponding rise in poverty. According to the global charity Oxfam wealth inequality impacts levels of child abuse and affects women and girls worse and is a contributory factor in the risk of developing childhood mental illness. In the UK 2000 Foodbanks have opened since 2010, handing out 2 million food parcels annually, where there are currently 4 million children officially living in poverty. This research demonstrates that there is a strong association between families’ socio-economic circumstances and the chances that their children will experience mental illness. Evidence of this association is found repeatedly across developed countries. The paper will conclude by arguing that psychologists, psychiatrists, psychotherapists, social workers and CAMHS specialists need to place more importance on this critical socio-economic variable when assessing referred children and also advocate for political priorities in governments to reduce poverty and lower the risk of childhood mental illness.

Keywords: poverty, resilience, risk factor, socio economic, susceptibility

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Authors: Nadia H. Mohammed, Anmar Al-Taie, Fadia H. Al-Sultany

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Although breast cancer prevalence continues to increase, mortality has been decreasing as a result of early detection and improvement in adjuvant systemic therapy. Nevertheless, this disease required further efforts to understand and identify the associated potential risk factors that could play a role in the prevalence of this malignancy among Iraqi women. The objective of this study was to assess the perception of certain predictive risk factors on the prevalence of breast cancer types among a sample of Iraqi women diagnosed with breast cancer. This was a retrospective observational study carried out at National Cancer Research Center in College of Medicine, Baghdad University from November 2017 to January 2018. Data of 100 patients with breast cancer whose biopsies examined in the National Cancer Research Center were included in this study. Data were collected to structure a detailed assessment regarding the patients’ demographic, medical and cancer records. The majority of study participants (94%) suffered from ductal breast cancer with mean age 49.57 years. Among those women, 48.9% were obese with body mass index (BMI) 35 kg/m². 68.1% of them had positive family history of breast cancer and 66% had low parity. 40.4% had stage II ductal breast cancer followed by 25.5% with stage III. It was found that 59.6% and 68.1% had positive oestrogen receptor sensitivity and positive human epidermal growth factor (HER2/neu) receptor sensitivity respectively. In regard to the impact of prediction of certain variables on the incidence of ductal breast cancer, positive family history of breast cancer (P < 0.0001), low parity (P< 0.0001), stage I and II breast cancer (P = 0.02) and positive HER2/neu status (P < 0.0001) were significant predictive factors among the study participants. The results from this study provide relevant evidence for a significant positive and potential association between certain risk factors and the prevalence of breast cancer among Iraqi women.

Keywords: Ductal Breast Cancer, Hormone Sensitivity, Iraq, Risk Factors

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Authors: Fulufhelo Oscar Maphiri-Makananise

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The main purpose of this paper is to explore and provide substantiated evidence based on the usage patterns of Information and Communication Technologies (ICTs) by females in the Vhembe District in Limpopo-Province, South Africa. The study presents a broader picture and understanding about the usage of ICTs from female’s perspective. The significance of this study stems from the need to discover the role, relevance and usage patterns of ICTs such as smartphones, computers, laptops, and iPods, internet and social networking sites among females following the trends of new media technologies in the society. The main objective of the study was to investigate the usability and accessibility of ICTs to empower the Vhembe District females in South Africa. The study used quantitative research method together with elements of qualitative research to determine the major ideas, perceptions and usage patterns of ICTs by females in the District. Data collection involved structured and self-administered questionnaire with both closed-ended and open-ended questions. Two groups of respondents participated in this study. Media Studies female students (n=50) at the University of Venda provided their ideas and perceptions about the usefulness and usage patterns of ICTs such as smartphones, internet and computers at the university level, while the second group were (n=50) Makhado comprehensive school learners who also provided their perceptions and ideas about the use of ICTs at the high school level. Also, the study provides a more balanced, accurate and rational results on the pertinent issues that concern the use of ICTs by females in the Vhembe District. The researcher also believes that the findings of the study are useful as a guideline and model for ICT intervention that work as an empowerment to women in South Africa. The study showed that the main purpose of using ICTs by females was to search information for writing assignments, conducting research, dating, exchanging ideas and networking with friends and relatives that are also members of social networking sites and maintaining existing friends in real life. The study further revealed that most females were using ICTs for social purposes and accessing the internet than entertaining themselves. The finding also indicated a high number of females that used ICTs for e-learning (62%) and social purposes (85%). Moreover, the study centred on providing strong insightful information on the females’ usage patterns and their perceptions of ICTs in the Vhembe district of Limpopo province.

Keywords: female users, information and communication technologies, internet, usage patterns

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Authors: Hamed Karimian, Noraziah Nordin, Mohamad Ibrahim Noordin, Syam Mohan, Mahboubeh Razavi, Najihah Mohd Hashim, Happipah Mohd Ali

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Satureja bachtiarica Bunge is a perennial medicinal plant belonging to the Lamiaceae family and endemic species in Iran. Satureja bachtiarica Bunge with the local name of Marzeh koohi is edible vegetable use as flavoring agent, anti-bacterial and to relieve cough and indigestion. In this study, the anti-cancer effect of Satureja bachtiarica Bunge on the MDA-MB-231 cell line as an Breast cancer cell model has been analyzed for the first time. Satureja bachtiarica Bunge was extracted using different solvents in the order of increasing polarity. Cytotoxicity activity of hexane extract of Satureja bachtiarica Bunge (SBHE) was observed using MTT assay. Acridine orange/Propidium iodide staining was used to detect early apoptosis; Annexin-V-FITC assay was carried out to observe the detection of cell-surface Phosphatidylserine (PS), with Annexin-Vserving as a marker for apoptotic cells. Caspase 3/7, 8 and-9 assays showed significantly activation of caspase-9 where lead intrinsic mitochondrial pathway. Bcl-2/Bax expressions and cell cycle arrest were also investigated. SBHE had exhibited significantly higher cytotoxicity against MDA-MB-231 Cell line compare to other cell lines. A significant increase in chromatin condensation in the cell nucleus was observed by fluorescence analysis. Treatment of MDA-MB-231 cells with SBHE encouraged apoptosis, by down-regulating Bcl-2 and up-regulating Bax, which lead the activation of caspase 9. Moreover, SBHE treatment significantly arrested MDA-MB-231 cells in the G1 phase. Together, the results presented in this study demonstrated that SBHE inhibited the proliferation of MDA-MB-231 cells, leading cell cycle arrest and programmed cell death, which was confirmed to be through the mitochondrial pathway.

Keywords: Satureja bachtiarica Bunge, MDA-MB-231, apoptosis, annexin-V, cell cycle

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Authors: Chi-Ying Yu

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In real life, the occurrence of disasters is always dreadful and heartbreaking, yet paradoxically, disaster film is a genre that has been popular at periodic intervals in motion picture history. This study attempts to compare the disaster film cycles of the 1970s, 1990s, and the early 21st century. Two research questions are addressed: First, how this genre has responded to the existing conditions of society in different periods in terms of the disaster proposition? Second, how this genre reflects a certain eternal substance of the human mind in light of its lasting appeal? Through cinematic textual analysis and literature review, this study finds that the emergence of disaster films in the 1970s reflected the turmoil in international relations and domestic politics situation in contemporary American society, and cinema screens showed such disaster stories as shipwrecks, air accidents, and skyscraper blazes due to human negligence. The 1990s saw the fervor of millennial apocalypse legends, and the awakening of environmental consciousness, which, together with the rapid advances in digital technology, once again gave rise to a frenzy of disaster films, with natural disasters and threats from aliens as the major themes of disasters. Since the beginning of the 21st century, the 911 Incident and natural disasters around the world have generated a consciousness of imminent crisis. Cinematic images simulated actual disasters, while aesthetic techniques focused on creating a kind of ‘empathetic’ experience in their exploration of the essence of the disaster experience. At the same time, post-apocalypse films that focus on post-disaster reconstruction have become an even more popular theme. Taking the approach of Jungian/post-Jungian film study, this study also reviews and interprets the commonly exhibited subliminal feelings in the disaster films of the three different periods. The imagination of disaster seems to serve as an underlying state of the human mind.

Keywords: disaster film, Jungian/post-Jungian film studies, stimulation, sublime

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Authors: Yi Shan Cheng, Ya Hui Yeh, Hsiao Wen Hsu

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Delirium is an acute state of confusion, which is mainly the result of the interaction of many factors, including: age>65 years, comorbidity, cognitive function and visual/auditory impairment, dehydration, pain, sleep disorder, pipeline retention, general anesthesia and major surgery… etc. Researches show the prevalence of delirium in hospitalized elderly patients over 50%. If it doesn't improve in time, may cause cognitive decline or impairment, not only prolong the length of hospital stay but also increase mortality. Some studies have shown that multiple nonpharmacological interventions are the most effective and common strategies, which are reorientation, early mobility, promoting sleep and nutritional support (including water intake), could improve or prevent delirium in the hospitalized elderly. In Taiwan, only one research to compare the delirium incidence of the older patients who have received orthopedic surgery between multi-nonpharmacological interventions and general routine care. Therefore, the purpose of this study is to address the prevention or improvement of delirium incidence density in medical hospitalized elderly, provide clinical nurses as a reference for clinical implementation, and develop follow-up related research. This study is a quasi-experimental design using purposive sampling. Samples are from two wards: the geriatric ward and the general medicine ward at a medical center in central Taiwan. The sample size estimated at least 100, and then the data will be collected through a self-administered structured questionnaire, including: demographic and professional evaluation items. Case recruiting from 5/13/2023. The research results will be analyzed by SPSS for Windows 22.0 software, including descriptive statistics and inferential statistics: logistic regression、Generalized Estimating Equation(GEE)、multivariate analysis of variance(MANOVA).

Keywords: multiple nonpharmacological interventions, hospitalized elderly, delirium incidence, delirium

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Authors: Juan Alfredo Guevara Carrio, Swamy Toolahalli Thipperudra, Riddhi Naik Dharmeshbhai, Sergio Graniero Echeverrigaray, Jose Vitorio Emiliano, Antonio Helio Castro

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In order to advance the hydrogen economy, several industrial sectors can potentially benefit from the trillions of stimulus spending for post-coronavirus. Blending hydrogen into natural gas pipeline networks has been proposed as a means of delivering it during the early market development phase, using separation and purification technologies downstream to extract the pure H₂ close to the point of end-use. This first step has been mentioned around the world as an opportunity to use existing infrastructures for immediate decarbonisation pathways. Among current technologies used to extract hydrogen from mixtures in pipelines or liquid carriers, membrane separation can achieve the highest selectivity. The most efficient approach for the separation of H₂ from other substances by membranes is offered from the research of 2D layered materials due to their exceptional physical and chemical properties. Graphene-based membranes, with their distribution of pore sizes in nanometers and angstrom range, have shown fundamental and economic advantages over other materials. Their combination with the structure of ceramic and geopolymeric materials enabled the synthesis of nanocomposites and the fabrication of membranes with long-term stability and robustness in a relevant range of physical and chemical conditions. Versatile separation modules have been developed for hydrogen separation, which adaptability allows their integration in industrial prototypes for applications in heavy transport, steel, and cement production, as well as small installations at end-user stations of pipeline networks. The developed membranes and prototypes are a practical contribution to the technological challenge of supply pure H₂ for the mentioned industries as well as hydrogen energy-based fuel cells.

Keywords: graphene nano-composite membranes, hydrogen separation and purification, separation modules, indsutrial prototype

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Authors: Victor Birikorang Danquah

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Ghana's primary energy supply is heavily reliant on petroleum, biomass, and hydropower. Currently, Ghana gets its energy from hydropower (Akosombo and Bui), thermal power plants powered by crude oil, natural gas, and diesel, solar power, and imports from La Cote d'Ivoire. Until the early 2000s, large hydroelectric dams dominated Ghana's electricity generation. Due to unreliable weather patterns, Ghana increased its reliance on thermal power. However, thermal power contributes the highest percentage in terms of electricity generation in Ghana and is predominantly supplied by Independent Power Producers (IPPs). Ghana's electricity industry operates the corporate utility model as its business model. This model is typically' vertically integrated,' with a single corporation selling the majority of power generated by its generation assets to its retail business, which then sells the electricity to retail market consumers. The corporate utility model has a straightforward value proposition that is based on increasing the number of energy units sold. The unit volume business model drives the entire energy value chain to increase throughput, locking system users into unsustainable practices. This report uses the qualitative research approach to explore the electricity industry in Ghana. There is a need for increasing renewable energy, such as wind and solar, in electricity generation. The research recommends two critical business models for the penetration of renewable energy in Ghana's power sector. The first model is the peer-to-peer electricity trading model, which relies on a software platform to connect consumers and generators in order for them to trade energy directly with one another. The second model is about encouraging local energy generation, incentivizing optimal time-of-use behaviour, and allowing any financial gains to be shared among the community members.

Keywords: business model innovation, electricity generation, renewable energy, solar energy, sustainability, wind energy

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Authors: Amy Stringer, Resa Chandler

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High Intensity Interval Training (HIIT) involves a 3-10-minute circuit of various exercises which is a viable alternative to a traditional cardiovascular and strength training regimen. Research suggests that measures of health-related fitness can either be maintained or actually improve with the use of this training method. After conducting a 6-week HIIT research study with 10-14 year old children, considerations for using a daily HIIT workout are presented. Is the use of HIIT with children a reasonable consideration for physical education programs? The benefits and challenges of this type of an intervention are identified. This study is significant in that achieving fitness gains in a small amount of daily class time is an attractive concept – especially for physical education teachers who often do not have the time necessary to accomplish all of their curricular goals in the amount of class time assigned. Basic methodologies include students participating in a circuit of exercises for 7-10 minutes at 80-95% of max heart rate as measured by heart rate monitors. Student pre and post fitness test data were collected for cardio-vascular endurance, muscular endurance, and body composition. Research notes as well as commentary by the teachers and researchers who participated in the HIIT study contributed to the understanding of the cost-benefit analysis. Major findings of the study are that HIIT has limited effectiveness but is a good choice for limited class times. Student efficacy of their ability to complete the exercises and visible heart rate data were considered to be significant factors in success of the HIIT study. The effective use of technology promoting positive audience effect during the display of heart rate data was more important at the beginning of the study than at the end. Student ‘buy-in’ and motivation, teacher motivation and ‘buy-in’, the variety of activities in the circuit and the fitness level of the student at the beginning of the study were also findings influencing the fitness outcomes of the study. Concluding Statement: High intensity interval training can be used effectively in a secondary physical education program. It is not a ‘magic bullet’ to produce health-related fitness outcomes in every student but it is an effective tool to enhance student fitness in a limited time and contribute to the goals of the program.

Keywords: cardio vascular fitness, children, high intensity interval training, physical education

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Authors: Muhamad Aris Burhanudin, Angga Firmansyas, Bagus Jaya Santosa

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Earthquakes are natural hazard that can trigger the most dangerous hazard, tsunami. 26 December 2004, a giant earthquake occurred in north-west Andalas Island. It made giant tsunami which crushed Sumatra, Bangladesh, India, Sri Lanka, Malaysia and Singapore. More than twenty thousand people dead. The occurrence of earthquake and tsunami can not be avoided. But this hazard can be mitigated by earthquake forecasting. Early preparation is the key factor to reduce its damages and consequences. We aim to investigate quantitatively on pattern of earthquake. Then, we can know the trend. We study about earthquake which has happened in Andalas island, Indonesia one last decade. Andalas is island which has high seismicity, more than a thousand event occur in a year. It is because Andalas island is in tectonic subduction zone of Hindia sea plate and Eurasia plate. A tsunami forecasting is needed to mitigation action. Thus, a Tsunami Forecasting Method is presented in this work. Neutral Network has used widely in many research to estimate earthquake and it is convinced that by using Backpropagation Method, earthquake can be predicted. At first, ANN is trained to predict Tsunami 26 December 2004 by using earthquake data before it. Then after we get trained ANN, we apply to predict the next earthquake. Not all earthquake will trigger Tsunami, there are some characteristics of earthquake that can cause Tsunami. Wrong decision can cause other problem in the society. Then, we need a method to reduce possibility of wrong decision. Fuzzy TOPSIS is a statistical method that is widely used to be decision seconder referring to given parameters. Fuzzy TOPSIS method can make the best decision whether it cause Tsunami or not. This work combines earthquake prediction using neural network method and using Fuzzy TOPSIS to determine the decision that the earthquake triggers Tsunami wave or not. Neural Network model is capable to capture non-linear relationship and Fuzzy TOPSIS is capable to determine the best decision better than other statistical method in tsunami prediction.

Keywords: earthquake, fuzzy TOPSIS, neural network, tsunami

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Authors: Paras Agarwal

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Background: Initially believed to be rare, metastases to the eye are the most common ocular malignancy. The choroid’s high perfusion rate not only makes it the most susceptible ocular site for tumour seeding, but also promotes its growth. The cancers most frequently responsible for choroidal metastases originate from the breast and lung, although a significant proportion have unidentified primaries at the time of presentation. Case Presentation: This case report describes a 34 year old female presenting to the ophthalmology department with a one month history of painless distorted vision. On fundus examination, she was noted to have bilateral choroidal lesionsand subsequently underwent a comprehensive diagnostic work-up. The patient was diagnosed with metastatic pulmonary adenocarcinoma, despite lacking conventional risk factors. As she was found to have a mutation in EGFR, the patient was commenced on tyrosine-kinase inhibition with afatinib. The choroidal lesions regressed with a significant improvement in visual acuity and a dramatic anatomical reduction of the choroidal masses. Conclusions: Our case demonstrates the importance of considering metastases as a differential diagnosis for choroidal lesions. Appropriate and thorough history-taking, examination and investigations may be required in order to deduce the underlying cause. Our case is unusual in view of the choroidal lesion being the primary manifestation of metastatic lung cancer in a young patient with no known risk factors. Early recognition of choroidal metastases is important as it is often the first sign of tumour dissemination and will prompt earlier treatment with systemic medications such as chemotherapy, immunotherapy, targeted therapy or hormonal therapy. Our case report also demonstrates the efficacy of afatinib for the treatment of choroidal metastases, with morphological and functional improvements observed with regard to the choroidal metastatic tumour.

Keywords: choroidal neoplasm, choroidal naevus, pulmonary adenocarcinoma, metastases, lung cancer

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Authors: Akhila Potluru

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Worldwide, more than 250 bodies of water are transboundary, meaning they cross the political boundaries of multiple countries. This creates a system of hydrological, economic, and social interdependence between communities reliant on these water sources. Transboundary water conflicts can occur as a result of this intense interdependence. Many factors contribute to the sparking of transboundary water conflicts, ranging from natural hydrological factors to hydro-political interactions. Previous attempts to predict transboundary water conflicts by analysing changes or trends in the contributing factors have typically failed because patterns in the data are hard to identify. However, there is potential for artificial intelligence and machine learning to fill this gap and identify future ‘hotspots’ up to a year in advance by identifying patterns in data where humans can’t. This research determines the extent to which AI can be used to predict and prevent transboundary water conflicts. This is done via a critical literature review of previous case studies and datasets where AI was deployed to predict water conflict. This research not only delivered a more nuanced understanding of previously undervalued factors that contribute toward transboundary water conflicts (in particular, culture and disinformation) but also by detecting conflict early, governance bodies can engage in processes to de-escalate conflict by providing pre-emptive solutions. Looking forward, this gives rise to significant policy implications and water-sharing agreements, which may be able to prevent water conflicts from developing into wide-scale disasters. Additionally, AI can be used to gain a fuller picture of water-based conflicts in areas where security concerns mean it is not possible to have staff on the ground. Therefore, AI enhances not only the depth of our knowledge about transboundary water conflicts but also the breadth of our knowledge. With demand for water constantly growing, competition between countries over shared water will increasingly lead to water conflict. There has never been a more significant time for us to be able to accurately predict and take precautions to prevent global water conflicts.

Keywords: artificial intelligence, machine learning, transboundary water conflict, water management

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Authors: Yasuyuki Takahashi, Hirotaka Shimada, Kyoko Saito

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Bone scintigraphy is widely used as a screening tool for bone metastases. However, the 180 to 240 minutes (min) waiting time after the intravenous (i.v.) injection of the tracer is both long and tiresome. To solve this shortcoming, a bone scan with a shorter waiting time is needed. In this study, we applied the Maximum Intensity Projection (MIP) and triple energy window (TEW) scatter correction to a whole body bone SPECT (Merged SPECT) and investigated shortening the waiting time. Methods: In a preliminary phantom study, hot gels of 99mTc-HMDP were inserted into sets of rods with diameters ranging from 4 to 19 mm. Each rod set covered a sector of a cylindrical phantom. The activity concentration of all rods was 2.5 times that of the background in the cylindrical body of the phantom. In the human study, SPECT images were obtained from chest to abdomen at 30 to 180 min after 99mTc- hydroxymethylene diphosphonate (HMDP) injection of healthy volunteers. For both studies, MIP images were reconstructed. Planar whole body images of the patients were also obtained. These were acquired at 200 min. The image quality of the SPECT and the planar images was compared. Additionally, 36 patients with breast cancer were scanned in the same way. The delectability of uptake regions (metastases) was compared visually. Results: In the phantom study, a 4 mm size hot gel was difficult to depict on the conventional SPECT, but MIP images could recognize it clearly. For both the healthy volunteers and the clinical patients, the accumulation of 99mTc-HMDP in the SPECT was good as early as 90 min. All findings of both image sets were in agreement. Conclusion: In phantoms, images from MIP with TEW scatter correction could detect all rods down to those with a diameter of 4 mm. In patients, MIP reconstruction with TEW scatter correction could improve the detectability of hot lesions. In addition, the time between injection and imaging could be shortened from that conventionally used for whole body scans.

Keywords: merged SPECT, MIP, TEW scatter correction, 99mTc-HMDP

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Authors: Zengda Li

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The tectonic evolution of the Beishan orogen, which forms part of the Central Asian Orogenic Belt, remains debated. This study reports the identification of three Triassic granitic plutons representing two distinct stages of magmatism in southern Beishan orogen. Zircon U–Pb dating constrains the early stage as 238–237 Ma and the late stage as 229–227 Ma. The granitoids belong to high-K calc-alkaline and shoshonitic series and exhibit alkalic-calcic and calc-alkalic features, and are weakly peraluminous rocks. Most of these granitoids are highly fractionated I-type and A-type granites. They have relatively high Isr values (0.7049–0.7086) and weak negative εNd(t) values of −1.5 to −2.1, with young Nd model ages of 1.04–0.91 Ga, indicating a crustal contribution. They also show markedly positive zircon εHf(t) values (+3.4 to +11.8) and two-stage Hf model ages of 1.06–0.69 Ga, indicating a mixture of mantle and crustal components. The lithospheric mantle beneath this region incorporating older subducted materials was metasomatized by fluids or melts. Partial melting of the metasomatized lithospheric mantle resulted in underplated magmas, which provided the heat and material input to generate the granitoids. The Middle Triassic granitic plutons show moderate negative Eu anomalies, enrichment of LILEs and depletion in Nb, Ta, and Ti suggesting partial melting of crustal components in response to the underplated mantle-derived magmas, probably linked to lithospheric delamination and asthenospheric upwelling. The Late Triassic granitic plutons show characteristics of post-orogenic granite with strong negative anomalies of Eu, Ba, Nb, Sr, P, and Ti, indicating fractional crystallization and crustal contamination during the emplacement process.

Keywords: Triassic, magmatism, geochronology, petrogenesis, Beishan orogen

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Authors: Dawit Hoyiso, Abinet Arega, Terefe Markos

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Background: - In spite of all the various programs and strategies to promote the use of research finding there is still gap between theory and practice. Difference in outcomes, health inequalities, and poorly performing health service continue to present a challenge to all nurses. A number of studies from various countries have reported that nurses’ experience of evidence-based practice is low. In Ethiopia there is an information gap on the extent of evidence based nursing practice and its associated factors. Objective: - the study aims to assess the implementation of evidence based nursing practice and associated factors among nurses in Jimma zone public hospitals. Method: - Institution based cross-sectional study was conducted from March 1-30/2015. A total of 333 sampled nurses for quantitative and 8 in-depth interview of key informants were involved in the study. Semi-structured questionnaire was adapted from funk’s BARRIER scale and Friedman’s test. Multivariable Linear regression was used to determine significance of association between dependent and independent variables. Pretest was done on 17 nurses of Bedele hospital. Ethical issue was secured. Result:-Of 333 distributed questionnaires 302 were completed, giving 90.6% response rate. Of 302 participants 245 were involved in EBP activities to different level (from seldom to often). About forty five(18.4%) of the respondents had implemented evidence based practice to low level (sometimes), one hundred three (42 %) of respondents had implemented evidence based practice to medium level and ninety seven (39.6 %) of respondents had implemented evidence based practice to high level(often). The first greatest perceived barrier was setting characteristic (mean score=26.60±7.08). Knowledge about research evidence was positively associated with implementation of evidence based nursing practice (β=0.76, P=0.008). Similarly, Place where the respondent graduated was positively associated with implementation of evidence based nursing practice (β=2.270, P=0.047). Also availability of information resources was positively associated with implementation of evidence based practice (β=0.67, P= 0.006). Conclusion: -Even though larger portion of nurses in this study were involved in evidence-based practice whereas small number of participants had implemented frequently. Evidence-based nursing practice was positively associated with knowledge of research, place where respondents graduated, and the availability of information resources. Organizational factors were found to be the greatest perceived barrier. Intervention programs on awareness creation, training, resource provision, and curriculum issues to improve implementation of evidence based nursing practice by stakeholders are recommended.

Keywords: evidence based practice, nursing practice, research utilization, Ethiopia

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Authors: Rosemary E. Huntriss, Lucy Jones

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Obesity and excess weight continue to be significant health problems in England. Traditional weight management programmes offer face-to-face support or group education. Remote care is recognised as a viable means of support; however, its effectiveness has not previously been evaluated in a tier 3 weight management setting. This service evaluation explored the effectiveness of online coaching, telephone support, and face-to-face support as optional management strategies within a tier 3 weight management programme. Outcome data were collected for adults with a BMI ≥ 45 or ≥ 40 with complex comorbidity who were referred to a Tier 3 weight management programme from January 2018 and had been discharged before October 2018. Following an initial 45-minute consultation with a specialist weight management dietitian, patients were offered a choice of follow-up support in the form of online coaching supported by an app (8 x 15 minutes coaching), face-to-face or telephone appointments (4 x 30 minutes). All patients were invited to a final 30-minute face-to-face assessment. The planned intervention time was between 12 and 24 weeks. Patients were offered access to adjunct face-to-face or telephone psychological support. One hundred and thirty-nine patients were referred into the programme from January 2018 and discharged before October 2018. One hundred and twenty-four patients (89%) attended their initial assessment. Out of those who attended their initial assessment, 110 patients (88.0%) completed more than half of the programme and 77 patients (61.6%) completed all sessions. The average length of the completed programme (all sessions) was 17.2 (SD 4.2) weeks. Eighty-five (68.5%) patients were coached online, 28 (22.6%) patients were supported face-to-face support, and 11 (8.9%) chose telephone support. Two patients changed from online coaching to face-to-face support due to personal preference and were included in the face-to-face group for analysis. For those with data available (n=106), average weight loss across the programme was 4.85 (SD 3.49)%; average weight loss was 4.70 (SD 3.19)% for online coaching, 4.83 (SD 4.13)% for face-to-face support, and 6.28 (SD 4.15)% for telephone support. There was no significant difference between weight loss achieved with face-to-face vs. online coaching (4.83 (SD 4.13)% vs 4.70 (SD 3.19) (p=0.87) or face-to-face vs. remote support (online coaching and telephone support combined) (4.83 (SD 4.13)% vs 4.85 (SD 3.30)%) (p=0.98). Remote support has been shown to be as effective as face-to-face support provided by a dietitian in the short-term within a tier 3 weight management setting. The completion rates were high compared with another tier 3 weight management services suggesting that offering remote support as an option may improve completion rates within a weight management service.

Keywords: dietitian, digital health, obesity, weight management

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Authors: Sajee A. Gamage, Champa J. Wijesinghe, Patricia Burtner, Ananda R. Wickremasinghe

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Background: Teachers working in the context of special education have an enormous responsibility of enhancing performance skills of children in their classroom settings. Fine Motor Skills (FMS) are essential functional skills for children to gain independence in Activities of Daily Living. Children with Down Syndrome (DS) are predisposed to specific challenges due to deficits in FMS. This study is aimed to determine the teachers’ experience on improving FMS of children with DS in the context of special education of Southern Province, Sri Lanka. Methodology: A cross-sectional study was conducted among all consenting eligible teachers (n=147) working in the context of special education in government schools of Southern Province of Sri Lanka. A self-administered questionnaire was developed based on literature and expert opinion to assess teachers’ experience regarding deficits of FMS, limitations of classroom activity performance and barriers to improve FMS of children with DS. Results: Approximately 93% of the teachers were females with a mean age ( ± SD) of 43.1 ( ± 10.1) years. Thirty percent of the teachers had training in special educationand 83% had children with DS in their classrooms. Major deficits of FMS reported were deficits in grasping (n=116; 79%), in-hand manipulation (n=103; 70%) and bilateral hand use (n=99; 67.3%). Paperwork (n=70; 47.6%), painting (n=58; 39.5%), scissor work (n=50; 34.0%), pencil use for writing (n=45; 30.6%) and use of tools in the classroom (n=41; 27.9%) were identified as major classroom performance limitations of children with DS. Parental factors (n=67; 45.6%), disease specific characteristics (n=58; 39.5%) and classroom factors (n=36; 24.5%), were identified as major barriers to improve FMS in the classroom setting. Lack of resources and standard tools, social stigma and late school admission were also identified as barriers to FMS training. Eighty nine percent of the teachers informed that training fine motor activities in a special education classroom was more successful than work with normal classroom setting. Conclusion: Major areas of FMS deficits were grasping, in-hand manipulation and bilateral hand use; classroom performance limitations included paperwork, painting and scissor work of children with DS. Teachers recommended regular practice of fine motor activities according to individual need. Further research is required to design a culturally specific FMS assessment tool and intervention methods to improve FMS of children with DS in Sri Lanka.

Keywords: classroom activities, Down syndrome, experience, fine motor skills, special education, teachers

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Authors: Suneeta Gireesh Panicker

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Aim: Aminopeptidase P (APP) is an enzyme that has specificity for proline, can specifically cleave Xaa-Proline peptides and is a metallo-aminopeptidase. The bonds nearby to the imino acid proline are tough to cleave by many peptidases, but APP can specifically break peptide bonds engaged with proline. Membrane-bound form and a cytosolic form are the two forms in which this enzyme exists. The exact physiological function of APP remains unclear and hence the present work attempts to determine it. Methods: In the present study, the expression pattern of cytosolic Aminopeptidase P (DAP) was determined in all the embryonic stages and larval stages of wild-type Drosophila by using polyclonal monospecific antibodies. To show the presence of DAP RNA in embryonic and larval stages, RNA in situ hybridization was performed. DAP promoter-LacZ fusion reporter gene vector was used to construct transgenic embryos to study the regulation pattern of DAP. To study the DAP expression profile, a transgenic fly consisting of a DAP promoter with β-gal and GFP reporter genes in front of it was constructed. Results: DAP protein expression was observed in neuroectodermal cells, posterior midgut primordium, proctodeum, ventral neuroblast and primordial stomatogastric nervous system. It was observed in the ventral cord and midgut in stage 12. The completely developed embryos showed the intense occurrence of it in the ventral cord and gut region. The eye-antennal disc, wing disc and leg disc also showed the presence of DAP protein. LacZ expression in transgenic embryos also showed the same pattern. Conclusion: Similar to various known multiple-functional proteins, DAP could be one with different functions at different stages and in different cells. Data presented here designates DAP functions in the early embryonic and imaginal dics differentiation and development, suggesting that it may be required for the metabolism of proteins like neuropeptides and tachykinins.

Keywords: aminopeptidase P, in situ hybridization, transgenic fly, embryonic stages

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Authors: Fendouli Ines, Zaafrane Nesrine, Mhamdi Hana, Knani Leila, Ghorbel Mohamed

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Introduction: Ocular infiltration of leukemia can involve orbit, uveal tract, retina and optic nerve. It may result from direct ocular infiltration by leukemic cells or indirect ocular involvement resulting from secondary hematologic changes, opportunistic infections and complications of various modalities of therapy. We here in report a case of central venous retinal occlusion associated to optic nerve infiltration as presenting signs of a relapse of acute lymphoblastic leukemia. Case Report: A twelve-year-old male -patient of acute B lymphoblastic leukemia presented with headaches and bilateral blurred vision in the left ee. Ophthalmic examination showed a visual acuity reduced to counting fingers in the right eye and no light perception in the left eye. Funduscopy revealed a voluminous disc edema surrounded by retinal haemorrhages in the right eye, and venous tortusities, papillary edema, and hemorrages suggesting central retinal venous occlusion in the LE. Swept source optical coherence tomography revealed a serous retinal detachment in the RE and .hyperreflective inner layers with macular edema in the left eye. Cerebro-orbital MRI showed bilateral thickened left optic nerve. There were no radiological signs of true papillary edema due to intracranial hypertension secondary to central nervous system involvement. Myelogram and lumbar punction demonstrated blast infiltration and confirmed ocular relapse of the leukemia. Conclusion: Ocular involvement lymphoblastic acute leukemias decreased since the introduction of a systematic prophylactic treatment of central nervous system. Periodic ophthalmic examination is necessary to allow early diagnosis and treatment.

Keywords: acute leukemia, optic nerve, infiltration, relapse

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Authors: Seval Kizildag, Ozge Can Aran

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The effective intervention of counselors’ in conflict between spouses may be effective in increasing the quality of marital relationship. At this point, it is necessary for counselors to consider their own value systems at first and then reflect this correctly to the counseling process. For this reason, it is primarily important to determine the needs of counselors. Starting from this point of view, in this study, it is aimed to reveal the perspective of counselor candidates about the universal values in marriage relation. The study group of the survey was formed by sampling, which is one of the prospective sampling methods. As a criterion being a candidate for counseling area and having knowledge of the concepts of the Marriage and Family Counseling course is based, because, that candidate students have a comprehensive knowledge of the field and that students have mastered the concepts of marriage and family counseling will strengthen the findings of this study. For this reason, 61 counselor candidates, 32 (52%) female and 29 (48%) male counselor candidates, who were about to graduate from a university in south-east Turkey and who took a Marriage and Family Counseling course, voluntarily participated in the study. The average age of counselor candidates’ is 23. At the same time, 70 % of the parents of these candidates brought about their marriage through arranged marriage, 13% through flirting, 8% by relative marriage, 7% through friend circles and 2% by custom. The data were collected through Demographic Information Form and a form titled ‘Universal Values Form in Marriage’ which consists of six questions prepared by researchers. After the data were transferred to the computer, necessary statistical evaluations were made on the data. The qualitative data analysis was used on the data which was obtained in the study. The universal values which include six basic values covering trustworthiness, respect, responsibility, fairness, caring, citizenship, determined under the name as ‘six pillar of character’ are used as base and frequency values of the data were calculated trough content analysis. According to the findings of the study, while the value which most students find the most important value in marriage relation is being reliable, the value which they find the least important is to have citizenship consciousness. Also in this study, it is found out that counselor candidates associate the value of being trustworthiness ‘loyalty’ with (33%) as the highest in terms of frequency, the value of being respect ‘No violence’ with (23%), the value of responsibility ‘in the context of gender roles and spouses doing their owns’ with (35%) the value of being fairness ‘impartiality’ with (25%), the value of being caring ‘ being helpful’ with (25%) and finally as to the value of citizenship ‘love of country’ with (14%) and’ respect for the laws ‘ with (14%). It is believed that these results of the study will contribute to the arrangements for the development of counseling skills for counselor candidates regarding value in marriage and family counseling curricula.

Keywords: caring, citizenship, counselor candidate, fairness, marriage relationship, respect, responsibility, trustworthiness, value system

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Authors: Kawar Salih

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It has been proven that designing sustainable buildings starts from early stages of urban design. The design of urban blocks specifically, is considered as one of the pragmatic strategies of sustainable urbanism. There have been previous studies that focused on the impact of urban block design and regulation on the outdoor thermal comfort in the semi-arid regions. However, no studies have been found that concentrated on that impact on the internal behavior of buildings of those regions specifically the daylight quality and energy performance. Further, most studies on semi-arid regions are focusing only on the cooling load reduction, neglecting the heating load. The study has focused on two parameters of urban block distribution which are the block orientation and the surface-to-volume ratio with the consideration of both heating and cooling loads of buildings. In Duhok (a semi-arid city in Kurdistan region of Iraq), energy consumption and daylight quality of different types of residential blocks have been examined using dynamic simulation. The findings suggest that there is a considerable higher energy load for heating than cooling, contradicting many previous studies about these regions. The results also highlight that the orientation of urban blocks can vary the energy consumption to 8%. Regarding the surface-to-volume ratio (S/V), it was observed that after the twice enlargement of the S/V, the energy consumption increased 15%. Though, the study demonstrates as well that there are opportunities for reducing energy consumption with the increase of the S/V which contradicts many previous research on S/V impacts on energy consumption. These results can help to design urban blocks with the bigger S/V than existing blocks in the city which it can provide better indoor daylight and relatively similar energy consumption.

Keywords: blocke orienation, building energy consumption, urban block design, semi-arid regions, surfacet-to-volume ratio

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Authors: A. N. Ghafar, O. A. Chaudhari, W. Oettel, P. Fontana

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This study is a part of the EU project GEOCOND-Advanced materials and processes to improve performance and cost-efficiency of shallow geothermal systems and underground thermal storage. In heat exchange boreholes, to improve the heat transfer between the pipes and the surrounding ground, the space between the pipes and the borehole wall is normally filled with geothermal grout. Traditionally, bentonite has been a crucial component in most commercially available geothermal grouts to assure the required stability and impermeability. The investigations conducted in the early stage of this project during the benchmarking tests on some commercial grouts showed considerable sensitivity of the rheological properties of the tested grouts to the mixing parameters, i.e., mixing time and velocity. Further studies on this matter showed that bentonite, which has been one of the important constituents in most grout mixes, was probably responsible for such behavior. Apparently, proper amount of shear should be applied during the mixing process to sufficiently activate the bentonite. The higher the amount of applied shear the more the activation of bentonite, resulting in change in the grout rheology. This explains why, occasionally in the field applications, the flow properties of the commercially available geothermal grouts using different mixing conditions (mixer type, mixing time, mixing velocity) are completely different than expected. A series of tests were conducted on the grout mixes, with and without bentonite, using different mixing protocols. The aim was to eliminate/reduce the sensitivity of the rheological properties of the geothermal grouts to the mixing parameters by replacing bentonite with polymeric (non-clay) stabilizers. The results showed that by replacing bentonite with a proper polymeric stabilizer, the sensitivity of the grout mix on mixing time and velocity was to a great extent diminished. This can be considered as an alternative for the developers/producers of geothermal grouts to provide enhanced materials with less uncertainty in obtained results in the field applications.

Keywords: flow properties, geothermal grout, mixing time, mixing velocity, rheological properties

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Authors: Samane Eftekhari Ranjbar

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Diabetes mellitus, a metabolic disorder characterized by elevated blood glucose levels, ranks among the leading causes of adult mortality. This study investigates the impact of an eight-week high-intensity interval training (HIIT) program combined with sodium nitrite supplementation on TNF- α, MURF1, and PI3K in a type 2 diabetes rodent model. Elevated TNF-α levels have been associated with insulin resistance, while MURF1 and PI3K play roles in muscle atrophy and insulin signaling pathways, respectively. In this experimental study, 15 eight-week-old rats from the Sara Laboratory Center in Tabriz were assigned to one of five groups: healthy control, diabetic control, diabetic with sodium nitrite supplementation, diabetic with eight weeks of intermittent exercise, and diabetic with eight weeks of interval training plus sodium nitrite supplementation. The HIIT protocol was designed to span eight weeks, with five weekly sessions at specified intensities and durations. Sodium nitrite, known for its vasodilatory and cytoprotective properties, was administered via injection. The findings revealed that the HIIT program and sodium nitrite supplementation influenced the examined biomarkers. ANOVA test outcomes indicated statistically significant differences in TNF- α (P=0.001), MURF1 (P=0.001), and PI3K (P=0.001) concentrations among the various groups. The healthy control group exhibited substantially decreased TNF- α, and MURF1 levels, as well as elevated PI3K levels compared to the diabetic control group. The exercise group, in conjunction with sodium nitrite supplementation, demonstrated a significant rise in PI3K levels (P=0.001) and a decline in TNF- α levels (P=0.018) relative to the diabetic control group. These results suggest that the combined intervention may help improve insulin sensitivity and reduce inflammation. However, MURF1 levels, which are related to muscle atrophy, showed no significant difference (P=0.24). In conclusion, in type 2 diabetic rats, an eight-week high-intensity interval training program with sodium nitrite supplementation does not affect MURF1 levels but does influence PI3K and TNF- α levels. This combination may hold potential for improving insulin sensitivity and reducing inflammation in type 2 diabetes patients, warranting further investigation and potential translation to human clinical trials.

Keywords: high-intensity interval training, sodium nitrate supplementation, type 2 diabetes, tumor necrosis factor-alpha, phosphatidylinositol-3-kinase, muscle RING-finger protein-1

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Authors: Rajlekha Sil

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This paper aims to investigate Ray’s portrayal of liminality and the female gaze in ‘Charulata’ (1964) and ‘Ghare Baire’ (1984), both of which primarily articulates the stories of two women (Charu and Bimala respectively), entangled within the cobwebs of their seething, unfulfilled sexuality, amidst a newly-globalised urban culture, punctuated with political turmoils and ideological conflicts. Their tempestuous interactions with the societal space, both tangible and intangible, that surrounds them, and the men in their lives makes them dwell in a liminal space, filled with an ambiguous sense of virtue. In Ray’s films, this sexual ambivalence is characterised by the liminality between the scenic and extrascenic spaces, which, in turn, defines the female gaze as the director’s lenses paint a picture of the new wave of socio-political and socio-cultural movements in early twentieth-century Bengal. Brinda Bose’s essay on ‘Modernity, Globality, Sexuality, and the City: A Reading of Indian Cinema’, analyses the ‘necessary’ process of urbanisation as a marker of ‘moral degeneracy of the nation easily analogous with female sexual transgression/ promiscuity with the nation personified as a woman, by using the concept of the liminal space, a site of both empowerment through transgression and containment through regulation.’ My paper, however, would focus on the liminal space propagated by Ray through his contrasting depiction of scenic and extrascenic spaces to satiate the equivocal voices in Charu and Bimala, along with their way of ‘gazing’ into an equally disheveled society - a gaze that helps them transcend the barriers of politics and urbanization into a state of universal uniformity, symmetrical with their sexual immorality. The first section of the paper would explore Ray’s usage of these theatrical spaces through his character sketches, shots and dialogues, while the second section of the paper would delve into the ‘female gaze’ on a newly revolutionised society.

Keywords: satyajit ray, space, gaze, female sexuality, charulata, ghare baire

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Authors: Vibhuti Amarnath Madhu Agrawal

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Artificial Intelligence (AI) and Intellectual Property are two emerging concepts that are growing at a fast pace and have the potential of having a huge impact on the economy in the coming times. In simple words, AI is nothing but work done by a machine without any human intervention. It is a coded software embedded in a machine, which over a period of time, develops its own intelligence and begins to take its own decisions and judgments by studying various patterns of how people think, react to situations and perform tasks, among others. Intellectual Property, especially Copyright Law, on the other hand, protects the rights of individuals and Companies in content creation that primarily deals with application of intellect, originality and expression of the same in some tangible form. According to some of the reports shared by the media lately, ChatGPT, an AI powered Chatbot, has been involved in the creation of a wide variety of original content, including but not limited to essays, emails, plays and poetry. Besides, there have been instances wherein AI technology has given creative inputs for background, lights and costumes, among others, for films. Copyright Law offers protection to all of these different kinds of content and much more. Considering the two key parameters of Copyright – application of intellect and originality, the question, therefore, arises that will awarding Copyright protection to a person who has not directly invested his / her intellect in the creation of that content go against the basic spirit of Copyright laws? This study aims to analyze the current scenario and provide answers to the following questions: a. If the content generated by AI technology satisfies the basic criteria of originality and expression in a tangible form, why should such content be denied protection in the name of its creator, i.e., the specific AI tool / technology? B. Considering the increasing role and development of AI technology in our lives, should it be given the status of a ‘Legal Person’ in law? C. If yes, what should be the modalities of awarding protection to works of such Legal Person and management of the same? Considering the current trends and the pace at which AI is advancing, it is not very far when AI will start functioning autonomously in the creation of new works. Current data and opinions on this issue globally reflect that they are divided and lack uniformity. In order to fill in the existing gaps, data obtained from Copyright offices from the top economies of the world have been analyzed. The role and functioning of various Copyright Societies in these countries has been studied in detail. This paper provides a roadmap that can be adopted to satisfy various objectives, constraints and dynamic conditions related AI technology and its protection under Copyright Law.

Keywords: artificial intelligence technology, copyright law, copyright societies, intellectual property

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Authors: S. Curtin, A. Trace

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Introduction: As patients can often be ambivalent about or resistant to any change in their smoking behavior the traditional ‘5 A’ model may be limited as it assumes that patients are ready and motivated to change. However, there is a stage model that is helpful to give guidance for dental students: the Transtheoretical Model (TTM). This model allows students to understand the tasks and goals for the pre-contemplation stage. The TTM was introduced in early stages as a core component of a smoking cessation programme that was integrated into a Behavioral Science programme as applied to dentistry. The aim of the present study is to evaluate and illustrate the students’ current level of knowledge from the questions the students generated in order to engage patients in the tasks and goals of the pre-contemplation stage. Method: N=47 responses of fifth-year undergraduate dental students. These responses were the data set for this study and related to their knowledge base of appropriate questions for a dentist to ask at the pre-contemplation stage of change. A deductive -descriptive analysis was conducted on the data. The goals and tasks of the pre-contemplation stage of the TTM provided a template for this deductive analysis. Results: 51% of students generated relevant, open, exploratory questions for the pre-contemplation stage, whilst 100% of students generated closed questions. With regard to those questions appropriate for the pre-contemplation stage, 19% were open and exploratory, while 66% were closed questions. A deductive analysis of the open exploratory questions revealed that 53% of the questions addressed increased concern about the current pattern of behavior, 38% of the questions concerned increased awareness of a need for change and only 8% of the questions dealt with the envisioning of the possibility of change. Conclusion: All students formulated relevant questions for the pre-contemplation stage, and half of the students generated the open, exploratory questions that increased patients’ awareness of the need to change. More training is required to facilitate a shift in the formulation from closed to open questioning, especially given that, traditionally, smoking cessation was modeled on the ‘5 As’, and that the general training for dentists supports an advisory and directive approach.

Keywords: behaviour change, pre-contemplation stage, trans-theoretical model, undergraduate dentistry students

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