Search results for: successful treatment

Authors: Kristel Dame Bañez Sumagaysay, Marie Victoria Cruz-javier

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The current subject is a case of a 21 year-old woman at 29 1/7 weeks of gestation with Pre-B cell Acute Lymphoblastic Leukemia who was admitted to the coronary care unit (CCU) of the St. Luke’s Medical Center-Global City for Severe Acute Respiratory Distress Syndrome (ARDS) secondary to hospital-acquired pneumonia secondary to pneumocystis jiroveci; central line-associated bloodstream infection (E. aerogenes). She presented with chronic hypoxemia caused by Pulmonary edema, probably secondary to heart failure secondary to cardiomyopathy chemotherapy-induced. Due to worsening feto-maternal status, extracorporeal membrane oxygenation (ECMO) for respiratory support was instituted, and an elective cesarean section was done due to multiple maternal factors and deteriorating health status under total intravenous anesthesia assisted by veno-venous extracorporeal membrane oxygenation. She delivered a live preterm newborn male, APGAR Score: 1, 0, 0, birth weight 985 grams, birth length: 40.5cm, small for gestational age.

Keywords: extracorporeal membrane oxygenation, pre-b cell acute lymphoblastic leukemia, severe acute respiratory distress syndrome, ethical dilemmas

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Authors: Xian Chen

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In recent years, the tendency that the decline of material and social vitality of old city in China becomes more and more serious. Nowadays, transformation and renewal of the old city have become a hot topic in urban research. The traditional mode of large-scale promotion has been criticized. Thus, exploration of new ways to update the city turns to be a necessity on the way of sustainable urban development. Pocket Park is a small city open space, its location choose is based on abandoned or idle lands on urban structure, is scattered or hidden in corner of the urban. It has a great significance on improving the old city environment. Based on the theory of ‘pocket park’, this paper summarizes the successful experience of domestic and foreign practice, and discusses the update strategies which are suitable for China's national conditions according to the characteristics and predicament of the old city in China. The main methods and results are as follows: 1)Based on the conception of ‘pocket park’, though describing the research status in domestic and foreign, summarizing the experience which is worth learning and existing problems. 2) From the analysis of ‘pocket park’ function, general design principles and types of the deep-seated difficulties in renewal the old city and the possibility of the application of ‘pocket park’,the varied implementation of ‘pocket park’ form are established, and application value in the old city renewal are summed up. 3) It can’t be denied that pocket park plays an irreplaceable role in solving the recession and renewing the vitality of the old city. Anymore, It is recommended to develop corresponding supportive development policies.

Keywords: sustainable development, strategy, old city renewal, pocket park

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Authors: X. Vecino, J. M. Cruz, A. Moldes

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The disposal and the treatment of sewage sludge is an expensive and environmentally complex problem. In this work, a lipopeptide biosurfactant extracted from corn steep liquor was used as ecofriendly and cost-competitive alternative for the mobilization and bioremediation of fluorene in sewage sludge. Results have demonstrated that this biosurfactant has the capability to mobilize fluorene to the aqueous phase, reducing the amount of fluorene in the sewage sludge from 484.4 mg/Kg up to 413.7 mg/Kg and 196.0 mg/Kg after 1 and 27 days respectively. Furthemore, once the fluorene was extracted the lipopeptide biosurfactant contained in the aqueous phase allowed the bio-degradation, up to 40.5 % of the initial concentration of this polycyclic aromatic hydrocarbon.

Keywords: fluorene, lipopeptide biosurfactant, mobilization, sewage sludge

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Authors: Ebrahim Sabermaash Eshghi, Donna Sandsmark

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Nowadays, successful companies try to create a reliable and unique competitive position in the market. It is important to consider that only choosing and codifying a competitive strategy appropriate with the market conditions does not have any influence on the final performance of the company by itself, but it is the connection and interaction between upstream level strategies and functional level strategies which leads to development of company performance in its operating environment. Given the importance of the subject, this study tries to investigate effective factors on product performance and prioritize them. This study was done with quantitative-qualitative approach (interview and questionnaire). In sum, 103 informed managers and experts of Pars-Khazar Company were investigated in a census. Validity of measure tools was approved through experts’ judgments. Reliability of the tools was also gained through Cronbach's Alpha Coefficient as 0.930 and in sum, validity and reliability of the tools was approved generally. Analysis of collected data was done through Spearman Correlation Test and Friedman Test using SPSS software. The results showed that management of distribution and demand process (0.675), management of Product Pre-test (0.636) and Manufacturing and inventory management(0.628) had the highest correlation with product performance. Prioritization of factors of structure of launching new products based on the average showed that management of volume of launched products and Manufacturing and inventory management had the most importance.

Keywords: product performance, home appliances, market, case study

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Authors: Mahdi Momeni

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The arrival of Mysticism to the subcontinent can be generally divided into two periods. The first period, was the Sporadic arrival of Sufis whom were traveling to the subcontinent according to the tradition of disquisition and the second period was; when the Sufi dynasties were sending missionaries and caliphs to guide and promote people from different direction to that land. Among the Sufi dynasty that entered to India in the thirteenth century, two dynasties of Chishti and Suhrawardîya were more successful than other Sufi dynasties. And thus they are very important in the spread of Islam and Mysticism to the subcontinent. Suhrawardiyya dynasty was founded by Sheikh Ziauddin Abu Najib Suhrawardi and was developed and spread by his nephew Sheikh Shahabuddin Suhrawardi Abo hafs Omar. Sheikh Shahabuddin sent many Caliphs and missionaries to India. Among these missionaries were People like Sultan Sakhi Sarwar, Seyyed Noureddin Mobarak Ghaznavi, Sheikh Jalal al-din Tabrizi and Sheikh Zakariya Multani. Since Suhrawardiyya doctrine relies on Asceticism and Sharia, so one of the important elements among Suhrawardiyya missionaries was inviting people to Islam. Accordingly Sheikh Shahab Caliphs had a great role in the spread of Islam and Mysticism in different territories, especially India. Such that it can be pointed out is the the role of Sheikh Baha-ud-din Zakariya Multani, the founder of Suhrawardiyya Dynasty in India. Sheikh Zakaria Multani after working in three areas, establishing monasteries, training managers, having numerous trips to different places, participating to social affairs provided the spread of Islam and Mysticism in subcontinent. This paper studies his role and actions in the subcontinent.

Keywords: islam, sufism, Suhrawardiyya, subcontinent, Multan

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Authors: Kalbende Krunal Ramesh

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The Carbon Capture and Storage Technology (CCS) provides a veritable platform to bridge the gap between the seemingly irreconcilable twin global challenges of ensuring a secure, reliable and diversified energy supply and mitigating climate change by reducing atmospheric emissions of carbon dioxide. Making its proper regulatory policy and making it flexible for the government and private company by law to regulate, also exploring the opportunity in this sector is the main aim of this paper. India's total annual emissions was 1725 Mt CO2 in 2011, which comprises of 6% of total global emission. It is very important to control the greenhouse gas emission for the environment protection. This paper discusses the various regulatory policy and technology adopted by some of the countries for successful using CCS technology. The brief geology of sedimentary basins in India is studied, ranging from the category I to category IV and deep water and potential for mature technology in CCS is reviewed. Areas not suitable for CO2 storage using presently mature technologies were over viewed. CSS and Clean development mechanism was developed for India, considering the various aspects from research and development, project appraisal, approval and validation, implementation, monitoring and verification, carbon credit issued, cap and trade system and its storage potential. The opportunities in oil and gas operations, power sector, transport sector is discussed briefly.

Keywords: carbon credit issued, cap and trade system, carbon capture and storage technology, greenhouse gas

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Authors: Saima Ali, Liaqat Ali, Nasir Orakzai

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Background: Hydronephrosis is the most common abnormal finding in the urinary tract on prenatal screening with Ultrasonography. The prenatal hydronephrosis is a diagnostic dilemma in differentiating between obstructive variant versus physiologic hydronephrosis. The assessment and prompt diagnosis of prenatal hydronephrosis is important because of the fact that untreated obstructive hydronephrosis usually leads to recurrent UTI, Urosepsis, deterioration of renal functions, non-functioning kidneys, and even end-stage renal disease. Objectives: To determine the etiology and outcome of postnatal treatment of children with prenatal hydronephrosis in two teaching hospitals of Khyber Pakhtunkhwa (KPK) Methods: It is a multicentric descriptive study that was conducted in department of Paediatrics in Kuwait teaching hospital Peshawar and Department of Urology in Institute of Kidney Diseases Hayatabad Medical Complex Peshawar from January 2008 till December 2010. Total numbers of 64 neonates were included in the study with the mean follow-up of 14.5 months. All the diagnostic data in prenatal, postnatal data, and operative and non-operative data were collected on structured Proforma and was analyzed on SPSS version 17. Results: Out of 64 patients, 39 (60.9 %) were male while 25 were female. 52 patients had unilateral while 12 patients had bilateral hydronephrosis. Based upon prenatal USG in term of AP diameter, 37 (57 %) patients had mild hydronephrosis (5-10 mm AP diameter), 14 patients had moderate hydronephrosis (10-15 mm AP diameter) while 13 patients had gross hydronephrosis (More than 15mm). Regarding etiology, 44(76 %) patients were labeled as physiologic hydronephrosis, 11 patients (9.3%) with PUJ obstruction, 5 patients with Vesicoureteric reflux (VUR) and 4 patients with posterior urethral valves. Surgery was performed in total of 15 (23.4%) patients that included open Pyeloplasty in 11 patients, Vesicostomy followed by posterior valve fulguration in 4 patients. All the patients of VUR treated medically. The severity in the grade of prenatal hydronephrosis is significantly associated with the need for definitive urological surgery p < 0.005. Ancillary procedures like percutaneous nephrostomy (PCN) were inserted 7 patients. Conclusions: Prenatal hydronephrosis is a common ailment associated with significant morbidity. Physiological Hydronephrosis and VUR can be successfully treated with medical treatment. However obstructive PUJ obstructions and posterior urethral valves require surgical correction with a good success rate.

Keywords: prenatal hydronephrosis, Pelviureteric Junction (PUJ) Obstruction, vesicoureteric reflux, posterior urethral valve, renography

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Authors: E. M. D. Akuoko, Eliana Vasquez Osorio, Marcel Van Herk, Marianne Aznar

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Radiotherapy is an integral part of treatment for many patients with breast cancer. However, side effects can occur, e.g., fibrosis or erythema. If patients at higher risks of radiation-induced side effects could be identified before treatment, they could be given more individual information about the risks and benefits of radiotherapy. We hypothesize that breast density is correlated with the risk of side effects and present a novel method for automatic evaluation based on radiotherapy planning CT scans. Methods: 799 supine CT scans of breast radiotherapy patients were available from the REQUITE dataset. The methodology was first established in a subset of 114 patients (cohort 1) before being applied to the whole dataset (cohort 2). All patients were scanned in the supine position, with arms up, and the treated breast (ipsilateral) was identified. Manual experts contour available in 96 patients for both the ipsilateral and contralateral breast in cohort 1. Breast tissue was segmented using atlas-based automatic contouring software, ADMIRE® v3.4 (Elekta AB, Sweden). Once validated, the automatic segmentation method was applied to cohort 2. Breast density was then investigated by thresholding voxels within the contours, using Otsu threshold and pixel intensity ranges based on Hounsfield units (-200 to -100 for fatty tissue, and -99 to +100 for fibro-glandular tissue). Volumetric breast density (VBD) was defined as the volume of fibro-glandular tissue / (volume of fibro-glandular tissue + volume of fatty tissue). A sensitivity analysis was performed to verify whether calculated VBD was affected by the choice of breast contour. In addition, we investigated the correlation between volumetric breast density (VBD) and patient age and breast size. VBD values were compared between ipsilateral and contralateral breast contours. Results: Estimated VBD values were 0.40 (range 0.17-0.91) in cohort 1, and 0.43 (0.096-0.99) in cohort 2. We observed ipsilateral breasts to be denser than contralateral breasts. Breast density was negatively associated with breast volume (Spearman: R=-0.5, p-value < 2.2e-16) and age (Spearman: R=-0.24, p-value = 4.6e-10). Conclusion: VBD estimates could be obtained automatically on a large CT dataset. Patients’ age or breast volume may not be the only variables that explain breast density. Future work will focus on assessing the usefulness of VBD as a predictive variable for radiation-induced side effects.

Keywords: breast cancer, automatic image segmentation, radiotherapy, big data, breast density, medical imaging

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Authors: Deepak Singh, Rail Kuliev

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This research article explores the significance of advanced data visualization techniques in enhancing decision-making processes within the oil and gas exploration and production domain. With the oil and gas industry facing numerous challenges, effective interpretation and analysis of vast and diverse datasets are crucial for optimizing exploration strategies, production operations, and risk assessment. The article highlights the importance of data visualization in managing big data, aiding the decision-making process, and facilitating communication with stakeholders. Various advanced data visualization techniques, including 3D visualization, augmented reality (AR), virtual reality (VR), interactive dashboards, and geospatial visualization, are discussed in detail, showcasing their applications and benefits in the oil and gas sector. The article presents case studies demonstrating the successful use of these techniques in optimizing well placement, real-time operations monitoring, and virtual reality training. Additionally, the article addresses the challenges of data integration and scalability, emphasizing the need for future developments in AI-driven visualization. In conclusion, this research emphasizes the immense potential of advanced data visualization in revolutionizing decision-making processes, fostering data-driven strategies, and promoting sustainable growth and improved operational efficiency within the oil and gas exploration and production industry.

Keywords: augmented reality (AR), virtual reality (VR), interactive dashboards, real-time operations monitoring

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Authors: Krestina V. Alsaraeva, Victor E. Gromov, Sergey V. Konovalov, Anna A. Atroshkina

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Processing of Al-19.4Si alloy by high intensive electron beam has been carried out and multiple increase in fatigue life of the material has been revealed. Investigations of structure and surface modified layer destruction of Al-19.4Si alloy subjected to multicycle fatigue tests to fracture have been carried out by methods of scanning electron microscopy. The factors responsible for the increase of fatigue life of Al-19.4Si alloy have been revealed and analyzed.

Keywords: Al-19.4Si alloy, high intensive electron beam, multicycle fatigue, structure

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Authors: Jan C. Droste, Justine Burns, Nithin Narayan

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Introduction: Life-threatening detrimental effects of inappropriate adrenaline (epinephrine) administration, e.g., by giving the wrong dose, in the context of anaphylaxis management is well documented in the medical literature. Half of the fatal anaphylactic reactions in the UK are iatrogenic, and the median time to a cardio-respiratory arrest can be as short as 5 minutes. It is therefore imperative that hospital doctors of all grades have active and accurate knowledge of the correct route, site, and dosage of administration of adrenaline. Given this time constraint and the potential fatal outcome with inappropriate management of anaphylaxis, it is alarming that surveys over the last 15 years have repeatedly shown only a minority of doctors to have accurate knowledge of adrenaline administration as recommended by the UK Resuscitation Council guidelines (2008 updated 2012). This comparison of survey results of the medical workforce over several years in a small NHS District General Hospital was conducted in order to establish the effect of the employment of multiple educational methods regarding adrenaline administration in anaphylaxis in adults. Methods: Between 2010 and 2017, several education methods and tools were used to repeatedly inform the medical workforce (doctors and advanced clinical practitioners) in a single district general hospital regarding the treatment of anaphylaxis in adults. Whilst the senior staff remained largely the same cohort, junior staff had changed fully in every survey. Examples included: (i) Formal teaching -in Grand Rounds; during the junior doctors’ induction process; advanced life support courses (ii) In-situ simulation training performed by the clinical skills simulation team –several ad hoc sessions and one 3-day event in 2017 visiting 16 separate clinical areas performing an acute anaphylaxis scenario using actors- around 100 individuals from multi-disciplinary teams were involved (iii) Hospital-wide distribution of the simulation event via the Trust’s Simulation Newsletter (iv) Laminated algorithms were attached to the 'crash trolleys' (v) A short email 'alert' was sent to all medical staff 3 weeks prior to the survey detailing the emergency treatment of anaphylaxis (vi) In addition, the performance of the surveys themselves represented a teaching opportunity when gaps in knowledge could be addressed. Face to face surveys were carried out in 2010 ('pre-intervention), 2015, and 2017, in the latter two occasions including advanced clinical practitioners (ACP). All surveys consisted of convenience samples. If verbal consent to conduct the survey was obtained, the medical practitioners' answers were recorded immediately on a data collection sheet. Results: There was a sustained improvement in the knowledge of the medical workforce from 2010 to 2017: Answers improved regarding correct drug by 11% (84%, 95%, and 95%); the correct route by 20% (76%, 90%, and 96%); correct site by 40% (43%, 83%, and 83%) and the correct dose by 45% (27%, 54%, and 72%). Overall, knowledge of all components -correct drug, route, site, and dose-improved from 13% in 2010 to 62% in 2017. Conclusion: This survey comparison shows knowledge of the medical workforce regarding adrenaline administration for treatment of anaphylaxis in adults can be considerably improved by employing a variety of educational methods.

Keywords: adrenaline, anaphylaxis, epinephrine, medical education, patient safety

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Authors: Debasis Sarkar

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Clean development mechanism (CDM) can act as an effective instrument for mitigating climate change. This mechanism can effectively reduce the emission of CO2 and other green house gases (GHG). Construction of a mega infrastructure project like underground corridor construction for metro rail operation involves in consumption of substantial quantity of concrete which consumes huge quantity of energy consuming materials like cement and steel. This paper is an attempt to develop an integrated clean development mechanism and risk management approach for sustainable development for an underground corridor metro rail project in India during its construction phase. It was observed that about 35% reduction in CO2 emission can be obtained by adding fly ash as a part replacement of cement. The reduced emission quantity of CO2 which is of the quantum of about 21,646.36 MT would result in cost savings of approximately INR 8.5 million (USD 1,29,878).But construction and operation of such infrastructure projects of the present era are subject to huge risks and uncertainties throughout all the phases of the project, thus reducing the probability of successful completion of the project within stipulated time and cost frame. Thus, an integrated approach of combining CDM with risk management would enable the metro rail authorities to develop a sustainable risk mitigation measure framework to ensure more cost and energy savings and lesser time and cost over-run.

Keywords: clean development mechanism (CDM), infrastructure transportation, project risk management, underground metro rail

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Authors: Shivani Dhande, Sanjiv Choudhary, Adarshlata Singh

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Introduction: Chemical peeling is a popular, relatively inexpensive day procedure and generally safe method for treatment of pigmentary skin disorders and for skin rejuvenation. Chemical peels are classified by the depth of action into superficial, medium, and deep peels.Various facial pigmentary conditions have significant impact on quality of life causing psychological stress, necessitating its safe and effective treatment.Aim & Objectives:To compare the efficacy of Salicylic acid, Trichloroaceticacid & Glycolic Acid in facial melanosis(melasma,photomelanosis& post acne pigmentation).To study the side effects of above mentioned peeling agents. Method and Materials:It was a randomized parallel control single blind study consisting of total of 36 cases, 12 cases each of melasma, photo melanosis and post acne pigmentation within age group 20-50 years having fitzpatrick’s skin type4. Woods lamp examination was done to confirm the type of melasma.Patients with keloidal tendency, active herpes infection or past history of hypersensitivity to salicylic acid, trichloroaceticand glycolic acid as well aspatients on systemic isotretinoin were excluded.Clinical photographs at the beginning of therapy and then serially, were taken to assess the clinical response. Prior to application a written informed consent was obtained. A post auricular test peel was performed. Patients were divided into 3 groups, containing 12 patients each of melasma, photomelanosis and post acnepigmentation.All the three peels SA peel 20% (done once in 2 weeks), GA peel 50% (done once in 3 weeks) and TCA 15% (done once in 3 weeks) were used with total six settings for each patient. Before application of peel patients were counseled to wash the face with soap and water. Then face was dried and cleaned with spirit and acetone to remove all cutaneous oils. GA, TCA, SA were applied with cotton buds/gauze withmild strokes. After a contact period off 5-10mins neutralization was done with cold water. Post peel topical sunscreen application was mandatory. MASI was used pre and post treatment to assess melasma. Investigator’s global improvement scale- overall hyperpigmentation (4-significant, 3-moderate, 2-mild, 1-minimal, 0-no change ) and Patient’s satisfaction grading scale (>70%- excellent response, 50-70%- good response, <50%- average response) was used to assess improvement in all the three facial melanosis.Results:In our study of 12 patients of melasma, 4 (33.33%)patients showed excellent results;3 (25%) with GAand 1(8.33%) of TCA.Good response was seen in 4 (33.33%) patients;1(8.33%) each for GA & SA and 2(16.66%) for TCA.Poor response was seen in 4(33.33%) patients;1(8.33%) for TCA and 3 (25%) for SA.Of 12 patients of photomelanosis, excellent resultswas seen in 3(25%)patients of TCA. Good response was seen in 4 (33.33%) patients, 1(8.33%) each of TCA &SA and 2(16.66%) of GA.Poor responsewas seen in 5(41.66%) patients;3 (25%) for SA and 2(16.66%) of GA.Of 12 patients of post acne pigmentation, excellent responsein 3 (25%) patients;2(16.66%) of SA and 1(8.33%) of TCA.Good responsewas seen in 5(41.66%) patients;2(16.66%) of SA and GA and1(8.33%) of TCA.Poor response was seen in 4 (33.33%) patients; 2 (16.66%) for SA and TCA both. No major side effects in the form of scarring or persistant pigmentation was seen. Transient blackening of skin with burning sensation was seen in cases treated with TCA and SA. Post procedural itching and redness was noted with GA peel. Conclusion- In our study GA(50%),TCA(15%) & SA(20%) peels showed excellent response in melasma, photomelanosis and post-acne pigmentation respectively.All the 3 peeling agents were well tolerated without any significant side-effects in the above specified concentrations.

Keywords: facial melanosis, gycolic acid, salicylic acid, trichloroacetic acid

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Authors: Mahnaz Khalafehnilsaz, Rozina Rahnama

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Introduction: The elderly population is growing rapidly, and with this growth comes an increased demand for healthcare services. Artificial intelligence (AI) has the potential to revolutionize the delivery of healthcare services to the elderly population. In this study, the various ways in which AI is used to create health content for elderly people and its transformative impact on the healthcare industry will be explored. Method: A systematic review of the literature was conducted to identify studies that have investigated the role of AI in creating health content specifically for elderly people. Several databases, including PubMed, Scopus, and Web of Science, were searched for relevant articles published between 2000 and 2022. The search strategy employed a combination of keywords related to AI, personalized health content, and the elderly. Studies that utilized AI to create health content for elderly individuals were included, while those that did not meet the inclusion criteria were excluded. A total of 20 articles that met the inclusion criteria were identified. Finding: The findings of this review highlight the diverse applications of AI in creating health content for elderly people. One significant application is the use of natural language processing (NLP), which involves the creation of chatbots and virtual assistants capable of providing personalized health information and advice to elderly patients. AI is also utilized in the field of medical imaging, where algorithms analyze medical images such as X-rays, CT scans, and MRIs to detect diseases and abnormalities. Additionally, AI enables the development of personalized health content for elderly patients by analyzing large amounts of patient data to identify patterns and trends that can inform healthcare providers in developing tailored treatment plans. Conclusion: AI is transforming the healthcare industry by providing a wide range of applications that can improve patient outcomes and reduce healthcare costs. From creating chatbots and virtual assistants to analyzing medical images and developing personalized treatment plans, AI is revolutionizing the way healthcare is delivered to elderly patients. Continued investment in this field is essential to ensure that elderly patients receive the best possible care.

Keywords: artificial intelligence, health content, older adult, healthcare

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Authors: Nora Mohammed Rehan Hussien

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Cities all over the world face daunting urban challenges that have increased in scope in recent years. The biggest challenge includes issues of urban planning, housing, safety aspects, scarcity of land for development and traffic congestion. So every city in the world aspires to adopt the strategy of ‘Livable City’ which guarantees the cities urbanization manner that preserves the environment, and achieve the greatest benefit from the resources and achieve a good standard of living. Essentially, a livable city should possess basic yet unique attributes to welcome people from all strata of society without marginalizing any particular group. Most of these cities began to move towards sustainability and livability to enhance quality and performance of urban services, to reduce costs and resources consumption, to engage more affectivity and actively with its citizens, and to describe the quality of life and the characteristics of cities that make them livable. From here came the idea of the research which is creating ‘A framework of livable and sustainable city’ as a sustainable approach that must follow to achieve the principle of sustainable livability. From this point of view the research deals with one of the most successful case studies all over the world in’ livable cities system’ (Vienna) to know how to explore and understand the issues and challenges in becoming a full- livable and creative city through analyzing the criteria, principles and strategy of livable city then deducing the framework towards this concept. Finally, it suggests a set of recommendations help for applying the concept of livable city.

Keywords: quality of life, livability & livable city, sustainability, sustainable city

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Authors: Mehrdad Taghipour, Mina Rostami, Mahdi Eskandarlou

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Partial-thickness skin graft is the cornerstone for scalp defect repair. Given the potential side effects following harvesting from these sites, this study aimed to compare the outcomes of graft harvesting from scalp and lower limb. This clinical trial was conducted among a sample number of 40 partial thickness graft candidates (20 case and 20 control group) with scalp defect presenting to Plastic Surgery Clinic at Besat Hospital, Hamadan, Iran during 2018-2019. Sampling was done by simple randomization using random digit table. The donor site in case group and control group was scalp and lower limb respectively. Overall, 28 patients (70%) were male and 12 (30%) were female. Basal cell carcinoma (BCC) and trauma were the most common etiology for the defects. There was a statistically meaningful relationship between two groups regarding the etiology of defect (P=0.02). The mean diameter of defect was 24.28±45.37 mm for all of the patients. The difference between diameters of defect in both groups were statistically meaningful while no such difference between graft diameters was seen. The graft “Take” was completely successful in both groups according to evaluations. The level of postoperative pain was lower in the case group compared to the control according to VAS scale and the satisfaction was higher in them per Likert scale. Scalp can safely be used as donor site for skin graft to be used for scalp defects associated with better results and lower complication rates compared to other donor sites.

Keywords: donor site, graft, scalp, partial thickness

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Authors: Francia Martinez

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This study documents and demonstrates the profound impact of the high status of American English and culture in Colombian commercial landscape due to the globalization and commodification of English. It also documents and describes how Colombian advertisers make use of various language and visual mechanisms in the commercial linguistic landscape to convey messages, create an image with which the target audience can identify, and build a relationship with that target audience. The data (in the form of pictures) were collected in different cities in Colombia and were classified and organized into different categories for the reliability and validity of the analysis. The research questions were: do the ubiquity and high status of American English and culture play a major role in the Colombian commercial linguistic landscape? If so, how?, what roles do national and local culture and language (Spanish) play in the commercial linguistic landscape?, and what different linguistic and visual strategies do Colombian advertisers employ to reach their target audience? Based on data analysis and results, American and local culture and icons play a major role when Colombian advertisers create and design their commercial logos and ads to get consumers’ attention and establish a rapport with them in a successful way. In order to achieve their objectives, Colombian advertisers rely on creative linguistic and visual techniques in their ads, such as puns, humor, irony, comparisons, metaphors, mocking, exaggeration, parody, personification, sarcasm, satire, allusion, onomatopoeias, and imitation (copycat or cloning).

Keywords: Colombian ads, linguistic landscape, rhetorical devices, sociolinguistics

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Authors: ZeinolAbedin Rahmani, Marzieh Evazi Borazjani, Nooshin Salehi

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Organizations are increasingly facing changes and developments scientific, technological, social, cultural changes among these organizations those ones are reckoned successful and effective that in addition to coordinating the development of modern society can forecast future changes and be able to accommodate these changes in order to create favorable developments to build a better future. But we can change that with the changes that occur in the organization of the program it will distinguish. Today's organizations need leaders that change and grow them have to survive. In fact, without transformational managers and leaders, it is certainly difficult to create changes in organizations. Both private and public organizations need to increase knowledge and awareness of the cause widespread changes in the structure, culture and practice for the viability and sustainability of life and growth and development. By now, different signs have determined different causes for a suitable function of employees. However, the important thing is that the commitment of the employees to their organization has always been very important. Since the decrease of organization commitment causes the high rate of absenteeism, turnover intentions, and even to reduce the impact of health staff. and these factors prevent organizations from achieving its goals. If organizations want to retain staff, the organization must find a way to be happy and continue their work with commitment, motivation, and willingness. So here is the need for strong leaders, analysts, creative and transformational upper ranks more than ever is felt. The aim of this study is to revise history, the leadership style of managers shipbuilding company by using the MLQ model.

Keywords: leadership style, managers, organizational, manufacturing company, sustainability of life

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Authors: Sergejs Kolesovs, Armands Vigants

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The use of dairy industry by-products and wastewater as a cheap substrate for microalgal growth is gaining recognition. However, the mechanisms of lactose utilization remain understudied, limiting the potential of successful microalgal biomass production using various dairy by-products, such as whey and permeate. The necessity for microalgae to produce a specific enzyme, β-galactosidase, requires the selection of suitable strains. This study focuses on a freshwater microalgal isolate's ability to grow on a semi-synthetic medium supplemented with lactose. After 10 days of agitated cultivation, an axenic microalgal isolate achieved significantly higher biomass production under mixotrophic growth conditions (0.86 ± 0.07 g/L, dry weight) than heterotrophic growth (0.46 ± 0.04 g/L). Moreover, mixotrophic cultivation had significantly higher biomass production compared to photoautotrophic growth (0.67 ± 0.05 g/L). The activity of β-galactosidase was detected in both supernatant and microalgal biomass under mixotrophic and heterotrophic growth conditions, showing the potential of extracellular and intracellular mechanisms of enzyme production. However, the main limiting factor in this study was the increase of pH values during the cultivation, significantly reducing the activity of the β-galactosidase enzyme after 3rd day of cultivation. It highlights the need for stricter control of growth parameters to ensure the enzyme's activity. Further research will assess the isolate's suitability for dairy by-product bioconversion and biomass composition.

Keywords: microalgae, lactose, whey, permeate, beta-galactosidase, mixotrophy, heterotrophy

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Authors: Anjali G. Pillai, S. Chadrakaran

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The extensive amount of sludge generated throughout the world, as a part of water treatment works, have caused various social and economic issues, such as a demand on landfill spaces, increase in environmental pollution and raising the waste management cost. With growing social awareness about toxic incinerator emissions and the increasing concern over the disposal of sludge on the agricultural land, the recovery of sewage sludge as a building and construction raw material can be considered as an innovative approach to tackle the sludge disposal problem. The proposed work aims at studying the recycling ability of the sludge, generated from the water treatment process, by incorporating it into the fired clay brick units. The work involves initial study of the geotechnical characteristics of the brick-clay and the sludge. Chemical compatibility of both the materials will be analyzed by X-ray fluorescence technique. The variation in the strength aspects with varying proportions of sludge i.e. 10%, 20%, 30% and 40% in the sludge-clay mix will also be determined by the proctor density test. Based on the optimum moisture content, the sludge-clay bricks will be manufactured in a brick manufacturing plant and the modified brick units will be tested to determine the variation in compressive strength, bulk density, firing shrinkage, shrinkage loss and initial water absorption rate with respect to the conventional clay bricks. The results will be compared with the specifications given in Indian Standards to arrive at the potential use of the new bricks. The durability aspect will be studied by conducting the leachate analysis test using atomic adsorption spectrometry. The lightweight characteristics of the sludge modified bricks will be ascertained with the scanning electron microscope technique which will be indicative of the variation in pore structure with the increase in sludge content within the bricks. The work will determine the suitable proportion of the sludge – clay mix in the brick which can then be effectively implemented. The feasibility aspect of the work will be determined for commercial production of the units. The work involves providing a strategy for conversion of waste to resource. Moreover, it provides an alternative solution to the problem of growing scarcity of brick-clay for the manufacturing of fired clay bricks.

Keywords: eco-bricks, green construction material, sludge amended bricks, sludge disposal, waste management

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Authors: Bashar Tarawneh, Yasser Hakam

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Rapid Impact Compaction (RIC) is a modern dynamic compaction device mainly used to compact sandy soils, where silt and clay contents are low. The device uses the piling hammer technology to increase the bearing capacity of soils through controlled impacts. The RIC device uses "controlled impact compaction" of the ground using a 9-ton hammer dropped from the height between 0.3 m to 1.2 m onto a 1.5 m diameter steel patent foot. The delivered energy is about 26,487 to 105,948 Joules per drop. To evaluate the performance of this technique, three project sites in the United Arab Emirates were improved using RIC. In those sites, a loose to very loose fine to medium sand was encountered at a depth ranging from 1.0m to 4.0m below the ground level. To evaluate the performance of the RIC, Cone Penetration Tests (CPT) were carried out before and after improvement. Also, load tests were carried out post-RIC work to assess the settlements and bearing capacity. The soil was improved to a depth of about 5.0m below the ground level depending on the CPT friction ratio (the ratio between sleeve friction and tip resistance). CPT tip resistance was significantly increased post ground improvement work. Load tests showed enhancement in the soil bearing capacity and reduction in the potential settlements. This study demonstrates the successful application of the RIC for middle-deep improvement and compaction of the ground. Foundation design criteria were achieved in all site post-RIC work.

Keywords: compaction, RIC, ground improvement, CPT

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Authors: Friday Godwin Okibe, Elaoyi David Paul, Oladayo Thomas Ojekunle

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In this study, Nitrogen and Phosphorous co-doped Zinc Oxide (NPZ) was prepared through a solvent-free reaction. The NPZ was characterized by Scanning Electron Microscopy (SEM) and Fourier Transform Infrared (FTIR) spectroscopy. The photocatalytic activity of the catalyst was investigated by monitoring the degradation of para-nitrophenol (PNP) under visible light irradiation and the process was optimized using factorial design of experiment. The factors investigated were initial concentration of para-nitrophenol, catalyst loading, pH and irradiation time. The characterization results revealed a successful doping of ZnO by nitrogen and phosphorus and an improvement in the surface morphology of the catalyst. The photo-catalyst exhibited improved photocatalytic activity under visible light by 73.8%. The statistical analysis of the optimization result showed that the model terms were significant at 95% confidence level. Interactions plots revealed that irradiation time was the most significant factor affecting the degradation process. The cube plots of the interactions of the variables showed that an optimum degradation efficiency of 66.9% was achieved at 10mg/L initial PNP concentration, 0.5g catalyst loading, pH 7 and 150 minutes irradiation time.

Keywords: nitrogen and phosphorous co-doped Zno, p-nitrophenol, photocatalytic degradation, optimization, factorial design of experimental

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Authors: Joana Beyer

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Background: Alzheimer’s disease (AD) is the predominant cause of dementia, characterized by progressive cognitive decline. Posterior cortical atrophy (PCA) is a less common variant of AD, primarily affecting younger individuals and presenting with visual, visuospatial, and visuoperceptual deficits, often leading to delayed diagnosis due to its atypical presentation. Case Presentation: We report the case of a 58-year-old woman referred to psychiatric services with a two-year history of progressive visuospatial decline, mild memory difficulties, and language impairments, notably anomia. Despite undergoing cataract and squint surgeries, her visual symptoms persisted, impacting her professional life as a music educator. The neuropsychological evaluation revealed profound visuoperceptual and visuospatial disturbances, with neuroimaging supporting a diagnosis of PCA. Treatment with Donepezil showed symptom improvement, highlighting the challenges and importance of early intervention and managing this atypical form of AD. Methods: The diagnostic process involved comprehensive physical, neuropsychological assessments, and neuroimaging, including MRI and F18 FDG PET CT, which demonstrated severe bilateral posterior cortical involvement. The case underscores the utility of these modalities in diagnosing PCA. Results: The initiation of Donepezil, an acetylcholinesterase inhibitor, resulted in symptom improvement, emphasizing the potential for AD treatments to benefit PCA patients. However, challenges in management, including treatment side effects and the necessity of multidisciplinary care, are discussed. Conclusion: This case highlights PCA's diagnostic challenges due to its atypical presentation and the broader implications for managing younger patients with early-onset dementia. It underscores the necessity for early recognition, comprehensive assessment, and tailored management strategies, including both pharmacological and non-pharmacological interventions, to improve patients' quality of life. Additionally, the case illustrates the need for expanding community memory services to accommodate younger patients with atypical forms of dementia, advocating for a more inclusive approach to dementia care.

Keywords: Alzheimer’s disease, posterior cortical atrophy, dementia, diagnosis, management, donepezil, early-onset dementia

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Authors: Chih Yuan Chen, Chien Chon Chen, Jin-Shyong Lin

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The microstructure characterization of tempered nanocrystalline bainitic steel is investigated in the present study. It is found that two types of plastic relaxation, dislocation debris and nanotwin, occurs in the displacive transformation due to relatively low transformation temperature and high carbon content. Because most carbon atoms trap in the dislocation, high dislocation density can be sustained during the tempering process. More carbides only can be found in the high tempered temperature due to intense recovery progression.

Keywords: nanostructure bainitic steel, tempered, TEM, nano-twin, dislocation debris, accommodation

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Authors: Jenee Gooden, Kevin Vasquez-monterroso, Lady Paula Dejesus, Sandra Wainwright, Daniel Kim, Mackenzie Walker

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Introduction: Pyoderma gangrenosum (PG) is a rare, rapidly progressive, neutrophilic ulcerative colitis condition with an incidence of 3 to 10 cases per year ¹ ². Due to the similar appearance, PG is often misdiagnosed as a diabetic ulcer in diabetic patients. Though they may clinically appear similar in appearance, the treatment protocol and diagnostic criteria differ. Also, end-stage renal disease (ESRD) is often a condition seen in diabetic patients, which can have a significant impact on wound healing due to the wide range of uremic toxins³. This case study demonstrates a multidisciplinary team and multimodal treatment approach by podiatric surgery, general surgery, rheumatology, infectious disease, interventional cardiology, wound care and hyperbaric medicine for an uncontrolled diabetic with pyoderma gangrenosum of a significant circumferential wound, covering almost the entire right lower extremity. Methods:56 y.o male presents with multiple PG ulcerations, including the chest, right posterior lower extremity and sacrum. All ulcerations were previously managed by the same wound care specialist. His chief complaint was worsening PG ulcerations accompanied by a fever of 103 °F . This case study focuses on the wound to his RLE. Past medical history significant for diabetes mellitus type 2 with hemoglobin A1c of 10% and end stage renal disease (ESRD) on hemodialysis. A multidisciplinary team approach by podiatric surgery, general surgery, rheumatology, infectious disease, interventional cardiology, wound care and hyperbaric medicine was successfully used to perform right lower extremity limb salvage. The patient was managed by rheumatology for the continuation of prior medication, as well as the mutual agreement with wound care for the addition of dapsone. A coronary CT angiogram was performed by interventional cardiology, but no significant disease was noted, and no further vascular workup was necessary. Multiple surgical sharp wide excisional debridements with application of allografts and split thickness skin grafts for the circumferential ulceration that encompassed almost the entire right lower extremity were performed by both podiatric surgery and general surgery. Wound cultures and soft tissue biopsies were performed, and infectious disease managed antibiotic therapy. Hyperbaric oxygen therapy and wound vac therapy by wound care were also completed as adjunct management. Results: Prevention of leg amputation by limb salvage of the RLE was accomplished by a multidisciplinary team approach, with the wound size decreasing over a total of 29 weeks from 600 cm² to 12.0 x 3.5 x 0.2 cm. Our multidisciplinary team included podiatric surgery, general surgery, rheumatology, infectious disease, interventional cardiology, wound care and hyperbaric medicine. Discussion: Wound healing, in general, can have its challenges, and those challenges are only magnified when accompanied by multiple systemic illnesses. Though the negative impact of diabetes on wound healing is well known, the compound impact of being a diabetic with ESRD and having pyoderma gangrenosum is not. This case demonstrates the necessity for a multidisciplinary team approach with a wide array of treatment modalities to optimize wound healing and perform limb salvage with prevention of lower extremity amputation.

Keywords: diabetes, podiatry, pyoderma gangrenosum, end stage renal disease

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Authors: Mohamed Abdullahi Gure, Farhia Ali Abdi

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There is almost a complete certainty among educators that parental involvement is the remedy for many of the problems facing schools. It is also widely acknowledged that school administrators and teachers have important roles in promoting parental involvement in children’s education. This work aims at examining the views of parents and teachers on school-partnership practices for promoting parental involvement in education in selected primary schools in Mogadishu-Somalia. The method, which has been employed in this study, is a mixed-method approach; data were collected from parents as well as from teachers of the selected schools using survey questionnaires and interviews. A sample size of 377 parents and 214 teachers participated in this study. This study used an instrument that has been developed by Epstein and Salinas (1993) to assess the perceptions of parents and teachers about parental involvement. Furthermore, data was collected qualitatively through interviews with parents and teachers of the selected schools. The findings of this study show that parents and teachers had similar positive perceptions towards school practices for parental involvement. This study is significant for several reasons. It contributes to the limited information on parental involvement in Somalia and therefore, filling a gap in the existing empirical literature. It offers information to educators as well as to parents, which will help them understand the issues that relate to parental involvement in education. It is hoped that information from this study will facilitate parents and teachers to understand each other’s ideas on parental involvement and develop positive working relations to support children to become successful in their education.

Keywords: Mogadishu, parents, school-partnership, practices, teachers

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Authors: Nazira Kakulia

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The analysis of transformation of institutional changes outlines two important characteristics. These are: the speed of the changes and their sequence. Successful transformation must be carried out in three different stages; On the first stage, macroeconomic stabilization must be achieved with the help of fiscal and monetary tools. Two-tier banking system should be established and the active functions of central bank should be replaced by the passive ones (reserve requirements and refinancing rate), together with the involvement growth of private sector. Fiscal policy by itself here means the creation of tax system which must replace previously existing direct state revenues; the share of subsidies in the state expenses must be reduced also. The second stage begins after reaching the macroeconomic stabilization at a time of change of formal institutes which must stimulate the private business. Corporate legislation creates a competitive environment at the market and the privatization of state companies takes place. Bankruptcy and contract law is created. he third stage is the most extended one, which means the formation of all state structures that is necessary for the further proper functioning of a market economy. These three stages about the cycle period of political and social transformation and the hierarchy of changes can also be grouped by the different methodology: on the first and the most short-term stage the transfer of power takes place. On the second stage institutions corresponding to new goal are created. The last phase of transformation is extended in time and it includes the infrastructural, socio-cultural and socio-structural changes. The main goal of this research is to explore and identify the features of such kind of models.

Keywords: competitive environment, fiscal policy, macroeconomic stabilization, tax system

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Authors: Anant Deogaonkar, Archana Nanoty

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The term civil service plays a vital role in functioning of any government. In today’s modern era of globalization civil services essentially contribute for the success of the good governance system. The civil service in India refers to the body of government officials employed in civil occupations that are neither political nor judicial. The Indian Civil Services were created to foster the idea of unity in diversity with the expectation of giving continuity and change in administration independent of the political scenario and turmoil affecting the country. The civil service is an integral part of administration and the structures of administration to determine the way civil service functions. The concept of good governance necessarily precludes the effective human resource management ensuring the root level reach of the good governance. The serious matter of concern is the element of change. The civil service in general has maintained status quo instead of sweeping changes in social and economic scenario. One may disagree for this but it is a fact on the street that the Indian civil service was not able to deliver up to the expectations of the people and was lacking on the service front. The effective management of human resources at civil service needs to be prioritized and will form a key factor in successful delivery of the desired results may be in minimum duration. This paper focuses on the various ways of effective management of human resources in civil services. It also highlights the importance of improvement in human resource management in civil services with the detailed discussion of positives and negatives if any of the human resource management in civil services.

Keywords: civil services, human resources management, India, governance

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Authors: Garima Sharma, R. N. Sharma

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Integrated watershed management programme based on 'Four Water Concept' was implemented in Sali village, in Jaipur District, Rajasthan State of India . The latitude 26.7234486 North and longitude 75.023876 East are the geocoordinate of the Sali. 'Four Waters Concept' is evolved by integrating the 'Four Waters', viz. rain water, soil moisture, ground water and surface water This methodology involves various water harvesting techniques to prevent the runoff of water by treatment of catchment, proper utilization of available water harvesting structures, renovation of the non-functional water harvesting structures and creation of new water harvesting structures. The case study included questionnaire survey from farmers and continuous study of village for two years. The total project area is 6153 Hac, and the project cost is Rs. 92.25 million. The sanctioned area of Sali Micro watershed is 2228 Hac with an outlay of Rs. 10.52 million. Watershed treatment activities such as water absorption trench, continuous contour trench, field bunding, check dams, were undertaken on agricultural lands for soil and water conservation. These measures have contributed in preventing runoff and increased the perennial availability of water in wells. According to the survey, water level in open wells in the area has risen by approximately 5 metres after the introduction of water harvesting structures. The continuous availability of water in wells has increased the area under irrigation and helped in crop diversification. Watershed management activities have brought the changes in cropping patterns and crop productivity. It helped in transforming 567 Hac culturable waste land into culturable arable land in the village. The farmers of village have created an additional income from the increased crop production. The programme also assured the availability of water during peak summers for the day to day activities of villagers. The outcomes indicate that there is positive impact of watershed management practices on the water resource potential as well the crop production of the area. This suggests that persistent efforts in this direction may lead to sustainability of the watershed.

Keywords: four water concept, groundwater potential, irrigation potential, watershed management

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Authors: Rubai M. Ochieng

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Cancer, which accounts for 7 percent of deaths per year in Kenya, is the third highest cause of death after infectious and cardiovascular diseases. Awareness Campaigns have tended to focus on leading cancers including breast and cervical for women as well as prostrate and Esophageal for men. Consequently, less common cancers such as Acute Myeloid Leukemia (AML) are rarely properly understood by the general population and a section of the medical fraternity. Diagnoses of AML in patients who may not have heard about it sometimes results in shock, denial and confusion not just to the diagnosed, but also to their family and friends. The diagnosed and caregivers are bound to receive a lot of contradicting information about prognosis, care and treatment of AML. This information, which often comes from diverse sources including doctors, friends, internet and social media platforms, causes further confusion and panic. The situation is handled differently by different people. Religious people sometimes resort to prayer. This paper, written from the perspective of a care giver, is based on data collected from a case of Acute Myeloid Leukemia diagnosed in a 32 year old male who lost his life within six weeks of diagnosis. The sample constitutes of 16 people who participated in prayers. Out of this total, 5 were males including the diagnosed and 11 were females. All the 16 were Christians of protestant orientation including Anglicans, Quakers and Church of God members. Data was collected by the researcher herself through participant of observation. Findings discuss how the 16 participants prayed individually at different times, together in an overnight prayer meeting and every morning through a group social media platform. They shared songs and words of encouragement from the bible. The group prayed for healing, peace and strength to the diagnosed and family, financial breakthrough and doctors’ work and decisions, among other challenges that came with the situation. The paper reveals the immense benefits of prayer to the diagnosed and his close relatives and friends. They include acceptance of the condition and a positive attitude in handling the challenges that arose from the disease and treatment processes. The challenges arising from the prayer approach of handling the situation are also discussed. The paper concludes that prayer as therapy goes a long way in cancer management.

Keywords: acute myeloid leukemia, Kenya, participant observation, prayer

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