Search results for: critical limb ischemia

Authors: Nirmal Singh, Rajesh Kumar

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Abstract- Information literacy aims to develop both critical understanding and active participation in scholars. It enables scholars to interpret and make informed judgments as users of information sources, and it also enables them to become producers of information in their own right, and thereby to become more powerful participants in society. Information literacy is about developing people‘s critical and creative abilities. Digital media – and particularly the Internet – significantly increase the potential for such active participation of the individual, provided scholars have the means and training to effectively access and use them. This paper provides definition, standards and importance of information literacy (IL). Keywords: Information literacy, Digital Media, Training, Communications Technologies.

Keywords: Information literacy, Digital Media, Training, , Communications Technologies

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Authors: Taylor Harris

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Gustilo-anderson grade III tibial fractures are exquisitely difficult injuries to manage as they require extensive soft tissue repair in addition to fracture fixation. These injuries are best managed collaboratively by Orthopedic and Plastic surgeons. While utilizing an Orthoplastics approach has decreased the rates of adverse outcomes in these injuries, there is a large amount of variation in exactly how an Orthoplastics team approaches complex cases such as these. It is sometimes recommended that definitive bone fixation and soft tissue coverage be completed simultaneously in a single-stage manner, but there is a paucity of large scale studies to provide evidence to support this recommendation. It is the aim of this study to report the outcomes of a single-stage "fix-and-flap" approach through a systematic review of the available literature. Hopefully, this better informs an evidence-based Orthoplastics approach to managing open tibial fractures. Systematic review of the literature was performed. Medline and Google Scholar were used and all studies published since 2000, in English were included. 103 studies were initially evaluated for inclusion. Reference lists of all included studies were also examined for potentially eligible studies. Gustilo grade III tibial shaft fractures in adults that were managed with a single-stage Orthoplastics approach were identified and evaluated with regard to outcomes of interest. Exclusion criteria included studies with patients <16 years old, case studies, systemic reviews, meta-analyses. Primary outcomes of interest were the rates of deep infections and rates of limb salvage. Secondary outcomes of interest included time to bone union, rates of non-union, and rates of re-operation. 15 studies were eligible. 11 of these studies reported rates of deep infection as an outcome, with rates ranging from 0.98%-20%. The pooled rate between studies was 7.34%. 7 studies reported rates of limb salvage with a range of 96.25%-100%. The pooled rate of the associated studies was 97.8%. 6 reported rates of non-union with a range of 0%-14%, a pooled rate of 6.6%. 6 reported time to bone union with a range of 24 to 40.3 weeks and a pooled average time of 34.2 weeks, and 4 reported rates of reoperation ranging from 7%-55%, with a pooled rate of 31.1%. A few studies that compared a single stage to a multi stage approach side-by-side unanimously favored the single stage approach. Outcomes of Gustilo grade III open tibial fractures utilizing an Orthoplastics approach that is specifically done in a single-stage produce low rates of adverse outcomes. Large scale studies of Orthoplastic collaboration that were not completed in strictly a single stage, or were completed in multiple stages, have not reported as favorable outcomes. We recommend that not only should Orthopedic surgeons and Plastic surgeons collaborate in the management of severe open tibial fracture, but they should plan to undergo definitive fixation and coverage in a single-stage for improved outcomes.

Keywords: orthoplastic, gustilo grade iii, single-stage, trauma, systematic review

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Authors: F. Clara Fang, Hernan Castaneda

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The Connecticut Department of Transportation (ConnDOT) has constructed four roundabouts in the State of Connecticut within the past ten years. VISSIM traffic simulation software was utilized to analyze these roundabouts during their design phase. The queue length and level of service observed in the field appear to be better than predicted by the VISSIM model. The objectives of this project are to: identify VISSIM input variables most critical to accurate modeling; recommend VISSIM calibration factors; and, provide other recommendations for roundabout traffic operations modeling. Traffic data were collected at these roundabouts using Miovision Technologies. Cameras were set up to capture vehicle circulating activity and entry behavior for two weekdays. A large sample size of filed data was analyzed to achieve accurate and statistically significant results. The data extracted from the videos include: vehicle circulating speed; critical gap estimated by Maximum Likelihood Method; peak hour volume; follow-up headway; travel time; and, vehicle queue length. A VISSIM simulation of existing roundabouts was built to compare both queue length and travel time predicted from simulation with measured in the field. The research investigated a variety of simulation parameters as calibration factors for describing driver behaviors at roundabouts. Among them, critical gap is the most effective calibration variable in roundabout simulation. It has a significant impact to queue length, particularly when the volume is higher. The results will improve the design of future roundabouts in Connecticut and provide decision makers with insights on the relationship between various choices and future performance.

Keywords: driver critical gap, roundabout analysis, simulation, VISSIM modeling

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Authors: Neeraj Vij, Amber Brennan, Jenni Winters, Hadi Salehi, Hamy Temkit, Emily Andrisevic, Mohan V. Belthur

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Idiopathic clubfoot is a common lower extremity deformity with an incidence of 1:500. The Ponseti Method is well known as the gold standard of treatment. However, there is limited functional data demonstrating correction of the clubfoot after treatment with the Ponseti method. The purpose of this study was to study the clinical and functional outcomes after the Ponseti method with the Clubfoot Disease-Specific Instrument (CDS) and pedobarography. This IRB-approved prospective study included patients aged 3-18 who were treated for idiopathic clubfoot with the Ponseti method between January 2008 and December 2018. Age-matched controls were identified through siblings of clubfoot patients and other community members. Treatment details were collected through a chart review of the included patients. Laboratory assessment included a physical exam, gait analysis, and pedobarography. The Pediatric Outcomes Data Collection Instrument and the Clubfoot Disease-Specific Instrument were also obtained on clubfoot patients (CF). The Wilcoxson rank-sum test was used to study differences between the CF patients and the typically developing (TD) patients. Statistical significance was set at p < 0.05. There were a total of 37 enrolled patients in our study. 21 were priorly treated for CF and 16 were TD. 94% of the CF patients had bilateral involvement. The age at the start of treatment was 29 days, the average total number of casts was seven to eight, and the average total number of casts after Achilles tenotomy was one. The reoccurrence rate was 25%, tenotomy was required in 94% of patients, and ≥1 tenotomy was required in 25% of patients. There were no significant differences between step length, step width, stride length, force-time integral, maximum peak pressure, foot progression angles, stance phase time, single-limb support time, double limb support time, and gait cycle time between children treated with the Ponseti method and typically developing children. The average post-treatment Pirani and Dimeglio scores were 5.50±0.58 and 15.29±1.58, respectively. The average post-treatment PODCI subscores were: Upper Extremity: 90.28, Transfers: 94.6, Sports: 86.81, Pain: 86.20, Happiness: 89.52, Global: 88.6. The average post-treatment Clubfoot Disease-Specific Instrument scores subscores were: Satisfaction: 73.93, Function: 80.32, Overall: 78.41. The Ponseti Method has a very high success rate and remains to be the gold standard in the treatment of idiopathic clubfoot. Timely management leads to good outcomes and a low need for repeated Achilles tenotomy. Children treated with the Ponseti method demonstrate good functional outcomes as measured through pedobarography. Pedobarography may have clinical utility in studying congenital foot deformities. Objective measures for hours of brace wear could represent an improvement in clubfoot care.

Keywords: functional outcomes, pediatric deformity, patient-reported outcomes, talipes equinovarus

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Authors: Hamza Javar Magnier, Leslie V. Woodcock

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It has been reported that at temperatures above the critical there is no “continuity of liquid and gas”, as originally hypothesized by van der Waals. Rather, both gas and liquid phases, with characteristic properties as such, extend to supercritical temperatures. Each phase is bounded by the locus of a percolation transition, i.e. a higher-order thermodynamic phase change associated with percolation of gas clusters in a large void, or liquid interstitial vacancies in a large cluster. Between these two-phase bounds, it is reported there exists a mesophase that resembles an otherwise homogeneous dispersion of gas micro-bubbles in liquid (foam) and a dispersion of liquid micro-droplets in gas (mist). Such a colloidal-like state of a pure one-component fluid represents a hitherto unchartered equilibrium state of matter besides pure solid, liquid or gas. Here we provide compelling evidence, from molecular dynamics (MD) simulations, for the existence of this supercritical mesophase and its colloidal nature. We report preliminary results of computer simulations for a model fluid using a simplistic representation of atoms or molecules, i.e. a hard-core repulsion with an attraction so short that the atoms are referred to as “adhesive spheres”. Molecular clusters, and hence percolation transitions, are unambiguously defined. Graphics of color-coded clusters show colloidal characteristics of the supercritical mesophase.

Keywords: critical phenomena, mesophase, supercritical, square-well, critical parameters

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Authors: Jared Abuga, Wesley Too

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Medical error is the third leading cause of death in US, with approximately 98,000 deaths occurring every year as a result of medical errors. The world financial burden of medication errors is roughly USD 42 billion. Medication errors may lead to at least one death daily and injure roughly 1.3 million people every year. Medical error reporting is essential in creating a culture of accountability in our healthcare system. Studies have shown that attitudes and practice of healthcare workers in reporting medical errors showed that the major factors in under-reporting of errors included work stress and fear of medico-legal consequences due to the disclosure of error. Further, the majority believed that increase in reporting medical errors would contribute to a better system. Most hospitals depend on nurses to discover medication errors because they are considered to be the sources of these errors, as contributors or mere observers, consequently, the nurse’s perception of medication errors and what needs to be done is a vital feature to reducing incidences of medication errors. We sought to explore knowledge among nurses on medical errors and factors affecting or hindering reporting of medical errors among nurses working at the emergency unit, KNH. Critical care nurses are faced with many barriers to completing incident reports on medication errors. One of these barriers which contribute to underreporting is a lack of education and/or knowledge regarding medication errors and the reporting process. This study, therefore, sought to determine the availability and the use of reporting systems for medical errors in critical care unity. It also sought to establish nurses’ perception regarding medical errors and reporting and document factors facilitating timely identification and reporting of medical errors in critical care settings. Methods: The study used cross-section study design to collect data from 76 critical care nurses from Kenyatta Teaching & Research National Referral Hospital, Kenya. Data analysis and results is ongoing. By October 2022, we will have analysis, results, discussions, and recommendations of the study for purposes of the conference in 2023

Keywords: errors, medical, kenya, nurses, safety

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Authors: Betty Kibirige

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Students entering the University of Zululand (UNIZULU) Science Faculty mostly come with skills that allow them to prepare for exams and pass them in order to satisfy requirements for entry into a tertiary Institution. Some students hail from deep rural schools with limited facilities, while others come from well-resourced schools. Personal experience has shown that it may take a student the whole time at a tertiary institution following the same skills as those acquired in high school as a sure means of entering the next level in their development, namely a postgraduate program. While it is apparent that at this point in human history, it is totally impossible to teach all the possible content in any one subject, many academics approach teaching and learning from the traditional point of view. It therefore became apparent to explore ways of developing a graduate that will be able to approach life with skills that allows them to navigate knowledge by applying conceptual and critical thinking skills. Recently, the Science Faculty at the University of Zululand introduced two Engineering programs. In an endeavour to approach the development of the Engineering graduate in this institution to be able to tackle problem-solving in the present-day excessive information availability, it became necessary to study and review approaches used by various academics in order to settle for a possible best approach to the challenge at hand. This paper focuses on the development of a deep rural child in a graduate with conceptual and critical thinking skills as major attributes possessed upon graduation. For this purpose, various approaches were studied. A combination of these approaches was repackaged to form an approach that may appear novel to UNIZULU and the rural child, especially for the Engineering discipline. The approach was checked by offering quiz questions to students participating in an engineering module, observing test scores in the targeted module and make comparative studies. Test results are discussed in the article. It was concluded that students’ graduate attributes could be tailored subconsciously to indeed include conceptual and critical thinking skills, but through more than one approach depending mainly on the student's high school background.

Keywords: graduate attributes, conceptual skills, critical thinking skills, traditional approach

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Authors: Abdallah Mohamed Kamel Mohamed Ali, Samah Saad Zahran, Mohamed Hamed Rashad

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Background: Flexible flatfoot (FFF) has been considered as a risk factor for several lower limb injuries and mechanical low back pain. This was attributed to the dysfunction of the lumbopelvic-hip complex musculature. Objective: To investigate the influence of FFF on electromyographic activities of erector spinae and multifidus. Methods: A cross-section study was held between an FFF group (20 subjects) and a normal foot group (20 subjects). A surface electromyography was used to assess the electromyographic activity of erector spinae and multifidus. Group differences were assessed by the T-test. Results: There was a significant increase in EMG activities of erector spinae and multifidus in the FFF group compared with the normal group. Conclusion: There is an increase in EMG activities in erector spinae and multifidus in FFF subjects compared with normal subjects.

Keywords: electromyography, flatfoot, low back pain, paraspinal muscles

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Authors: Mukund Ramchandra Mogarekar, Pankaj Kumar, Shraddha Vilas More

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Background: Myocardial infarction (MI) is defined as myocardial cell death due to prolonged ischemia as a consequence of atherosclerosis. TC, low-density lipoprotein cholesterol (LDL-C), very low-density lipoprotein cholesterol (VLDL-C), Apo B, and lipoprotein(a) was found as atherogenic factors while high-density lipoprotein cholesterol (HDL-C) was anti-atherogenic. Methods and Results: The study group consists of 40, MI subjects and 40 healthy individuals in control group. PON 1 Arylesterase activity (ARE) was measured by using phenylacetate. Phenotyping was done by double substrate method, serum AOPP by using chloramine T and Apo B by Turbidimetric immunoassay. PON 1 ARE activities were significantly lower (p< 0.05) and AOPPs & Apo B were higher in MI subjects (p> 0.05). Trimodal distribution of QQ, QR, and RR phenotypes of study population showed no significant difference among cases and controls (p> 0.05). Univariate binary logistic regression analysis showed independent association of TC, HDL, LDL, AOPP, Apo B, and PON 1 ARE activity with MI and multiple forward binary logistic regression showed PON 1 ARE activity and serum Apo B as an independent predictor of MI. Conclusions: Decrease in PON 1 ARE activity in MI subjects than in controls suggests increased oxidative stress in MI which is reflected by significantly increased AOPP and Apo B. PON1 polymorphism of QQ, QR and RR showed no significant difference in protection against MI. Univariate and multiple binary logistic regression showed PON1 ARE activity and serum Apo B as an independent predictor of MI.

Keywords: advanced oxidation protein product, apolipoprotein B, PON 1 arylesterase activity, myocardial infarction

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Authors: Rosy Chaudhary, Pushpa Parajuli

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Background and Objectives: Informational support to family members has a significant potential for reducing this distress related to hospitalization of their patient into the critical care unit, enabling them to cope better and support the patient. The objective of the study is to assess family members’ perception of informational support, anxiety, satisfaction with care and to reveal the association with selected socio-demographic variables and to investigate the correlation between informational support, anxiety and satisfaction with care. Materials and Methods: A descriptive cross-sectional study was conducted in 39 family caregivers of patients admitted in critical care unit of BPKIHS(B.P. Koirala Institute of Health Sciences). Consecutive sampling technique was used wherein data was collected over duration of one month using interview schedule. Descriptive and inferential statistics were used. Results: The mean age of the respondents was 34.97 ± 10.64 and two third (66.70%) were male. Mean score for informational support was 25.72(SD = 5.66; theoretical range of 10 - 40). Mean anxiety was 10.41 (SD = 5.02; theoretical range of 7 - 21). Mean score for satisfaction with care was 40.77 (SD = 6.77; theoretical range of 14 - 64). A moderate positive correlation was found between informational support and satisfaction with care (r = 0.551, p < .001) and a moderate negative correlation was found between anxiety and satisfaction with care (r = -0.590; p = 0.000). No relationship was noted between informational support and anxiety. Conclusion: The informational support and satisfaction of the family caregivers with the care provided to their patients was satisfactory. More than three fourth of the family caregivers had anxiety; the factors associated being educational status of the caregivers, the family income and duration of visiting hours. There was positive correlation between informational support and satisfaction with care provided justifying the need for comprehensive information to the family caregivers by the health personnel. There was negative correlation between anxiety and satisfaction with care.

Keywords: anxiety, caregivers, critical care unit, informational support, family

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Authors: Radhika V., J. M. Chandra Kishen

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The theory of critical distances (TCD), due to its appealing characteristics, has been successfully used in the past to predict the strength of brittle as well as ductile materials, weakened by the presence of stress risers under both static and fatigue loading. By utilising most of the TCD's unique features, this paper summarises an attempt for a reformulation of the point method of the TCD to predict the strength of notched plain concrete beams under mode I quasi-static loading. A zone of micro cracks, which is responsible for the non-linearity of concrete, is taken into account considering the concept of an effective elastic crack. An attempt is also made to correlate the value of the material characteristic length required for the application of TCD with the maximum aggregate size in the concrete mix, eliminating the need for any extensive experimentation prior to the application of TCD. The devised reformulation and the proposed power law based relationship is found to yield satisfactory predictions for static strength of notched plain concrete beams, with geometric dimensions of the beam, tensile strength, and maximum aggregate size of the concrete mix being the only needed input parameters.

Keywords: characteristic length, effective elastic crack, inherent material strength, modeI loading, theory of critical distances

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Authors: Crescentia Ugwuona

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Considering the importance of proverbs in socio-cultural life through socialization in any given society, it is deemed important for people to understand the hidden meanings that proverbs may convey. So far, there has been hardly any systematic research in the representation of different genders in Nigeria. Although there are writings on the representation of women in Nigerian proverbs, they are based on the writers’ introspection. Beyond that, investigators often tend to overlook the representations of men in proverbs. This study therefore explores from the perspective of sociolinguistics and critical discourse analysis (CDA) how different genders (men and women) are represented in Nigerian proverbs with particular reference to Igbo-Nigerians; with the aim of uncovering hidden gender inequalities that exist in them. The analysis reveals that Igbo proverbs consistently perpetuate an ideology of gender inequality, that is, male proverbs depict male achievements, power, bravery, and male supremacy; while that of female connotes their submissions to cultural and traditional female domestic roles, chastity, less competent, and women subjugation. The study alerts to how gendered language in proverbs can reflect, create, and sustain gender inequality in societies; and contributes to an education aimed at gender equality, emancipator practice of appropriate language in proverbs, respect for human rights; and of the need to develop strategies for addressing the problem.

Keywords: critical discourse analysis, gender representation, gender stereotypes, Igbo-Nigerian, sociolinguistics analysis, proverbs

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Authors: Bodhayan Nandi, Shubhajit Roy Chowdhury

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This paper presents the development of a portable blood glucose monitoring device based on Near-Infrared Spectroscopy. The system supports Internet connectivity through WiFi and uploads the time series data of glucose concentration of patients to a server. In addition, the server is given sufficient intelligence to predict the future pathophysiological state of a patient given the current and past pathophysiological data. This will enable to prognosticate the approaching critical condition of the patient much before the critical condition actually occurs.The server hosts web applications to allow authorized users to monitor the data remotely.

Keywords: non invasive, blood glucose concentration, microcontroller, IoT, application server, database server

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Authors: Gerhard Gritsch, Ana Skupch, Manfred Hartmann, Wolfgang Frühwirt, Hannes Perko, Dieter Grossegger, Tilmann Kluge

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Rehabilitation of stroke patients is dominated by classical physiotherapy. Nowadays, a field of research is the application of neurofeedback techniques in order to help stroke patients to get rid of their motor impairments. Especially, if a certain limb is completely paralyzed, neurofeedback is often the last option to cure the patient. Certain exercises, like the imagination of the impaired motor function, have to be performed to stimulate the neuroplasticity of the brain, such that in the neighboring parts of the injured cortex the corresponding activity takes place. During the exercises, it is very important to keep the motivation of the patient at a high level. For this reason, the missing natural feedback due to a movement of the effected limb may be replaced by a synthetic feedback based on the motor-related brain function. To generate such a synthetic feedback a system is needed which measures, detects, localizes and visualizes the motor related µ-rhythm. Fast therapeutic success can only be achieved if the feedback features high specificity, comes in real-time and without large delay. We describe such an approach that offers a 3D visualization of µ-rhythms in real time with a delay of 500ms. This is accomplished by combining smart EEG preprocessing in the frequency domain with source localization techniques. The algorithm first selects the EEG channel featuring the most prominent rhythm in the alpha frequency band from a so-called motor channel set (C4, CZ, C3; CP6, CP4, CP2, CP1, CP3, CP5). If the amplitude in the alpha frequency band of this certain electrode exceeds a threshold, a µ-rhythm is detected. To prevent detection of a mixture of posterior alpha activity and µ-activity, the amplitudes in the alpha band outside the motor channel set are not allowed to be in the same range as the main channel. The EEG signal of the main channel is used as template for calculating the spatial distribution of the µ - rhythm over all electrodes. This spatial distribution is the input for a inverse method which provides the 3D distribution of the µ - activity within the brain which is visualized in 3D as color coded activity map. This approach mitigates the influence of lid artifacts on the localization performance. The first results of several healthy subjects show that the system is capable of detecting and localizing the rarely appearing µ-rhythm. In most cases the results match with findings from visual EEG analysis. Frequent eye-lid artifacts have no influence on the system performance. Furthermore, the system will be able to run in real-time. Due to the design of the frequency transformation the processing delay is 500ms. First results are promising and we plan to extend the test data set to further evaluate the performance of the system. The relevance of the system with respect to the therapy of stroke patients has to be shown in studies with real patients after CE certification of the system. This work was performed within the project ‘LiveSolo’ funded by the Austrian Research Promotion Agency (FFG) (project number: 853263).

Keywords: real-time EEG neuroimaging, neurofeedback, stroke, EEG–signal processing, rehabilitation

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Authors: Nir Schreiber, Reuven Cohen, Simi Haber

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The Potts model has been widely explored in the literature for the last few decades. While many analytical and numerical results concern with the traditional two site interaction model in various geometries and dimensions, little is yet known about models where more than two spins simultaneously interact. We consider a ferromagnetic four site interaction Potts model on the square lattice (FFPS), where the four spins reside in the corners of an elementary square. Each spin can take an integer value 1,2,...,q. We write the partition function as a sum over clusters consisting of monochromatic faces. When the number of faces becomes large, tracing out spin configurations is equivalent to enumerating large lattice animals. It is known that the asymptotic number of animals with k faces is governed by λᵏ, with λ ≈ 4.0626. Based on this observation, systems with q < 4 and q > 4 exhibit a second and first order phase transitions, respectively. The transition nature of the q = 4 case is borderline. For any q, a critical giant component (GC) is formed. In the finite order case, GC is simple, while it is fractal when the transition is continuous. Using simple equilibrium arguments, we obtain a (zero order) bound on the transition point. It is claimed that this bound should apply for other lattices as well. Next, taking into account higher order sites contributions, the critical bound becomes tighter. Moreover, for q > 4, if corrections due to contributions from small clusters are negligible in the thermodynamic limit, the improved bound should be exact. The improved bound is used to relate the critical point to the finite correlation length. Our analytical predictions are confirmed by an extensive numerical study of FFPS, using the Wang-Landau method. In particular, the q=4 marginal case is supported by a very ambiguous pseudo-critical finite size behavior.

Keywords: entropic sampling, lattice animals, phase transitions, Potts model

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Authors: S. Kida

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We consider the flow of an incompressible viscous fluid in a precessing sphere whose spin and precession axes are orthogonal to each other. The flow is characterized by two non-dimensional parameters, the Reynolds number Re and the Poincare number Po. For which values of (Re, Po) will the flow approach a steady state from an arbitrary initial condition? To answer it we are searching the instability boundary of the steady states in the whole (Re, Po) plane. Here, we focus the rapidly rotating and weakly precessing limit, i.e., Re >> 1 and Po << 1. The steady flow was obtained by the asymptotic expansion for small ε=Po Re¹/² << 1. The flow exhibits nearly a solid-body rotation in the whole sphere except for a thin boundary layer which develops over the sphere surface. The thickness of this boundary layer is of O(δ), where δ=Re⁻¹/², except where two circular critical bands of thickness of O(δ⁴/⁵) and of width of O(δ²/⁵) which are located away from the spin axis by about 60°. We perform the linear stability analysis of the steady flow. We assume that the disturbances are localized in the critical bands and make an expansion analysis in terms of ε to derive the eigenvalue problem for the growth rate of the disturbance, which is solved numerically. As the solution, we obtain an asymptote of the stability boundary as Po=28.36Re⁻⁰.⁸. This agrees excellently with the corresponding laboratory experiments and numerical simulations. One of the most popular instability mechanisms so far is the parametric instability, which turns out, however, not to give the correct stability boundary. The present instability is different from the parametric instability.

Keywords: boundary layer, critical band, instability, precessing sphere

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Authors: Carlos Cuenca, Diego Sarzosa

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Ductile fracture occurs by the mechanism of void nucleation, void growth and coalescence. Potential sites for initiation are second phase particles or non-metallic inclusions. Modelling of ductile damage at the microscopic level is very difficult and complex task for engineers. Therefore, conservative predictions of ductile failure using simple models are necessary during the design and optimization of critical structures like pressure vessels and pipelines. Nowadays, it is well known that the initiation phase is strongly influenced by the stress triaxiality and plastic deformation at the microscopic level. Thus, a simple model used to study the ductile failure under multiaxial stress condition is the Stress Modified Critical Strain (SMCS) approach. Ductile rupture has been study for a structural steel under different stress triaxiality conditions using the SMCS method. Experimental tests are carried out to characterize the relation between stress triaxiality and equivalent plastic strain by notched round bars. After calibration of the plasticity and damage properties, predictions are made for low constraint bending specimens with and without side grooves. Stress/strain fields evolution are compared between the different geometries. Advantages and disadvantages of the SMCS methodology are discussed.

Keywords: damage, SMSC, SEB, steel, failure

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Authors: Michael Steve Lopez Bernabe

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Political news coverage of tabloid sheets as one of the print media molds or influences public opinions and perceptions. In this study, Critical Discourse Analysis was employed to 30 political news taken from major tabloid sheets in the Philippines in order to determine the linguistics features and other features characterizing the political news in tabloids such as discursive styles, news topics or contexts, journalistic roles and news sources. The political underpinnings through framing were also explored in the study. The results revealed that the linguistics features of the news coverage include moods and modalities (morphology), passivity and transitivity, nominalization, appositives and embedding (syntax), and pre-modifications, the use of verbs and omissions (grammatical features). The discursive features were direct or indirect speech; cohesion; endophora and classifications. In terms of news sources were politicians, experts, and journalists; and the tabloid perform the journalistic roles such as an intervention, watchdog, loyal-facilitator, service, infotainment and civic. The news was also evident of different political underpinnings such as game or strategic framing, conflict framing, human interest framing, attrition of responsibility framing, morality framing, economic consequences framing and issue framing.

Keywords: critical discourse analysis, political news, applied linguistics, Philippines, tabloid sheets

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Authors: Sri Rejeki Dwi Astuti, Suyanta

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The demanding of the asessment in learning process was impact by policy changes. Nowadays, the assessment not only emphasizes knowledge, but also skills and attitude. However, in reality there are many obstacles in measuring them. This paper aimed to describe how to develop instrument of integrated assessment as alternative assessment to measure critical thinking skills and science process skills in electrolyte solution and to describe instrument’s characteristic such as logic validity and construct validity. This instrument development used test development model by McIntire. Development process data was acquired based on development test step and was analyzed by qualitative analysis. Initial product was observed by three peer reviewer and six expert judgment (two subject matter expert, two evaluation expert and two chemistry teacher) to acquire logic validity test. Logic validity test was analyzed using Aiken’s formula. The estimation of construct validity was analyzed by exploratory factor analysis. Result showed that integrated assessment instrument has 0,90 of Aiken’s Value and all item in integrated assessment asserted valid according to construct validity.

Keywords: construct validity, critical thinking skills, integrated assessment instrument, logic validity, science process skills

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Authors: Baluku Nathan

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Transferring critically ill patients from one health facility to another poses a major risk to the patient because of increased oxygen demands. transferring patients with critical COVID-19 from a rural health canter in a rural district to a national referral hospital over 350 km in 7 hours would require three size H oxygen cylinders for successful transfer. It was always difficult to arrange the three size cylinders in the ambulance as workspace was greatly compromised for the ambulance assistant. Purpose: The purpose of this study was to investigate the impact and effectiveness of transport ventilators on the transportation of the critically ill patients from rural health canters to national referral hospitals in Uganda. Methodology: This was a descriptive cross-sectional study conducted in sept 2022 among critical care nurses and ambulance assistants who had used both methods of transportation (ventilators and cylinders). A semi structured questionnaire was used to collect quantitative data after informed consent. Results: From the findings, distribution of transport ventilators to the regional referral hospitals by the Ministry of Health has gradually improved patient transfer as the team requires less than one size oxygen cylinder to successfully transfer a patient. We use two ambulance assistants (a critical care nurse and another nurse who has been trained on use of the ventilator) when transferring patients with critical COVID-19 as the teams have to interchange over the long distance. Conclusions: Transport ventilators are effective and efficient in transferring critically ill patients, therefore should be rolled out to lower levels coupled with user training to improve outcomes of patients transferred in ambulances in lower income countries.

Keywords: emergency medical technician, critically ill, COVID-19, transport ventilator

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Authors: Ayanda Magida

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The paper aims to provide a critical review of the current state-of-the-art literature on emerging digital business theories. They are specifically focusing on the emergent theories on digital transformation, digitization, and digitalization and their importance in the global south. Digital business is an emergent field that cuts across the different existing disciplines. The paper is threefold- to provide the conceptual and theoretical definition of the DT, digitization and digitization. There is a growing need to provide some of the differences between digitalization, digitization and digital transformation from a theoretical and conceptual basis. These tend to be confused and often use interchangeably the second aim is to focus on the emerging theories on digital transformation and digital business. Finally, the paper provides some critical review of the importance of scholarship in the field from the global south. The systematic review of the literature was conducted through the different research databases to provide some of the major theories in the field of digital business and critically argue for the global south stance. Much of the research on the development and adoption of digital technologies, specifically digital transformation, has been done in the west and developed countries. There is thus a dearth of research conducted in developing countries and the global south.

Keywords: digital transformation, digitization, digital business, digitalization

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Authors: Benn Van Den Ende

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Over the last three decades, there has been an exponential increase in developments in implantable technologies such as the cardiac pacemaker, bionic prosthesis, and implantable chips. The effect of these technologies has been well researched in many areas. However, there is a lack of critical research in security studies. This paper will provide preliminary findings to an ongoing research project which aims to examine how implantable technologies effect the practices of governmentality in the context of security. It will do this by looking at the practices and techniques of governmentality along with different implantable technologies which increase, change or otherwise affect governmental practices. The preliminary research demonstrates that implantable technologies have a profound effect on the practices of governmentality, while also paving the way for further research into a potential ‘new’ form of governmentality in relation to these implantable technologies.

Keywords: critical security studies, governmentality, security theory, political theory, Foucault

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Authors: Joyce Fernandez

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This study examined the effects of critical incident stress debriefing and other related interventions on the psychological recovery of earthquake survivors. It is a mixed experimental and qualitative study using post-test only control group design and focus group discussion. After the conduct of critical incident stress debriefing activities and other related interventions in the form of counseling and psychiatric treatment to the survivors of a 6.9 magnitude earthquake, a post-test measuring the level of psychological recovery was given to randomized participants categorized as intervention and control groups. Using the traumatic assessment and belief scale as instrument for the quantitative aspect in order to gauge recovery in the psychological need areas of safety, trust, esteem, intimacy and control, the findings are the following: Intervention group participants have relatively better adjustment along the five psychological need areas compared to the control group participants; there is no significant difference in the psychological recovery among female and male participants of the invention and control groups and; there are significant differences between intervention and control groups in the psychological need areas of self-safety, self-trust, other-trust, self-esteem, and self-intimacy. Using a guided interview for the qualitative data, the themes derived are the following. Safety: The world is an unsafe place to live because of the calamities. Trust: Trust and dependence are anchored on the family. Esteem: Participants are having confused self-worth. Intimacy: Participants are thriving on attachment with their family. Control: Participants have unaltered desire to help but feeling restricted because of personal and logistical concerns.As an outcome of the study a Psychosocial Care Program for Individuals, Families and Communities Affected by Disaster and Trauma was proposed.

Keywords: critical incident stress debriefing, earthquake survivors, psychological recovery, related interventions

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Authors: Zuhairah Abdul Hadi, Mohd Nazir bin Md. Zabit, Zuriadah Ismail

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Metacognitive has been empirically evidenced to be one important element influencing learning outcomes. Expert learners engage in metacognition by monitoring and controlling their thinking, and listing, considering and selecting the best strategies to achieve desired goals. Studies also found that good critical thinkers engage in more metacognition and people tend to activate more metacognition when solving complex problems. This study extends past studies by performing a qualitative analysis to understand metacognitive patterns among two high and two low performing groups by carefully examining video and audio records taken during Problem-based learning activities. High performing groups are groups with majority members scored well in Watson Glaser II Critical Thinking Appraisal (WGCTA II) and academic achievement tests. Low performing groups are groups with majority members fail to perform in the two tests. Audio records are transcribed and analyzed using schemas adopted from past studies. Metacognitive statements are analyzed using three stages model and patterns of metacognitive are described by contexts, components, and levels for each high and low performing groups.

Keywords: academic achievement, critical thinking, metacognitive, problem-based learning

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Authors: Afshin Veisi

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In this study, the physical properties of wood in poplar wood (Populous sp.) were analyzed in longitudinal and radial directions of the stem. Three Populous Alba tree were cut in chaloos zone and from each tree, 3 discs were selected at 130cm, half of tree and under of crown. The test samples from pith to bark (heartwood to sapwood) were prepared from these discs for measuring the involved properties such as, wet, dry and critical specific gravity, porosity, volume shrinkage and swelling based on the ASTM standard, and data in two radial and longitudinal directions in the trank were statistically analyzed. Such as, variations of wet, dry and critical specific gravity had in radial direction respectively: irregular increase, increase and increase, and in longitudinal direction respectively: irregular decrease, irregular increase and increase. Results of variations to moisture content and porosity show that in radial direction respectively: irregular increasing and decreasing, and in longitudinal direction from down to up respectively: irregular decreasing and stability. Volume shrinkage and swelling variations show in radial direction irregular and in longitudinal axial regular decreasing.

Keywords: poplar wood, physical properties, shrinkage, swelling, critical specific gravity, wet specific gravity, dry specific gravity

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Authors: Nkeiruka Elsie Ezomike, Chinwe L. Onyekonwu, Anthony N. Ikefuna, Bede C. Ibe

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Superficial fungal infections (SFIs) are one of the common cutaneous infections that affect children worldwide. They may lead to school absenteeism or school drop-out and hence setback in the education of the child. Community-based studies in any locality are good reflections of the health conditions within that area. There is a dearth of information in the literature about SFI among primary school children in Enugu. This study aimed to determine the clinicomycological pattern of SFIs among primary school children in rural and urban communities in Enugu. This was a comparative descriptive cross-sectional study among primary school children in Awgu (rural) and Enugu North (urban) Local Government Areas (LGAs). Subjects' selection was made over 6 months using a multi-stage sampling method. Information such as age, sex, parental education, and occupation were collected using questionnaires. Socioeconomic classes of the children were determined using the classification proposed by Oyedeji et al. The samples were collected from subjects with SFIs. Potassium hydroxide tests were done on the samples. The samples that tested positive were cultured for SFI by inoculating onto Sabouraud's dextrose chloramphenicol actidione agar. The characteristics of the isolates were identified according to their morphological features using Mycology Online, Atlas 2000, and Mycology Review 2003. Equal numbers of children were recruited from the two LGAs. A total of 1662 pupils were studied. The mean ages of the study subjects were 9.03 ± 2.10years in rural and 10.46 ± 2.33years in urban communities. The male to female ratio was 1.6:1 in rural and 1:1.1 in urban communities. The personal hygiene of the children was significantly related to the presence of SFIs. The overall prevalence of SFIs among the study participants was 45%. In the rural, the prevalence was 29.6%, and in the urban prevalence was 60.4%. The types of SFIs were tinea capitis (the commonest), tinea corporis, pityriasis Versicolor, tinea unguium, and tinea manuum with prevalence rates lower in rural than urban communities. The clinical patterns were gray patch and black dot type of non-inflammatory tinea capitis, kerion, tinea corporis with trunk and limb distributions, and pityriasis Versicolor with face, trunk and limb distributions. Gray patch was the most frequent pattern of SFI seen in rural and urban communities. Black dot type was more frequent in rural than urban communities. SFIs were frequent among children aged 5 to 8years in rural and 9 to 12 years in urban communities. SFIs were commoner in males in the rural, whereas female dominance was observed in the urban. SFIs were more in children from low social class and those with poor hygiene. Trichophyton tonsurans and Trichophyton soudanese were the common mycological isolates in rural and urban communities, respectively. In conclusion, SFIs were less prevalent in rural than in urban communities. Trichophyton species were the most common fungal isolates in the communities. Health education of mothers and their children on SFI and good personal hygiene will reduce the incidence of SFIs.

Keywords: clinicomycological pattern, communities, primary school children, superficial fungal infections

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Authors: Sekou Kangoye, Alexis Todoskoff, Mihaela Barreau

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Modified Condition/Decision Coverage (MC/DC) is a structural coverage criterion that is highly recommended or required for safety-critical software coverage. Therefore, many testing standards include this criterion and require it to be satisfied at a particular level of testing (e.g. validation and unit levels). However, an important amount of time is needed to meet those requirements. In this paper we propose to automate MC/DC test data generation. Thus, we present an approach to automatically generate MC/DC test data, from software module description written over a dedicated language. We introduce a new merging approach that provides high MC/DC coverage for the description, with only a little number of test cases.

Keywords: domain-specific language, MC/DC, test data generation, safety-critical software coverage

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Authors: ShuPei Wang, Yina Patterson

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This article outlines strategies for improving oral expression to advance proficiency in speaking and listening skills through structured argumentation. The objective is to empower students to effectively use the target language to express opinions and construct compelling arguments. This empowerment is achieved by honing learners' debating and questioning skills, which involves increasing their familiarity with vocabulary and phrases relevant to debates and deepening their understanding of the cultural context surrounding pertinent issues. Through this approach, students can enhance their ability to articulate complex concepts and discern critical points, surpassing superficial comprehension and enabling them to engage in the target language actively and competently.

Keywords: debate, teaching and materials design, spoken expression, listening proficiency, critical thinking

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Authors: Susan Lubbers

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This study applies critical discourse analysis to the language used by educators to frame international students of Asian backgrounds in Anglo-Western universities as quiet, shy, passive and unable to think critically. Emphasis is on the self-promoted ‘internationalised’ Australian tertiary context, where negative stereotypes are commonly voiced not only in the academy but also in the media. Parallels are drawn as well with other Anglo-Western educational contexts. The study critically compares the discourse of these persistent negative stereotypes, with in-class and interview discourses of international students of Asian and Western language, cultural and educational backgrounds enrolled in a Media and Popular Culture unit in an Australian university. The focus of analysis of the student discourse is on their engagement in critical dialogic interactions on the topics of culture and interculturality. The evidence is also drawn from student interviews and focus groups and from observation of whole-class discussion participation rates. The findings of the research project provide evidence that counters the myth of student as problem. They point rather to the widespread lack of intercultural awareness of Western educators and students as being at the heart of the negative perceptions of students of Asian backgrounds. The study suggests the efficacy of an approach to developing intercultural competence that is embedded, or integrated, into tertiary programs. The presentation includes an overview of the main strategies that have been developed by the tertiary educator (author) to support the development of intercultural competence of and among the student cohort. The evidence points to the importance of developing intercultural competence among tertiary educators and students. The failure by educators to ensure that the diverse voices, ideas and perspectives of students from all cultural, educational and language backgrounds are heard in our classrooms means that our universities can hardly be regarded or promoted as genuinely internationalised. They will continue as undemocratic institutions that perpetrate persistent Western educational hegemony.

Keywords: critical discourse analysis, critical thinking, embedding, intercultural competence, interculturality, international student, internationalised education

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Authors: M. A. Suazlina, H. Azhan, S. A. Syamsyir, S. Y. S. Yusainee

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Fe2O3 was doped to Bi-2223 superconductor prepared in bulk form using high purity oxide powders via solid state reaction technique with intermediate grinding. A stiochiometric of x=0.00, 0.02, 0.04, 0.06, 0.08 and 0.10 Fe are systematically added to the well balanced Bi1.6Pb0.4Sr2Ca2Cu3-xFexOy in order to trace the effect of Fe doping to the system. Microstructure, resistive transitions, phase volume, and cell parameters were hence investigated. Substitution of Fe is found to slowly decrease the Bi-2223 phase volume and the resistive transitions for x=0.00 – 0.10 samples whereas accelerated formation of the Bi-2212 phase is detected for further substitutions. Changes in superconducting properties of Fe-doping Bi-2223 system were discussed and the findings were further compared with available literature.

Keywords: BSCCO, critical temperature, critical current density, XRD, flux pinning

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