Search results for: blood flow restriction training

Authors: A. Giani

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The current pedagogical culture recognizes an educational scope within the sports practices. It is widely accepted, in the pedagogical culture, that thanks to the acquisition and development of motor skills, it is also possible to exercise abilities that concern the way of facing and managing the difficulties of everyday life. Sport is a peculiar educational environment: the children have the opportunity to discover the possibilities of their body, to correlate with their peers, and to learn how to manage the rules and the relationship with authorities, such as coaches. Educational aspects of the sport concern both non-formal and formal educational environments. Coaches play a critical role in an agonistic sphere: exactly like the competencies developed by the children, coaches have to work on their skills to properly set up the educational scene. Facing these new educational tasks - which are not new per se, but new because they are brought back to awareness - a few questions arise: does the coach have adequate preparation? Is the training of the coach in this specific area appropriate? This contribution aims to explore the issue in depth by focusing on the reality of the Football School. Starting from a possible sense of pedagogical inadequacy detected during a series of meetings with several football clubs in Piedmont (Italy), there have been highlighted some important educational needs within the professional training of sports coaches. It is indeed necessary for the coach to know the processes underlying the educational relationship in order to better understand the centrality of the assessment during the educational intervention and to be able to manage the asymmetry in the coach-athlete relationship. In order to provide a response to these pedagogical needs, a formative plan has been designed to allow both an in-depth study of educational issues and a correct self-evaluation of certain pedagogical skills’ control levels, led by the coach. This plan has been based on particular practices, the Educational Practices of Pre-test (EPP), a specific version of community practices designed for the extracurricular activities. The above-mentioned practices realized through the use of texts meant as pre-tests, promoted a reflection within the group of coaches: they set up real and plausible sports experiences - in particular football, triggering a reflection about the relationship’s object, spaces, and methods. The characteristic aspect of pre-tests is that it is impossible to anticipate the reflection as it is necessarily connected to the personal experience and sensitivity, requiring a strong interest and involvement by participants: situations must be considered by the coaches as possible settings in which they could be found on the field.

Keywords: relational needs, values, responsibility, self-evaluation

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Authors: Mohammad Arabi

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Business Process Reengineering (BPR) is a systematic approach to fundamentally redesign organizational processes to achieve significant improvements in organizational performance. At Fars Regional Electric Company, implementing BPR is deemed essential to increase productivity, reduce costs, and improve service quality. This article examines how BPR can help enhance the performance of Fars Regional Electric Company. The objective of this research is to evaluate and analyze the advancements in process modeling and reengineering at Fars Regional Electric Company and to provide solutions for improving the productivity and efficiency of organizational processes. This study aims to demonstrate how BPR can be used to improve organizational processes and enhance the overall performance of the company. This research employs both qualitative and quantitative research methods and includes interviews with senior managers and experts at Fars Regional Electric Company. The analytical tools include process modeling software such as Bizagi and ARIS, and statistical analysis software such as SPSS and Minitab. Data analysis was conducted using advanced statistical methods. The results indicate that the use of BPR techniques can lead to a significant reduction in process execution time and overall improvement in quality. Implementing BPR at Fars Regional Electric Company has led to increased productivity, reduced costs, and improved overall performance of the company. This study shows that with proper implementation of BPR and the use of modeling tools, the company can achieve significant improvements in its processes. Recommendations: (1) Continuous Training for Staff: Invest in continuous training of staff to enhance their skills and knowledge in BPR. (2) Use of Advanced Technologies: Utilize modeling and analysis software to improve processes. (3) Implementation of Effective Management Systems: Employ knowledge and information management systems to enhance organizational performance. (4) Continuous Monitoring and Review of Processes: Regularly review and revise processes to ensure ongoing improvements. This article highlights the importance of improving organizational processes at Fars Regional Electric Company and recommends that managers and decision-makers at the company seriously consider reengineering processes and utilizing modeling technologies to achieve developmental goals and continuous improvement.

Keywords: business process reengineering, electric company, Fars province, process modeling advancements

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Authors: Jutharat Attawet, Alex Y. Wang, Cindy M. Farquhar, Elizabeth A. Sullivan

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Background: Adverse maternal and perinatal outcomes of multiple pregnancies resulting from multiple embryo transfers (ET) has become significant concerns. This is particularly relevant for gestational carriers since they usually do not have infertility issues. Single embryo transfer (SET) therefore has been encouraged to assist reproductive technology (ART) practice in order to reduce multiple pregnancies. Objectives: This systematic review aims to investigate the pregnancy and birth outcomes of SET and multiple ET in surrogacy arrangements. Search methods: This study is a systematic review. Electronic databases were searched from CINAHL, Medline, Embase, Scopus and ProQuest for studies from 1980 to 2017. Cross-references and national ART reports were also manual searchings. Articles without restriction of English language and study types were accessed. Carrier cycles involving in SET and multiple ET were identified in database searching. The main outcome measures including clinical pregnancy, live delivery and multiple deliveries per gestational carrier cycle were compared between SET and multiple ET. Mantel-Haenzel risk ratios (RRs) with 95% confidence intervals (CIs), using the numbers of outcome events in SET and multiple ET of each study were calculated suing RevMan5.3. Outcomes: The search returned 97 articles of which 5 met the inclusion criteria. Approximately 50% of carrier cycles were transferred a single embryo and 50% were transferred more than one embryo. The clinical pregnancy rate (CPR) was 39% for SET and 53% for multiple ET, which was not significantly different with RR = 0.83 (95% CI: 0.67-1.03). The live delivery rate was 33% for SET and 57% for multiple ET which was not significantly different with RR = 0.78 (95% CI: 0.61-1.00). The multiple delivery rate per carrier was greater risks in the multiple ET carrier cycles (RR =0.4, 95% CI: 0.01-0.26). There were 104 sets of twins (including one set of twins selectively reduced from triplets to twins) and 1 set of triples in the multiple ET carrier cycle. In the SET carrier cycles, there were 2 sets of twins. Significance of the study: SET should be advocated among surrogate carriers to prevent multiple pregnancies and subsequent adverse outcomes for both carrier and baby. Surrogacy practice should be reviewed and surrogate carriers should be fully informed of the risk of adverse maternal and birth outcome of multiple pregnancies due to multiple embryo transfers.

Keywords: assisted reproduction, birth outcomes, carrier, gestational surrogacy, multiple embryo transfer, multiple pregnancy, pregnancy outcomes, single embryo transfer, surrogate mother, systematic review

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Authors: Timilehin Martins Oyinloye, Won Byong Yoon

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Simulation technology is being adopted in many industries, with research focusing on the development of new ways in which technology becomes embedded within production, services, and society in general. 3D printing (3DP) technology is fast developing in the food industry. However, the limited processability of high-performance material restricts the robustness of the process in some cases. Significantly, the printability of materials becomes the foundation for extrusion-based 3DP, with residual stress being a major challenge in the printing of complex geometry. In many situations, the trial-a-error method is being used to determine the optimum printing condition, which results in time and resource wastage. In this report, the analysis of 3 moisture levels for surimi paste was investigated for an optimum 3DP material and printing conditions by probing its rheology, flow characteristics in the nozzle, and post-deposition process using the finite element method (FEM) model. Rheological tests revealed that surimi pastes with 82% moisture are suitable for 3DP. According to the FEM model, decreasing the nozzle diameter from 1.2 mm to 0.6 mm, increased the die swell from 9.8% to 14.1%. The die swell ratio increased due to an increase in the pressure gradient (1.15107 Pa to 7.80107 Pa) at the nozzle exit. The nozzle diameter influenced the fluid properties, i.e., the shear rate, velocity, and pressure in the flow field, as well as the residual stress and the deformation of the printed sample, according to FEM simulation. The post-printing stability of the model was investigated using the additive layer manufacturing (ALM) model. The ALM simulation revealed that the residual stress and total deformation of the sample were dependent on the nozzle diameter. A small nozzle diameter (0.6 mm) resulted in a greater total deformation (0.023), particularly at the top part of the model, which eventually resulted in the sample collapsing. As the nozzle diameter increased, the accuracy of the model improved until the optimum nozzle size (1.0 mm). Validation with 3D-printed surimi products confirmed that the nozzle diameter was a key parameter affecting the geometry accuracy of 3DP of surimi paste.

Keywords: 3D printing, deformation analysis, die swell, numerical simulation, surimi paste

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Authors: Guler Duru Asiret, Cemile Kutmec Yilmaz, Gulcan Bagcivan, Tugce Turten Kaymaz

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This descriptive study was conducted to determine the relationship between caregiver burden and life satisfaction who give home care to elderly individuals. The sample was recruited from the internal medicine unit and palliative unit of a state hospital located in Turkey on June 2016-2017. The study sample consisted of 231 primary caregiver family member, who met the eligibility criteria and agreed to participate in the study. The inclusion criteria were as follows: inpatient’s caregiver, primary caregiver for at least 3 months, at least 18 years of age, no communication problem or mental disorder. Data were gathered using an Information Form prepared by the researchers based on previous literature, the Zarit Burden Interview (ZBI), and the Satisfaction with Life Scale (SWLS). The data were analyzed using IBM SPSS Statistics software version 20.0 (SPSS, Chicago, IL). The descriptive characteristics of the participant were analyzed using number, percentage, mean and standard deviation. The suitability of normal distribution of scale scores was analyzed using Kolmogorov-Smirnov and Shapiro-Wilk test. Relationships between scales were analyzed using Spearman’s rank-correlation coefficient. P values less than 0.05 were considered to be significant. The average age of the caregivers was 50.11±13.46 (mean±SD) years. Of the caregivers, 76.2% were women, 45% were primary school graduates, 89.2% were married, 38.1% were the daughters of their patients. Among these, 52.4% evaluated their income level to be good. Of them, 53.6% had been giving care less than 2 years. The patients’ average age was 77.1±8.0 years. Of the patients, 55.8% were women, 56.3% were illeterate, 70.6% were married, and 97.4% had at least one chronic disease. The mean Zarit Burden Interview score was 35.4±1.5 and the Satisfaction with Life Scale score was 20.6±6.8. A negative relationship was found between the patients’ score average on the ZBI, and on the SWLS (r= -0.438, p=0.000). The present study determined that the caregivers have a moderate caregiver burden and the life satisfaction. And the life satisfaction of caregivers decreased as their caregiver burden increase. In line with the results obtained from the research, it is recommended that to increase the effectiveness of discharge training, to arrange training and counseling programs for caregivers to cope with the problems they experienced, to monitor the caregivers at regular intervals and to provide necessary institutional support.

Keywords: caregiver burden, family caregivers, nurses, satisfaction

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Authors: V. Sacca, A. Sarica, F. Novellino, S. Barone, T. Tallarico, E. Filippelli, A. Granata, P. Valentino, A. Quattrone

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In the last few years, resting-state functional MRI (rs-fMRI) was widely used to investigate the architecture of brain networks by investigating the Blood Oxygenation Level Dependent response. This technique represented an interesting, robust and reliable approach to compare pathologic and healthy subjects in order to investigate neurodegenerative diseases evolution. On the other hand, the elaboration of rs-fMRI data resulted to be very prone to noise due to confounding factors especially the head motion. Head motion has long been known to be a source of artefacts in task-based functional MRI studies, but it has become a particularly challenging problem in recent studies using rs-fMRI. The aim of this work was to evaluate in MS patients a well-known motion correction algorithm from the FMRIB's Software Library - MCFLIRT - that could be applied to minimize the head motion distortions, allowing to correctly interpret rs-fMRI results.

Keywords: head motion correction, MCFLIRT algorithm, multiple sclerosis, resting state fMRI

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Authors: Arpit Rai

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In this work, we propose PatchMix, a semi-supervised method for pre-training visual representations. PatchMix mixes patches of two images and then solves an auxiliary task of predicting the label of each patch in the mixed image. Our experiments on the CIFAR-10, 100 and the SVHN dataset show that the representations learned by this method encodes useful information for transfer to new tasks and outperform the baseline Residual Network encoders by on CIFAR 10 by 12% on ResNet 101 and 2% on ResNet-56, by 4% on CIFAR-100 on ResNet101 and by 6% on SVHN dataset on the ResNet-101 baseline model.

Keywords: self-supervised learning, representation learning, computer vision, generalization

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Authors: Elizabeth B. Katana, Brenda N. Simbwa, Josephine Namayanja, Bob O. Amodan, Edirisa J. Nsubuga, Eva A. O. Laker

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Background: Understanding stakeholders’ perceptions towards the implementation of a mass vaccination campaign is important to ensure the design of better strategies to address challenges. We explored stakeholders’ perceptions of the implementation of a nationwide door-to-door mass vaccination campaign for the oral polio vaccine (nOPV2) in Uganda for the two rounds that occurred in January and November 2022. Methods: A qualitative study was conducted among stakeholders who participated in the campaign implementation from 8 districts in Uganda using random sampling. We conducted 46 In-depth interviews lasting 30 – 40 minutes with 6 national/central supervisors, 12 district, 14 sub-county, and 14 parish-level supervisors. Stakeholders were asked about their experiences in the campaign implementation, including challenges faced and their opinions of the campaign impact and use of the door-to-door strategy. Data were analyzed thematically in line with the major campaign activities. Results: Most of the stakeholders were primarily concerned about poor planning, inadequate training of vaccination teams, community resistance including schools, challenges with recruitment and teaming of vaccinators, poor and delayed payments, lack of logistics and motivation for vaccination teams, the timing of the activities and implementing amidst COVID-19 and Ebola. The stakeholders believed that the first round was not well planned and implemented, while the second round was leveraged in their previous experiences. On the other hand, some positive experiences were noted with regard to communication, advocacy and mobilization, vaccine delivery and distribution, district readiness assessments, and cold chain management. Conclusion: This study identified many challenges that were faced in the implementation of the door-to-door mass campaign for nOPV2 in Uganda. This study identified that more needs to be done to improve door-to-door mass campaigns with a focus on motivating the implementers. These findings highlight the need for conducting performance reviews, improved planning, especially routine updates and verification of target populations and training in microplanning, and adequate mapping of community resistance to inform the implementation of future mass campaigns.

Keywords: mass polio vaccination campaigns, door-to-door strategy, stakeholders' perceptions, implementation challenges

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Authors: M. Amo, A. Alvaro, A. Astudillo, R. Mc Culloch, J. C. del Castillo, M. Gómez, J. M. Martín

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Polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/Fs) of course comprise a range of highly toxic compounds that may exist as particulates within the air or accumulate within water supplies, soil, or vegetation. They may be created either ubiquitously or naturally within the environment as a product of forest fires or volcanic eruptions. It is only since the industrial revolution, however, that it has become necessary to closely monitor their generation as a byproduct of manufacturing/combustion processes, in an effort to mitigate widespread contamination events. Of course, the environmental concentrations of these toxins are expected to be extremely low, therefore highly sensitive and accurate methods are required for their determination. Since ionization of non-polar compounds through electrospray and APCI is difficult and inefficient, we evaluate the performance of a novel low-flow Atmospheric Pressure Photoionization (APPI) source for the trace detection of various dioxins and furans using rapid Mass Spectrometry workflows. Air, soil and biota (vegetable matter) samples were collected monthly during one year from various locations within the vicinity of an industrial incinerator in Spain. Analytes were extracted and concentrated using soxhlet extraction in toluene and concentrated by rotavapor and nitrogen flow. Various ionization methods as electrospray (ES) and atmospheric pressure chemical ionization (APCI) were evaluated, however, only the low-flow APPI source was capable of providing the necessary performance, in terms of sensitivity, required for detecting all targeted analytes. In total, 10 analytes including 2,3,7,8-tetrachlorodibenzodioxin (TCDD) were detected and characterized using the APPI-MS method. Both PCDDs and PCFDs were detected most efficiently in negative ionization mode. The most abundant ion always corresponded to the loss of a chlorine and addition of an oxygen, yielding [M-Cl+O]- ions. MRM methods were created in order to provide selectivity for each analyte. No chromatographic separation was employed; however, matrix effects were determined to have a negligible impact on analyte signals. Triple Quadrupole Mass Spectrometry was chosen because of its unique potential for high sensitivity and selectivity. The mass spectrometer used was a Sciex´s Qtrap3200 working in negative Multi Reacting Monitoring Mode (MRM). Typically mass detection limits were determined to be near the 1-pg level. The APPI-MS2 technology applied to the detection of PCDD/Fs allows fast and reliable atmospheric analysis, minimizing considerably operational times and costs, with respect other technologies available. In addition, the limit of detection can be easily improved using a more sensitive mass spectrometer since the background in the analysis channel is very low. The APPI developed by SEADM allows polar and non-polar compounds ionization with high efficiency and repeatability.

Keywords: atmospheric pressure photoionization-mass spectrometry (APPI-MS), dioxin, furan, incinerator

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Authors: Ross Calvert, Colin Whittaker, Alison Raby, Alistair G. L. Borthwick, Ton S. van den Bremer

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Large concentrations of plastic have polluted the seas in the last half century, with harmful effects on marine wildlife and potentially to human health. Plastic pollution will have lasting effects because it is expected to take hundreds or thousands of years for plastic to decay in the ocean. The question arises how waves transport plastic in the ocean. The predominant motion induced by waves creates ellipsoid orbits. However, these orbits do not close, resulting in a drift. This is defined as Stokes drift. If a particle is infinitesimally small and the same density as water, it will behave exactly as the water does, i.e., as a purely Lagrangian tracer. However, as the particle grows in size or changes density, it will behave differently. The particle will then have its own inertia, the fluid will exert drag on the particle, because there is relative velocity, and it will rise or sink depending on the density and whether it is on the free surface. Previously, plastic pollution has all been considered to be purely Lagrangian. However, the steepness of waves in the ocean is small, normally about α = k₀a = 0.1 (where k₀ is the wavenumber and a is the wave amplitude), this means that the mean drift flows are of the order of ten times smaller than the oscillatory velocities (Stokes drift is proportional to steepness squared, whilst the oscillatory velocities are proportional to the steepness). Thus, the particle motion must have the forces of the full motion, oscillatory and mean flow, as well as a dynamic buoyancy term to account for the free surface, to determine whether inertia is important. To track the motion of a floating inertial particle under wave action requires the fluid velocities, which form the forcing, and the full equations of motion of a particle to be solved. Starting with the equation of motion of a sphere in unsteady flow with viscous drag. Terms can added then be added to the equation of motion to better model floating plastic: a dynamic buoyancy to model a particle floating on the free surface, quadratic drag for larger particles and a slope sliding term. Using perturbation methods to order the equation of motion into sequentially solvable parts allows a parametric equation for the transport of inertial finite-sized floating particles to be derived. This parametric equation can then be validated using numerical simulations of the equation of motion and flume experiments. This paper presents a parametric equation for the transport of inertial floating finite-size particles by ocean waves. The equation shows an increase in Stokes drift for larger, less dense particles. The equation has been validated using numerical solutions of the equation of motion and laboratory flume experiments. The difference in the particle transport equation and a purely Lagrangian tracer is illustrated using worlds maps of the induced transport. This parametric transport equation would allow ocean-scale numerical models to include inertial effects of floating plastic when predicting or tracing the transport of pollutants.

Keywords: perturbation methods, plastic pollution transport, Stokes drift, wave flume experiments, wave-induced mean flow

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Authors: Vandana Mohan, Ashwani Koul

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Aim: To evaluate the potential of Aqueous Tinospora cordifolia stem extract (Aq.Tc) and Arabinogalactan (AG) on pulmonary carcinogenesis and associated tumor markers. Background: Lung cancer is one of the most frequent malignancy with high mortality rate due to limitation of early detection resulting in low cure rates. Current research effort focuses on identifying some blood-based biomarkers like CEA, ctDNA and LDH which may have potential to detect cancer at an early stage, evaluation of therapeutic response and its recurrence. Medicinal plants and their active components have been widely investigated for their anticancer potentials. Aqueous preparation of T. Cordifolia extract is enriched in the polysaccharide fraction i.e., AG when compared with other types of extract. Moreover, reports are available of polysaccharide fraction of T. Cordifolia in in vitro lung cancer models which showed profound anti-metastatic activity against these cell lines. However, not much has been explored about its effect in in vivo lung cancer models and the underlying mechanism involved. Experimental Design: Mice were randomly segregated into six groups. Group I animals served as control. Group II animals were administered with Aq. Tc extract (200 mg/kg b.w.) p.o.on the alternate days. Group III animals were fed with AG (7.5 mg/kg b.w.) p.o. on the alternate days (thrice a week). Group IV animals were installed with Benzo(a)pyrene (50 mg/kg b.w.), i.p. twice within an interval of two weeks. Group V animals received Aq. Tc extract as in group II along with it B(a)P was installed after two weeks of Aq. Tc administration following the same protocol as for group IV. Group VI animals received AG as in group III along with it B(a)P was installed after two weeks of AG administration. Results: Administration of B(a)P to mice resulted in increased tumor incidence, multiplicity and pulmonary somatic index with concomitant increase in serum/plasma markers like CEA, ctDNA, LDH and TNF-α.Aq.Tc and AG supplementation significantly attenuated these alterations at different stages of tumorigenesis thereby showing potent anti-cancer effect in lung cancer. A pronounced decrease in serum/plasma markers were observed in animals treated with Aq.Tc as compared to those fed with AG. Also, extensive hyperproliferation of alveolar epithelium was prominent in B(a)P induced lung tumors. However, treatment of Aq.Tc and AG to lung tumor bearing mice exhibited reduced alveolar damage evident from decreased number of hyperchromatic irregular nuclei. A direct correlation between the concentration of tumor markers and the intensity of lung cancer was observed in animals bearing cancer co-treated with Aq.Tc and AG. Conclusion: These findings substantiate the chemopreventive potential of Aq.Tc and AG against lung tumorigenesis. Interestingly, Aq.Tc was found to be more effective in modulating the cancer as reflected by various observations which may be attributed to the synergism offered by various components of Aq.Tc. Further studies are in progress to understand the underlined mechanism in inhibiting lung tumorigenesis by Aq.Tc and AG.

Keywords: Arabinogalactan, Benzo(a)pyrene B(a)P, carcinoembryonic antigen (CEA), circulating tumor DNA (ctDNA), lactate dehydrogenase (LDH), Tinospora cordifolia

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Authors: Mohammad Ghandehari Motlagh

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Purpose: To evaluate validity of simplified Javal’s rule (Total Ast=Corneal Ast-0.50@9) in 147 pre-op cataract eyes. Methods: Due to change in lens tissue and structure in a cataract crystalline lens, we conceive the simplified javal’s rule may not be valid in cataract cases.In this cross-sectional study,147 pre-op cataract eyes without oblique astigmatism were enrolled in this study. Ocular biometry (with IOL master 500)and keratometry and refraction findings were recorded. Results: Mean age of our patients was 64.95 yrs/old (SD+_9.86) that confirms on senile cataract. Mean Axial length and average keratometry were respectively 23.86 and 44.62.Prevalence of systemic diseases diabet and high blood pressure were respectively 43 (29.25%) and 44 (29.93%)and shows importance of these diseases. The Corneal astigmatism axis is correlated with refractive astigmatism in cataract eyes (R=0.493). Simplified Javal’s rule is valid in cataract eyes (P<0.001). Conclusion: Simplified Javal’s rule is a valid formula in pre-op cataract eyes and can be used for keratometry results confirmation.

Keywords: javals rule, cataract, keratometry, ocular axial length

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Authors: Cláudia Patrocínio, Beatriz Fernandes, Ana Filipa Pires

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Background: Mirror therapy (MT) is used to improve motor function after stroke. During MT, a mirror is placed between the two upper limbs (UL), thus reflecting movements of the non- affected side as if it were the affected side. Objectives: The aim of this review is to analyze the evidence on the effec.tiveness of MT in the recovery of UL function in population with post chronic stroke. Methods: The literature search was carried out in PubMed, ISI Web of Science, and PEDro database. Inclusion criteria: a) studies that include individuals diagnosed with stroke for at least 6 months; b) intervention with MT in UL or comparing it with other interventions; c) articles published until 2023; d) articles published in English or Portuguese; e) randomized controlled studies. Exclusion criteria: a) animal studies; b) studies that do not provide a detailed description of the intervention; c) Studies using central electrical stimulation. The methodological quality of the included studies was assessed using the Physiotherapy Evidence Database (PEDro) scale. Studies with < 4 on PEDro scale were excluded. Eighteen studies met all the inclusion criteria. Main results and conclusions: The quality of the studies varies between 5 and 8. One article compared muscular strength training (MST) with MT vs without MT and four articles compared the use of MT vs conventional therapy (CT), one study compared extracorporeal shock therapy (EST) with and without MT and another study compared functional electrical stimulation (FES), MT and biofeedback, three studies compared MT with Mesh Glove (MG) or Sham Therapy, five articles compared performing bimanual exercises with and without MT and three studies compared MT with virtual reality (VR) or robot training (RT). The assessment of changes in function and structure (International Classification of Functioning, Disability and Health parameter) was carried out, in each article, mainly using the Fugl Meyer Assessment-Upper Limb scale, activity and participation (International Classification of Functioning, Disability and Health parameter) were evaluated using different scales, in each study. The positive results were seen in these parameters, globally. Results suggest that MT is more effective than other therapies in motor recovery and function of the affected UL, than these techniques alone, although the results have been modest in most of the included studies. There is also a more significant improvement in the distal movements of the affected hand than in the rest of the UL.

Keywords: physical therapy, mirror therapy, chronic stroke, upper limb, hemiplegia

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Authors: Xiaolian Jiang, Dongling Liu, Kun Liu

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Aims: To examine the prevalence of POST-TRAUMATIC STRESS DISORDER (PTSD) symptoms among Tibetan adolescents in heavily-hit disaster area three years after Yushu earthquake, and to explore the interactions of the psycho-social-genetic risk factors. Methods: This was a three-stage study. Firstly, demographic variables，PTSD Checklist-Civilian Version （PCL-C），the Internality、Powerful other、Chance Scale，（IPC），Coping Style Scale（CSS），and the Social Support Appraisal（SSA）were used to explore the psychosocial factors of PTSD symptoms among adolescent survivors. PCL-C was used to examine the PTSD symptoms among 4072 Tibetan adolescents，and the Structured Clinical Interview for DSM-IV Disorders（SCID）was used by psychiatrists to make the diagnosis precisely. Secondly，a case-control trial was used to explore the relationship between PTSD and gene polymorphisms. 287adolescents diagnosed with PTSD were recruited in study group, and 280 adolescents without PTSD in control group. Polymerase chain reaction-restriction fragment length polymorphism technology（PCR-RFLP）was used to test gene polymorphisms. Thirdly，SPSS 22.0 was used to explore the interactions of the psycho-social-genetic risk factors of PTSD on the basis of the above results. Results and conclusions: 1．The prevalence of PTSD was 9.70%. 2．The predictive psychosocial factors of PTSD included earthquake exposure, support from others, imagine, abreact, tolerant, powerful others and family support. 3．Synergistic interactions between A1 gene of DRD2 TaqIA and the external locus of control, negative coping style, severe earthquake exposure were found. Antagonism interactions between A1 gene of DRD2 TaqIA and poor social support was found. Synergistic interactions between A1/A1 genotype and the external locus of control, negative coping style were found. Synergistic interactions between 12 gene of 5-HTTVNTR and the external locus of control, negative coping style, severe earthquake exposure were found. Synergistic interactions between 12/12 genotype and the external locus of control, negative coping style, severe earthquake exposure were also found.

Keywords: adolescents, earthquake, PTSD, risk factors

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Authors: Abdulaziz F. Ettir, Ghait Bashir, Tarek S. Duzan

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A proper well planning is very vital to achieve any successful drilling program on the basis of preventing, overcome all drilling problems and minimize cost operations. Since the hydraulic system plays an active role during the drilling operations, that will lead to accelerate the drilling effort and lower the overall well cost. Likewise, an improperly designed hydraulic system can slow drill rate, fail to clean the hole of cuttings, and cause kicks. In most cases, common sense and commercially available computer programs are the only elements required to design the hydraulic system. Drilling optimization is the logical process of analyzing effects and interactions of drilling variables through applied drilling and hydraulic equations and mathematical modeling to achieve maximum drilling efficiency with minimize drilling cost. In this paper, practical software adopted in this paper to define drilling optimization models including four different optimum keys, namely Opti-flow, Opti-clean, Opti-slip and Opti-nozzle that can help to achieve high drilling efficiency with lower cost. The used data in this research from vertical and horizontal wells were recently drilled in Waha Oil Company fields. The input data are: Formation type, Geopressures, Hole Geometry, Bottom hole assembly and Mud reghology. Upon data analysis, all the results from wells show that the proposed program provides a high accuracy than that proposed from the company in terms of hole cleaning efficiency, and cost break down if we consider that the actual data as a reference base for all wells. Finally, it is recommended to use the established Optimization calculations software at drilling design to achieve correct drilling parameters that can provide high drilling efficiency, borehole cleaning and all other hydraulic parameters which assist to minimize hole problems and control drilling operation costs.

Keywords: optimum keys, namely opti-flow, opti-clean, opti-slip and opti-nozzle

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Authors: Mohamed Rajab Peer Mohamed, Thiruvenkatasamy Kannabiran

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In the present investigation, the scour around a circular pier subjected to a steady current were studied numerically using two-dimensional MIKE21 Flow Model (FM) and Sand Transport (ST)Modulewhich is developed by Danish Hydraulic Institute (DHI), Denmark. The unstructured flexible mesh generated with rectangular flume dimension of 10 m wide, 1 m deep, and 30 m long. The grain size of the sand was d50 = 0.16 mm, sediment size, sediment gradation=1.16, pier diameter D= 30 mm and depth-averaged current velocity, U = 0.449 m/s are considered in the model. The estimated scour depth obtained from this model is validated and it is observed that the results of the model have good agreement with flume experimental results.In order to estimate the scour depth, several simulations were made for three cases viz., Case I:change in sediment transport model description in the numerical model viz, i) Engelund-Hansen model, ii) Engelund-Fredsøe model, and iii) Van Rijn model, Case II: change in current velocity for keeping constant pile diameter D=0.03 m and Case III:change in pier diameter for constant depth averaged current speed U=0.449 m/s.In case I simulations, the results indicate that the scour depth S/D is the order of 1.73 for Engelund-Hansen model, 0.64 for Engelund-Fredsøe model and 0.46 for VanRijn model. The scour depth estimates using Engelund-Hansen method compares well the experimental results.In case II, simulations show that the scour depth increases with increasing current component of the flow.In case III simulations, the results indicate that the scour depth increases with increase in pier diameter and it stabilize attains steady value when the Froude number> 2.71.All the results of the numerical simulations are clearly matches with reported values of the experimental results. Hence, this MIKE21 FM –Sand Transport model can be used as a suitable tool to estimate the scour depth for field applications. Moreover, to provide suitable scour protection methods, the maximum scour depth is to be predicted, Engelund-Hansen method can be adopted to estimate the scour depth in the steady current region.

Keywords: circular pier, MIKE21, numerical model, scour, sediment transport

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Authors: Orkide Donma, Mustafa M. Donma

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Obesity is a low-grade inflammatory disease and may lead to health problems such as hypertension, dyslipidemia, diabetes. It is also associated with important risk factors for cardiovascular diseases. This requires the detailed evaluation of obesity, particularly in children. The aim of this study is to enlighten the potential associations between lipid ratios and obesity indices and to introduce those with discriminating features among children with obesity and metabolic syndrome (MetS). A total of 408 children (aged between six and eighteen years) participated in the scope of the study. Informed consent forms were taken from the participants and their parents. Ethical Committee approval was obtained. Anthropometric measurements such as weight, height as well as waist, hip, head, neck circumferences and body fat mass were taken. Systolic and diastolic blood pressure values were recorded. Body mass index (BMI), diagnostic obesity notation model assessment index-II (D2 index), waist-to-hip, head-to-neck ratios were calculated. Total cholesterol, triglycerides, high-density lipoprotein cholesterol (HDLChol), low-density lipoprotein cholesterol (LDLChol) analyses were performed in blood samples drawn from 110 children with normal body weight, 164 morbid obese (MO) children and 134 children with MetS. Age- and sex-adjusted BMI percentiles tabulated by World Health Organization were used to classify groups; normal body weight, MO and MetS. 15^th-to-85^th percentiles were used to define normal body weight children. Children, whose values were above the 99th percentile, were described as MO. MetS criteria were defined. Data were evaluated statistically by SPSS Version 20. The degree of statistical significance was accepted as p≤0.05. Mean±standard deviation values of BMI for normal body weight children, MO children and those with MetS were 15.7±1.1, 27.1±3.8 and 29.1±5.3 kg/m², respectively. Corresponding values for the D2 index were calculated as 3.4±0.9, 14.3±4.9 and 16.4±6.7. Both BMI and D2 index were capable of discriminating the groups from one another (p≤0.01). As far as other obesity indices were considered, waist-to hip and head-to-neck ratios did not exhibit any statistically significant difference between MO and MetS groups (p≥0.05). Diagnostic obesity notation model assessment index-II was correlated with the triglycerides-to-HDL-C ratio in normal body weight and MO (r=0.413, p≤0.01 and r=0.261, (p≤0.05, respectively). Total cholesterol-to-HDL-C and LDL-C-to-HDL-C showed statistically significant differences between normal body weight and MO as well as MO and MetS (p≤0.05). The only group in which these two ratios were significantly correlated with waist-to-hip ratio was MetS group (r=0.332 and r=0.334, p≤0.01, respectively). Lack of correlation between the D2 index and the triglycerides-to-HDL-C ratio was another important finding in MetS group. In this study, parameters and ratios, whose associations were defined previously with increased cardiovascular risk or cardiac death have been evaluated along with obesity indices in children with morbid obesity and MetS. Their profiles during childhood have been investigated. Aside from the nature of the correlation between the D2 index and triglycerides-to-HDL-C ratio, total cholesterol-to-HDL-C as well as LDL-C-to- HDL-C ratios along with their correlations with waist-to-hip ratio showed that the combination of obesity-related parameters predicts better than one parameter and appears to be helpful for discriminating MO children from MetS group.

Keywords: children, lipid ratios, metabolic syndrome, obesity indices

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Authors: Khalil Abdullah Ahmed Khalil, Elsadig Mohamed Ahmed

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Ginger is one of the most important medicinal plants, which is widely used in folk medicine. This study was designed to go further step and evaluate the hypoglycemic and hypolipidaemic effects of the aqueous ginger root extract in normal and alloxan diabetic rabbits. Results revealed that the aqueous ginger has a significant hypoglycemic effect (P<0.05) in diabetic rabbits but a non-significant hypoglycemic effect (P>0.05) in normal rabbits. There were also significant decreases in the concentrations (P<0.05) in serum cholesterol, triglycerides and LDL – cholesterol in both normal and diabetic rabbits. Although there was an elevation in serum HDL- cholesterol in both normal and diabetic rabbits, these elevations were non-significant (P>0.05). Our data suggest the aqueous ginger has a hypoglycemic effect in diabetic rabbits and lipid-lowering properties in both normal and diabetic rabbits.

Keywords: aqueous extract of ginger root (AEGR), hypoglycemic, cholesterol, triglyceride

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Authors: Olivera Lupescu, Taina Elena Avramescu, Mihail Nagea, Alexandru Dimitriu

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Acetabular fractures represent a real challenge due to their impact upon the long term function of the hip joint, and due to the risk of intra- and peri-operative complications especially that they affect young, active people. That is why treating these fractures require certain skills which must be exercised, regarding the pre-operative planning, as well as the execution of surgery.The authors retrospectively analyse 38 cases with acetabular fractures operated using the posterior approach in our hospital between 01.01.2013- 01.01.2015 for which complete medical records ensure a follow-up of 24 months, in order to establish the main causes of potential errors and to underline the methods for preventing them. This target is included in the Erasmus + project ‘Collaborative learning for enhancing practical skills for patient-focused interventions in gait rehabilitation after orthopedic surgery COR-skills’. This paper analyses the pitfalls revealed by these cases, as well as the measures necessary to enhance the practical skills of the surgeons who perform acetabular surgery. Pre-op planning matched the intra and post-operative outcome in 88% of the analyzed points, from 72% at the beginning to 94% in the last case, meaning that experience is very important in treating this injury. The main problems detected for the posterior approach were: nervous complications - 3 cases, 1 of them a complete paralysis of the sciatic nerve, which recovered 6 months after surgery, and in other 2 cases intra-articular position of the screws was demonstrated by post-operative CT scans, so secondary screw removal was necessary in these cases. We analysed this incident, too, due to lack of information about the relationship between the screws and the joint secondary to this approach. Septic complications appeared in 3 cases, 2 superficial and 1 profound (requiring implant removal). The most important problems were the reduction of the fractures and the positioning of the screws so as not to interfere with the the articular space. In posterior acetabular fractures, pre-op complex planning is important in order to achieve maximum treatment efficacy with minimum of risk; an optimal training of the surgeons insisting on the main points of potential mistakes ensure the success of the procedure, as well as a favorable outcome for the patient.

Keywords: acetabular fractures, articular congruency, surgical skills, vocational training

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Authors: Reza Shakoori

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This paper presents a structural correction of Arabic and Persian strokes using manipulation of their chain codes in order to improve the rate and performance of Persian and Arabic handwritten word recognition systems. It collects pure and effective features to represent a character with one consolidated feature vector and reduces variations in order to decrease the number of training samples and increase the chance of successful classification. Our results also show that how the proposed approaches can simplify classification and consequently recognition by reducing variations and possible noises on the chain code by keeping orientation of characters and their backbone structures.

Keywords: Arabic, chain code normalization, OCR systems, image processing

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Authors: Jonghyuk Yoon, Hyoungwoon Song

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Recently, there are lots of increasing interest in a smart farming that represents application of modern Information and Communication Technologies (ICT) into agriculture since it provides a methodology to optimize production efficiencies by managing growing conditions of crops automatically. In order to obtain high performance and stability for smart greenhouse, it is important to identify the effect of various working parameters such as capacity of ventilation fan, vent opening area and etc. In the present study, a 3-dimensional CFD (Computational Fluid Dynamics) simulation for single-span greenhouse was conducted using the commercial program, Ansys CFX 18.0. The numerical simulation for single-span greenhouse was implemented to figure out the internal thermal and flow characteristics. In order to numerically model solar radiation that spread over a wide range of wavelengths, the multiband model that discretizes the spectrum into finite bands of wavelength based on Wien’s law is applied to the simulation. In addition, absorption coefficient of vinyl varied with the wavelength bands is also applied based on Beer-Lambert Law. To validate the numerical method applied herein, the numerical results of the temperature at specific monitoring points were compared with the experimental data. The average error rates (12.2~14.2%) between them was shown and numerical results of temperature distribution are in good agreement with the experimental data. The results of the present study can be useful information for the design of various greenhouses. This work was supported by Korea Institute of Planning and Evaluation for Technology in Food, Agriculture, Forestry and Fisheries (IPET) through Advanced Production Technology Development Program, funded by Ministry of Agriculture, Food and Rural Affairs (MAFRA)(315093-03).

Keywords: single-span greenhouse, CFD (computational fluid dynamics), solar radiation, multiband model, absorption coefficient

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Authors: Hanaa M. Abu El Einin, Ahmed T. Sharaf El- Din

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Biomphalaria snails play an integral role in the transmission of Schistosoma mansoni, the causative agent for human schistosomiasis. Two species of Biomphalaria were reported from Egypt, Biomphalaria alexandrina and Biomphalaria glabrata, and later on a hybrid of B. alexandrina and B. glabrata was reported in streams at Nile Delta. All were known to be excellent hosts of S. mansoni. Host-parasite relationship can be viewed in terms of snail susceptibility and parasite infectivity. The objective of this study will highlight the progress that has been made in using molecular approaches to describe the correct identification of snail species that participating in transmission of schistosomiasis, rapid diagnose of infection in addition to susceptibility and resistance type. Snails were identified using of molecular methods involving Randomly Amplified Polymorphic DNA (RAPD), Polymerase Chain Reaction, Restriction Fragment Length Polymorphisms (PCR-RFLP) and Species - specific- PCR. Molecular approaches to diagnose parasite in snails from Egypt: Nested PCR assay and small subunit (SSU) rRNA gene. Also RAPD PCR for study susceptible and resistance phenotype. The results showed that RAPD- PCR, PCR-RFLP and species-specific-PCR techniques were confirmed that: no evidence for the presence of B. glabrata in Egypt, All Biomphalaria snails collected identified as B. alexandrina snail i-e B alexandrinia is a common and no evidence for hybridization with B. glabrata. The adopted specific nested PCR assay revealed much higher sensitivity which enables the detection of S. mansoni infected snails down to 3 days post infection. Nested PCR method for detection of infected snails using S. mansoni fructose -1,6- bisphosphate aldolase (SMALDO) primer, these primers are specific only for S. mansoni and not cross reactive with other schistosomes or molluscan aldolases Nested PCR for such gene is sensitive enough to detect one cercariae. Genetic variations between B. alexandrina strains that are susceptible and resistant to Schistosoma infec¬tion using a RAPD-PCR showed that 39.8% of the examined snails collected from the field were resistant, while 60.2% of these snails showed high infection rates. In conclusion the genetics of the intermediate host plays a more important role in the epidemiological control of schistosomiasis.

Keywords: biomphalaria, molecular differentiation, parasite detection, schistosomiasis

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Authors: Vanessa Kummer, Maik Meusel

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Real estate demand estimates are typically derived from transaction data. However, in regions with excess demand, transactions are driven by supply and therefore do not indicate what people are actually looking for. To estimate the demand for housing in Switzerland, search subscriptions from all important Swiss real estate platforms are used. These data do, however, suffer from missing information—for example, many users do not specify how many rooms they would like or what price they would be willing to pay. In economic analyses, it is often the case that only complete data is used. Usually, however, the proportion of complete data is rather small which leads to most information being neglected. Also, the data might have a strong distortion if it is complete. In addition, the reason that data is missing might itself also contain information, which is however ignored with that approach. An interesting issue is, therefore, if for economic analyses such as the one at hand, there is an added value by using the whole data set with the imputed missing values compared to using the usually small percentage of complete data (baseline). Also, it is interesting to see how different algorithms affect that result. The imputation of the missing data is done using unsupervised learning. Out of the numerous unsupervised learning approaches, the most common ones, such as clustering, principal component analysis, or neural networks techniques are applied. By training the model iteratively on the imputed data and, thereby, including the information of all data into the model, the distortion of the first training set—the complete data—vanishes. In a next step, the performances of the algorithms are measured. This is done by randomly creating missing values in subsets of the data, estimating those values with the relevant algorithms and several parameter combinations, and comparing the estimates to the actual data. After having found the optimal parameter set for each algorithm, the missing values are being imputed. Using the resulting data sets, the next step is to estimate the willingness to pay for real estate. This is done by fitting price distributions for real estate properties with certain characteristics, such as the region or the number of rooms. Based on these distributions, survival functions are computed to obtain the functional relationship between characteristics and selling probabilities. Comparing the survival functions shows that estimates which are based on imputed data sets do not differ significantly from each other; however, the demand estimate that is derived from the baseline data does. This indicates that the baseline data set does not include all available information and is therefore not representative for the entire sample. Also, demand estimates derived from the whole data set are much more accurate than the baseline estimation. Thus, in order to obtain optimal results, it is important to make use of all available data, even though it involves additional procedures such as data imputation.

Keywords: demand estimate, missing-data imputation, real estate, unsupervised learning

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Authors: Mareli Fischer, Kevin G. F. Thomas

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Although Attention-Deficit/Hyperactivity Disorder (ADHD) is one of the most prevalent childhood neurobehavioural disorders, little empirical research has been published on its clinical presentation in Africa, and, globally, few studies evaluate ADHD intervention programs that emphasize parent training. Hence, Stage 1 of this research programme aimed to describe the functional impairment of South African children with ADHD, and also sought to investigate the influence of sociodemographic variables (e.g., sex, age, socioeconomic status, family environment) and clinical variables (e.g., ADHD subtype and comorbidity) on the degree of that impairment. We used the Mini International Neuropsychiatric Interview for Children and Adolescents as a diagnostic tool, and the Child Behavior Checklist, the Strengths and Difficulties Questionnaire, and the Impairment Rating Scale as measures of functional impairment. Results from this stage of the research indicated that South African children and adolescents who meet diagnostic criteria for ADHD experience most functional impairment in the school domain, as well as in the area of social functioning. None of the measured sociodemographic variables had a significant detrimental or protective effect on how ADHD symptoms impacted on functioning. In terms of comorbidity, the presence of Major Depressive Disorder, Conduct Disorder, and Oppositional Defiant Disorder were all associated with significantly impaired overall functioning. Stage 2 of the research programme aimed to design, implement, and evaluate a child-specific intervention that targeted the primary areas of impairment identified in Stage 1. Existing literature suggests that a positive parent-training programme, in the group format, is one of the best options for cost-effective and successful ADHD intervention. Hence, the intervention took that form. Parents were taught basic behaviour analysis concepts within a supportive group context. Evaluation of the intervention’s efficacy used many of the same measures as in Stage 1, but also featured semi-structured interviews with participants and naturalistic observation of parent-child interaction. We will discuss preliminary results of that evaluation. Studying functional impairment and designing intervention plans in this way will pave the way for evidence-based treatment plans for children and adolescents diagnosed with ADHD.

Keywords: attention deficit/hyperactivity disorder, children, intervention, parenting groups

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Authors: N. Uchegbu Nneka

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This study was conducted to investigate the effect of the antioxidant activity of germinated African Yam Bean (AYB) on oxidative stress markers in alloxan-induced diabetic rat. Rats were randomized into three groups; control, diabetic and germinated AYB–treated diabetic rats. The Total phenol and flavonoid content and DPPH radical scavenging activity before and after germination were investigated. The glucose level, lipid peroxidation and reduced glutathione of the animals were also determined using the standard technique for four weeks. Germination increased the total phenol, flavonoid and antioxidant activity of AYB extract by 19.14%, 32.28%, and 57.25% respectively. The diabetic rats placed on germinated AYB diet had a significant decrease in the blood glucose and lipid peroxidation with a corresponding increase in glutathione (p<0.05). These results demonstrate that consumption of germinated AYB can be a good dietary supplement in inhibiting hyperglycemia/hyperlipidemia and the prevention of diabetic complication associated with oxidative stress.

Keywords: African yam bean, antioxidant, diabetes, total phenol

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Authors: Mehmet Kale, Ramazan Sencan, Sibel Yavru, Ahmet Ak, Nuri Mamak, Sibel Hasırcıoglu, Mesih Kocamuftuoglu, Yakup Yıldırım, Hasbi Sait Saltık

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Bovine Papilloma Virus (BPV)-induced warts can cause mastitis, teat blindness, reduction of milk yield, udder deformities, and a difficulty in getting the teats into the milking machine. Especially, surgical operations cannot be performed in BPV-induced teat warts because of the increased sensitivity of the breast region and small-sized papillomas. Thus, there is a need to find new topical treatment methods. We have developed a pomade for treatment of BPV in cattle. The pomade is consists of lanoline, snakeskin (two special kind of snake), alcohol, vaseline, and ether. Firstly, we determined 46 cattle with teat warts. In the study, BPV antigen was detected in 28 cattle blood samples (61%) by ELISA. The pomade was applied to all BPV infected animals. The regression and recovery of warts were 100% in all animals. We advised using the pomade for treatment of BPV-induced warts in teats.

Keywords: bovine papilloma virus, pomade, teat, udder

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Authors: Rim Frikha, Nouha Bouayed, Afifa Sellami, Nozha Chakroun, Salima Douad, Leila Keskes, Tarek Rebai

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Recurrent pregnancy loss (RPL), classically defined as the occurrence of two or more failed pregnancies, is a serious reproductive problem, in which, chromosomal rearrangements in either carrier are a major cause; mainly the chromosome aneuploidy. This study was conducted to determine the frequency and contribution of X-chromosome aneuploidy in recurrent pregnancy loss. A retrospective study was carried out among 100 couples with more than 2 miscarriages, referred to our genetic counseling. In all the cases the detailed reproductive histories were taken. Chromosomal analysis was performed using RHG banding in peripheral blood. Of a total of 100 couples; 3 patients with a detected X-chromosome aneuploidy were identified with an overall frequency of 3%. Chromosome abnormalities are as below: a Turner syndrome with 45, X/46, XX mosaicism, a 47, XXX, and a Klinefelter syndrome with 46, XY/47, XXY. These data show a high incidence of X-chromosome aneuploidy; mainly with mosaicism; in RPL. Thus, couples with such chromosomal abnormality should be referred to a clinical geneticist with whom the option of pre-implantation genetic diagnosis in subsequent pregnancy should be discussed.

Keywords: aneuploidy, genetic testing, recurrent pregnancy loss, X-chromosome

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Authors: Qian Wang, Haibo Gu

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To drive practical interpretations and applications of various policies in building the transnational education joint-ventures, middle managers learn to navigate through uncertainties and ambiguities. However, the current literature views very little about those middle managers’ experiences, perceptions, and practices. This paper takes the empirical approach and aims to uncover the middle managers’ experiences by conducting interviews, campus visits, and document analysis. Following the qualitative research method approach, the researchers gathered information from a mixture of fourteen foreign and Chinese managers. Their perceptions of the China-foreign cooperation in higher education and their perceived roles have offered important, valuable insights to this group of people’s attitudes and management performances. The diverse cultural and demographic backgrounds contributed to the significance of the study. There are four key findings. One, middle managers’ immediate micro-contexts and individual attitudes are the top two influential factors in managers’ performances. Two, the foreign middle managers showed a stronger sense of self-identity in risk-taking. Three, the Chinese middle managers preferred to see difficulties as part of their assigned responsibilities. Four, middle managers in independent universities demonstrated a stronger sense of belonging and fewer frustrations than middle managers in secondary institutes. The researchers propose that training for managers in a transnational educational setting should consider these discoveries when select fitting topics and content. In particular, middle managers should be better prepared to anticipate their everyday jobs in the micro-environment; hence, information concerning sponsor organizations’ working culture is as essential as knowing the national and local regulations, and socio-culture. Different case studies can help the managers to recognize and celebrate the diversity in transnational education. Situational stories can help them to become aware of the diverse and wide range of work contexts so that they will not feel to be left alone when facing challenges without relevant previous experience or training. Though this research is a case study based in the Chinese transnational higher education setting, the implications could be relevant and comparable to other transnational higher education situations and help to continue expanding the potential applications in this field.

Keywords: educational management, middle manager performance, transnational higher education

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Authors: Makda Aamir, Sood Aayushi, Syed Omar, Nihan Khuld, Iskander Peter, Ijaz Naeem, Sharma Nishant

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Introduction:Glycogen Storage Disease Type-1 (GSD-1) is a rare phenomenon primarily affecting the liver and kidney. Excessive accumulation of glycogen and fat in liver, kidney, and intestinal mucosa is noted in patients with deficiency of Glucose-6-phosphatase deficiency. Patients with GSD-1 have a wide spectrum of symptoms, including hepatomegaly, hypoglycemia, lactic acidemia, hyperlipidemia, hyperuricemia, and growth retardation. Age of onset, rate of disease progression and its severity is variable in this disease.Case:An 18-year-old male with GSD-1a, Von Gierke’s disease, hyperuricemia, and hypertension presented to the hospital with nausea and vomiting. The patient followed an hourly cornstarch regimen during the day and overnight through infusion via a PEG tube. The complaints started at work, where he was unable to tolerate oral cornstarch. He washemodynamically stable on arrival. ABG showed pH 7.372, PaCO2 30.3, and PaO2 92.2. WBC 16.80, K+ 5.8, HCO3 13, BUN 28, Cr 2.2, Glucose 60, AST 115, ALT 128, Cholesterol 352, Triglycerides >1000, Uric Acid 10.6, Lactic Acid 11.8 which trended down to 8.0. CT abdomen showed hepatomegaly and fatty infiltration with the PEG tube in place.He was admitted to the ICU and started on D5NS for hypoglycemia and lactic acidosis. Per request by the patient’s pediatrician, he was transitioned to IV D10/0.45NS at 110mL/Hr to maintain blood glucose above 75 mg/L. Frequent accuchecks were done till he could tolerate his dietary regimen with cornstarch. Lactic acid downtrend to 2.9, and accuchecks ranged between 100-110. Cr improved to 1.3, and his home medications (Allopurinol and Lisinopril) were resumed. He was discharged in stable condition with plans for further genetic therapy work up.Discussion:Mainstay therapy for Von Gierke’s Disease is the prevention of metabolic derangements for which dietary and lifestyle changes are recommended. A low fructose and sucrose diet is recommended by limiting the intake of galactose and lactose to one serving per day. Hypoglycemia treatment in such patients is two-fold, utilizing both quick and stable release sources. Cornstarch has been one such therapy since the 1980s; its slow digestion provides a steady release of glucose over a longer period of time as compared with other sources of carbohydrates. Dosing guidelines vary from age to age and person to person, but it is highly recommended to check BG levels frequently to maintain a BG > 70 mg/dL. Associated high levels of triglycerides and cholesterol can be treated with statins, fibrates, etc. Conclusion:The management of hypoglycemia in GSD 1 disease presents various obstacles which could prove to be fatal. Due to the deficiency of G6P, treatment with a specialized hypoglycemic regimen is warranted. A D10 ½ NS infusion can be used to maintain blood sugar levels as well as correct metabolic or lactate imbalances. Infusion should be gradually weaned off after the patient can tolerate oral feeds as this can help prevent the risk of hypoglycemia and other derangements. Further research is needed in regards to these patients for more sustainable regimens.

Keywords: von gierke, glycogen storage disease, hypoglycemia, genetic disease

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Authors: Abdul Hadi Butt, Asfandyar Arshad

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The purpose of this paper is to study the thrust variation in different configurations of clustered nozzles. It involves the design and analysis of clustered configuration of nozzles using Ansys fluent. Clustered nozzles with different configurations are simulated and compared on basis of effective exhaust thrust. Mixing length for the flow interaction is also calculated. Further clustered configurations are analyzed over different altitudes. An optimum value of the thrust among different configurations is proposed at the end of comparisons.

Keywords: CD nozzle, cluster, thrust, fluent, ANSYS

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