Search results for: counseling stress experience

Authors: P. Panwalkar, K. Veravalli, R. Gwynn, M. Tofighi, R. Clement, A. Mofidi

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When operating on tibial plateau fracture especially medial tibial plateau, it has regularly been said “where do I put my thumb to reduce the fracture”. This refers to the ideal placement of the buttress device to hold the fracture till union. The aim of this study was to see if one can identify this sweet spot using a CT scan. Methods: Forty-five tibial plateau fractures with medial plateau involvement were identified and included in the study. The preoperative CT scans were analysed and the medial plateau involvement pattern was classified based on modified radiological classification by Yukata et-al of stress fracture of medial tibial plateau. The involvement of part of plateau was compared with position of buttress plate position which was classified as medial posteromedial or both. Presence and position of the buttress was compared with ability to achieve and hold the reduction of the fracture till union. Results: Thirteen fractures were type-1 fracture, 19 fractures were type-2 fracture and 13 fractures were type-3 fracture. Sixteen fractures were buttressed correctly according to the potential deformity and twenty-six fractures were not buttressed and three fractures were partly buttressed correctly. No fracture was over butressed! When the fracture was buttressed correctly the rate of the malunion was 0%. When fracture was partly buttressed 33% were anatomically united and 66% were united in the plane of buttress. When buttress was not used, 14 were malunited, one malunited in one of the two planes of deformity and eleven anatomically healed (of which 9 were non displaced!). Buttressing resulted in statistically significant lower mal-union rate (x2=7.8, p=0.0052). Conclusion: The classification based on involvement of medial condyle can identify the placement of buttress plate in the tibial plateau. The correct placement of the buttress plate results in predictably satisfactory union. There may be a correlation between injury shape of the tibial plateau and the fracture type.

Keywords: knee, tibial plateau, trauma, CT scan, surgery

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Authors: Jakub Zembrzuski, Bartosz Sobczyk, Mikołaj MIśkiewicz

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Besides designing new constructions, engineers all over the world must face another problem – maintenance, repairs, and assessment of the technical condition of existing bridges. To solve more complex issues, it is necessary to be familiar with the theory of finite element method and to have access to the software that provides sufficient tools which to enable create of sometimes significantly advanced numerical models. The paper includes a brief assessment of the technical condition, a description of the in situ non-destructive testing carried out and the FEM models created for global and local analysis. In situ testing was performed using strain gauges and displacement sensors. Numerical models were created using various software and numerical modeling techniques. Particularly noteworthy is the method of modeling riveted joints of the crossbeam of the viaduct. It is a simplified method that consists of the use of only basic numerical tools such as beam and shell finite elements, constraints, and simplified boundary conditions (fixed support and symmetry). The results of the numerical analyses were presented and discussed. It is clearly explained why the structure did not fail, despite the fact that the weld of the deck plate completely failed. A further research problem that was solved was to determine the cause of the rapid increase in values on the stress diagram in the cross-section of the transverse section. The problems were solved using the solely mentioned, simplified method of modeling riveted joints, which demonstrates that it is possible to solve such problems without access to sophisticated software that enables to performance of the advanced nonlinear analysis. Moreover, the obtained results are of great importance in the field of assessing the operation of bridge structures with an orthotropic plate.

Keywords: bridge, diagnostics, FEM simulations, failure, NDT, in situ testing

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Authors: Kimmo J. Kurppa

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This paper describes the development of the buyer-supplier dyad concept over the years and proposes improvements, clarifications and extensions to the prevailing definitions published in 1970’s and 1980’s. This paper suggests a partition of the buyer-supplier dyad to concepts of Commercial Dyad (dyadic interaction in vertical relationships) and Innovative Dyad (dyadic interaction in horizontal relationship) since dyadic interaction takes place in two major types of contexts between industrial firms. Especially the context of joint product development in a dyadic relationship has not been adequately recognized being totally different from the interaction taking place in commercial buyer-supplier interaction. This paper provides therefore a solution to the existing gap in research by clarifying the descriptions and the context where dyadic interaction takes place between industrial firms. This paper also illustrates and explains how the firm’s organization and the interaction taking place inside it, is connected to the dyadic interaction structure between the firm and its partner firm. This theme has been discussed earlier but the phenomenon has not been adequately described and has not been illustrated in earlier research. This conceptual study has been interested in how the dyad concept of Industrial Marketing has been defined in the earlier research and how the definition could be improved. This conceptual paper has been constructed by using the systematic review methodology and proposes avenues for future research. The concept and existence of relationship and interaction between firm’s internal interaction network and external interaction between firm’s dyadic counterparts, need to be verified through empirical research.

Keywords: dyadic interaction, industrial dyad, buyer-supplier relationship, strategic reciprocity, experience, socially adjusted opportunism

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Authors: Pratishtha Singh

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Gender-based violence (GBV) or gendered violence refers to violence inflicted on a person because of their gender. Majority of men who perpetrate gender-based violence, first do so during their teenage years. Further, the first sexual experience of most girls is coerced. In order to reduce the widespread occurrence of GBV, it is vital to intervene and reach people, especially boys, when their attitudes and beliefs about sexuality and gender are developing. This study aims to understand GBV through an adolescent lens, focusing on their knowledge, attitudes and experiences regarding gendered abuse. This is a cross-sectional, qualitative study. The respondents are Delhi based students in grades 11th and 12th, recruited via snowball sampling. Sixteen in-depth, telephonic interviews were carried out in the month of April, 2020. The data was transcribed verbatim into MS Word and qualitative coding was undertaken in Atlas.ti 8. Twelve out of sixteen respondents admitted experiencing sexual GBV. Out of these, a little more than half of the victims reported it to somebody. Thematic analysis revealed key themes of: (i) Introduction and reinforcement of a patriarchal structure (ii) Violence in teen dating (iii) Acceptability and normalization of violence and (iv) Justice System. Findings reflect a process wherein GBV becomes an intricate part of adolescents’ lives. Participants showed a moderately well-informed understanding of gendered abuse whereas attitudes reflected a complex combination of internalized patriarchy and a desire to bring positive societal reform. The results of this study highlight a need for health promoting, gender-equitable interventions.

Keywords: adolescents, gender, health, violence

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Authors: Djordjevic J. Sladjana, Djordjevic-Milošević B. Suzana, Milošević M. Slobodan

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The potential of biomass as a renewable energy source leads Serbia to be the top of European countries by the amount of available but unused biomass. Technologies for its use are available and ecologically acceptable. Moreover, they are not expensive high-tech solutions even for the poor investment environment of Serbia, while other options seem to be less achievable. From the other point of view, Serbia has a huge percentage of unused agriculture land. Agricultural production in Serbia languishes: a large share of agricultural land therefore remains untreated, and there is a significant proportion of degraded land. From all the above, biomass intended for energy production is becoming an increasingly important factor in the stabilization of agricultural activities. Orientation towards the growing bioenergy crops versus conventional crop cultivation becomes an interesting option. The aim of this paper is to point out the possibility of growing energy crops in accordance with the conditions and cultural practice in rural areas of Serbia. First of all, the cultivation of energy crops on lower quality land is being discussed, in order to revitalize the rural areas of crops through their inclusion into potential energy sector. Next is the theme of throwing more light on the increase in the area under this competitive agricultural production to correct land use in terms of climate change in Serbia. The goal of this paper is to point out the contribution of the share of biomass in energy production and consumption, and the effect of reducing the negative environmental impact.

Keywords: agro-energy crops, conditions for plantation, revitalization of rural areas, degraded and unused soils

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Authors: Constance Kirker

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This paper examines examples of the shared use of mango references as a culinary metaphor powerful in maintaining immigrant identity in the works of diaspora authors from a variety of regions of the world, including South Asia, the Caribbean, and Africa, and across a variety of genres, including novels, culinary memoirs, and children’s books. There has been past criticism of so-called sari-mango literature, suggesting that use of the image of mango is a cliché, even “lazy,” attempt to “exoticize” and sentimentalize South Asia in particular. A broader review across national boundaries reveals that diaspora authors, including those beyond South Asia, write nostalgically about mango as much about the messy “full body” tactile experience of eating a mango as about the “exotic” quality of mango representing the “otherness” of their home country. Many of the narratives detail universal childhood food experiences that are more shared than exotic, such as a desire to subvert the adult societal rules of neatness and get very messy, or memories of small but memorable childhood transgressions such as stealing mangoes from a neighbor’s tree. In recent years, food technology has evolved, and mangoes have become more familiar and readily available in Europe and America, from smoothies and baby food to dried fruit snacks. The meaning associated with the imagery of mangoes for both writers and readers in diaspora literature evolves as well, and authors do not have to heed Salman Rushdie’s command, “There must be no tropical fruits in the title. No mangoes.”

Keywords: identity, immigrant diaspora, culinary metaphor, food studies

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Authors: Joanne Joyce-McCoach

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Short courses are an integral part of the higher education sector, providing a pathway into tertiary qualifications. Recently, the Australian government has implemented a range of initiatives to support the development of short courses and micro-credentials designed to upskill the labor market and meet the needs of the healthcare workforce. While short courses have been an ongoing component of Australian nursing continuing professional development, there is an immediate need for more education opportunities as a response to the workforce shortages. However, despite the support for short courses, there are identified challenges for learners undertaking these courses online. As a result of restrictions to face-to-face classes and limited access to health services caused by the pandemic, education providers have had to transition to an online delivery requiring the redesign of skills acquisition. This paper will outline the transition of an immunisation short course to a fully online format, including the redesign of classes, content and assessment. Concurrently the enrolments for the immunisation short course substantially increased in direct response to the demand for nurse immunisers. In addition to providing a description of the curriculum changes implemented, an analysis of learners’ feedback on their experience of the new format will be discussed. Furthermore, it will explore the principles identified in the transition process for improving the short course design and learning activities. Finally, it will propose recommendations to integrate into the delivery of online short courses and to meet the learners' needs.

Keywords: nurse, immunisation, short course, micro-credential, continuing professional development, online design

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Authors: Marzieh Yassin, Fereshteh Navaee, Javad Sarrafzadeh, Reza Salehi

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Introduction: Myofascial trigger point (MTrP) is one of the most common sources of musculoskeletal pain. Approximately 30-85% of the patients with musculoskeletal pains would experience MTrP in their life. The prevalence of MTrP has reported in the patients seen in a general orthopedic clinic, general medical clinic and specialty pain management centers, 21%, 30% and 93% respectively. Nowadays, dry needling is suggested as a standard treatment for MTrPs. The purpose of the present study was to examine the effectiveness of dry needling with stretching upper trapezius muscle on pain and pain pressure threshold in participants with active myofascial trigger point. Methods: Thirty participants with an active myofascial trigger point of the upper trapezius muscle were randomly divided into two groups: dry needling with passive stretch (n=15) and passive stretch alone (n=15). They received 5 sessions of the treatments for three weeks. The outcomes were pain intensity and pain pressure threshold that were assessed with visual analogue scale and algometer respectively. Results: Significant improvement in pain and pain pressure threshold was observed in both groups (P=0.0001) after the treatment. Also, the results showed a significant difference in measurements between two groups (P<0.05). Conclusion: Dry needling with passive stretch can be more effective on pain and pain pressure threshold than passive stretching alone in short term in participants with active myofascial trigger points.

Keywords: dry needling, myofascial pain syndrome, myofascial trigger point, stretching

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Authors: Soheil Heydari, Ailar Hajimohammadi, Nasser Khalili

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Polystyrene, being made from a monomer called styrene, is a rigid and easy-to mould polymer that is widely used for many applications, from foam packaging to disposable containers. Considering that the degradation of waste polystyrene takes up to 500 years, there is an urgent need for a sustainable application for waste polystyrene. This study evaluates the application of waste polystyrene as an asphalt modifier. The inclusion of waste plastics in asphalt is either practised by the dry process or the wet process. In the dry process, plastics are added straight into the asphalt mixture and in the wet process, they are mixed and digested into bitumen. In this article, polystyrene was used as an asphalt modifier in a dry process. However, the mixing process is precisely designed to make sure that the polymer is melted and modified in the binder. It was expected that, due to the rigidity of polystyrene, it will have positive effects on the permanent deformation of the asphalt mixture. Therefore, different mixtures were manufactured with different contents of polystyrene and Marshall specimens were manufactured, and dynamic creep tests were conducted to evaluate the permanent deformation of the modification. This is a commonly repeated loading test conducted at different stress levels and temperatures. Loading cycles are applied to the AC specimen until failure occurs; with the amount of deformation constantly recorded the cumulative, permanent strain is determined and reported as a function of the number of cycles. Also, to our best knowledge, hybrid mixes of polystyrene with crumb rubber and low-density polyethylene were made and compared with a polystyrene-modified mixture. The test results of this study showed that the hybrid mix of polystyrene and low-density polyethylene has the highest resistance against permanent deformation. However, the polystyrene-modified mixture outperformed the hybrid mix of polystyrene and crumb rubber, and both demonstrated way lower permanent deformation than the unmodified specimen.

Keywords: permanent deformation, waste plastics, polystyrene, hybrid plastics, hybrid mix, hybrid modification, dry process

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Authors: Kofi Kyei, Kenchi Matsui

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Loss of vegetable products has been a major constraint in the post-harvest chain. Sources of post-harvest loss in the vegetable industry start from the time of harvesting to its handling and at the various market centers. Identifying vegetable farmers’ perceptions about post-harvest loss sources is one way of addressing this issue. In this paper, we assessed farmers’ perceptions about sources of post-harvest losses in the Ashanti Region of Ghana. We also identified the factors that influence their perceptions. To clearly understand farmers’ perceptions, we selected Sekyere-Kumawu District in the Ashanti Region. Sekyere-Kumawu District is one of the major producers of vegetables in the Region. Based on a questionnaire survey, 100 vegetable farmers growing tomato, pepper, okra, cabbage, and garden egg were purposely selected from five communities in Sekyere-Kumawu District. For farmers’ perceptions, the five points Likert scale was employed. On a scale from 1 (no loss) to 5 (extremely high loss), we processed the scores for each vegetable harvest. To clarify factors influencing farmers’ perceptions, the Pearson Correlation analysis was used. Our findings revealed that farmers perceive post-harvest loss by pest infestation as the most extreme loss. However, vegetable farmers did not perceive loss during transportation as a serious source of post-harvest loss. The Pearson Correlation analysis results further revealed that farmers’ age, gender, level of education, and years of experience had an influence on their perceptions. This paper then discusses some recommendations to minimize the post-harvest loss in the region.

Keywords: Ashanti Region, pest infestation, post-harvest loss, vegetable farmers

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Authors: Othoman Elsayah, Naren Gupta, Binsheng Zhang

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The construction sector constitutes one of the most important sectors in the economy of any country. Contractor selection is a critical decision that is undertaken by client organizations and is central to the success of any construction project. Contractor selection (CS) is a process which involves investigating, screening and determining whether candidate contractors have the technical and financial capability to be accepted to formally tender for construction work. The process should be conducted prior to the award of contract, characterized by many factors such as: contactor’s skills, experience on similar projects, track- record in the industry, and financial stability. However, this paper evaluates the current state of knowledge in relation to contractor selection process and demonstrates the findings from the analysis of the data collected from the Delphi questionnaire survey. The survey was conducted with a group of 12 experts working in the Libyan construction industry (LCI). The paper starts by briefly explaining the general outline of the questionnaire including the survey participation rate, the different fields the experts came from, and the business titles of the participants. Then, the paper describes the tests used to determine when the experts had reached consensus. The paper is based on research which aims to develop rank contractor selection criteria with specific application to make construction projects in the Libyan context. The findings of this study will be utilized to establish the scope of work that will be used as part of a PhD research.

Keywords: contractor selection, Libyan construction industry, decision experts, Delphi technique

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Authors: U. S. Babuga, A. H. Danwanka, A. Garba

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The research was carried out to compare the yield of respondents before and after access to extension services on crop production technologies in the study area. Data were collected from the study area through questionnaires administered to seventy-five randomly selected respondents. Data were analyzed using descriptive statistics, t-test and regression models. The result disclosed that majority (97%) of the respondent attended one form of school or the other. The majority (78.67%) of the respondents had farm size ranging between 1-3 hectares. The majority of the respondent adopt improved variety of crops, plant spacing, herbicide, fertilizer application, land preparation, crop protection, crop processing and storage of farm produce. The result of the t-test between the yield of respondents before and after access to extension services shows that there was a significant (p<0.001) difference in yield before and after access to extension. It also indicated that farm size was significant (p<0.001) while household size, years of farming experience and extension contact were significant at (p<0.005). The major constraint to adoption of crop production technologies were shortage of extension agents, high cost of technology and lack of access to credit facility. The major pre-requisite for the improvement of extension service are employment of more extension agents or workers and adequate training. Adequate agricultural credit to farmers at low interest rates will enhance their adoption of crop production technologies.

Keywords: comparative, analysis, yield, access, extension

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Authors: Nirmal Kumar Gupta, Amrit Gupta, Varuna Varma, Prabhakar Mishra

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Even in developed nations where the standard of maternal and cardiac care is systematic and available easily to all, pregnancy still represents a unique challenge in women with prosthetic heart valves. Pregnancy unmasks the underlying cardiac diseases due to large hemodynamic changes. It’s a retrospective cohort study done at a tertiary care institute in North India. 683 married young women aged between 19-35 years (childbearing age) received mechanical prosthetic valves at a single unit. Ninety-two pregnancies out of 587 surviving were followed to study the pregnancy outcomes. All women received only oral Nicoumalone as an anticoagulant as the standard of care before pregnancy. Pregnant women were managed jointly by the Departments of Maternal and Reproductive Health (MRH) and Cardiovascular and Thoracic Surgery. When indicated, antepartum foetal well-being was monitored, and serial ultrasonic measurements and antepartum non-stress cardiotocography were performed. The mean age was 32.45 years, and the mean weight was 45.78kg. The majority of women had mitral valve repair (71.91%), (20.21%) had DVR, and (7.87%) had AVR. 46 (66.7%) women had successful deliveries, and the rest, 23(33.3%), had single or multiple pregnancy failure. (Table 1). (41.30%) women had LSCS, and (54.34%) had normal vaginal delivery. Foetal morbidity was 37.68% and none of the pregnant women had valve thrombosis. The majority had successful outcomes, except for (13.04%) of children who developed anticoagulation-related congenital defects. This was mainly seen in those women who presented late in pregnancy. Various high-risk factors were correlated with the maternal and Neonatal outcomes and will be presented. The decision regarding anticoagulation in pregnancy requires intense counselling done at multiple sittings in terms of complete prospective follow-up to predict the efficacy and safety of any regime in pregnancy.

Keywords: maternal outcome, anti-coagulation, prosthetic valve, valvular heart disease, pregnancy

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Authors: G. Wojcik, J. Gindlhuber, A. Syarif, K. Hoetzenecker, P. Bohm, P. Vesely, V. Biasin, G. Kwapiszewska

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Pulmonary fibrosis is a rare disease where uncontrolled wound healing processes damage the lung structure. Intensive changes within the extracellular matrix (ECM) and its interaction with fibroblasts have a major role in pulmonary fibrosis development. Among others, collagen is one of the main components of the ECM, and it is important for lung structure. In IPF, constant production of collagen by fibroblast, through TGFβ1-SMAD2/3 pathways, leads to an uncontrolled deposition of matrix and hence lung remodeling. Abnormal changes in lipid production, alterations in fatty acids (FAs) metabolism, enhanced oxidative stress, and lipid peroxidation in fibrotic lung and fibrotic fibroblasts have been reported; however, the interplay between the collagen and lipids is not yet established. One of the FAs influx regulators is Angiopoietin-like 4 (ANGPTL4), which inhibits lipoprotein lipase work, decreasing the availability of FAs. We hypothesized that altered lipid composition or availability could have the capability to influence the phenotype of different fibroblast populations in the lung and hence influence lung fibrosis. To prove our hypothesis, we aim to investigate lipids and their influence on human, animal, and in vitro levels. In the bleomycin model, treatment with the well-known metabolic drugs Rosiglitazone or Metformin significantly lower collagen production. Similar results were noticed in ANGPTL4 KO animals, where the KO of ANGPTL4 leads to an increase of FAs availability and lower collagen deposition after the bleomycin challenge. Currently, we study the treatment of different FAs on human lung para fibroblasts (hPF) isolated from donors. To understand the lipid composition, we are collecting human lung tissue from donors and pulmonary fibrosis patients for Liquid chromatography-mass spectrometry. In conclusion, our results suggest the lipid influence on collagen deposition during lung fibrosis, but further research needs to be conducted to understand the matter of this relationship.

Keywords: collagen, fibroblasts, lipidomics, lung, pulmonary fibrosis

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Authors: Enze Zhang

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One of the most challenging steps in implementing virtual water content (VWC) analysis of crops is to get properly the total volume of consumptive water use (CWU) and, therefore, the choice of a reliable crop CWU estimation method. In practice, lots of previous researches obtaining CWU of crops follow a classical procedure for calculating crop evapotranspiration which is determined by multiplying reference evapotranspiration by appropriate coefficient, such as crop coefficient and water stress coefficients. However, this manner of calculation requires lots of field experimental data at point scale and more seriously, when current growing conditions differ from the standard conditions, may easily produce deviation between the calculated CWU and the actual CWU. Since evapotranspiration caused by crop planting always plays a vital role in surface water-energy balance in an agricultural region, this study decided to alternatively estimates crop evapotranspiration by Budyko framework. After brief introduce the development process of Budyko framework. We choose a modified Budyko framework under unsteady-state to better evaluated the actual CWU and apply it in an agricultural irrigation area in North China Plain which rely on underground water for irrigation. With the agricultural statistic data, this calculated CWU was further converted into VWC and its subdivision of crops at the annual scale. Results show that all the average values of VWC, VWC_blue and VWC_green show a downward trend with increased agricultural production and improved acreage. By comparison with the previous research, VWC calculated by Budyko framework agree well with part of the previous research and for some other research the value is greater. Our research also suggests that this methodology and findings may be reliable and convenient for investigation of virtual water throughout various agriculture regions of the world.

Keywords: virtual water content, Budyko framework, consumptive water use, crop evapotranspiration

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Authors: Andi Tenri Ayu Rahman, Citrakesumasari, Devintha Virani

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Breast milk is the complex biological fluid mix of macronutrient and micronutrient that are considered as perfect food for babies. Zinc has a role in various biological functions and physical growth. This research aims to know the average zinc (Zn) micronutrients content of breast milk by determinants of infant (birth weight) and mother (nutritional status and food intake) and description of the pattern of mothers breastfeeding. The type of research used is observational analytic with cross-sectional study design. The population was 41 mothers in Kassi-Kassi health center within one month. Sample research is mothers who gave birth at term and breastfed her baby. Sampling was done with random sampling technique involving 37 people. Samples of breast milk were analyzed in the laboratory by using the method of Atomic Absorption Spectrofotometry (AAS). This research find that from the samples (n=37) the average contents of zinc in the breast milk is 0,88±0,54 mg/L with the highest value on the group of low birth weight babies (1,13 ± 0,67mg/L), mothers who had normal nutritional status (0,981 ± 0,514 mg/L) and intake low zinc (0,94 ± 0,54 mg/L). Regarding breastfeeding pattern, 67,6% of the samples had had breastfeeding experience and 81,1% of breastfed more than eight times a day. In summary, the highest average value of the zinc content of breast milk was in the group of low birth weight babies, mother with normal nutritional status, and mothers having relatively low intake pattern.

Keywords: zinc, breastmilk, mother, baby

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Authors: Suvorov Vasyl, Filipchuk Viktor

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Developmental Dysplasia of the Hip (DDH) is a frequent pathology in pediatric orthopedist’s practice. Neglected or residual cases of DDH in walking patients are usually treated using pelvic osteotomies. Plastic changes take place in hinge points due to acetabulum reorientation during surgery. Classically described hinge points and a traditional division of pelvic osteotomies on reshaping and reorientation are currently debated. The purpose of this article was to evaluate biomechanical changes during the most commonly used pelvic osteotomies (Salter, Dega, Pemberton) for DDH treatment in pediatric patients. Methods: virtual pelvic models of 2- and 6-years old patients were created, material properties were assigned, pelvic osteotomies were simulated and biomechanical changes were evaluated using finite element analysis (FEA). Results: it was revealed that the patient's age has an impact on pelvic bones and cartilages density (in younger patients the pelvic elements are more pliable - p<0.05). Stress distribution after each of the abovementioned pelvic osteotomy was assessed in 2- and 6-years old patients’ pelvic models; hinge points were evaluated. The new term "restriction point" was introduced, which means a place where restriction of acetabular deformity correction occurs. Pelvic ligaments attachment points were mainly these restriction points. Conclusions: it was found out that there are no purely reshaping and reorientation pelvic osteotomies as previously believed; the pelvic ring acts as a unit in carrying out the applied load. Biomechanical overload of triradiate cartilage during Salter osteotomy in 2-years old patient and in 2- and 6-years old patients during Pemberton osteotomy was revealed; overload of the posterior cortical layer in the greater sciatic notch in 2-years old patient during Dega osteotomy was revealed. Level of Evidence – Level IV, prognostic.

Keywords: developmental dysplasia of the hip, pelvic osteotomy, finite element analysis, hinge point, biomechanics

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Authors: Jamie R. Chua, Christina Irene D. Mejia, Regina P. Berba

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Disseminated tuberculosis is an infectious disease caused by Mycobacterium tuberculosis involving two or more non-contiguous sites identified through bacteriologic confirmation or clinical diagnosis. Over the five year period included in the study, the UP-PGH TB DOTS clinic had total of 3,967 referrals, and the prevalence of disseminated tuberculosis is 1% (68/3967). The mean age was 33.9 years (range 19-64 years) with a male: female ratio of 1:1. 67% (52 patients) had no predisposing comorbid illness or immune disorder. The most common presenting symptoms were abdominal pain (19%), back pain (13%), abdominal enlargement (11%) and mass (10.2%). Anemia, leukocytosis, hypoalbuminemia, and high-normal serum calcium were common biochemical and hematologic findings. Around 36% (25) of patients were diagnosed clinically with disseminated tuberculosis despite lacking bacteriologic evidence of multi-organ involvement. The lungs (86%) is still the most commonly involved site, followed by intestinal (22%), vertebral/Pott’s (27%), and pelvic/genital (19%). The mean time from presentation to initiation of therapy was 22 days (SD 32.7). Only 18 patients (29.3%) were properly recorded to have been referred to local TB DOTs facilities. Of the 68 patients, only 16% (11 patients) continued follow-up at PGH, and all had documented treatment completion. Treatment outcomes of the remaining were unknown. Due to the variety of involved sites, a high index of suspicion is required. Knowledge on clinical features, common radiographic findings, and histopathologic characteristics of disseminated TB is important as bacteriologic evidence of infection is not always apparent.

Keywords: disseminated tuberculosis, Mycobacterium tuberculosis, miliary tuberculosis, tuberculosis

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Authors: Hsiao-Chien Tsai, Yu-Pin Chen, Ruei-Ming Chen

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Introduction: Osteoarthritis (OA) is characterized by joint destruction and causes chronic disability. One of the prominent symptoms is pain. Alleviating the pain is necessary and urgent for the therapy of OA patients. However, currently, understanding the mechanisms that drive OA-induced pain remains challenging, which hampers the optimistic management of pain in OA patients. Semaphorin 4D (Sema4D) participates in axon guidance pathway and bone remodeling, thus, may play a role in the regulation of pain in OA. In this study, we have established a rat model of OA to find out the mechanisms of OA-induced pain and to deliberate the roles of Sema4D. Methods: Behavioral changes and the pro-inflammatory cytokines (IL-1β, TNF-α, and IL-17) associated with pain were measured during the development of OA. Sema4D expression in cartilage and synovial membrane at 1, 4, and 12 weeks after inducing OA was analyzed. To assess if Sema4D is related to the neurogenesis in OA as an axon repellant, we analyzed the expression of PGP9.5 as well. Results: Synovitis and cartilage degradation were evident histologically during the development of OA. Mechanical hyperalgesia was most severe at week 1, then persisted thereafter. It was associated with stress coping strategies. Similar to the pain behavioral results, levels of IL-1β and TNF-α in synovial lavage fluid were significantly elevated in the OA group at weeks 1 and 4, respectively. Sema4D expression in cartilage and the synovial membrane was also enhanced in the OA group and was correlated with pain and pro-inflammatory cytokines. The marker of neurogenesis, PGP9.5, was also enhanced during the development of OA. Discussion: OA induced mechanical hyperalgesia, which might be through upregulating IL-1β/TNF-α-mediated Sema4D expressions. If anti-Sema4D treatment could reduce OA-induced mechanical hyperalgesia and prevent the subsequent progression of OA needs to be further investigated. Significance: OA can induce mechanical hyperalgesia through upregulation of IL-1β/TNF-α-mediated Sema4D and PGP9.5 expressions. And the upregulation of Sema4D may indicate the severity or active status of OA and OA-induced pain.

Keywords: traumatic osteoarthritis, mechanical hyperalgesia, Sema4D, inflammatory cytokines

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Authors: Volker Koch, Sigrid Swobodnik, Bernd M. Zunk

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The success of companies on globalized markets is significantly influenced by the performance of purchasing departments and, of course, the individuals employed as professional purchasers. Nonetheless, this is generally accepted in practice, in literature as well as in empirical research, only insufficient attention was given to the assessment of this relationship between the personality of professional purchasers and their individual performance. This paper aims to describe the relationship against the background of the 'Big Five Inventory'. Based on the five dimensions of a personality (openness to experience, conscientiousness, extraversion, agreeableness, and neuroticism) a research model was designed. The research model divides the individual performance of professional purchasers into two major dimensions: operational and strategic. The operational dimension consists of the items 'cost', 'quality delivery' and 'flexibility'; the strategic dimension comprises the positions 'innovation', 'supplier satisfaction' as wells as 'purchasing and supply management integration in the organization'. To test the research model, a survey study was performed, and an online questionnaire was sent out to purchasing professionals in Austrian companies. The data collected from 78 responses was used to test the research model applying a group comparison. The comparison points out that there is (i) an influence of the purchasers’ personality on the individual performance of professional purchasers and (ii) a link between purchasers’ personality to a high or a low individual performance of professional purchasers. The findings of this study may help human resource managers during staff recruitment processes to identify the 'right performing personality' for an operational and/or a strategic position in purchasing departments.

Keywords: big five inventory, individual performance, personality, purchasing professionals

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Authors: Elham Shakerian, Reza Afarin

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The hepatic disease causes approximately 2 million deaths/year worldwide. Liver fibrosis is the last stage of numerous chronic liver diseases, and until now there is no definite cure or drug for it. Activation of hepatic stellate cells (HSCs) is the main reason for fibrosis. Transforming growth factor (TGF-β), as a main profibrogenic cytokine, if increased in these cells, leads to liver fibrosis through smad3 signaling pathways and increasing the expressions of Collagen type I and III, and actin-alpha smooth muscle (αSMA) genes. Curcumin (CUR) is a polyphenolic compound and an active ingredient derived from the rhizome of the turmeric plant that exerts effective antioxidant, anti-inflammatory, and antimicrobial activity. It has been shown that daily consumption of curcumin may have a protective effect on the liver against oxidative stress associated with alcohol consumption. In this study, we investigate the role of Curcumin in decreasing HSC activation and treating liver fibrosis. First, the human HSCs were treated with 2 ng/ml of (TGF-β) for 24 hours to become activated, then with Silibinin for 24 hours. Total RNAs were extracted, reversely transcribed into cDNA, Quantitative Real-time PCR, and western blot were performed. The mRNA expression levels of Collagen type I and III, αSMA genes, and the level of smad3 phosphorylation in TGF-β activated human HSCs treated with Curcumin were significantly reduced compared to human HSCs untreated with Curcumin. Curcumin is effective in reducing the expression of fibrogenic genes in the activated human HSCs treated with TGFB through downregulation of the TGF-β/smad3 signaling pathway. Therefore, Curcumin possesses significant antifibrotic properties in hepatic fibrosis

Keywords: hepatic fibrosis, human HSCs, curcumin, fibrogenic genes

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Authors: Gopal Lamichhane, Biswash Sapkota, Grinsun Sharma, Mahendra Adhikari

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Urolithiasis is a condition in which insoluble or less soluble salts like oxalate, phosphate etc. precipitate in urinary tract and causes obstruction in ureter resulting renal colic or sometimes haematuria. It is the third most common disorder of urinary tract affecting nearly 2% of world’s population. Poor urinary drainage, microbial infection, oxalate and calcium containing diet, calciferol, hyperparathyroidism, cysteine in urine, gout, dysfunction of intestine, drought environment, lifestyle, exercise, stress etc. are risk factors for urolithiasis. Wide ranges of treatments are available in allopathic system of medicine but reoccurrence is unpreventable even with the surgical removal of stone or lithotripsy. So, people prefer alternative medicinal systems such as Unani, homeopathic, ayurvedic etc. systems of medicine due to their fewer side effects over allopathic counterpart. Different plants based ethnomedicines are being well established by their continuous effective use in human since long time in treatment of urinary problem. Many studies have scientifically proved those ethnomedicines for antiurolithiatic effect in animal and in vitro model. Plant-based remedies were found to be therapeutically effective for both prevention as well as cure of calcium oxalate urolithiasis. Plants were known to show these effects through a combination of many effects such as antioxidant, diuretic, hypocalciuric, urine alkalinizing effect in them. Berberine, triterpenoids, lupeol are the phytochemicals established for antiurolithiatic effect. Hence, plant-based medicine can be the effective herbal alternative as well as means of discovery of novel drug molecule for curing urolithiatic disorder and should be focused on further research to discover their value in coming future.

Keywords: urolithiasis, herbal medicine, ethnomedicine, kidney stone, calcium oxalate

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Authors: Ahlam A. Alghamdi

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For many years and until now, education based on gendered division is endorsed in the public Saudi schools starting from the primary grades (1,2, 3rd grades). Although preschool has no boys and girls segregation restrictions, children from first grade starting their first form of cultural ideology based on gender. Ensuring high-quality education serving all children -both boys and girls- is an aim for policymakers and early learning professionals in Saudi Arabia. The past five years have witnessed a major change in terms of shifting the paradigm to educating young children in the country. In May 2018, the Ministry of Education (MoE) had declared a commencement decision of inclusion schools serve both girls and boys in primary grades with a high-quality early learning opportunity. This study sought to shed light on one of the earliest schools that have implemented the inclusion experience. The methodological approach adopted is based on the qualitative inquiry of case study to investigate complex phenomena within the contexts of inclusion school. Data collection procedures included on-site visitations and semi-structured interviews with the teachers to document their thoughts, narratives, and living experiences. The findings of this study identified three themes based on cultural, educational, and professional interpretations. An overview of recommendations highlighted the benefits and possible challenges of future implementations of inclusion schools in Saudi Arabia.

Keywords: early learning, gender division, inclusion school, Saudi Arabia

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Authors: M. Shahadat Hossain

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People experiencing economic disadvantages have limited access to justice system. Employment status is a key indicator of economic disadvantage. There is a link between employment status and vulnerability to legal problems. This paper addresses the obstacles unemployed people experience to secure justice in Australia. This paper further explores exiting services for economically disadvantaged people to secure justice where these unemployment people can get access. It reveals that unemployed people are vulnerable to multifaced crime and violence. Due to high cost of legal services, these unemployed people are unable to afford legal services to access justice. They are often found higher levels of nonactions in terms of access to justice also due to lack of their initiatives. This paper further reveals that legal aid commissions are state and territory statutory agencies in Australia which provide free legal information, advice, duty lawyers, and legal representation services. Community legal centres are independent, non-profit government organizations with a focus of early advice, problem solving, and working with other agencies to address connected, financial, and health problems. Moreover, the private profession helps people who cannot afford to pay for a lawyer in several ways. But there are problems of shortage of funding for these legal services and making available to economically disadvantaged people. However, this paper argues that people experiencing long-term unemployment face barriers to secure justice due to their economic disadvantages. It further argues that services available for them to access to justice is inadequate.

Keywords: economic disadvantages, unemployment, access to justice, Australia

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Authors: Bhaddiya Tanchangya

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This article discusses the Four Noble Truths, the foundational teachings of Buddhism, and their significance to Buddhist philosophy. The Four Noble Truths are the Noble Truth of Suffering, the Noble Truth of the Cause of Suffering, the Noble Truth of the End of Suffering, and the Noble Truth of the Path Leading to the End of Suffering. The first truth, the Noble Truth of Suffering, explains that suffering or dukkha is an inherent part of existence, including emotional, physical, and existential forms of suffering, including the Five Aggregates, which refer to the five components that make up a sentient being's experience of existence, as they are all conditioned, interdependent, subject to the Three Characteristics of Existence: impermanence, unsatisfactoriness and emptiness. The second truth, the Noble Truth of the Cause of Suffering, states that craving or attachment to the sensory experiences of the Five Aggregates leads to suffering and identifies three types of craving: craving for sensual pleasures, craving for existence, and craving for non-existence. Through the doctrine of Dependent Origination (Paṭiccasamuppāda), the Buddha graphically shows how the entire process of suffering arises and ceases. The third truth, the Noble Truth of the End of Suffering, asserts that there is a way to end suffering and attain a state of liberation called Nibbāna that marks the end of the cycle of birth and death by removing that very craving towards the sensory experiences by cultivating the Noble Eightfold Path. The fourth truth, the Noble Truth of the Path Leading to the End of Suffering, describes the Noble Eightfold Path, a set of guidelines to develop insight and wisdom to overcome craving and attachment and attain liberation from suffering. The article emphasizes that the Four Noble Truths are universal, applicable to all people regardless of culture, background, or beliefs, and form the foundation of Buddhist philosophy and practice.

Keywords: four noble truths, impermanence, suffering, not-self-ness, interconnectedness, emptiness, morality, concentration, wisdom, nirvana, happiness

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Authors: Olga Guseynova

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Being an individual activity, the memorizing process is affected to a greater degree by the individual variables; therefore, one of the decisive factors influencing the memorization is students’ individual characteristics. Based on an extensive literature study in the domains of piano education, psychology, and neuroscience, this comprehensive research was designed in order to develop three memorizing strategies that are reflective of individual students’ learning modalities (visual, kinesthetic and auditory) applied to the piano education. The design of the study required an interdisciplinary approach which incorporated the outcome of neuropsychological and pedagogic experiments. The objectives were to determine the interaction between the process of perception and the process of memorizing music; to systematize the methods of memorizing piano sheet music in accordance with the specifics of perception types; to develop Piano Memorization Inventory (PMI) and the Three Memorizing Strategies (TMS). The following research methods were applied: a method of interdisciplinary analysis and synthesis, a method of non-participant observation. As a result of literature analysis, the following conclusions were made: the majority of piano teachers and piano students participated in the surveys, had not used and usually had not known any memorizing strategy regarding learning styles. As a result, they had used drilling as the main strategy of memorizing. The Piano Memorization Inventory and Three Memorizing Strategies developed by the author of the research were based on the observation and findings of the previous researches and considered the experience of pedagogical and neuropsychological studies.

Keywords: interdisciplinary approach, memorizing strategies, perceptual learning styles, piano memorization inventory

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Authors: Hanen Bouaziz, Moez Rafrafi, Ghada Ben Salah, Kamel Jamoussi, Tahia Boudawara, Najiba Zeghal

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The present study investigated the protective role of Hyparrhenia hirta against sodium nitrate (NaNO3)-induced nephrotoxicity. A high-performance liquid chromatography coupled with a mass spectrometer (HPLC-MS) method was developed to separate and identify flavonoids in Hyparrhenia hirta. Seven flavonoids were identified as 3-O-methylquercetin, luteolin-7-O-glucoside, luteolin, apigenin-7-O-glucoside, apigenin-8-C-glucoside, luteolin-8-C-glucoside and luteolin-6-C-glucoside. Wistar rats were randomly divided into three groups: a control group and two treated groups during 50 days with NaNO3 administered either alone in drinking water or co-administered with Hyparrhenia hirta. NaNO3 treatment induced a significant increase in plasma levels of creatinine, urea and uric while urinary level decreased significantly. Nephrotoxicity induced by NaNO3 was characterized by significant increase in creatinine clearance. In parallel, a significant increase in malondialdehyde level along with a concomitant decrease in total glutathione content and superoxide dismutase, catalase and glutathione peroxidase activities were observed in the kidney after NaNO3 treatment. The histopathological changes in kidney after NaNO3 administration were shrunken. There were renal tubule cell degeneration and infiltration of mononuclear cells. Most glomeruli revealed shrinkage, a wide capsular space and a peri-glomerular mononuclear cells infiltration. Hyparrhenia hirta supplementation showed a remarkable amelioration of the abnormalities cited above. The results concluded that the treatment with Hyparrhenia hirta had a significant role in protecting the animals from nitrate-induced kidney dysfunction.

Keywords: flavonoids, hyparrhenia hirta, kidney, nitrate toxicity, oxidative stress, rat

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Authors: Murad Ghanim

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The citrus greening disease, also known as Huanglongbing, caused by the phloem-limited bacterium Candidatus Liberibacter asiaticus (CLas) has resulted in tremendous losses and the death of millions of citrus trees worldwide. CLas is transmitted by the Asian citrus psyllid (ACP) Diaphorina citri. The closely-related bacterium Candidatus Liberibacter solanacearum (CLso), which is associated with vegetative disorders in carrots and the zebra chips disease in potatoes, is transmitted by other psyllid species including Bactericera trigonica in carrots and B. ckockerelli in potatoes. Chemical sprays are currently the prevailing method for managing these diseases for limiting psyllid populations; however, they are limited in their effectiveness. A promising approach to prevent the transmission of these pathogens is to interfere with the vector-pathogen interactions, but our understanding of these processes is very limited. CLas induces changes in the nuclear architecture in the midgut of ACP and activates programmed cell death (apoptosis) in this organ. Strikingly, CLso displayed an opposite effect in the gut of B. trigonica, showing limited apoptosis, but widespread necrosis. Electron and fluorescent microscopy further showed that CLas induced the formation of Endoplasmic reticulum (ER) inclusion- and replication-like bodies, in which it increases and multiplies. ER involvement in bacterial replication is hypothesized to be the first stage of an immune response leading to the apoptotic and necrotic responses. ER exploitation and the subsequent events that lead to these cellular and stress responses might activate a cascade of molecular responses ending up with apoptosis and necrosis. Understanding the molecular interactions that underlay the necrotic/apoptotic responses to the bacteria will increase our knowledge of ACP-CLas, and BT-CLso interactions, and will set the foundation for developing novel, and efficient strategies to disturb these interactions and inhibit the transmission.

Keywords: Liberibacter, psyllid, transmission, apoptosis, necrosis

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Authors: Safia Asif, Saadia Bano

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In a world with rapidly depleting resources, using artificial lighting during daytime is an act of human ignorance. Imitated light is the major source of energy consumption in public buildings. Despite, the fact that substantial working hours of these buildings usually persist in natural daylight time; there is a trend of isolated, un-fenestrated and a-contextual interiors majorly dependent on active energy sources. On the contrary, if direct and un-controlled sunlight is allowed inside the building, it will create visual and thermal discomfort. Controlled daylighting with appropriate design mechanisms is one of the important aspects of achieving thermal and visual comfort. The natural sunlight can be utilized intelligently with the help of architectural thermal controlling mechanisms to achieve a healthy and productive environment. This paper is an attempt to investigate and analyze the importance of daylighting with reference to energy efficiency and thermal comfort. For this purpose, three public buildings including two educational institutions and one general post office are selected, as case-studies in the context of Karachi, Pakistan. Various parameters of visual and thermal comfort are analyzed which includes orientation, ceiling heights, overall building profile along with daylight controlling mechanisms in terms of penetration, distribution, protection, and control. In the later part of the research, a questionnaire survey is also conducted to evaluate the user experience in terms of adequate daylighting and thermal comfort.

Keywords: daylight, public buildings, sustainable architecture, visual and thermal comfort

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Authors: Parmeet Kaur, Nighat Yaseen Sofi, Shakti Kumar Gupta, Veena Pandey, Rajvaedhan Azad

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Nutritional status and prevailing blood glucose level trends amongst hospitalized patients has been linked to clinical outcome. Therefore, the present study was undertaken to assess hospitalized Diabetic Eye Disease (DED) patients' anthropometric and dietary intake trends. DED patients with type 1 or 2 diabetes > 20 years were enrolled. Actual food intake was determined by weighed food record method. Mifflin St Joer predictive equation multiplied by a combined stress and activity factor of 1.3 was applied to estimate caloric needs. A questionnaire was further administered to obtain reasons of inadequate dietary intake. Results indicated validity of joint analyses of body mass index in combination with waist circumference for clinical risk prediction. Dietary data showed a significant difference (p < 0.0005) between average daily caloric and carbohydrate intake and actual daily caloric and carbohydrate needs. Mean fasting and post-prandial plasma glucose levels were 150.71 ± 72.200 mg/dL and 219.76 ± 97.365 mg/dL, respectively. Improvement in food delivery systems and nutrition educations were indicated for reducing plate waste and to enable better understanding of dietary aspects of diabetes management. A team approach of nurses, physicians and other health care providers is required besides the expertise of dietetics professional. To conclude, findings of the present study will be useful in planning nutritional care process (NCP) for optimizing glucose control as a component of quality medical nutrition therapy (MNT) in hospitalized DED patients.

Keywords: nutritional status, diabetic eye disease, nutrition care process, medical nutrition therapy

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